NursingZen

Last week of the summer (first) quarter. I’m responsible for total care of one patient. I think I managed it pretty well…except one day when I was so engrossed in the care of one woman that I forgot to give an antibiotic to another patient. This was a good lesson learned: It’s all too easy to give my all to a patient, but I can’t afford to do that. I need to stay vigilant of the fact that other patients relying on me.

I got to change the dressing of a deep wound abscess. Instead of freaking out about it, I dove right in. I know myself—if I didn’t dive into it, it would’ve built up into this scary concept in my mind. My patient and compassionate clinical instructor guided me through the process…It was like 80 degrees in the room on one of these recent hot San Francisco days. As sweat slowly beaded up on my forehead, I prodded a long Q-tip into a wound on a guy’s back. “Pry deeper,” my instructor told me, because there was “tunneling” beneath the skin that one couldn’t see but that had to be packed with gauze so that it would heal properly. I prodded deeper. And deeper. After determining how far the abscess went, I withdrew the Q-tip and slowly packed in the gauze until the inch-deep wound was filled in. I covered it with the right materials and signed the date, time and my name. There was my first mark.

Last week of the first quarter. I feel like I’ve been in school for 6 months instead of two. My classmates all look at one another and marvel at how far we’ve come. It’s a pretty amazing feeling.

There has been a lot going on (good and not so good) that I’ve been wanting to share (here’s a preview), but unfortunately I’ve been trying to catch up on my class readings. It’s amazing: We’re down to our last two weeks of this first quarter, yet this past weekend was the first weekend in which I felt truly motivated and focused to read! Clinicals have always been exciting and challenging–that’s where I give it my all–but the class instructions? Something had to give, and that was it.

I used to think that I’d been slacking this quarter, but I think I was actually just adapting. I’m finally getting in the groove of reading, studying, and sleeping on schedule. (I think) I’ve accepted that I’m going to get sleepy by 10 p.m. and that on Fridays I’m going to be thrilled about staying home–and sleeping.

During my break I’m going to get deeper into what MEPN has been like. I want to write up information that I would’ve wanted to know as a prospective student. I’ve started with these two ongoing lists: ‘Things I wish I knew about UCSF MEPN‘ and ‘Surprising things about UCSF MEPN.’

Here’s a preview: The rose-tinted glasses have come off. The program has some serious flaws. Sometimes the problems make us feel like we’re stupid, crazy and/or helpless, but since we all feel the same way, we know it’s not us; we’re not crazy. Unfortunately some of us have become apathetic; others have gotten angry. (More to come about this.)

• More surprises at this page.

OK, I admit it: I have a real thing for libraries, especially the one at UCSF.

I walked into it for the first time recently and the hushed quiet made me feel like I had walked into the Grace Cathedral. I felt right at home among the plush couches, loads of free books, esoteric journals, and international newspapers.

But here, it’s the view that takes the cake: Like the rest of the UC buildings, the library is perched atop a hill so steep that even on the second floor you can look out through massive windows at nearly all of San Francisco (makes some sense since UCSF seems to own nearly half the city)!

On this particular day, the fog hung like a curtain in front of the window. I nestled into a seat, propped my legs up, watched the fog swirl around, and took a perfect little nap.

Note to those moving here for MEPN: Bring a down coat. Become one with the mist. Laugh, jump and skip when the sun comes out on random days (and on many days in September and October). Don’t bother with Weather.com, or any weather forecast for that matter.

Interesting fact: UCSF is the second largest employer in San Francisco, after the City of SF.

So far the biggest challenge and greatest anxiety I’ve faced in my first quarter (which is quickly winding down –- 3 more weeks before break) is not the coursework or clinicals; it is going to sleep at a decent hour!

On the days before I’m to be up at 5:30 a.m., my anxiety about falling asleep slowly mounts throughout the day. At night I lie awake for hours thinking about having to fall asleep. I usually sleep only 5 or 6 hours. Next week, the pattern repeats.

But despite the part where I have to get out of bed, I like being up early. When it’s still dark out, I feel like I’m 12 again, waking up in the dead of winter and eating breakfast with my dad before school. I miss him. Now when I walk outside and the streets are just coming alive, I acknowledge the affinity I feel to the stray grey cat, the lone man crouched on the corner, and the workers on the empty bus.

A shift in perspective
Today at the hospital went by really quickly. Instead of wondering when I’d see or get to do something “exciting” (and feeling cheated when my classmates seemed to have more “interesting” patients) it recently dawned on me that everything I’m seeing and doing now is interesting and important. Giving a bed bath or walking with a patient may not make for a great story or for deep reflection, but they’re important because they’re part of what the patient needs for wellness. With this new perspective, everything I did for my patients today was infused with meaning. In particular:

• I spent time talking to an old Japanese woman with astonishingly beautiful skin. She came to the U.S. because she married an American 14 years ago but they since divorced. Before I spoke with her, everyone around me said she was “Japanese-speaking only.” Not true. If they had spent a few extra minutes with her they would’ve found her understanding and speaking English pretty well, only slowly. She just needed time (but time doesn’t seem to exist in hospitals). I chuckled when she asked me, “Why am I here again? I feel fine.”
• I fed breakfast to a 40-year-old black man dying of cancer. Literally dying. He couldn’t move and could barely eat, but he wanted to eat. He had nibbles of hash browns, eggs, bacon and oatmeal. It was a privilege to feed him one of his last meals.

Friday Update: I went into the hospital today thinking that I could see the man again. I was told he passed away last night with his family and friends surrounding him. I can’t stop thinking about the short time I spent with him and how I literally helped with one of his last meals. It rocks me a bit, but I’m glad I was there.