1. every time i think i've seen one of the worst things that i've ever seen, i see something else awful.
last week i was taking care of a young guy with a bunch of kids and awful head and neck cancer that was literally rotting away at him. it was truly one of the worst things that i've ever seen (see above), and i can't imagine a more painful and scary way to die. all that i could do was try to make him comfortable and pray that he would decide to become a DNR before he coded. the cancer was dangerously close to his carotid artery, and one day i walked in and he was spraying blood out of the side of his neck. i grabbed him to put pressure on the wound, which was excruciatingly painful for him. i think he could tell that things were really bad, and at this point he was trached and couldn't talk. he grabbed his little white board and started to write. at first i thought he was trying to tell me something, but then i realized that he was actually writing a goodbye letter to his wife. i can't even describe the emotions that i felt in that moment. it was sacred and terrible, and i thought for sure that he was dying. but wouldn't you know, i lifted my hand and the bleeding had stopped. the patient got to spend 6 more days with his family before he finally died. he had me copy his letter to his wife, and on the day where he slowly slipped into unresponsiveness, i gave it to her.
i keep finding myself intertwined into the most important moments of people's stories. on one hand it's a privilege, on the other a burden.
2. make a power of attorney. have everyone you know make a power of attorney. after the first month in the ICU, i found myself telling all of my friends, coworkers, and families to never let me become a trached and PEGed TBI. seriously. you can intubate me, but no trach and no PEG. i would literally rather be dead.
this week i got my first emergent transfer from the floor, a 90+ year old in a halo in respiratory with periods of apnea lasting up to 30 seconds. a full code. what started out as a fairly stable situation quickly deteriorated into an emergency fiberoptic intubation with anesthesia, and me giving poor grandpa 1 chest compression before someone finally found a thready pulse (courtesy of his pacemaker).
DO NOT DO THIS TO THE ELDERLY PEOPLE IN YOUR LIFE.
and do not make nurses commit elder abuse in the form of CPR and other forms of life-saving assault. it's just barbaric.
3. teamwork is the only thing that allows people to survive in this hostile environment. every single person in the ICU has been kind to me. they've said encouraging things, they've answered my questions, and they've jumped in to help me when someone is trying to die. i gave up the best team in the world, and i think that i may have found one just as supportive.
4. you HAVE to find the humor wherever you can, or you will go completely crazy.
in the spirit of teamwork, when an admission comes in everyone jumps in to help. nasal swab, finger stick, temperature, bath...boom boom boom. we got a patient a few days ago who had broken into a restaurant and went about cooking himself up some food, namely a few steaks. the owner came in and caught him, a fight ensued, and the patient got stabbed in the chest. he walked himself to a local hospital and told them his chest hurt, however failed to mention the stabbing. he was immediately transferred to us, where he proceeded to refuse surgery. he rolled up to the ICU, where i decided to be helpful and catalog his belongings. i recorded a couple of bags of clothes, and then came to a heavy plastic bag full of brown goo. upon opening the bag, i realized it was a to-go box of food.
it was the steaks.
and it that moment, i had the once in a lifetime opportunity of recording "bag of meat" in the patient belongings list.
--------------------------------------------------------------------------------------------------------------------------
this has not been easy for me, but there's something rewarding in challenging yourself and realizing that you're capable of hard things. 12 weeks down, 2 to go.
Friday, December 11, 2015
Saturday, October 17, 2015
goodbye
when i decided i was finally ready to transfer to the ICU, i knew that people would die more frequently. i've done a decent share of palliative care in the past, and it's something that i enjoy. but, once again, i was not prepared for the reality of dealing with that level of grief.
on orientation, my main goal needs to be to see as many things as i can. that means that when there's a challenge, i need to take it. it's the only way i'll get enough experience, and the only way i'll be able to survive on my own in a few months. so when i saw that there was a patient who we were going to be withdrawing cares on, i seized the learning opportunity.
my patient was a middle aged man who fell down the stairs. he was found by his teenaged son. neurosurgery had determined that he has a non-survivable brain injury, so the family made the decision to terminally extubate him.
terminal extubation- not a thing that i have ever experienced before. essentially, we remove the breathing tube that's keeping a person alive with the knowledge that they will die soon thereafter. depending on the level that the patient needs the ventilator, death can happen quickly or take days.
