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Author: thewriterlyroad_2o62in

Under the Influence

December 23, 2012

This week is the end of a module in our nursing program. As a clinical instructor, I must give the students their final evaluations, a sometimes painful process in which I sit down with each one and tell them whether or not they’ve passed the clinical rotation.

For the most part, giving and receiving evaluations is a happy, even fun, experience. Students are truly excited and proud to learn they did so well. They are spending a lot, both in time and money, and they are busting their tails to succeed. They have a lot at stake.

If you ask each student why they chose nursing,  you’ll get a different answer from each one. But often there is one theme that runs like a vein through every answer: someone in their family–usually their parents–wants them to become a nurse. It wasn’t the student’s idea, but they are going along to make their parents proud.

This rotation one student did not pass the clinical. She was one of the weakest in the rotation. Unable to transfer theoretical knowledge into the clinical setting, she can’t give rationales for her answers to NCLEX review questions, and she struggled and failed to pass the math and dosage calculation tests. I worked with her, tutored her, and offered assistance with her care plans, but ultimately none of this helped. She simply didn’t rise to the level expected.

There was something else: she wasn’t coming to me for help on her own. Other than the times we had mandatory math tutoring, I never saw her. Also, she didn’t seem upset about the fact that she was doing so poorly. She wasn’t resigned, she was indifferent.

When I sat down with her and explained why she did not pass, a single tear leaked out of her left eye and trailed down her cheek. Then she said, “Okay.” That was it. Nothing else. It surprised me that she wasn’t more upset, but I can never gauge exactly how a student will respond to failing. I assumed she was a little stunned and that’s why her reaction was so minimal.

Later that day, she went and spoke with my Program Coordinator. After the student left the office, I sat with the Coordinator and asked about her conversation with my clinical student.

“Well, her tears dried quickly when she told me that she doesn’t want to be a nurse.” What? I thought. I had no idea.

My Coordinator continued. “I asked her why she enrolled in the program. She said her mother wants her in nursing. I asked why she thinks her mom wants her to do this. She said, “My mom wants me to have the title.”” Clearly, this is not what the student wants. After hearing this, her indifference made sense to me.

Nursing is a hard profession, but it’s especially hard if you don’t want to do it, if you’re just appeasing someone else. Are you willing to deal with all of the unpleasant aspects of nursing: the smells, the long hours, not being able to go to the bathroom for hours on end, not being able to eat for hours on end, and unappreciative patients and doctors? If the answer is yes and you love what you do, you can work around the other stuff.

What you can’t do is allow others to influence what you choose for your life’s work. That decision is too important, so base it on your passion to do a certain type of work and your belief that it is your calling.

If you do that, everything else will fall into place.

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How Do You Know When It Is Real?

February 13, 2013

On the eve of Valentine’s day, I’m ruminating on a different kind of interpersonal devotion: the devotion some nursing students feel towards their instructors. Or should I say, the devotion some nursing students pretend to feel towards their instructors. Sometimes I can’t help but wonder whether everything said to me by my fresh-faced students is the real deal.

I have had so many amazing students pass through my clinical rotations. In my mind, the list is long of wonderful personalities, compassionate and thoughtful patient care, and well-crafted care plans. The students work so hard, are so committed, and are so chronically sleep-deprived. It takes a special kind of masochism to put yourself through nursing school, but they endure it. At the end of the rotation, I am fortunate to hear most students singing my praises, telling me how much they appreciate how much they’ve learned and how great I am.

Then there are those I can’t quite believe.

Often it’s a compliment about my hair or the sweater I’m wearing. These are students who never speak to me outside of class or the clinical, but all of a sudden my fashion choices are inspiring. The smile always gives it away: it is too bright, too toothy, too…needy.  And I know my bullshit meter is not finely calibrated enough to tell the difference between sincere appreciation and false flattery. If you’re a student and you’re lying to me about being sick or your missing care plan, I can smell a rat a mile away. But if you fool me with praise, I get all turned around and can’t find my way back on the path.

What does it matter, you may ask. It matters because I pride myself on being a straight-shooter. What you see is what you get, and I like the same in return. I don’t do well with subterfuge, and I don’t like feeling that people need to put up a facade in order to interact with me. I like real, whether it’s the boyfriend who expresses their love on Valentine’s day or the student who swears I am “The most awesome–ever.” If you don’t truly feel that way, just don’t say anything.

Does my lack of finesse in this realm make me a bad teacher, weak, or foolish? I don’t know. I try to remember that for so many of these students, it feels like their life and their future are on the line. They are desperate to make a leap in a positive direction and will do all kinds of things (some honest, some manipulative) to get to the finish line.

I can’t fault them for their tenacity, I just wish I was better at figuring it out.

