"Every Time We Say Goodbye..."

Last night marked the end of time in the Emergency Department--I couldn't have asked for a better shift to finish my stay. As I made my way through the familiar halls towards the parking ramp in the wee hours of the morning, I was overwhelmed with the knowledge that this could be the last time I made this journey. I knew I would enjoy my time at Mayo, even before I came way back in June--I just didn't anticipate that I would become so attached to it so quickly. And unlike when I leave school at the end of a semester, there's no promise that I'll be back.

I spent the day packing up my belongings and cleaning the apartment, which is woefully quiet and empty, as Camille has left and Echo and her family have packed most of her things and are staying at their hotel this evening. Being the procrastinator I am, this evening finds me probably 60% packed--but rather than being at the apartment finishing up, I'm at Caribou Coffee, enjoying the free wireless and an iced coffee purchased with the gift card Vince gave me last night ("Here," he said, "something to keep you awake while you're driving tomorrow.") I'm ready to leave, to spend a week in Chicago working at a health clinic for my practicum and then (finally) make my way home next Saturday. I'm just struggling with the transition--wouldn't it be lovely to be able to snap my fingers and find my stuff packed, the car loaded, and be ready to go?

But eventually everything will find a place, and I'll leave, bringing with me more than just physical possessions, but new memories, knowledge, experiences--my life is richer because of my time here. And I'm so excited to come back to my loved ones and share what I've found and how I've grown, and simply enjoy once again being in their presence.

Mom, Dad, Hannah, all of my wonderful, supportive, amazing family, my dear friends who are practically family--I love each and every one of you so very much. See you soon.

"Time Flies When You're Having Fun"

Hard to believe, but the summer is almost over. This is week 10, the last of the program. I can hardly believe how quickly the time flew.

I worked Saturday and Sunday, twelve hour shifts which always leave me extra tired afterwards. And yet, despite being exhausted and at times overwhelmed, I've never dreaded going to work. Not once. My family (who are privy to my usual evening mantra of "But I don't want to go to work tomorrow!") can testify that that's a pretty significant improvement. I've loved the time I've had here, the ER and the nurses and others I've met. I can say, with more conviction than previously, that I will enjoy being a nurse.

My roommate mentioned today that a friend texted her, saying how ready she was to go back to school. My roommate couldn't sympathize--like me, she thinks the summer has gone way too fast. "Yeah," I added, "and if summer's gone this fast, just think how quickly this next year will go!"

"Stop!" She cried, covering her ears. "If you say it, it's going to happen!"

Unfortunately for both of us, it probably doesn't matter whether I say it or not--time is a quirky entity. Even though we can measure it out in minutes and hours and days and weeks, we've all experienced how very fluid it can be. Some days, it simply seems to creak slowly by (or even stand still). Other days, we lose track of whole hours, often while doing something enjoyable.

I'm glad to have come through three years of college, and excited to look forward to being a nurse. But I'm also enormously grateful for another year before that time arrives--another year to learn and grow, to live with the friends I've come to know and love like family over the past three years. The first hints of change will arrive in December, when my dear friend Margie graduates--the first brave one of us to venture into the "real world". And from there, it just continues.

Change will come, sure as the sun will rise. But there will also be so many good times and rich memories in the interim--and I'm ready to soak them in.

An Update

I figured I should do a little follow-up from my last post, let everyone know how the meeting went and what the outcome was.

I arrived back at the ED around 11:30 am, nice and early for my noon meeting time. Let's be honest: after a seven day stretch of work, it was the last place I wanted to be on my day off, but you gotta do what you gotta do, right?

I found Susan up at the garage triage desk, which is the area where any patients who arrive via ambulance or private car (rather than walking in through the waiting room) are initially assessed and then roomed. We have paperwork which is to be filled out on a weekly basis; however, Susan and I had gotten a little lax with it (whoops) and we needed to get our ducks in a row before we went to the meeting. However, this IS the Emergency Department, and somehow things just never go as planned.

