nursing
The Clinical Journal Entries started as a clinical assignment but then turned into tradition. Unfortunately, we are back into the assignment mode, and that takes all of the fun out of it. It will start out as a copy-paste from Word (the doc I emailed my professor) and now I get to tell you how the day really happened (or at least my uncensored and way-more-fun version of it)
This is our geriatric/rehabilitation rotation. I signed up for the only section that was less than an hour from my house, a nursing home in Akron. A solid 30 minute drive at 6:20am for an instructor who wants us there prior to 7am because "these patients are already awake anyways!" Right.
Now, I love old people. I'm a sucker for grandparents, and I even enjoyed working on the Acute Care of the Elderly unit for my first-ever clinical rotation. Old people, the elderly, seniors... however it's politically correct to call them these days, are full of stories and have such varying personalities. They're just like us twenty-somethings, only a whole lot smarter with many more lessons learned. They're so easily stereotyped, while to them, we're probably just as easily stereotyped. The more you're around the people who hit their '80s, '90s, or even 100s (101 - like one of our residents!) the more you realize that they're just people like you or me, only their bodies sometimes get worn out from this life and they need extra help. That's all. Alzheimer's and incontinence aside, forget about the hearing aids and teeth sitting on the counter... Each and every old person in the world has a personality, interests, dislikes, memories, habits, values, and fears. And, like everyone else, they just want to love and be loved.
Studying the process of what can go wrong in old age, however, is a different case. We have clients, not patients. They're here because they, the government, or their families are paying for their stay. They're here to get better so they can go be good Grandmas again. They're here to play games and sing songs until they go across the river. They're here because they are a little forgetful and someone needs to help them know to take their medicine. They might be here because their spouse died, their family couldn't take them, yet they couldn't quite live on their own. And then some have colorful rooms filled with photos and banners and flowers and things from the home they will soon return to. See, it's a different kind of place. It has a distinct smell and sound, and yes, there are medicines and health problems, but it doesn't feel like a hospital. Instead, nursing homes seem like big dorms for old people. And I'm a nurse, just not that kind of nurse. Just when I was getting proficient with tubes, needles, systems, IV pumps, intricate computer charts... I get dropped off on the doorstep of an old people dorm and am told to make myself useful and take assessments and give meds, charting it all in 4" 3-ring binders . Hand-charting aside, those things really don't take long. But this does - this takes 10 hours on our feet, looking busy, and some weeks we will have alert patients, while some weeks we may not even have a patient who can talk back. I'm the busy-busy-busy nurse, the one in the group who just doesn't slow down, so this might be a problem. I foresee a lot of craft events and afternoons spent at the group "Dining Room Movie." If I have to feed a few people or clean up after them, that's okay, too. If I have to smile at a mean old lady or help him clean his dentures, that's okay, too. And if I get to do a dressing change on a stage 3 pressure ulcer or get to go with a patient to see how dialysis works in our (rare in-nursing-home kidney dialysis) center, then it'll definitely be a good day! I just don't like the smell of that place, especially at 7am, and I really, really, really don't like being bored.
Today was just orientation, see the unit, meet the staff, here's-all-the-assignments-and-final-paper-i-want-to-kill-you-with kind of day. So next week, maybe something will change or I'll have some sort of different opinion. Probably, yes, most likely. :)
Oh yes, and because this is an assignment, I must state 3 personal goals, one with a clinical focus, one with a gerontological focus, and one with a rehabilitation focus.
Clinical: To increase my patient assessment skills (...Seeing how one of the only things we are doing here is, well, patient assessments, lol)
Gero: To be comfortable with dementia patients (Because let's face it - they're scary. I had one when I student tech'ed at General and it was a BAD experience)
Rehab: To help a patient work on skills so he/she can return to home (Because we do have a few "acute" older people, and we all know that homes are soooo much better than nursing homes!)
My next journals will be on activities I did with residents or random things the syllabus wants us to do ("Make a list of stereotypes of older people"), citing a website that taught me more about my patient's condition, citing a journal regarding one of my patients... ya' know.... just the normal fabulous stuff the professors sit at home and make lists of because they have nothing better to do. All while reading about 4-8 (50 page-ish) chapters of 2 textbooks a week. (Well, technically 3 textbooks. The one was so big they had to make Vol. 1 and Vol. 2. Not. even. kidding.) Whoooo!!!
