St. Valentine

While I confess to the occasional superstitious bent, it had not occurred to me that this year Z and I would be sharing our thirteenth Valentine’s Day together. If I had realized that ahead of time, perhaps what followed would have seemed wholly appropriate and even inevitable. In our years of love, we have celebrated this day in multiple cities and even in another country. We have exchanged the usual (chocolates, flowers) and indulged in the fine (high tea with champagne, expensive whiskey). We have sacrificed comfort in order to celebrate love: our first Valentine’s Day was spent on the beach at 5:00am, eating donuts and drinking orange juice because we were poor college students both with extremely busy schedules and that was the only time we had that day to spend together. He still brought me roses; we watched the sun rise; he read me The Offshore Pirate, his (then) favorite of F. Scott Fitzgerald’s short stories.

Since our marriage six years ago, Valentine’s Day has become both more intimate and more comfortable: elaborate meals prepared and eaten in the privacy of our home while wearing our best clothes. With this in mind, I felt a sense of relief as Valentine’s Day 2018 approached…the first Valentine’s since the birth of our child. We can do this, I thought, it will not be so difficult to prepare a nice meal and wear decent clothes. The baby goes down by 7:30 and we can enjoy our dinner together. S had been sick since the previous weekend, but was showing signs of recovery and sleeping moderately well at night, all things considered. And then I woke up at 3:00am on the morning of Valentine’s Day and found myself rushing to the bathroom, violently ill. Thankfully, it proved only a 24-hour stomach virus, but it lasted through the day, rendering me almost completely unable to function. Caring for the baby was nearly beyond me, let alone preparing a meal that I would not be able to eat.

Love is not always pretty or fancy or grand. On Valentine’s Day 2018, in the W household, love looked like an exhausted man going in late to work and coming home early to take care of a sick wife and baby. As I wrote to my in laws, “Z was the Valentine present: leaving late this morning and coming home early to take care of us, watching S so I could sleep (even though he has so much thesis grading to do), and cleaning the dirty laundry so we can sleep on clean sheets in clean clothes. He is the best Valentine and we are so thankful for him.”

God bless him, he still brought me roses and chocolates.

“That was one of the two true things I told you.”
“Perhaps I can guess the other one,” she said; and reaching up on her tiptoes she kissed him softly in the illustration.
– The Offshore Pirate, F. Scott Fitzgerald

Movement

One year ago today, I felt my son move for the first time in a powerful way. For nearly a month I had been feeling those quickening flutters that only a mother can detect, internal movement but unable to be felt by hand. Like many, I initially struggled to distinguish my baby’s movements from my own intestinal rumblings. Later, I would learn that he had an anterior placenta, which muffled those early flutterings significantly. But on January 13, 2017, I distinctly felt him wiggle and twist and kick. I remember exactly where I was: in the CR-V, driving home from the clinic, coming up over the Newhall pass. There was a palpable thump on the upper right quadrant of my belly…and then another…and another.

January 2017 was a dark month in many ways, most starkly in the loss of my grandfather. Pregnancy was a sharp source of grief as well, a costly and unasked-for gift that sapped my strength physically, and mentally consumed me with doubt, anger, and uncertainty. On that day, January 13, 2017, I was 24w+1d gestation. My grandfather had died one week and a day earlier; we would be holding his funeral the following day. When I started my drive home from the clinic, my thoughts were filled with sorrow, missing my grandfather terribly. As I drove up the Newhall pass the scene out my windows was filled with rough, rocky hills, twisting scrub oaks, and an expansive blue sky overcast with white clouds billowing in dramatic formation.

And then that little rhythmic thumping started. Thump. Thump. Thump. Pause.

I could visibly see that spot on my stomach pulsing with each kick. Oh, hello little Sprout. I placed my hand gently over that area where a tiny foot was kicking me from the inside. We drove home like that: my hand on my belly, over his tiny foot, and he continuing to kick, steadily and rhythmically, for the remainder of the drive.

