So here I am, nearly 2 weeks into my Community/Public Health rotation.

My partner and I went to our assigned community agency for the first time today. It is a small converted house in a poor residential neighborhood that supports a variety of programs including childcare, social work, and drop-in personal growth/social opportunities.

Our big project with this agency is to plan, develop, and implement a handwashing/hygiene presentation for preschoolers and their parents. We will have about 6 days total to come up with the lesson plan and resources. Everything will be documented into a presentation for our peers, since different students are assigned to different agencies.

So while my partner and I were brainstorming ideas for a short presentation on handwashing, my phone rang. I didn't recognize the number, but it looked like my instructor, so I sighed as I reached for my phone and rolled my eyes because she had just called me......

.....until I realized it was the hiring manager for the local Emergency Department!!! Yep, the one I volunteer at :) And the one that is literally across the street from me.

I had applied for a UNE position (Alberta Health Service's position for Undergraduate Nursing Employees on a summer/temp basis) last year as well but I didn't realize how many skills I was lacking. And I went to Thailand - no shocker they didn't hire me! So this year I was really pumped when I sent in my application at the beginning of this month.

My interview is on April 14! So excited.

The core reasons I'm interested in working Emerg over the summer are because (in this particular ED, anyway) of the high degree of collaboration between physicians and nurses, and amongst the nurses themselves, the population will be all ages and sizes and socioeconomic statuses, I will see a high volume of presenting conditions and learn about how to prioritize/plan for them, and I will get to use plenty of skills.

Did I mention I was excited? :)

I started this post several times over the past few days. Friday was the last day of my acute care rotation, where I have been stationed on a Vascular Surgery unit.

You may recall that my instructor quit halfway through my rotation due to family issues, and we got a new instructor. Not just any instructor, but my Patho instructor from last year. I wasn't sure how changing instructors halfway through could possibly give either instructor a decent overview on how I did on this rotation. Especially considering how I was raked over the coals at my last evaluation. My confidence was so shaken and it's been nearly a year since my last acute care placement.

Wow. I take back almost everything I said about my Patho instructor last year. It actually pains me to read how harshly I critiqued her. I still remember how it felt, though, to be in her class and be absolutely boggled by how she would jump from one topic to the next without clear linear relationships between disease processes. It made me absolutely crazy and I learned Patho from a textbook because her teaching style didn't resonate with me.

But - as a nurse? As a clinical instructor?

I have been SO privileged to be under her care and direction for the past few weeks.

I even wrote on my course evaluation that she should be promoted to teaching other clinical instructors, she's that good. It's hard to put into words what exactly worked for me, but I'll try, so that one day I can remember what it took to make me feel like I have it in me, somewhere, to become a great nurse:

1. Greet every student with a warm genuine smile, and a holistic appraisal of who we are and what we want to be. Even if that thing isn't in Nursing.
2. Collaborate with students and encourage us to use our theoretical knowledge in practice. That knowledge is in there, somewhere - draw it out! Get us talking!
3. Have high, high expectations for us. Expect that we will be safe, compassionate, knowledgeable caregivers. Have faith in our education. We will rise up to your high expectations and we might even exceed them.
4. Once the plan of care has been decided, ask us to explain what we're about to do, and then leave us to it. We can and will do a much better job without an instructor breathing down our necks (such as priming TPN lines, choosing appropriate IV med tubing, choosing appropriate needles/syringes and drawing up meds). Follow up after to check our work. We will feel the weight of surveillance float right off our backs.
5. Get involved in the patient's perspective and demonstrate how easy and spontaneous therapeutic communication can be! Segue seamlessly into those tough questions like suicide risk and spirituality! Show us how it's done!
6. Give instant feedback. Good and bad.
7. Treat us like adults. We are.
8. Be excited for us. Be happy for us. Share in our accomplishments and celebrations. Encourage us liberally.
9. Be fair, honest, and genuine in your appraisals.
10. Come with us for a drink after the last evaluation. We all worked hard, dammit! We won't judge you. See #7.

