- Email: [email protected]
The sea of graduate education: One nurse's experience
I
h a v e b e e n circling the "sea of g r a d u a t e e d u c a tion" for q u i t e s o m e time, t h i n k i n g a b o u t c r o s s i n g it. I feel the n e e d for the k n o w l e d g e a n d "answers" I k n o w t h a t will c o m e w i t h t h a t formal t r a i n i n g process. I w a n t to b e able to u n d e r s t a n d a n d s p e a k the hospital f i n a n c i a l - t y p e s ' l a n g u a g e w i t h t h e legiti m a c y of a n a d d i t i o n a l credential. But I'll k e e p it on m y m e n t a l list of "things to do someday." I a m v a g u e l y c o g n i z a n t of the size a n d effort for u n d e r t a k i n g a s u c c e s s f u l c r o s s i n g of t h a t large "body of water." I d o n ' t h a v e the t i m e now. Then, m y p o s i t i o n is d o w n s i z e d out of e x i s t e n c e . Is this the "sign" to take the o p p o r t u n i t y to e n t e r t h e "waters of e d u c a t i o n " n o w ? T h e s t r u c t u r e d s t i m u l a tion is a p p e a l i n g . It will give m e a n i n s t a n t a n e o u s , a c c e p t a b l e purpose; m y a n s w e r for, "What are you d o i n g now?" I find myself r u n n i n g t o w a r d the s e a of g r a d u a t e e d u c a t i o n w i t h almost reckless a b a n d o n m e n t . I a m happily filled w i t h refreshing a n t i c i p a t i o n a n d excitem e n t . I will learn n e w t h i n g s a n d h a v e t h e freedom to s t u d y m y interests. I a m g o i n g to learn w h a t to do so t h a t I c a n n e v e r b e d o w n s i z e d again.
Approaching the water in a swimsuit I will t e s t the w a t e r s w i t h "just one course." I severely u n d e r e s t i m a t e the work of merely g e t t i n g into the water. A l t h o u g h the school is obviously courting me, I still m u s t supply m u c h w a r m - u p time a n d effort for the application, GMAT, transcripts, references, a n d essay. I e x c i t e d l y o p e n m y official a c c e p t a n c e letter. I b u y a n u p d a t e d T u r a b i a n reference book. 1 I eagerly p o i n t out "my school." Polly Gerber Zimmermann is staff nurse III, Emergency Department, Occupational Health, Swedish Covenant Hospital, associate nurse, American Airlines Occupational Health, and faculty at Truman College, Chicago, Illinois. For reprints, write PollyGerber Zimmermann, RN, MS, MBA, CEN, 4200 N. Francisco, Chicago, IL 60618. J Emerg Nuts 1997;23:59-63. Copyright © 1997 by the Emergency Nurses Association. 0099-1767/97 $5.00 + 0
18/9/78890
But I ' m also nervous. Have I b e e n out of school too long? Is e v e r y o n e s m a r t e r t h a n m e ? I tell m y peers a b o u t e n t e r i n g t h e sea, a n t i c i p a t i n g s u p p o r t . Surprisingly, s o m e g r e e t m e w i t h a g g r e s s i v e d i s c o u r a g e m e n t . "Why are you d o i n g that?!?" T h e y feel compelled to tell m e a b o u t everyone t h e y k n o w w h o w e n t to school a n d d e c i d e d it w a s n o t w o r t h it. I d o n ' t h a v e the p e r s p e c t i v e at the t i m e to u n d e r s t a n d they m a y feel m y school a t t e n d a n c e is a t h r e a t to them. T h e y m a y n e e d to justify their o w n d e c i s i o n to not go to school n o w or fear t h a t I a m g o i n g to g r e e n e r pastures. But I ' m r e a d y to give it a go. I line up at the starti n g block.
Dipping in a toe A n d I ' m off. The first day is a foggy upheaval: g e t the p a r k i n g sticker, t u r n in i m m u n i z a t i o n record, locate the classroom, find a bathroom. F e e l i n g s of c o n f u s i o n a n d terror o v e r s h a d o w t h e first s e s s i o n in economics. W h a t l a n g u a g e is that professor s p e a k i n g ? He p a t i e n t l y a n s w e r s m y q u e s t i o n b y r e e x p l a i n i n g the n e w c o n c e p t in totally "foreign" terms. ("The p a t t e r n I ' m referring to is that ROA a n d financial leverage t e n d to b e inversely related.") I h a v e no confidence. C a n I m a k e it? A t t i m e s m y b r a i n feels rusty, creakingly t r y i n g to get i n stride. A friend e n c o u r a g e s me, "Hang in there, you'll get u s e d to s t u d y i n g again." I look a r o u n d at the b u s i n e s s s u i t s a n d y o u t h in the classroom. C a n I fit in? I c o m p u l s i v e l y find myself a s k i n g all the other s t u d e n t s a b o u t their b a c k g r o u n d , feeling hopeful w h e n it is as limited in b u s i n e s s as m i n e a n d d r e a d w h e n it is not. I find a n o t h e r n u r s e in the class a h e a d of m e a n d latch on to her like a drowning woman. I ask the s t u d e n t s w h y t h e y are here. M a n y n e e d t h e d e g r e e ' s credibility to v a l i d a t e their already o b t a i n e d k n o w l e d g e . Some w a n t to c h a n g e career directions; others seek job security. Only a few are like m e w h o desire to learn to do their c u r r e n t roles
February 1997 59
JOURNAL OF EMERGENCY NURSING/Zimmermann
better. Is a b u s i n e s s d e g r e e t h e right c h o i c e for a n u r s e ? M a y b e I ' m s w i m m i n g in t h e w r o n g r a c e ? M y d o u b t s feel o v e r w h e l m i n g . Should I forget it a n d t u r n b a c k to t h e n e a r b y s h o r e n o w ?
The first 100 yards I like t h e "sea." C l a s s r o o m d i s c u s s i o n is a rich diversity as experienced adult learners share their unique p e r s p e c t i v e s a n d maturity. E v e n t h e jokes s e e m b e t ter. H o w i n t r i g u i n g to h e a r b u s i n e s s s t u d e n t s ' disd a i n of t h e " g o o d y t w o - s h o e s w h o w a n t to s a v e t h e world" ("Hmmm, I r e s e m b l e t h a t remark.") d u r i n g a c a s e analysis. W h a t a n o p p o r t u n i t y to "infiltrate" a n d s e e h o w t h e o t h e r s i d e t h i n k s a n d to l e a r n effective counters. T h e p e r k s t h a t go a l o n g w i t h b e i n g in t h e r a c e are great: s t o c k e d libraries w i t h helpful librarians a n d a h i g h - t e c h c o m p u t e r l a b w i t h all t h e l a t e s t features. This is like b e i n g a kid in a c a n d y store. Yet it is b e c o m i n g starkly clear t h a t t h e c o u r s e w o r k is e n r i c h i n g b u t also difficult a n d t i m e - c o n suming. Although I had painstakingly carved out t i m e for t h e c l a s s hours, I h a d s i m p l y n o t m a d e p l a n s on h o w to a c c o m m o d a t e t h e 2 to 6 h o u r s of s t u d y i n g n e e d e d to s u p p o r t e a c h c l a s s r o o m hour. W h a t s h o u l d I do? I d e c i d e I will h a v e to j u s t s t r o k e h a r d e r to k e e p up. I ' m also b e g i n n i n g to r e c o g n i z e t h a t I s h o u l d h a v e d o n e m o r e to rectify m y d e f i c i e n c i e s before I started. Instructors assume I have what I need. I'm o b v i o u s l y n o t g o i n g to a b s o r b t h e n e e d e d a d v a n c e d c o m p u t e r a n d m a t h skills j u s t b y o s m o s i s . M a y b e I s h o u l d j u s t go b a c k a n d g e t o u t of t h e w a t e r a n d try a g a i n a n o t h e r time.