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Just Choose

June 15, 2013

I am one week away from a major life change. I am leaving my teaching job in California, packing up some stuff, giving even more stuff away, and heading to Austin, Texas.

When I say this out loud, people look at my quizzically. They aren’t sure they heard me right. Texas? Why on earth would you want to go to Texas when you already live in California? Of course, the thinking goes, EVERYONE wants to live in California. If you don’t want to stay here, you are missing the point.

My answer doesn’t make them feel any better.

When asked why I’m moving to Austin, my answer is: why not? I’m not married and don’t have children. I don’t have any other family living in the area either. Sure, I’m giving up what many would consider a “good” job, but I am a nurse. I have faith I can find a job no matter where I go.

Besides, why do I feel compelled to justify every decision I make? Why isn’t it okay to choose something and go after it? Why is everything a debate?

I need to make it alright to just choose and then just go. I spend so much time agonizing over the alleged “right” or “wrong” decision that I suck all the joy out of a new and exciting adventure.

While I might not know how my move is going to end up or even if I’ll be happy in Austin (I really hope I will be), I do know this: It’s okay to jump. Check the depth of that pond before you swan dive through the air and make sure there aren’t any rocks directly in your path. Beyond that, you just have to let go and make the leap.

The leap makes you free.

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The End of the Shift

September 15, 2015

Tonight I can write the saddest lines.

To think that I do not have her.

To feel that I have lost her.

To hear the immense night, still more immense without her.

And the verse falls to the soul like dew to the pasture.

–from ‘Tonight I Can Write’ by Pablo Neruda

Yesterday I lost a dear friend.

I’ve known Andrea for over fifteen years. We met and “worked in the trenches” together at an urgent care in San Diego. Later, she became my supervisor in the same urgent care. She never let the title go to her head, though. She was just as down-to-earth, spunky, and kind as ever. She was the supervisor every nurse hopes to have: she supported her nurses and showed us genuine respect.

Andrea was so much more than an amazing nurse. She was a friend to many, a wife to Brian, and a mom to a lovely three-legged dog named Gracie. Andrea was also a long-time diabetic who, after years of suffering with the disease, received the gift of a kidney/pancreas transplant. Despite being cured of diabetes, she continued to work tirelessly and volunteer her time to help raise money and awareness so that, one day, no one would have to live with this debilitating and life-shortening disease.

Her energy was boundless.

Last year, when I decided to become a living donor and give one of my kidneys to my friend David Ybarra, Andrea was my touchstone. She was someone I could speak openly with about my fears and hopes, who truly understood what it meant to share such an amazing and unique gift with another human being. She helped me to navigate successfully the complex and sometimes overwhelming emotions associated with organ donation.

She held me in high esteem, even when I doubted my abilities and felt like a fuck-up. She always reminded me what a wonderful person I am, how smart and capable, how kind, and (with that Wisconsin accent) “Oh my gahd! That voice and that hair!”

Just like with her patients, she saw the good in me and shone a spotlight on the most positive aspects of my personality. During the tough times, she reminded me I would make it through and come out whole on the other side. These are the same qualities embodied in an exceptional friend and nurse.

My shock at her loss is matched only by my belief that the world has lost a vital, bright spirit.

Andrea, even though I told you on more than one occasion how much I appreciated you (and thank goodness I did), I will never be able to thank you enough for everything you meant to me. As a friend and a fellow nurse, you are deeply missed by all of us who loved you and remembered for the countless lives you touched.

Your shift is over. It’s time to go home and rest.

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The Waiting Room: Excerpt from Memoir

Snow makes the world silent. The streets of Aurora are deserted. It is three nights before Christmas in 1991. My big Buick Le Sabre—like other items in my life—is a hand-me-down from my parents. The blue beast rolls along, crushing the snow beneath her weight. She is not a pretty thing, but her heft ensures my safety. The Buick was stolen once from outside the nursing home where my mom works. When the police finally found it and returned it, my dad knew how the thieves carried out their crime. The steering column was busted open. My father didn’t repair this defect; instead, he put a start switch underneath the console on the driver’s side. After I flip the switch, I use a screwdriver inserted into the steering column to start the car.

I was one of the closing servers at the restaurant where I work. My co-worker Diane suggested we get breakfast after finishing our side work. We spent several hours eating cheesy omelets and hash browns, drinking coffee dosed with milk and sugar, and talking. I pull up across the street from my house. My parent’s new Buick and my younger sister’s Pontiac are not parked on the street outside. That’s weird, I think. Where could they all be at this time of the morning? Last minute Christmas shopping?

I go inside and look around. The lights in the kitchen and living room are on. Our Christmas tree stands in one corner of the living room next to the window. Small, white blinking lights adorn the tree as well as round and odd shaped Christmas ornaments, and those aluminum-looking fake icicles which always fall all over the floor and clog up the vacuum cleaner. Presents of all sizes litter the floor.

