Me and my drum

Dear Mom,

Since you died I've considered myself successful during the holiday season if I can avoid hearing "Little Drummer Boy".  For some reason I can tolerate every other carol but that one.  I burst into tears when I hear it because it reminds me of you.

I've been a nurse for six months now.  Remember when I first told you I wanted to be a nurse?  I was working in the dietary department at South Coast Hospital when, one day, I knew I was supposed to be a nurse.  I started taking classes then, and I remember you were very supportive.  But then I divorced my first husband and started using drugs and selling real estate and education just didn't seem as important.  I thought about it again during that long stretch when Daddy was in ICU at that same hospital, but by that time I was way too deeply involved with finding my second husband to be in college.  Then Daddy died and I spent the next ten years or so wrapped up in some really dysfunctional grieving and being mad at you because you got involved with another man.

Virgil, our roommate and her daughter and I decorated our tree very early this year.  It was before Thanksgiving, in fact.  The thing is, it's so dark at this time of year in Alaska that the tree with a whole bunch of lights on it seems like a good idea after about November 1st.  We leave the lights on all the time and I suspect we won't pull that tree down and box it up again until February.  Some of your ornaments are on it - all those Hawaiian angels you bought while we lived there, and a couple that you made. I smiled when I hung them on the tree.

We don't really celebrate Christmas with gifts.  Not like we used to when we were all together.  You always bought so many gifts for me, and I remember that even when I was 18 I was beyond excitement waking up on the morning of the 25th of December.  You'd cook a great dinner, the house always smelled wonderful, and there would be Christmas carols playing.  Daddy could never do too much because of his COPD, but you would bustle around and drink your toddies and then we'd sit down to "open".  One by one we'd each open a gift, and ooh and aah over it, and you'd keep a list of who we needed to thank for what.  It would always be warm in the house, and the sun would be shining because we were, after all, in southern California.  Some years we were really lucky and could see all the way to Table Mountain in Mexico from your deck.  That was some view.  I can close my eyes and see the curve of the coast and the sunlight sparkling on the ocean to this day.  That view is forever etched in my memory.

So anyway, I'm writing to you this year to tell you that I forgive you.  I'm a couple of years older than you were when Daddy died, and now I realize that you deserved to have a man in your life once he was gone.  I've worked through a lot of anger about how you latched onto me when I was very young and treated me like your best friend, or your mother, instead of your child.  I know about fear now, and I know you were afraid of being alone.  I know you were afraid of all the uncertainty in life, and having enough money, but most of all you were terrified of being alone.  I know it must have been very difficult for you to be a parent, because yours died so young and you had no models.  You were, in essence, abandoned.  Sometimes when I think about how difficult it was for me to please you, or get along with you, I still feel angry for a minute or so, but these days when I feel that hurt rising up in my heart I tell myself that you did the best that you could, because I believe that you did.

I forgive you. Thank you for the nights you spent teaching me new words.  Thank you for saving your money so that you could leave me enough so that I could leave California and go to nursing school.  Thank you for teaching me how to be a good conversationalist, and a good hostess.  Thank you for that day in the nursing home when I left your room and you called me back in just to tell me that you loved me.  That was the first time you ever said it to me that I believed you.  I think it was because I worked so hard those last six years you were alive - to make sure that you were safe and that your care was good - I finally believed that I was good enough and had made up for all the times I disappointed you. 

Wow, I've gone on too long with this.  I'm just having lots of feelings and missing you terribly because now I can see through the fog of resentment and anger and look at the scared woman behind all that who made fabulous Christmases for her daughter.

I heard the damn carol the other day, sung by a new group, and as I listened to their beautiful voices I smiled.  I cried, too, because it was "that song", but the way they sang it was so sweet and smooth and full of joy that I think it sort of healed me.  I think you know that, too, because I could feel you there while I was listening.  I could smell dinner cooking in your oven and saw the light shining on the sea and you were there with me and we were really smiling at each other.  Especially when they sang, "I played my drum for him pa-rum-pum-pum-pum, I played my best for him pa-rum-pum-pum, rum-pa-pum-pum, rum-pa-pum-pum...then, he smiled at me pa-rum-pum-pum-pum, me and my drum."

Merry Christmas, Mom.

Love,
Your little drummer boy

wet feet

I wonder where the term "getting your feet wet" originated?  Is that the first stage of "diving in" or does it lead to "swimming with sharks"?  As it relates to my first nursing job, I think it applies to both.

