Brave Woman

Adventures of a future nurse-midwife

Blog

view:  full / summary

When the Nurse is a Patient

Posted by Lucille on January 24, 2016 at 8:35 PM Comments comments (0)

In the first week of this term, I found myself in urgent care, nodding while a sympathetic doctor told me they'd found white blood cells and blood in my urine. This was my first experience as a patient since officially entering the healthcare world, and I found myself wondering what this appointment would look like to someone with a different level of healthcare literacy or other barriers. I'd never had a UTI before, but the doctor assured me that it would be simple to treat. She prescribed medications I hadn't studied and urged Travis and I to hurry so we could fill the prescription that night.

We made it to the pharmacy shortly before closing. I told the pharmacist I hadn't taken these medications before, and he warned me not to wear white because they may cause my sweat to come out pink. Sweet! I didn't know this adventure would give me new superpowers!

I was exhausted, so I didn't look closely at the bottle or the papers he hadn't me. It was well past my bedtime when we got home, and I took my first dose and went to sleep. I woke up dark and early for clinical, took my second dose, and caught the bus to the hospital.

The morning was a four hour meeting with my clinical group in a cramped, windowless room, to go over skills we had learned last term but needed to recertify in to work at this new hospital. My head started bobbing within the first hour. My sleep schedule was messed up from winter break, I told myself. I drank ice water to stay awake and tried to avoid blinking, because every time my eyes closed they were perilously difficult to open again, and my clinical instructor seemed to jump to a different topic midsentence. I found myself staring at the student across from me, trying to make her two blurry heads overlap into a clear figure. My friends were awesome and looked out for me over the lunch break. They joked that I looked the way we all felt. We enjoyed a therapeutic complaint session over having had to redo work from last term when we had so much to study, and talked about what we were looking forward to about working in oncology in the coming weeks.

The afternoon was a skills lab where we would be learning to insert nasogastric tubes and trachs on mannequins. Eating and moving around had woken me up a little over lunch, but now I found myself feeling dizzy and paralyzed with exhaustion again. The late night trip to urgent care must have worn me out more than I thought, I told myself. I leaned my (supposed to be sterile!) hands against the bed to steady myself and had to start over. A friend asked if I was okay. I assured her I was, and heard the words come out of my mouth much more slowly than I had intended. I wasn't okay. I looked down and realized I'd been planning on inserting the NG tube through the mannequin's trach hole. Backwards.

I took off my gloves and stepped back from the bed. The room spun a little, so I sat down and tried to make the floor tiles come into focus as a few friends gathered around me to see if I was alright. I shook my head. I was looking back on the day and marveling at the chain of rationalizations I'd come up with to normalize these sensations. I think it says a lot about the quality of the people in my group that they moved straight from empathizing with my exhaustion to recognizing something was up, and instead of keeping to themselves and hoping to never be my patient, they spoke up and started looking for ways to help. Someone remembered me mentioning a visit to urgent care and asked if I was taking any new medications. (Woohoo! Way to think like nurses, you guys!)

I pulled the bottles out of my bag (noticing a big label for the first time that warned me not to drive) and looked the medications up in my drug guide. Turns out fatigue, dizziness, and uncontrolled eye movements are common side effects both the doctor and pharmacist forgot to mention. I marveled again, this time at how easily something could have gone wrong in treating a simple condition in someone with high health literacy, full health insurance, no language or learning barriers, a pharmaceutical guide in her backpack, and a classroom full of nurses and nursing students. If all that had not stopped me from being unknowingly impaired at the bedside of an imaginary patient, how do we expect people with much less privilege and potentially much more complicated health conditions to navigate this system safely?

I notified my clinical instructor of what was going on and we made a plan in case I was still experiencing side effects when I started real patient care in a few days. She was familiar with the medications and shared that most of the time, the body adjusts to the side effects quickly. Luckily, this turned out to be true, and I started working with patients again a few days later with no problems.

In the end I didn't even sweat pink. I'm calling ripoff-- all kryptonite and no superpowers. Overall I give UTIs a one out of five stars, would not recommend.

Intention

Posted by Lucille on December 30, 2015 at 5:30 PM Comments comments (0)

In lieu of new year resolutions, a few years ago I started choosing a word or phrase to carry with me as an intention over the next year.

