So, it’s been a week since my last day in the MICU. This has given me an opportunity to look back on the progress and growth I have experienced throughout my career.

Wow! I have changed a lot.

I remember when I started Pre-nursing courses. It all seemed so complex and difficult. Intro to Chemistry? I studied so hard!!! Looking back now, it is all elementary. (Thanks for that Dr. Watson.) A&P? Ugh! Terrible. I made a C the first time I took the class. Obviously, I took it again. I had to.

Then, fast forward through nursing school. It’s okay, most of it is a blur anyway. I got my first job in the medical field as a Nurse Tech on a Renal Telemetry floor. Let me tell you, this was the last place I ever dreamed I would find my first professional home. These patients were tough! I fell in love with the frenetic pace and the patients. They were mostly chronically ill, and they were often in the hospital way to much.

Perhaps my favorite thing to watch were Renal Transplant surgeries. There is a moment when the kidney is hooked back up, and it turns pink as blood is coursing through it. That is a magical moment.

I graduated, and became a grown- up nurse. After a little more than a year, I moved to MICU. I started the stressful times all over again. I used to cry all the time. I remember the day my first patient died. It was August 4. I think I cried harder than his daughter did.

Eventually, I learned to distance myself a little more from the grief. I learned how to be there, and not feel devastated every time a patient died. Unfortunately, there were still patients who haunted me. Times they hit a little too close to home. The young man who reminded me of my brother. The other young man who reminded me of my brother. The man who made me think of my granddad.

After a couple of years, I knew I wanted to be a nurse practitioner. So, I applied to school. I had already taken graduate level statistics, I was ready. (I really was not, but it was as good a time as any.)

Once the clinical portion of grad school started, I realized no one was going to teach me how to do this job, I had to pay attention and learn. I was so lucky to have wonderful teachers and mentors who were so dedicated to their profession. Dr. Rivas, Dr, Johnson, Dr. Smith, Dr. Kadiyala, Dr. Bradley, Dr. Simfukwe, and Ruan Reast were tireless. They taught me compassion, and they taught me how to look things up. They taught me how to be confident. I am so grateful for these people. I could have never done any of these things without their support.

Now, once I graduated… I knew what job I wanted. Unfortunately, they already had an NP. I waited. For over a year. It was the longest year of my life. Then, the position was open. Keep in mind, they had trained me for two years.

The transition from bedside nurse to NP was hard. Most likely, the hardest part of the battle was in my head. I may have felt I had something to prove. (I am not going to actually admit to that though.) There were times I had to show people I knew what I was talking about, and in my naiveté, I probably made mistakes in how I spoke to them. However, I would like to point out, it was not always unprovoked. Unfortunately, two wrongs never seem to make a right. I hate that. I really do. I want to have some justification for my defensiveness. There is none.

Here are some of the things I learned though.

1. You do not have to prove you are right.
2. Tearing someone else down is never the answer.
3. Sometimes life is not fair.
4. The patient may come first, but the entire team needs support.
5. You cannot take back your tone of voice.

Perhaps most importantly, it is never okay to be unwilling to listen. These lessons are going to help me in the future. I am going to be a better NP for them.

Another lesson I learned, it is okay to move on. Your dream job does not mean you have to stay there forever. This has been emotionally difficult for me. There are times I have felt extreme guilt and shame at the thought of leaving. Why? I am not certain. I suppose I felt I owed it to the people who had taught me so much.

There was also a sense of righteous indignity at the way every thing had turned out. I felt the need to convince some people I had not had bad intentions, therefore I was not being difficult. Well, perhaps. Perhaps not. It really does not matter.

Here is the point. The transition from nurse to nurse practitioner is hard. So, very hard. The best thing may be to start in a place where they don’t remember you crying at the bedside because your filter tubing did not flow. (That was embarrassing- I did not know to open the vent.) Sometimes, it is easier to grow up, both personally and professionally when you are not surrounded by people who watched all the awkward phases of your maturation.

I imagine it is not unlike adult sibling relationships. You are still quick to bicker and squabble over the small things. However, when you meet people as an adult, you tend to forge more mature relationships.

While I am going to miss my friends and work family, I am so excited to move on to new experiences. I imagine the learning curve is going to be quite stimulating for me. I love a challenge. I have to admit though, I hope they don’t forget me.