so after family meetings, hospice paperwork, and a whole lot of waiting, the respiratory therapist pulled the tube. i'm not sure what i expected to happen, but it was a bit anti-climactic. we suctioned the patient, and gave him a ton of morphine to manage his air hunger. his family stepped out during the extubation process, but i quickly called them to the bedside so they could be there. i felt that things would go pretty quickly, as the patient became tachycardic and his oxygen levels immediately dropped.
i felt the way that i've felt in these situations in the past: sad, but at peace. i knew this was the right thing to do. and i felt that way until the patient's son came to the bedside. and then i witnessed the most heartbreaking goodbye that i have ever experienced in my entire life.
a teenager shouldn't have to sit and hold the hand of his dying father. it just seemed so incredibly cruel to me, the fact that less than 24 hours before everything had been normal for this kid. i stood quietly in the corner and just watched this kid sob, apologize, and promise to be a good person who would make his dad proud.
after a half an hour, the patient died, and the family said their final goodbyes and left. and to be honest, the enormity of the moment didn't hit me right away. there was so much to be done...calling the donor network, getting paperwork together, preparing the body. my preceptor and i made ink handprints of the patient and sent them along with him for his son. we sent the patient down to the morgue, and i still had another patient to take care of along with a ton of charting that needs to be done perfectly before the body can be released.
so it wasn't until i was driving home, and couldn't stop thinking about this family, that i realized what a toll the day had taken on me. i was physically and emotionally exhausted. i couldn't stop thinking about the patients son, and about how he was feeling. about what would happen to him.
i wasn't all that surprised when all of the sudden there were flashing lights behind me, because i was in a daze and didn't remember most of the ride home. the officer came up to my car, and saw my scrubs and badge. he asked if i was coming home from work, and must have asked me something about my day, because the next thing i knew i was sobbing on the side of the road and pouring out the whole story to this stranger.
sometimes this job just hurts. i have seen things that i would rather forget, but will always remember. i have so many storied locked away inside that i would never tell my family or non-nursing friends because i don't want them to have to carry that weight. but i carry it. most days i don't even think about it, but on a day like this one, sometimes i get so tired that i don't think i can take another step. it's exhausting. it's a huge responsibility. and it scares me, because i just signed myself up as a witness to more grief and pain than i could previously imagine. what will that do to me? i am not a person who can just go about my life like these things never happened. i care. i care sometimes even when it's detrimental to myself.
how do you keep yourself separate from the pain of other people without being cold? how to you empathize with their grief without getting hurt? there must be a line somewhere, one that i'm going to have to learn to tip-toe up to without crossing. i think it must be a skill like any other, one that i'll learn with time. at least i hope so.
on orientation, my main goal needs to be to see as many things as i can. that means that when there's a challenge, i need to take it. it's the only way i'll get enough experience, and the only way i'll be able to survive on my own in a few months. so when i saw that there was a patient who we were going to be withdrawing cares on, i seized the learning opportunity.
my patient was a middle aged man who fell down the stairs. he was found by his teenaged son. neurosurgery had determined that he has a non-survivable brain injury, so the family made the decision to terminally extubate him.
terminal extubation- not a thing that i have ever experienced before. essentially, we remove the breathing tube that's keeping a person alive with the knowledge that they will die soon thereafter. depending on the level that the patient needs the ventilator, death can happen quickly or take days.
so after family meetings, hospice paperwork, and a whole lot of waiting, the respiratory therapist pulled the tube. i'm not sure what i expected to happen, but it was a bit anti-climactic. we suctioned the patient, and gave him a ton of morphine to manage his air hunger. his family stepped out during the extubation process, but i quickly called them to the bedside so they could be there. i felt that things would go pretty quickly, as the patient became tachycardic and his oxygen levels immediately dropped.
i felt the way that i've felt in these situations in the past: sad, but at peace. i knew this was the right thing to do. and i felt that way until the patient's son came to the bedside. and then i witnessed the most heartbreaking goodbye that i have ever experienced in my entire life.
a teenager shouldn't have to sit and hold the hand of his dying father. it just seemed so incredibly cruel to me, the fact that less than 24 hours before everything had been normal for this kid. i stood quietly in the corner and just watched this kid sob, apologize, and promise to be a good person who would make his dad proud.
after a half an hour, the patient died, and the family said their final goodbyes and left. and to be honest, the enormity of the moment didn't hit me right away. there was so much to be done...calling the donor network, getting paperwork together, preparing the body. my preceptor and i made ink handprints of the patient and sent them along with him for his son. we sent the patient down to the morgue, and i still had another patient to take care of along with a ton of charting that needs to be done perfectly before the body can be released.
