Monday, September 24, 2007


I've been working hard to drag myself out of a trip to the sucking thought-spiral of despair for the past couple weeks. I had been feeling sad and lonely, and sort of on the verge of tears - the kid wouldn't go to sleep, I was being a raving angry shrew anytime we were together, and then teared up when he told me he wanted to go spend the night with his dad. That's the first time he's said that, and though I knew it would happen at some point, I just figured that point would be in five years when I wouldn't let him go bungee jumping or something. All my free time had been taken up with writing essays about how super super great of a student and a human being I am so that nameless bureaucrats would award me some money, which other nameless bureaucrats in the Fin Aid office would then process in such a way that I couldn't get my hands on and pay my cell phone bill, which somehow was doubled this month because of usage charges since I was out of class for three weeks and everyday was a holiday!

And then my clinical instructor wrote "Very interesting! Let's discuss!" on the top of my write-up for Psych, and I cried on her when we had our midterm conference. I figured she meant interesting like "I'm speechless with how poorly you have completed this assignment! Let's talk about how you can get some points for this by re-doing it entirely! You actually have no empathy and should consider a new professional track immediately. " I cried, and stammered that it seemed like she was telling me that I didn't listen to my patient, and of course I listened to my patient, I had just written 500 words about how I want to be a nurse because my inherent capacity for empathy and attentive listening that I will provide my patients from traditionally underserved groups.
She suggested that I seek counseling, because as I had shared with the group, these patients and their PTSD and alcohol abuse issues were obviously close to some emotional issues I hadn't yet resolved with my own father. She didn't say anything that I hadn't said in post-conference to the whole group, honestly - she just linked all that I had said to the fact that "I was moved to tears by feedback on my first paper" and said that "my reaction suggested that I have a bit more anxiety about this rotation than I thought I did". She was calm and compassionate. My reaction to her suggestion that I seek counseling, when I had, in fact, sought counseling in the past, and was currently medicating my way through a bout of depression/anxiety, was to instantly feel like I am much crazier than I thought, and that I had embarrassed myself in revealing what it was like to grow up with a father who had PTSD.

In fact, it turns out she wrote that on everyone's paper, because it was the first time any of us had done an IPR (interpersonal recording - patient said, nurse said, was nurse therapeutic, how is patient's diagnosis exhibited?).

What I'm really proud of is how I handled it. Not initially, of course. For three days or so, I mucked around in a shallow pond of self-doubt and pity. I had imaginary conversations with her, and started arguments with my ex-husband about the cell phone bill and our custody arrangement. I told the story of our conversation to any friend that would listen, and filled in any boring places with sarcasm and dramatic analogies. I felt betrayed by this professor, who I had for a class my first semester and for whom I had much respect.

But then, I went for a long walk in the woods on the cross country trail near my house. I took my mp3 player and listened to the Non-Violent Communication files I have saved. I realized how far removed from reality and the present moment I had become lately. I sweated and swang my arms and stomped along the hills of the trail. I ate an entire huge slice of chocolate cake and checked out two discs of Scrubs to watch back to back. I made notecards for the house to remind me to say "I feel --------- because I -------." instead of "You made me really mad!" and "It's none of my business what anyone else thinks of me." and last but not least, "You can't MAKE anyone do anything. You can only make them regret it." And I decided that I had shared my experiences appropriately at the time, and that my embarrassment was about exposing my tears and emotions to my instructor. And that my sense of betrayal was based on an assumption that because I already had a level of comfort with her, that she wouldn't push me at all during this rotation, when I explained that there was some real potential to get sad while talking to veterans that reminded me a lot of my dead father.

I also remembered that each semester so far has had its own teary day. Remember when I burst into tears because of I couldn't inject saline into the hotdog! How much fun was that?! I realized that I thought that the Wellbutrin was going to protect me from emotional outbursts - and decided that I had experienced the emotional equivalent of breakthrough bleedings. I'm actually grateful to know that I can still have super sad experiences while taking the meds; it would be scary to think of never experiencing strong emotions again.

And that when one, who shall nameless, walks around looking for things to mock and deride, then she will get really really good at mocking and derision. And one who is really really good at mocking and derision will be tempted, nay, compelled to occasionally mock and deride herself.

And then I was not an asshole to the kid for one whole afternoon, and made oatmeal cookies with him, which he pronounced "surprisingly delicious".

All is well.


Loving Pecola said...

I remember psych clinical all to well. It was a very emotionally draining clinical rotation for me. keep truckin' along and climbing your way out of the depressive fog, which you seem close to having done!


that big girl said...

Did you reveal the emotionally draining aspect of it to anyone? I know that there are limited folks that you can open up to at your school, but I'm wondering what kind of options there are at other schools for student self-reflection/processing, etc?

It is just soo weird to me for faculty to say things like "Nurses eat their young, they always say." and then continue to perpetuate exactly that same type of denial and refusal to model good self-care or awareness that students may need some emotional assistance with nursing school.

I stand by my assertion from the first week that nursing school is this bizarre mix of Pathophysiology/Pharmacology and How to Be a Good Person in 24 Months.


Loving Pecola said...

Many students in my program take advantage of the psych support offered through the university and several students began psych meds for the first time after starting school here. So, yes, I guess that counts as "getting help" although maybe not directly from nursing faculty.

We have a few methods of "checking in" that are built into certain classes. For example MedSurg had a check-in component, but Psych did not. In MedSurg we met as a large class and just shared experiences (people were very emotional, but I couldn't really relate at the time) We were also asked to write "reflection pieces" about our experiences.

My midwifery classes have many check-in components. We (the students) have our own check-in together every other week for an hour during lunch. But we are also divided into three groups of 5/6 to check in with a designated faculty member about our clinical experiences. And then we are each required to meet individually with out advisors at least 3 times a semester to check-in yet again. And I we also have potlucks with all SNMs and faculty which also kind of serve as check-ins as well. But this is not how the other specialties at my school are.

I talked about the stuff I was dealing with in Psych with my best friend (cancer dance friend) and she understood completely. I also blogged about it, journaled about it and prayed about it. I have talked to other students, especially minority ones because of our tendacy to NOT seek mental health care, and they are wading these territories alone or over the phone like I did. We try to check up on eachother (I once had a friend here go through a depression screening with me) routinely with emails, cocktails, and lunch meetings. It helps.

Here's a post from when I was on the Psych rotation:

And here's another:

It's so important to gotta figure out a way...


that big girl said...

that really helps - thanks!