Saturday, December 18, 2010

And I'm Done

After 18 long months, it is over. Now what? I think I'll start with sleeping in and catching up on reading. But while I contemplate what I really want to do, I'll leave you with my speech from the other night that I delivered to a group of nursing alumni from my alma matter.

As I sat and attempted to write this speech I struggled with how to organize my thoughts. In-between submitting my paper on global health financing initiatives and another paper on cryptosporidium, I realized that this was the first non-academic or work related thing I had written since finishing in this past Tuesday. How could I possibly write something with no formatting guidelines, no page limit, and no profound questions to analyze? What is a girl to do? But then it came to me….SBAR.

Here we go.

I’m a xx year old Penn graduate, now 3 ½ years out of getting my BSN. I work full time as a senior staff nurse in the Burn Unit at BigNameHospital. As of this past Tuesday, I completed graduate school at Columbia earning and MPH with a concentration in health policy and management. Despite, two fancy degrees I still don’t know what I want to be when I grow up.

I don’t know about all of you, but when I applied to college I questioned if I really wanted to be a nurse. In all honesty, I was choosing between architecture and nursing. (Yes, clearly I had some internal conflict). But then I went to an open house at the Marriott hotel in Newton, MA and met M.S. who sold me on Penn and nursing. So I guess you can blame her for having to listen to me this evening. But I also have to thank the Hillman foundation for it’s integral role in my transformation from country bumpkin (as my mother affectingly liked to call me) to city lover. I don’t know if I would have chosen NYC on my own, but I can't imagine living anywhere else and I’ve had so many amazing experiences here. When I tell people that I work in the burn unit, I get one of two responses: “ WOW! You are a saint. or Eww! Why did you chose that?”

Here’s how I got there. During college I spent one summer living at home working the ED at BigTeachingHospitalBoston and I was hooked on the adrenaline rush. I loved the train wrecks, the codes, and drunks (they really did have the best one-liners). The following summer I externed at FancyChildFocsuedHospital on the surgical trauma floor and realized that although I loved the kids, maybe I didn’t love their parents. But then came my senior year of college and I had to make a big decision, where to do clinicals? Of course I chose the ED at BigNameHopital. I walked in the first day to mass chaos. I was assigned to preceptor who wanted me to dive right in. He told me that I better learn to walk the walk and talk the talk. And I did just that. But when it came time to get a job, working in the ED would mean getting into the ED nurse residency program. I thought it was a sure thing. I mean, I was a student there. They loved me, right? And I had a degree from Penn! Wrong. It wasn’t in the cards. But that’s okay. After I cried for about a week thinking my life was over, I got a call from the recruiter asking me if I wanted to interview for the Burn Unit. I hopped on the train and interviewed. A few days later they offered me the job. Now here we are 3 ½ years later.

I must admit, I secretly thought that by working in the Burn Unit I’d meet a nice firefighter for a husband. I’m sad to report, though, that hasn’t happened YET! But back to being a nurse. Orientation was rough. I had 38 different preceptors, yes I said 38. The one on the first day called me useless. The second day I passed out during wound care of a patient whose extremities had been blown off in a 3rd rail electrical accident. I was off to a great start. Somehow I made it through my 16 weeks of orientation. And then it happened, I had got my first big admission. A 5 year old kid with 60% TBSA. He was a mess and we thought he was going to die that night. I was there when his mother saw him for the first time and helped catch her as she collapsed into hysterics. However, the worst was yet to come. That night, the kids father was escorted to the bedside from Rykers shackles and all. I listened to him say goodbye to his son. But somehow he made it through the night and the countless surgeries, bouts of sepsis, and the rehabilitation that occurred over the next four months. And then I came into work one day and experienced a true gift. I found out that he was going home and I had the privilege of discharging him. I felt like everything had come full circle.
I could tell more stories about patient miracles and tragedies, or the frustrations of the being the charge nurse, or the comedies precepting, but we all have those. That's the beauty of nursing--something new and different everyday--even if some of them make you go prematurely gray!
When I decided to go back to school full-time last September (and stay working full-time) everyone asked me why and called me crazy. To be honest, I wanted to see where else I could apply my nursing background and in what other ways I could influence both patients and healthcare. I did gain some valuable skills in the classroom, but it was my experiences outside of the classroom during my summer internship and doing consulting work for clients that gave me the most fulfillment. This past semester with two classmates we developed an evaluation strategy for all ambulatory care network programs at BigHospital and last spring I evaluated a multiplayer data reporting project for the NYBGH. Did you know that nurses are involved in disaster planning? Me neither until this summer when I was asked to join the taskforce. But what is my point? My time at the beside has provided me with not only an invaluable set of skills, but also real world experience that gives me a unique perspective to healthcare and health systems issues that can be applied outside the 4 walls of a hospital room.

Keep an open mind. Don’t close yourself off to opportunities. Absorb as much as you can, but there will always be more to learn. Be proud to be a nurse.

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