Just when Susan was about halfway through the paperwork, we were interrupted by a persistent little beeping. Susan was carrying the code pager that morning, and lo and behold, it was going off. [For those who don't know, at St. Mary's Hospital, any code situations, patient or otherwise, are handled internally by one of two groups: from the ground up to the 3rd floor and anywhere on the outside grounds, the ED staff responds, and floors 4-8 are handled by the Medical-Cardiac ICU staff.]

So, approximately 10 minutes before we were due at my evaluation, Susan and I were off and running--first to grab the code bag, and then to an outpatient area on the ground floor adjacent to the ED. Fortunately, when we arrived, the situation turned out to be less serious than expected: a hospital interpreter had fainted at the sight of blood, but was now responsive, although a little woozy. After checking vital signs, labs, etc (you can never be too cautious) we wound up admitting him to the ED for observation. By this time, we were now half an hour late for the meeting; luckily, someone had informed Mike what was going on, so we didn't get in trouble!

After all that excitement, the meeting was pretty tame. Mike asked about my perception of my time and experience in the ED, and I told him how much I loved it, and how much I knew I had learned and improved my nursing skills. Susan seconded that opinion, telling Mike that she felt I was functioning at 90% of the level that would be expected of an RN. That was so encouraging to hear: Susan is constantly pushing me, asking me questions, giving me tips to improve my practice, and some days I feel like I'm just never going to get it--but evidently, I'm starting to.

Mike responded in the affirmative, saying he shared Susan's opinion, and he would like to recommend me for hire. Obvious the ED doesn't take new graduates, but he asked for my areas of interest, because he's planning to set up meetings with the Nurse Managers in those areas before I leave. I agreed to that, but told him I know I'm not ready at this point to make a final decision. He said that was fine; I would probably have until January or February before they would be looking for a definite commitment.

So, that's that. The option is there; now I just need to figure out if it's the right one.

"Two Roads Diverged in a Yellow Wood..."

Tonight Mike, one of the Nurse Managers in the ED, caught up with Susan and I. You see, this is the seventh week of the Summer III program, which means only three more left. One of the program requirements is a meeting between myself, my preceptor(s), both Nurse Managers, and our Nursing Education Specialists--some of the key players for nursing staff within the ED. The goal of the meeting? Predict my future.

No, not really. In reality, they'll talk with Susan and find out her opinion of me: have I been growing and learning? What are my strengths? my weaknesses? And essentially, after I graduate, will I be the kind of nurse Mayo wants to hire?

During our group meeting, they'll share their perceptions and ask me for mine, and then we'll talk about my options--the ED doesn't hire new grads, but if they think I'm a good fit, they'll arrange for me to work a couple years in one of the ICUs, at which time I would then transfer to the ED. Or, if I don't think the ED is right for me at this point, they'll explore what I might be interested in, and get me connected with those floors.

Needless to say, I'm a little nervous. Susan has been reminding me that I don't have to give a "yes or no" answer tomorrow--I have time to think and make a decision. And in reality, I came into the program having already done some serious thinking and with my decision almost made. But now I have to follow through on it, and I wonder--am I doing the right thing?

"Two roads diverged in a yellow wood,
And sorry I could not travel both
And be one traveler, long I stood
And looked down one as far as I could...

Oh, I kept the first for another day!
Yet knowing how way leads on to way,
I doubted if I should ever come back..."

[Robert Frost]

Family Time

My family arrived Friday evening while I was working, so I didn't see them until Saturday morning, when we had brunch together downtown. The week has flown by--a tour of Mayowood (the Mayo family mansion), an excursion up to the Cities, a day at the Mall of America--and lots and lots of family time.

After living on my own, I am realizing how much of a difference there is between living on your own and being with your family. The past six weeks, I've been my own boss--went to bed and woke up when I wanted to, ate the food I wanted, gone to the places that interested me. Families mean a a jumble of opinions and preferences and dislikes (sometimes opposing), which have to somehow be discussed and synthesized in order to do anything.

And I realized, I'm fortunate--my family is pretty good at that. Sure, we have our tense moments, but who doesn't? Traveling with my family helps me move outside of myself, to consider what others are thinking and feeling. And somehow, we also have fun--even when things are rotten, we can still find something to laugh about.

I realized that the older I become, the more my chances to particpate in family vacations decrease. Hopefully someday, I'll get to do this with my own family, a husband and kids. Until then, I'm grateful for trip that comes along.

