Pinning

It all began with a plain piece of 8.5 x 11 paper. A little more than two years ago, a lump sat decidedly in my throat as I nervously opened an envelope from a school. My eyes searched that simple sheet of paper, finding the only words that mattered: “Congratulations! We are pleased to inform you that you have been accepted into our nursing program.” That summer seemed to crawl by as I anxiously awaited the beginning of my nursing career.

On a late spring evening in 2014, I sported a traditional white scrub dress and goofy-looking cap, as my mother pinned the hard-earned nursing school pin to my chest. I stood before my family, my closest friends, and my classmates as I lit my candle and recited the Nightingale Pledge. I promised to be the best nurse I could be, and to serve my patients above all.

The two years in between were the most difficult I’ve ever endured, and were fraught with more challenges than I’d ever imagined. There were unfair, condescending professors. There was the one instructor who looked me dead in the eye and said, “EMS is for people who aren’t smart enough to get through nursing school.” There were cut-throat classmates. There were absurd policies, forcing students to choose between missing a family member’s funeral or paying $850 to make up their schoolwork privately. There was the ever-looming threat of failure, made all too real by the steady loss of 62% of my classmates. Some friendships drifted apart–some probably irreparably so. There were brutal shifts on the ambulance. There were calls and incidents that shook me to my core and made me question things I was so ignorantly secure in. There was the loss of my only living grandparent–a loss that was unexpected, and occurred with a simultaneously shocking speed and a heartbreaking slowness. There was my father’s diagnosis of cancer. There were plenty of all-nighters, tears, and swearing I could not take another day in this program.

If that dark picture entirely described my two years of nursing school, there’s no way I would have made it. The nursing cap and pins on my bookshelf would never be there. There were people who gave me strength to give it just one more day, to try just one more time. There were professors who pulled me aside and told me I was going to be a great nurse. There were classmates who would vent with me, give me incredible words of wisdom, and drive to Chipotle for dinner while blasting music at an unreasonable level. There were instructors who tried to fight unfair policies that put students in unreasonable positions.  There were new friendships that were forged under the hot stress of school, and older friendships that were strengthened. There were shifts at work that were filled with camaraderie and fun, and were absolutely vital to keeping my sanity. The calls and incidents that had caused me so much pain are sewn into the fiber of my being, making me stronger and wiser than before. And there were calls that reminded me why I love taking care of people so much. The loss of my grandmother brought my family even closer. My father’s illness is allowing me to reorganize my priorities, to think less selfishly. I’m learning to look for the things I can change and help with. And, I’m learning to accept that some things are out of my control. Above all, the love, support, and compassion I’ve received has absolutely astounded me. All I can do is say “Thank you,” although words could never adequately express what these selfless kindnesses have done for me, and what they continue to do.

My nursing pin is a celebration of all that has happened, all I have pushed through, and everyone who was there along the way. It is for the bad as much as it is for the good.

And now, for better and worse, on to the next…

November

Physically, the drive to Major Medical Center is a little easier when driving a car instead of an ambulance. There’s not nearly as much surface area for the wind to toss the vehicle around when I’m cruising down mountain roads in my car. The drive goes by a little faster when listening to loud music in the confines of my personal vehicle. Emotionally, however, this drive is a completely different story.

In the ambulance, I have protection. Occasionally, old memories start to stir in the back of my mind. But they’re easily buried beneath the more intense focus I have when driving this large vehicle. I can hide in the professionalism I put on with my uniform. I can drown it out when chatting with my partner. But in the car? I have none of those luxuries. It’s just me, the radio, and this long drive that does nothing but dig up old memories.

A year ago, almost to the day, I was making this same journey in this same small vehicle. The same jagged lines of mountains and valleys lay just beyond the metal guard rail. The same bare trees stood in the piles of dead, reddened leaves. The same enormous building sprawled out before me, patient windows glittering in the afternoon sun. The same road wound past the ambulance entrance, where I’d parked my truck many times before, and continued down to visitor parking. And an eerily similar sense of dread settled into my stomach when I put the car in park.

A year ago, I made that drive knowing that, once at my destination, I would play a part in making that ultimate decision for my grandmother: comfort measures only, or aggressive medical and physical therapies. I felt fleeting emotions in a numb, hollow space in my chest: fear, sorrow, grief, strength, anger. It was an awful experience I wouldn’t forget. I just didn’t realize that a year later, I’d be making this same journey.