so it wasn't until i was driving home, and couldn't stop thinking about this family, that i realized what a toll the day had taken on me. i was physically and emotionally exhausted. i couldn't stop thinking about the patients son, and about how he was feeling. about what would happen to him.
i wasn't all that surprised when all of the sudden there were flashing lights behind me, because i was in a daze and didn't remember most of the ride home. the officer came up to my car, and saw my scrubs and badge. he asked if i was coming home from work, and must have asked me something about my day, because the next thing i knew i was sobbing on the side of the road and pouring out the whole story to this stranger.
sometimes this job just hurts. i have seen things that i would rather forget, but will always remember. i have so many storied locked away inside that i would never tell my family or non-nursing friends because i don't want them to have to carry that weight. but i carry it. most days i don't even think about it, but on a day like this one, sometimes i get so tired that i don't think i can take another step. it's exhausting. it's a huge responsibility. and it scares me, because i just signed myself up as a witness to more grief and pain than i could previously imagine. what will that do to me? i am not a person who can just go about my life like these things never happened. i care. i care sometimes even when it's detrimental to myself.
how do you keep yourself separate from the pain of other people without being cold? how to you empathize with their grief without getting hurt? there must be a line somewhere, one that i'm going to have to learn to tip-toe up to without crossing. i think it must be a skill like any other, one that i'll learn with time. at least i hope so.
Saturday, October 10, 2015
growing pains
so it's official, i have a new job. that's right, after over seven years on the trauma unit, i finally decided to move on and am now a nurse in the surgical critical care area. it's definitely challenging, and i'm learning a lot. i'm trying to adjust to my orientation schedule, and to being brand new instead of being the resident expert. things are going well!!
...so that's pretty much what i say to people when they ask how things are going. i'm trying to be positive and tactful, and to avoid saying anything that will get back to the wrong people and get me in some kind of trouble with my new unit. but the truth?
THIS IS SO HARD.
i won't say that it's the hardest thing i've ever done, because it's still better than being fresh out of nursing school. but not by too terribly much. first of all, i hate change. hate it. HATE IT. i would much rather be warm and cozy in my familiar environment with people who love me and accept my neuroses. instead, i'm treading lightly so these people don't think that i'm actually insane and trying to keep a handle on all my feels because, as i've been told, "there's no crying in the ICU".
to my credit, i haven't come close to crying at work. yelling at people, maybe. quitting to become a librarian, yes. cursing the day that i thought i should do this, oh for sure. i have run through every possible emotion. and i know in my heart that this is the only way for me. as i said before, change is not my thing. this is how i react to it. this is basically what i knew would happen.
but knowing it and going through it are two different things. first of all, i'm exhausted all the time. when i can sleep, i sleep for like 12 hours. it's like being a newborn baby. i also have what fellow coworker (thank God I have one friend from the floor who's doing this with me!) and I have coined as "ICU brain". in short, the high volume of new knowledge leaves no room for anything else, including basic brain functions and motor skills. this leads you to completely forget entire conversations, to drop pretty much everything on the floor, and to throw your car keys into garbage bins instead of actual trash. it's debilitating.
also a delight is the 29387489723 hours of online education that i now get to enjoy. this ensures that when i actually do have a day off, i feel either stressed or guilty. it's a throwback to nursing school, minus large volumes of alcohol.
and of course the main issue: this people are terrifyingly sick. this week i had a lady on nine drips. Another patient's pressors ran out and his blood pressure tanked. one day i was half way though pushing a med and my patient when into an unstable rhythm, then into V-fib (read: bad. dying.), then back into an unstable rhythm, leading my preceptor to utter the terrifying words "we're going to have to code her". um, yeah, ok. we can do that after i finish PEEING MY PANTS. for all of those who think that i should have expected this, duh, i thank you in advance for keeping those (very true) thoughts to yourself.
also something i've noticed about the ICU: everybody dies. ok, not everybody. but people die at an alarming rate. i've been on the floor for three weeks and two of my patients are dead with one other not far behind. again, in my head this is something i knew that i'd have to deal with. but it's way different in practice than in theory.
so at this point you probably wonder if i'm going to
a. jump off a cliff
b. end up institutionalized or
c. quit
and the answer is...none of the above. i am in this for better or worse. i am doing this, i am not quitting, and i will get through it. these are growing pains, these feelings are normal, and it will get better. it HAS to get better.
because that thought is what is currently getting me through my days.
