Preceptorship???

Before we started our last summer rotation in pediatrics, our managing director handed out preceptorship applications. This was one of those things in July that stressed me out, because in a certain sense, I had no direction on what course to take with regard to specialty. I talked to my Labor and Delivery OB clinical instructor (she's been a nurse for over 30 years) and asked her advice. I thought she'd push me to request a rotation in maternity or public health since she wears her hats so proudly, but instead she asked me what I thought about my nursing school experience.

Contemplating the journey, I was at a loss for what to think because I came into nursing with so many preconceived notions about what I wanted. Initially, I thought, I'd be one of those ICU experts who would enjoy the 2:1 patient ratios, and 1:1 with higher acuity...I also harkened back to my experiences with my father as a patient, my daughter as a pediatric patient and those I loved who succumbed to cancer. Did I want onocology? Did I want pediatrics?

Pediatrics was about to begin and I had not idea what to expect. I asked to be put with the sickest kids to see how well I'd function, but this wasn't a part of the consideration for precepting, because the applications were due before the rotation began, so I stewed for about a week.

My clinical instructor asked me the following week and I explained my dilemma. She then said without missing a heartbeat. "You need a solid foundation, one that will get you employed at the end of this" Go back to basics...go to med-surg. Hmm...really? Yes, give a bunch of meds, do a lot of IVs, procedures, reports and care and refine your style of nursing...do that for yourself.

She told me about a nursing student at another school's campus who had idealized everything about her nursing school experience and was thrust into the Veterans Hospital for her preceptorship. She reluctantly went and found out that everything she ever needed to know she learned at the local VA hospital. That sounded very appealing to me. I contacted this nurse and she said she tried two different settings in my area, one a private, not for profit hospital and the VA. She preferred the VA.

This got me thinking about Comrade X (who is also a VA nurse) and it occurred to me that all the things I love about nursing; the advocacy, protections, education that nurses offer to vulnerable clients could be well served at the level of serving our nation's veterans. It was an epiphany.

I think the nursing director at my school was surprised by my request, but when I turned in my application, I was convinced that I needed to serve in this capacity to launch my nursing career. Giving back doesn't always necessarily mean making tons of money. Sometimes, it just means doing something that we feel called to do.

Post Partum last day - Week 5 - Newborn Nursery

I had the chance to hang out again the nursery at the end of my rotation. The baby assessments were interesting and fun. I enjoyed checking in on the new ones, showing the primips (first time moms) 'the tricks of the trade' when it came to taking care of, holding and feeding their babies. It was a great opportunity to share motherhood as well as nursing.

The nurses in PP were all long timers, meaning they had their teams in place, the colleagues they liked and trusted and physicians they preferred to work with. They were willing to work with the students who wanted to work hard and learn. Overall, it felt like med-surg without the meds. We did vital signs every shift unless orders specified more frequently, we took out a lot of c-section staples, talked to the moms about their babies and what to expect in the first weeks. Mostly, we had long philosophical discussions with our clinical instructor about the present state of nursing and health care. The agency I was at was a teaching hospital, so I enjoyed working with the medical students and nursing staff. Mostly, I loved welcoming new little people into the world.

Triage - IV practice, no laughing matter

I missed my triage day because it was scheduled on a day off...but that didn't stop me from eventually getting in there one way or another.

I had a very slow last shift of labor/delivery. I was following a grouchy nurse who wasn't a big fan of students, so we spent the first half of the shift playing hide and go seek. I stocked her patient's room, helped the OB put in an internal fetal monitor and then she did the disappearing act. Rather than play the game with her (I've seen this with my classmates), I headed over to triage to see what Trude was up to. She was super busy. She promised me an IV stick at the first opportunity. so when she called me in on a difficult patient second triage in as many days due to dehydration. I gathered everything I needed to get it started, prepped the patient, found the scant trace of a vein and went in quickly. She screamed. I could hear my sister from another mother snickering in the hall. Ooops. Three RNs and 4 sticks later, the IV finally was started. The care nurse signed my stick sheet with the words "a very difficult stick." All I remember is Trude laughing.