Penn Nursing Diaries: A Day in the Life-- Cali Wang
This spring, Cali worked at a free clinic in central Pennsylvania that provides gynecological services for uninsured people.
5:23 A.M. It’s still dark. I wake up two minutes before my alarm is due to go off. I’m proud to have worked my eight-and-a- half-hour sleep cycle to a science.
5:35 A.M. I slice a piece of ginger for hot tea into my thermos. We caught a mouse last night—number three in four weeks. No one had mentioned this to me before I moved to Philly. No time today to take care of it; I’ll let my roommates get it this time…
5:45 A.M. I get in my car and turn on Psalm 8 on audio to get my day started. I get through the long drive by singing along to Shane & Shane and talking to God. I’m grateful for the sunrise, which I watch in my rearview mirror, and for a new stash of mints that will help me survive all the odors I will inevitably encounter in clinic today.
7:35 A.M. I park in the “Provider Only” lot right behind the building, with permission granted by my preceptor on the first day of clinical. It’s quite nice. I put on my silver molecule earrings of estrogen and serotonin. I have a rule to always wear something fun. I think it makes me look more personable, and every little bit helps, especially in this line of work where I’m getting all up in people’s business who may be meeting me for the first time that day.
I grab my white coat. Five weeks into clinical, I’m still feeling a bit awkward and pretentious wearing it even though I know it’s normal to feel that way. I enter the building, greet the receptionist at the front desk, and politely decline fresh coffee. Coffee makes me jittery. I’m at 100% capacity with eight-and-a-half- hours of sleep every night this week. I have my water bottle with me, so I’ll remember to drink lots of water and snack on my trail mix throughout the day.
Print the schedule for the day, eat my banana for breakfast, and make prep notes for each patient
8:00 A.M. My preceptor arrives and we catch up. She lets me run every other visit, so I have time to chart.
Schedule for the day
28 y.o. start birth control
40 y.o. IUD replacement
70 y.o. annual gyne, vaginal dryness
21 y.o. pap/STI screen/vaginal itching
27 y.o. male penile wart treatment with TCA
19 y.o. chlamydia treatment 52 y.o. peri-menopausal gyne 43 y.o. abnormal v. bleeding x2 weeks
I realize I am wearing mismatched shoes—at least they are both black!
I notice that my first patient has no history of any Pap smear (cervical cancer screening) in her chart. ACOG recommends that all females start at the age of 21 and get screened for sexually transmitted diseases (STDs). During our visit, I take the time to explain why we recommend these preventative services. One of the challenges is to not use medical lingo when we’re talking to patients. It’s been drilled into us at Penn Nursing. I’m glad to have practiced using common language in the classroom. It truly is a skill that, sadly, not all providers have. I end up doing a full gynecological-exam with her (pap, STD swab, pelvic exam).
My preceptor saw the young lady who came in for a depo shot. She is from South America. The clinic had tried to notify her of her positive chlamydia test, but the phone number had been disconnected. A letter had been sent to her address as a last attempt to reach her. Good thing she was due for a depo and had already been scheduled to come in. The licensed practical nurse (LPN) came in to translate for my preceptor. It took twice the time to relay all the necessary information to her and assure her of the treatment that would cure the STD.
I am reminded of the stark reality of health care. This clinic has a show-rate of 50%. We could have the most advanced treatments and services, but all of that is useless to someone who we cannot reach or communicate with in a language they understand.
2:05 P.M. Debrief the day with my preceptor in the office and eat my lunch (leftover Brussels sprouts, salmon, sweet potatoes). She lets me ask her any questions I have without making me feel inadequate.
Edit my cheat-sheet notes for how to evaluate and treat abnormal uterine bleeding, then write a spiel on how to talk about birth control methods, and practice by saying it five times. Clock in my hours on CEP.
3:00 P.M. I pass by an Amish farm in Intercourse on the way home and stop to buy raw milk, eggs, and a jar of homemade rhubarb jam for $5. I strike up conversation with
Emma, the clerk who helped me with my purchases. She is the second-eldest of thirteen. I come to find out all the siblings were born at home, except one who was sent to the hospital. She leaves me the name of the midwife who works with
the Amish community—maybe I’ll try to reach out and shadow her someday. In return, I leave my number with her in case she ever wants to venture out to the city.
4:45 P.M. I make a stop at Horseshoe Trail in Valley Forge to go for a run. I meditate on the goodness of God and ask Him to help the people I saw today. Brokenness (of the body, of the spirit, of relationships) is all around us, yet somehow in nature, time stops, and the heart seems to know that God is still at work and He is still good. I linger in that stillness.
5:40 P.M. Get back on the road. Traffic as usual. Tune the radio to 90.1 WRTI classical and jazz. Call my sister.
7:15 P.M. Home. I turn on classical radio again, and make dinner.
9:10 P.M. Shower and get on my PJs. Day off tomorrow. I’m asleep in 30 seconds.