...so that's pretty much what i say to people when they ask how things are going. i'm trying to be positive and tactful, and to avoid saying anything that will get back to the wrong people and get me in some kind of trouble with my new unit. but the truth?
THIS IS SO HARD.
i won't say that it's the hardest thing i've ever done, because it's still better than being fresh out of nursing school. but not by too terribly much. first of all, i hate change. hate it. HATE IT. i would much rather be warm and cozy in my familiar environment with people who love me and accept my neuroses. instead, i'm treading lightly so these people don't think that i'm actually insane and trying to keep a handle on all my feels because, as i've been told, "there's no crying in the ICU".
to my credit, i haven't come close to crying at work. yelling at people, maybe. quitting to become a librarian, yes. cursing the day that i thought i should do this, oh for sure. i have run through every possible emotion. and i know in my heart that this is the only way for me. as i said before, change is not my thing. this is how i react to it. this is basically what i knew would happen.
but knowing it and going through it are two different things. first of all, i'm exhausted all the time. when i can sleep, i sleep for like 12 hours. it's like being a newborn baby. i also have what fellow coworker (thank God I have one friend from the floor who's doing this with me!) and I have coined as "ICU brain". in short, the high volume of new knowledge leaves no room for anything else, including basic brain functions and motor skills. this leads you to completely forget entire conversations, to drop pretty much everything on the floor, and to throw your car keys into garbage bins instead of actual trash. it's debilitating.
also a delight is the 29387489723 hours of online education that i now get to enjoy. this ensures that when i actually do have a day off, i feel either stressed or guilty. it's a throwback to nursing school, minus large volumes of alcohol.
and of course the main issue: this people are terrifyingly sick. this week i had a lady on nine drips. Another patient's pressors ran out and his blood pressure tanked. one day i was half way though pushing a med and my patient when into an unstable rhythm, then into V-fib (read: bad. dying.), then back into an unstable rhythm, leading my preceptor to utter the terrifying words "we're going to have to code her". um, yeah, ok. we can do that after i finish PEEING MY PANTS. for all of those who think that i should have expected this, duh, i thank you in advance for keeping those (very true) thoughts to yourself.
also something i've noticed about the ICU: everybody dies. ok, not everybody. but people die at an alarming rate. i've been on the floor for three weeks and two of my patients are dead with one other not far behind. again, in my head this is something i knew that i'd have to deal with. but it's way different in practice than in theory.
so at this point you probably wonder if i'm going to
a. jump off a cliff
b. end up institutionalized or
c. quit
and the answer is...none of the above. i am in this for better or worse. i am doing this, i am not quitting, and i will get through it. these are growing pains, these feelings are normal, and it will get better. it HAS to get better.
because that thought is what is currently getting me through my days.
Wednesday, June 17, 2015
too little, too late.
i just came from a meeting in which i was handed everything that i wanted.
terrible manager is leaving. nice CNS is now new interim manager. staffing is improving. we're taking the next six months to "focus on us".
and it sounds ungrateful and entitled, but my mind was screaming the entire meeting: IT'S NOT ENOUGH.
not enough to make up for the past 5 years in which we were constantly told to do better. not enough to undo the repeated threats of "consequences" and "corrective action". not enough to make me forget the agonizing meeting i had in the office where i was told that i'm negative, or the one where i tried to make them understand how bad things on the unit were getting only to be handed a mental health brochure.
i. am. so. angry. they made me feel like a failure. they made me believe that there was something wrong with me. i felt crazy, like it was all in my head and maybe i just couldn't cut it as a trauma nurse and that it was all my fault.
then, in one 2 hour meeting, all is supposed to be forgiven and forgotten? as if the "leadership team" didn't know exactly what was going on all that time? i feel like some bullied kid, picked apart for years and years and now the bully is gone and i'm just supposed to put a smile on my face like it never happened.
it happened. it hurt me. it made me a different person.
and you can give me more staff, a kinder/gentler manager and free prizes, but it doesn't make it go away.
i'm not sure how to deal with this. everyone is so happy, so relieved, and i'm just sitting here frustrated and uneasy, wondering exactly how i'm supposed to get over years of hurt and bitterness.
