Today marks my 1 year anniversary of being hired at UCSF Benioff Children's Hospital. One year ago today I jumped up and down embarrassingly ecstatic outside the Parnassus Starbucks while I tried (and failed) to not drop my phone (or my coffee) out of shock and to keep my cool, using my adult voice on the phone to say why yes I would love to accept your offer of my dream job. But in reality I did not succeed in doing this and I'm pretty sure my new boss could hear that I was basically happy crying on the phone. But I digress, a year ago I somewhat embarrassingly and very excitedly accepted my offer to be a per diem Patient Care Assistant at UCSF in the Intensive Care Nursery. 

Never then could I have imagined the things this job would bring me. I knew I would learn, but I had no idea the insight I would gain into this badass field I am joining. I expected I would connect with patients, but never could I have imagined the stories I would hear and the heartbreak and also happiness I would feel alongside the families. I knew I would get tired but never could I have predicted how it feels to hit 3 am on your third night shift in a row. I knew I would meet great people but I was so not expecting the amazing atmosphere and camaraderie found within the staff on my floor. I knew I would gain resilience, but I was not expecting how it feels to lose a patient and move forward to hope for the next. The list goes on and on, but in short, I am so so so very grateful for the experiences, skills, and growth I have been gifted from UCSF.  

In the last year I have come far. I started as fresh, albeit a little over-excited 18 year old ready to cuddle any baby I could get my hands on and learn every possible thing I could. Now, I would say that I might be a little less fresh-faced after countless night shifts and my eager heart may be more guarded by some tragic losses, but my hunger to learn remains intact and I look forward to the next year and the 30 after that I plan to spend in this field and I feel excited, ready and more resolved than ever to become the best nurse I possibly can be. A huge thanks to those who have taught me, supported me, cheered me on, and encouraged me to do my best, I love ya, couldn't do what I do without you! 

This month marks my 6 month anniversary working in the Intensive Care Nursery at UCSF. I am happy to report that I love my job more with each passing shift and am continually inspired by the amazing nurses, families, and patients I work with daily. But as with any job dealing with life and death, there are the good days and the really bad ones.

The bad ones often start off unsuspecting, like any other shift there is friendly banter as the new staff arrives, change of shift report, and the regular bustle of the unit. One minute it is business as usual, until on the turn of a dime, a baby will code, or mom will die, we'll lose someone. I should expect it more I guess. I am in the business of medicine, which is definetly not always a success story, specifically in the Intensive Care Unit.

 I have grown this year in my acceptance of death. This fall I had my nursing clinical on a palliative care unit at Laguna Honda. Every day I fed and bathed people who could no longer speak, wondering if this would be their last day, giving extra care to tuck them in nice with extra human touch. I had a patient die and sat with the family, listened to stories, and tried to share the burden of grief. I was honored to be a part of these patients' lives even for a short time. I learned about death in class, how to identify it, how to help the patient and family mourn and accept. And through this learning, I confronted my own ideas about death, and began to understand it more. 

Coming to work in the ICN, the first thing I thought was how fun it would be to work with cute, cuddly babies. But the reality I was confronted with is that a lot of these kids are extremely sick. Many of them get better and leave us and go on to live wonderful and normal lives. Some heal a little and learn to live with their chronic illness, or move upstairs into the Pediatric ICU. But the worst is when some leave us because of death. It happens. It is horrible each and every time to witness a life lost and the resulting devastation to parents, family, and us, the staff. Plainly put: the death of a child is a horrible event. 

When I first started working here it caught me offgaurd even thinking about babies dying, and how that was a sad but normal part of life here. On the dark days when we lose a child or a mother I witness how deeply it effects the staff.  On those shifts, those who know what happened walk with heads hung, bearing the devastating grief of the family. Several staff pass me with red, puffy eyes and running noses, heading to assist the patients they still can. The rest of the staff is unknowing, giving out friendly waves at 3am as they shuffle past me. It always astounds me that life goes on. That for a few people the world has stopped turning, stuck on the moment they learned the truth. But for everyone else it is another night shift, another hour closer to going home, a cruel reality that I am still learning.

In summary I am saying that dealing life and death is hard. It is so hard and something I struggle with every day here. And tonight is an especially hard one. But I will go and cuddle another sweet baby because that is what we must do as caregivers, find hope in the patients we can help. As always, I leave this shift so grateful for everything I am learning here, good days and bad days, I wouldn't trade it for the world. 

I've been working a lot this month. Last weekend I did two night shifts, and a 12 hour shift. And this past weekend I did two 8's. This led to me being a) exhausted beyond belief and b) more in love with my job than ever before.

I am the first to say how important it is to get a job you like, or if at all possible, a job you love. I am extremely lucky to have the latter. This month I am passing my 4 month anniversary working as a Patient Care Assistant in the Intensive Care Nursery at UCSF Benioff Childrnen's Hospital (say that ten times fast). Every time I head to work, I kid you not, I get excited for the 8 or 12 hours ahead of me. This may seem crazy to some, but I am just undeniably in love with my job.

I get a lot of questions about what I actually do. As a PCA, I basically am in charge of helping make the floor run smoothly and do anything the nurses don't have time for. This means I do a lot of the busy work, like stocking the linen warmer, making sure each bedside and admit cart is stocked, and making sure each room has the right equipment. This also includes running to and from the blood bank, pharmacy, and lab for what is needed. I also work with the triage RN to set up for whenever we get a transfer. We can get babies from Labor and Delivery or from other hospitals via helicopter or ambulance. When we get them from our own Ors I help set up. I am in charge of making sure every syringe, ET tube, suction, etc. is in place so the nurses and doctors can do their job. I am also a self-proclaimed professional baby soother at this point. Really, I think I should put it on my resume, I can't even tell you how many hours I've rocked, held, and soothed babies. It is undeniably the best part of the job. But with a census that can go as high as 55 babies, I am always busy, always running to do something, and never end a shift feeling anything less than exhausted.

Some shifts are harder than others, and unfortunately since this is a hospital sometimes this means not all the babies live.  When people hear that I work with babies, they often coo and comment how fun that must be. And it IS cute and fun, some of the time. But there's also a darker side to the job. I spend a lot of time comforting very sick babies. I'll hold them because they are just so uncomfortable that they won't stop crying or sometimes because their parents can't visit (often because they are trying to work and make enough money to pay for the child's care). And then there's the babies that don't get better. Some babies stay sick for months and just can't seem to heal, and some babies die. And that is so sucky. Nothing is worse than trying to comfort a screaming baby at 4 am and knowing you really can't do anything more than put their pacifier back in and rock them to sleep.

But thankfully other shifts are my saving grace. Recently, I got to attend my first C section! I can go to C sections with our triage RN if I am not busy doing something else. The section was everything I imagined it would be. I am a self-proclaimed Grey's Anatomy enthusiast, having been a loyal fan for years. As most Grey's Anatomy fans will attest to, I felt prepared for the OR, after watching Mer and Der and the whole gang preform countless surgeries. But it was different than I expected. First of all, these doctors, unlike McDreamy or McSteamy, have their faces covered (for obvious sanitation reasons), and astonishingly enough, don't talk about hospital gossip over the open patient. Secondly, it was thankfully, not as intense! The C section was quick, maybe 15 minutes, and before I knew it, out popped the screaming baby. It was truly a humbling experience to see a new life begin.

This weekend was such a lesson for me. It reminded me of life's fragility and beauty. It made me grateful for my job and my life. I often leave work feeling both heartbroken and in love. I ache for the babies I can't help and the ones we lose. But I am in love with this profession and I always can barely wait to walk back through the front doors to do it all again.