Beyond the Textbook
In a field filled with challenges, one student finds her calling
Maya Svec
Caitlin Curran
It was a quiet Monday evening in Oxford. The dark, rain-damp streets made it feel like the middle of the night. The sound of cars splashing against the wet pavement occasionally broke the silence.
Inside my college house, I hunched over my computer, trying to focus when a sudden beam of bright white light penetrated the blinds behind me. Expecting it to fade like a passing car, I waited, but the light lingered.
That’s when I knew she was home.
Curious, I lifted the shade with two fingers and peeked one eye through like a sleuth in the night. There she was, sitting alone in her black Honda CR-V.
My eyes were finally relieved when the lights flickered off. Expecting her to step out, I saw her face partially lit by the soft light of her phone. She was speaking passionately, but the look on her face wasn’t a happy one; if she wasn’t crying at that moment, it looked like she was about to.
As I attempted to refocus on my homework, I heard the car door slam. I glanced back out the window to see her get out of the car, grab her bag from the back seat and head towards the front door. Knowing she was about to walk in, I returned to my laptop.
The front door squeaked open.
“Oh hey,” I said, trying to keep my cool.
“Hey,” she said back.
“You’re back late. How was it?” I asked.
“I honestly don’t want to talk about it. I’m exhausted, I'll talk to you tomorrow.”
“OK, night.”
As she walked away, I sank deeper into the couch, wondering what had happened this time.
The next day, I sat on my porch doing work when a burst of laughter broke my focus. I looked up to see three girls walking towards my house. I only recognized one of them: Kylie.
“Hey, how was class?” I asked as she approached.
“Same old,” she shrugged.
As she went on a tangent about some intricate heart failure protocol she didn’t understand, I couldn’t help but think of what I had witnessed the night before. Her face, lit by the faint light of her phone, caught up in something so intense.
Why was she in such distress? Who was she talking to? Why did she get home later than usual?
So I asked.
“Oh, by the way, are you OK? I saw you on the phone in the car before you came in last night. Were you crying?”
Kylie’s face softened.
“Oh yeah, I was on the phone with my mom,” she paused. “Clinical was just so scary last night. I genuinely don’t know if I can do it anymore. I feel like I’m going crazy.”
Kylie’s not one to show emotion. She doesn’t get worked up by drama, let alone school. She’s strong, confident and I’ve rarely seen anything shake her. But last night had clearly been different.
That night at her psych clinical rotation, Kylie was assigned to sit with a suicidal patient. All night. Things got out of hand, and the woman got hold of a pencil to cut herself.
“There was blood everywhere,” she recalled. “On the floor, on her legs. Literally everywhere. We had to do a squat and cough.”
A squat and cough is an invasive search method used in special institutions to check for hidden objects. In this case, a patient is ordered to squat down and cough to reveal any objects hidden in the anal or vaginal canal.
That night, Kylie witnessed a bloody pencil fall out from underneath the patient.
—
Kylie Pfeifer is a senior nursing student at Miami University, where she’s part of the highly competitive undergraduate program. Only around 80 students are directly admitted each year.
Kylie wanted to be in the medical field from a very young age. With five of her closest relatives working as nurses, it was almost inevitable.
Her great aunt dedicated 57 years to Christ Hospital in Cincinnati, where she eventually became vice president. Her grandma spent 53 years as a scrub and bedside nurse at St. Luke Hospital in Kentucky. Her mom worked as a nurse for four years, but retired when she had kids. Her aunt has been at Christ Hospital for 30 years and is still working, and her older sister transitioned from seven years in bedside care to specializing as an infertility nurse in Chicago.
These were the women who shaped Kylie’s early understanding of nursing.
She said she grew up with them as role models, which kept nursing in the back of her mind. It’s not that she felt pressured; her family was supportive no matter what. Yet, there was a unique draw to the career, something about watching these women pour themselves into their work, caring for strangers of all ages, coming home and wanting to do it all over again.
Aside from classes, students at Miami are expected to begin their clinical rotations at the start of their sophomore year. Clinical rotations allow students to gain hands-on experience, taking the knowledge they learn in the classroom to the real world.
Each year, the program progresses, moving from basic tasks to more complex, high-stakes rotations in fields like labor and delivery, pediatrics and mental health.
While the program guides each student along the same rigorous path of clinicals, lectures and nursing simulations, it can only lead them so far. As they near graduation, every nursing student is faced with the decision of which field they’ll dedicate themselves to. Whether it’s pediatrics or psych, each student must decide where their strengths and limits lie.
And for Kylie, the end of this journey looms closer, with that final choice weighing on her heavily.
—
The sky was black with no hint of morning light in sight. Inside was filled with that same darkness, a silence so loud you could hear a pin drop.
