A Week in the Life of a Nurse and Premed Student
How I manage coinciding demands of multiple roles
Days 1–3: ICU shifts
I have just completed three consecutive 12-hour shifts in the ICU. Each of these shifts started at 7am and ended around 7:30pm. Because of the lengthy commute, I had to be awake by 5am and would get home close to 9pm. This means I was awake for about 18 hours out of the 24.
Getting 5 hours of sleep isn’t terrible, but if the demands of your shift exceed your body’s energy reserves, then you’ll feel the effects of sleep deprivation intensify throughout the day. This particular string of shifts was rough.
I had a patient who’d unpredictably go into Paroxysmal Sympathetic Hyperactivity (PSH) aka “storming”: heart rate in the 120s, diaphoresis, respirations between 40s-50s, systolic blood pressure 190s-220’s, O2 saturation of 80% on a ventilator.
Because only 15%-33% of individuals who suffer severe traumatic brain injury (TBI) demonstrate storming, it was something the team didn’t see very often. There was a delicate balance between achieving adequate pain relief and keeping the patient’s blood pressure from dropping too low. We had to start a vasopressor at some point, discontinue it, turn it back on, etc. These episodes occurred multiple times each shift. All the while, I had to make sure that my other patient was stable at all times.
By the evening of the third shift, I was feeling the exhaustion creep up from my lower back all the way up to my temple.
Before I could think about the hour-long, always-delayed, multiple-train odyssey back to my apartment, an even bigger worry came to mind. It stood firmly with its arms-crossed and foot tapping against the corner of mind: my first organic chemistry exam of the semester was in 4 days and I was 2 chapters behind.
This meant that I had to read the 2 new chapters, finish the corresponding practice problems, review the lecture notes, and then review all of that for the other chapters again, all in the next three days.
What was I gonna do? I didn’t plan to fall behind, but I did.
I didn’t anticipate my patient assignment being so heavy, but it was.
Now I had all this catch-up work to do (and everything else already on the to-do list: homework for my other classes, putting in research hours, laundry, exercise, self-care, etc.)
The exam was scheduled for 1:30pm on Day 7.
Day 4: Study & Sleep
I woke up with the type of exhaustion that makes you question the purpose of your existence. I stared up at the ceiling wondering if I should go back to bed and sleep more or get the day started. It was like my mind was moving in slow motion. The to-do list was hazy, the order of importance in disarray. My eyes felt strained, my neck was unilaterally stiff, my lower back was aching.
How can I study all day when I’m so tired? The simple answer is, that I couldn’t.
But I definitely could study some of the day.
And that’s exactly what I did. I studied as much as I could and rested every time I needed a break.
Day 5: Research, Study, & Sleep
I am so fortunate to have found a research opportunity that allows so much flexibility. My boss learned that I was a postbac when she interviewed me for the position, and even after seeing a sample of my typical weekly schedule, she chose to hire me anyway. She gave me the option of self-scheduling my hours each week. Because this day was the only one I could make this week, I went in for a few hours, saw patients, and collected/organized data. Afterward, I went right back home to study and rest.
Day 6: ICU shift
The day before the exam, I had to do another shift in the ICU. I retained one of my patients from earlier in the week and received a new patient as well. The shift went smoothly, but residual tiredness lurked. By the end of this day, I was just about done with all the chapters to be covered on my exam. I went home and slept early.
Day 7: Exam Day
I woke up early, had breakfast, and completed my final review for the exam, which I then took the same afternoon.
I survived!
Now, you might be wondering:
- Why do you work so much?
Well, I usually don’t work 4 shifts over 7 days, but because this was a new position at the time, I had to work a full-time schedule during the orientation period, which lasted less than 8 weeks because I had prior work experience.
- How did you do on the exam?
It wasn’t my best score but was still better than I expected. I’ve found that studying a little at a time is better than not doing it at all. This is particularly important for science courses to maintain exposure to the material on a daily basis. (I ended up with an A in the course)
At the end of this exhausting experience, I took the time to reflect on the week and my responses to the challenges I faced. My conclusion was that I did the best I could given the circumstances and succeeded. I cared for my patients well, studied as much as I could, passed my exam, and protected my body from burnout. It was difficult to celebrate my efforts when I was in the middle of it all, and that’s why I think it was important to reflect once I caught I break.
Everyone’s story is different and it can be really discouraging to see social media platforms showcasing the most perfectly balanced lives. For me (and I’m sure many others), the balance is far from perfect. This particular week I described isn’t typical, fortunately. I do a pretty good job of planning ahead and prioritizing school, but because my work and school schedules clashed this time, I struggled. The most important thing is that I survived and that I learned from the experience. I made sure to spend the next few days resting and also have made sure to prevent that type of schedule clash since then.
If you’ve experienced or are currently experiencing the same type of hectic stretch, you’re not alone. You can and will get through it. Try your best to re-arrange your schedule if you can so that things aren’t all happening at once. If you can’t do that this time, save your energy for the most important tasks, and then rest every chance you get in between. Lastly, remember to ask for help when you need it.
I hope you liked this post, thank you so much for reading!
Originally published at https://thepostbac.com on February 4, 2020.