Mom, Dad, Hannah--I love you :)

A Three Hour Tour...

Well, not quite that--and don't worry, this tour can be enjoyed from the comfort of your own home--no need to worry about getting stranded on some desert island with quirky characters.

What we have here is a little mini-photo tour of Rochester and the surrounding area, courtesy of my wonderful roommate Camille's camera (as mine is currently out of commission.) Hope you enjoy them!

On Monday of this past week, Camille and I headed over to an ice cream social sponsored by a community group for mentally disabled individuals. Besides great ice cream and carnival games, there was also some guy in a gorilla outfit, seen at left. After confiding in Camille how uneasy these types make me, she very sensitively motioned him over and asked for a picture. I would interpret my look here as something along the lines of, "Gee thanks, Camille...just remember, I know where you sleep at night." Of course, Camille then offered to have her picture taken as well...notice how much happier she looks in her's!

After the ice cream social, we trekked back downtown, and Camille caught this great picture of the Kahler Hotel. The hotel was opened just a short time after St. Mary's Hospital opened (the portion of the Clinic where I work in the ER) and it originally served as a convalescent building for patients who had undergone their treatment but were unable to travel back to their homes right away. During our orientation, we spent some time there, and the building is really quite beautiful.

After the ice cream social, we headed downtown to find a good place to eat (we were employing the "dessert-first" method that evening). We wandered into Chester's Kitchen, which turned out to be a trendy little place (for which we were slightly underdressed, but nobody really seemed to care much). The food was great, and when Camille pulled out her camera to get a picture of us, a friendly lady who was just passing our table offered to take this--voila! She told us it was her first time using a digital camera, and when we showed her the picture she had taken, she was pretty proud of herself!

On the left is the fountain which was in the plaza just outside of the restaurant we ate it. The picture does not do it justice--up close it's really beautiful, although you get pretty wet checking it out! The picture above is one of the more unique and amazing Barnes and Noble's I've seen--it's housed in what an old theater, and leaving the marquee outside gives it such a cool feel.

Well, that's all for now, folks. There are more pictures coming--from our day trip to Lanesboro,a cute little town about an hour south of Rochester, and maybe some other fun stuff as well. Hope you enjoyed the tour--and I wish you all could come visit and see it in person with me :)

Things Fall Apart

Tonight, the ER became a very different place than what I had become accustomed to over the past three weeks. Reality broadsided me--Vince (my preceptor) and I were in one of the less acute areas, and I expected the evening to precede--well, not normally, because there is really no such thing as a normal day, but whatever I expected, I wasn't entirely ready for what we got.

The shift started poorly with what (in retrospect) seems like a bad omen: I poked myself with a needle for the very first time (don't worry, it was sterile and straight out of the package) and wound up with a Band-Aid on my left pointer finger. Makes things like putting on gloves and dressing IVs and washing your hands rather difficult, you know. Then, we simply seemed to get one patient after another with such difficult cases--intoxication, sexual assault, motor vehicle accident with casualties. More than once I found myself fighting back tears as I gazed upon shock, brokenness, grief, which seemed to seep from my patients.

And you find there is so little you can do. You can treat their physical issues, provide them with resources, but when it's all said and done, they walk out those front doors to--who knows what. I found myself praying a lot, asking that God would take everything we did and multiply it, that He would pick up where we left off in mending their bodies and minds and spirits. I am indescribably comforted that He hears and sees and knows them each by name.

Say Good-night, Gracie...

I worked from 1530-2330 tonight (3:30-11:30 pm for those who don't do military time) and we stayed pretty busy throughout the evening. At the end of shift, I made the trek to the parking garage (Mayo is HUGE--I probably walk close to a mile round trip from my car to the ER). As I pulled out of the garage and onto the street, I heard the familiar, adrenaline-inspiring sound of the Mayo One helicopter landing, most likely bringing an acutely ill patient to the ER. The lights were shimmering, and I could just barely make out the forms of the air medics as they jumped onto the tarmac and started unloading their patient.

For a moment, there was an urge inside to turn back--to return to the floor, see what was going on, help in the limited way that I am able in those situations. But that feeling was quickly mellowed with gratitude--the awareness that when we go home from our day's work, others come to replace us, to carry on the work we have been doing.