In 2014, it was 'being proactive and practicing gratitude'. I started the home stretch of my undergrad degree, which consisted almost completely of large, non-interactive, memorization-based classes. I had let go of several dear friendships that I recognized I'd been trying to save from the changes of time for far too long, but I was struggling to form new friendships, a challenge exacerbated by my classes and schedule. The isolation, coupled with knowing I was about to leap out of college into the vast unknown, sent my mind turning in circles. I noticed anxiety showing up in a different way than before, swelling over the banks of emotion and spreading into patterns of thought and being. Those changes needed my attention. 'Being proactive and practicing gratitude' became my framework for addressing them. With the encouragement of a counselor, I started attending a different meetup group every week. Most were not, ultimately, what I was looking for, but proactively pushing out of my comfort zone got me out of my apartment and, more importantly, out of the circles in my head. Gratitude came in finding the kernels of beauty in places (physical and mental) that I might not choose to visit again, but that I learned from by passing through.

2015 was a year of transition. This was the year I wrote my undergrad thesis, supported nine awesome families as a doula, volunteered mentoring newer advocates on the SARC hotline, graduated college, applied to and was rejected from the midwifery program, applied to and was accepted into nursing school... It was wild and tedious, anxiety-producing and awe-inspiring, a slow crawl and an exciting blur, and a little bit of everything else you can think of. What it wasn't, was grounded. The constant of this year was the feeling of being airborne between two trapeezes: free, excited, and trying not to look down.

It's hard to explain the feeling of starting a gap year when you have been in school consistently for the two decades of your remembered life. Everything is wide open. You not only get to decide how to spend each minute of your time, you have to-- there is no blueprint to follow. The feeling of uncertainty was exacerbated by knowing that this year was a turning point, and that every little decision I made could impact my entire future. Through all of this, I was on call and ready to drop everything if a baby was ready to come earthside.

There was a sense of disparateness. All of my endeavors were completely separate, with no one overseeing the whole except for me. This was mirrored socially-- I had friends, but none of them knew each other, and most did not know me outside of whatever activity we shared. The different roles I took on were starting to feel like their own characters, rather than different facets of a central person.

As I tried to find language for this deep yearning that I felt, the word that surfaced was belonging. I worried that it was petty at first. I was learning so much and having amazing experiences as a doula and advocate. Why should I be bothered by this feeling of being ungrounded? Rationalizing the feeling away proved unhelpful, so I tried to get curious about it instead. Humans are, at our roots, tribal creatures. We evolved living in communities-- not just collections of individual relationships, but groups united by a shared experience. In many ways we define ourselves in relation to our community. It came together, then. I was not just looking for belonging socially. I was looking for belonging in my identity: in my work, my relationships, my body, my whole self.

The issue with belonging as an intention is that it isn't an action, and is usually thought of as being conferred externally. But belonging has a sister: welcoming. My intention for 2015 was 'belonging and welcoming', as I tried to embrace all the joys and challenges my gap year had to offer, welcoming the uncertainty in order to find belonging in the questions.

I'd like to say that this process worked. Maybe it did, partially, but I think the bigger part was the years before that of moving toward the things that I felt passionate about: all the decisions and experiences that led to me starting nursing school.

Nursing school continues to be intense. We are learning so much and growing so fast that I've found myself looking in the mirror as though I should be able to see the difference, and taking pictures as though I need to document it to make sure I'll still recognize myself at the end of this. Even though my mind and heart get overwhelmed and start spilling out my eyes with some regularity, there is a deep sense of fit. I may not know exactly where I'm going from here (I just reapplied to the midwifery program and should hear back in March!), but I know that right now, this is exactly where I want to be at this point in my life. I belong here.

The only regret I have about nursing school is how little time it leaves to hang out with my cohort. Writing about this might be a little weird now that this blog is more public, but we're going on five years of radical vulnerability on here so I'm going to just go ahead. I freaking love the people in my cohort. So much that it's kind of weird and I have to talk myself down like an overexcited child, because otherwise I would probably latch on to people's legs and be like, "Yep, this human. I like this one. And that one. Actually, all of them. I just want to take them home and make them pancakes and snuggle and talk about Harry Potter forever and ever like a never-ending slumber party." Although the internet appears to endorse this strategy, I'll admit that it's a little rough in that some people's partners and kids would prbably miss them and we'd all fail our finals. I'm still working on the details.

In all seriousness, I am surrounded by amazing people who are interested in the things I'm interested in and it is a gift. Forgive me for going on a tangent, but two stories deserve to be told in more detail.