I was hired "on call".  That wasn't what I applied for, but it was what I got.  I wasn't happy about it, and I regret that everybody knows that.  I do tend to be up front about my disappointments, and I really wanted a full time permanent position on one unit with regular hours, vacation pay, sick leave, blah blah blah.  What I got instead was a comprehensive education on how things work on several units specializing in different populations in a psychiatric hospital.  Not only are the clients different on these individual units; the procedures are different.  Equipment, paperwork and other items I use to do my job are kept in various places in the unit nursing offices - and no two units are the same.  To make it even more interesting, two of the units are mirror images of each other, so everything is literally backwards.

About three weeks ago I left work one morning (I work nights) and stood in the parking lot for a minute realizing that I almost, kind of, maybe a little tiny bit know what I'm doing on the job.  It was a shock - the thought hit me like lightning.  Scared the hell out of me.

I'm in line for a permanent full time position and will probably interview for it this week.  I'm looking forward to having a more normal life.  If working nights in a psychiatric hospital can be considered normal.  I'll know what nights I'm working in advance, every week, and where I'm working.  I'll get to know my colleagues, and in some cases, my clients.  I have my fingers crossed.  I love holiday pay and vacation time and paid sick leave.

A few thoughts about working nights.  My body wants to be up all night and asleep during the day.  It always has.  I DESPISE having a job that requires me to be at work early in the morning because I cannot fall asleep before 1 am.  So, I love working nights.  I am particularly grateful for my open all night gym, and open all night grocery stores.  I love not having to drive anywhere in rush hour traffic (such as it is in Anchorage).  I am also grateful for an AA meeting that starts at 6:30 am.  I can go to that meeting on my nights off, do a little shopping afterwards, then go home, watch some tv and go to bed.

I've enrolled in an online college to start working on my Bachelors degree beginning November 1st.  That will necessitate fewer hours of Tivo during the night, but I think I can live with it. 

flipping, 3 12s and other joys of the wee hours in healthcare

I've been working as an RN for about a month now.  When you go to nursing school and learn a whole new language they don't tell you that you'll have to learn another one when you actually become a nurse.

My schedule has been "3 12s" so far during my orientation.  Three 12 hour shifts are really three 13 hour shifts if you're working in a "union shop" while orienting to a job.  Don't ask me why, because I cannot answer you.  My 3 13s have been "noc", which means I go to work at 7pm on one night and leave work the following morning at 8am (although we use military time: 1900 - 0800).  Friday.  Saturday.  Sunday.  This schedule is both wonderful because I am a night owl and difficult because I do like to sleep occasionally.  When you have only 11 hours to sleep, feed the cats, bathe and eat some chocolate for three days/nights in a row it can be challenging, particularly if you're living in Alaska during the summer when the sun hardly sets.  A friend gave me a sleep mask when I moved to the land of the midnight sun four years ago and I'm using it for the first time.

The obvious up side to 3 13s is the fact that if you only work three days, you have four days off every week.  This "four days off" thing is misleading.  When I fall into bed at 10 am on Monday after working  3 13s,  it's safe to say I'm TIRED.  I sleep for maybe eight hours, get up, marvel at the fact that I have 4 days off, wander around wondering why I just got up and everyone else is eating dinner, try to remember whether I've already taken my morning medications/vitamins, try to remember whether I fed the cats their breakfast when I got home that morning, maybe ride my bike a few miles, return home to watch some television and fall asleep again.  That's my first day off.  Yippee.

So, I really have three days off.  Here's where "flipping" comes in.  The theory is that one can actually live a normal life for three days per week with my current schedule.  One can adjust sleep and wake times and convert from vampire to human for three days, then switch back when work rolls around again.  I haven't flipped before now because I love being up all night and have no responsibilities that require me to be awake during the "day". Until now.  I finished my last stint on "noc" last night at midnight and start two weeks of days tomorrow.  I've been carefully planning this flip.  I slept for only four hours between my 8am departure from work yesterday morning and return to work at 7pm last night, came home and forced myself to stay awake until 4am, and set my alarm for 8 am this morning.  Result: sleep deprivation.  Hope:  I will be able to sleep enough tonight so that when I show up at work tomorrow morning at 7am and work 13 hours I won't be a danger to myself or others.  I'm flipping.