Getting all wet I enjoy feeling a s e n s e of e m p o w e r m e n t a s a m a s t e r ' s s t u d e n t " c o n s u m e r " in a p r o g r a m t h a t p r o c l a i m s t h e i m p o r t a n c e of c u s t o m e r service.71 d o h a v e .a v o i c e a n d a p o w e r I n e v e r felt in a n u n d e r g r a d u a t e program. M a y b e I ' m b e g i n n i n g to find m y r~iythmic p a c e in t h e race. Yet d o u b t s still n a g me. M y d e c i s i o n for a slow, p a r t - t i m e s c h e d u l e is n o t working. It is h a r d to hold your o w n r h y t h m a g a i n s t t h e u n d e r t o w of t h e a c a d e m i c p r o g r a m ' s flow. G o i n g leisurely m e a n s y o u m i s s r o t a t i o n s a n d c h a n g e c l a s s m a t e s e a c h t i m e for t h e g r o u p work. I ' m feeling p u l l e d a l o n g w i t h t h e fast current, e n g u l f e d b y t h e water. Life n o w h a s a n ongoing, hurried tempo. T h e realities of t h e a c a d e m i c s e a a r e s e t t i n g in. D e s p i t e all t h i s w o r k a n d money, e v e r y a n s w e r to h e a l t h c a r e ' s p r o b l e m s is n o t here, j u s t w a i t i n g to b e t a p p e d . M y p r o f e s s o r s v a r y in t h e i r abilities to i m p a r t
60
Volume 23, Number 1
wisdom. Egotistic power plays and politics exist here, too. I d o u b t m y c h o i c e of schools. F o c u s e d on d e c i d i n g w h e t h e r to go to school, I h a d not t h o u g h t m u c h a b o u t which school to a t t e n d . A s I i n c r e a s i n g l y b e c o m e a w a r e of t h i s school's i n a d e q u a c i e s (as all have), I b e g i n looking at t h e p a t h s n o t t a k e n . But I feel too far a l o n g in t h e r a c e to c h a n g e to a different s e a a n d s t a r t over at t h e s t a r t i n g lineup. B e s i d e s , p e o p l e u s u a l l y only focus on t h e d e g r e e o b t a i n e d , n o t t h e s c h o o l it c a m e from, e s p e c i a l l y in this field. M y first tuition bill s t u n s me. S o m e h o w r e a d i n g t h e c o s t p e r q u a r t e r hour d i d n o t m e n t a l l y t r a n s l a t e into this m u c h money. H o s p i t a l a n n u a l t u i t i o n r e i m b u r s e m e n t d o e s n o t e v e n cover one course. A classmate nonchalantly states what I had avoided putting into c o n c r e t e terms, "This d e g r e e r e q u i r e s a selfi n v e s t m e n t of at l e a s t $25,000." I seek scholarships. A good decision but one that a d d s w o r k to m y stroking. I s t a r t a g a i n t h e r o u n d of a p p l i c a t i o n s , t r a n s c r i p t s , e s s a y s ("How o b t a i n i n g t h i s d e g r e e will allow m e to rid d i s e a s e a n d p e s t i l e n c e from mankind"), a n d r e f e r e n c e s . I ' m c h a f e d a n d w o r n b y t h e w i n d of m y o w n i n n e r turmoil. A s i g n i f i c a n t n u m b e r of c l a s s m a t e s h a v e d r o p p e d out or a c t i v e l y c o n s i d e r it; o t h e r s c u t b a c k . Shall I join t h e m ? E n j o y e d t h e s w i m b u t b e t t e r r e t u r n to t h e still e a s i l y a t t a i n a b l e shore?
One quarter down S w i m m i n g along, I realize I h a v e e n t e r e d into a loveh a t e r e l a t i o n s h i p w i t h school. I l e a r n s o m e t h i n g i n t r i g u i n g or u n i q u e - - "I a m so p r i v i l e g e d to b e a p a r t of this e x p e r i e n c e . " I s p e n d 30 e x h a u s t i n g h o u r s in t h e c o m p u t e r lab w i t h a f o r e c a s t i n g p r o j e c t t h a t is n o t c o m i n g out r i g h t - - " I h a t e t h i s t i m e a n d w h a t it is d o i n g to m e a n d m y life." M y life is n o w a c o n s t a n t , frantic p a c e . School's influence is oozing into a n d c o n s u m i n g every a r e a of m y life. Hour b y hour, w e e k after w e e k is m a p p e d out. I r e s e n t t h e t i m e s p e n t cooking dinner d u r i n g finals week; t h e n I h a v e guilt a b o u t t h e s e feelings. I r a c e b a c k to m y room to s t u d y until m i d n i g h t at an o v e r n i g h t n u r s i n g conference. I no longer e v e n d e l u d e myself w i t h t h e possibility of a n y n e w activity; prog r a m a n n o u n c e m e n t s are t h r o w n a w a y w i t h o u t o p e n i n g them. I fear I a m on t h e e d g e of b e i n g out of control a n d drowning. I r e m i n d myself it is only school; k e e p t h e b i g g e r p i c t u r e of life in mind. But t h e a b s o r b i n g r a c e a c r o s s t h e s e a h a s t a k e n on a life of its own. Strangely, however, I also n o w feel n e w s u r g e s of creativity. I d o n ' t u n d e r s t a n d if it is t h e forced cont i n u o u s productivity, e x p o s u r e to n e w c o n c e p t s a n d
Zimmermann/JOURNAL OF EMERGENCY NURSING
ideas, or t h e s h e e r a d r e n a l i n e . All I k n o w is t h a t in s p i t e of e v e r y t h i n g else, I m u s t a n d do w r i t e t h a t journal a r t i c l e n o w .
Hitting the wall I h a v e r u n i n t o a "brick wall" a n d fear t h a t I a m s i n k ing. M y b e s t f r i e n d s h a r e s h e r d i s a p p o i n t m e n t t h a t I h a v e n o t b e e n t h e r e for h e r d u r i n g h e r c u r r e n t crisis. M y n e w b o r n n i e c e is g r o w i n g u p w i t h o u t a n y of m y a t t e n t i o n . I e x c u s e m y s e l f f r o m a v i s i t w i t h close, o u t o f - s t a t e r e l a t i v e s to study. I t a k e t h e " m a k e s or b r e a k s y o u " c o u r s e , w h e r e half fail t h e m i d - t e r m e x a m . For t h e first t i m e in m y life, all m y s t u d y h o u r s s e e m to have made no difference. This race can't continue on status quo; I am p h y s i c a l l y a n d e m o t i o n a l l y s p e n t . S o m e t h i n g h a s to g i v e . W h a t at first s e e m e d so o b v i o u s l y a g o o d a n d r i g h t t h i n g to d o n o w s e e m s s o q u e s t i o n a b l e . T h i s m i g h t b e t h e t i m e to let t h e l i f e g u a r d s a f e l y c a r r y m e b a c k to t h e s h o r e . I d e s p e r a t e l y s e a r c h for t h e lifeline like a d r o w n ing woman. I contact everyone I know who has been in g r a d u a t e s c h o o l . I l e a r n t h i s c o n f l i c t s t a g e of s t r e s s , a n g e r , a n d d o u b t is a n o r m a l p a r t of t h e " r e t u r n to school syndrome" documented by Donea Shane. 2 T h e s u r v i v a l m e s s a g e b e c o m e s clear: u n d e r s t a n d t h a t t h i s is n o r m a l , m a k e a d j u s t m e n t s , u s e y o u r u s u a l coping methods, and get supportive school peers. I make retching, winnowing personal decisions. I purge out other activities; I resign from being church t r e a s u r e r a n d d e c l i n e h e l p i n g in a n i m p o r t a n t , n e e d e d c o m m u n i t y s e r v i c e role. I s i m p l i f y m y life: n o c o u p o n c u t t i n g , n o C h r i s t m a s t r e e , n o e n t e r t a i n i n g . It feels like failure b e c a u s e I w a s so d e t e r m i n e d t h a t s c h o o l w a s n o t g o i n g to c h a n g e m y i n v o l v e m e n t in v a l u e d a c t i v i t i e s . B u t I r e s o l v e t h a t t h i s is j u s t a t e m p o r a r y p e r i o d of m y life. I h a d v i e w e d s c h o o l f r i e n d s h i p s as a s u p e r f l u o u s l u x u r y I d i d n ' t h a v e t i m e for. T h e y n o w b e c o m e m y lifesaving flotation device. Classmates alone uniquely u n d e r s t a n d a n d s u p p o r t m e d u r i n g t h i s i s o l a t i n g , s t r e s s f u l t i m e . H o w s u s t a i n i n g it b e c o m e s to k n o w o t h e r s a r e s t r u g g l i n g , too. W h a t a n e m o t i o n a l b o o s t to h a v e a p e e r ask, " A r e y o u d o i n g o k a y ? " a n d m e a n it.
