NursingZen

In response to my post last week, a classmate offers a slightly different take on this quarter. It also seems that s/he had different information. (Thanks for chiming in, fellow MEPN!)

In response to question #1: There has been a lot of misinformation passed around, especially when word travels so quickly. We were informed that the search for CI’s began last March, NOT during the Christmas holidays. The CI’s that were hired either went on maternity leave or flaked out at the last minute. No one could’ve predicted that it would come to a head like this. It is an unfortunate situation, but our wonderful professor, superstar that she is, has worked around the clock and pulled strings so that all of us (regardless of our clinical placement) can get some inpatient peds experience.

As for question #3: We were also told the peds course was not designed for every student to be on the floor every Thursday and Friday. That would make it physically impossible because we would be tripping over each other. The observations at the day care centers, the community health clinic, in urgent care, etc. are not “distractions.” They’re intended to provide us with a holistic view of peds nursing, giving us a sense of taking care of children in different states of health.

Keep in mind that this course is only 6 weeks long (and we’re at the half-way mark). There is only so much you can learn even if you were to be on the floor every Thursday and Friday. Let’s try to stay positive.

A fellow MEPN, who is in Group B, has started a blog about his own journey, with particular focus on ethical issues. I like. (And wish I had the same diligence to write as he does.) Read The One Year Nurse.

On Monday I joined a meeting of frustrated students to write a letter to the school with concrete suggestions about how our Thursdays and Fridays could be put to good use if clinical instructors are not found by the end of the week. We came up with great ideas, such as having optional lectures by a variety of guest speakers who we wanted to hear from (pediatric nurses, advance practice nurses specializing in pediatric diabetes and other conditions, Pediatric Advanced Life Support training, social workers, caregivers of sick children, etc.). We requested a meeting with the powers that be by Wednesday, since we felt time was quickly slipping away.

The letter was well received by the rest of the class, and we sent it off with some hope, a dash of relief for taking some kind of action, and more than a bit of skepticism. We quickly received a reply that didn’t surprise any of us. It read something like: Thank you for the great ideas … your patience is appreciated … Next step plans will follow in the days to follow …

But to their credit, slowly over the next couple days we received news that a few more people would have a rotation through a hospital this week. A couple new CIs had been pulled in. With every announcement, every one of us clamored for an opportunity to see a sick child—and to learn.

Finally, some nursing…
Yesterday I had the opportunity to shadow a Home Health Nurse on a home visit to a newly discharged newborn and mom. The purpose is to check the mom for hemorrhage, infection, and stable vital signs; see how she’s lactating and bonding with her baby; assess her mood; and check her meds. For the baby, the nurse wants to make sure the weight is stable, assess the level of jaundice, and do a complete head to toe assessment. Michelle, the nurse, had worked in Labor & Delivery for about 20 years and had become a certified lactation consultant. Unfortunately she had only one assignment that day, but the upside was that we could spend more time with the family.

The mother was breastfeeding when we arrived (surprise!). The parents were in their early 30s. The baby girl, just four days old, shocked me by how small she was, and how deafening her cry was. She was a full term baby but she weighed 6 pounds so her “newborn” socks and beanie hat kept falling off her (hee hee!).

I could tell the parents were happy but very anxious. They were worried that their baby was feeding every single hour throughout the day and night. Could it be that the mom’s breast milk was not nutritious enough? They had a list of questions for Michelle. Here was where I love the role of the nurse. As she conducted her physical assessments on mom and baby, Michelle answered their questions with ease, confidence, and humor. The parents needed to hear that everything that was happening was normal, that their baby was healthy and strong, and that they were being good, attentive parents.

I finally got to place my stethoscope on a child, and was thrilled by the speed of the baby’s heart and the soft, slight breath sounds. I also palpated her head and inspected her spine. When I touched the baby with my suddenly huge (and cold) hands, I grimaced to myself: Wow, I feel like a real live ogre.

We spent two hours with the family. Time is what Michelle says she loves most about doing home health. Her parting words to the new parents were: Try to be gentle with yourselves.

Week 1
Winter quarter started Wednesday, January 3. Family & Child Nursing is our main course, and it lasts only 6 weeks because we will then have Psychiatric nursing. Our Pediatric clinical rotations were scheduled to begin this first Thursday & Friday, but at the last minute we were told that some of us had the week off and some were observing healthy kids at daycare centers instead. Still in vacation mode, many of us were relieved to not have to jump right back into back-to-back 12-hour shifts. We thought our professor was being kind to us.

Week 2
The Family & Child Nursing readings and lectures are well under way. Because the course is 6 weeks, it’s going to fly by. Med-Surg is our foundation, but we’re now learning about how pediatric health conditions and nursing interventions differ from adults. Child development informs everything. It’s a refreshing way to look at nursing. As I read the text, I’m intermittently excited for the challenge of working with kids and their parents, and also worried about seeing very sick children. The thought of sticking a needle or a foley into a child pains me. But the professor, also a Pediatric nurse practitioner, is an empathetic and enthusiastic teacher. She makes me excited to apply what we’re hearing in lecture to real patients. For days I’ve been mentally prepping myself for clinicals. I go to Whole Foods to buy a bottle of herbal sleep aid pills.

Suddenly at the end of lecture, three administrators come in to our class unannounced and begin talking. At first I’m utterly confused. I feel like I* just joined a conversation that had been going on, instead of them joining us. For 2 minutes they talk in circles about how they’re trying very hard to ‘figure out’ our clinical rotations.

