3.14. Metaphorsis

Like a butterfly goes through four stages in complete metamorphosis, registered nursing students go through (at least) four semesters. It's a torturous journey, filled with trips to the underworld, no looking back (or you'll turn into a 1000 ml bag of 0.9% normal saline), slogging away in hopes of a better life ahead.

I. Egg, first semester.
You are a round lump. Circle or oval, an ineffective, three-dimensional, zero. You know nothing. Everything you knew up until now is probably wrong. Apparently vitamin C is more abundant in broccoli than in fruit. Pharmacology makes you wish you were never born. You tumble along, from modern hospital to nursing home to rural hospital. Good thing Mom is there to help, because you are sleepless and starved and cannot survive without support. If you don't make it through this semester, you don't get a second chance.

II. Caterpillar, second semester.
You are a worm. Pathetic, wriggling along on the floor, waiting for someone to stick a pin (or angiocath) in you, or squash you (just a little). It's no use struggling; just hold still and take the pain. Eat and study (and drink) so you can cope and grow quickly. This semester is like a House episode, except your house is on fire. Your exoskeleton, former world view, schema, old skills check-offs, are no longer good enough. As you grow out of your former skin, you must molt, free yourself from what no longer fits. You feel vulnerable, weak, and sick to your stomach. Growing pains. You break down only to build yourself back up again (or scrape yourself off the floor of the hospital, as close to the original shape you were in when you crawled onto the maternal newborn, emergency, surgery, telemetry, or medical-surgical units at 6:20am.)

III. Chrysalis, third semester.
From the outside you look like a lazy sack of green and blue hanging from a branch. You're not as active or fast as you were before, but inside is where all the action takes place. You are developing independent nursing judgment, looking at the big picture, the whys and hows and insides and outsides of disease processes, labs, psychosocial concerns. You yourself are changing inside. Your little butterfly innards and parts are being reconstructed from goop inside the iridescent, green, chrysalis. (Or maybe it's just IBS). You can relate to the high risk babies, sick children, and ICU patients; some days it feels like only a matter of time before you need CPR or mechanical ventilation yourself. Occasionally, you forget to breathe. Yes, the air is terrible, but airway, breathing, circulation = staying alive.

IV. Butterfly, fourth semester.
After some psych, intensive and heart issues, congratulations--you're about to be released into the world. On first emergence, new wings are soft and folded, and must be flapped to pump blood into them before the butterfly spreads them and soars. Your preceptor is the air current keeping you afloat. Strengthen your current lab skeletons; build good bones. You know it is not possible to know everything, but you try your absolute best. There are lung transplants, and there are fecal transplants. You take what you get and you don't get upset. The NCLEX world is different from the real world, a realm where all required orders are in place, rare complications always occur, (non-psych) patients tell you the truth, and everything is literally textbook. When in doubt, go back to your patients. Reassess. Safety. History. They are why you put yourself through all of this, right? (You certainly didn't do it for the pin--that, you can get for $16 right now on Etsy.)