Tips for successful educational experience 1. Firmly know why you w a n t to go to school. You need the clear goal for inspiration w h e n the going gets rough, 2. Accept that school will be a major commitment of time and money. It cannot be added on top of an already full schedule or budget. 3. Remedy deficiencies (computer skills, required clinical credentials) b e f o r e starting formal classes. It may be impossible to handle the stress and time of ACLS or learning spreadsheets during regular class work. 4, Review all possible schools before carefully picking the right one for you. The investment requires a thoughtful choice that will then help reassure you w h e n normal doubts surface. 5. Start the application process early. It can take 3 to 9 months to complete entrance requirements, 6. Get your bearings ahead of time. Lessen your initial jitters by walking around the campus, locating the library, classrooms, and parking lot before the first day. 7. Map out your term's scheduled classes and course work deadlines. The peaks and lulls become apparent and you can more easily plan your life. 8. Enlist support from classmates. They alone can uniquely understand and aid you in the process. 9. Enlist those with different backgrounds for required group work. Although it is tempting to only work with people who are similar, you'll learn from others' various perspectives as you create a more well-rounded result. 10. Stay on the outlined course track. Jumping around to the courses you like hinders the planned schedule's intent for classes to build on each other.
Hitting my stride
taken aback; stunned by my own comment. Who said t h a t ? I d o n ' t talk a b o u t f i n a n c e s ; I talk a b o u t q u a l i t y of care, n u r s i n g i s s u e s . I h a d e x p e c t e d to l e a r n n e w information during the race but somehow I did not e x p e c t to b e c h a n g e d . I h a d n ' t c o n s i d e r e d t h a t I m i g h t s t a r t to t h i n k a n d p r o c e s s i n f o r m a t i o n differently. I f e e l w o r r i e d r a t h e r t h a n e l a t e d . Do I w a n t to b e s p o u t i n g f i n a n c i a l p e r s p e c t i v e s ? Is t h i s m e ? T h e p i n n a c l e arrives. I w i n a $15,000 f e l l o w s h i p p r o v i d e d I g e t m y m a s t e r of s c i e n c e in n u r s i n g d e g r e e in a d d i t i o n to m y m a s t e r ' s d e g r e e in b u s i n e s s a d m i n i s t r a t i o n . S o m e b o d y b e l i e v e s in m e .
I n o w h a v e a r h y t h m t h a t w o r k s as I s w i m p a s t t h e p r o g r e s s m a r k e r s . A s a n " u p p e r " - c l a s s m a n , it is n o w closer to c o n t i n u e rather t h a n t u r n back. I m a p o u t e a c h q u a r t e r w i t h its r e q u i r e m e n t s ' p e a k s a n d lulls as I n o t e a n e w c o n f i d e n c e in myself. I c a n do this; I will s u c c e e d . T h e w o r k is h a v i n g a n effect. D u r i n g a d i s c u s s i o n o n a p r o p o s e d c h a n g e , I a u t o m a t i c a l l y b l u r t out, " W h a t w o u l d b e t h e c o s t / b e n e f i t ratio of t h a t ? " I ' m
I b e g i n to b e c o m e a w a r e of a d i s t u r b i n g t r e n d . I a m g r i n d i n g o u t t h e c l a s s e s a n d work, only f o c u s i n g o n getting done rather than learning. I deliberately force m y s e l f to alter m y s t r i d e a little to s a v o r t h e c o n t e n t . T h e l a s t h o u r of c l a s s h a s t h e s a m e c o s t s a n d p o t e n tial b e n e f i t as t h e first.
Staying the course
February 1997
61
JOURNAL OF EMERGENCY NURSING/Zimllaerlllann
i finish t h e MBA d e g r e e . I can s e e n o w that t h e t h i n g s I r e s i s t e d m o s t are n o w w h a t I a p p r e c i a t e in t h e "big picture." Yes, m a r k e t i n g projects w e r e all puff b u t i s n ' t t h a t t h e p r e s e n t a t i o n a s p e c t n u r s i n g often lacks? But I h a v e a n e w worry a s I start t h e nursing curriculum. A m I too e x h a u s t e d to complete this s e c o n d half of the e x t e n d e d race? "I found about 2 years of gradu a t e e d u c a t i o n w a s all I could tolerate," w a r n s one peer.
Entering the nursing leg of the race The differences between the nursing and business "legs" are stark. I feel like a n o v i c e r a t h e r t h a n a n ongoing graduate student. I n o t i c e t h e following c o n t r a s t s : •
•
•
•
•
•
•
•
M o s t M B A s t u d e n t s w e a r b u s i n e s s attire; m o s t n u r s i n g s t u d e n t s c a s u a l l y d r e s s in j e a n s a n d runn i n g shoes. Use a n y r e f e r e n c e f o r m a t in b u s i n e s s ; n u r s i n g only w a n t s A m e r i c a n P s y c h o l o g i c a l A s s o c i a t i o n S format w i t h r e d - i n k e d d e d u c t e d p o i n t s for m i n o r infractions. B u s i n e s s c l a s s e s w e r e c o m p e t i t i v e , p i t t i n g one w o r k g r o u p a g a i n s t a n o t h e r for t h e b e s t solutions. N u r s i n g is c o o p e r a t i v e a n d collaborative, p e o p l e helpfully s h a r e their information. I n e v e r k n e w s o m e of m y MBA c l a s s m a t e s ' n a m e s ; in contrast, I know the nursing students' children's names. MBA degree requirements have standard course m a t e r i a l y o u m u s t m a s t e r ; in n u r s i n g you i n d e p e n d e n t l y c h o o s e t h e s p e c i a l t y a r e a you wil] explore a n d master. You m a n i p u l a t e c o m p l e x calc u l a t i o n s for M B A a s s i g n m e n t s ; y o u w r i t e profusely a n d proficiently for t h e n u r s i n g courses. T h e M B A d e g r e e is c o n s i d e r e d b y s o m e a s e q u i v a l e n t to 10 y e a r s of o n - t h e - j o b b u s i n e s s work experience; nursing advanced degrees t e n d to e m p h a s i z e different skills in their n e w e r d e p t h of n u r s i n g . Your clinical e x p e r t i s e is good, b u t you m u s t n o w also do r e s e a r c h . T h e M B A faculty m e m b e r s h a v e r e c ~ n t b u s i n e s s e x p e r i e n c e a n d e m p h a s i z e c u r r e n t a c t i v i t y in t h e m a r k e t p l a c e ; s o m e of t h e n u r s i n g faculty m e m b e r s h a v e m i n i m a l n u r s i n g e x p e r i e n c e as t h e y e m p h a s i z e t h e o r i e s a n d t h e i r t e a c h i n g expertise. T h e M B A d e g r e e is a c c o m p l i s h i n g s e q u e n t i a l material, tests, a n d projects; t h e n u r s i n g i n c l u d e s t h e o m n i p r e s e n t thesis h a n g i n g over your h e a d t h e entire time. T h e M B A w o r k is g r o u p projects d o i n g c a s e a n a l y s i s a n d p r e s e n t a t i o n s ; n u r s i n g is i n d i v i d u a l papers and seminar teaching.
A l t h o u g h I felt ]ike a visitor a n d i m p o s t o r in t h e halls of b u s i n e s s , I fit r i g h t in t h e n u r s i n g world. It
62
Volume 23, Number 1
n e v e r b e c o m e s a q u e s t i o n of ffI c a n do t h e work; it is only a m a t t e r of h o w a n d w h e n to do it.
Three fourths done I do t h e thesis; it's b e f u d d l i n g d i v i n g into a p r o j e c t t h a t h a s so m a n y o b s t a c l e s to c o m p l e t i o n . I w a n t to m e n t i o n e v e r y p e r s o n w h o r e t u r n s a s u r v e y in m y will. M y "simple" 3 - m o n t h p r o j e c t d r a g s o n 12 months as I pay my continuation fees and watch e x p e n s e s balloon 200%. T h e w a t e r k e e p s c h u r n i n g p a s t a s I m o v e on. Oh, it's a l r e a d y C h r i s t m a s a g a i n .