On the first day of finals week, Portland had record-setting rainfall and the streets were flooded. I was going to catch the shuttle up the hill, but traffic was all backed up, and I ended up walking so I wouldn't be late. I was crossing a street with a huge muddy puddle on the other side (that I was going to walk around) when a truck driver who didn't see me started turning into the crosswalk, leaving me no choice but to barrel through the puddle (which came over my knees) to get out of the way while the truck sent a wave of water over my head. I was wearing a rain jacket and everything, but I don't think a single part of me was dry. I made it to my final with a few minutes to spare, dripping. As soon as I walked into the room, people started jumping up with offers to help, and by the time the test started I had dry shoes, socks, pants, shirt, jacket-- even a mug of hot tea! I felt like I was wearing a hug from my entire cohort. Even my teacher left to bring me dry socks from her car. As a friend commented, it's almost like we all want to take care of people for a living or something.

There are ten people in my cohort who will be continuing directly into the midwifery program, and similar groups who will be going into the psychiatry and family nurse practitioner programs. Sometimes these smaller groups get together to talk about the programs or just get to know each other more closely than you can at a larger event. The midwifery group got together earlier this term, and even though I am not in the midwifery program, they invited me to come along.

I considered it carefully. I knew that if I went to the midwifery get togethers and then didn't get into the program, it would be heartbreaking to know that the people I'd been getting to know over the last year would all be going on without me. But if I did get in, and knew that I'd missed out all year out of insecurity, that might be worse. The thing is, sooner or later, I am going to be a midwife. Whether or not these amazing women will be my classmates after this year, they will one day be my comrades in this work, and saying no to hanging out with amazing people out of fear of getting hurt is just kind of ridiculous.

I went. It took me a while to find parking, so most people were there by the time I arrived, and they jumped up and welcomed me and told me how happy they were I was able to make it. We talked about clinical, books, favorite spots in Portland, etc. I couldn't tell you much of the specifics. What I remember is that I felt so seen, and so welcomed.

I went home and cried. Proactive inclusion is so powerful. It's freaking magic.

I'll be sure to post when I hear back about the midwifery program in March. Until then, I'm glad that the application is out of my hands so that I can focus on being present with everything this term will bring.

As I sit here, eyeing the school supplies I need to organize in time for the start of term on Monday, I know it's time to pick a new intention for the coming year. The first phrase that popped into my head was drinking from a firehose. Although that's a pretty apt description for nursing school, it's not quite an intention. The second thing I think of is opening. I am diving into so much that is new and unknown to me, and I think of opening myself to everything this next year could hold...but that's not quite right either. Nursing school is too much of an active process of prioritizing and discerning what to take into my practice for me to simply be open to everything. The word I choose is becoming.

This time next year, I will be a nurse, and maybe a student midwife. Allons-y.

Happy New Year, everyone!

Ka-Clunk Ba-Da-Clunk

Posted by Lucille on December 30, 2015 at 4:45 PM Comments comments (0)

I am learning to drive a stick shift.

When I was first learning to drive, I decided that I would learn on an automatic, and then add in the stick shift once I grew comfortable.

That was seven years ago. It never got comfortable. I've never been in an accident, but still, whenever I get in the car I feel acutely aware of the fact that I will be piloting a box on wheels many times faster than nature ever intended me to go. If something happens, split-second decisions on my part could have life-or-death consequences for me and others. And that's before you even factor in that many of those other drivers, whether because they're angry, drugged, or distracted, drive like they're trying to kill us. It never got comfortable, and I'm not sure it should.

But then there are external contexts. I've been using Dad's van for years because I needed to be able to be on call as an advocate and doula. Because I'm not on call anymore and the price of a parking spot downtown should be considered robbery, it was time to give back the van (especially because my little brother will be old enough to get his permit soon--eek!). Most things in Portland are reachable by public transport, and Travis has a car (a reliable smaller car that's older than he is) so we shouldn't have trouble getting ourselves where we need to go. There is just one catch: his car is a stick shift.

Ahh, necessity, the mother of scary new learning. (I'm pretty sure that's how it goes, anyway).

I didn't feel ready. But I knew I'd probably never feel ready, and this term has already been one long exercise in not-readiness, so what the heck? I gave it a go.

We were going to be visiting Travis's folks for the holidays, and I asked if they would be willing to give me a few lessons. On the morning of my first lesson, I was very brave and composed. Just kidding. I was literally shaking and briefly tried to hide in the closet. Impressing my partner's parents: check. (It's a good thing they have such a great sense of humor.) We went out by an old airport where there was plenty of room and not a lot of people. They explained the basics, and then I gave it a try.