like how terrible manager chased away so many of my coworker friends. or how i would send emails about problems that were never addressed. and when i did bring issues to light, i felt as if i had a target on my back for mentioning something that wasn't positive. or how we had terrible staff satisfaction scores for years, and wasted so much time making action plans that never changed anything.
i resent all of that.
and, if i'm being honest, i think i resent that this change is happening when i'm finally ready to move on. here i am, more likely than not getting a new job in the next several weeks and NOW is when we're finally going to solve the problems? NOW is when we're going to start listening to the staff? NOW is when we've decided to say out loud what we've all been thinking for years? really??
well go figure.
i think that what i've realized above all else is that i'm doing the right thing. if i can't be happy about this, about the best possible scenario coming true, what would make me happy? nothing. so i'm trying to make a conscious effort to be glad for my coworkers left behind. to embrace these changes and not say the things that i'm thinking. to let this news make other people happier and more satisfied at work.
but for me?
it's just too little, too late.
terrible manager is leaving. nice CNS is now new interim manager. staffing is improving. we're taking the next six months to "focus on us".
and it sounds ungrateful and entitled, but my mind was screaming the entire meeting: IT'S NOT ENOUGH.
not enough to make up for the past 5 years in which we were constantly told to do better. not enough to undo the repeated threats of "consequences" and "corrective action". not enough to make me forget the agonizing meeting i had in the office where i was told that i'm negative, or the one where i tried to make them understand how bad things on the unit were getting only to be handed a mental health brochure.
i. am. so. angry. they made me feel like a failure. they made me believe that there was something wrong with me. i felt crazy, like it was all in my head and maybe i just couldn't cut it as a trauma nurse and that it was all my fault.
then, in one 2 hour meeting, all is supposed to be forgiven and forgotten? as if the "leadership team" didn't know exactly what was going on all that time? i feel like some bullied kid, picked apart for years and years and now the bully is gone and i'm just supposed to put a smile on my face like it never happened.
it happened. it hurt me. it made me a different person.
and you can give me more staff, a kinder/gentler manager and free prizes, but it doesn't make it go away.
i'm not sure how to deal with this. everyone is so happy, so relieved, and i'm just sitting here frustrated and uneasy, wondering exactly how i'm supposed to get over years of hurt and bitterness.
like how terrible manager chased away so many of my coworker friends. or how i would send emails about problems that were never addressed. and when i did bring issues to light, i felt as if i had a target on my back for mentioning something that wasn't positive. or how we had terrible staff satisfaction scores for years, and wasted so much time making action plans that never changed anything.
i resent all of that.
and, if i'm being honest, i think i resent that this change is happening when i'm finally ready to move on. here i am, more likely than not getting a new job in the next several weeks and NOW is when we're finally going to solve the problems? NOW is when we're going to start listening to the staff? NOW is when we've decided to say out loud what we've all been thinking for years? really??
well go figure.
i think that what i've realized above all else is that i'm doing the right thing. if i can't be happy about this, about the best possible scenario coming true, what would make me happy? nothing. so i'm trying to make a conscious effort to be glad for my coworkers left behind. to embrace these changes and not say the things that i'm thinking. to let this news make other people happier and more satisfied at work.
but for me?
it's just too little, too late.
Wednesday, June 3, 2015
seven years
i was thinking about nursing, and about what i've learned over the last year. there's always something...another crazy story, a new way to get doctors to do what you want, how to fly under management's radar. but when i really thought about it, i realized that this was the year that i finally learned how much of myself to give to other people.
that sounds silly, because nurses are supposed to be this bottomless pit of compassion and selflessness, but sometimes that's just not realistic. i've learned the hard way that i have to take care of myself, or i'll have nothing else to give to other people.
i've said it before, this job is HARD. you see and hear terrible, sad things that make you ache for people and wonder how the world could possibly be so cruel. and you're frustrated on a level that you never thought you could even get to, because you're literally fighting for peoples lives and yet still have to deal with trivial things like money and ego and resources. meanwhile, the people who are supposed to be supporting you are some of your biggest rivals, and you find yourself fighting for better staffing and more security and things that you really shouldn't have to ask for, much less beg repeatedly for.
and in the midst of all this, i let myself get worn down to the point where i could barely keep going. i kept hearing how much i was supposed to be giving to my patients...the hourly rounding, the mountain of charting, the folders upon folders of teaching, and i actually believed that i could do it. and when i fell short again and again, i started to believe that i was failing and that i was terrible and i started asking myself why i even wanted to be a nurse in the first place. so before i went completely crazy, i decided that something had to give.
