CAP-ping It All Off

The countdown toward 75% nurse-hood is here, folks! We officially have only four more weeks of classes before summer semester is finito. How in the world that happened so fast is beyond me…

With the approach of our final semester (before the NCLEX at least) have come many frantic conversations regarding our “Capstone.” Also known as practicum, senior internship, call it what you will, it is the culmination of our student clinical experience. It is a place to try something we haven’t had exposure to before, or to spend more intensive time in a specialty we think we want. Often it leads to a job offer (although the economy has resulted in hiring freezes at many local hospitals, causing many in the cohort ahead of us to receive verbal offers that were later retracted). Basically we are assigned a preceptor and we work whatever our preceptor works…days, nights, weekends, whatever, we get a little taste of life as an RN. 180 hours’ worth of a taste. It is our primary commitment this fall, besides our nursing leadership seminar and a review class to prepare for the NCLEX.

Word on the street is that we’ll be meeting with the faculty in charge of placements within the next few weeks, to learn exactly how this process works. But in the meantime, all kinds of rumors are flying… What if we want a placement that isn’t set up yet – is it possible to find a preceptor ourselves? What if there’s a lot of competition for a particular kind of placement…how do they decide? For example, do you really need to get a top score on the Pediatrics ATI in order to get a Peds placement? Is GPA a factor? Do we need letters of recommendation? We’re all kind of feeling each other out, to see who else among us might want what we want. And trying to figure out how hard to fight for our own preferences.

What I do know is that we have to give them a list of 3-4 places we’d really like to be, and they make every effort to get us somewhere on that list. So now begins Nurse Teeny’s typically obsessive mental anguishing over how to rank her preferences. I love peds, that much is true. And I love oncology. So obviously Option #1 will be Peds Hematology/Oncology.

While it would be a dream come true for that to work out, it’s also not the end of the world if I DON’T get my first choice (who knows if there’s even a spot available?). But where does that lead me? Do I request a peds placement anywhere because it would get me a step closer to a job in pediatrics (or try to get into peds cardiology)? Or do I request an oncology placement so that I become an expert in cancer care and then move into peds at some point in the future? Like I’ve said before, I ended up really liking adult nursing, so I wouldn’t be heartbroken to do adult oncology. It’s cathartic in a way, to care for people like my dad and make a difference in their lives the way his nurses did for us. I’ve heard again and again from current and former cancer patients that oncology nurses are a breed unto themselves. It would be an honor to give back.

Or there’s the option of a hospice placement…I know that I want to do hospice/palliative care nursing, preferably in home health and preferably with kids. But do I really want to start there? Would it not be better to get some exposure to hospital nursing, so I know where people who end up in hospice have been? Would that sort of placement limit job opportunities because I would have fewer hours in an acute care setting?

I know that there’s nothing I can do about it for now so I should probably just take a chill pill, but it’s getting so close and we’re talking about it more and more. These are the questions that keep me up at night…

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