Starting out

My first job I landed as a nurse practitioner was working in women's health.  I was very fortunate to get that experience.  I had a blast too.  What better patients to relate to?  They have questions that I may have asked myself, they have parts that I can certainly relate to and they have concerns that I can sympathize with.  I spent my years in nursing in Cardiac, so the physical exam took a little while to learn how to do efficiently.  I was used to listening to lung and heart sounds, managing IV lines and monitors for the heart.  I could do an EKG in no time flat, but a pap smear, endometrial biopsy, interpret a transvaginal ultrasound?  That was going to take some getting used to.  We had to learn how to do paps in clincials during our last rotation in school, but there was always someone in the room there to help guide you to the correct angle to get the cervix into view.  There was an instructor there to hand you the instruments in the right order.  What am I going to do when I have to remember the order in which to proceed and find that retroverted anatomy with the difficult cervix that doesn't want to come into view without a fight?

My first week on my own was a rapid progression of successes and failures.  I think I did about 3 pap smears on my first morning before I was able to get the cervix to pop into view on my first try.  I was pretty impressed and I think I startled my patient a little bit with my outward celebration of identifying her anatomy without any assistance.  I was quick to reassure her that things were fine and her pap was a success(and that I wasn't a weirdo just happy that I did it on my own and I knew what I was looking at).  Other nurses and nurse practitioners know how it feels to have sat through hours and hours of lectures and clinical rotations watching others show you what to do and guiding your hands. It is only when you are in a room by yourself and run into difficulties and finding a solution for the first time while everything that you have learned is falling into place.  Those are the special moments that your patients may or may not realize that they are a part of.  It is about your patient and delivering the best possible care, but until that light goes off and everything that you have read about is finally making sense that you start to become the practitioner that you have been preparing for.

In my previous posts I have complained and put down nursing and the medical field, but ultimately I do think it is a calling and a special touch that you have to possess in order to make this work.  Nursing is one of those special fields where you are able to touch people's souls, but what you don't realize is that they are going to touch yours too.