And I need to rant just a little more to get "today" out of my system, because I'm tired and was up too early and am crabby from being bored and so stressed... I would have guessed a nursing home would be on the warm side, but this place was HOT. We toured all 4 (or 5?) "units" and went on two different floors, all the different wings, and there was not one single cool spot beyond opening-wide a window or a door. So next week, other than coming in swim-scrubs, I have no idea what I'm supposed to do. I figured it would be rude to steal an "out of it" patient and turn on their room A/C. Definitely rude. And mean. Neither of which I'm into being. But it's like, we can put nice warm blankets and Snuggies and jackets on them, yet we are not allowed to take off any more clothing without violating some kind of rule or law. Yes I have a tank top under my scrubs, but will they let me walk around in that? No, because how un-professional! Yeah, well then get a thermostat that works, set it where normal people set it, and try that for professional!
And to think if this was any other day, I'd have my reason for doing this, the hope of the ONLY one thing that I fought through this much school for already. But it's funny... we humans are odd creatures. I'm still fighting and even the faintest hope of my reason is gone. So am I fighting for nothing? Probably. Uh-oh, I can't let my mind go that way. K, turn this way...
5. More. Weeks. Of. This... And I wish I could say I'm getting the summer off, but I'm NOT. I will be spending 6 weeks taking what I should have taken January through last week but nervous breakdown'ed my way out of.
If I can keep going at this insane pace, I'll be done in 1 year, 1 1/2 months, making my grand total... 6 painful years.
And then what? A nanny who just happens to have a nursing degree? God help me! All I wanted was a part-time job that I loved (which could be nursing, yes, could be this....) and to work because of want and not need, with the ultimate goal of staying home with my children. Somehow all of my dreams got really mixed up into the life I have now. Add a degree and a part time RN job, keep the nannying, and I have everything in the dream except the kids... The kids I pour so much into are kind of other people's kids. Oh, and a husband... I think somewhere in there the dream was being married first. Yeah, and that's a sore subject right now. But yes, he would be present because I would be working because I want to, not because I have to, right? Remember that part? Not sure how this knot of "dreams" came to be, or how to untangle it, but we'll get there... look around, assess, reassess... intervene when necessary. Follow the plan of the Divine, foremost. Stay on for the ride, because it's sure going to be interesting how this one plays out!
(Sidenote - Nurses, did you know that after 2015, the MSN is no more? The next step is the doctorate of nursing practice I think. I'm not sure if they're moving CNS NP CRNA, etc. up to PhD level or what, but the masters will cease to exist. The nursing board smartypants are doing the physical therapist thing where all existing MSNs will be "grandfathered in" but anyone wanting to be a grad student has to work to PhD. So my plan is, you guessed it, to start my masters the latest day in my life possible before I can no longer get "grandfathered" in for my MSN.)
I can't believe I haven't posted in 2 weeks! Of course a lot of things have happened. I'll post on them later as I get pictures done, thoughts together, etc., but today was a big day for me. Today, I went back to school, spring semester, to get through one more semester of clinicals. So far, this has been not one bit easier than last semester was when I found the strength to return in the first place. It's actually harder because I spent a couple of my Christmas break weeks sick with different things, and right now I am just feeling run-down and exhausted.
But like a new friend of mine said, "Not trying to play was never an option."
So today, I went to school and tried. I almost fell asleep several times (and that was on the stimulants I have prescribed) and I wondered on about two dozen various occassions, "When did we ever cover that?" (Answer: "Duh, Amanda, when your brain was in a zillion pieces after your car accident.") I left feeling inadequate, unprepared, and too weak mentally to get going in our only 5-credit hour clinical (aka, this class counts, and for a lot!)
Tomorrow, I'll try again, and I will next Monday, too. And even when I have my first clinical - 12 1/2hours with a one hour drive each way - I will continue to try with all of my heart.
My plan is, if I try my hardest until our first exam and if I just cannot grasp all the information when I'm suffering with this much pain (the last 3 weeks have been unbelievable), then I will drop the course and wait to start Geriatrics/Rehab in March. It's a full clinical day and two days of lecture, but after a break of a few weeks, it shouldn't be anything to worry about.