Making mistakes in a stick shift has a comical lack of subtlety. In an automatic, you can take something a little too fast or too slow, and say to your teacher, "Hmm...I'll try to take that a little more (this way) on the next round." In a clutch, if you take things a little too fast or too slow, it goes, "Ba-da CLUNK BUNK DUNKETY-- (deafening silence)." To someone not accustomed to hearing these sounds from a car, it basically sounds like you're going to explode.

Anyway, I got in a few lessons and feel pretty good driving around an airport now. Driving on roads with other people, or, god forbid, hills, will have to wait until I can get more lessons from Travis or my parents in Portland.

Baby steps.

Points for practicing learning-while-nervous, my new favorite skill.

Someone needs to go tell Google to hurry up with those self-driving cars.

Trust

Posted by Lucille on December 4, 2015 at 3:50 PM Comments comments (0)

An annual Gallup poll consistently finds that nurses are the #1 most trusted profession (with the exception of 2001, when firefighters took top place right after 9/11). Our teachers remind us of this regularly. At first I didn't understand why they brought it up so often. Okay, nurses are trusted. That's good. And?

But then I went to clinical. I walked onto a hospital floor wearing green scrubs, thin plastic armor, and my heart on my sleeve. I started interacting with patients and nurses at the frontlines of human vulnerability. And the power of giving and receiving trust under these conditions hit me like a waterfall and pulled me back to the first week of nursing school, when our teachers warned us that this would be not just an academic program, but an existential journey. I believed them, but I could not have known, without experiencing it, how powerful this process would really be.

Stories. People I've barely met gift them to me before the disinfectant has dried on my hands (or alternatively, are reserved at first and then open up to me like a flood when I least expect it). I knew that I would become a carrier of deeply personal stories in this work, but I didn't realize just how quickly and continually they would come: awe-inspiring stories, tragic stories, hilarious stories...stories so poignant or with such serendipitous timing that I simply could not make them up. And then ten minutes later, another story, and from a different patient, another, each one so profoundly different that I can feel my chest swelling with them, as they break my heart and mend it, again and again. I wish I could write them here, partially to share them with you, and partially for myself-- because I can already tell that I am taking in more stories than I could possibly remember. I can't share them for privacy reasons, but that's okay. It adds something to the intimacy of these stories to know that they are fleeting, shared moments, and that the next moment, and the next, hold something new.

Patients trust us not only with their stories, but with their bodies. The transplant floor was a great place to start out this term because I got a lot of experience with hygiene care. When was the last time someone else brushed your teeth? Cleaned you up after you went to the bathroom? Brushed your hair? I have difficulty imagining how vulnerable it must feel to need to trust such personal tasks to strangers, and yet these are the nursing tasks that are arguably the least invasive.

I had the opportunity to perform a few procedures on real patients for the first time this term. I've heard that, unless you are specifically asked, you shouldn't tell the patient that you've never done something before. I felt an uncomfortable sense of dishonesty with these instructions, but understood their purpose. Presumably, patients would rather have someone with more experience do the procedure, but if only experienced healthcare providers worked on patients, they would eventually die out and there would be no healthcare. Every patient, when I explained that they needed a procedure done (catheter insertion, wound dressing, etc.), asked me how many times I had done the procedure before. I answered honestly. Which is why I was blown away when every single one asked me to continue, and in some cases specifically requested that I be the one to do it. They chose to give me the chance to learn and practice procedures, even painful procedures, knowing that my inexperience would prolong their discomfort. They requested it. What do you do with that level of trust and kidness? I don't know. I don't have words. You do your damndest to keep your head in the game and perform the procedure as well and as efficiently as possible, without letting tears of disbelief and gratitude blur your vision. (Then, if their diet orders allow for it, you bring them ice cream.)

Sometimes you're forced to draw on that trust, spend a little of it, to make sure a patient's decision is well-informed. All of my background experience is in emotional support. A big part of my job as an advocate and doula was reminding people that they are in control and can decline anything at any time. As a nurse, sometimes I have to push against those choices by providing patient education the patient may not want to hear. It feels really uncomfortable. But as my clinical instructor says, they are receiving care from professionals for a reason, and as professionals it is our responsibility to share our knowledge when a patient's choices put them at risk.

