My First Stint as an NP...Sorta

So, today was my first 'official' "clinical" as an NP...there are so many quotes there because I spent the day at a Health Fair, and did nothing beyond general nursing. But as it happened under the purview of my NP curriculum, I'm counting it. I wasn't so sure what to expect; we were at a very cool organization by Columbia's main campus, and were there all day to do general screening and whatnot for the employees, of which there were many.
I started out the morning at the Urology station, shadowing a dickens of a doctor, who told me, upon meeting him, that he was "One hundred and forty years old!" and proclaimed his profession to be "plumber", when asked if he was a doctor! He was an absolute hoot! Anyone who knows me knows my odd affinity for all people old, and I wanted to just put him in my pocket and take him home with me, he was so adorable! He was talking about his history, speaking in a mellow Irish brogue, reciting his tales of med school and training. He has been in the states for years, but grew up and received training in Dublin and London, and came here with his family many years ago.
His favorite thing to talk about was urology jokes. Definitely inapprops, and most likely offensive to at least half of the general populace, but coming from him, it just made one laugh. He really liked one about a Polish urologist: "You know how doctors do a rectal exam of your prostate with just one finger? Well, there was this Polish urologist. And another doctor was with him one day, and noticed that the Polish urologist was doing an exam with two fingers, instead of the customary one. So he asked him about it. The Polish doctor answered, 'I do it with two...one to do the exam, the other to give a second opinion!'" Laughing ensues:) Then he asked us if we had ever heard of the 'pasteurized' diet. No, we answered, you mean like milk and stuff? "Oh no", he says, and winks at me. "You just watch the food go past-your-eyes!!" Hahaha. So stinkin adorable, I almost couldn't take it. We talked about pelvic floor exercises and stress incontinence (peeing your pants when laughing/coughing/etc) and other such delightful subjects. I loved working with him!
Then it was time to rotate out. Giti and I went out to the registration table, the table that pretty much determined the flow of the whole room. It was our turn to direct things. And by direct, I mean, collate some papers and give them to people to sign. The funny thing was, by this time, I was getting low blood sugar cause I hadn't eaten in a few hours, and was starting to see everything as quite funny. Giti seemed to be similarly affected, so that didn't really bode well for the professionalism aspect that we are supposed to portray as NPs.
So we receive a quick tutorial from some fellow students, and sit down to see what we can do. Which turns out to be, not much. Anything beyond putting intake papers on a clipboard and telling people to bring back the pens seemed to be totally beyond us. If someone asked us a question about anything but that, we'd look at each other, and feel like saying, "Yeah. Between the two of us we have about five advanced degrees. But we're doing the papers. So we're gonna go ahead and direct you to that person over there who most likely knows as little as we do, but will make up an answer for you. Have a lovely day." No, we didn't say that, but we sure as hell felt like it. We'd send people to the blood pressure table, thinking, "Riiiiiiggghhhht. Why don't you just go over there to (whomever-insert classmate's name here), and she'll hook you up with a reeeeaal nice blood pressure. Yeah, I know a guy. You want a good pressure? Something to lower your rates for the insurance company? Yeah, just go see my friend over there. She'll take care of you good..." said in best imitation mob member voice.
We were laughing so hard that at one point I had tears rolling down my face and was gasping for air. And I was not unobtrusive at all, which made it worse. We got to the point of saying the same thing over and over, "Hi! Welcome. Just fill out all your information on the white part, sign here by the x, then (turning to next page), sign your name here and date. Then bring back the clipboard and pen, and we'll direct you where to go next!" and maybe it was the repetitiveness of it or something, but Giti was rolling through the schpeal and I lost it. I bent over and 'pretended' to be looking for some papers under the table but was really silently laughing so hard I almost peed my pants. And then I hear Giti losing it as she explains things to a client, which is NOT good, and when she is done, she gets up and excuses herself. She has to leave the room she is laughing so hard. We physically could not even look at each other without losing it.
I have this bad feeling that someday, I'll get attacked with the giggles at an inapprops time, which honestly, happens to me more than it should, and a patient will think I'm laughing at them. Like, someone comes in to see me, and I am reviewing the results of their bloodwork with them, and it turns out that they are positive for tumor markers and their MRI shows a mass and the biopsy came back positive, and I have to tell them they have cancer. And I look up at them, and start laughing. Deep, trembling belly laughs. Totally inappropriate laughing. And I can't stop. I just can't stop. I would probably be the person who laughs at a funeral, even though inside I might be devastated and weeping and missing the person so badly, outside, something would strike me as funny and I'd be off. I really need to work on this.
So when we came back from lunch, I was doing blood pressures, which morphed into health counseling, and I found myself spewing out info about cholesterol levels, BMI, blood pressure, etc. and I had no idea where it was coming from. Turns out I know a little more than I generally think I do. But I often feel like I know just a wee bit more than a patient, and think, "Wow, if you really knew that I am desperately searching my mind for this info, and I'm pretty sure I know it, but maybe I don't, I don't know..." but having to appear completely confident on the outside, it makes me think of what my friend Ash says about it. Seeing as we are all new nurses, she said that her first few months on the job felt like it was all smoke and mirrors...you say something to the patient which you are mostly sure about, but you have to convey it in an ultra-confident manner. Now, I don't want anyone to get the impression that we don't go ask someone if we don't know; we do, and I hope I do for the rest of my career. But it is just funny because you put on these professional white coats and have your stethoscope and people come up to you and ask you about cholesterol or something and you think,"Dang! Thank God I just reviewed that this morning, otherwise I'd really not know what to say!"
So, overall good day, fun stuff, and I am feeling very nurse practitioner-y tonight.

