#newgrad

Chapter 17: Theories of Growth and Development 

(development, health promotion)

Study guide focuses on:

Erik Erikson’s Psychosocial Theory

Jean Piaget’s Cognitive Development Theory

Lawrence Kohlberg’s Moral Development Theory

and of course, Sigmund Freud’s Psychosexual Theory

As always, a mini quiz is provided at the end! 

I have no one else to talk to so I’m going to post my feelings, thoughts, and everything in between here, onto the world wide web. 

I’ll go by the pseudoname November Lee. 

I’m a CS major, a 4th year, and I’m graduating Summer of 2020. 

So here it is: I can’t find a job. 

I’ve never felt like this before. I’ve always been confident in myself and my abilities. Everyone I know has found a job -- from Big N and FAANG companies, too. And yet, here I am. One rejection after another. It’s hitting me so hard and I’ve never felt so down, so lonely, and so sad in my life before. 

You might call it a first world problem. Yes, I have a roof over my head and the privilege to attend a 4-year university but this is the only life I have. This is the life I’m living in and in this community that I am a part of, there’s an expectation put on my by my parents and those around me to get a job. 

And I can’t even do that. 

Is it because I’m not good enough? I’ve been trying to do leetcode problems and I have so much trouble tackling them. I can do the easy ones fine but the medium ones... 

It’s just frustrating. I feel incompetent. I’ve spent four years studying this major, pursuing it because I thought I was passionate about it, and I can’t even solve some puzzle questions. In my technical interviews, I always stumble with difficult questions and have a hard time getting a working solution. 

I just don’t know what more I could be doing. 

I need a job so, so bad. I need it soon because I’m going abroad and I need something secured before then. Otherwise, I’ll be interviewing while I’m abroad. I won’t be able to do onsites. No onsites --> harder interviews. 

I’m grateful that I’ve been able to go to college and enjoy the little luxuries of state-of-the-art facilities and opportunities to work at research labs. But why, why, why, can I not get a job? It’s so hard and it’s so frustrating. 

I feel like I’m sacrificing my grades and mental health for the sake of prepping for these interviews and it’s never good enough. 

I'm done with all the long hours and stress of nursing school!!! 2 long years of struggle. RN!!!! 👩🏾‍⚕️👩🏾‍⚕️👩🏾‍⚕️

🥳🥳🥳🥳🥳

 My heartbeat’s rhythm is a lonesome sound Just like the rubber turning on the ground Always lost and nowhere bound

~Chris Stapleton

I can’t count how many times I have been in this situation. But, I know it’s been hundreds . Maybe, if I am really digging deep... thousands.

She was a cardiac arrest with a long down time and multiple subsequent cardiac arrests. My optimism for recovery was a zero. She had periorbital edema and her pupils were questionable to respond.  A breathing tube, temperature probe and gastric tube all crowded her mouth and pushed her swollen tongue listlessly to the side. A central line hung out of her groin and allowed the IV pumps to carry lifesaving anti-arrhythmics and blood pressure medications to her blood stream. Her body was swollen with fluids meant to save her life. Her kidneys, that had been tenuous on a good day, were no longer functioning to get rid of all the medicine and fluid we dumped into her.

I wrote report in the same short hand that I used for everyone. Another experienced nurse would understand, but many would not. A few steps from where I blankly absorbed a litany of information, my orientee stood scribbling madly. His eyes were alight with interest and his posture was one of barely contained energy.

The day before we had decided to give up our continuous renal replacement patient (CRRT) and take something more acute. He had said multiple times throughout the day, “I want a code. I need a sick patient.”  

So, as I took report I looked at him and shook my head. The patient had been coded for 35minutes in a sister hospital before transferring to us where she got shocked 12 times during the night. By 7 am she was pseudo-stable and we were supposed to fix whatever mayhem was remaining. I was less than thrilled.  

After 8 years in an ICU, I like to have the same patients for days. And, I may be shunned for saying it, but I like the sedated intubated ones. I like the control I have over them. I like that no matter what is happening with them- I am 100% in charge. Awake patients can muddy the water with meaningless complaints that are benign. A sedated, intubated patient can’t. If their body does something- it is a true blue symptom needs to be addressed. 