Nearing the end T h e final leg of t h e r a c e b e g i n s . Part of m e totally a c h e s for t h e finish. Yet I also feel a t w i n g e of s a d n e s s as a m e n t a l t e r m i n a t i o n p r o c e s s b e g i n s , "This is t h e last time." W i t h t h e a d d i t i o n of a d e m a n d i n g p r a c t i c u m , I work 33 d a y s straight without a d a y off. I focus on merely suIviving, on doing i n s t e a d of being. This is a battle to just k e e p m y h u m a n spirit and soul intact, m a d e w o r s e b y a difficult professor requiring c o n s t a n t rewrites. ("This p a p e r d o e s n ' t q u i t e m e e t t h e objectives.") Everyone's sacrifice for school is a p p a r e n t as c l a s s m a t e s share their bland, ordinary p o s t g r a d u a t e desires: "clean t h e house," "cook a good meal," "see a movie." I feel a n u r g e n c y to s t a r t f o c u s i n g on p o s t r a c e a c t i v i t i e s b u t s i m p l y d o n ' t h a v e t h e t i m e or energy. S o m e c l a s s m a t e s s t a r t i n t e r v i e w i n g for n e w j o b s a n d o b t a i n t h e s e c u r i t y of k n o w i n g t h e i r future. Q u e s t i o n s from o t h e r s h a v e c h a n g e d from "Why?" to "What?" L a c k i n g a definitive answer, s o m e g i v e a d i s c o u n t i n g r e s p o n s e t h a t t h e d e g r e e m u s t b e only for m y "self-enrichment." I w o u l d n e v e r t a k e on t h i s m u c h s e l f - i m p r o v e m e n t . I feel a n g r y a n d p u z z l e d w i t h t h e a s s u m p t i o n t h a t I'll l e a v e nursing. T h e y m e a s u r e m y h e a d for t h e g r a d u a t i o n cap. J u s t h a n g in there. I r e s o r t to m e n t a l l y c r o s s i n g off t h e w e e k s , l e a n i n g t o w a r d t h e finish line.
Crossing the finish line G r a d u a t i o n d a y is a g r a n d o r c h e s t r a t e d p a c k a g e of t r i u m p h extraordinaire. T h e air c r a c k l e s w i t h joy a n d t h e a s s u m p t i o n t h a t all g r a d u a t e s will go on to w o n derful t h i n g s . A r o u s i n g r e n d i t i o n of "Looks like w e m a d e it" w o u l d b e a p p r o p r i a t e . I had mentally pictured myself sprinting across t h e finish line, w a v i n g m y a r m s in exhilaration, w h i l e t h e "Chariots of Fire" t h e m e m u s i c p l a y e d . I n s t e a d , I a m b a r e l y c r a w l i n g across. Tears of relief, n o t joy, c o m e w h e n I look at m y d e g r e e . G r a d u a t e s h e s i t a n t l y s h a r e their c o m m o n feeli n g s of d e p r e s s i o n or s a d n e s s , t h o u g h t h e y a r e h a r d p r e s s e d to u n d e r s t a n d why. Is it t h e n o r m a l l e t d o w n
Zilnmermann/JOURNALOF EMERGENCYNURSING
after a b i g e v e n t ? Is it b e c a u s e w e are done a n d a w a r e of our personal i n a d e q u a c i e s , feeling as if w e h a v e n ' t m a s t e r e d a n y t h i n g ? Is t h e "now what?" l o o m i n g over our h e a d s ? Is this part of the c h a n g e process, a d i s o r i e n t i n g "loose e n d s for n e w " ? School h a s g i v e n a s e n s e of direction, purpose, a n d routine. A b r u p t w i t h d r a w a l from t h e w a t e r r e m o v e s t h e p a s t s i n g u l a r focus. No m a t t e r w h a t reasons m o t i v a t e d the school race e n t r a n c e , it's almost i m p o s s i b l e to c o n t i n u e s t a t u s quo after g r a d u a t i o n . Nor do you w a n t to. You are different w h e t h e r you s o u g h t to b e or not. Your n e w c r e d e n t i a l s a n d self d e m a n d a different position or responsibility. Are w e "grieving" t h e l e a v i n g b e h i n d of w h a t w a s good in the old e v e n if it is to seek the b e t t e r i n the n e w ?
job m a r k e t has resulted in stricter hiring r e q u i r e m e n t s with more c o m p e t i n g qualified people. Those with the d e g r e e s t h e m s e l v e s k n o w there is still so m u c h left to learn; t h e y w a n t to k n o w a b o u t work experience. In s o m e w a y s I feel "all e d u c a t e d u p w i t h no place to go."
Cooldown period
A few s e e m t h r e a t e n e d b y m y d e g r e e s a n d d e m e a n them. They almost dare m e to prove I'm better b e c a u s e of it. They have a point: in a n y held, with a n y degree, you are still w h o you decide you will be. Try as t h e y can, it is still hard for professors to instill character, work values, a n d personality in a n y student. A l t h o u g h I d e t e s t t h e s e e m i n g s n o b b e r y from s o m e n u r s e s with a d v a n c e d degrees, I do s e n s e t h a t s w i m m i n g the "sea of higher education" has c a u s e d some personal a n d professional refining a n d b r o a d e n ing. I automatically process s o m e information deeper or differently N e w arenas of possibilities are n o w open e v e n t h o u g h I feel i n t i m i d a t e d b y the n e w challenges. Three m o n t h s after b e i n g i n class, I a m the "master'sprepared preceptor" a n d role model l e a d i n g a class. I slowly, excitedly a w a k e n to just h o w m u c h I do k n o w a n d c a n do. I value myself, abilities, a n d time more. So I h a v e joined the roster of g r a d u a t e - p r e p a r e d nurses. A m I a b e t t e r p e r s o n ? Maybe. Has it m a d e m e a b e t t e r n u r s e ? In s o m e ways, yes. Most i m p o r t a n t to me, as I look back, is the deep, private s e n s e of s a t i s f a c t i o n a n d c o n t e n t m e n t . I h a v e d e v e l o p e d "muscles" a n d "techniques." C r o s s i n g the sea is s o m e t h i n g I h a v e a c c o m p l i s h e d a n d no one c a n ever take away. I ' m glad I Swam the race.
I start u s i n g m y n e w initials after m y n a m e . T h e y look great. My credibility s e e m s e n h a n c e d ; I say t h e s a m e t h i n g b u t n o w people s e e m to a s s u m e I m i g h t a c t u ally k n o w w h a t I ' m talking about. A few w o n d e r if I've s t a r t e d m y doctorate (Huh?r?). I h a v e m i x e d feeli n g s w h e n d e n i e d a c c e s s to t h e c o m p u t e r lab because I'm a "non-student." It takes the entire s u m m e r to dry off a n d c h a n g e out of m y swimsuit, to regain a s e n s e of m y life again. Initially I compulsively c o n t i n u e to try to p r o d u c e every single m i n u t e . Thesis still echoes in m y head. "You're deneH' I r e m i n d myself. Slowly I relearn the pleasure of a purely social, leisurely conversation; I laugh more. Regular activities a n d their b u s y - n e s s slowly start trickling b a c k in. W h e r e is all the "free time" I w a s g o i n g to h a v e ? I h a d partially fallen for t h a t attractive d e l u s i o n t h a t e v e r y t h i n g w o u l d b e "all better" o n c e school w a s over.
Looking back at the "sea" There is a n e w group of s w i m m e r s in the sea now. I w a i t to see w h a t they do as they relate their familiars o u n d i n g a n t i c i p a t i o n a n d fears. W h a t often i s n ' t a c k n o w l e d g e d is that each racer d e c i d e s w h a t he or she w a n t s to accomplish in the sea a n d h o w m u c h effort to p u t into the race. The s a m e degree a n d initials are r e w a r d e d to everyone crossing the finish line. I w a n t e d e v e r y t h i n g I could get; others choose differently a n d e v e n b r a g a b o u t their m i n i m a l effort. Reflection slowly seeps back into m y life. I seek perspective, glancing back at the "sea of higher education" I just crossed. Was it worth it? What did I gain? I'm told b y those who d o n ' t have m y degrees that the "world is n o w open." Well, not quite. The t i g h t e n i n g
I'm told b y t h o s e w h o d o n ' t have my degrees that the "world is n o w o p e n . " Well, n o t quite.
References 1. Turabian K. Manual for writers of term papers, thesis, and dissertations. 6th ed. Chicago: University of Chicago Press, 1996. 2. Shane DL. Returning to school: a guide for nurses. Englewood Cliffs (NJ): Prentice-Hall, 1983. 3. American Psychological Association. Publication manual of the American Psychological Association. 4th ed. Washington, DC: The Association, 1994.