At that time I did not know I was having a boy. It is a persistent, albeit intermittent, source of sorrow that I was not able to share that news with my grandfather before he passed. At least I was able show him my first ultrasound picture. At least I was able to tell him, You are going to be a great-grandfather. His joy at that news alleviated some of my own distress. He wanted to be called “G.G.” as his special name. Much later I would be stuck by the realization that G.G. knew, well before I did, that he was having a great-grandson.

Tomorrow will be one year since Grandpa’s funeral, that moment when, to me, he seemed truly “gone”. This holiday season has been bittersweet with memories of the previous year and time spent with him. But today was filled with the lovely remembering of Sprout’s movements, which would become the most cherished aspect of pregnancy. What a difference one year makes, no? Today, Sprout’s movement encompassed the whole living room and hallway and kitchen and into the bedroom as he crawled, and crawled, and crawled. When he paused it was to pull up on something, a bookshelf or the futon or the box on which the Christmas tree stands. He can stand and cruise with skill. I think the deepest desire of his heart is to walk.

From those precious kicks to crawling…what growth. Perhaps, someday, when I have greater perspective, I will be able to write about my own growth. Today I sit in that bittersweet space between mourning the loss of a loved one and the deep joy in my little love.

Grant me Lord
What I can’t afford:
To be made right
To be restored.

Take not Thy spirit
From my chest,
Or I regress.
Or I regress.

Draw me near,
Or I regress.
– from We’re Not Lost by The Show Ponies

NYE

(from the board on our fridge, in Z’s messy scrawl)

1. Put baby to bed
2. Drink champagne
3. Sleep
4. Repeat as needed

FNP

I passed.

Performance Anxiety

There are three things I have wanted more than anything else in my entire life: to marry Z, to write a novel, and to become a nurse practitioner. Of all the resources I have ever possessed, the majority have been devoted to these three goals.

I should mention that I am starting this post approximately twenty minutes after having scheduled my FNP boards.

Learning the language of nursing was hard, but learning how to be a provider (aka “nurse practitioner”) was natural once I found the right clinical site. I was a good clinical student (a good classroom student, too, for that matter) and there are a number of people who have been telling me to just take the exam because they are convinced I will be fine and feel so much better afterwards. I don’t know why I am so afraid.

I have been terrified of exams before. Every test ever taken in any of those prerequisite classes was an ordeal, carrying with it the potential for shame and failure. While I never feared the exams during my BSN quite so deeply (since my expectations were considerably lower) the NCLEX-RN itself was a beast. But the FNP boards aren’t like the NCLEX-RN.

The NCLEX-RN was a game, albeit a twisted, sordid little game, but one that I could play since I had an understanding of the rules. The FNP exam isn’t computer-adaptive. It won’t shut off once I’ve managed to survive long enough and convince it that I am minimally competent to practice. I will have to take all of the questions and I will have to get a certain amount of them correct. If the NCLEX-RN was a professional torturer, at least there was the knowledge the torture would end once I had proven myself. The FNP exam is simply Judgment Day.

When I was preparing for the NCLEX-RN I had the benefit of a Kaplan review course at the end of my program. Together with the rest of my cohort, I learned how to play the game from an experienced and delightful instructor. After that, I did practice questions (daily, I think?) in preparation. As I said in a previous post, I scheduled my exam kind of on a whim. I’m not sure I felt “ready”, but I definitely wasn’t terrified. I felt anxious and frustrated the day before my test, but not petrified.

I think I’ve cried every single day that I’ve been studying for my FNP boards. I melt down. I have to baby-talk myself down from dizzying heights of anxiety. It is probably a good thing I’m a psych nurse, since I am using all of my tricks on myself right now. (It’s the day after I scheduled my exam, right now, by the way.)