It's hard to teach an old dog new tricks.  Hard, but possible.  It's 11 am now.  Must be time for dinner?

The beginning

I start my first job as a registered nurse tomorrow morning.  I passed the nursing "board" exam that I took on Friday and I am now a full-fledged licensed registered nurse.

I thought I would feel different once I was a nurse.  I thought I would feel all knowing/all powerful with regard to medical knowledge.  I don't.  I know that I have a lot to learn, and that this just the beginning.  But, I did it.  I studied and tested and got up way too early in order to participate in clinical rotations.  I stood on concrete floors until my feet screamed for mercy.  I lived apart from my husband during college semesters, took out loans, watched a baby being born, started IV lines, and hung IV medications in order to treat clients.  Then there was that fascinating day working in the emergency department.

All I had to do was do it.  Step by step, exactly what my instructors and advisors told me to do.  It wasn't easy.  It was the most stressful thing I have ever done, but it was what I wanted and I was determined to complete the process no matter how much weight I gained, how badly my feet hurt, and how lonely I was without my husband.

I believe that we are capable of doing whatever it is that we want to do if we have enough determination and are willing to sacrifice to achieve our goals.  I did this crazy thing in my 50s.  I'm 57 and a new nurse.  So what?  I've always wanted to do it, and I did it.  I saw my name posted on the Alaska Board of Nursing website late on Friday, and it had "Licensed Registered Nurse" next to it.  I had just taken the board exam that afternoon and was sure I had failed.  I saw my name and I sobbed out loud - those deep lurching, keening sobs that I wailed when my mother died.  God that felt good.  Oh my God, I did it!

Alyx McNeal, RN

Whose idea was this, anyway?

In two hours, I will be taking the test that will either make me a Registered Nurse, or not.  It is called the NCLEX, and those five letters are the most terrifying that a recent nursing school grad encounter.  Trust me.

I have studied for two solid weeks.  I graduated from nursing school with a GPA of 3.88.  Still, I am worried that I won't pass this exam.  I am the only person I know who is concerned; everyone else is sure that I will pass it.

What is it in me that makes me believe that I'm not good enough?  That in spite of all evidence to the contrary, I won't pass this exam?  I think it's because, on some level, I hear old tapes playing.  I hear the words of my mother - words she didn't mean to use to scar me for life.  I was never told that I wasn't smart enough.  I was told that I was smart enough to do whatever I wanted to do with my life.  I was also told that I wasn't living up to my potential.  In all fairness, I wasn't.  As I have grown, and lived, I have learned that what my mother thought really doesn't matter.  All that matters is what I think, and more importantly, what I do.

Therefore I have studied five NCLEX prep programs, eaten both some complex carbohydrates and some protein, and hydrated myself enough (not too much...I cannot leave the testing area except for scheduled breaks, which are infrequent).  Last night I rode my bike over 10 miles to blow off a little steam.  I got enough sleep.  I am wearing comfortable clothes.  I know how to get to the test site and will allow myself plenty of time.  I've asked my Higher Power to remove my worry.

That's all I can do. 

Nurse Ratched

This past Friday afternoon I showed up at the big auditorium on the University of Alaska Anchorage campus with the funky black cap, funkier green and gold tassel, and treasured gold cord that identifies honor students.  I waited with my classmates and was given a black gown to wear over my clothes.  Then I stood around fanning myself for about an hour, waiting for the nursing "pinning" ceremony to begin.

In the audience were my husband (who had cut his hair and beard for the occasion), my sister and her husband who had flown up from Seattle, my cousin and her husband who had driven 160 miles to be there, an old friend who had driven 220 miles, my cousin's lovely adult daughter, my "soul sister" who had left the nursing program after our second semester to make some money and is hoping to be readmitted to complete her nursing degree, her boyfriend, and the couple who own the bed and breakfast that was my home away from home for two years of nursing school.

Lined up with me were my fellow students.  Some of them I like.  Some of them I love.  One doesn't navigate four semesters of nursing school without developing relationships with peers.