I give trust as well. As a student, and a green-as-can-be student, I rely on my instructors and nurses for guidance. We were asked in debrief on our last day of the term what we would like to go back and tell ourselves from ten weeks ago. What I would like to say is that you won't feel ready. Ever. Every day in clinical is just one long string of moments you don't feel ready for, that you will step into anyway, again and again, until feeling truly ready for something starts to feel like a weird exception. You won't feel ready, but, neither will you feel unsafe. No matter where you are, there is a nurse either with you or reachable within moments. Your teacher and peers will be available to offer ideas and feedback. During every procedure I performed, a nurse's sterile hands were just inches from mine, ready to step in should I have needed it. And if something comes up that you truly don't know how to handle, you have the might of an entire hospital behind you.

As green as I am, there are a lot of things I don't know how to handle, but the scariest of these are what I have deemed the 'oh shit' symptoms. You know what they are: crushing chest pain, sudden changes in mental status, sudden limpness on one side of the body, a rash coupled with struggling to breathe, etc. It wasn't common, but there were a couple of times when I was alone with a patient when something came up that meant they needed help from someone more knowledgeable than me, STAT. I stayed with them and hit the call light. I was impressed that even though my heart was trying to pound out of my chest, my voice came out cool and calm, sounding strangely like the elevator voice at the Ministry of Magic as I said, "Hi, I am a student working in room # and my patient is experiencing XYZ. I need help now, please." And then there was nothing to do but get out of the way as nurses and doctors flooded into the room to take over.

So, younger self, know that you are ready for more than you think you are and that there will be a lot of things you have to experiment with or figure out on your own- but, your learning environment is safe. If you or your patient truly need it, there is an entire healthcare team there to support you. Help will always be given at Hogwarts to those who ask for it.

I was on the bus to clinical one (very early) morning, and even though I'd spent hours prepping for my patient the night before, I had a sense that the day was not going to be anything like I expected. (I was right.) As the bus navigated the switchbacks up the hill, I thought about what it felt like to walk into a day of the unknown. A thought came to me that felt deeply significant:

"I am not worried, Harry," said Dumbledore, "I am with you."

I felt a deep sense of comfort, followed by confusion. I was sitting on a bus alone. Who was I talking to?

My first thought was the entire team I was going to be joining: my peers, teacher, nurses, the wider team of healthcare providers. I trusted them, and that was a big part of it, but not all. I was also talking to myself.

Every day at clinical felt like one long exercise of feeling NOT READY, but I was practicing showing up fully anyway, and getting better at it. And every day, I went home. It has been too fast, almost, for me to marvel at how quickly I am growing. Once-scary ideas (like stepping foot on the unit) became more comfortable and my focus would shift forward to taking vitals, then administering medications, inserting catheters, or providing support through complex medical or psycho-social situations. I knew that whatever was going to happen that day would be something new that I wasn't prepared for. Whatever I improvised would not be the best solution, but it would be enough: to address what I could, to get help for what I couldn't, and to serve as a springboard for further learning.

Next term, I will be in a different hospital, on different units with different responsibilities, and the entire learning curve will start again. I don't feel ready. But I will have new nurses and teachers to guide me and a new group of peers to learn with. I am ready to show up whole heartedly, ready or not.

That is enough.

The Skin I'm In

Posted by Lucille on November 20, 2015 at 3:55 PM Comments comments (0)

Some really wise people I know have a policy of not discussing body insecurities, with the reasoning that as a culture we spend way, way more time worrying about our bodies than we need to and that there are almost always more pressing things that deserve our attention. I respect this, and for myself, disagree. More often than not, our relationships with our bodies are complicated. The way we approach this complexity as a culture is problematic, but neither is this complexity served by silence.

I've noticed my thoughts toward my body edging toward adversarial lately, and I think it's time to get those thoughts out of the dark corners of my head and onto the page.

I gained weight last year. I don't fault myself for this-- writing my thesis alone while being continually on call was stressful, and I did what I could to adapt to the situation. I expected that once I was back on a normal schedule, my body would shift back to what I know to be normal for me. I believe in the innate wisdom of bodies, and thought that so long as I supported my body's intuition, it would move back toward homeostasis on its own.

This was my first time trying to lose weight on purpose. To my surprise, it was really hard. Is really hard. Six months into my new schedule, I am still struggling to reverse changes in my body that happened rapidly and without effort last year.

