This fall, I'll embark on my first clinical rotation as a student nurse practitioner. In preparation, I'm required to take an advanced health assessment course. This is the course in which we learn how to conduct a health history and perform a comprehensive physical examination, or a "physical." While the techniques themselves aren't too difficult, the amount of material that we're expected to learn over the course of the semester is overwhelming. Each week, we cover a different body part or system. We're assigned anywhere from 50 to 250 pages of reading to both complete and master prior to coming to class. Our weekly lecture is about 90 minutes long and is followed by three hours of lab, during which we practice the skills of examination on each other and in simulated clinical scenarios using SimMan. At the end of each lab, we take a quiz on the week's reading material. In general, the quizzes focus on the identification of abnormal assessment findings and the subtle ways in which the presenting symptoms of one disease tend to differ from those of another. For any given body system, there are at least 20 common conditions that we're expected to be able to diagnose in a preliminary sort of way. Because we learn new material and are tested weekly, the pace of the course is relentless. I've never had to work this hard for a class, not even for pathophysiology last semester or advanced pharmacology this semester. It's a sad state of affairs when advanced pharmacology is your easy class, but I know that this is all in the name of preparation for next semester. In my program, our clinical rotations are conducted simultaneously with our classes on family nursing theory, diagnosis and treatment. In other words, I'm going to start to see patients armed only with the knowledge that I retain from my health assessment course.
It's a wake-up call for which I wasn't totally prepared. Had I known this semester would be so intense, I would have cut back on my hours at work. I already plan to stop working full-time once my clinical rotations start. Without even counting the amount of time I'll need to study, there's no way that I can work full-time in addition to taking a full day of classes plus three to four eight-hour days of clinical each week. Knowing that I'll have to make this change is bittersweet. For one thing, I'll miss the money and benefits that I currently enjoy as a result of my full-time job. For another, I'll miss my colleagues and my patients. I also know that it will be a challenge to begin again. I may be an experienced staff nurse, but I am most definitely a novice nurse practitioner. Then again, it's exciting that I'm finally reaching my long-standing goal of becoming a nurse practitioner. Although I've enjoyed working in the hospital immensely, my intent has always been to care for vulnerable populations in a community-based primary care setting. And when I look at my to-do list for the week, I know I can't possibly continue to be successful in any of my endeavors if I continue at my current pace. I'm just barely holding onto my GPA, I've been sick for my entire spring break, and my blood pressure has been elevated above normal for the first time in my life. Something's gotta give, I don't want it to be my grades, and by all means I know that it shouldn't be my health. So I will continue to work until the fall when, for the first time ever, I will be a full-time student. I won't pretend I'm not excited.
