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A Calling to Care
As the Louise Herrington School of Nursing wraps up the celebration of its centennial, the Line takes you inside the daily life of an exemplary nursing student.
Story by Jeff Hampton, Photographs by Dan Bryant
On a rainy Monday morning in Dallas, Jerry Garcez begins another long day on his journey to become what he believes God has called him to be—a nurse.
 He follows in the footsteps of 5,300 women and men who, over the past one hundred years, have traveled through the classrooms and wards of Baylor University’s Louise Herrington School of Nursing (LHSON). For Garcez, the call to nursing came while he was a senior in high school in Helotes, near San Antonio. He followed the call to Waco for two years of prerequisites at “Big Baylor,” as nursing students fondly call it, and then to Dallas to join a new class of sixty-seven nursing students.
But on this particular day—February 8, 2010—the call foremost in Garcez’s mind is coming from the alarm clock,
signaling the start of another exciting, sometimes trying, often exhausting, always interesting day.
Students at LHSON have two distinct types of day: class days that give them the intellectual and emotional tools to care for patients in hospitals, and clinical days that put those tools to work.
CLASS DAY
6 a.m. Getting Up, Getting Ready
Garcez is out of bed, showering, printing PowerPoint documents for his morning class, and eating a breakfast of oatmeal and fruit.
“I need to have breakfast because I’d be falling asleep in class or I’d be starving by the time lunch comes,” he says. “At Big Baylor, our classes were only an hour or an hour-and-a-half, but here they are three hours.”
6:45 a.m. Out the Door
Garcez loads his backpack and leaves his East Dallas apartment for the fifteen-minute hike to the nursing school. Nursing students previously resided at Wilma Bass Memorial Hall, adjacent to the school, but now they live in apartments just down the street.
The new arrangement gives students more personal space, helps them disconnect from school a little, and adds to their professional outlook, Garcez says. “It allows us to think, ‘Okay, we’re growing up; we have our own living space now.’”
7 a.m. Early Morning Prayer, Seminar Room 204
As Garcez enters the front doors of LHSON, he passes under a banner announcing the school’s centennial year. It reads “Learn, Lead, Serve”—fitting words for students who do all three every day.
Today, Garcez’s service begins by leading Early Morning Prayer, a time of worship and prayer open to all students and faculty. Garcez was asked by the school chaplain to lead the weekly gatherings this year. He’s also his class’s Missions and Ministry officer and organizes events such as mission trips to the Texas-Mexico border.
Garcez takes these roles seriously—propelled by a strong faith nurtured by his parents, who took him on Sunday mornings to Oak Hills Church in San Antonio. One of the ministers there is author and speaker Max Lucado, but Garcez attributes much of his spiritual energy to his sister’s discipleship.
“She went to Abilene Christian University and came back just all on fire for God, and she really influenced me,” he says. “She started showing me how to read the word, how to pray.”
Garcez brings that energy to the Monday prayer meetings, but he starts every other day in prayer too.
“I need something to fill me up in the mornings because I know the day is going to be hard,” he says. “I know there’s going to be challenges, even trials some days, so I feel that it’s crucial to spend time with the Lord.”
Garcez is earnest about that relationship because he believes God has led him to this place in his life.
A high school football player, he was offered scholarships to several Division II schools and verbally committed to one in Missouri. “I knew that unless I gained one hundred pounds and grew by a foot, football was only going to be for a season,” he says, so he looked beyond athletics and submitted one more application—to Baylor.
“When I was accepted at Baylor, that was when I started to wonder about where I was meant to be. I started praying about it,” he says. “I really wanted to do something with my life that was worthwhile.”
Garcez initially was interested in both architecture and nursing, but the more he looked at nursing the more he felt God’s call.
“I think the heart behind a nurse really got me—knowing that each and every day, they’re laying down their lives, humbling themselves, and serving another human being and showing the love of Christ. I thought that would be a great way to live my life and to walk out my faith.”