I tried working out and eating a little less, expecting to fill the gap with the calories I had stored. Instead, whenever I started to feel hungry, I also started to feel scared. And then I would eat to quell the fear as well as the hunger, and end up eating more than I would have in the first place. My first few months of trying to lose weight, I actually gained more.

I felt angry, and even a little betrayed. I was body positive! I was exercising! I was eating healthy food! I was doing this all for my health, rather than my appearance! (Okay, maybe a little bit was about appearance. We're all about radical honesty here.) I found myself thinking, "I'm trying to be healthy, body. Isn't that what you want? Why are you fighting me on this?!"

So here's the thing. My body is wise. It's just that that wisdom was hard-earned over millenia, and sometimes, it can be a little out of date. My genes can't comprehend that these days, I am more at risk of heart disease than famine. They have never before experienced food abundance. When my genes tell me to take in and hang onto calories, even when I have enough, just in case there is not enough tomorrow, they are not acting against me. They are trying to protect me, albeit in a misguided way.

Gender plays a role in this, too. Despite gaining about the same amount of weight last year, Travis lost weight much more easily. His genes want him to be ready to hunt and protect me. My genes want me to make babies. Oh my goodness do they want to make babies. This year, especially, my body has decided that getting pregnant is URGENT. It started rejecting birth control methods that had previously worked for years, pushing out two IUDs and rebelling against hormones (with and without estrogen). I am trying to get through nursing school, body! I promise to listen to you on this someday, but this is emphatically NOT the time!

I need a soapbox moment. How do we not have enough long term, reliable birth control methods to ensure all women can find something that works for them? How do we not have any LARCs for men?! How, when there are so many issues with education, access, and options in reproductive health, is abortion so stigmatized? This is the 21st century!!!

Okay. Stepping off soapbox. Back on track.

Sometimes when I'm anxious about school, my body gets ready to run or fight, making it a lot harder to study.

Sometimes, when I'm trying to get to a healthier weight, my body declines, saying, "But winter and scarcity are coming!"

Sometimes my body's goals regarding pregnancy differ from my own.

All of that is my body looking out for me. She is like a loving grandmother, doing her best to help me navigate, not necessarily my world, but the world she used to know. And just like with loving but misguided grandparents, there is not much to do but thank them and love them and go about doing your thing.

My body does so much for me. SO much. Working with patients in the hospital is a constant reminder.

I am grateful for healthy liver and kidneys. I never truly appreciated how much your liver does before working on the transplant floor this term. If your kidneys fail, at least there is dialysis. If your liver fails, all you can do is hope for a transplant, and hope you get one before the your kidneys fail from trying to compensate. Thank you, liver, for working so hard to process and metabolize things to their useable/excretable forms. You are the powerhouse of the body. I'm sorry for underestimating your work for so many years.

I am grateful for healthy guts. They take in just what they need to, and push out the rest. I've seen what it is like for patients whose guts aren't working, even if they are just temporarily sleepy after surgery. Thank you, guts, for all that you do.

I am grateful for healthy bones and muscles that let me get up and go, taking care of myself, letting me be on my feet all day in clinical sometimes to take care of others. Thank you.

I am grateful for healthy senses and the ability to communicate, that together let me take in and engage with the world around me.

I am grateful for a healthy reproductive system that lets me enjoy intimacy with my partner and preserves the option of fertility for me, even if I'm not ready to take advantage of that option yet.

I am grateful for healthy heart, lungs, and blood vessels, working together constantly since the day I was born to make sure my whole body is well nourished with oxygen.

I'm grateful for a perfectly tuned immune system, that works to fight off invaders without ever taking it too far and hurting me.

I'm grateful for a mind that, even when my head is in the clouds, keeps my feet grounded in reality. My brain experiences joy and wants to keep on living and learning. For that alone, I give thanks a hundred times.

Brains Are Funny That Way

Posted by Lucille on November 20, 2015 at 3:50 PM Comments comments (0)

As soon as I stopped trying to make my sleep fit a pre-defined schedule and gave myself permission to just sleep whenever I could, my sleep fell into a rhythm for the first time this term. I felt like every cell in my body took a warm sigh of relief.

A Call to Self Care

Posted by Lucille on November 3, 2015 at 12:45 PM Comments comments (2)

New times call for new strategies.

My sleep schedule got all flipped around over summer break. As much as I tried, I couldn't seem to get back into a routine when this term started. I would be exhausted all day, and then wired as soon as it was time to sleep. My lying awake for hours at night and then struggling to get out of bed in the morning was taking a toll on both me and Travis.

