“Summer’s almost over and I’m crying and I don’t know why…” The lyrics of Cheryl Wheeler’s song echo in my head as I think about CHC’s NP Residency and Post Doc Residency Graduation Ceremony last night.  It has been a great summer for CHC and our residents.

Our Clinical Director, Margaret Flinter, often speaks of the residency program as ‘hardening off’ newly graduated Nurse Practitioners.  Non-gardeners may misunderstand what this means.

One article about hardening plants puts it this way,

Young, pampered seedlings that were grown either indoors or in a greenhouse will need a period to adjust and acclimate to outdoor conditions, prior to planting in the garden. This transition period is called “hardening off”. Hardening off gradually exposes the tender plants to wind, sun and rain and toughens them up by thickening the cuticle on the leaves so that the leaves lose less water. This helps prevent transplant shock; seedlings that languish, become stunted or die from sudden changes in temperature.

Providers working in community health face very complicated cases.  It can be a shock to a newly graduated nurse practitioner or psychology post-doc.  A year of working with a skill preceptor can make these transitions much easier.

Another line from Cheryl Wheeler’s song comes to mind about “the thing I knew I couldn’t do and now I know I can”.  Time after time, our newly graduated residents spoke about a different type of learning, not book learning, but learning, through the assistance of the preceptors some of the things that they can now do, and being given the opportunity to practice at the full scope of their license.

One of the residents summed it up nicely with the oft quoted line from Dr. Seuss “You have brains in your head. You have feet in your shoes. You can steer yourself any direction you choose. You’re on your own. And you know what you know. And YOU are the one who’ll decide where to go”

Summer’s almost over and the Kleenex box on the podium was well used, but we all knew why.  We knew that deep friendships had been forged, life changing experiences had been shared for preceptors, residents and patients alike.  Some dear friends are staying in Connecticut, others are going to Memphis and Seattle and beyond.

Yet for all these positive experiences, we still don’t know what these residents are fully capable of.  We know that they have experience working in a world class primary care system and they will bring their experiences of our model of care to organizations around the world, but how much more are they capable of?  How many will become clinical directors, will establish other residency programs, will help shape new models of care or public policy, or achieve things we haven’t even dreamed of yet?  This, we will have to wait eagerly to see.

Summer’s almost over but we know why there were so few dry eyes.  There is sadness In knowing that we will see certain people we care greatly for less frequently mingled with overwhelming joy about the great new opportunities