But I'm a pusher, I'm a trier, nothing unlike me there. Just this time, this is a bigger try than I like to have. This is a try out of my comfort zone, but try I still will.
Tonight, I felt like coming home and ripping my biggest class out of my schedule but then I thought how carefully it was placed there probably by God himself. I was able to get a coveted seat in the program, I was able to get my 1-day (vs. 2) clinical, and although it's too far to drive to, I also nailed a rare spot at the Cleveland Clinic - a wonderful place to learn. This goes for 7-8 weeks and then I begin the next rotation, and I'm balancing 2 online courses on top of it. Online classes have the technology now to accomplish anything you can in a classroom, which means "online classes are such a joke!" no longer applies. In fact, I wish I was only taking clinicals and no other classes because it's a lot to balance. Or the comparatively easy road - just online classes and no lecture/clinical. Will I ever feel "up" to clinicals? I really want to hope so! And by all means, if I had that promise in front of me today, I'd stop what I was doing, move this clinical out of my way to take later, and do whatever else I could to fill the time between then and now. But I'm a realist. I can't sit and shovel the same classes around and around in circles for the end of time. I sort of did that with Human Physiology. A poorly timed class (literally and figuratively!) and a terrible professor left me with two "withdrawls" on my transcript, which anyone in acadamia will warn "Withdrawls are the curse!" but really, if you're holding a strong GPA, employers don't really care. At least in this field, my field, nursing.
I should have known when I had a nice week or so during break that it would be gone soon. I did know it, though, I really did. It was so amazing to feel capable of breathing air in a somewhat sustainable pattern, and I tried to hold onto those moments until spring semester would dance before my eyes.
So today was Day 1. What I really want to do is scream, "Okay, I DID it, I TRIED!!! Are you HAPPY now?!?!?!" as I fiercely throw my course materials to the wind and literally remove my name from the roster. BUT. The word try is inspiring me, as are the words of my friend Tom Golarz, so I will try. Like it or not. And I will try tomorrow. Over the weekend. Monday, and then Tuesday, first clinical. More lectures, clinicals, then Exam 1. Then we shall re-evaluate all the components, all the issues, all the pros and cons. Because if you left it to me, I'd follow my heart. I'd have taken this course a year ago and might be dead from what all these strenuous courses have stolen from me, but at least I'd have the one thing I know I worked harder than anyone else in the world to obtain.
And even if I don't have that, I do have the one I know God made just for me, and quite honestly, that's the only thing I need. God, and my soulmate.
Does that make all the previous irrelevant? No! Would I be lost without what I believe is my true calling? Yes! The degree to be a nurse is a huge need as well, something our society interlaces with achievement, success, and in my case, safe patient care. Nurses are vital to healthcare reform, for spontaneous nursing care, to perform in-depth techniques, to mediate, to guard, to give hope to the hopeless. One day I'll get there, but for the point I'm trying to make here, I can't say my life honestly depends on whether or not I take a few more courses to get me a license to get me a job.
We all can make someone smile every day.
We all can do something big every day.
Isn't that what matters most?
We'll all be okay.
... because it's the end of the semester!
No more clinical till 2010! Yay!
Here is a paper I had to write regarding Ricki Lake's documentary, "The Business of Being Born." At least skim through to see the stats... pretty shocking!
Next week is finals week, and our huge case study is due Friday. If you feel so inclined, you may read it here:
I can't believe I've had it done since yesterday. It's no mystery I'm itching to get out of this semester. I can't wait for break. I need this break. Plus, it's Christmas, and I love, love, love Christmas! I can't wait to just relax with my family, friends, and fiance. :)
There are no headlines
for everyday heroes
there is no tickertape
no standing ovation
sometimes it's all they can do
to set their feet on the floor
in the morning
they go through their days
the best they know how
no rainbow need arch
through the sky
to inspire them
they have a special courage
shining deep inside
they go through their days
the best they know how
Ted Hibbard
This came into my inbox today while I was at clinical.
Today, I could not wake up. My alarm went off, I took a shower, threw on my scrubs, ate a bowl of Cheerios in record time, and left for clinical. We were supposed to be on OB today and next Friday, but our instructor said since everyone has seen births, we had an option of not going to clinical next week and going to campus instead. It's December, and we're all dead. Guess which option we chose. So today was our last day in clinical for obstetrics. We're done. (Well, next Friday we have presentations, course evals, and an "educational" movie, but that doesn't count.)