 8:30 a.m. “Human Needs” Class, Seminar Room 206
The education of a nursing student is a steady accumulation of knowledge that begins in undergraduate school with anatomy and physiology and continues at LHSON with pharmacology (drugs and medicines), pathology (disease processes and symptoms), and classes specific to clinical rotations in obstetrics, pediatrics, and psychiatry. “Human Needs” teaches students how to think as a nurse and to respond to the conditions and needs of patients in different circumstances.
“Our first ‘Human Needs’ class started out very basic, and from that first semester on it’s just been building and building,” says Garcez. “This semester, we’re taking everything and putting it into our long-term memory.” The class is small and personal, with thirty students seated at long tables.
“Class size has definitely been a plus, and we have great technology too,” Garcez says. “Our teachers love discussion. They’ll prompt us and guide us: ‘What is this patient going to do? What are his vital signs showing us? How do we, as nurses, need to respond to that?’”
On Tuesdays, Garcez’s 8:30 class is “Leadership and Management.”
“For seniors in their last semester, this is a great class because it teaches us how to prepare our résumés, our cover letters, our ‘thank you’ letters. It teaches us about delegation—what we can ask someone else to do while we’re in the hospital. It teaches us the laws that the Board of Nursing has for nurses in Texas. It prepares us for the real world and the nursing profession.”
11:30 a.m. Lunch Break, Yearbook Photo
Garcez runs back to his apartment to eat lunch and get a change of clothes for his yearbook photo.
In past years, Baylor nursing students had to go to Waco for Round Up photos. This year Baylor sent a photographer to the nursing school, and Garcez is not going to miss the chance to be in the “Big Baylor” annual for his senior year. He and his roommate, Matt Seitz from Kingwood, have pieced together the top half of a suit. Seitz uses it first, and then it’s Garcez’s turn to pose in the white shirt, dark jacket, and tie.
Afterward, he runs the suit back to his apartment and hustles back to school.
3:15 p.m. Waiting for Facilitator, Second Floor Hallway
On Tuesday afternoons, Garcez has another three-hour class—an elective called “Health Promotion” that helps nurses maximize their patient care by managing their own health, stress, and time—but on Mondays he meets with the facilitator of his clinical internship.
“We worked the past week for two or three shifts, and we come back the next week to debrief,” Garcez explains.
While Garcez and his classmates wait for the facilitator, the mood is focused but friendly. Garcez admits that virtually every conversation he has at the school is about classes, projects, and clinical shifts. “It’s our life,” he says, but at this level there is support and camaraderie.
“When we first came to the nursing school, it felt very competitive because there’s just such demand to get into this school,” he says. “But then we started recognizing that we’d have to join together, we’d have to start study groups, we’d have to quiz each other, we’d have to be accountable to each other.”
As they’re waiting, Garcez greets another student, who tells him she’s worried about her hospital shift and study load. “You can do it,” he says with a smile.
3:30 p.m. Internship Meeting, Seminar Room 204
Garcez and nine classmates take seats around a square table with John Paschal, MSN, for the weekly “check up” on their clinical internship.
“I think everybody is doing good on their paperwork,” Paschal says, but he reminds them that they need to keep up with their self-evaluations and case studies, the latter being 50 percent of their grade. The case study is a full work-up on the history and disease process of a patient and the treatment and care that a nurse can provide. Self-evaluations are required after every five days of clinical shifts.
“Continue to work on teaching [talking to patients and their loved ones],” Paschal says. “You have the knowledge in your heads—you just need to practice.”
He asks three students to stay for a moment, but he tells them all: “You all are doing really good. Keep up the good work. I know you’re really tired, but it’s nearly over.”
He’s talking about the eleven clinical shifts in a seven-week period that the students have had while keeping up with classes, studying, and the extensive paperwork that accompanies everything.
3:45 p.m. Nursing School Library, Fourth Floor
The meeting with Paschal is brief, and Garcez is on his own for the rest of the day.
“A lot of students do different things,” he says, “but I think the majority would say that we take thirty minutes to an hour just to take a deep breath, because we’ve gained so much information over the past six hours.”
On this day, Garcez heeds Paschal’s advice and goes upstairs to the library to work on his self-evaluation.
