Monday, August 17, 2009

My Last Shift as an Educationally Unadulterated Nurse

I finished my final contract up North on Thursday. Suffice to say it has been quite an interesting summer up there. The majority of the docs were very supportive and excited about the fact that I was going to medical school, and thus gave me as many teaching opportunities and hands on experiences as they could.

Last week I did my first subcuticular sutures with a facial laceration (under the direct observation of one of the MD's). I was brought back to one of my first shifts as a nurse in the ED when this patient came in who had been hit in the face with a broken beer bottle. His cheek was basically hanging in a flap about the size of a coffee-table coaster, off to one side. He came in from the bar hollering some story about how he had just been breaking up a fight between a man and a woman, how he'd been minding his own business, etc. etc. Amazing how he didn't work a burning bus and saving a poodle into the whole chain of events...regardless, his face was a mess.

I tried to watch the ED doc fix up this man's face. It involved many many subcuticular sutures and the whole laceration was very large and seemingly complicated. I had to keep leaving the room for fresh gulps of air because looking at this guy's cheek-hamburger was just a little much for my young nursing eyes. I was fascinated and totally impressed at this physicians ability to restore this man's face, but the 'everything-going-red-in-the-corner-of-my-vision-is-that-the-spins-now?' part was forcing me to step outside from time to time. When it was all finished, he had one line of sutures falling along his laugh line, from just beneath his eye crease to the corner of his mouth. It looked fantastic. I recall thinking--I really wish I had the skill and stomach to do a repair like that.

Fast forward 6 years--HEY! I did it!

It was by no means as beautiful and artistic as Dr. S's repair many moons ago. But I suddenly realized that I was doing a procedure that I could hardly watch in the past*. It was an exciting night for me and I was very pleased with how the final product turned out**.



These confirmations that I am doing the right thing by choosing to go into medicine are coming faster and with greater frequency than before.

During my last shift as an unadulterated-by-medical-school-nurse one of my colleagues commented on the fact that I was entering a different phase in my career which had no turning back.

It is true. I've thought about how from now on I will have one foot on the lily pad of nursing and one on the lily pad of medicine. I think there will be times where this divide is going to make for some interesting interpretations of my role with patients and co-workers. I wonder how I'll feel the first time I ask someone to do a task that I am normally expected to do. Why would I ask a nurse to put in a cath when I can do it myself? Or put a dressing on when I can do it to my liking in less than one minute?

I know these issues are a long way off as when I return to Canada to work in the summer I will be working with the constraints of my nursing license during the day, and trotting around behind docs as a med student by night. Still, I wonder how others have made that transition.

I was in the shower the morning of my last shift. I could feel a small lump in my throat as I thought about all the wonderful colleagues and friends I would be saying goodbye to. Life, so far has been nothing if unpredictable and though I do plan on returning to the ED I once haunted, who knows when and how that will happen.

Nursing has done me well and I have learned many many valuable lessons about standards of care, the focus of the different professions within health care, the opportunity for nurses to develop unique bonds with patients and family members, and the importance of having strong and super-smart nurses on the floor with you.

I have had the chance to visit remote parts of Canada and India because of nursing...I was able to work 6 months a year and travel, ski, cook, and climb the other 6. Overall it's been a sweet gig and I cannot pretend that I will not miss many aspects of it.

And so, in less than 2 weeks now, a new chapter begins. I hope that I will be able to continue with some interesting content on this blog...but if past performance is any indicator...the postings will start rolling out as soon as the studying is supposed to start (note last summers daily blog postings as I was meant to be studying for the MCAT).

Thanks for coming along for the ride.







*This bodes well for when I get into the OR, but that is another story altogether.
**Photo taken and used with patients permission.

9 comments:

Keet said...

Go forward and mumble mumble something wise. I can't remember the cliche i was about to unleash on you. I'm very proud of you, who convinced me to ditch my zoological dreams for a career that has led me as far and near to a home and myself as possible. Best of luck! See you soon!!!

Albinoblackbear said...

Awww...thanks Keet. It was all over a boston brute--remember? ahahah
Now what kind of restaurant will I have to take you to in order to bring you to the dark side of medicine now?

Rob said...

Good luck, ABB. Congratulations and best wishes on the next chapter.

WWWebb said...

God bless, you'll do fine.

You have my email- feel free to use it if you want the opinion of an old fart...


i expect to see blogposts from time to time.

And stay away from the karaoke, okay?

Albinoblackbear said...

Rob..WWWebb...gentlemen...thank you.

Man, I 'rokeed a few days ago and fell backwards over a plant while singing "I'm So Excited". I managed to frig my knee and the worst part is I was stone cold sober. The highlight of the night was (in my humble opinion) me completely massacring the Macarena. You just can't buy that shit with a gold card.

Bostonian in NY said...

good to hear you've got control of your vagal tone...and nice lac repair!

Med school is a strange, strange trip indeed...you'll be fine and your nursing experience will give you a more grounded approach to your patients and co-workers. Congrats on finishing up your contract!

Albinoblackbear said...

BINY--Why thank you! I was like a 5 year old for the next couple of days--"come see my lac repair! Come see my lac repair!" hahhhaha. I am so pathetic. Sigh. He was in our ICU for several days after so I was able to keep an eye on the healing...

I am starting to get less stressed about the social aspect of school, we've got a facebook group now (of course) and plans are afoot to go out the day before classes start. I can already tell that there are some interesting cats in my group.

The main thing I am worried about now is who I am in the dorm with...but that mystery will not be revealed for another week and a half...

Yes, I am glad to be done for now, though I am sure that before too long I am going to wish we were in clinical...

Old MD Girl said...

You are going to be a kick ass doctor. And who knows, perhaps surgery is in your future.... That was some pretty nice handiwork!

Albinoblackbear said...

OMDG--Thanks! That is always nice to hear. In terms of surg, unless there is a condensed 'discount Jim's school of surgical residency--only 2 years!' I doubt it'll be my choice...I don't really want to be 40 when I start my career. Not that that is much better than the projected 37 I suppose...hmmm...