Tuesday, February 1, 2011

Nursing School

Disclaimer: Long post.

I get a lot of questions from family, friends, and neighbors about medical issues. This seems to be a weekly occurrence for me. People call me all the time and ask me in-depth medical questions. I always enjoy trying to help or give guidance on seeking qualified medical attention. Nursing has served me well in my life and I always consider it a blessing to have had the opportunity to work as a nurse. I have not practiced nursing in 21 years and am not licensed anymore to do so. When opting to stay home with my children, that meant I opted to let my license lapse. Without a license, one cannot work as a nurse. I was always under the impression that when my children were raised, I would go back and refresh my license. The state of Utah no longer offers refresher license options. I would have to move out of state for that to happen. That said, I am only in the category of a former nurse. Nevertheless, people still call me. Just yesterday my sister called me from North Carolina about her daughter. That got me thinking about a blog entry about nursing school.

I am an RN diploma graduate. Anyone who works in the field of nursing understands what that means. It carries with it the distinction of being an 'old fashioned, good bedside nurse.' :) Diploma programs are very rare these days but there are still a few in the US. Health care has changed dramatically and I always advocate anyone wanting to become a nurse to receive their BSN, a bachelor's in nursing. I was accepted to a BSN program in upstate New York but opted instead to attend Albany Medical Center School of Nursing. It was a hospital based diploma program. Had I to do it all over again, hands down, I would do the same thing. So much so that when I graduated from the University of Utah with a BA in Chinese, I decided to not attend my graduation. My graduation from nursing school meant so much to me, it still does. That's the graduation I wanted to remember.
Graduation Day 1980

When I attended Albany Med as we referred to it, it was ranked as one of the top ten medical centers in the country at the time. I don't know how it ranks now. It was a huge regional hospital servicing locals as well as many outlying areas. It was just a great hospital and it was huge.

Our nursing program was three years long. We only had four weeks off a year and most of the time, only two weeks off at a time. Our dorms were a part of the hospital. When we ate our meals, we ate them in the hospital cafeteria. We passed the operating room suite on the way to the cafeteria every day. I always loved hospitals. To this day, I get very excited when I go into a hospital...love them.

The program was set for the entire three years. There was no choice of classes or choice when to take the classes. Every student did the same thing. The first six months we only worked on the floors in the hospital one day a week. The other four days were spent in intensive classwork. Every week regardless of classwork or clinical,  the workweek was 36 hours. At the end of the first six months, we had our capping ceremony. I remember chatting with a recent grad from a BSN program about whether or not they ever did any type of capping or referencing to capping any more. She just sort of burst out laughing at me as if to say that was so archaic. Perhaps...but it was so wonderful. In ancient times when I went to nursing school, we wore caps. Just like a good old fashioned nurse. :) They represented who you were to the patients and to the rest of the hospital. Nowadays it is kind of hard to know who's who. Oh well...The capping ceremony had a component where we all recited the Florence Nightingale pledge I think.

"I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician, in his work, and devote myself to the welfare of those committed to my care"
Receiving my cap, age 18.
A wonderful old ceremony.

From the time of receiving our caps, the extreme intensity of training began. They don't train like this anywhere anymore that I know of. Too bad really. In most BSN programs for instance, two years of the four years are spent in general education and prerequisite classes. Then the nursing part of the program begins for the remaining four semesters with clinical training usually being two days a week with a minimal case load and an instructor always present.

My program was very different. The remaining 2 1/2 years of my schooling was spent having a 3 day clinical experience 48 weeks a year and a 2 day classroom experience. We worked in the hospital every other weekend. The classroom work always tied to the clinical work so there was book learning and valuable hands on training as well. That made the nursing and the learning "gel" so to speak. The classroom setting was always 8 am to 4 pm with lunch in the middle. Those were long days. 

Our junior year was very fun and a bit different. Those were the years we did 3 months of obstetrics, 3 months of pediatrics, 3 months of psychiatry nursing, and a one month intense operating room experience with two extra weeks in the recovery room. The first six weeks of the first three on this list mentioned was spent with the 3 days clinical, 2 days classes routine. The second six weeks were spent on the floors for 36 hours per week. This meant that during the second six weeks, we did 2 weeks of evening shifts and 1 week of night shifts per specialty (except for psychiatry which was only evenings). We were highly trained. The instructors didn't have to check in much. We literally helped staff the hospitals with large case loads similar to the regular RN's. I remember a night shift on obstetrics where I was the only nurse in the delivery room helping the delivery because that's just the way it was. I remember having 10 newborns in the newborn nursery all to myself on the night shift because that's just the way it was. The pediatrics rotation saw us having extensive pediatric ICU experience. The psychiatry rotation saw us having six weeks of experience on the locked psych ward and six on the regular floor. These types of experience based training programs were worth gold but not a degree apparently. Go figure.

