Sunday, December 7, 2014

The dreaded learning curve

I think I have discovered the antidote to pride.

Some people might tell you it's humility or loving other people, blah, blah, blah. Maybe those work, but a faster way to combat pride is to keep altering you career path slightly, so you always feel a little stupid.

Here's an example. I don't know how it happened, but somehow I made it through more than 500 clinical hours as a nurse practitioner student without ever checking a live male for a hernia.

Sure, we talked about how to do it and what to check for in one of my classes. TWO years ago.

And so it was that, fully licensed and orienting at my new job with the PA, that he assigned me a male physical exam. "I'm not even going to go in the room with you. You just do the whole thing." Now, to clarify, I worked in the hospital as an RN for more than 5 years before going back to school. I have seen EVERYTHING.

(Let me quickly interject that you should all know that someday you're going to be old and get pneumonia and go to the hospital, and once there you will pay good money to have your dignity taken away from you. I don't say that to make you panic. I just want you to know what's coming).

But there, in that little office, with the poor guy's dad watching from the sidelines, I did every single part of the exam that I could think of, even checking a few unnecessary things, trying to stall for time. Then it came down to it. I was going to have to check for a hernia and I had to make it look like I'd done so a hundred times before. The problem was, being a woman myself, I wasn't sure what the protocol was. So I panicked, handed him a sheet, and told him to undress while I stepped out of the room.

I returned, red in the face and sweating bullets, to find him wrapped in the sheet and his dad laughing at him. I did the hernia check, signed his papers, and shuffled them on their way.

I came home that evening to ask Isaac what usually happens when a person has a hernia checked. "They just have you drop your drawers and cough. It takes like 10 seconds."


My little brother is still laughing about the whole incident.

And thus I revisit the dreaded learning curve. I rode the learning curve when I was a new nurse, and hoped to never, EVER ride it again.

I recall, with a lot of discomfort, the time that I, brand new as an RN, called a rapid response (a team in the hospital that responds to patients that are acutely deteriorating) on a lady having chest pain, only to have the team show up and ask what her vitals were.

Wait, what? I was so busy panicking about her chest pain that I forgot to do the obvious stuff like check her blood pressure. Turns out this patient had chest pain all the time, even before coming to the hospital. I felt very, very, small. 

After some years working as a nurse I stopped being the one making REALLY stupid mistakes and gradually became the person that other people asked for help.

Then I decided to go back to school and started the process again. And I was back to that stupid feeling.

Like my first day in clinicals when I went to look in someone's ear and couldn't remember how to turn on an otoscope (it's actually not that intuitive).

Or my first pap smear, during which I learned the hard way not to open the speculum until you're ALL the way inside. Ouch.

Or, again as a newly licensed NP, again orienting with that same PA, when he put me in a room with a guy that had cut his hand and told me to suture it. Then left. I'd put in sutures before, but never without supervision! My little hands were shaking so hard I could barely grab the needle. I got the sutures in, and they looked fine, but I think I did the slowest suturing job in the history of medicine.

The way I figure, if you start really, really low, then there's nowhere to go but up.


  1. I got a good laugh! The learning curve can be so challenging, but it's oh so necessary. I love that you found the humor in it.

  2. You crack me up. That was funny to read and I'm so glad you posted it. I had many similar moments in the beginning of my dental assisting days.