(Scratch that, it’s now the day before I’m supposed to take this @*#&$^%&* exam and I am stressed beyond description. I also have a BA in English Literature. This should give anyone an idea of how stressed I am if I am stressed beyond — oh, wait. If I just illustrated that…maybe it counts as description…? I DON’T KNOW. I DON’T KNOW ANYTHING. I AM SO STRESSED.)

I don’t want to play anymore games, I don’t want to take anymore tests, I just want this to be over and to read the word PASSED on my computer screen. Commence melting down once more.

(It is now the morning of this #*!$&%!*@#^*&^ exam.) I am so tired and so anxious. I completed the bundle of practice quizzes I bought two days ago. Averaged an 80.9%. Is that good? I don’t know. Took the practice exam off the AANPCP website, 75 retired questions. Got a 91%. I think that’s good? I also think my head is going to explode from trying to retain so much information. Yesterday, I was reviewing the content from my books, doing the practice questions within the books, and thought, “Oh, I should take a predictor exam,” as though that would give me the last-minute confidence I am so desperately seeking.

So I bought a predictor exam from APEA around 8:00pm last night and then started it up around 10:00. WHYYYY? It’s like I have to procrastinate about every single little step. And then, of course, even though I thought I was being strategic by waiting until Z was tucked quietly into bed before attempting, the police cars and helicopters chasing someone up and down the nearby area completely ruined my concentration. I wanted to scream at them.

Time was running out on my predictor exam and I could barely concentrate on the questions. I blazed through at least the last 30 questions without carefully reading them, costing me a number of points, I’m sure. I finished the test with two minutes to spare and pressed the end button. The number “80” popped up on a screen with the questions I missed and that’s when I broke down for good. There’s no way I can pass the real exam, I thought. If I only got 80 questions right on this stupid predictor it’s going to say that I’m not at all likely to pass. I shouldn’t have scheduled the test; I’m going to fail. 

Then I got mad at the predictor exam. What are these questions anyway? I thought angrily. They make no sense and I don’t think they’re important for primary care! Why can’t the questions just reflect what I need to know to start practicing competently?

I thought about just closing the whole thing, but decided to review my errors anyway. There’s still one question that I think my answer was correct and the scoring was wrong. Anyway, I reviewed the mistakes, made notes, and clicked the button to take me to the next page for a breakdown of my scores by knowledge area (“Hematology”) and testing domain (“Assessment”).

That’s when I see it – 80%. Not 80 questions out of 150 correct, which probably would have put me in the red “unlikely success on certification exam” category. No, 80% puts me in the green “highly likelihood of success on certification exam” category. Ah, so that’s why the number was in green…like a stoplight. The realization of this shocks and numbs me, not so much that I stop crying completely, but I manage to make it to bed without sobbing and waking Z up.

It wasn’t until this morning that I realized I probably had way more time for that predictor than I thought. For some reason, I expected it to shut off at two hours (like the 75-question AANPCP practice test) but since it was a full 150 question…I probably had at least another hour.

I wish I could say that taking the predictor (under less-than-ideal circumstances! with many distractions! in a constrained time format!) and successfully passing (only needed 70% to pass! got 80%!) has imbued me with a well of confidence about taking my test today. It has not. I am still shaking with fear and feeling queasy. The only thing it has done is convince me that maybe, just maybe, it wasn’t a mistake to schedule the test for today. And that maybe, just maybe, I know enough to scrape by.

This morning, I told Z: “Pray that the test that pops up on my screen is the one that I’ve studied for.” I don’t know everything. I’m not even convinced I know enough. And there is probably at least one version (maybe more) of this test that I cannot pass. But there is also probably at least one version (maybe more) of this test that I can pass. So I am praying fervently that that is what shows up on my screen today.

Bloom

And here we are, the annual post.

One year ago today, I managed to scrounge up a resolution for 2015, a hope for growth with the self-admonition to “bloom where I was planted”. It amazes me, a little, how the single, focused, resolutions I have adopted over the past three years have actually shaped my actions and given me motivation. This past year was no different. As I mentioned, one year ago, the previous years (2013-2014) were spent practicing self-care and being brave, or “plowing and planting”.  I was ready to see growth in 2015, the fruit of those labors. This was compounded by the fact that I was turning thirty in March 2015, a milestone year.

