I walked off the peds hem/onc unit Saturday at 1930 and felt sad, excited, and wistful. It was an incredible senior capstone – better than anything I could have imagined for myself – and it was bittersweet to say goodbye.

It was also somewhat anticlimactic, as my last days of clinical have always been. I’m realizing that that’s just the breaks of being a nursing student. You have this amazing, transformative experience, laugh a little, cry a little, learn how to be a nurse. And then you leave, and life goes on without you. Perish the thought. 🙂

The muffins and Starbucks coffee were a hit. I believe one nurse’s comment was, “You’re hired!” If only…

So the next time I walk onto a hospital unit in uniform, it will be as an RN. Now THAT’s a terrifying thought. Do I feel ready? Hell to the NO.

Is that normal? Absolutely. After all, the NCLEX is assessing our “minimal competence” to be a nurse. If I hear that one more time from a professor, I think I will need an emesis basin. I am expecting to feel completely lost and overwhelmed on Day 1. Probably til the end of Year 1. But that’s okay. It’s part of the journey. I’ll muddle through and come out on the other end with a lot of learning experiences (and a lot of great stories for this blog).

My last few days at clinical were spent caring for a kiddo with an immune deficiency disorder. I cared for him a lot throughout my rotation, and I have to say he was just about the cutest little guy ever.

It breaks my heart because there seem to be miscommunications along the way. I don’t think they’ve purposely lied, but they certainly haven’t been upfront about his situation. They’ve just micro-managed each setback with new procedures, and new medications, and new transfusions, without thinking about the big picture.

Part of the reason it bothers me so much is because it’s eerily familiar. It reminds me a little too much of my family’s own experience with an oncologist who wouldn’t go there and say the words “Your dad is dying.” Our nurse was the one who spoke up, the morning before he went into a coma. So I know there’s a little counter-transference going on and I have to be careful about not taking this case personally.

But it’s also the exact reason I want to do peds palliative care. So I can advocate for kiddos before it’s too late. Most pediatric patients who wind up in hospice are only there for a few weeks or days or hours, because people wait so long and the kids suffer for WAY too long.

I also want to advocate for palliative care not only being about the end of life. “Palliative” means to alleviate suffering. Sick children suffer way before they die. So why not involve palliative care experts at the time of diagnosis, and address symptom and pain management from the beginning, regardless of whether the story ends in cure or death? It’s time to debunk the myth that palliative care equals hospice.

It’s also time to contest the notion that hospice equals “giving up.”

It’s not a battle you win or lose, folks. It’s the circle of life. We are born, we live, we die. Sometimes the journeys are shorter than we want them to be. It’s tragic, and unfair and oh so painful. But taking care of the people we love, helping them not to suffer and letting them die where they want, surrounded by the people they love, is not giving up. It’s showing how much they mean to us.

I’ll get off my soapbox now. But I’m fired up and I’m more committed than ever to the path I’ve begun to travel.

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