At 5:35 a.m., Kylie’s alarm buzzed for the first time. Its sharp tone sounded abruptly through the darkness. She reached out, moaning and half-blind, and silenced it with a touch. The room fell quiet again.
But it wasn’t till the second alarm went off that she finally threw back the covers.
She tiptoed quietly to the bathroom, careful not to disturb her roommate. She brushed her teeth, splashed cold water on her face and returned to her room. Using only a flashlight to guide her, she undressed and put on her scrubs: black pants and a red top layered over a snug black undershirt. She shrugged into her jacket, clipped on her badge and ran a straightener through her long, blonde hair.
By 6:05 a.m., Kylie was in the kitchen, filling her water bottle and packing her backpack. Outside, the sky remained cloaked in darkness, and the world was still as she slipped through the back door and into her car.
Her day was beginning in this quiet hour, with her journey to the hospital underway before the sun was in sight.
—
For all its rewards, nursing is a profession that demands resilience. Burnout is a reality many nurses face, shaped by long shifts, high patient loads and the emotional toll of caring for people between life and death. Kylie has seen this reality up close through her own experiences in clinical rotations and from the lives of her family members.
Her older sister, Danielle, worked as a bedside nurse during the height of the COVID-19 pandemic. After eight years in the role, she transitioned to a clinic with shorter hours and no weekend shifts because she couldn’t sustain the relentless pace and emotional strain.
Similarly, Kylie’s work as a Patient Care Assistant (PCA) at Cincinnati Children’s Hospital has provided insight into the pressures of the field. She often finds herself the sole PCA on the floor, responsible for assisting multiple nurses while managing the needs of nearly 30 patients.
A 12-hour shift often stretches to 14 when factoring in early wake-ups, the commute and the inevitable delays, whether it’s the transition from night nurses to day nurses or a patient’s last-minute needs.
These challenges are part of the reason Kylie has been deliberate in planning her career. She knows the importance of starting her professional life in a supportive environment, one where she can learn and grow without fear of being overwhelmed.
Kylie knows nursing requires a constant balance between work and personal life, between caring for others and caring for yourself, but these challenges have fueled her determination to the demanding and deeply rewarding field.
—
The nursing building felt like an entirely different world from the rest of campus. As we walked in, I was immediately hit with the smell of new paint and freshly polished floors, a sharp contrast to the historic brick buildings that dominate Miami.
Kylie’s class was in the basement, so we headed down a stairwell that opened to a spacious floor filled with students in blue scrubs. I whispered a quick “whoa” as I locked eyes on them. They were hunched over their iPads, intensely focused on whatever diagram was on their screens.
“They’re pre-med,” Kylie said with a smirk. “Not nursing.”
As we walked into her sterile classroom, the place buzzed with chatter. There was a mix of laughter and whispers as I noticed a few curious glances thrown my way. The nursing program was small, and it was obvious I didn’t belong. I could feel the students staring at me, an unexpected visitor, as I made my way to Kylie’s assigned seating area.
Students were already settled, each with their PowerPoints loaded, iPads out and notebooks open, ready to begin. I could immediately tell this wasn’t the type of class where people scrolled through online shops or caught up on other assignments.
The professor, a younger woman with pulled-back dark hair, began to pace energetically between two large projectors without a single note in her hand.
“Alright, everyone,” the professor said. “We’re kicking things off with a game: stroke bingo.”
Naturally.
The same typical bingo rules apply for stroke bingo. Students scanned their cards intently, listening for clues.
“Bingo!” Kylie shouted five minutes into the game.
The prize? Obviously, a small stress ball shaped like a brain.
After the game, the professor moved seamlessly into the day’s lesson.
“Today is all about endocrine disorders,” she said as she began pacing again. “Let’s start with the posterior pituitary.”
The what?
I watched as the students followed along, tapping away on their tablets, heads nodding as terms like serum osmolality and urine osmolality were introduced. When the professor continued to diabetes insipidus, a few hands shot up, students eager to clarify any questions. No one missed a beat; this was a room that demanded focus.
“Now, we’re moving into the thyroid gland, which is crucial for every cell in the body,” she continued. “It produces T3 and T4 hormones that impact every cell.”
As I glanced around, I realized this lecture wasn’t just about endocrine systems. It was about the commitment these students held toward a field that required full focus, from tiny stress ball prizes to the intense study of disorders.
This is the very foundation of their training, where their future careers will be built upon. Every diagram, every term, every case study is designed to prepare them for the realities they will face in clinicals and beyond. These lessons aren’t just facts to memorize to pass an exam, they are tools to rely on when making split-second decisions or calming a panicked family.
This wasn’t merely a class they had to attend: It was their choice.