5 p.m. Dinner and Study, Apartment
In addition to making the grade and being accepted into nursing school, one of Garcez’s top accomplishments at Big Baylor was meeting Lindsey Owens, a 2009 Baylor graduate, who now is his fiancé. They’re getting married in July, but tonight they’re still preparing for their careers—his as a nurse, and hers as a speech pathologist. She’s working on her graduate degree from UT Dallas and was fortunate to get an apartment in the same complex as Garcez.
“We were both exhausted from our day, and since it will be hard to have dinner together the rest of the week due to my work schedule, we decided to use our ‘going out’ money and go to a nearby Mexican food diner,” he says.
After dinner they go back to Owens’s apartment, where he works on his case studies and she reads for her next classes.
7 p.m. Study, Apartment
Garcez and Owens go back to his apartment to check on his roommate, who has just gotten off a twelve-hour shift at Children’s Medical Center. The three visit briefly but quickly fall back into study mode.
“All three of us are accountable to each other for our different assignments for the week,” says Garcez. “Most days we study together to help motivate each other.”
Garcez uses study breaks to get ready for the next day: iron his scrubs, prepare lunch, get paperwork in order. And on some nights, he leads another Bible study at his apartment.
10 p.m. Finish Homework, Go to Bed
Garcez walks Owens back to her apartment and then goes home to finish studying before sleep overtakes him. “On most days, I try to go to bed by 11 or 11:30,” he says. “It’s hard to stay awake when I work two to three shifts and I’m supposed to be studying for tests or completing projects for the next week.”
CLINICAL DAY
Working in a large metropolitan area like Dallas, Baylor nursing students experience a variety of hospital settings. Garcez has worked at Baylor University Medical Center at Dallas, Baylor Medical Center at Garland, Texas Health Presbyterian Hospital Dallas, Methodist Richardson Medical Center, and Children’s Medical Center of Dallas. Some of his classmates have gone to Baylor Medical Center at Waxahachie.
“They try to give us a variety of hospitals so we get a feel for each of the systems,” he says.
Within those facilities, students have rotations in general medical/surgical, obstetrics, pediatrics, and psychiatry. They also observe in operating rooms, emergency rooms, and intensive care units and are exposed to other facets of the nursing profession.
“Last semester, we went to a court hearing for our psych rotation,” Garcez says. “They also sent us to a mock trial that shows a nurse who is being prosecuted for malpractice. It shows the process of what a nurse would have to go through if they’re sued.”
In their last semester, students get to repeat a rotation of their choice. Garcez chose the pediatric ICU at Children’s Medical Center.
5:30 a.m. Up and Out
Garcez rolls out of bed, puts on his scrubs—dark green with an interlocking gold BU on the shoulder patch—and eats breakfast. By 6:15 a.m., he’s driving the eight miles to Children’s Medical Center.
 6:45 a.m. Morning Report, Pediatric ICU, Children’s Medical Center
Garcez looks over the patient reports from the night-shift nurses with his preceptor, who is a licensed nurse. First-semester interns are monitored by an on-site professor, but final-semester interns work alongside a preceptor, adopting that person’s schedule and patient load.
“This week my preceptor works Wednesday, Thursday, and Saturday, so those are the days I’ll be in the hospital,” Garcez says.
His preceptor is Sarah Carr, a five-year nurse and graduate of the nursing school at Oral Roberts University. They’ve worked together three-and-a-half weeks—halfway through the seven-week internship.
The preceptor-intern relationship is one of setting goals and gradually increasing responsibilities. At first the preceptor is leading, then they are working together, and then the intern leads. “I want him to tell me what to do next,” Carr says.
“It’s been a challenge to get into the role of, ‘Okay, I’m the nurse now. What would I do next?’” Garcez says. “Everything I’ve learned in class has to come out.”
“He’s doing excellent,” Carr says. “I’ve seen a lot of progress. He definitely seems more comfortable than he did on the first day.”
7 a.m. Patient Assessments
Interns and their preceptors working on regular hospital floors can have up to five patients in a shift, but in the pediatric ICU they have just two.
“After the morning report, we start preparing everything we need to see our patients for the first time, then we make our morning assessments,” Garcez says. “In the ICU, we have to assess our patients sometimes every hour, but the standard is every two hours.”