Expecting to bloom may have given impetus to bloom. This in spite of the fact that 2015 was not an “easy” year. Are there ever easy years? The academic year opened with what turned out to be the worst clinical course of my entire graduate program. I struggled through, hating the didatic portion and bolstered only by my continued joy in the clinical setting. In the midst of this class, I turned thirty. In fact, I completed the midterm on my birthday. The summer proved distinctly more enjoyable, as both the didatic and clinical portions of the course were pleasant and interesting. However, I had to leave my favorite clinical site for a specialty practice, so there was a bittersweet edge to even that course.

The final semester of graduate school was overloaded. Ever the procrastinator, I had no choice but to cram the last of my elective units in with the required concluding courses. Somehow, I manage to thrive amidst the chaos of a schedule bursting at the seams. My comprehensive exam paper and Adolescent Health Care proved a fine and enjoyable end to a program that often felt like a storm. I remember clawing my way through the courses of the BSN program, struggling to earn decent grades. Keeping that in mind, it feels good to have passed my final graduate semester with flying colors.

But what about blooming? Well, if growth can be counted in accomplishments, here are the major accomplishments of 2015:
– Thirty years old
– Master of Science in Nursing
– Wrote a novel

I also read nearly forty books, more than twice the amount in any of the previous two years.

Now, I’m struggling to come up with an appropriate resolution for 2016. Closing the door on a particular chapter of life is fine, but it leaves a space to fill. My mind can’t quite comprehend or fill the space right now, so I’m going to hold off on making resolutions too quickly.

And, that’s a wrap.

 

 

Make It So

It’s the last day of 2014 and I feel like that deserves a post. One year ago I was writing from a beautiful house in Oahu, in the midst of an in-law family vacation. I had already survived two bouts of severe stomach flu on the trip and was trying to be brave and not a grumpus. I had spent 2013 practicing self-care and bravery called to me as the next step. So 2014 was the year of being brave, or at least trying to be brave.

This year I’ve completed three more semesters of graduate school, endured my first two clinical courses, and passed the hardest class I’ve ever taken. I said “No!” to a preceptorship in the summer that was a terrible fit, even though I was uncertain at the time if I would be able to find something better. I was blessed with the best preceptor I could have asked for, who encouraged my bravery and pushed me to practice independently in the clinic setting. I switched jobs and faced a much harder learning curve than I expected in psychiatric nursing.

If I hadn’t made bravery a goal for 2014, I think some of these challenges would have overwhelmed me and sent me spiraling back into a dark and timid place. However, because I had just one resolution [“be brave”] every change became an opportunity to step out bravely. It wasn’t the year of fearlessness, there was plenty of fear and doubt. But it was the year of bravely facing fears and doubts. It was a year of bravery but not recklessness, of continuing to practice the self-care started in 2013.

I hope 2015 will see the same seamless transition. Honestly, I don’t have a clear-cut goal for the year other than “finish graduate school”. I’m still “finding my voice” which was part of this year’s resolution to be brave. When I try to sum up my hopes for 2015, it comes out a bit trite: “bloom where you’re planted”. Yet the phrase encapsulates what I hope to see: growth. I have a theory that the past two years have been spent metaphorically plowing and planting. I’m ready to see some fruit in 2015.

Exhausted

I have no energy for the creation of witty titles. The blunt truth will have to do instead. I’m spent. Worn out. Exhausted. Running on fumes. Unfortunately, in the responsible adult world being spent does not excuse one from getting up the next morning and giving 100%. So, I finished my first shift yesterday. Since I’m just training right now, I spent a lot of time watching the lead nurse, trying to make sense of the daily tasks in order to understand what exactly I will need to do when I strike out on my own (which will hopefully not be for a while). But, being as hands-on as possible when training is the best way for me to learn. So, I did the RN rounds, a few of the assessments, and some of the admission paperwork for a patient.

