Mid-sleep panic

I spent many hours yesterday making my flashcards and reviewing lecture and reading material. Right up until bed time, in fact.. of course, I did listen to a book on tape of something entirely fictional and fluffy in between studying and really falling asleep, but I think the nursing material was still on my mind.

I remember waking up a couple of times in the middle of the night and feeling panicky with thoughts of, "I'm not going to be able to do this, I'm not good enough, I can't memorize it all, I won't get a job..."

I was able to tell myself that the middle of the night is not the right time to be considering these things, and fall back asleep. And I feel..well..pretty good about my path and future by the light of day.

I'm doing well in my classes, clinical is going very nicely this term, and I feel very supported and liked by my teachers and most of my classmates and the staff nurses I've worked with. I don't know why I'm filled with so much self doubt sometimes.

Internship in ED this fall

During our 3rd (of 4) semester, my class was given the opportunity to apply for internships with some of our local hospitals. We get 1 unit of course credit for the experience, and it's a good networking opportunity as well as a way to get more hands on skills and experience.

We put in our application (a cover letter, a resume) to a person in the education department of a group of hospitals, told her which unit was our 1st, 2nd, 3rd preference, etc and then waited to hear back. I said emergency department first, NICU second, ICU third. We've gotten to do "outrotations" from clinical to some other areas in the department. So, so far, I've seen med surg, ICU, ED, Peds, mother-baby, NICU, L&D and OR. The outrotations that I was the most excited about so far have been the emergency dept and NICU. I was torn about which to put first, however the hospital that was offering a NICU internship was quite a bit farther away. Also, I thought I'd get a better broad experience and wider variety of skills in the ED.

I had an interview with the ED department manager over the summer. I believe ED was the only department that actually had us students come in person for an interview; the others were phone interviews. Three of us got placed in the ED at this hospital. During our third semester of the RN program, we have 2 days of regular school clinical every other week, so I'm doing one day per week at the internship only on the weeks I don't have normal clinical. The requirement for the course credit is that we do 54 hours of hands on time, but with the department director's consent, we can do more. It's unpaid.

 I had my first day there this past Monday. What a blast. I was there for about 8 hours, and had about that many patients. I was working directly with an ER nurse that is a graduate of my program. I got to see a dressing type I hadn't done before on a finger wound, do lots of glucoscans, discontinue IV's, do assessments on a wide variety of patients, lots of urinalysis, talk with someone who had just tried to commit suicide, prime IV lines (we are not allowed to actually *give* any medications at the internship), do patient education.

I left really excited about becoming a nurse, and hopeful that maybe at some point I could become an ED nurse. It think the variety is really the excitement for me. And the faster pace. On the med surg floor, it can sometimes feel like babysitting. Morning assessment, morning meds, hygiene care, morning treatments, nursing interventions, noon meds, more hygiene care. Some people really like it because it's a more wholistic experience with the patient. At this point in my student life though it feels really good to just be exposed to *a lot* of different situations, even if I don't get the same depth I would if I were following the same 3 patients all day.

I'm sad I won't be going back for another week and a half; I've got a lot of stuff to do in the mean time. Had a quiz today, an exam is tomorrow in my neuro class, we're covering IV push meds in lab on Friday, and I'm back at normal clinical for two days in a row at the beginning of next week. So I'll stay busy. But I'm really excited about going back to intern again!

First few days of RN program

Monday: Arrive at 8am, sit through 6 1/2 hours of mostly lecture. Ask lots of questions and feel little timid about asking them because I don't know my teachers and classmates yet, not really. Feel completely awed by the first two professors I meet. Go to work immediately after school until 10:30pm, leave about an hour before shift end with my med tech partner's agreement, and crash HARD.

Tuesday: Arrive at 9am having slept like a brick the night before. Everyone is sitting in the same seats as yesterday. There are about 20 chapters of reading I was supposed to have done just for the first week, out of 16 or so different books, and feeling pretty overwhelmed by the quantity of information coming our way and being behind on the reading, but yet also thankful that I'm able to follow everything the teacher is saying so far, and that my most recent job has given me a lot of valuable experience that will help me in this first semester. Almost start crying during the portion of a lecture on therapeutic communication because I've just had a somewhat traumatic experience (for both me and the resident) two nights ago at work that is still lingering in my mind). Even more awed by the teachers today than the ones from yesterday. Especially one of them. I contemplate the fact that I never really admired my science professors as much as I do these nurses I've just barely met. Knowledgeable, wise, and so very intelligent, both academically and emotionally/socially.

