The Heart's Truth: Essays on the Art of Nursing

Twenty-four Hours in the Life of a Nurse Practitioner

37 Twenty-four Hours in the Life of a Nurse Practitioner October 7 :00 a.m. Something wakes me—a dream? The house is quiet, and the yellow light from my husband’s clock radio glows into the bedroom. I turn on my right side, wiggle my toes, and wait to drift away again. I tell myself I have to get some sleep. 6:05 a.m. The alarm goes off and a cold chill creeps through the covers. My husband yawns and gets up. I get up too, shivering. Today is one of my twelve-hour shifts in the women’s health center, the hospital-based clinic where I’ve worked with the poor and underserved ever since leaving private practice. Twelve hours means three clinic sessions without a break. Already, I’m tired. 6:0 a.m. Standing in the shower, it takes me a minute to get oriented. I shampooed yesterday. I shaved my legs yesterday too. Funny how a woman will say, as she slides down into the stirrups for her Pap test, I hope you don’t mind that I didn’t shave. I say I don’t even notice. The bathroom steams up quickly. Light filters through the blinds, and suddenly I feel awake. And happy. The day will begin, and the day will end, a cycle over which, I remind myself, I have little control. I say a quick prayer in the shower. There’s something about this warm space that seems primal and exposed, as if here my soul might be as naked as my body. At the same time, I wonder if God objects to a woman who prays naked, soaping and scrubbing while she asks Him to protect her family, her friends, her patients. Dry off. Get dressed: Black Victoria’s Secret bra and black panties. Black slacks and an olive green slinky top. A slick of mascara and a line of brown pencil under my lower lashes. Professional on the outside, but inside I feel a little sexy. More like a poet—what I am on my days off—than a nurse practitioner. So this is what middle age looks like, I think, staring into the mirror. 38 the heart’s truth 7:00 a.m. While I eat breakfast, I reread a favorite book of poems, Sloan Kettering , by Abba Kovner, who wrote as he was dying of throat cancer. The poems are spare and wonderful. Suffering and blessings, endings and beginnings. 7:5 a.m. Out the door. If I’m lucky, if traffic hasn’t picked up, if the school bus is behind, not in front of me, I’ll arrive at the hospital by 7:50 a.m. As I drive through our neighborhood, I feel, viscerally, the seasons shift. The feel of the air has changed, reined in after the fullness of summer. In the sky, streaks of blue struggle to emerge from clouds. On the radio, the news, distant and personal at the same time: shootings, accidents, the ever-present clash of country against country, ideology against ideology. I try to imagine myself as victim, as patient. I remind myself to be kind. 7:5 a.m. I run up three flights from the parking garage to the women’s health clinic, thighs burning. Have to do more exercise. Have to take care of my body. But when I enter the hospital corridor, everything—the rest of my life—is put on hold. I clock in and walk into the back conference room I share with eight residents, another nurse practitioner, nurses, and secretaries—a room in which I have no desk, no chair, nothing but a drawer. I put my pocketbook into it, pull on my lab coat. This morning is our monthly staff meeting. Afterward, I’ll post myself in the hallway where I’ll stand all day in between seeing patients. I check the schedule. Sixty patients due between 9 a.m. and :0 p.m. And another fifteen patients in the evening. 8:0 a.m. Waiting for the others to arrive, I call M., the coordinator of the hospital ’s Breast and Cervical Cancer Screening Program, and we talk about the latest abnormal Paps and mammograms. She shows me five reports, each one evidence of a problem that will require surgery, chemotherapy, or radiation. M. and I chat, both of us aware that these reports will change five women’s lives forever. 8:5 a.m. Finally, everyone...