This time, I’m driving up to go see my father. It was supposed to be a relatively simple surgery for a relatively simple problem. Instead of this quick, easy procedure and recovery, we were met with complications and phone calls, sleepless nights and unknowns, running nurses and worried doctors. A week-and-a-half later, time and progress feels as though it’s standing still.

Something about November, Major Medical Center, and my family. I hope with all my heart that we don’t have to make the same decision this year.

Please keep him in your thoughts. Thank you.

Growing up in EMS: Lesson #53

“You are way too young to be this bitter,” My partner said, shaking his head. We’d spent the better half of this drive to a nursing home venting about our separate love lives, or lack thereof. As he backed our truck up in the parking lot, I made that bold, broad, terminal statement that love is stupid. Or maybe I said it wasn’t real. Or that it was for the birds. Really, any of those described how I was feeling.

“Too young? Psh, too old to be this bitter. I know it’s childish and immature. I just can’t help it.”

We grabbed our gloves, our clipboard, and our stretcher. We stood up straighter, smiled, and stuffed those feelings into the backs of our minds–away from the professional exterior our patient deserved. Our patient was sitting in a chair beside her husband. They held hands, and watched the commotion of the floor with quiet, content smiles. My partner and I introduced ourselves to the couple.

“Well, Mrs. Smith*, your chariot awaits,” I said playfully, making a sweeping Vanna White gesture.

My partner offered his arm to support her for the few steps to the cot. Once we got her settled, her husband rose from his chair, slowly and unsteadily. He shuffled over to her, took her face in his hands, and brought her nose-to-nose.

“I’ll see you soon, beautiful,” He said, before planting a shaky, tender kiss on her forehead. She grinned back at him, looking back at him lovingly through her thick glasses.

We completed the run in the usual way, getting her to where she needed to be. My partner and I climbed into the cab of the truck, signed back in service, and hit the road.

“You see?” My partner nudged me. “That right there is why I believe in love. Yeah, getting your heart broken again and again sucks. But that? That lady and her husband? They’ve probably been married like 50 years or something crazy like that. Maybe more! But you could just see it. They got it right. Love is there. It’s possible.”

I’m pretty stubborn, but I have to admit that maybe he’s got a point. We get to bear witness to life and death, good and bad, hate and love; and everything in between. All in all, we’re exposed to some pretty powerful and inspirational things. There’s something to be said about that.

Mother’s Day

I worked for a few hours today, before my family had woken up to start their day. There was a kind, elderly farmer’s wife who we picked up off the floor. Another call brought us to the humble house of a gentleman experiencing some difficulty breathing. Later, a young couple flagged down our ambulance to ask for directions to a local breakfast place. And in some way, I was able to get all of these people to at least crack a smile. I returned to my house feeling at peace with the knowledge that I did a little something to improve the days of these total strangers.

But when I got home, that element of my day wound up causing some confusion and frustration in my little heart.

Today is Mother’s Day. Everyone in the country knows that. Regardless how you view the commercialism of the day, it’s supposed to be about honoring your mother and expressing your love and gratitude for all that she is and does. But, what none of you know, is that today is also almost exactly 6 months since my maternal grandmother passed away.

I made a card, like I do every year. I put a ton of thought into the perfect gift for my mother. And I fully expected to spend the day doting on her, and showing her all sorts of affection and gratitude…the kind that she deserves every day. The kind that I am inexplicably and inexcusably hesitant to show her every day.

Yet, when I came home from my shift, and met her in the kitchen with a hug and a kiss and a “Happy Mother’s Day!”, it all seemed…flat. It’s her first mother’s day without her mom. And, obviously, she’s going to be sad. What frustrated me was that I didn’t know what to do. The little trinket I was so excited and proud to give her didn’t make her feel better. The extra housework that I did (that she always does without complaining) didn’t seem to help. The hugs, kisses, and “I love you’s” that aren’t given out nearly enough…well, that didn’t seem to do much either; except maybe make her quiet sorrow a little more visible for a brief, fleeting second. She carried on the way she tends to: strong, with barely a hint that something was wrong. You had to know her to see it.

I can make any stranger smile. Whether it’s a tough old bird who slipped, a scared man who can’t pull enough air into his lungs, or a lost couple, I can figure something out. They can present me with anything on a whole spectrum of problems, and I can usually find a way to make them feel a little bit better, even if it’s only for a minute. And yet, I can’t seem to do that for my own mother today. I tried, but didn’t know how, to make mother’s day happy.

Grandma, we miss you. And Mom? I do love you, even if I’m not the most open about showing it.

And to all, happy mother’s day.