Fallishness

I was talking to my mother this morning, receiving the requisite advice about life in general, walking through the streets of NYC, and just generally feeling very happy. I have to be honest, and I know my California friends will absolutely boo this thought, but I'm not so thrilled about the 73 weather...I think fall should feel and look like fall...although I'm sure after a few days of freezing-ness, I'll be complaining about that too!
But talking to my mom suddenly shifted me back many years, to the great Wisconsin falls, and split pea soup. I can close my eyes and picture exactly a scene that took place, and repeated itself, many many years ago. My mom always made delicious, thick, split pea soup which we garnished with yummy croutons, and I'd sit at the kitchen table, looking out our windows and seeing that characteristic fall sky, nearly-leafless trees waving gently in the late afternoon breeze. The soup would be bubbling on the stove, mom and I both starving, but waiting for dad to get home from work so we could dive in to the green goodness. I can still smell and taste it! I told my mom this, and she told me that she was washing dishes this morning and suddenly flashed back to when I was a little girl, probably no more than three or four, helping my dad with the dishes. There is a picture of me, standing on a chair next to the sink, a towel tied around my waist, and 'helping' dad wash and dry our supper dishes. I've always loved doing the dishes, except for a brief stint of hating them in high school, so I guess this love came early. As far as I remember, I think I used to ask to help do the dishes...weird kid that I was!
It feels nice to take a few minutes to sit down and write something; it feels like forever. My days have been absorbed with studying for the recent slew of tests, studying that I am fervently praying paid off. Grad school is tough, but I love what I'm learning, even if, as my friend Kathleen pointed out, it often feels disorganized at best, and we have to reconcile ourselves to the fact that we will mostly be teaching ourselves. But, for what its worth, I am so thankful to God for the opportunity. The sucky thing though is not keeping in better touch with friends that I have around the country...those of you I owe calls to, please know I love you and always will, and we'll talk soon!
My birthday this year was indescribably fabulous, and I wake up each day, astonished at the blessings that the Lord has seen fit to give me, from amazing, irreplaceable friends, to a cozy apartment, to enough (but just barely enough) money in the bank acct, to loving parents, to a great Kitty! Life is not always easy; ha, who am I kidding? It is never easy; but God has given all of us blessings, every day, and I pray that we are all able, no matter where we are or what circumstances we find ourselves in, be able to have the eyes to see them. "Every good and perfect gift comes from the Father above", and what an incredible Father He is.