When A Nursing Student Depends on Others To Protect Her

Nursing student Rachel writes about how being unable to rely on her immune system has made her into a stronger vaccine advocate.

Like every little kid, I always changed my career plans. However, unlike, most kids, they all had one common theme: they were all medical or health care fields. I switched from veterinarian to doctor, from pharmacist to physical therapist, and so on. All throughout my childhood and high school, I immersed myself in medical shows such as Mystery Diagnosis and researched different diseases and medical treatments just because I found them fascinating. Like my mechanical engineer brother whose first word was “car”, my family had a pretty good idea of what field I would be going into.

When I finally graduated high school, I decided to go into nursing. With so many interests, I felt that with a career in nursing, I would have many opportunities to explore new fields.  As I progressed through nursing school, I learned more and more about what I was interested in, but more than that, I fell in love with the field. I knew this is what I wanted to be doing with my life.

One topic I frequently researched in my free time was vaccines, and it developed into a passion of mine. I believe that education is one of the most important things we can do as nurses. The topic of vaccines is especially important to discuss because it is a subject flooded with misinformation. I used the knowledge I have acquired to discuss the topic with patients who refused vaccines for themselves or their children. I was very careful not to sound accusatory or pushy, and discussing the topic with patients allowed them to explore their fears and misconceptions about vaccination, and some of the patients changed their minds about them. This is something I’m very proud of.

Everything was going great, but the summer before my senior year, I noticed something was wrong. Long story short, I was diagnosed with Microscopic Polyangiitis (MPA), which is a rare autoimmune vasculitis of the small and medium-sized vessels in the body. Most patients are either middle-aged or elderly, but I was only 21-years old. In my case, it had affected the vessels in my skin, joints, lungs, eyes, and kidneys, but can also affect the ears and GI tract. The only treatment available for many autoimmune diseases is to suppress your immune system. While my first thought should have been directed towards my health, it was actually, “How can I continue nursing if I’m immunosupressed?” It was a scary time for my family and I.

I was extremely fortunate to have been diagnosed so early and over the summer before school started back up again. Even though my case was considered severe because I experienced an alveolar hemorrhage, there was no noticeable permanent lung damage, the kidney damage was minimal, and there was no permanent damage to anything else. I responded to treatment, Rituxan infusions and high dose prednisone, quite well (even though no one likes to be on prednisone). Most people who are diagnosed are not as fortunate as I have been and have more severe kidney and/or lung damage. After talking to my rheumatologist, he said I can continue nursing school and clinicals, but that I had to be careful and wear a mask around patients with URIs and certain other illnesses for the time being.

Thankfully, my diagnosis hasn’t otherwise affected my performance in nursing school. After completing over 3 years of schooling, I wasn’t going to let my diagnosis stop me. Other students noticed that my face got a bit puffier from the prednisone, but most of them didn’t say anything and thankfully, I’m now off of prednisone and the puffiness is gone. I’ve discussed my diagnosis with a few of the other students when it came up and used it as an opportunity to educate them. After exploring my interests, I ultimately fell in love with pharmacology and the operating room, which is why I’m striving to eventually become a CRNA. I’m now in the last semester of my senior year, and I’m set to graduate with my BSN from Rutgers in May.

I was a huge advocate of vaccines before my diagnosis, but this solidified my beliefs. I had to start treatment before the annual flu vaccine was available, so by the time I received it, my body couldn't create an immune response to it. I have to rely on others to be vaccinated in order to protect myself. With a weakened immune system and no B-cells, I’m vulnerable to many illnesses and catching them could be dangerous for me. Not many people under 60 can claim to have received the pneumococcal vaccine, but I am one of them. And since MPA has a high relapse rate, I will be receiving maintenance infusions of Rituxan every four months for two years.

My diagnosis, while not pleasant, has had many upsides. I learned what it was like to be a patient and how scary it is to be uncertain about your health. I’ve learned what it’s like to be dismissed, like when people just don’t believe you or think you’re making things up when you know something’s wrong. I’ve learned how frustrating it is be NPO for long periods of time, and go through test after test only to find nothing. I learned how important community immunity is for individuals like myself. But maybe most importantly, although MPA may not have left me physically stronger, it has certainly has made me mentally stronger, and it given me a new perspective that will allow me to be the best nurse I can be.

Nurses Who Vaccinate member Rachel Herman is in the last semester at Rutgers Camden for her BSN. Most of her interests are ridiculously nerdy, but she also loves animals, music, and traveling. She is by no means a writer, and hopes to pursue a career as a nurse anesthetist.


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