February 1997 63
h a v e b e e n circling the "sea of g r a d u a t e e d u c a tion" for q u i t e s o m e time, t h i n k i n g a b o u t c r o s s i n g it. I feel the n e e d for the k n o w l e d g e a n d "answers" I k n o w t h a t will c o m e w i t h t h a t formal t r a i n i n g process. I w a n t to b e able to u n d e r s t a n d a n d s p e a k the hospital f i n a n c i a l - t y p e s ' l a n g u a g e w i t h t h e legiti m a c y of a n a d d i t i o n a l credential. But I'll k e e p it on m y m e n t a l list of "things to do someday." I a m v a g u e l y c o g n i z a n t of the size a n d effort for u n d e r t a k i n g a s u c c e s s f u l c r o s s i n g of t h a t large "body of water." I d o n ' t h a v e the t i m e now. Then, m y p o s i t i o n is d o w n s i z e d out of e x i s t e n c e . Is this the "sign" to take the o p p o r t u n i t y to e n t e r t h e "waters of e d u c a t i o n " n o w ? T h e s t r u c t u r e d s t i m u l a tion is a p p e a l i n g . It will give m e a n i n s t a n t a n e o u s , a c c e p t a b l e purpose; m y a n s w e r for, "What are you d o i n g now?" I find myself r u n n i n g t o w a r d the s e a of g r a d u a t e e d u c a t i o n w i t h almost reckless a b a n d o n m e n t . I a m happily filled w i t h refreshing a n t i c i p a t i o n a n d excitem e n t . I will learn n e w t h i n g s a n d h a v e t h e freedom to s t u d y m y interests. I a m g o i n g to learn w h a t to do so t h a t I c a n n e v e r b e d o w n s i z e d again.
Approaching the water in a swimsuit I will t e s t the w a t e r s w i t h "just one course." I severely u n d e r e s t i m a t e the work of merely g e t t i n g into the water. A l t h o u g h the school is obviously courting me, I still m u s t supply m u c h w a r m - u p time a n d effort for the application, GMAT, transcripts, references, a n d essay. I e x c i t e d l y o p e n m y official a c c e p t a n c e letter. I b u y a n u p d a t e d T u r a b i a n reference book. 1 I eagerly p o i n t out "my school." Polly Gerber Zimmermann is staff nurse III, Emergency Department, Occupational Health, Swedish Covenant Hospital, associate nurse, American Airlines Occupational Health, and faculty at Truman College, Chicago, Illinois. For reprints, write PollyGerber Zimmermann, RN, MS, MBA, CEN, 4200 N. Francisco, Chicago, IL 60618. J Emerg Nuts 1997;23:59-63. Copyright © 1997 by the Emergency Nurses Association. 0099-1767/97 $5.00 + 0
18/9/78890
But I ' m also nervous. Have I b e e n out of school too long? Is e v e r y o n e s m a r t e r t h a n m e ? I tell m y peers a b o u t e n t e r i n g t h e sea, a n t i c i p a t i n g s u p p o r t . Surprisingly, s o m e g r e e t m e w i t h a g g r e s s i v e d i s c o u r a g e m e n t . "Why are you d o i n g that?!?" T h e y feel compelled to tell m e a b o u t everyone t h e y k n o w w h o w e n t to school a n d d e c i d e d it w a s n o t w o r t h it. I d o n ' t h a v e the p e r s p e c t i v e at the t i m e to u n d e r s t a n d they m a y feel m y school a t t e n d a n c e is a t h r e a t to them. T h e y m a y n e e d to justify their o w n d e c i s i o n to not go to school n o w or fear t h a t I a m g o i n g to g r e e n e r pastures. But I ' m r e a d y to give it a go. I line up at the starti n g block.
Dipping in a toe A n d I ' m off. The first day is a foggy upheaval: g e t the p a r k i n g sticker, t u r n in i m m u n i z a t i o n record, locate the classroom, find a bathroom. F e e l i n g s of c o n f u s i o n a n d terror o v e r s h a d o w t h e first s e s s i o n in economics. W h a t l a n g u a g e is that professor s p e a k i n g ? He p a t i e n t l y a n s w e r s m y q u e s t i o n b y r e e x p l a i n i n g the n e w c o n c e p t in totally "foreign" terms. ("The p a t t e r n I ' m referring to is that ROA a n d financial leverage t e n d to b e inversely related.") I h a v e no confidence. C a n I m a k e it? A t t i m e s m y b r a i n feels rusty, creakingly t r y i n g to get i n stride. A friend e n c o u r a g e s me, "Hang in there, you'll get u s e d to s t u d y i n g again." I look a r o u n d at the b u s i n e s s s u i t s a n d y o u t h in the classroom. C a n I fit in? I c o m p u l s i v e l y find myself a s k i n g all the other s t u d e n t s a b o u t their b a c k g r o u n d , feeling hopeful w h e n it is as limited in b u s i n e s s as m i n e a n d d r e a d w h e n it is not. I find a n o t h e r n u r s e in the class a h e a d of m e a n d latch on to her like a drowning woman. I ask the s t u d e n t s w h y t h e y are here. M a n y n e e d t h e d e g r e e ' s credibility to v a l i d a t e their already o b t a i n e d k n o w l e d g e . Some w a n t to c h a n g e career directions; others seek job security. Only a few are like m e w h o desire to learn to do their c u r r e n t roles
February 1997 59
JOURNAL OF EMERGENCY NURSING/Zimmermann
better. Is a b u s i n e s s d e g r e e t h e right c h o i c e for a n u r s e ? M a y b e I ' m s w i m m i n g in t h e w r o n g r a c e ? M y d o u b t s feel o v e r w h e l m i n g . Should I forget it a n d t u r n b a c k to t h e n e a r b y s h o r e n o w ?
The first 100 yards I like t h e "sea." C l a s s r o o m d i s c u s s i o n is a rich diversity as experienced adult learners share their unique p e r s p e c t i v e s a n d maturity. E v e n t h e jokes s e e m b e t ter. H o w i n t r i g u i n g to h e a r b u s i n e s s s t u d e n t s ' disd a i n of t h e " g o o d y t w o - s h o e s w h o w a n t to s a v e t h e world" ("Hmmm, I r e s e m b l e t h a t remark.") d u r i n g a c a s e analysis. W h a t a n o p p o r t u n i t y to "infiltrate" a n d s e e h o w t h e o t h e r s i d e t h i n k s a n d to l e a r n effective counters. T h e p e r k s t h a t go a l o n g w i t h b e i n g in t h e r a c e are great: s t o c k e d libraries w i t h helpful librarians a n d a h i g h - t e c h c o m p u t e r l a b w i t h all t h e l a t e s t features. This is like b e i n g a kid in a c a n d y store. Yet it is b e c o m i n g starkly clear t h a t t h e c o u r s e w o r k is e n r i c h i n g b u t also difficult a n d t i m e - c o n suming. Although I had painstakingly carved out t i m e for t h e c l a s s hours, I h a d s i m p l y n o t m a d e p l a n s on h o w to a c c o m m o d a t e t h e 2 to 6 h o u r s of s t u d y i n g n e e d e d to s u p p o r t e a c h c l a s s r o o m hour. W h a t s h o u l d I do? I d e c i d e I will h a v e to j u s t s t r o k e h a r d e r to k e e p up. I ' m also b e g i n n i n g to r e c o g n i z e t h a t I s h o u l d h a v e d o n e m o r e to rectify m y d e f i c i e n c i e s before I started. Instructors assume I have what I need. I'm o b v i o u s l y n o t g o i n g to a b s o r b t h e n e e d e d a d v a n c e d c o m p u t e r a n d m a t h skills j u s t b y o s m o s i s . M a y b e I s h o u l d j u s t go b a c k a n d g e t o u t of t h e w a t e r a n d try a g a i n a n o t h e r time.
