Sunday, June 9, 2013

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

Friday, June 7, 2013

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. 

Sunday, May 5, 2013

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.

Saturday, April 20, 2013

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.


Friday, February 15, 2013

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.

Sunday, January 13, 2013

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.


Saturday, December 22, 2012

the big steam

For some reason I woke up at 7:30 am today and couldn't go back to sleep.  There are a handful of days in any given year when, for me, waking at 7:30 am is cause for suicidal ideation, and this was one of them.

I'm on "winter break" from college.  As the last day of our third semester of nursing school approached, the sane students in my cohort (everyone but me) looked forward to the freedom, festivities, and fun winter break can deliver.  I, on the other hand, was very afraid.  When I woke (at the reasonable hour of 10 am) the day after I took my final exam, I felt lost.  No test to study for, no paper to write.  Nothing but a yawning expanse of free days for nearly a month.  Free time is not my friend during the winter months here in Alaska, at least not in Kenai, where I live when I'm not in school.  I don't have trouble with free time during the summer because I can ride my bicycle at any hour of the day or night (what night?) and when I ride my bicycle I'm in heaven.

Last winter I bought a second hand bike with studded tires so that I could ride during the dark months.  Soon thereafter I learned that there is more to winter riding than studded tires.  There's the 30 minutes it takes to layer on long underwear, fleece pants, wool socks, ski pants, a couple of shirts, air activated heat pads in the toes of my snow boots, leg warmers over the ski pants, jacket, neck warmer, beanie, face warmer, helmet, and gloves.  There's the fact that what from the street looks like a plowed bike path is really a potentially deadly trek through the Himalaya; humping up and down even small piles of snow and globs of ice is a lot more work (and more dangerous) than it would seem.  There's the fact that when one breathes through a face warmer, one's glasses fog up.  Over and over again.  And, stopping to wipe them with a tissue only makes them steam up more.

I looked at the thermometer at 7:40 am knowing that unless I could get some exercise today I'd probably wander out onto an ice floe and drift toward the Bering Sea.  For some reason I also considered, albeit only for a millisecond, flying to Las Vegas and finding some cocaine. Colorful, right?  Know what happens to nurses who get caught with cocaine?  They don't get to be nurses anymore.  Not only that, I don't drink alcohol or use drugs, and I don't like Las Vegas because it's too hot.  I've been terminally bored since I came home, and today was the bore-peak.  The thermometer read -16 F.  I stared at it and a single tear rolled from my right eye.  The sun wasn't going to come up for hours, and even then, would be making only a brief appearance.  I was screwed.  Way too cold to ride.

Once again, my sister Linda talked me back from the edge.  I called her and made my case for rushing out and buying a stationary bike (maybe $250).  Sounded perfectly reasonable to me.  She reminded me that I have a stationary bike at my place in Anchorage and that I'm only home for a couple of weeks. "So?", I thought.  What the hell does she know?  She then suggested that I see if any of the local gyms had day rates.  I sulked.  That would be so much work, calling around to the gyms!  Spending $250 on a piece of exercise equipment sounded a lot easier.

I hung up and called the gym.  $10.30 (I know, weird number) for one day gym usage.  Drove 8 miles to said gym, swapped snow boots, gloves, and full length down coat for gymlike attire and got on the bike.  50 minutes later, soaked with sweat, the world was a very different place, and still is as I write this.  The snow sparkles, the temperature is "brisk", and the big steam that rises from the ocean when the air is -16 is a glorious phenomenon instead of a horrifying reminder of how cold it is outside.

Ah, the joys of whipping up a cocktail of seasonal affective disorder, boredom, and a little bit of plain old cranky.

Only 24 days until school starts again.  Not a moment too soon.