And then it dawns on each of us: they are still trying to hire Clinical Instructors (CIs) and until they find six CIs, none of us will have clinicals at our designated sites! Whoa!!

A classmate interrupts and lays it out in plain terms, and the administrators concede the truth: They have been searching for CIs since December but they can’t find anyone because of the “terrible nursing teacher crisis.” They have been putting off telling us the real situation until it got to a critical point. They joke that our professor has been “great at distracting” us with daycare and other hospital observations while they look for CIs.

Nursing teacher shortage? Understood. But I’m stunned by how we got where we are:

1) Why didn’t MEPN have Clinical Instructors hired and ready to go from months before this quarter? Why were they looking for CIs during the Christmas holidays? (A classmate saw a job posting on Craigslist.org over the holidays.)

2) Why wasn’t MEPN transparent about the situation from the beginning? I’m inclined to believe that the staff is trying their best to deliver what the program promised us, but it’s hard to not feel like I’m being misled when they’re not upfront and straightforward.

3) What does this mean for our qualification for the Board of Registered Nursing license? What if we are required to have a certain number of clinical hours in Pediatrics? (Looking into this.)

Some people are annoyed, some are ambivalent, many are angry, especially partners and family members. I feel badly for classmates who are specializing in Pediatrics. Some suffered through 12 weeks of Med Surg with an eye on this quarter. I’m disappointed because I was looking forward to the challenge of peds nursing, because who knows — though the thought of nursing sick kids scares the crap out of me right now, an in-depth clinical experience might change my mind and make me realize that I’d love to work in this area! I was all set to ride the highs and lows of peds nursing and to write about my Growth and awesome, beautiful, painful, rewarding, fun times! I really do not like writing about this other crap. Unfortunately, this crap has gotten in the way of those experiences.

I’m sure the staff is working furiously on damage control, or else this will all be hugely embarrassing. Let’s see what happens next week, Week 3.

Winter quarter started last week right after New Year’s Day. I was still a little hungover in class after a raucous time at a house in the woods with friends. (I highly recommend getting out of town for New Year’s Eve, getting a space with your friends, and not spinning in circles asking each other: ‘So what are you doing for NYE?’)

I have a lot of juicy news about this quarter (Family & Child Nursing and Sociocultural Issues), but I know a few readers have MEPN interviews coming up really soon, so on the off chance that you read this before your interview, I want to answer a burning question: “For MEPN interviews, what do you think they like to see in students?”

I alluded to this issue in a post under Things I wish I knew:

• Don’t overthink the admissions process or your application. It seems like there’s no one tie that binds all of us. Sometimes we seem totally random. Everyone is different. For example, some people had hardly a clue about the nursing profession, while others did a lot of work in public health or health care. Some people dreamed of being a nurse and advanced practice nurse for years, while others decided to try nursing two months before the application deadline.

How do you like my non-answer? “Totally random.” Well, all right, despite the randomness, if I had to pick out some threads, I’d say that my classmates have had enriching life and/or work experiences, a desire to help people, and confidence (and I don’t mean in a Russell Crowe kind of way. Many classmates have a quiet confidence that comes through if you take time to talk and listen to them).

Some classmates at the interview stage had little volunteer experience and no clue about what a nurse practitioner or clinical nurse specialist does. I admit, I was a little surprised by this because a) isn’t community service important? and b) shouldn’t one have a good idea what nurses and advanced practice nurses do before going into the profession?

More concrete insight into the interview process:

• Wear what makes you feel comfortable and confident. No need to wear a suit if you dread that type of thing. One-third of my classmates during my interview day wore suits, but the rest were dressy casual (if not way too casual).
• Read this guy’s summary about the process in 2005. Nothing changed for me, except the number of applicants, interviewees, and available spots.

When I had my interview with a nursing supervisor, I thought I bombed it. She hardly smiled and kept hitting me with the same type of question and comment over and over again:

• Nursing is hard.
• We need nurses who want to be professionals.
• Nurses need to be able to speak up and stand up for themselves and their patients. Can you do that?
• There are two types of nurses: those who are there to punch the clock and those who are leaders.
• Nursing is hard.

I felt like she was trying to ‘break’ me. Needless to say, I wasn’t too optimistic after this interview. But in retrospect, I believe she was simply trying to be upfront and honest about the profession, so that I could be upfront and honest with myself about whether I really wanted to stick my neck into it. I’m now more than halfway done with MEPN, and I don’t have any regrets. Good luck! Please share your interview experiences at this blog if you can.

Apologies for flaking out for so long! My winter break wasn’t as much of a vacation as I had hoped for. But I did manage to read a few interesting books: The Alchemist, The Kite Runner, The Beginner’s Guide to Insight Meditation, and The Good Heart - A Buddhist Perspective on the Teachings of Jesus - His Holiness the Dalai Lama.

Arinna Weisman and Jean Smith’s The Beginner’s Guide to Insight Meditation helped answered some of my burning questions about Buddhism, such as do Buddhists have to believe in reincarnation? (Many don’t.) Are all Buddhists vegetarian? (No. Buddhists in Tibet and Japan often eat meat.) The writers also resonated with me by acknowledging that it’s not important to categorize or label oneself as a Buddhist because it may not necessarily be a true reflection of whether the person lives by Buddhist thought. Many people don’t call themselves Buddhist, yet they practice “awareness and awakening.” I could get carried away by spiritual talk, but I’ll just say that striving for awareness and awakening has been enriching my whole nursing experience and making the MEPN bubble a lot easier to live in.