—
Kylie’s journey through her nursing rotations wasn’t a straight line of confidence or success. It was a process of confronting and overcoming challenges, each one testing her in new ways and forcing her to adapt.
As a sophomore in med-surg, she was tasked with head-to-toe assessments and basic patient interactions. She said she remembers her hands shaking the first time she had to interact with a patient. The weight of responsibility felt enormous, even when it was something as simple as taking vitals or documenting symptoms. Every interaction was supervised, and the feedback often felt overwhelming.
In med-surg II, she was pushed even further, managing IV drips and mapping out care plans for patients. Each task demanded more focus and accountability. For Kylie, this rotation marked a turning point. The shift from theory to practice became apparent as she was confronted with real patients and scenarios.
These weren’t just simulations or homework; these were real people, with real consequences if she made a mistake.
None of these experiences, however, prepared her for the emotional and professional test that was her mental health rotation. Kylie encountered patients whose struggles couldn’t be resolved with a procedure or medication. The unpredictability of their behaviors and the need for therapeutic communication couldn’t be found in a textbook. She had to learn how to navigate barriers of trust, relying on intuition as much as training.
Through each rotation, Kylie began to see the pattern. Nursing wasn’t just about learning how to perform tasks; it was about learning how to respond to the unknown, how to face the unexpected and adapt. The shift from the classroom to reality, the theoretical to the real, is something every nursing student must grapple with.
By the time Kylie reached her pediatric rotation, she felt a shift. The confidence she had built over the years through trial and error allowed her to focus not only on completing tasks, but on being truly present for her patients.
—
Kylie grew up babysitting and loved being around kids, so she always had pediatrics in the back of her mind. However, it wasn’t until her pediatric rotation at Cincinnati Children’s Hospital that she felt a deep pull toward this specialty.
This rotation wasn’t without its heartbreaking moments. One day, as she was clocking in, a code blue was called on her floor because a recurring patient had lost his pulse. The boy, just 4 years old when he first arrived at the hospital, had accidentally shot himself after finding a gun in his parents’ room. Since then, his parents gave him up, leaving him in the hands of the state.
Now 6, the boy passed away at the start of Kylie’s shift. She was ordered to clean the body with soap and water. The moment was irreplaceable; a neglected child, the victim of tragic circumstances, now lifeless before her, his eyes still open.
The body stayed on the floor for eight hours. It took eight hours for a family member to show up for the boy’s body. Eight hours.
Another day at clinical, Kylie was floated to a rehabilitation floor and assigned to act as a sitter for two young patients, a role usually given to those needing close monitoring. When she arrived, she learned the children had been brought in by the police. They were siblings, barely old enough to comprehend what had happened to them, but scarred in a way she could hardly process.
The little girl, no older than 5, had third-degree burns across the backs of her legs and lower body, inflicted when her parents had set her on a lit stove, while her younger brother had cigarette burns scattered across his small body.
For her entire eight-hour shift, Kylie was assigned to care for them.
They were too young to understand the details of what had happened, yet knew enough to be afraid. Throughout the day, the little boy clung to her, wanting nothing more than to be held.
Kylie felt the weight of his small arms around her neck and would hold him tightly, shielding him from the world’s cruelty. It was the only way she knew to soothe him.
Meanwhile, the little girl struggled to trust anyone who came near her. When she needed to use the restroom, Kylie would hold her up gently to support her. But even this simple task was excruciating; the pain from her burns was too much, and she sobbed and screamed as she went to the bathroom, gripping Kylie’s neck.
“That’s when I started crying,” Kylie recalled. “It was the first time I ever cried at work. I just cried with her as I cradled her.”
The experience stayed with Kylie, lingering even after her shift ended. She couldn’t shake the image of those children or the memory of the aunt who came to pick them up, cold and indifferent to the burns on their bodies.
She had been there to comfort and protect, and while she knew her role was limited, the experience awakened something within her: a commitment to help children who needed someone who cared.
In pediatrics, she saw both the pain and the resilience of her young patients, and it reminded her why she had chosen this path. Even if it were only for a few hours, it was enough to change everything.
Kylie said she would always remember their names.
—
As Kylie neared the end of her nursing program, that final choice hovered closer than ever.
In her mind, the answer was clear: pediatrics.
And the hospital was even clearer: Cincinnati Children’s Hospital.
In pediatrics, she found a path that fulfills the need she has felt since childhood. Her journey at Miami has taught her more than medical protocols and emergency procedures; it’s shown her where her calling lies. And as she ranked her choices, she did so with a newfound certainty.
The choice wasn’t just about following in her family’s footsteps anymore; it was about returning to that moment on the rehabilitation floor, holding those small, scarred children.