I walk past the kitchen down the hall. My parent’s bedroom is the last room on the right. Their light is on too. I look through the doorway. The bed is in disarray, and empty. On the floor next to the bed is a white t-shirt with a yellowish-brown stain on it. Something about that stain prevents me from looking around any further. I leave the t-shirt on the floor, turn off the light, and go to the bathroom to start getting ready for bed.

I have already washed my face and put on my long red and black flannel nightgown when the phone rings. It is my sister Cheryl.

“You need to come to the hospital,” she says.

“Why? What’s going on?”

“Mom’s had a heart attack. You need to come.”

“Oh my God. Is she ok?”

“You need to come. We’re at Aurora Presbyterian in the emergency room.”

I quickly change into a pair of jeans and a sweatshirt. I grab my coat and run for the front door. As I hurry to my car, I can see my breath coming out in big white gusts, like a thoroughbred racing through the night air. There is no noise, only the sound of my boots impacting the packed snow. It is snowing again. It comes down in big, fluffy flakes. One lands on my left cheek and melts.

The hospital is six blocks from our house.  As I drive my hands grip the steering wheel. Even through my gloves, the wheel is freezing.  Please don’t let her be dead. Please don’t let her be dead. Please don’t let her be dead. I wish it over and over and over into the biting air, all the way to the parking lot of the hospital. 

The hospital is decorated in twinkly red, blue, and green Christmas lights. They look like small colored icicles. There is a big inflatable Santa Claus propped up outside the main entrance. His left arm waves back and forth in the air as a gesture of welcome. His rotund belly and ruddy cheeks irk me. Why is that fucker smiling?

I find the entrance to the emergency room once I enter the hospital. At this late hour three days before Christmas, it is as quiet as a church. I go to the receptionist desk, but there’s nobody there. I look to the left to see the waiting room. Beyond the grimy chairs and televisions suspended from chains in the ceiling is a room enclosed in glass. My two sisters, my brother, and my dad are in there, an aquarium of family fidelity. My dad is in the middle, and my sisters sit on both sides of him. My sister Cheryl tucks into the crook of my dad’s right arm. He is holding on for dear life. My sister Catherine sits in the middle of the room. Her wheelchair won’t fit anywhere else. My brother Steve and my sister-in-law Liana sit a couple of chairs down on the right. My father’s eyes are red and watery. Even at a distance, his vulnerability is palpable.

I walk towards the room, and my dad looks up and sees me. He looks up and locks in on me. I know my mom is dead. I hear someone saying, “She’s not dead! She’s not dead!” It is the cry of a wounded animal, a shrieking, high-pitched wail. I realize the person screaming is me, and I can’t stop. I have to get to where my family is but my legs won’t work. I sit down cross-legged on the floor near an empty Doritos bag. I keep saying, “She’s not dead,” but soon this is unintelligible because of my sobbing.

Cheryl comes and picks me up off the floor. I go to my dad, and he grabs me and hugs me harder than he ever has in my entire life. I can feel his breathing, jagged and broken against my winter coat. Tears run in rivulets down his face.

“We lost her,” he says. “Oh God, we lost her.” He sobs uncontrollably. I cry too, along with the rest of my family.

We sit in this room and time recedes. A nurse comes in and tells us we can go in and see our mother, but we cannot touch her or move anything attached to her body. I have no idea what this last part means, but I nod my head in agreement. My dad, Cheryl, and I get up. My brother, his wife Liana, and my sister Catherine do not go with us. None of us talk about why we’re going in while they are staying. We are operating in unknown territory.

I don’t see any other patients or families. We must be the only people in the emergency room. We follow the nurse down a long hallway. As we move away from the waiting room, the air becomes cooler. The nurse brings us into the room where my mother’s body is lying on a metal gurney. She has IV tubing inserted into both of her arms, and there is a plastic breathing tube in her mouth which is taped to her face. Her face is a yellowish-bluish color.

Despite the nurse’s instructions, my dad lunges for the gurney.

“Barb, oh God,” he says. “No, no, no Barb,” he cries. My dad grabs my mother as if he wants to hug her or pull her off the table and take her with him back home. Cheryl and I each catch one of his arms and tell him to stop, that he’s not supposed to touch her. He isn’t listening. He keeps repeating my mother’s name and holds on to the side of the gurney.

We stay in the room for a while longer. The same nurse comes back to the room and asks us if we want to speak with a grief counselor. My father shakes his head. We go back to find the rest of our family, still the only people in the waiting room.

“We have to go home,” my dad says. “We need to clean and get the house ready for condolence calls.”

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