hourly rounding? not going to kill myself over that. CHF teaching on people who have 23908457 folders at their house? nope. i started to delegate more tasks, because that's why our techs are there. and as bad as it sounds, i started to help my coworkers less, because they don't need me hovering over them all the time. i am not lab and dietary and PT and pharmacy and social work. i started to worry less about everybody else's jobs and think more about my little piece of the pie.
i'm a micromanager and i'm particular and i like things to be tidy and perfect. but that's not realistic, and i've finally realized that i can't kill myself over those things anymore. i'm getting better at prioritizing, and taking time to sit down and chart, and also at not giving everyone everything that they want right this minute.
it makes me happier, and it makes me feel like i'm doing a better job.
and then there are the days that i just say screw it and decide to do the things that people really need, efficiency be damned!! the last shift that i worked i gave 2 people afternoon baths, because it really needed to happen. then i wheeled my GSW to the chest over to postpartum to meet his twin sons for the first time. and as i stood over there for a half hour, i probably should have been initialing some rounding logs or filling out some duplicate paperwork somewhere, but i really didn't care. because i got to watch the patient hold his babies for the first time and just stare at them. it was a rare and magical glimpse of what nursing should be and what i thought i signed up for, and it was worth it.
in the past seven years i've learned a lot about caring for other people. its taken me a long time to realize that i need to be just as focused on taking care of myself.
that sounds silly, because nurses are supposed to be this bottomless pit of compassion and selflessness, but sometimes that's just not realistic. i've learned the hard way that i have to take care of myself, or i'll have nothing else to give to other people.
i've said it before, this job is HARD. you see and hear terrible, sad things that make you ache for people and wonder how the world could possibly be so cruel. and you're frustrated on a level that you never thought you could even get to, because you're literally fighting for peoples lives and yet still have to deal with trivial things like money and ego and resources. meanwhile, the people who are supposed to be supporting you are some of your biggest rivals, and you find yourself fighting for better staffing and more security and things that you really shouldn't have to ask for, much less beg repeatedly for.
and in the midst of all this, i let myself get worn down to the point where i could barely keep going. i kept hearing how much i was supposed to be giving to my patients...the hourly rounding, the mountain of charting, the folders upon folders of teaching, and i actually believed that i could do it. and when i fell short again and again, i started to believe that i was failing and that i was terrible and i started asking myself why i even wanted to be a nurse in the first place. so before i went completely crazy, i decided that something had to give.
hourly rounding? not going to kill myself over that. CHF teaching on people who have 23908457 folders at their house? nope. i started to delegate more tasks, because that's why our techs are there. and as bad as it sounds, i started to help my coworkers less, because they don't need me hovering over them all the time. i am not lab and dietary and PT and pharmacy and social work. i started to worry less about everybody else's jobs and think more about my little piece of the pie.
i'm a micromanager and i'm particular and i like things to be tidy and perfect. but that's not realistic, and i've finally realized that i can't kill myself over those things anymore. i'm getting better at prioritizing, and taking time to sit down and chart, and also at not giving everyone everything that they want right this minute.
it makes me happier, and it makes me feel like i'm doing a better job.
and then there are the days that i just say screw it and decide to do the things that people really need, efficiency be damned!! the last shift that i worked i gave 2 people afternoon baths, because it really needed to happen. then i wheeled my GSW to the chest over to postpartum to meet his twin sons for the first time. and as i stood over there for a half hour, i probably should have been initialing some rounding logs or filling out some duplicate paperwork somewhere, but i really didn't care. because i got to watch the patient hold his babies for the first time and just stare at them. it was a rare and magical glimpse of what nursing should be and what i thought i signed up for, and it was worth it.
in the past seven years i've learned a lot about caring for other people. its taken me a long time to realize that i need to be just as focused on taking care of myself.