So we had a business meeting. We pulled out our calendars and made a schedule to try to make our bed and wake times as consistent as possible. There were a few exceptions allowed: sleeping in Thursday because my Wednesday is really long, and naps permitted on weekends.

Fast forward a few weeks.

Sometimes things would come up and I would have to go to bed late or get up early, but I was disciplined and would stay awake so that I could get to bed on time the next night. Things were going okay. I made it through midterms. I even did well. But I felt like a mess. I was on edge with Travis in the evenings, giggling one minute and weeping the next. I was getting everything done, and doing well in clinical-- but that subtle shift in perception had happened, from problem solving to putting out fires.

I was taking the trail down the hill from school the other day. I got lost in thought, and when I came back to myself, the words in my head were, "I am not okay."

I took a deep breath, and told myself thank you. I didn't use to talk to myself with that level of clarity.

When I got home, I dropped my school stuff in a pile, went straight to the table, and pulled out a piece of paper.

I had anxious little hampster wheels spinning in my head, worrying about everything you could think of: my relationship, my health, my appearance, my friends, my family, suffering children in Syria, the fate of our country and the world. (Everything except my neglected midwifery application. Even my little hampsters were too anxious to take that on.)

I got a pen and titled the page, "Things That Are True."

I meant it as a counting your blessings sort of thing.

I was going to write about how this program is exactly where I want to be at this point in my life. How it is an accelerated program, which means mastery is not expected-- a semblance of functional competency at this point means I am doing GREAT. I'm doing well in my classes. I'm making wonderful friends (hallelujah). I have great teachers who are pushing me and challenging me, but also making sure my learning environment is safe. I've already had a couple of interactions where I feel like I made a positive impact in someone's care. I have wonderful people who love me and care about me, even when I'm too stressed to be present with them the way they deserve.

That's what I was going to write. But when I put pencil to paper, the first thing that came out was, "I am not getting enough sleep."

I stared at the words I had written and took a deep breath. Okay.

I looked at the clock. It was just before 6PM.

I left my backpack by the door and went to bed.

Travis came home a few hours later, came in to kiss me, and then tucked me right back in.

I didn't wake up until my alarm went off at 6AM.

The next night, I slept twelve hours again.

It is amazing how much more capable I feel with a full night's sleep (and with a full night defined by what my body says it needs, rather than what I think my body should need). Adrenaline is not sleep. Caffeine is not sleep. Sleep is sleep.

So we have a new plan. It's called, "If you can sleep, sleep." If you can sleep, logistically and physically: stop thinking about it and go the hell to bed.

Having different (and variable) sleep schedules is still being a strain for Travis and I, but it is less of a strain than me being exhausted. It means that some evenings (or mornings or afternoons), I'm sleeping instead of being there. But when I'm present, I'm actually present.

Hopefully my sleep schedule will stabilize. Until then, this is a compromise I'm willing to make.

Deep breaths. One thing at a time.

Can you believe we're halfway through the second term already?!

Drinking from a Firehose

Posted by Lucille on October 27, 2015 at 4:00 PM Comments comments (0)

I am on the unit one day a week.

My first day, I was qualified to do vitals, emotional support, and comfort measures.

My second day, I was qualified to do that, plus assessment, hygiene care, and charting.

My third day, I was qualified to do all that plus catheter care, wound assessment/dressing, and medication administration.

Next week there will be more.

And that's all for clinical. There are three other classes.

It's all significant. It's all new. It's a lot.

I am learning so fast, and every single thing I learn is important. It's all I can do to try to integrate the new information, skills, and experiences enough to be ready for the next thing. Welcome to the "existential journey that is nursing school". I feel like a slightly different person every time I walk off the unit, and I find myself rushing to fill friends and family in on what I've done and learned (in HIPAA compliant ways, of course) in the hope that they will still recognize me at the end of this.

Even when that means monologuing about the clinical and spiritual things I learned from doing perineal care for incontinent patients all day long. To my family. Over dinner.

Yeah, not my proudest moment from nursing school so far.

Every new experience is intense in its own way. It's thrilling and overwhelming at the same time. We are in the middle of midterms, so lately things have been tilted a bit toward overwhelming, not from any negative experiences, but just from the sheer volume of it all.

I'm feeling really grateful to my friends in the cohort, for being able to just 'get it' when I can't find the words.