I begged to go to OB Triage today simply because our instructor was confused and assigned other people to Labor & Delivery and I sure was not going to do Postpartum again. Plus, a lot of births were going on so I figured Triage would be a happening place (Any pregnant patient who comes to the hospital is sent up to OB Triage. They could have the flu, a broken bone, or be in labor - most of them know to come to OB Triage and the ones who go to the ER get sent up anyways.)
Not a single patient came in until probably about 11am. It was all insane from there. December 1st was a full moon, so don't ask why it all happened today, 3 days later, but it did.
We got a woman who had a stomach virus (and was vomiting so loudly that I almost wanted to do so myself) and we loaded her up with a cocktail of phenergan/benadryl/reglan. Then we had a woman who had a scheduled C-section (4th baby, 4th C-section!) who needed prepped. This was my favorite patient because I got to start her IV! Now, rumor has it that no one teaches us IV insertion in nursing school. Apparently it's the orientation responsibility of wherever we get a job. That always sounded stupid to me, and thankfully my instructor isn't into going by all of the program rules. (I love her for it though - she's smart about it, she just has a much more creative, free-spirited approach to nursing) Everyone knows though that one of the meds I'm on make my hands shake. As in a tremor kind of shake. I'm a steller phelebotomist (or I was in my nurse technician days) but sometimes it freaks patients and instructors out. So my instructor felt my hands to see if she wanted to "let" me try the IV. Not even kidding. Then she randomly puts her hand on my stomach and says, "Wow, your entire body tremors." Yeah, welcome to the misery. I told her I was comfortable doing it and thought I could, so after I told her what med I was on and she about attacked me to find out why the doctors make me take it (umm, because I'm allergic to every single aternative?) she finally agreed to let me attempt it. She asked me what I'd need to start an IV and draw some blood (I voted for the 22 gauge, but the RN said I had to do an 18 - scary!), we reviewed the exact steps the process entailed, and I beautifully gathered all of the supplies in a Chux and carried them into the patient's room. (Of course I know exactly what you need to start an IV - I've only had like 100 in my lifetime...)
Oh and let me just insert here that Jen (my bestie) taught me how to do an IV (at my kitchen table - just like the time she taught me how to draw blood!) but I completely blew her vein. She told me to try again, and I was too traumatized by creating a huge blood bruise to accept the offer. I had just asked her this morning to come over this weekend so we could practice again. Too late!
So the patient was African American and didn't have good veins at that. So not only were her veins harder to see, but they just were crooked, deep, or way too "wiggly." I put the tourniquet on and felt around. I finally found a hand vein that curved back and forth but it was the best she had. My instructor liked the site and told me to go for it. I inserted the needle, bevel up, and there was no flash. I was panicking when my instructor said, "Push it in just a little more." Flash!!! I pushed the button to retract the needle and threaded the catheter in. Blood started spurting everywhere (that's a good thing!) so I quickly connected the adaptor and popped a blood vial in. Full. 2nd vial. Full. I removed the adaptor and popped the IV tubing on. Beautiful. I got a warm rag to clean up the blood on her hand, and we covered it with a Tegaderm and taped the tubing securely. I had primed the Lactated Ringers so I opened the line and let it go. (I guess in Triage they just "eye" it and don't put it through a pump.) Drop. Drop. Drop. The LR were infusing perfectly in an IV that I had put in. It was working! Then later I piggybacked 2 bags of antibiotics, and they worked, too! (Why they wouldn't, I have no idea. But I was still on IV-high.) I had an issue with the 2nd bag, but the RN said sometimes it's just the position of their hand, and sure enough, we had the patient place her hand a different way, and the med started infusing. Good to know.