Instead of the stable patient we had the day before, we found ourselves knee deep in this cardiac arrest patient. We talked about pressors and doing thorough neuro exams. We talked paralytics and vent dysynchrony. We talked... we talked. As the day went on, though the patient did not cardiac arrest, I was less than optimistic. My orientee surprised me though... As sure as I was that she wouldn’t wake up, he was just as sure she would.

“She turned a corner” he said many times through the day as we turned, cleaned and treated her.  I smirked at his sweet naivete and shook my head. I had seen my share of surprises in this job. But, an elderly individual with multiple co-morbidities and multiple arrests? That was something that was usually a direct recipe for anoxic brain injury.

At 1600, when we went to turn her, we both jumped when she turned her head to our voices. A few moments of talking to her elicited a slight but very present nod of her head. We exchanged a look and walked from the room.  I looked at the young new grad before me and felt a sense of sadness. I missed those days. The days of endless hope and optimism for every patient that came through.  The feeling that you saved people and made a true difference. The feeling that death wasn’t a given.

These days I distance myself from patients.  It is almost like I see them as time-bombs waiting to go off.  They may not die this minute... but they will die. Patient’s like the one we had, in my experience, rarely wake up... let alone leave the ICU alive.

But, there was a time when I believed it could happen.  A time before death after death hammered my soft heart into something unrecognizable. Something hard and yet brittle. Something I keep hidden from my patients now. Something I feel jolt when a new nurse with wide expressive eyes and an earnest heart reminds me of how I used to feel.

I don’t know if the patient will leave the ICU. I don’t know if she will survive this horrific ordeal her body has been subject to.  But, I do know, if she does it isn’t because of me. 

I’ve just returned from a wonderful relaxing week in Mexico with my boyfriend. It was one of the best weeks of my life and I am so sad to be back home. He is starting night school starting tomorrow, and will still be working full time, and I am still working crazy hours- so things are about to change. Luckily we are getting our own place together hopefully in the coming weeks, so that is something to look forward to. I’ve definitely been struggling since I started this job, and I don’t know what I would do without Christian constantly believing in me, and loving me and making me laugh even when I don’t feel like it. The love and joy I feel when I’m with him is the kind of stuff that makes me believe in God. 

Before my vacation, I had a night where I was so physically ill from anxiety that I called in sick. It was hard to force myself to go back into work. When I did, my manager talked to me and asked me how I was doing. She said they have only hired one or two new grads ever, and that I should feel very proud to have gotten this position as a new grad. She said she didn’t originally want to pair me with the preceptor I am with, but after my intended preceptor took a part time line, she didn’t have much of an option. She said she knows my preceptor can be really ‘strict’ and ‘intimidating’. She said if I ever feel overwhelmed to come talk to her. I feel overwhelmed every day. And I feel good knowing that the intimidation I feel isn’t all in my head. Part of me wants to ask my manager if I can switch preceptors, though at the same time, I dont hate my preceptor, I’m just scared of her, and I think I can hold out. It also felt really good to hear that they rarely hire new grads, it makes me feel proud, but at the same time, it makes me feel really under qualified for this position. Which honestly, I am. I don’t understand what they saw in me at my interview, and it is my dream job and I am still so happy and thankful I got this job, but I don’t understand why. There was much more qualified people that applied, I know it. But my manager says I’m doing a good job. I don’t really feel like I am. 

I am currently in the process of new hire documents/paper work. I officially start in January 2018. I am so excited and so scared because this will be the real thing! I have been working as a care partner (cna/nursing assistant) for about 1 year and a half. The scope of practice as a care partner is so limited, but I have become used to certain tasks/responsibilities. Now that I have an RN job I have to shift my gears and focus on a new scope of practice. We were emailed schedules in regards to EPIC training, safe patient handling class, ekg classes, unit orientation and lecture days. I am so ready and yet so scared. I have been relaxing since August and now it feels like I am going back to school. Ready for this new journey!