Talking to myself: the new semester

I write so rarely, this is like talking to myself. I don't know if anyone looks anymore, which makes it hard to want to write, which means people don't look. . . it isn't a cycle as vicious as familial abuse, certainly, but it does cycle just as much.

A new semester has begun: new classes and new things to learn. This semester is adult care -commonly called medical-surgery or med-surg- and I'll be spending two days each week for the next 15 weeks at the hospital. I'll be on different surgical floors, and spend time in the ICU, the ER, and PCU (the step down between ICU and home) and even one day in surgery.

Did you know that while the majority of nurses go to work in the hospital, it's (only) just over 50%? There are so many choices available! I could be a certified nurse midwife and deliver babies (my original ambition); I could be a family practice nurse, and have a clinic with patients; I could be a prison nurse (although I likely won't); I could do research and have little to do with patients at all.

More than just a nurse, I feel like I want to make changes. There is a professional hostility between certified nurse midwives and direct entry midwives (who commonly attend home births). Part of it is a territorial dispute, part of it is an educational snobbery, and I think part of it is based on envy: CNMs have really high malpractice insurance (although I can't imagine that DEMs have it too much better). But it bugs me, because in school the big theme repeated endlessly is the role of the nurse: patient advocate.

Another place that fascinates me is community nursing. People go on medical missions to foreign countries and feel righteous and holy (and certainly they are doing good work). Why not a medical mission to urban areas in the US? "There are free clinics here already."

So if there is already some mechanism in place to provide medical care to people who live on the fringes of society, why is there this mad rush to socialize medicine? Where are the flaws and gaps? Why are the free clinics not doing the job? What obstacles do they have? What are the limitations?

I'm not poised to become a bleeding heart liberal; I am excited about the power of the individual to make a difference. I hope that I can make a difference for the better, where ever I finally land professionally.