Since this a mental health facility, it should go without much explanation that patient safety (including continued monitoring of patient whereabouts) is paramount. Thus, a staff member is responsible for charting the location and status of all patients on the unit every fifteen minutes. Typically, a psych tech will do the rounds. However, every two hours the RN must do the rounds herself. It’s pretty straightforward, so I did all the RN rounds yesterday. The paperwork (and there is an endless ton of paperwork) is far less straightforward. Some of the paperwork includes assessments (all patients on the unit must be assessed at least once per day), admissions (and it is difficult when a patient arrives late in the evening, towards the end of shift, to get all the documents in order), and discharges.

Yesterday’s shift left me overwhelmed and tired. The exhaustion is a product of my four hours of class Tuesday night plus yesterday’s shift plus six hours of clinical today. I am pleased to say that I have managed to also complete my fitness challenge workouts each day (today was the third). Tomorrow I get the day off from my workouts, but I do have four hours of clinical from 9:00am-1:00pm. And it is the longest four hours of clinical ever, because I don’t really do much but observe. Sigh. At least today I was busy pretty much the whole six hours. Which is why my PA is the best: she lets me do so much in terms of hands-on assessing and interacting with patients. Love her. Also, hoping and scheming to do more of my rotations with her.

I napped for an hour or so this afternoon post-clinical, so hopefully that will help stave off some of my exhaustion. I also just ate some scrambled eggs and am now feeling quite perky. Eggs! Protein! Yeah! On a less perky note, one of the worst aspects of my new shift hours (coupled with being a graduate student and the requisite clinical time) is the way in which my schedule and Z’s tend to orbit around each other. Right now, he is driving back from a late evening work function. Yesterday, I didn’t get home until midnight (my shift runs 3:00pm-11:30pm). I’m scheduled to work Saturday-Sunday this weekend. It feels like we’re dancing around each other. Almost like a long-distance relationship. Good thing we have lots of practice…

Black and enduring separation
I share equally with you.
Why weep? Give me your hand,
Promise me you will come again.
You and I are like high mountains
And we cannot move closer.
Just send me word
At midnight sometime through the stars.
– Anna Akhmatova, ‘In Dream’

Fitness|Brave

Full disclosure: I have never hated my body. Not as an adolescent, not in college, not in my mid-twenties. However, I have at times been critical of, or even disliked, my body. But I have to say, at 29, that I dislike my current body more than I ever have. Thus, in keeping with my personal challenge to “be brave” in 2014, I decided to start a 30 day fitness program. By that I mean I downloaded two workout regimens and started them today. (Yes, two, because the “30 Day Ab Challenge” wasn’t going to work out all of my problems. I needed the squat challenge for my legs.)

In other news, I finished orientation for my new job last week and will begin training on the different units starting tomorrow. This is a mental health hospital and will be a completely new experience for me (excepting, of course, my my mental health rotation as a student nurse). I’ve been wanting to work at this facility for about a year now, so I’m pretty excited that it’s finally happening. Right now I’ve signed on to work a per diem schedule, which means I turn in a list of my available dates to the scheduling coordinator and then I work only those dates unless I get called off.

To me, this seems like a perfect arrangement, since I can flex my hours around my school and clinical schedules. Speaking of which, Primary Adult Care is kicking me swiftly and repeatedly in the seat of my pants. And now I need to finish reading about COPD.

Update(s)

1. Successfully completed first graduate clinical course

2. Classes started last week, already have 18 clinic hours

3. Orienting for new job Monday-Wednesday this week

4. Still have four “fun” books to read, I refuse to stop

5. Huntington memberships are the best

6. Potted garden continues to thrive

7. Three peppers on my pepper plant

Life moves pretty fast. If you don’t stop and look around once in a while, you could miss it. – Ferris Bueller