Alex Fazio

I think from the day I decided I would make the 6-year long commitment to go to college to be a nurse, in the back of my mind I knew I always wanted to work in Pediatrics. Something about kids just drew me in, and still does now a whopping 10 years later.

In nursing school my experience with kiddos was limited, I think maybe 6 weeks of lecture combined with clinicals at Phoenix Childrens in Los Angeles. I fell in love with the NICU and had my heart set on it when I first laid eyes on the micro-premie diapers that were the size of my debit card. Life got busy, right after nursing school I got the first job I could find since it was where a couple of nursing school friends were going to work and I needed to start saving money for my wedding that was 6 months away. I worked nights on a cardiac/telemetry unit and learned a lot but knew it was always just temporary. The month before my wedding I turned in my notice and really never looked back.

The entire month of our wedding I applied at various places in Arizona since my husband and I had made the ambitious and adventurous decision to move there soon after we got married. The day before the wedding actually I got a call from one of the positions I had applied for asking me to interview on Monday, I had to decline since I would be on a plane heading to Mexico but scheduled it not even 2 days after getting home from our honeymoon. Talk about a fast and furious and life changing two weeks: last minute details of the wedding, an interview for a position in an ICU (minor freak out, hello I am a new nurse and can barely put in an IV and am being considered to work in ICU?!), the unexpected passing of my Grandma the day before my wedding, the best day of my life, planning a move to another state and moving out of my parents home for the first time in my life, a honeymoon that sadly ended with a horrible stomach bug that found us, a 2 day flight alone to Arizona, and finally an offer for that position in the ICU that I had freaked out over.

So it started, my career in the ICU. Three solid months of super scary orientation with a preceptor and mentor who has grown to be one of my nearest and dearest and most cherished friends. What I learned from her I could never put a value on, life lessons, spiritual lessons, communication skills, patience, compassion, parenting skills, and other things not appropriate for this blog but that are tucked in my memory for safe keeping. She told me that in no time I would be a confident and assertive nurse with great critical thinking skills, a “go-to” person and mentor to other newer nurses, and that I would someday be ready to take any patient that rolled through the door of that ICU. I never believed her, I felt that there was just so much to learn and there was no way I could ever possess those skills. I poured my heart into learning everything I could, expanding my knowledge with each patient I cared for, reading about new diseases and conditions, understanding the medications we used most often, learning policies and procedures. The list goes on really. I quickly became acquaintances with nurses who soon became what are now life-long friends and not only was I able to learn from them and go to them when I needed clarification or just plain had no clue what was going on, but I watched how they interacted with their patients and families, their colleagues and managers, studied their assessment and decision making skills, and was able to pick up different things from each of them that all helped to form me into that confident and assertive nurse that I did eventually become.

I did become that nurse. It took a long time, but eventually I stopped being so terrified and started finding joy in what is ICU nursing. One of my biggest fears and hesitations in working in the ICU was dealing with death, I just thought there was no way I would ever just be OK with having a patient who died or was close to dying, I was scared of my emotions taking over or getting in the way of taking care of them. Eventually I became OK with having a dying patient, and end-of-life care became something that I enjoyed doing. Not to sound weird or heartless or uncaring, but death is a natural process and whether it happens in their 80′s and 90′s as a result of aging and/or chronic disease or it happens in the 30′s and 40s’ as a result of something tragic and devastating, God has a plan for everyone and if I can play just a small part in that plan by making that transition just a touch easier on that husband or wife, mother or father, sister or brother, then I am doing my job. I became a nurse who would be assigned to a patient who was in the stages of dying and their family was just not ready to let go because I was comfortable discussing the situation, the facts, the prognosis, the emotions that I know played into it, and many times helped them make that decision to finally let go. I learned so much from my families, that letting go is incredibly hard and un-selfish when at the core of them all they want is to hold on another hour or day or week just because they themselves cannot bear the thought of life without their loved one. I have learned that doing whats best for that person does not mean they don’t love them but means they love them enough to let go of that hope of a miracle that will never be. Letting go of that sliver or thread or prayer that this is all just some horrible nightmare and seeing that reality is they are staring that loved ones mortality right in the face. It was never easy for me, but over time the more that I dealt with those situations I became so much more comfortable being that nurse that was a shoulder to cry on or a hand to hold in those gut-wrenching moments. I became comfortable offering my prayers or silence, encouraging those last hugs or cries or words, asking about their emotional states, support systems, and resources.

No, I did not deal with death every moment of the day, probably more like a couple times a month, sometimes more and sometimes less. Some were easier to stomach than others, some I would break down and cry with my families or co-workers or to my mom on my way home from work, but most were a peaceful transition of that person from life on earth to eternity and I could go to sleep at night knowing I did my job and I did it well. Another part of being in the ICU I came to love was the adrenaline of having a really sick patient and having to be quick on your toes and useful of your resources. I love all the numbers and alarms and monitors and equipment. I love the camaraderie that was the culture of my unit, knowing each others strengths and sometimes weaknesses but working together for the good of the patient and the sanity of all involved. I love the relationships with the Doctors and the trust that is built in working with them daily. I love the autonomy of the nursing process with ICU patients. I love that my biggest life accomplishments, Olivia and Gianna, were born in that hospital and shared with my friends and colleagues who all were such a support through it all. Even with all of the things that I loved and still hold really close to my heart in being an ICU nurse, pediatrics was always in the back of my mind gnawing at me to just put myself out there and give it a shot.

So I went out on a crazy whim making a complete 180 and started working in a level 1 trauma center/pediatric emergency room. Not just switching from adults to pediatrics, but from ICU to ER, which in the nursing world are polar opposites. I also switched hospital systems and schedules, I know I am crazy but if I had turned down the offer I would have wondered forever “what if” I had just given it a shot. So here I am, brand new to the department and the patient population. I don’t know but a handful of names of the employees because the unit is 10 times the size of the one I came from. I am no longer a “go-to” person who can handle any patient coming through the door but a “new girl” who still feels like I have no clue what I am doing. I am back in that scary place, where I am terrified of dealing with the trauma or death of a child. I am back feeling like I will never gain that confidence or skill set to be considered one of the “stronger nurses” on the unit. Its a hard place to be in and there have been a few moments where I just wanted to run back to my comfort of the ICU and forget about my dream altogether but I am sticking it out. I will do just the same here as I did before, pour my heart into learning and experiencing all that I can, making those friendships and work relationships with people who I am sure will one day be just as dear to me as my ICU friends. I will give 100% of myself until I do become “that nurse” because that is just the core of who I am and the reason I became a nurse in the first place. I know I will see sadness that will stab even deeper than things I have already seen because now it will all be with little people. I am sure those moments where I wanted to run wont be the last but I believe in myself and I plan on honoring this comitment just as I did the last.

Bring it on kiddos, I’m ready for ya ;)