The New Normal

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It’s so easy to get caught up in the whirlwind of my schedule this term…there’s always one more thing. Case in point: I told myself I wanted to be in bed by 10pm, to get at least 7 hours of sleep before a full day of clinical. I rolled into bed at 11 instead. Despite the long list of things and limited hours in the day, this post has been on my mind for a while and I don’t want to forget how amazing it feels right now to be diving deep into the nitty-gritty of acute hospital-based care.

I swim through each day vacillating among feelings of overwhelm, thrill, anxiety, nervousness, accomplishment…and if exhaustion counts as a feeling, well, throw that in, too. One of the nice things about my clinical site this term is that it’s a 15 minute walk from home…so I have a built-in half hour each day for deep breathing, movement and reflection. Some days I can’t wait to get home (to eat or sleep, or do research on a patient’s condition). Some days I linger at the local coffee shop on the way home, needing a little more time and space to process what I’ve witnessed and learned.

My New Normal is a paradox of routine and semi-controlled chaos. I’ve been trying really hard to wake up and go to bed around the same time each day, even on weekends. I’m not naturally an early morning person, especially since B’s a night owl…but this term, I feel like I have to be more consistent. So, 5:30am wake-up and 9:30-10pm bedtime it is. I’m actually really loving it. I get so much more done in a day! I’m developing my little morning routine, which has been really grounding.

So, you ask, what does it actually look like? Monday mornings I have a Leadership class from 8:30 to 11:30. It’s part two of a two-term course. Then Tuesday through Thursday I’m at my clinical site (surgical oncology for the first five weeks, medical for the second five), from 7am to 3:30pm. Fridays from 9-3 I have my Acute/End of Life Care theory class, in which we review case studies and talk about what nurses actually do to care for their patients. Each week we review a different category of acute illness–this week it’s neuro-focused (stroke and delirium). The weekends are spent working on case studies, writing clinical reflections…and catching up on laundry and trying to cook ahead for the week.

My New Normal involves lots of Not Knowing. I walk onto the unit each morning with a patient I’ve been assigned the night before. I look up their history, their medications, try to wrap my head around their story and experience of their illness or condition and develop some semblance of a plan of action to move them closer to discharge…but each day offers New Surprises. Flexibility and Plan A-Z is the name of the game. Some of surprises are related to the patients I’m privileged to work with and care for. Many more of the surprises are about myself and my capacity to stretch and push myself past the fear and anxiety of “messing up.”

The reality is, seasoned nurses don’t get the night before at home to prep. They walk on the floor, they meet their patients (sometimes 4 or even 5 of them!) and they just roll. The more I observe my preceptors, the more in awe I am of the work they do. I have observed some stellar nurses on the surgical oncology floor so far…they exemplify compassion and healing of nursing care, in addition to being superb teachers.

My New Normal includes a lot of adding things to my list of Things to Look Up. It doesn’t stop, my friends, and there’s not enough time to do it all…and that’s part of the New Normal, too: learning, sometimes painfully, how to prioritize. Call it the Art of Nursing 101.

One of the things I appreciate most about this rotation is the clarity it’s bringing to other aspects of my life. Being on an oncology unit brings you in close proximity to death. It’s not something I’ve ever been afraid of, per se…but there is something very profound about working with people who are nearing the end of their life.

I have not yet witnessed a patient’s passing, but it’s entirely possible that I might in the next eight weeks. I don’t think there’s anything that can prepare me for that. But I find myself checking in more frequently, trying to figure out my own personal life priorities. It’s so, so hard to do this when you’re in school and life is moving at 150 miles an hour. But the greatest gift that we bring to our patients is our humanity–without that core, we are nothing as nurses. So I find myself resonating deeply with this question from Pema Chödrön:

Since death is certain, but the timing is uncertain, what is the most important thing?

The Asking of this question, the Listening, and the Living with the answers that emerge in the quiet moments, are slowly forming my New Normal.

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