There is a huge pressure in our society to prove our worth, our importance to those around us. We strive to be crucial, almost indispensable, in whatever our field, so that there will never be any question as to whether or not we're really needed. But that drive to prove ourselves can lead to so many unhealthy and destructive behaviors--and those around us, our families, our co-workers, our clients--many times they bear the weight of our actions.

So tonight, it was good to be replaceable--to know that while I go home and rest my body and my mind, there are other hands and minds which can step in and do exactly the same work (and most certainly do it better!) Tomorrow is another day, and I'll be back, helping and caring and learning once again. But for now...

Good night :)

A Matter of Life and Death

"And death, who’d stepped toward him, paused and stared.

Light many lamps and gather round his bed.
Lend him your eyes, warm blood, and will to live.
Speak to him; rouse him; you may save him yet...

But death replied: ‘I choose him.’ So he went,
And there was silence in the summer night;
Silence and safety; and the veils of sleep..."

--"The Death Bed," Siegfried Sassoon

While spending two summers and multiple holidays working at Hospice, I became acquainted with Death--the signs which preceded it, the look and sound and smell of it, the aftermath of its appearance, played out in the grief of those left behind.

In my experience, however, death almost always was predicted, acknowledged--sometimes months in advance. Every man knows he must face it eventually, and the patients I cared for had some warning--a chance to contemplate their life and, hopefully, set into order those matters, relationships, etc which needed attention before they left them forever.

The ER is different. Heartwrenchingly so. No one expects to land there--no one gave that individual a warning, that today they would be laying on a gurney, unresponsive and unaware, while many people labored ferociously to bring them back, give them another chance. The team of nurses and doctors I'm privileged to work with are wonderful--they are intelligent, talented, and dedicated to their work. But they aren't miracle workers. There are patients they cannot save, despite their most valiant efforts.

May we all be so blessed as to know Death is coming for us, to snatch the remaining time allotted to us to make sure we leave nothing undone, untended to in our lives. But don't expect that gift-make sure every day, you live as fully as you can. Say "I love you" to your dear ones. Admit your mistakes and do what you can do make them right. Say "I'm sorry" when you need to. The list goes on--figure out what is written on yours.

Top Ten Reasons I Loved Today

(Well, there might not be quite ten on my list, but somehow "Top Four" or "Top Seven" doesn't have quite the same ear-grabbing appeal, you know? It must be the alliteration.)

#1 After wearing either scrubs or dress clothes all of last week, today we were permitted to wear jeans, as there was a welcome event planned for the evening. If we had to sit through seven hours of classes on "Mutual Respect" and "Psychosocial Components of Nursing Care", at least we were going to be comfortable during them!

#2 Instead of meeting downtown in one of the main Clinic buildings, they transported us to Assisi Heights, which is a beautiful building and campus which is now home to some of the Sisters of St. Francis who were instrumental for many years at the Clinic. We were allowed to explore the grounds during our lunch break, and the sunshine and blue skies were absolutely delightful after a weekend full of rain and thunderstorms.

#3 After classes were over, we all headed out to a camp in the country, where we enjoyed a presentation by the camp's director (a paraplegic who has completed over 100 marathons), really good barbecue, and some fun games. There are over forty horses at the camp, and Camille (my roommate) and I hiked out to see them, as well as a little bit of one of the nature trails.

#4 Mayo Clinic provided one of their photographers to capture the event on film, and Camille found his "facial structures" extremely attractive. I teased her about that most of the evening, and when we finally were getting ready to leave, she unexpectedly blurted out, "I should give him my phone number!" Well, that was all it took--after a few minutes of debating, we decided that Camille would write her name and number on a piece of paper, and I was delegated to deliver it to the gentleman. Neither of us had ever done anything quite like that, and Camille and I giggled about it the rest of the night. He has been dubbed "Mike the Mayo Photographer", and Camille says she owes me one...we'll see if I have any need to call in that favor. :)

#5 When we arrived back at the apartments, I had a letter from my dear friend in Scotland, which I curled up on my bed to browse through--a perfect ending to a most enjoyable day!

