May FNP Update

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The days are flying by but here’s another update on school, life and baby…

Baby #2: If you follow me on social media, you saw that we announced some super exciting news a few weeks ago…we’re having another baby! And it’s a boy! We’ve kept this news to ourselves for a while now but after I had a healthy report at my 20 week sono and we found out the gender, I figured it was time to share. I’m due September 1st, which is about 3-4 weeks after I finish my master’s degree. Good timing? Bad timing? I guess only time will tell! Either way we’re super excited to welcome this little man into our world. For several reasons I thought we would end up with all girls so this news was probably the best surprise we’ve ever had (along with meeting Evy when she was born!) I’m starting to wrap my mind around the fact that I will be a BOY mom too. The thought of having two sweet babies in the world brings me to tears daily and I absolutely cannot wait to meet him and for Evy to meet her little brother.

Pregnancy: This pregnancy has been vastly different than my first and now that we know we’re having a boy, it makes sense. Thankfully I was on a break from school during my first few weeks because those were ROUGH. Nausea, severe exhaustion, and a general feeling that I might die before I make it to twelve weeks. But that passed and now I’m dealing with a whole host of ailments that never happened to me with my daughter- melasma, leg swelling starting at 12 weeks and erythema nodosum. (GROWING A HUMAN IS HARD WORK) Despite all of these things, baby is doing well and I seem to be doing fine working all these hours. That brings me to the next topic…

School: I FINISH IN LESS THAN 90 DAYS. I am in my LAST semester. Yes, this is true but it does not yet feel real. I’ve been in school for almost three years now and I cannot imagine a day where I’m not pouring through books or scheduling clinical shifts. I will definitely be a life-long learner (you have to be in the world of medicine) but it will be so freeing to get to the end. To see the completion of everything I’ve worked for. To simply work normal hours again. So until August 10th, I need all the prayers you’ve got! My calendar is full literally everyday and if I look at it too long, I start to get short of breath. It’s going to be a tight squeeze to get 360 clinical hours in 13 weeks along with my 24 hours per week at the hospital. Honestly I don’t know how I’m going to do it but the Lord hasn’t let me down yet and I’m trying to let go of my control (or lack thereof) and trust Him.

Work: I’ve been back in the ICU for a while now and it’s been both easier and harder to come back than I had imagined. What about it has been easier? Well I haven’t been nearly as worried about leaving my daughter for those long hours as I was when she was a baby. This makes sense because she’s three and way more independent and she’s usually awake when I get home from work so I can help put her to bed. When I went back to work after she was born it really tore me apart (hence quitting for a while). I was constantly worried about her and it took a toll on me. Now, I don’t have any of those worries and thankfully I still get to see her everyday when I get home.

What’s been harder? Well the patients haven’t changed and although I’ve had to pick up on the few new things that have come into effect over the time I was gone, for the most part being an ICU nurse is the same. People still come in crazy sick and you still work to make them better. The hardest thing has been going from being one of the more experienced nurses to feeling back at the bottom of the totem pole. I spent seven years cultivating skills, relationships and a level of respect that kind of evaporated while I was gone. Now there are a ton of new staff who don’t even know me and it’s humbling to admit everyday that I don’t know all the answers anymore. (Essentially I feel somewhat incompetent at work AND at clinical- ha, fun times).

Nevertheless, I’m glad to be back working with patients. It’s funny how my mindset has shifted now that I’m much closer to being a provider. Instead of just giving the diabetes medications, I wonder why the providers chose that drug or that dosage or why they ordered one lab test over another. I find myself correlating patients that I see in clinic with ones in the hospital because many times it’s simply a continuum of care. My patient in the clinic has super high triglycerides that we’re trying to control and my patient at the hospital was hospitalized for pancreatitis due to high triglycerides. In short, many times I’m seeing the beginning and the end, the first signs of trouble and the extreme manifestations of that trouble. I wish I could take pictures of my ICU patients and use them as motivating factors for all the people in clinic who won’t agree to make changes. (Do you want THIS to happen to YOU??) But that would be both illegal and terrible so I won’t!

Preparing for boards: My birthday was a few days ago and I told my husband the two things I wanted to do were exercise and study because those are activities that I hardly have time for anymore! I did get a pedicure and go out to dinner so don’t think I’m completely lame. Still, I wish I had more time to pour over my review book. THERE ARE SO MANY THINGS I DON’T KNOW YET. Or things that I have forgotten over time. So many lab tests. So many obscure diagnoses that need to be on my differential. So many medication side effects. Sick people are complicated? Yes. So extremely complicated. I’m taking a board review class in July because I think it’s essential regardless of the fact that it’s inconvenient. I’ll be missing two potential clinical days and the class wasn’t cheap. But I believe it’s worth it so I’m making room in my life for it.

The reality is that I’ll probably pass the boards but I will still feel like there is a knowledge gap. I’ve heard this from all new NPs. So all I can do is surrender to that feeling of incompetence and use it to continue to learn and take better care of my patients. I’ve come to accept that much of what I need to be a good NP is exposure- hours logged seeing patients. Expertise comes with time and the more hard days I have with difficult patients, the more I’ll remember everything I need to know. Essentially, it’s important for me to continue to mess up because that’s how all of this will get solidified in my mind. That’s a hard pill to swallow when you’re one of those people who wants to get everything right the first time!

Have you had enough? My husband and three year old have been my biggest fans. My husband is rearranging his schedule for the summer so he can home more with our daughter and my mom and MIL are signing up for days to play with Evy. Evy goes around telling people that she’s a nurse practitioner and I can’t stand it I’m so proud of her. Hopefully she will be proud of me too!

I’ll try to post another update in June. Thanks for reading!

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