Fledgling Nurse, Part 14: Closure

I am fully out of orientation at my new job!  So while I'm reveling in how I don't have a phone with me over the course of the whole day that keeps ringing incessantly with necessary but still endless demands on my time and attention, I immediately noticed a huge difference between this role and my previous one.  I had a discussion with it one day with some nursing students back on my old floor.  Hell, I've even written about it already.  It's not something that's said explicitly in nursing school:  when patients discharge from the inpatient setting, they go off into the ether.  I have no idea what happens to them, unless they're readmitted.  I only know where we sent them last, not if they have improved or declined or followed anything that we have instructed at all.  There's simply void.  

I'm not entitled to know the conclusion.  In fact, I cannot legally get into their record to find out anything about their continued care from here, even if they remained in the hospital.  The most I can do is check the obituaries for any familiar names.  There is no closure.

Now the ambulatory patient world, this is a different beast.  I have patients that come into the clinic three times a week for multiple weeks, months even.  Even since I started at the end of November, there are patients that I have been getting to know (for better or worse) and that are getting to know me (ditto).  I can see their wound improve or worsen, celebrating or mourning with them in turn.  We see steps in the journey together; we talk about how adhering to the plan is going; we discuss how to work their care around life events and vacations.  

I can see progress.  I have packed and placed the same wound vac on some people multiple times, watching as it steadily shrinks, a nine-centimeter problem shrinking to five and one and a half and then in such a way that it cannot be stuffed any longer.  I can release them from care knowing a portion of that conclusion and that they know where to find us if anything new comes up.  It's rewarding, to see something tangible change and have a small part in it.  I have a role where I couch, guide, wrap, teach, correct, encourage, and see what happens.  I have people with chronic issues that we can bound over, finding mutual empathy in that shared space.  

There are spaces where there is grieving about that chronic issue when progress feels too slow.  There are times when I cannot force someone to take care of themselves.  There are times when despite everyone's best efforts, amputation is the best option.  These exist, too.  

And then there are days where we ring a literal bell specifically for this purpose and cheer and clap to celebrate healing.  

In short, I am liking my new job.