Getting all wet I enjoy feeling a s e n s e of e m p o w e r m e n t a s a m a s t e r ' s s t u d e n t " c o n s u m e r " in a p r o g r a m t h a t p r o c l a i m s t h e i m p o r t a n c e of c u s t o m e r service.71 d o h a v e .a v o i c e a n d a p o w e r I n e v e r felt in a n u n d e r g r a d u a t e program. M a y b e I ' m b e g i n n i n g to find m y r~iythmic p a c e in t h e race. Yet d o u b t s still n a g me. M y d e c i s i o n for a slow, p a r t - t i m e s c h e d u l e is n o t working. It is h a r d to hold your o w n r h y t h m a g a i n s t t h e u n d e r t o w of t h e a c a d e m i c p r o g r a m ' s flow. G o i n g leisurely m e a n s y o u m i s s r o t a t i o n s a n d c h a n g e c l a s s m a t e s e a c h t i m e for t h e g r o u p work. I ' m feeling p u l l e d a l o n g w i t h t h e fast current, e n g u l f e d b y t h e water. Life n o w h a s a n ongoing, hurried tempo. T h e realities of t h e a c a d e m i c s e a a r e s e t t i n g in. D e s p i t e all t h i s w o r k a n d money, e v e r y a n s w e r to h e a l t h c a r e ' s p r o b l e m s is n o t here, j u s t w a i t i n g to b e t a p p e d . M y p r o f e s s o r s v a r y in t h e i r abilities to i m p a r t
60
Volume 23, Number 1
wisdom. Egotistic power plays and politics exist here, too. I d o u b t m y c h o i c e of schools. F o c u s e d on d e c i d i n g w h e t h e r to go to school, I h a d not t h o u g h t m u c h a b o u t which school to a t t e n d . A s I i n c r e a s i n g l y b e c o m e a w a r e of t h i s school's i n a d e q u a c i e s (as all have), I b e g i n looking at t h e p a t h s n o t t a k e n . But I feel too far a l o n g in t h e r a c e to c h a n g e to a different s e a a n d s t a r t over at t h e s t a r t i n g lineup. B e s i d e s , p e o p l e u s u a l l y only focus on t h e d e g r e e o b t a i n e d , n o t t h e s c h o o l it c a m e from, e s p e c i a l l y in this field. M y first tuition bill s t u n s me. S o m e h o w r e a d i n g t h e c o s t p e r q u a r t e r hour d i d n o t m e n t a l l y t r a n s l a t e into this m u c h money. H o s p i t a l a n n u a l t u i t i o n r e i m b u r s e m e n t d o e s n o t e v e n cover one course. A classmate nonchalantly states what I had avoided putting into c o n c r e t e terms, "This d e g r e e r e q u i r e s a selfi n v e s t m e n t of at l e a s t $25,000." I seek scholarships. A good decision but one that a d d s w o r k to m y stroking. I s t a r t a g a i n t h e r o u n d of a p p l i c a t i o n s , t r a n s c r i p t s , e s s a y s ("How o b t a i n i n g t h i s d e g r e e will allow m e to rid d i s e a s e a n d p e s t i l e n c e from mankind"), a n d r e f e r e n c e s . I ' m c h a f e d a n d w o r n b y t h e w i n d of m y o w n i n n e r turmoil. A s i g n i f i c a n t n u m b e r of c l a s s m a t e s h a v e d r o p p e d out or a c t i v e l y c o n s i d e r it; o t h e r s c u t b a c k . Shall I join t h e m ? E n j o y e d t h e s w i m b u t b e t t e r r e t u r n to t h e still e a s i l y a t t a i n a b l e shore?
One quarter down S w i m m i n g along, I realize I h a v e e n t e r e d into a loveh a t e r e l a t i o n s h i p w i t h school. I l e a r n s o m e t h i n g i n t r i g u i n g or u n i q u e - - "I a m so p r i v i l e g e d to b e a p a r t of this e x p e r i e n c e . " I s p e n d 30 e x h a u s t i n g h o u r s in t h e c o m p u t e r lab w i t h a f o r e c a s t i n g p r o j e c t t h a t is n o t c o m i n g out r i g h t - - " I h a t e t h i s t i m e a n d w h a t it is d o i n g to m e a n d m y life." M y life is n o w a c o n s t a n t , frantic p a c e . School's influence is oozing into a n d c o n s u m i n g every a r e a of m y life. Hour b y hour, w e e k after w e e k is m a p p e d out. I r e s e n t t h e t i m e s p e n t cooking dinner d u r i n g finals week; t h e n I h a v e guilt a b o u t t h e s e feelings. I r a c e b a c k to m y room to s t u d y until m i d n i g h t at an o v e r n i g h t n u r s i n g conference. I no longer e v e n d e l u d e myself w i t h t h e possibility of a n y n e w activity; prog r a m a n n o u n c e m e n t s are t h r o w n a w a y w i t h o u t o p e n i n g them. I fear I a m on t h e e d g e of b e i n g out of control a n d drowning. I r e m i n d myself it is only school; k e e p t h e b i g g e r p i c t u r e of life in mind. But t h e a b s o r b i n g r a c e a c r o s s t h e s e a h a s t a k e n on a life of its own. Strangely, however, I also n o w feel n e w s u r g e s of creativity. I d o n ' t u n d e r s t a n d if it is t h e forced cont i n u o u s productivity, e x p o s u r e to n e w c o n c e p t s a n d
Zimmermann/JOURNAL OF EMERGENCY NURSING
ideas, or t h e s h e e r a d r e n a l i n e . All I k n o w is t h a t in s p i t e of e v e r y t h i n g else, I m u s t a n d do w r i t e t h a t journal a r t i c l e n o w .
Hitting the wall I h a v e r u n i n t o a "brick wall" a n d fear t h a t I a m s i n k ing. M y b e s t f r i e n d s h a r e s h e r d i s a p p o i n t m e n t t h a t I h a v e n o t b e e n t h e r e for h e r d u r i n g h e r c u r r e n t crisis. M y n e w b o r n n i e c e is g r o w i n g u p w i t h o u t a n y of m y a t t e n t i o n . I e x c u s e m y s e l f f r o m a v i s i t w i t h close, o u t o f - s t a t e r e l a t i v e s to study. I t a k e t h e " m a k e s or b r e a k s y o u " c o u r s e , w h e r e half fail t h e m i d - t e r m e x a m . For t h e first t i m e in m y life, all m y s t u d y h o u r s s e e m to have made no difference. This race can't continue on status quo; I am p h y s i c a l l y a n d e m o t i o n a l l y s p e n t . S o m e t h i n g h a s to g i v e . W h a t at first s e e m e d so o b v i o u s l y a g o o d a n d r i g h t t h i n g to d o n o w s e e m s s o q u e s t i o n a b l e . T h i s m i g h t b e t h e t i m e to let t h e l i f e g u a r d s a f e l y c a r r y m e b a c k to t h e s h o r e . I d e s p e r a t e l y s e a r c h for t h e lifeline like a d r o w n ing woman. I contact everyone I know who has been in g r a d u a t e s c h o o l . I l e a r n t h i s c o n f l i c t s t a g e of s t r e s s , a n g e r , a n d d o u b t is a n o r m a l p a r t of t h e " r e t u r n to school syndrome" documented by Donea Shane. 2 T h e s u r v i v a l m e s s a g e b e c o m e s clear: u n d e r s t a n d t h a t t h i s is n o r m a l , m a k e a d j u s t m e n t s , u s e y o u r u s u a l coping methods, and get supportive school peers. I make retching, winnowing personal decisions. I purge out other activities; I resign from being church t r e a s u r e r a n d d e c l i n e h e l p i n g in a n i m p o r t a n t , n e e d e d c o m m u n i t y s e r v i c e role. I s i m p l i f y m y life: n o c o u p o n c u t t i n g , n o C h r i s t m a s t r e e , n o e n t e r t a i n i n g . It feels like failure b e c a u s e I w a s so d e t e r m i n e d t h a t s c h o o l w a s n o t g o i n g to c h a n g e m y i n v o l v e m e n t in v a l u e d a c t i v i t i e s . B u t I r e s o l v e t h a t t h i s is j u s t a t e m p o r a r y p e r i o d of m y life. I h a d v i e w e d s c h o o l f r i e n d s h i p s as a s u p e r f l u o u s l u x u r y I d i d n ' t h a v e t i m e for. T h e y n o w b e c o m e m y lifesaving flotation device. Classmates alone uniquely u n d e r s t a n d a n d s u p p o r t m e d u r i n g t h i s i s o l a t i n g , s t r e s s f u l t i m e . H o w s u s t a i n i n g it b e c o m e s to k n o w o t h e r s a r e s t r u g g l i n g , too. W h a t a n e m o t i o n a l b o o s t to h a v e a p e e r ask, " A r e y o u d o i n g o k a y ? " a n d m e a n it.
