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Two days later, Julia's teachers met and concluded that she needed at least two extra weeks of training, meaning that she could graduate with her class on March 28 but would not be allowed to work on her own until at least mid-April. The next day, Julia sat across a conference table from Jeanne, M.J., and Susan Tully, the SICU's chief nurse, to get the bad news officially.

Julia argued that she couldn't be expected to be as accomplished as veteran nurses and that she would always ask for help in situations where she had doubts. But M.J. and Jeanne made it clear that they wanted to see improvement in the way Julia planned for her patients' care. ''It's very hard to get back on your plan if you don't have a plan," said M.J.

In addition, the two teachers felt that Julia wasn't listening critically enough when the doctors came by on rounds, and that she seemed reluctant to go back to the residents for clarification or help. In fact, M.J. said, Julia seemed to want to do most things herself. During the extra two weeks of training, they would have Julia work from a checklist of priorities for each patient

''It doesn't mean you're not going to graduate, but these things are serious enough that you're not going to be ready to be on your own in two weeks," M.J. reassured her.

At first, Julia was discouraged: Had she worked for four years to become an ICU nurse only to find out she wasn't very good at it? ''I was thinking, probably I didn't do well," she recalled, ''but then I thought, no, I don't think so. I think I'm able to be realistic about myself."

Julia agreed that she could use more practice in some areas, such as handling new patients who are rapidly going downhill. ''It's a luxury, actually, to get all this training," Julia concluded.

By the time graduation day rolled around, Julia was chatting cheerfully with other new ICU nurses about her situation.

When she saw Jeanne, they embraced warmly, and Jeanne pressed a pastel bouquet of daisies and snapdragons into Julia's arms. ''You deserve it," Jeanne said.

Julia was content, for the moment, but she had also made a promise to herself. If her teachers tried to add still more time to her apprenticeship, she would resist: ''I would say, 'You know what, guys? I'm getting out of here.' "

Part 3: Trauma case puts her capacity for clear-headedness to the test

Scott Allen can be reached at allen@globe.com.