Shortly before they called my name to walk across the stage and be "pinned", I tilted my head back and looked up.  I whispered words of thanks to my mother and father, the woman I'm named after, and my Higher Power.  When my name was called, I walked.  It seemed like a long walk from one side of the stage to the other, perhaps because I was so completely in that moment.  That moment was mine, all mine.  I heard applause, but as if from far away.  My feet carried me solidly and purposefully toward the woman waiting at the other end of the stage.  I've been on stages before as a speaker, or a salesperson, or an actor.  I'm no stranger to stages.  But this, this was different.  This I had earned.   I looked every bit of my 57 years and carried the 25 extra pounds I've gained since I began nursing school.  I wore waterproof clogs instead of the heels most of my fellow female graduates had squeezed into for the event.  Under my robe I wore black jeans and a cheap long sleeved shirt.  I was hot and sweaty under that damn robe and wore chapstick instead of lipstick and my hair stuck out at all angles from underneath my cap because I cut it myself with bandage scissors about a week ago.  I couldn't get to the hairdresser, so I did it myself.  My my, how I have changed.

The Dean of the School of Nursing placed a yellow ribbon around my neck that was held together at the bottom with a simple round pin that says "Associate Degree of Nursing, University of Alaska".  She also handed me a yellow rose.  I shook her hand and left the stage to return to my seat.

As I write this I can see my cap with its tassel, my gold cord, and that yellow ribbon sitting on my dresser.  I looked at the pin closely this afternoon.  There on the back are engraved the letters EAM and the numbers 2013.  Elinor Alyx McNeal walked across a stage to be recognized for having completed an Associate of Science degree in Nursing in 2013.

Never, ever give up on your dreams.  There are not adequate words to describe what it feels like when they come true.

Pulling into the driveway

Two weeks remain until I am "pinned" as a nursing graduate.  I have a job interview scheduled for next week.  I have moved from my room at the B&B into a townhome I share with one of my nursing school friends.  We'll welcome my husband and four cats to the townhome (fondly called "The Dump" - there is much work to be done on it but it meets our basic needs) as soon as he can transfer jobs, likely as soon as July.  Almost everything is in order.

And yet, I'm emotionally disorganized.  I'm dreaming of my dead parents, of my past, of abandonment, of ex husbands.  Monumental dreams.  Big ones.  Dreams that seem like they carry huge meaning.  I wake from them surprised at their depth.  I'm quick to weep these days.

I knew I wanted to be a nurse when I was 18 and took some prerequisites then.  I took more prerequisites when I was in my 40s.  I floated from job to job, played hard at life, and ended up as an executive in sales and marketing.  I lived the beautiful life surrounded by success and beautiful people, all the while knowing that I didn't fit.  That nagging feeling in the back of my mind that whispered "be authentic" was ever-present.

Four years ago I grabbed the hand of my inner child and promised her that we were going to change things.  We enrolled in science courses and completed them.  We worked hard.  We managed to be accepted to a nursing program.  We pushed everything else to the back burner and dove in.  We kept going when continuing seemed impossible.  We leaned heavily on my husband, my sister, my cousin, my friends.  We fought and clawed our way through learning to use our body to do work instead of just our mind.  We used every single life skill we had learned in 50something years to trudge through two years of mind-boggling academic and physical challenges.

On May 3rd, we will wear a cap and gown.  We will wear a gold cord that signifies that we are graduating with honors.  My sister and her husband are flying 1500 miles to be here.  My cousin and her husband will be driving 160 miles to get here, and a good friend will drive 200 miles.

I was a wild child.  I am a recovering alcoholic.  My sister tells me that years ago I would tell her that I was coming to visit her, but she learned not to believe me until she saw me pull into the driveway.
On May 3rd, I will pull into my own big driveway.  It has been a long, long journey. 

I am authentic.  I am proud.  I am happy.  I am amazed.  I am home.

yes, yes, yes!

18 months ago I was a quivering mass of uncertainty when, during my first course in nursing school, I struggled to hear heart sounds through a stethoscope.  I knew I wanted to be a nurse more than I had ever wanted anything before, but I couldn't imagine ever feeling confident actually caring for clients in the hospital.  There was so much I didn't know.  Furthermore, I had always earned a living working with my brain, and nursing demands that you develop some psychomotor skills.  Nurses lift, inject, and hang IV fluids.  Nurses use objects to help people heal.  I'm not an object person.