Today, Garcez and Carr are caring for a two-year-old girl who was born at just over twenty-five weeks and has been in and out of the hospital with chronic lung disease. They also have a three-month-old boy with a respiratory virus. Winter finds the ICU dealing with a lot of respiratory issues, and last semester Garcez saw some H1N1 cases.
8 a.m. Doctors’ Rounds
Doctors make rounds in the ICU twice a day, and Garcez’s training has prepared him for this. “This semester, they’re getting us ready for the real world,” he says, “so we have assignments where we either communicate with the doctor or simulate what we would say to the doctor under certain circumstances.”
 9 a.m. Medication Administration
Doctor rounds are followed by the administration of medications. Mornings also usually include parent visits, and Garcez’s training has included the kind of “teaching” that Paschal stressed: communicating medical conditions and procedures to patients and their loved ones in terminology they can understand.
“And because Baylor is a faith-based university, we’ve been taught how to assess our patients’ spiritual life,” Garcez says. “In some classes, we’ve had discussions about how to talk to someone when they’re dying. We’ve been equipped to do that.”
Today, both patients are improving, and by noon the little boy is moved to a regular room on another floor. When things slow down, Garcez gets extra training by observing other nurses, especially if they are dealing with patient issues that he hasn’t seen before.
12:30 p.m. Covering for Neighbors
Teamwork is king in the ICU, and Garcez and Carr keep an eye on their neighboring nurses’ patients while the nurses go to lunch. The same will be done for them in a little while.
1 p.m. Lunch, Break Room
Patient stability dictates everything, including lunchtime. With their one patient doing well and covered by other nurses, Garcez and Carr go down the hall to the break room. They sit at a table with others working on the floor: nurses, patient care technicians, respiratory therapists. Joining them too is Emily MacElroy, another Baylor nursing intern.
Garcez says he learns from them all, and it’s clear from the lively banter that he is well-liked in the ICU. “I feel like I’m in the presence of greatness today,” a nurse teases him as he’s followed into the room by a reporter and photographer.
Lunch for Garcez is the turkey and cheese sandwich, blueberries, Jell-O, and applesauce he packed the night before. He and Carr talk mostly about work, but they have common connections through their churches, so there are other topics, too.
 1:30 p.m. Back to Work
Garcez and Carr return to the ICU, where the morning routine repeats itself. They deliver what they call “cluster care”—doing assessments, giving medications, and performing any procedures that are needed at one time so they can let the patients rest.
“It’s really all about time management,” Garcez says. “That’s what it’s about for me and my classmates this semester—learning time management.”
7 p.m. Evening Reports
The shift ends as it begins, but this time it is Garcez and Carr handing off their report to the night-shift nurses. “There’ve been days when I’ve worked up to about eight o’clock because our patient has needed our care,” Garcez says.
In that regard, he says that he and his fellow students don’t just go to nursing school. “We go to medical school. When a patient is in our care, we are just as responsible for their well-being as any other medical professional.”
8:30 p.m. Home
Back at his apartment, Garcez strikes a balance between resting and gearing up for tomorrow’s shift. He doesn’t take a rest opportunity lightly.
“I know many of my classmates work full time to support themselves or their families,” he says. “Their commitment to becoming a nurse inspires many people, including me.”
TOMORROW
Garcez doesn’t know what tomorrow’s shift at Children’s will bring, but he’s already making plans for his life after graduation in May. His short-term goal is to get a full-time job at Children’s Medical Center.
“I love their facility. It’s recognized as one of the top in the nation,” he says. “Their technology is top of the line, and the environment they have at that hospital is very sincere. I can see in the children’s faces that even though they’re hurting and sick, they still feel very safe.”
His long-term plan is to go to graduate school in a year or two.
“I hope to become a nurse practitioner, and I hope to take that education and go to the nations,” he says. “I have a heart for ministry and missions, so I hope to take the education I have and go care for people all over the world. I hope to fulfill the vision that God gave me before I came to Baylor.”
Jeff Hampton ’81 is a freelance writer in Dallas and a past contributor to the Baylor Line. For more on Baylor’s Louise Herrington School of Nursing, go to baylor.edu/nursing.
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