We Have A Winner!

Last night after an incredible day on the school-age peds unit, I was experiencing a vocational crisis of sorts. Those of you who know me (or read this blog often enough) know that I tend to get ahead of myself. But regardless, I was stressing big time about how to rank my capstone choices because I worried not only about whether I would learn from the experience, but also about what kind of job prospects it would present both immediately and in the long-term. If I did adult oncology, how hard would it be to eventually get a job in peds? But did I really want to work on a peds general floor?

The search is over, folks. I spent today on the peds day treatment unit. Un-freaking-believable. From toddlers to teens, from cancer patients to kids with genetic disorders, I saw it all today. Day treatment is where (mostly) outpatients go for infusions of chemo, rheumatoid arthritis treatments, etc., as well as procedures such as lumbar punctures and bone marrow aspirations. The staff there worked like a team, and the place was a well-oiled machine. Best of all, they threw me right in. I was helping with lab draws, setting up infusions, drawing up meds, taking periodic vitals, and observing/assisting with procedures all day long. The doctors were respectful and helpful. I was even part of a code today, which was a heart-wrenching experience (yet one that was important to have). Don’t worry though, the patient turned out okay.

The nurses really encouraged me to think about doing my capstone there because of the skills I would learn that I could take anywhere. They told me they’d have me doing IV starts and accessing ports in no time. Most of the patients have been coming weekly or monthly for a long time, so their families are familiar with the process and the kids know the drill. There are genuine relationships between the staff and the families. Who knew? I feel like it would be an amazing place to learn clinical skills while still practicing family nursing. I think I’d be more comfortable working as an RN on a peds floor if I was more confident in my clinical skills. On the other hand, I’d also be able to market those same skills to an adult oncology unit too (or cancer treatment center/clinic). So wherever I looked for work, I’d be in good shape. Chances are that when the time comes, I’ll apply to both options anyway and cross my fingers that something pans out. Then I can make that decision…no need to stress about it now.

Not to mention, they’re only open M-F, from 7:30 to 5:30, so no nights or weekends. Score!

So without further ado, here is my “short-list” that I’ll be submitting for capstone requests. Drumroll, please…

1. Peds Day Treatment
2. Adult Oncology
3. Peds Floor (preferably school-age)

I can already feel my anxiety level about this one simmering down.

No Habla Espanol

Imagine you are a 15-year old girl who just underwent a kidney transplant a few months ago. You are readmitted to the hospital because the doctors fear a transplant rejection. Imagine that although the danger of rejection is ruled out, they do decide to run a number of tests because you have a urinary tract infection. One of the tests determines that you have moderate vesicoureteral reflux…when you urinate and your bladder contracts, urine backs up into the ureters and kidneys, putting you at risk for repeated infection.

Now imagine going through all of that when you can barely comprehend, let alone speak, English. And your mom understands even less than you do.

That was one of my patients this week. We did have an interpreter for part of the day, but during the procedure to test for reflux (known as a VCUG), no one in the room spoke a lick of Spanish, adding to the emotional and physical stress both patient and mom were experiencing.

Back in high school, I decided to be “out of the box” and take Latin…for six years. Great for my SAT scores, not so great for enhancing my actual communication skills. Then college came and I had an opportunity to choose a language that would be more useful.

German. Smart thinking, Nurse Teeny.

We live in a society that is multicultural, and grows ever more so every day. And whatever the talking heads may say about requiring immigrants to learn English, it matters little when you’re standing awkwardly in a room, trying to educate a family about how important it is that a patient finish her entire course of antibiotics. If our job is to meet patients where they are, that most certainly includes being respectful and aware of cultural and linguistic differences that could affect the quality of care they receive. If we don’t speak the language, we most certainly have an obligation to make sure there’s someone who does.

As for me, I’m looking for ways to learn Spanish. Any ideas?