Get to go home early that afternoon, around 1:30. Need to tune my brain out for a bit, so put on some TV and end up watching it longer than intended just because it feels so good to let go of that brain overload feeling for a few hours.

Get myself back on track, do a review of some math that's going to be on a test tomorrow (already!) to make sure I remember how roman numerals work and can do all types of fraction math with speed, briefly consider watching the videos about basic bedside care that I'm supposed to watch for tomorrow's skills day, but decide sleep is more important. Then have a fitful night's sleep.

Wednesday: Arrive on campus at 7:30am to the skills lab for an all day basic care activity nicknamed "CNA in a day". Realize that although I have been working in an RCFE (residential care facility for the elderly) for the last 8 months, I don't have a lot of the skills that are considered basic in a long term care facility, like giving a bed bath, sitting a bed bound patient on a commode, taking blood pressures the old fashioned way, brushing a patient's teeth for them or shaving their face, etc.

Tomorrow, Thursday, I'll be going to my first clinical site for orientation with my clinical instructor. My clinical instructor just got hired two days ago, and I'm a little wary of that fact. She will be shadowing another more experienced instructor while teaching us. She seems nice enough so far though.

Should I know already?

I have 2 weeks to go until nursing school starts, and I have to say that lately I've been feeling self conscious when people ask me what *kind* of nurse I want to be, and I really don't have an answer.

My plan has just been to get a wide variety of experiences during the clinical rotations that are a part of my school program, and at graduation time, go with my gut, or alternatively, where the jobs are. I don't feel like I know enough yet to be able to say, "OH, well, I'm going to be a pediatric nurse, definitely."

I currently work with seniors, and I like them, and they me, but I don't know that that's where I want to specialize long term. I could see myself moving around a lot within the nursing field to keep learning and growing. Or working on a unit that sees a really wide variety of patients. Or, hey, maybe I'll find myself just completely enchanted with something I have no experience with yet.

I have a friend who is a surgical nurse, and she loves it. A friend of that friend, also a surgical nurse, told me that she liked it because the patients are mostly asleep! Oh, and it pays well. But you have to be very, very good at getting along with doctors.

I am pretty sure that I do not want to work in a prison, or the state mental hospital. I want to be able to feel safe with my patients, for the post part.

I was reminded of my indecision again when one of the school staff was talking about helping us write our personal statements. And I was thinking, gosh, I bet they want you to say what area of nursing you are most interested in there, too.

In a scholarship application I recently turned in, I'll admit I catered to what I thought the scholarship provider would want me to say. It was a conglomerate that owns several senior care centers in the community. I expressed in my essay answers that I enjoyed working with seniors, and hoped to continue that. That's true, in a sense, but I don't know that I want that to be my entire job.

So, for now, the jury's out. One of the things that appealed to me when I was first starting to look into nursing as a career was that once you were "in the club" with that RN, you had A LOT of options, and you could move around, too, you weren't stuck where you started. Am I just rationalizing my indecision?

Academia vs. nursing...

I have been a little concerned occasionally when I hear someone who's been to nursing school or is a nurse themselves talking about older nurses eating their young, etc. That is part of the reason I left academic research --- because there was a whole lot of that.

But I was browsing around catching up on a few blogs I read sometimes and I found this post on the "Head Nurse" blogspot:

http://head-nurse.blogspot.com/2011/06/thank-god-im-nurse.html

It turns out she's got a unique perspective in that her whole family is entrenched in the academic world, while she's a nurse. My favorite quote from the blog entry:

"See, Dad was talking about academic politics and who gets what professorship and what one's ranking in the department was dependent on, and how that was affecting this, that, and the other thing. And I was sitting there, alternately casting my eyes Heavenward and thinking, "Y'know, if some jackass tried *that* shit around me, they'd never set foot in my unit again.""

