Pop

This past week, our little class of returning nurses went to Other Famous Hospital (which is to say, the same illustrious institution where my dad was hospitalized for two weeks last fall) for our initial orientation to our clinical placements. Tucked around a conference table in a claustrophobic room on the first floor of one of the more historical buildings in the medical center, we listened as a preppy blond woman walked us through a packet of hand-outs. Afterwards, she led us to a basement office to get our temporary IDs and then to a 10th floor office to fill out computer access paperwork. Finally, she gave us a bit of a tour. It's a vast place--multiple connected buildings, a zillion floors--and I actually was kind of glad to know my way around a little bit already (even if some of the memories stirred by the various locations made my chest clench). I think I would have been utterly overwhelmed if I were seeing it all for the first time. We walked around quite a bit, got oriented to cafeterias and cafes didn't really do more than look at the actual clinical units they're assigning us to. My understanding is that they haven't yet finished lining up all the preceptors.

This whole program, we students have privately agreed, seems pretty loosey-goosey in a lot of respects. We get information in dribs and drabs, and still don't know when our clinicals will actually start. What's funny is that from what we can tell, this is actually the tightest-run program of its kind in our area, though it does sort of make sense. There are no particular certification requirements for nurses returning to practice--we have RN licenses, and anything beyond that is at our own discretion (and that of our prospective employers). If a hospital wanted to hire a nurse who hadn't touched a patient in 20 years, they legally could, so long as she had kept her license active (in most states that requires documentation of a certain number of continuing education hours plus writing a nice little check every couple years; in some states, though, you only need the check). So there aren't any mandates or even guidelines for nurse refresher programs to follow.

Anyway, a couple of class sessions ago, our primary instructor announced that they'd already had a request for a returning nurse/student from our program from one unit that had never participated before--would any of us be interested in doing oncology? Everybody else made "uh-uh, not me" kinds of noises, while I felt a sensation in my mind that was kind of like a little *pop* . The sound of a piece fitting into place, I guess, or maybe of a membrane breaking. I want to do oncology. Oh my goodness, of course. I hadn't known, and then she asked, and then I knew, just like that. I didn't want to be too quick and greedy, in case my classmates would think I was pushy, and what if somebody suddenly realized that it was the perfect thing and I stole it from them, but as soon as a small but decent interval had passed, I raised up my little hand and said, um, yes, I would.

And ever since then, I've felt actual, positive anticipation of getting started. When I was assuming I was going to be doing general med-surg, I was kind of looking forward to getting started, at least in a let's-get-the-show-on-the-road kind of way, but it also was looking like a very long spinach-liver-7th-grade-gym kind of experience. Good for me and humiliating in approximately equal measure. But thinking about doing oncology, I guess it's that I feel like I, personally, actually have something to offer. It's not just something I'm doing to have done it, to pay my dues and learn my lessons and make my nursing career grow big and strong, all while sucking at it in a major funny-pathetic way. Oncology seems like a place I might actually belong, where who I am might be as much a help as a hindrance. Even if I still suck at fitting everything I have to do into a shift, and I'm raw-green-new at a lot of procedures, and don't know my [patient's] ass from my [her] elbow in physical assessment, it still changes the whole gestalt. Pain, suffering, fear, joy, presence, uncertainty, life, death. That I can do.

And meanwhile, in class, I've been learning or relearning all kinds of good and useful stuff, which has been heartening and kind of exciting in itself. Interpreting arterial blood gases, which kinds of IV fluids you use in which situations, heart murmurs and split S2 vs. S3 vs. S4, what a pleural friction rub sounds like. Today we had an amazingly good lecture on wound care, and the lady who gave it (a PhD nurse) actually works at Other Famous Hospital, and invited us to give her a call if we ever have questions while we're on the floor.

I kind of could go on and on, but I've been trying for 5 days now to finish this one measly post, and I need to go to bed now. The beauty of the blog is that tomorrow is another day.