So I hope I'm not sounding too sappy, but I absolutely, 100%, believed in, respected, and wanted her feedback on everything. She is a Great Nurse, and a Great Educator, and an Inspiring Leader, and how many times do you meet someone like that?

I can't tell you how many times former-students-now-RNs would come and find her on our unit, with tears in their eyes, and thank her for her contribution to their lives. Doubtless, I'll be the same way.

"UgRN," she said, reaching for my lapel;

"I wish there was a higher grade to give you than A+. You are caring, skilled, and holistic. This hospital is practically run by former students of mine. In my 15 years of teaching, I have developed an instinct for people who are Going Places. I can honestly say that you are one of them."

She pinned a small angel to my lapel.

"This is to remind you of 3 things.

"One, to remind you to connect to your spirituality if you find yourself in a situation that overwhelms you. If you are doing postmortem care for a recently-passed patient, and they moan as you turn them [I had told her about my possible interest in Oncology]. Connect it back to your spirituality, and I don't care if that's God, Buddha, Mohammed, or the Circle of Life. Once you do that, you will remember who you are and the importance of what you are doing.

"Two, you can be anything and go anywhere in nursing. I don't think you would like it, but you could be in management. You can be a Nurse Practitioner. You can excel at anything you put your mind to.

"Three, if you need me to vouch for you - and I don't care if it's 15 years from now - call me anytime. I might need you to send me your picture. But do that, and I will remember you, and you will have an excellent reference."

She smiled at me with tears in her eyes. I did the same. I have never felt that someone Got Me in the way that my instructor Got Me. She totally understood who I am and where I am coming from. She could see how much I love this work.

I am so very honored that she gave me the angel pin. I am not much of an "angel" person, but the significance of it outshines anything else I may ever get from an instructor. Every time I look down at my uniform, I will smile and remember what she said to me.

This post will be short since I'm posting from my phone.

One of our classmates died a few weeks ago. I didn't know her well but I'd heard she was a cancer survivor.. She then got into NS and busted her ass for 2 years like the rest of us, got married to her highschool sweetheart last summer, and by September she was too sick to come back to school. I heard it was lung ca.

At the time it was sad but I didn't take it to heart. However for the last few days, the universe has conspired to bring hospice, mortality, and the randomness of cancer to the forefront. My classmate died, I had a bad dream about my beloved grandparents (they are mid-80s), and I spent all day Sunday working on my cancer nursing certificate and learning about genetic mutations. Then my class yesterday was about caring for dying patients. Then I found out a family friend was being treated for bone ca.

All the while wondering why her? Why now? Why not me? Why my dad? How is her family? How is her husband dealing with this?

And just wondering.... Man, why am I even considering oncology? This is so hard.

But the more I think about it.... If I can be THAT nurse, the one who took the gentlest, kindest care of your loved one as he/she left this world, who made sure pain was as distant a memory as it could be, who focused as much as possible on comfort and family strength...

If I can be THAT nurse -

What an incredible thing I can do for families who need it so much.

-- from the cellular desk of undergrad RN

A quick story because I am heading out to clinical soon -

Patient has been in hospital for several weeks now, post op for a diabetes-related amputation. Side effect is HUGELY swollen genitals with some really awful skin breakdown. Guy is in a lot of pain. He is both needy and withdrawn. He is not handling the patient role very well. He wants his control back.

He's had a student with him for several shifts. Student has the time to be with him constantly. Student talks to him, gets to know him, works to understand and resolve his concerns. Turns out there's a lot of underlying stuff about him that no one knew about. Patient is super grateful for the care. Patient calls student (note - I'm not the student!) an "angel from heaven".

Next shift, staff balks at allowing a student in his room anymore, stating that the 1:1 care of a student is "making them look bad".

What say you?