Tips for successful educational experience 1. Firmly know why you w a n t to go to school. You need the clear goal for inspiration w h e n the going gets rough, 2. Accept that school will be a major commitment of time and money. It cannot be added on top of an already full schedule or budget. 3. Remedy deficiencies (computer skills, required clinical credentials) b e f o r e starting formal classes. It may be impossible to handle the stress and time of ACLS or learning spreadsheets during regular class work. 4, Review all possible schools before carefully picking the right one for you. The investment requires a thoughtful choice that will then help reassure you w h e n normal doubts surface. 5. Start the application process early. It can take 3 to 9 months to complete entrance requirements, 6. Get your bearings ahead of time. Lessen your initial jitters by walking around the campus, locating the library, classrooms, and parking lot before the first day. 7. Map out your term's scheduled classes and course work deadlines. The peaks and lulls become apparent and you can more easily plan your life. 8. Enlist support from classmates. They alone can uniquely understand and aid you in the process. 9. Enlist those with different backgrounds for required group work. Although it is tempting to only work with people who are similar, you'll learn from others' various perspectives as you create a more well-rounded result. 10. Stay on the outlined course track. Jumping around to the courses you like hinders the planned schedule's intent for classes to build on each other.
Hitting my stride
taken aback; stunned by my own comment. Who said t h a t ? I d o n ' t talk a b o u t f i n a n c e s ; I talk a b o u t q u a l i t y of care, n u r s i n g i s s u e s . I h a d e x p e c t e d to l e a r n n e w information during the race but somehow I did not e x p e c t to b e c h a n g e d . I h a d n ' t c o n s i d e r e d t h a t I m i g h t s t a r t to t h i n k a n d p r o c e s s i n f o r m a t i o n differently. I f e e l w o r r i e d r a t h e r t h a n e l a t e d . Do I w a n t to b e s p o u t i n g f i n a n c i a l p e r s p e c t i v e s ? Is t h i s m e ? T h e p i n n a c l e arrives. I w i n a $15,000 f e l l o w s h i p p r o v i d e d I g e t m y m a s t e r of s c i e n c e in n u r s i n g d e g r e e in a d d i t i o n to m y m a s t e r ' s d e g r e e in b u s i n e s s a d m i n i s t r a t i o n . S o m e b o d y b e l i e v e s in m e .
I n o w h a v e a r h y t h m t h a t w o r k s as I s w i m p a s t t h e p r o g r e s s m a r k e r s . A s a n " u p p e r " - c l a s s m a n , it is n o w closer to c o n t i n u e rather t h a n t u r n back. I m a p o u t e a c h q u a r t e r w i t h its r e q u i r e m e n t s ' p e a k s a n d lulls as I n o t e a n e w c o n f i d e n c e in myself. I c a n do this; I will s u c c e e d . T h e w o r k is h a v i n g a n effect. D u r i n g a d i s c u s s i o n o n a p r o p o s e d c h a n g e , I a u t o m a t i c a l l y b l u r t out, " W h a t w o u l d b e t h e c o s t / b e n e f i t ratio of t h a t ? " I ' m
I b e g i n to b e c o m e a w a r e of a d i s t u r b i n g t r e n d . I a m g r i n d i n g o u t t h e c l a s s e s a n d work, only f o c u s i n g o n getting done rather than learning. I deliberately force m y s e l f to alter m y s t r i d e a little to s a v o r t h e c o n t e n t . T h e l a s t h o u r of c l a s s h a s t h e s a m e c o s t s a n d p o t e n tial b e n e f i t as t h e first.
Staying the course
February 1997
61
JOURNAL OF EMERGENCY NURSING/Zimllaerlllann
i finish t h e MBA d e g r e e . I can s e e n o w that t h e t h i n g s I r e s i s t e d m o s t are n o w w h a t I a p p r e c i a t e in t h e "big picture." Yes, m a r k e t i n g projects w e r e all puff b u t i s n ' t t h a t t h e p r e s e n t a t i o n a s p e c t n u r s i n g often lacks? But I h a v e a n e w worry a s I start t h e nursing curriculum. A m I too e x h a u s t e d to complete this s e c o n d half of the e x t e n d e d race? "I found about 2 years of gradu a t e e d u c a t i o n w a s all I could tolerate," w a r n s one peer.
Entering the nursing leg of the race The differences between the nursing and business "legs" are stark. I feel like a n o v i c e r a t h e r t h a n a n ongoing graduate student. I n o t i c e t h e following c o n t r a s t s : •
•
•
•
•
•
•
•
M o s t M B A s t u d e n t s w e a r b u s i n e s s attire; m o s t n u r s i n g s t u d e n t s c a s u a l l y d r e s s in j e a n s a n d runn i n g shoes. Use a n y r e f e r e n c e f o r m a t in b u s i n e s s ; n u r s i n g only w a n t s A m e r i c a n P s y c h o l o g i c a l A s s o c i a t i o n S format w i t h r e d - i n k e d d e d u c t e d p o i n t s for m i n o r infractions. B u s i n e s s c l a s s e s w e r e c o m p e t i t i v e , p i t t i n g one w o r k g r o u p a g a i n s t a n o t h e r for t h e b e s t solutions. N u r s i n g is c o o p e r a t i v e a n d collaborative, p e o p l e helpfully s h a r e their information. I n e v e r k n e w s o m e of m y MBA c l a s s m a t e s ' n a m e s ; in contrast, I know the nursing students' children's names. MBA degree requirements have standard course m a t e r i a l y o u m u s t m a s t e r ; in n u r s i n g you i n d e p e n d e n t l y c h o o s e t h e s p e c i a l t y a r e a you wil] explore a n d master. You m a n i p u l a t e c o m p l e x calc u l a t i o n s for M B A a s s i g n m e n t s ; y o u w r i t e profusely a n d proficiently for t h e n u r s i n g courses. T h e M B A d e g r e e is c o n s i d e r e d b y s o m e a s e q u i v a l e n t to 10 y e a r s of o n - t h e - j o b b u s i n e s s work experience; nursing advanced degrees t e n d to e m p h a s i z e different skills in their n e w e r d e p t h of n u r s i n g . Your clinical e x p e r t i s e is good, b u t you m u s t n o w also do r e s e a r c h . T h e M B A faculty m e m b e r s h a v e r e c ~ n t b u s i n e s s e x p e r i e n c e a n d e m p h a s i z e c u r r e n t a c t i v i t y in t h e m a r k e t p l a c e ; s o m e of t h e n u r s i n g faculty m e m b e r s h a v e m i n i m a l n u r s i n g e x p e r i e n c e as t h e y e m p h a s i z e t h e o r i e s a n d t h e i r t e a c h i n g expertise. T h e M B A d e g r e e is a c c o m p l i s h i n g s e q u e n t i a l material, tests, a n d projects; t h e n u r s i n g i n c l u d e s t h e o m n i p r e s e n t thesis h a n g i n g over your h e a d t h e entire time. T h e M B A w o r k is g r o u p projects d o i n g c a s e a n a l y s i s a n d p r e s e n t a t i o n s ; n u r s i n g is i n d i v i d u a l papers and seminar teaching.
A l t h o u g h I felt ]ike a visitor a n d i m p o s t o r in t h e halls of b u s i n e s s , I fit r i g h t in t h e n u r s i n g world. It
62
Volume 23, Number 1
n e v e r b e c o m e s a q u e s t i o n of ffI c a n do t h e work; it is only a m a t t e r of h o w a n d w h e n to do it.
Three fourths done I do t h e thesis; it's b e f u d d l i n g d i v i n g into a p r o j e c t t h a t h a s so m a n y o b s t a c l e s to c o m p l e t i o n . I w a n t to m e n t i o n e v e r y p e r s o n w h o r e t u r n s a s u r v e y in m y will. M y "simple" 3 - m o n t h p r o j e c t d r a g s o n 12 months as I pay my continuation fees and watch e x p e n s e s balloon 200%. T h e w a t e r k e e p s c h u r n i n g p a s t a s I m o v e on. Oh, it's a l r e a d y C h r i s t m a s a g a i n .