Kids Say The Darnedest Things

Observations and opinions of one of my pedi patients…

Junior: Do you have any kids?

P2P: Nope.

Junior: Oh. That’s too bad. You’re nice, like my mom. I think you’d be a good mom.

P2P: (totally taken aback and blushing): Oh…Thank you, that’s very kind of you.

Junior: Are you married?

P2P: Nope.

Junior: Do you want to get married?

P2P: Someday, I think I would like to.

Junior: Why don’t you want to get married now?

P2P: Just haven’t found the right person yet.

Junior: How old are you?

P2P: Twenty.

Junior: Jeez…you’re running out of time.

 

Thanks, kid.

I gave him a sticker anyway. He still won the “Coolest Patient of the Day” award.

Saving My Life

I need to hear that shrill tone. The one that pulls me from my day and thrusts me into that of another’s. The one that orders me into my little car, and sends me to the station. The one that sits me on the bench of the ambulance, soaking in the smell of plastics and chemical cleaners. The one that captivates my attention for an hour or two.

I need the illusion that I belong. That what I do matters. To justify my reason for being. I need the excuse to keep me here another day. I need the time to think about something other than whether I should stay or go. Other than if my mistakes of yesterday outweigh my possibilities of tomorrow.

I need to feel like I’m part of something bigger than just me. Bigger than the emotional storm clouding my thoughts, raging in my head and my heart. I need to be given a few hours where I can stop worrying about yesterday and tomorrow. Where the only thing that matters is right here in this moment. The only thing that matters is the person whose hand I’m holding; the life that I’m caring for.

I need that tone to go off. Just one more time. I just need one more day to figure this out. Just get me through today.

EMS is saving my life. Hopefully, one day, I’ll be able to say it’s saved my life.

Are You Taught To Hate Your Field?

Why on earth is the healthcare provider education system so hell bent on burning people out before they’ve even got their license in hand?

At least that’s the way it seems. Maybe it’s just a regional thing. Maybe all the schools in my area are teaching using similar techniques, and all the teachers subscribe to a similar mindset. Or maybe I’ve officially lost my mind (I am certainly not ruling that out).

This post is going to mostly be about nursing school, because that’s what I’ve experienced. But, any new-grad paramedic I know has talked about similar problems.

For any of you that actually read my rambling, babbling, nonsensical drawl, you know that I am unhappy in nursing school. Yes, I do feel absolutely miserable. Every week, I find myself up in the wee hours of the morning on the verge of a mental meltdown. Every drive to school is filled with anxiety, and every drive home is filled with discouragement. It feels almost like a trap some days. The further into the program I get, the worse I feel, but the more obligated I feel to finish it. At my worst, I find myself panicky, physically sick, unable to sleep, and waking up with horribly graphic and disturbing nightmares. Sometimes I start wondering why I ever decided to go into nursing. In my stress, I start to look for other careers I could do. Maybe I’ll find my calling in something else. In the past, I’ve considered going to paramedic school. Currently, I have some wild aspiration to go into law enforcement…which I’m sure would be greatly discouraged by anyone who actually knows me. I have to stop and wonder if these aspirations are real, or if I’m just looking into them because it’s something other than what I’m going through right now.

I’m in an associate’s degree program, so it’s only 2 years long. Most paramedic programs are about that long as well. It’s a short amount of time in which to learn a lot of important things. It’s not like earning a typical degree…after we get out of school, our decisions could greatly impact the lives of others. The stakes are very high, and it’s incredibly important to learn as much as we can in the short time that we have. Maybe these programs are just too short to be reasonable. I find that students in these shorter healthcare degrees/certification programs are just so stressed out and inundated with schoolwork that they find themselves discouraged or disliking the career they are about to enter. It’s heartbreaking to work so hard towards something, and then to be almost directed to hate it.

Maybe I just don’t love my potential career enough. Maybe I’m not dedicated enough. And like I mentioned before, maybe it’s purely a regional thing. Regardless, something should change here. Maybe it’s just me. Or maybe it’s the healthcare system. Or perhaps something in between.

Are any of you having problems similar to this? Or did I really just plain old lose my mind.

So A Celiac and some EMT’s go into a restaurant…

When some friends and I try to go out to dinner after work…

P2P: I have a severe allergy to gluten, which means I can’t–

Waitress: –Ohh, do you mean glucose?

P2P: No. I mean gluten. Anyway, I can’t have–

Waitress: Y’know. Glucose. Like sugar.