The day I performed my very first blood draw on a real patient (Jen doesn't count) I was teching and I called and texted pretty much everyone I knew (and Twittered!) and about died from excitement and pride and well, it was a little weird how excited I was. Well, that was nothing compared to the IV. The feeling of knowing I could successfully insert an IV made me feel almost like I'm a real nurse now - the IV is always the "big, scary" thing that everyone is petrified to do. Well, I've done it, and I did it well. So I can do it again. And it feels sooooo good! Major high. Other than things involving my fiance like our engagement, first kiss, picking out the ring, blah blah blah, oh and maybe getting accepted into the nursing program, or the birth of my furbaby puppy, it was probably one of the most exciting moments of my life. (And if you're not a nurse or nursing student, you probably don't get it - that's okay.)
Wow, I use a lot of parentheses. So many thoughts!
Anyways...
That was the highlight of my day, and I spent the rest of it helping check in new patients and then wasting time. Not kidding. The story...
We had this huge rush of new patients in Triage, all with what they called "contractions," one who said, "I'm not sure, but I think my water may be leaking. I don't know," and then a couple women who both said their due dates were tomorrow so they were sure they were in labor. Funny because most of the patients were in such early labor we couldn't even admit them. Anyways, I went in with the nurses and helped put on the fetal and contraction monitors, get their urine samples, answer questions, get their data... etc. After awhile, everyone was just chilling because that's what the Triage patients do - they sit there for a couple hours (unless they're obviously in active labor) so we can read a good amount of monitors to see what stage of labor (if any) the patient is in, and how the baby's heartrate is. I think it's more like a "we know you're not in labor, but we need to legally cover our butts" kind of thing. Not sure, but that's my theory because it's kind of monotonous. And yes, most of them end up being sent home. If you're contractions aren't under 5 minutes apart and completely regular, if you are in no obvious distress and have not had your water break, don't come to the hospital. The nurses and doctors don't mind, but you will be very, very bored and miserable waiting and watching and then being sent home.
So Triage got quiet really fast. Everyone just waiting to be sent home to walk around, have sex, do whatever they want to get their labor going faster. Then they'll probably be back tomorrow in active labor. It's crazy.
Our instructor said if we were bored, we could go study in the conference room. A lot of things happened in the morning and early afternoon, so there were a few of us who were bored out of our minds by 2:30/3. We went to the conference room and rested, talked, went to the cafeteria (yes, just because we were bored and hungry), came back, talked some more, and just waited for postconference. We were all completely absent from our brains by that time, one of us had a broken arm, another hurt her back when a patient attacked her this week at her tech job (seriously!), a few were hungover, I was in extreme fibromyalgia pain and had a migraine coming on, and of course we all knew it was the last day on the floor. We were slaphappy and exhausted, and our instructor looked like death (she has fibro too and was having a bad day), so we all agreed to leave a little early.
And now I am typing this as I babysit (which is insane seeing how much pain I am in from this day) and will momentarily take a nap until Mom and Dad come home. I'm with my nanny girls, and L Bug's grandma watched her today and let her talk her out of taking a nap. I literally had to drag L Bug into bed as she's screaming, "I'M (sob) NOT (sob) SLEEPY (sob sob)!!!!!" She's barely 2 so it was kind of cute, but also distressing at the same time. She's never that bad. All I could think was, "I feel like sobbing and yelling I AM SLEEPY!!!!"
This nursing thing - although amazing and fulfulling and perfect- is going to physically take every last bit of me. 3 more semesters + a summer externship. It seems impossible, but I don't know what else to do.
Oh and as a side note, Jen (my best friend, remember?) took her boards yesterday and PASSED! She's an RN! She was going to reschedule her test but failed to do so within 24 hours so either had to take it without studying at all or waste the money and pay to take it again. She told me she knew she'd fail, but she figured she'd already paid for it and it would be good practice, so she went. And passed. Without studying. That is so my best friend. She texted me this AM and said "I know you're in clinical but I need you to call me ASAP." I snuck into a hallway behind a door and called her. We were both almost crying. It was such a great moment. Then she called me tonight. She techs at a hospital and landed a job on her floor, which she loves. Apparently she talked to the nurse recruiter this afternoon, and she's having Jen start orientation on Monday. Tomorrow is her last day teching forever. She's an RN, and she starts making an insane amount of money Monday morning. She will be working on her favorite unit, loving every minute of it, and making the living she's worked so hard for. Snaps for Jen. I'm so proud of my amazing, crazy soul sister. 24 hours ago, she thought she was taking a practice NCLEX and she'd definitely fail it, and right now, she is an RN and starts work on Monday on her dream unit. Absolutely insane. God is pretty awesome. Oh, and she has a new boyfriend too. First "real" boyfriend ever. It's so sweet when life is so good.