And grateful to my friends and family, for reminding me that they don't need to 'get it' to get me.

Vicarious Grief and Pad Thai

Posted by Lucille on October 23, 2015 at 11:40 PM Comments comments (0)

One of the things we are studying this term is end of life, and as part of that, we were assigned to choose and read a blog that dealt with that theme. Most people chose the blog of someone personally diagnosed with terminal illness. The blog I chose followed a woman's journey through the loss of her first child to infant leukemia, infertility, and, later, pregnancy and parenting after loss. I thought it would be suitable reading for an aspiring midwife, considering that many of the people I work with will have experience with these issues.

I got home a couple hours before Travis one day and decided to use the time to read. Even though the blog was several years old, this mother's grief came through the page so palpably that I was crying before I'd even finished a page. I got up to go to the fridge at some point and saw that Travis had left some spicy pad thai (spicy in the way that I would normally NEVER eat). I grabbed it. Even though I was reading in an empty apartment, it made me feel better about having to dry my eyes every few posts to be able to see the page.

I read for hours. Even though I was crying, I felt like I was doing a pretty good job of remaining in my role as a nursing student, remembering that this was someone else's grief, not mine. The pain in her words was fresh and searing, and empathy kept dripping stubbornly from my eyes, but through it all I was able to look between her words for the meaning that was useful to me as a student. What was helpful to her in her grief? What was not? What did she need? How could a nurse address that?

And then I got to a post where she talked about looking back at her past self, at her innocence and naivete, with anger. She was in so much pain, and she unleashed it on herself, wondering how she could have been so carefree, how she could have possibly NOT KNOWN that this was where her life would take her. She looked back at a picture of herself at around my age with what I interpreted as disgust, and said that in her first semester of college she had been hospitalized with a misdiagnosed sore throat, and that at the time, she actually thought that she had really been through something.

This sudden striking similarity whipped me out of my academic head space and into the raw reality of what she was living through.

I lost it.

And of course that was when Travis walked in. Right then. To me bawling over his pad thai.

He dropped his things and ran over to me. "What happened? Why are you crying?"

I tried to explain through sobs that I was crying because our baby was going to die, but i don't think it did much to clear up the situation.

Travis reminded me that our baby was not dying. We do not have a baby, because I have never been pregnant.

It's amazing how helpful having someone calmly repeat the obvious can be.

I was laughing at myself and blowing my nose when he noticed the pad thai.

His mouth fell open in shock. "Did you eat this?! This is spicy pad thai! It's like ten times spicier than the spiciest thing you eat, ever! You ate this? Really?"

The fact that out of the entire situation, this was what surprised him, broke me open with love and gratitude all over again.

Coming home to me bawling because a stranger lost their baby almost a decade ago-- par for the course. But me eating his spicy pad thai? Mind-blowing.

Snapshots

Posted by Lucille on October 22, 2015 at 1:15 AM Comments comments (0)

Being someone's student nurse is very different from being their doula.

The situation is different, obviously. The people I care for are sick, not pregnant. The role is different, in that I am providing not just emotional/physical support, but nursing care.

But so far the biggest difference that has struck me is the difference in time.

I miss the continuity of getting to see the arc of someone's experience. As a doula, I wasn't there for a client's whole story, but I often got to walk with them through a full chapter of it. As a student nurse, I get snapshots. The day after someone's surgery. A day in someone's recovery. The day they were diagnosed with a complication. The day someone who had been hospitalized for months finally went home.

I get a brief, intimate window into the present moment of their life, and then the next day, I do the same with a new patient.

It's against HIPAA to look up a patient's chart just to see how they're doing. As a student, I actually can access a patient's chart for a while after I'm done working with them, just in case there was something I didn't understand about their care that I want to look up. I'm doing my best to consult them only for that purpose. It's hard. There's a reason having a patient is called caring for them-- you can't have that intimate a role with someone and not care about them.

I can't contact any of the people I've cared for to let them know I'm thinking about them. But I hope they know.


Rss_feed


Subscribe

Facebook Like Button

HIPAA Disclaimer

Sometimes I have the privilege of being a part of intimate, powerful moments in other people’s lives. I cannot and would not share these stories, because they are not mine to tell. However, they touch my life and become part of my own story. When I share these moments here, you can trust that I have not broken anyone’s confidentiality. The characters are invented. They are not real, but could be. I take creative license to communicate the essence of my experience while respecting the privacy of others.