Three weeks ago I was in the middle of my psychiatric clinical rotation.  I loved it.  LOVED it.  Give me someone who is in mental crisis and I'm not only fascinated, I'm drawn to that person like a bee to honey.  I may not "have" the mental illness the client is suffering from, but having spent a good portion of my life living on the dark side, it isn't hard for me to imagine being the client's shoes.  My mind was working overtime during those clinical hours.  I understood.  I empathized.  I felt completely, utterly, gloriously at home in a psychiatric hospital behind its locked doors.  So, it was decided:  I'm a psychiatric nurse.

Yesterday was my first day of clinical rotation for my Adult Nursing II class.  I was assigned to a cardiac care unit in an acute care hospital, and I was very nervous.  Back to the object stuff: administering medications, assessing incision sites for clients who have undergone open heart surgery, measuring output of urine and drainage from chest tubes, taking vital signs.  A new hospital, a new group of procedures to learn.  New electronic medical record software to navigate.  Yesterday I felt like an idiot (again).  Then I met my client.  No dark side there, just someone recovering from a cardiac surgery.  Developing rapport was easy.  I'm very good at that - that's a mind thing, not an object thing.

Tonight I left the hospital grinning from ear to ear.  That same client is making huge strides and recovering beautifully.  There can be a deep human intimacy between a student nurse and a client.  We see them naked, we see them helpless, we encourage, we teach, we celebrate bowel movements, we administer medication to help ease pain, we comfort them and their families.  When they walk the halls and return to their rooms having walked a little farther this time and are less short of breath than they were the last time, it can feel like their success is our success.  That feeling is like a swelling round of silent applause for their efforts, the surgeon's efforts, and the unbelievable resiliency, complexity and self-healing capacity of the human body.  Today I loved, loved LOVED my Adult Nursing II clinical rotation.

The fact is, I love it all (except pediatrics).  And today, I'm not so sure I'm a psychiatric nurse.  I think I'll wait and see where the universe wants me to work.  Wherever that is, I suspect I'm going to love it.

the beautiful people

I drove across the ice rink that is Anchorage, Alaska, this morning to scope out the location of the trauma nursing course I'm taking before dawn tomorrow; I also stopped at the grocery store to pick up a few items.  Wearing cleats strapped on my snow boots, I skated warily across the store's parking lot and found 10 items I couldn't live without.  I mention the number of items for a reason.  There were only a few checkout lanes open and there were at least two people with overflowing shopping carts in each lane.  I headed for the "15 item or less express lane", moving slowly because I still had my cleats on and it's about as easy to fall down and break a hip wearing cleats on a cement floor as it is walking on ice without the cleats.

A couple sped into the express line ahead of me.  They weren't wearing cleats and could move faster, not to mention that they were probably at least 20 years younger than I am.  I'm always a little irritated when someone beats me to a checkout line by that thin a margin, but when I peered into their cart, I escalated.

They had at least 30 items in that cart.

After I had counted their items (I know, I can hear Bill W. and Bob S. chanting the serenity prayer in my ear) I took a closer look at them.  I had plenty of time, too, because they were taking their time placing items on the counter.  She was maybe mid thirties, had beautifully cared for long red hair, and by my estimate, a size 6.  She moved gracefully, albeit slowly.  I could picture her taking pilates lessons, slipping out of her designer jeans and donning footless tights with no grease marks or tears in them.  He had thick hair, a classically handsome face, no beer belly, was about her age, wore designer jeans and carried himself with an air of confidence.

I hated them.

Entire glaciers could have melted in the time it took them to place their groceries on the conveyor belt, and of course one of the items required a price check.  I watched the checker, scanning her face for signs of annoyance.  Her affect remained perfectly flat.  When they handed her a stack of coupons, I felt bile rise in the back of my throat, but maintained my distance and kept my mouth shut.  When they swiped their credit card and the checker turned to her cash register to pull out CASH BACK I nearly lost it.  I swiveled around to see three people waiting in line behind me, one of whom was a young woman holding a salad and a drink who was anxiously checking her watch.  I know that poor girl was on her all-too-short lunch break.

FINALLY the checker handed them their receipt and they wheeled away.  I stepped up and as the checker processed my legal-sized order, we chatted.  We talked about how rude people are, how people can't count, and how some people have a sense of entitlement.  She said, "You have no idea some of the behavior I witness, or how desperately I wish I could tell some of the customers in this line to _ _ _ _  _ ff."

That made me feel better.  That's "customer service".  I understand the concept.  What I don't understand is how the beautiful people seem to think they're special, and different.  They aren't.  Wait until I'm ordered to give one of them an enema.