Thursday, May 21, 2015
moving on.
first of all, i'm not dead.
that being said, back to the same old same old. i guess i just felt like i was whining about the same things over and over, because nothing really ever changes. it's the same old issues that cycle around. the floor is bad and the floor is terrible and then things get better and so on. maybe i've just learned to accept that this is the way things are.
but i don't like it. i don't like the way i feel about my job, and i don't like that i've grudgingly accepted the nonsense that occurs on a daily basis and that i've adopted the "it is what it is" mentality. i've noticed a change in myself, and i miss the person that i used to be. i feel like healthcare has been completely de-humanized in the time that i've been working as a nurse. every part of my nursing practice is now scripted. i see my patients at a set timeframe. i introduce myself using a specific script. I use alliterating buzzwords to see if they have any needs each time i'm in the room. i talk about the things that i'm told to talk about, and any sort of individual thought is completely left out of the equation.
i'm a nursing drone. i feel completely and utterly ordinary and like i'm totally replaceable. i get to make very few decisions independently, and there is pretty much no area of my practice in which i'm allowed to have choices.
my job is pretty unsatisfying, because i have fought the man for the past 7 years and they have slowly chipped away at my reserves. i woke up one day and realized that i've just started to do what's easiest, because i don't have any more to sacrifice for people.
i go into my patients' rooms and try to spend as little time there as possible. get in and get out. be efficient. need to make sure that i have plenty of time to chart or else i'll be sitting in front of a computer until 1 am.
the things that i'm supposed to care about, i just don't have time to care about. walking people? psssh, like i can find 15 whole consecutive minutes to spend on one person. we had a staff meeting today where they talked about how we need to be doing patient education, and i actually caught myself thinking about how that should be someone else's job because i have too many other things to do and don't have time for that.
or more accurately, i DO have time but it is time stolen from another patient or from myself.
i have basically nothing left to give.
and i know i've said this all before, but this time it's different.
i've realized in the past several months that there has GOT to be better than this. and as more and more of my coworkers leave for new jobs, jobs where they're appreciated and generally happier, i've finally see that it's not me. i'm not broken, i'm not a crappy nurse, i work in a toxic environment under an unsympathetic and ineffective manager and it's next to impossible to succeed in that kind of environment. so i'm done.
i've made the decision to leave, and even though i don't know where i'm going yet, it still feels official. this is the first time in the past 7 years that moving on truly feels right. it's bittersweet, because i love my coworkers and i still have so much nostalgia about how things used to be. but i can't do this job anymore. i won't put myself through it. and although i've tried to bring various problems to light over the years, i feel that actions speak louder than words. they never listened when i talked, maybe they'll listen when i walk.
but it's more than that. if i'm being honest, i think i'm still doing what i'm doing because it's comfortable. it's familiar. it's honestly all i know. and i still believe it's important, and underrated, and that i make a difference. but am i happy? am i being challenged? do i love this? is this the only thing i could ever imagine doing?
not anymore.
and so it's time for moving on.
that being said, back to the same old same old. i guess i just felt like i was whining about the same things over and over, because nothing really ever changes. it's the same old issues that cycle around. the floor is bad and the floor is terrible and then things get better and so on. maybe i've just learned to accept that this is the way things are.
but i don't like it. i don't like the way i feel about my job, and i don't like that i've grudgingly accepted the nonsense that occurs on a daily basis and that i've adopted the "it is what it is" mentality. i've noticed a change in myself, and i miss the person that i used to be. i feel like healthcare has been completely de-humanized in the time that i've been working as a nurse. every part of my nursing practice is now scripted. i see my patients at a set timeframe. i introduce myself using a specific script. I use alliterating buzzwords to see if they have any needs each time i'm in the room. i talk about the things that i'm told to talk about, and any sort of individual thought is completely left out of the equation.
i'm a nursing drone. i feel completely and utterly ordinary and like i'm totally replaceable. i get to make very few decisions independently, and there is pretty much no area of my practice in which i'm allowed to have choices.
my job is pretty unsatisfying, because i have fought the man for the past 7 years and they have slowly chipped away at my reserves. i woke up one day and realized that i've just started to do what's easiest, because i don't have any more to sacrifice for people.
i go into my patients' rooms and try to spend as little time there as possible. get in and get out. be efficient. need to make sure that i have plenty of time to chart or else i'll be sitting in front of a computer until 1 am.
the things that i'm supposed to care about, i just don't have time to care about. walking people? psssh, like i can find 15 whole consecutive minutes to spend on one person. we had a staff meeting today where they talked about how we need to be doing patient education, and i actually caught myself thinking about how that should be someone else's job because i have too many other things to do and don't have time for that.
or more accurately, i DO have time but it is time stolen from another patient or from myself.
i have basically nothing left to give.
and i know i've said this all before, but this time it's different.