P2P: Nope. No, it’s gluten. Not glucose.

Waitress: Are you sure?

P2P: …what?

EMT Friend: Of course she’s sure. It’s her medical history.

Waitress: I know how tough it is. My cousin had an allergy to glucose. We have a few sugar-free things on our menu.

EMT Friend: Okay, well, that’s nice. We better be going.

And that is why I don’t go out to eat. Also why I love having friends that look out for me.

On another note…Sweetheart…if your cousin had an allergy to glucose, they probably wouldn’t be alive…what with that whole glucose-being-necessary-in-metabolism issue.

Celiac Disease and Dining Out

And now, for something completely different…

The concept of celiac disease shouldn’t be that hard to grasp. And yet, people interpret it in the weirdest ways. Hell, you don’t even need to know the nitty gritty and all the science behind it. I’ll over-simplify it for you. “I have an allergy to gluten.” And because most people kind of furrow their brows and go, “Huh? What’s a gluten?”, I usually follow that up with a list of things I can’t eat…wheat, barley, rye, oats, modified food starch, etc.

Now, when someone says, “I have a peanut allergy,” people go way out of their way to make sure there are no peanuts anywhere near that person or the food that person will eat. In elementary school, one of my classmates had a peanut allergy. Our class had to eat at tables in the hallway outside of the cafeteria so there’d be no risk of her getting a whiff from some kid enjoying a PB&J. None of us were allowed to eat peanut products in the hallway. If we had a peanut-y lunch, we had to go in the cafeteria to eat it, and wash our hands and brush our teeth when lunch was done before we returned to the classroom.

I don’t expect that level of avoidance or safety with my celiac disease. But my point is, people go out of their way to make sure the allergy-sufferer is safe. If someone added peanut butter to a slice of bread with a knife, most people would think twice before using that same knife to prepare food for a person with peanut allergies. People get that. Whether or not they realize it, they understand the concept of “cross contamination.”

So when I say, “I have a severe allergy to gluten. Which means I can’t have croutons in my salad. They will make me very sick. In fact, you can’t even pick the croutons out. It will still make me sick,” I expect a server–particularly one in the food serving/preparation business–to say, “Hm. She’s severely allergic. She specifically emphasized ‘no croutons’. I shouldn’t put croutons on her salad.” I would hope that most people would realize that it wouldn’t be okay to pick the croutons out of the salad afterwards, but I tend to explain that as well. You know, just to clarify. Which I don’t mind doing, especially because it is going to keep me safe.

So when I find a crouton like half-deep into my salad, yes, I’m going to be pretty annoyed. And when you tell me, “Oh, I forgot to pick that one out,” I’m going to be even more annoyed.

And I’m met with a shrug of the shoulders, and, “Oh well.” Because my diet is much harder to stick to than most other allergies, does that make it less severe? Does that mean it’s okay to be less stringent? I just don’t get it. No, I won’t go into anaphylaxis, but judging by how ignorant these people are about gluten allergies and celiac disease, they don’t realize that. Even if they did know that, I can guarantee you that being very very sick for a week or more isn’t much fun either.

What makes it so different?? Why is this such a difficult concept???

Paramedic or RN?

Well, here we are again, internet friends. Back to the soul searching and looking for advice from my favorite anonymous third party!

Firstly, if you’ve been following my whining about nursing school, you know I’ve been dealing with several really mean individuals. I’m happy to report that most of them will not be in my class this coming semester. Yay! There’s something to be said about karma, I suppose. Well, that and hard work.

During my Christmas break from school, I picked up more hours at my department. Going back and being able to do something I love…that all by itself makes me happier. Plus, trying out my new ALS skills has been really exciting too. Anyway, with all of these additional hours, I’ve obviously been to area hospitals more often, and to the local nursing homes as well. It just seems to remind me more and more that EMS is where I belong.

That, combined with some major screw ups at my school (losing my tuition, for instance) is making me rethink the whole nursing thing. I’m planning on applying to transfer…the problem is, should I transfer into another nursing program? Stick with it? Bridge to paramedic later? Or scrap it, become a paramedic, and bridge to RN eventually? It seems like the RN-first path means I’ll have lots of years doing things I hate in order to get where I really want to be (pre-hospital medicine, although ER would be fine too). Paramedicine, however, means putting my time and energy into a field I love.

I understand the RN position would be more financially stable, and I would have the opportunity to change specialties and get out of the emergency scene if it gets to be too much for me. But the idea of being a paramedic still pulls at me. So, here we are. Paramedic? Or RN?