Today, her day, almost makes me forget how far away from nursing I feel after remember what I realize at the end of each clinical day - my body cannot do this job for more than a couple hours. My heart can, just not my body. Everything starts aching and throbbing and crushing and burning. My energy dips steeply at about noon, and then I drag. I come home and load up on percocet, a muscle relaxer, a pain patch, sometimes a zofran... and I sleep for 2 solid days. Then during the week, I forget how hard it was and look forward to the next clinical. Then it nearly kills me, and it happens all over again. I think it hurts my soul more than it hurts my body.
One of these days, life will be okay. One of these days...
We all know how much I love alternate experience days were we get to break away from the somewhat monotonous clinical experience and go somewhere new and exciting!
One day during the semester, I shadowed two nurses at the hospital's Women’s Health Clinic. Thursday is the Clinic's High-Risk day where they see patients who are labeled high risk for varying reasons such as seizure disorders, diabetes, thyroid disorders, chronic high blood pressure, previous preterm deliveries, multiples, or even drug use. The patients usually come in every week for the duration of their pregnancies just to ensure things are going smoothly.
The clinic runs with the help of two nurse practitioners, one attending physician, several residents, many medical assistants, and a handful of registered nurses. The NPs see patients for annual exams, contraceptives, and sexually transmitted diseases while the residents primarily see the pregnant moms who come in. The medical assistants accompany the residents for exams, help patients, and assist with tests.
I spent my day observing the roles of two of the RNs, K and C. While I would have thought K would do more of what the medical assistants did, she helped check in patients, obtain vitals, administer vaccines, and perform blood draws. C was a case manager, and her job was making sure all of her patients were progressing well with their plans of care throughout their pregnancies.
Regarding the population, I learned from K that 90% of all of the patients the clinic sees receives healthcare insurance from Medicaid. Additionally, some of the patients who aren’t on Medicaid may have seen the office on a list of insurance-approved clinics and come in “by accident,” and other non-Medicaid patients are often previous patients who are more financially stable now but still want to continue being seen by the same healthcare providers.
Many of the patients were in their teens and early 20s. Many Americans on Medicaid are at a low economic status, and I observed the majority of the patients seemed less educated and even sometimes ill-mannered in comparison to other patients I've observed. Some patients responded to our care with short, one-word answers given with attitudes, while a few were friendly and kind. A few people on the day's list neglected to arrive to their appointments without even the courtesy of a phone call. But like anywhere else, the Clinic sees many different people, and financial status is not always indicative to patients' demeanors or health-seeking behaviors and choices.
A few scenarios of high-risk mothers we saw in the clinic are as follows: a woman in her mid-30s at 12 weeks gestation with a complication of a right ovarian cyst, a 16 year old at 8.5 months gestation with complications from a previous brain aneurism and recurring headaches. Then we had a more typical case of a woman with Type 1 diabetes carrying her second baby. Her first baby was preterm, so she is hoping to have a healthy, term infant. We also saw a 19 year old woman pregnant with her second child, and she produces an antibody causing hydrops fetalis, a serious condition where a fetus becomes edematous in various areas. Overall, it seemed that we saw more diabetic patients than anything else.
After calling a patient in from the waiting room, K would obtain her weight. We'd then go into a room where we'd chat for a few minutes with the patient and - if she came with someone - her partner, children, or mother. We also tested each patient's urine for sugar and protein, and if the patient was diabetic, ketones. Other than the occasional vaccine or blood draw, that's what K's job entailed. It may not seem like much, but since most of the patients come in on a weekly basis, K has the opportunity to form trusting relationships with each of them, and I found it refreshing to observe.
There are two RNs who are case managers at the Clinic, and I spent time with one of them, C. Each patient at the clinic is assigned a case manager who follows her throughout her pregnancy to ensure she's adhering to her plan of care and is taking optimal care of herself and her fetus. C has three formal discussions spread out over each woman's pregnancy where she goes down thorough checklists encouraging the mothers to attend a prenatal or parenting class, maintain an optimal diet, adhere to any prenatal medications, and even obtain a safe car seat and crib. She arms them with support and provides additional resources such as WIC. C also comes in to check on her patients at every visit, and although less formally, she still assesses each patient's progress in preparing for the remainder of her pregnancy, labor and delivery, and living at home with a new baby. She has a great responsibility to teach her patients especially since many of the Clinic's pregnancies are not planned, and many of the mothers are unmarried, unemployed or of a low income. In some cases, the patients may not have any support available to them at home.
