Life As An RN & Also An NP Student

Last Thursday I wrapped up my fifth semester of nursing school. Five semesters including a degree in 18 months seems crazy, yet normal all at the same time. I can still so vividly remember the day I packed up a rental car and moved my entire life to NYC. And when I think about it, that all seems surreal. Most days when I’m walking or biking through the city, I still find myself thinking back to the first weeks I was here and thinking, “I can’t believe God had this story written all along.”

Going back to nursing school has been one of the most unknown and uncertain, yet peaceful and confident decisions of my life. I had no idea what the demands of school would entail, the emotions I would feel, the patients I would interact with, how I would even learn to be a nurse, how I would navigate and settle into New York City, what friends + community would look like, or if I would love Columbia. But even among all the uncertainties and instabilities and at times seemingly impossible work load, I never once second guessed my decision to go back to school.

Ever since entering my dietetic internship and being in the hospitals as a dietetic intern I was fascinated with the direct patient care side of things and always had a pull in my heart to care for patients in a more hands-on way. I remember my first day of clinical, seeing my first patient – an older Hispanic man at a hospital in the Bronx – and even through my broken Spanish I knew this was what I was created to do. To nurse. To care for people in their most vulnerable state and help them heal. Help them heal both emotionally and physically.

Last month I started a job as an IV infusion nurse for a private practice doctor. It’s been a quick learning curve, and my first few IV sticks weren’t the most perfect, but now I’ve settled in and I’m loving it. The hours are flexible and being able to start an IV painlessly for patients and care for them before/after treatments has been really life-giving. I finally feel like a nurse now that I’m actually nursing. Ideally, I’d love to nurse in a hospital, but right now that just isn’t feasible with my schedule and Nutshell and everything else going on. So for now, this is a good fit.

The first year of our program was spent getting a BSN and it was the perfect storm.  It was total immersion in school as we took 60 credits in three semesters. School demanded a lot of my time, my clinical group and classmates became family and we learned so much in such little time. Passing the NCLEX and putting RN behind my name felt bittersweet. I loved that first year of nursing school and was so glad the busyness of it was over, but I was so sad to know things would be changing and we’d never get that year back. You bond with people quickly when you’re together 8-12 hours day cramming for tests, trying to survive a clinical day, talking through an emotional breakdown or keeping yourself sane with a happy hour.

Now that we’re two out of five semesters into our MSN and now Nurse Practitioner students, things look so different. Still good, but just different. Our credit load is now much less where we’re taking around 12-13 credits a semester and I’m only up at Columbia 1-2 days a week and then at clinical 1-2 days a week. Instead of living in Harlem which is only a couple miles from school, I now live down in the East Village which is about a 50 minute commute on the train. So all in all, this year feels a lot more autonomous and less connected. It’s been hard for me to adjust to that because I love the feeling of closeness and community. But it’s teaching me to be more organized and on top of things and also to be intentional about continuing to grow the friendships that were natural and easy to maintain when we spent 50+ hours a week together.

Shifting out of an RN mindset and into an NP mindset has been an adjustment too, but exciting. As a nurse, you’re the one carrying out the orders that the MD, NP, or PA puts in. So you’re not the one calling all the shots, making the diagnosis, prescribing mediations, ordering tests + labs, and creating a plan of care. As a Nurse Practitioner though, I will be. When I think about being someone’s potential primary care provider and autonomously managing their health I get nervous, but super pumped about that.

For one, they are trusting you to take care of them which is a lot of responsibility, but also having the responsibility of being able to take care of someone comprehensively and care for them well is awesome. This is why I went back to school. I think of the Nutshell clients I’m working with now and I get giddy at the thought of being able to manage their PCOS or hypothyroidism or anemia or amenorrhea or diabetes or gastroparesis from both a nutrition + medical perspective. To order labs + tests, hopefully take people off medication, and do gynecologic care for women and all of that stuff – to care for every aspect of a persons health. That excites me.

We have 12 short months until graduation which is unreal. Next semester I’m doing clinicals at a new urgent care center in Brooklyn that acts like a “fast track” ER for the community. A huge problem in the city is people not having primary care providers so they go the ER for any and all concerns. This center is an attempt to hopefully clear out the ERs and give people a place to go when they aren’t having a major health event like a heart attack or stroke or a trauma. They see anyone with a non life-threatening concern. I love and thrive in fast paced environments and I’m excited that we’ll be seeing a wide variety of patients – men, women, kids, elderly – so I’m eager to learn a ton!

My first semester of NP school I was a TA for a physical assessment lab and took Antepartum Care, Advanced Pharmacology and a Health and Public Policy class. This past semester I took FNP I [Family Nurse Practitioner I], Genetics, Advanced Clinical Assessment. Next semester I’ll be taking Diagnosis and Management, FNP II, Family Theory and then our Clinical Practicum. I’m most looking forward to Diagnosis and Management because after learning the ins and outs of clinical assessment I’m ready to learn how to diagnose and then manage. So that’s that!

Going into next year, I’m not quite sure how everything is going to work and how all the parts are going to keep moving. What I do know is that things are going to have to shift -` I always want to put my all into school, care for Nutshell clients really well, be an attentive and great nurse and also love my church, my family, my friends, and Nick well. So while I know all these things are important, I’m in the process of figuring out how much time needs to be devoted to each so I’m focused on doing what matters most.

But what I do know is that the past 18 months in this city have been the biggest adventure. It’s been wild and messy and unexpected and beautiful and sweet all at the same time. Here’s to the next 12, NYC!