I still cringe when I think of the operating room rotation. Albany Med had 18 operating rooms. There was a specialty per room. We rotated through all of them except the open heart surgery room. My first day in the OR I 'observed' in the morning. My trainer smiled and said, "Go to lunch. When you come back, you'll scrub in." Fear struck my heart, I still remember it. Granted, she scrubbed in with me but that was only for the first two days I think. I still remember when she 'broke scrub' with a smile on her face. That was it. I was it. Shaking all the way I think. That meant I was the nurse assisting the surgeon in the surgery. The OR was so cool and so intense. I spent time in the room for brain surgery where I dropped a metal can on the floor (twice) during one operation when the surgeon let me know in no uncertain terms not to do that anymore. Oops. I scrubbed in on orthopedic surgery where the surgeon's tools looked like my dad's workbench tools. Someone handed me someone's colon once after a portion of it was resected for cancer. Abdominal aortic aneurysm surgery was a blood bath, never saw anything like it. Eye surgery was boring. General abdominal surgery was exhilarating. What a great way to learn anatomy. I scrubbed in on most surgeries. But I didn't want to become an OR nurse.

I favored bedside nursing, good old fashioned bedside nursing. This always involved a lot of backbreaking work. That's why I have arthritis in my low back now. I lifted, pulled, tugged, and turned all shapes and sizes. I loved sitting with patients and talking to them. As a matter of fact, my psych instructors wanted me to become a psych nurse. They said that was what I should be doing. But I preferred pediatrics. I did a specialty on pediatrics as a senior for further experience. I worked as a nurses aid on pediatrics for a year while going to school for extra money. I also did a special internship on rehab working with paraplegics, quadriplegics, and stroke victims. Bravery and suffering are the two words that come to mind.

We had an infectious disease floor for specialized training. I spent 23 weeks on the eye, nose, and throat floor. I suctioned out a ton of trach tubes. We spent a month in ICU. We were assigned two patients each there, just like the regular nurses. We had three weeks of emergency room training. I LOVED the fast, frenetic pace of the ER. And we spent weeks and weeks and weeks on regular medical floors and surgical floors-the backbone of hospital nursing.

We did a lot of team-leading nursing where we were the nurse responsible for 30+ patients and all those who worked under us on our team. We had charge nurse duties on various floors and various shifts which meant we took over for the charge nurse...nursing in the trenches where the buck stopped with us. Other nursing programs just never offered that component.

When we graduated, we were fully trained. Transitioning to a job after graduation was very easy. We just had to learn the logistics of the new hospital. In my case, I took a job on a step down ICU/surgical floor in Connecticut. I loved that job.
Someone took this picture for a brochure for the hospital I worked at. This guy was great. We had fun doing this picture. He tried to look really sick. The stripe on my cap meant I was a graduate RN, no longer the nursing student with the pink sleeves.

In nursing school, we had myriad opportunities to try our hand and visit many different types of nursing. Outpatient child psychiatry comes to mind as well as various outpatient clinics. One day we visited an inpatient facility at another hospital that housed a hospice floor. Something lit up inside of me. So much so that I found myself doing several research papers on the topic of death and dying. My friends thought I was quite morbid sometimes. That topic always intrigued me.

After my mission and marriage, I took a job as a staff RN on an oncology/overflow medicine floor. This was hard, hard work. The nursing was intense. The experience invaluable. 

That led to an opportunity for me to leave hospital nursing and take a part time job as a community hospice RN. At that time, there were only two hospice programs in the city. I never did work as a pediatric nurse as it never worked out for me that way. But I spent four years working part time hospice RN caring for people who were terminally ill. I was able to choose my own hours and worked my patient visits around my husband's school schedule so he could babysit our two children. My working as a hospice RN rarely effected my time with them. I loved that job. I learned so much from my patients. At one point, I was offered the position of becoming the director of that hospice program. I reminded the person offering me that job that I did not have a BSN...just my treasured diploma. That didn't seem to matter to them. I turned them down because of my children and soon found I was pregnant with my third child. At that point, it was time to step down for good.

Do I have any regrets? Nope? Sad? A little sometimes but only because I miss the rewarding nature of giving and caring and teaching patients and helping patients and their families. My back could never take nursing anymore but my heart could. 

Back to the beginning of this post I guess. People still call me. Most times, the information is right there in my brain. I see myself in my mind's eye in some clinical setting as a nursing student and I remember the related course work. Sometimes I just need a refresher on the internet to jog my memory. There is a lot I have forgotten, but it's all there...somewhere, and I just need to tap into it.

My kids just think I'm a Mom. Emma called me two weeks ago when I was in the fabric store. She said, "Mom, why aren't you home? You're always home." I said, "Emma, I do have a life you know." She said, "No you don't, you're always home."

What a nice way for them to remember me. :)

I was a young RN here. 
I had this picture taken for Jim 
just before I left for my mission.


  1. I always valued your nursing background. I remember one day when a neighbor's child had an injury they came running over to our house for help. Not to mention that I call you every week for medical questions. :) I have also always loved hospitals and I have always had a special affinity for first aid kits. Must be genetic. :)

  2. Liz, I'll have to share this post with my mom next weekend. She talks often about her nursing days and how things are so different now. I have a picture of her in her cap that is very special to me. I remember growing up when my mom would get the medical calls from parents and all the kids would get sent to see Mrs. Skelly so she could check out their wounds. She also used to give weekly allergy shots to several people. Once a nurse, always a nurse I guess!

  3. Thanks Jeanne, give her my best. She would probably enjoy the post and would probably love to have you record some of her own memories somewhere. I bet that would make her day. It was a fun post for me to do, glad I did it. BTW, this picture of me with the patient was taken when I was at the Griffin. You are such a big part of my happy memories there in Connecticut. Love you.