Overall, I was surprised at the RN roles in the Clinic. I had been expecting neither, but after spending the day with both K and C, I realized that both of them play vital roles in the lives of their patients. I think seeing the same RNs at each office visit is critical to every patient in all clinical fields as it encourages patient trust and increases the positive image of the professional RN. The more patients trust nurses, the more they will feel comfortable confiding in them and asking them health-seeking questions. I believe nurses can increase patients' image of the healthcare system overall, even in an age where people don't seek care because the system is so complicated, expensive, and downright frightening. Patients often leave a physician's visit feeling disconnected from their doctors for various reasons, while encouraging words from a familiar nurse can only foster a positive relationship and hopefully, a positive outcome.
Today was clinical, but we got off early because my instructor had to go out of town.
Instead of seizing the day and getting things done, I've been thinking.
And I've come up with this.
It's my favorite time of the year, and I don't have a spare second to enjoy a minute of it. I don't have time to enjoy the stress of shopping, make special gifts for my loved ones, or decorate my room insanely early just to enjoy my pink tree a little longer.
I am miserable.
And I know exactly why.
Even worse, I know what will make it better, but I also know the cure comes with an entire set of new problems.
So the original problem is this...
I'm too busy medicating myself to get through each day of this education with a drug that has pretty much taken all but my life. It's a vicious circle - I want to graduate and be a nurse, but with my health like this (and masking it with a drug that I can barely even tolerate), I couldn't even tell you when I'd realistically be done with school. By then, I'd probably be past my strength anyways.
For weeks now, I've been wrestling with a big decision. A decision I don't want to make, a decision I don't want to have to make. And you know what's funny? I thought I finally came to a conclusion today, and then there it was, in my inbox.
These words.
When considering a difficult decision, look ahead in your life toward the day when you will die, and consider: which option would you regret most not doing. In most cases, your answer will be immediately clear.
(m. zetty)
What I would regret most not doing? The very thing that is trying to kill me. The very thing that is stealing my happiness. My drug, the thing I keep coming back to even though I know it's going to be the thing that kills me...
Nursing.
I need it to have a job so I can have health insurance so I can get married, but do I need it for more than that? Do I need it to complete me? Knowing how I could make a difference in the lives of so many people every single day makes me think yes. Seeing the politics of the job and the insane conditions of working out there make me think it might be easier said than done.
Then there's that minor thing - finishing nursing school. It's all a game out there. Seeing how I should have graduated already, I'm in classes with people who act like 12 year olds, and I have professors who act like catty teenage girls among each other and nasty, conniving micromanagers to their students. I'm in a school whose only goal is to raise board passing rates, and they're willing to sacrifice our sanity to make sure they get ahead. Professors give us exams on questions they can't answer themselves and grade our papers using their opinions of us as their rubrics. Then get out there in the work force, and well, I nurse tech'ed so I know how it is. The nurses where I was probably had ulcers and panic attacks and will quit from burnout by the time they're 30. Why would I want a life like that? All to help a few people?
Or is it more than that?
I think it's more, but lately I'm not sure. I just know I'm not as strong or as resilient as I was last time I attempted this, and I know for a fact that my mental state any given day since the last week of August has been a polar opposite of what it was in July. I was finally getting better, things were starting to look up. Then with one fell swoop, I decided to force myself to limits I was sure I'd be strong enough to reach. I decided this was the only way to fight for my future, my happiness, my impending marriage.
So don't ask me what I'm supposed to do now, because I don't know either. Take a semester off? Keep killing myself each day? Decide to settle for that degree in Integrated Health Studies?
All I know is that I have no idea how I'm even going to get through the remaining two weeks of school and then finals, so how could I ever get through three more semesters?
So much is at stake each way, and anyways, if I wasn't doing this, what else would make up the difference? Would it be enough? Would it be the right thing? How would I know for sure?