"You Don't Say 'No' to Mayo"

At least according to the girl sitting behind me on the bus today. She and her friend were discussing other friends who had applied for the Summer III program, but chosen to accept other internships. Both girls were in utter disbelief that a nursing student could turn down an offer to work at the Mayo Clinic in favor of some other internship--after all, nothing else could be quite as prestigious.

Six months ago, I would have been in hearty agreement with them. Miss the opportunity to intern at one of the nation's premiere health care facilities? Never! And of course, if the possibility of coming to work for them full-time was offered, I would have seized the opportunity without a second thought.

But I find my mindset changing somehow. I am still abundantly grateful for the opportunity to be here, and even when those difficult, nitty-gritty days come, I don't think I would trade this summer for anything. But other realizations are dawning, slowly but convincingly--like, the world's most elite or financially lucrative job means nothing if your life outside of work isn't as rich and fulfilling. And that sort of fulfillment comes from a select number of things in my life: communion with God through Christ, the love and presence of my family, the companionship and camaraderie of my close friends.

So what does all that translate into for my life and future? Not sure yet. But as I am learning daily what are the true priorities in my life, the drive and desire for the impressive and prestigious is being tempered by gratitude and appreciation of the richer and more precious things in life. If I am so blessed as to be able to possess both at some point in my life, I certainly won't complain. But given the choice between the two, I know with conviction which I would take, time after time.

The Long Day Is Over

Alright, here I am: collapsed on the couch in my apartment, physically and mentally exhausted, but I made it! I'm done with my first day of employment at the Mayo Clinic.

The day started bright and early with a bus ride downtown and a lovely breakfast along with a welcome from the director of the program. We were seated with the nurse educators from our different departments, and I met Kristi, the only other Summer III student in the ER with me. We speculated on how in the world we wound up in the ER out of over 140 nursing students, and didn't come up with any good answers!

But after meeting the nurse managers and some of the staff nurses, I am glad to be in the ER. Scott, one of the nurse managers, took us on a tour of the ER, which was intense and a little intimidating. They had had a busy morning (two car accidents and another trauma patient) and the afternoon was bringing little relief. The nurses were busy and a little stressed, but they all took the time to say hello and ask us a few questions.

The rest of the day was packed with classes and information and schedules---my roommates and I spent the evening going through our stacks of papers, sorting out what needed to go in the planner, be signed and returned, etc. Tomorrow morning begins even earlier, so I'm definitely planning on hitting the sack soon.

-Later-

There is absolutely nothing like a conversation with a friend to cheer you up and encourage you. My recently graduated suitemate and dear friend also started a new nursing job today, so we compared notes, and reminded one another how good it is to be working in "real life" rather than clinicals! So wonderful--friends are blessings, and I think mine are some of the best :)

Empty Suitcases and A Full Heart

Tomorrow is the big day. I am headed north for the summer, to town of Rochester, Minnesota, the Mayo Clinic Emergency Room, and ten weeks of learning firsthand what it means to be a nurse.

We leave tomorrow morning at 9 AM. My trusty old car is sitting patiently in the driveway, waiting to swallow my belongings into the gaping mouth of its trunk. The same belongings which at this moment--less than 18 hours from my departure--are still scattered about my room, in varying states of disarray.

I've spent most of the morning trying to instill some order to the diverse and sundry items to be packed, and also to the contents of my heart and mind. I'm a mixture of fear and excitement, apprehension and expectancy--a tangled bunch of thoughts and feelings and nagging fears.

You see, I'm horrible at change. In the school of life lessons, I'm still lagging desperately below average in this area. Leaving the familiar and the comfortable is one of the most difficult undertakings for me--doesn't matter how attractive or wonderful or beneficial the situation I am heading towards. Nope, I'd much rather stay right where I am, thank you very much.

But the past three years have taught me that is not a possibility. What I must do is change: recognize the fear of uncertainty within me, then choose to act despite it. This summer, my internship, a new home and job and town and roommates, is yet another chance to practice this terrifying yet exhilarating behavior.

So come tomorrow morning, I'm heading north, towards a great many unknowns. But I know I am not going alone. And that knowledge is precisely what I need.