6 weeks

That's all I have left and I am done with nursing school.  I am excited, I admit it.  More than that though, I am terrified.  This quarter has been very humbling for some reason.  I guess I walk into clinical each time knowing that my last one will be in just a few weeks, and I get worried when I realize I am doing/seeing a relatively common nursing procedure for the 1st time, or when I have no clue about something.  I get worried when I realize that I have really good physical assessment skills... as long as I can just go through the motions and never have to actually pick out any irregularities.  Ok, some I am okay at.  I can tell if someone has edema (swelling) in the ankles, for example, although my edema rating skills are somewhat questionable some days.  There are some things that I need a lot of work on though.  Last week, I had a patient with a heart murmur.  I knew he had a heart murmur before I ever went in there to listen to his heart.  Despite knowing that it was there, I couldn't hear it.  I had to have my professor come in and listen with me and tell me what I was supposed to be hearing.  There is no way on this earth that I could have walked in there all by myself with no previous knowledge of his murmur, listened to his heart, and picked up that it was there.  I couldn't even pick it up when I knew it was there.  Those are the things that scare me.  I know that I will begin my career in real life nursing with training, and I am sure it will be extremely helpful, but I still worry that I am completely unqualified to do this.  How can I get out there to employers and tell them they should hire me when I am not even sure they should?  Yes, it's scary.

But then there are the moments when I remember what it's about.  Today was one of them.  I have actually been dreading this day for 2 terms, and most particularly since the beginning of this term.  I think I talked about it on this blog 2 terms ago when we did this experience.  I did it again this morning.  Drexel hires actors to come in and pretend to be a patient with a certain condition. This time, they gave us 20 possible conditions our patient might have to help us study.  The day of the experience, called the simulated patient or SP experience, they lead each student outside a different patient's room (in this special lab they have designed for this) and we read a very quick and short explanation of what our patient is doing in the hospital. Moments later, an overhead speaker system instructs us to go into the room and it begins.  We take a history on the patient, perform a physical based on the patient's condition and the information obtained in the history, and we do some patient teaching as appropriate, all within a certain time frame.  It's just sort of nerve wracking because they video record the whole thing, and it is, essentially, an exam.  After it is over, we have to go back in, and the SP talks about how they felt as a patient in our care.  This part isn't about what we forgot to do in our history, physical, or patient teaching.  It's simply about how they felt.  I could tell from the beginning that my SP was a very nice person, so I wasn't horribly nervous when it came time for this part. But my SP was generous in his compliments, and it gave me a little boost in my confidence level.  He said I made him feel comfortable and ready to open up from the very beginning of the interview with my "sunny" demeanor and matter-of-fact ways.  He said my physical assessment was particularly strong because I explained the whole procedure to him as we went, making him feel more in control and at ease in a potentially awkward situation.  He said he felt respected in terms of privacy.  He also said that he thought my teaching was very effective- non-judgmental, but firm enough to make him feel that what I was saying was important.  Now I don't really know about all that.  Like I said, he was a really nice guy, and really generous in his compliments, but I just remembered again why I am doing this.  I enjoy patients... more particularly real patients where I am not being video recorded and tested.  I love to interact with them.  I like to make them feel comfortable.  I like to turn a situation that might otherwise be terrible into something a little better.  I like to find ways to preserve their dignity.  I do not know how effective I am at all that, but that's why I am here.  That's why I am going to go out there and tell some employers that I am qualified to work for them.  That's why I am putting myself through 11 months of sheer torture that has been hard on my mind, my body, my marriage, and my emotions.  I am sure there will be many more difficult moments when I feel unprepared, incompetent, and scared to death.  Hopefully this reminder can help me ride through those moments.