Nearing the end T h e final leg of t h e r a c e b e g i n s . Part of m e totally a c h e s for t h e finish. Yet I also feel a t w i n g e of s a d n e s s as a m e n t a l t e r m i n a t i o n p r o c e s s b e g i n s , "This is t h e last time." W i t h t h e a d d i t i o n of a d e m a n d i n g p r a c t i c u m , I work 33 d a y s straight without a d a y off. I focus on merely suIviving, on doing i n s t e a d of being. This is a battle to just k e e p m y h u m a n spirit and soul intact, m a d e w o r s e b y a difficult professor requiring c o n s t a n t rewrites. ("This p a p e r d o e s n ' t q u i t e m e e t t h e objectives.") Everyone's sacrifice for school is a p p a r e n t as c l a s s m a t e s share their bland, ordinary p o s t g r a d u a t e desires: "clean t h e house," "cook a good meal," "see a movie." I feel a n u r g e n c y to s t a r t f o c u s i n g on p o s t r a c e a c t i v i t i e s b u t s i m p l y d o n ' t h a v e t h e t i m e or energy. S o m e c l a s s m a t e s s t a r t i n t e r v i e w i n g for n e w j o b s a n d o b t a i n t h e s e c u r i t y of k n o w i n g t h e i r future. Q u e s t i o n s from o t h e r s h a v e c h a n g e d from "Why?" to "What?" L a c k i n g a definitive answer, s o m e g i v e a d i s c o u n t i n g r e s p o n s e t h a t t h e d e g r e e m u s t b e only for m y "self-enrichment." I w o u l d n e v e r t a k e on t h i s m u c h s e l f - i m p r o v e m e n t . I feel a n g r y a n d p u z z l e d w i t h t h e a s s u m p t i o n t h a t I'll l e a v e nursing. T h e y m e a s u r e m y h e a d for t h e g r a d u a t i o n cap. J u s t h a n g in there. I r e s o r t to m e n t a l l y c r o s s i n g off t h e w e e k s , l e a n i n g t o w a r d t h e finish line.
Crossing the finish line G r a d u a t i o n d a y is a g r a n d o r c h e s t r a t e d p a c k a g e of t r i u m p h extraordinaire. T h e air c r a c k l e s w i t h joy a n d t h e a s s u m p t i o n t h a t all g r a d u a t e s will go on to w o n derful t h i n g s . A r o u s i n g r e n d i t i o n of "Looks like w e m a d e it" w o u l d b e a p p r o p r i a t e . I had mentally pictured myself sprinting across t h e finish line, w a v i n g m y a r m s in exhilaration, w h i l e t h e "Chariots of Fire" t h e m e m u s i c p l a y e d . I n s t e a d , I a m b a r e l y c r a w l i n g across. Tears of relief, n o t joy, c o m e w h e n I look at m y d e g r e e . G r a d u a t e s h e s i t a n t l y s h a r e their c o m m o n feeli n g s of d e p r e s s i o n or s a d n e s s , t h o u g h t h e y a r e h a r d p r e s s e d to u n d e r s t a n d why. Is it t h e n o r m a l l e t d o w n
Zilnmermann/JOURNALOF EMERGENCYNURSING
after a b i g e v e n t ? Is it b e c a u s e w e are done a n d a w a r e of our personal i n a d e q u a c i e s , feeling as if w e h a v e n ' t m a s t e r e d a n y t h i n g ? Is t h e "now what?" l o o m i n g over our h e a d s ? Is this part of the c h a n g e process, a d i s o r i e n t i n g "loose e n d s for n e w " ? School h a s g i v e n a s e n s e of direction, purpose, a n d routine. A b r u p t w i t h d r a w a l from t h e w a t e r r e m o v e s t h e p a s t s i n g u l a r focus. No m a t t e r w h a t reasons m o t i v a t e d the school race e n t r a n c e , it's almost i m p o s s i b l e to c o n t i n u e s t a t u s quo after g r a d u a t i o n . Nor do you w a n t to. You are different w h e t h e r you s o u g h t to b e or not. Your n e w c r e d e n t i a l s a n d self d e m a n d a different position or responsibility. Are w e "grieving" t h e l e a v i n g b e h i n d of w h a t w a s good in the old e v e n if it is to seek the b e t t e r i n the n e w ?
job m a r k e t has resulted in stricter hiring r e q u i r e m e n t s with more c o m p e t i n g qualified people. Those with the d e g r e e s t h e m s e l v e s k n o w there is still so m u c h left to learn; t h e y w a n t to k n o w a b o u t work experience. In s o m e w a y s I feel "all e d u c a t e d u p w i t h no place to go."
Cooldown period
A few s e e m t h r e a t e n e d b y m y d e g r e e s a n d d e m e a n them. They almost dare m e to prove I'm better b e c a u s e of it. They have a point: in a n y held, with a n y degree, you are still w h o you decide you will be. Try as t h e y can, it is still hard for professors to instill character, work values, a n d personality in a n y student. A l t h o u g h I d e t e s t t h e s e e m i n g s n o b b e r y from s o m e n u r s e s with a d v a n c e d degrees, I do s e n s e t h a t s w i m m i n g the "sea of higher education" has c a u s e d some personal a n d professional refining a n d b r o a d e n ing. I automatically process s o m e information deeper or differently N e w arenas of possibilities are n o w open e v e n t h o u g h I feel i n t i m i d a t e d b y the n e w challenges. Three m o n t h s after b e i n g i n class, I a m the "master'sprepared preceptor" a n d role model l e a d i n g a class. I slowly, excitedly a w a k e n to just h o w m u c h I do k n o w a n d c a n do. I value myself, abilities, a n d time more. So I h a v e joined the roster of g r a d u a t e - p r e p a r e d nurses. A m I a b e t t e r p e r s o n ? Maybe. Has it m a d e m e a b e t t e r n u r s e ? In s o m e ways, yes. Most i m p o r t a n t to me, as I look back, is the deep, private s e n s e of s a t i s f a c t i o n a n d c o n t e n t m e n t . I h a v e d e v e l o p e d "muscles" a n d "techniques." C r o s s i n g the sea is s o m e t h i n g I h a v e a c c o m p l i s h e d a n d no one c a n ever take away. I ' m glad I Swam the race.
I start u s i n g m y n e w initials after m y n a m e . T h e y look great. My credibility s e e m s e n h a n c e d ; I say t h e s a m e t h i n g b u t n o w people s e e m to a s s u m e I m i g h t a c t u ally k n o w w h a t I ' m talking about. A few w o n d e r if I've s t a r t e d m y doctorate (Huh?r?). I h a v e m i x e d feeli n g s w h e n d e n i e d a c c e s s to t h e c o m p u t e r lab because I'm a "non-student." It takes the entire s u m m e r to dry off a n d c h a n g e out of m y swimsuit, to regain a s e n s e of m y life again. Initially I compulsively c o n t i n u e to try to p r o d u c e every single m i n u t e . Thesis still echoes in m y head. "You're deneH' I r e m i n d myself. Slowly I relearn the pleasure of a purely social, leisurely conversation; I laugh more. Regular activities a n d their b u s y - n e s s slowly start trickling b a c k in. W h e r e is all the "free time" I w a s g o i n g to h a v e ? I h a d partially fallen for t h a t attractive d e l u s i o n t h a t e v e r y t h i n g w o u l d b e "all better" o n c e school w a s over.
Looking back at the "sea" There is a n e w group of s w i m m e r s in the sea now. I w a i t to see w h a t they do as they relate their familiars o u n d i n g a n t i c i p a t i o n a n d fears. W h a t often i s n ' t a c k n o w l e d g e d is that each racer d e c i d e s w h a t he or she w a n t s to accomplish in the sea a n d h o w m u c h effort to p u t into the race. The s a m e degree a n d initials are r e w a r d e d to everyone crossing the finish line. I w a n t e d e v e r y t h i n g I could get; others choose differently a n d e v e n b r a g a b o u t their m i n i m a l effort. Reflection slowly seeps back into m y life. I seek perspective, glancing back at the "sea of higher education" I just crossed. Was it worth it? What did I gain? I'm told b y those who d o n ' t have m y degrees that the "world is n o w open." Well, not quite. The t i g h t e n i n g
I'm told b y t h o s e w h o d o n ' t have my degrees that the "world is n o w o p e n . " Well, n o t quite.
References 1. Turabian K. Manual for writers of term papers, thesis, and dissertations. 6th ed. Chicago: University of Chicago Press, 1996. 2. Shane DL. Returning to school: a guide for nurses. Englewood Cliffs (NJ): Prentice-Hall, 1983. 3. American Psychological Association. Publication manual of the American Psychological Association. 4th ed. Washington, DC: The Association, 1994.
February 1997 63