I also enjoyed this comment made by an anonymous reader:

"Thanks to the nasty politics in academia, I made the transition from academician to nurse and haven't looked back. My former colleagues are still shocked about my decision (I get some version of the "how can you can go from thinking profound thoughts to wiping dirty butts?" question from them everytime). I try to be polite when I tell them it's better than believing that some minutae of lyric poetry is going to change the world and sucking up to some quack of a dean to keep your pathetic job of teaching 6 sections of composition day and night."

So someone else out there has successfully made the jump from academia into nursing and seems to be much happier with it. Looks like he/she was in literature before, where I was in science, but I'm sure a lot of the stupid politics and infighting are common to the two.

More confirmation that I'm headed in the right direction is always welcome...!

Why Community College?

When I started looking into this whole nursing thing, I had basically come to the decision that I wanted to move home. I was living out of state at the time, the only one of my family so far away, and especially since the birth of my first niece, it was really bothering me to be so far away.

Things had come to a screeching halt with my research career. Total melt down with my academic advisor, realization that academia really was not going to be a good fit for me (this article explains part of the reason: The Disposable Academic), and realizing that without my grad student stipend and no immediate job prospects where I was living at the time, it was going to be difficult to get by.

Nursing, and more broadly, the all-encompassing "health professions" were something I had considered in the past. I think I may have first considered nursing specifically in early high school, but my family basically told me I should do "better" and I moved on to other things. It is an idea I have revisited several times since then, and especially since starting grad school.

So when I decided that I was definitely going to pursue a career change, and narrowed my decision down to nursing, I started looking into the various training programs: The most efficient way for me to become a nurse at this point would be one of those accelerated BSN programs. I already have a bachelor's in biology, so I could enroll in one, and graduate all snappy like in 18 months, ready to search for my new job as an RN. The problem with that plan goes back to my yearning to be closer to my family; my family lives in a small-ish town, well-removed from any of the big cities where those programs are offered. Also, those programs cost upwards of 50 grand. Yes, I could take out a loan, and hope that whatever hospital hires me afterward would have a partial tuition reimbursement program, but geez... and there's also a lack of confidence issue there. I already chose one career, pursued it pretty doggedly for about a decade, and then admitted to myself it wasn't for me. I don't think that's going to be the case again, but if it is, I don't want to jump into a huge vat of debt right away.

Conveniently, where my family lives, the local community college has a well-respected ASN program.

The shortfalls are:
* it will be 4 years before I'm an RN (prereq's, application period, 2 year program)
* when I'm done I'll only have an associates in nursing
But on the plus side:
* it's cheap (about $2,000 for the 2 year nursing program)
* I can work part time while I'm in the program (not possible in the accelerated programs)
* the graduates are well-recruited by local hospitals from what I've heard
* I can stay local to my family (emotional and financial benefits)
* I'm tip-toeing into my new career field rather than diving, giving me opportunities to alter my course if necessary
* If I complete the ASN and then decide I need the BSN later, I can easily complete one of those online bridge programs (using my future employer's continuing education reimbursements) while working full time

Until I found local full-time work, I was somewhat doubting this decision, but I feel good about it now.

Family Reaction to my career choice

My family has been for the most part pretty supportive around the idea of me transitioning toward a career in the health professions. Right now they're helping me keep a roof over my head until I can find work again, which is very much appreciated.

But there are some things that are nagging at me:

-My mom insists on saying "nursey-nurse" instead of just "nurse" when we are talking about it. I have told her I find this demeaning and disrespectful, and she didn't say she didn't mean it this way; she said "well how about if I'm allowed to say that about student nurses but once they get their license they become 'nurse'"
-My mom makes little comments here and there about it really would be better if your end goal were to become a nurse practitioner or a doctor, instead of "just a nurse". This isn't too surprising, as several years ago when I brought up the idea of being a nurse as a teen, she told me "nurses just wipe butt".
-My dad expresses concern that it will be hard to get a job as a nurse in our specific town, even though in general nursing jobs are easier to come by right now, because our town is a place where lots of people would like to live.


My dad's comment at least is logical and comes from a place of concern, but my mom's comments I really find distasteful and mean. I read somewhere that nurses (along with firemen) are one of the most trusted and respected careers in the U.S. Why does she have such scorn for them? And why can't she keep her mouth shut when this is something I feel good about and want to pursue?