i've realized in the past several months that there has GOT to be better than this. and as more and more of my coworkers leave for new jobs, jobs where they're appreciated and generally happier, i've finally see that it's not me. i'm not broken, i'm not a crappy nurse, i work in a toxic environment under an unsympathetic and ineffective manager and it's next to impossible to succeed in that kind of environment. so i'm done.
i've made the decision to leave, and even though i don't know where i'm going yet, it still feels official. this is the first time in the past 7 years that moving on truly feels right. it's bittersweet, because i love my coworkers and i still have so much nostalgia about how things used to be. but i can't do this job anymore. i won't put myself through it. and although i've tried to bring various problems to light over the years, i feel that actions speak louder than words. they never listened when i talked, maybe they'll listen when i walk.
but it's more than that. if i'm being honest, i think i'm still doing what i'm doing because it's comfortable. it's familiar. it's honestly all i know. and i still believe it's important, and underrated, and that i make a difference. but am i happy? am i being challenged? do i love this? is this the only thing i could ever imagine doing?
not anymore.
and so it's time for moving on.
Friday, January 30, 2015
humans and monsters
I've been thinking a lot lately about compassion, and justice, and how it's really scary that evil doesn't look like you think it would.
last week i took care of a murderer. now a lot of my patients aren't exactly saints. and i've definitely taken care of people whose poor choices meant that they killed someone. but there's a big difference between driving drunk and hitting someone with your car and stabbing four people, two to death.
i guess that i don't know what to think. once again, nursing school never prepared me for this. i'm a strong believer in being kind to people despite what they've done. in treating people the way that they treat you, even if they are a drug dealer or a pedophile or a manslaughterer. never before have i felt guilty for being nice to someone. but last week, i did.
the first time i met my patient, he looked like any other post-op patient. he was young. vulnerable. but he was also covered in the blood of the people he'd killed. and somehow, it was my job to wash that blood, the blood of his murdered baby, off of his hands.
it was surreal. disturbing. and it made me feel like somehow i shouldn't be taking care of him. like he should have to sit there and think about what he'd done, and i shouldn't be giving him blankets or offering him food or having him rate his pain. but that is not a thing. people don't get cared for based on whether or not they deserve help. i believe that everyone deserves to be treated well, and that what they've done has nothing to do with the care that i provide. don't i? i thought that i did.
so i treated this patient like any other. then i went home and couldn't sleep. i can ALWAYS sleep. i just can't help thinking that we got it wrong. society believes that evil has a face, some sort of tell. that you can see it in someone's eyes. and while i'm pretty savvy, i bought into it. to me, killers fell into a few categories: people who do stupid things without thought of consequences, mentally ill people who don't know what they're doing, cold calculated serial killers who actually like that kind of thing. reckless, crazy, or defective. but this patient was none of those things. he was basically a kid. he looked scared. he cried. i actually somehow felt bad for him. and it's still upsetting to me, because that's not what evil is supposed to look like. and try as i might to figure out how someone can be so human and still do something so horrific, i can't.
the day after, i got to work and everyone was in a panic. the surviving victims had ended up on the floor as well, and their families were out for blood. the news had informed them that my patient was at the hospital, and they wasted no time in scouring the doors looking for his name and knocking on windows trying to draw him out. my coworkers who were caring for those patients heard the plan loud and clear: they were going to find him and kill him.
sadly this is not the first time that i've felt like i could be in danger caring for someone. but to cut down on the risk of more violence, the decision was made to transfer the patient off the floor. unfortunately, we were literally backed into a corner, and the only way out was past the victims and their families. i ended up pushing my patient through a usually locked back door, wearing a surgical cap and mask, wrapped completely in blankets and accompanied by a 5 person police and hospital security detail. and once again, i somehow felt that i was doing something wrong. i was helping a murder escape vigilante justice!! but clearly, diffusing the situation and getting the patient off the floor was the right decision for everyone. so i no longer had to care for the patient, and i tried unsuccessfully to put him out of my mind.
the week after, he was formally charged and his face was all over the news and social media. as usual, everyone felt the need to throw their two cents in and post things like "fry him" and detailed descriptions of how they wanted him to get raped to death in prison. and somehow, i felt like i should DEFEND him. enter more guilty feelings. what this man did was horrible. unforgivable. he should receive whatever punishment he gets, and it still won't be enough to even things out. people are justified in their outrage, and i understand why they would say those things when they heard what he did.
but they didn't have to look into his face. they didn't see him cry. they have the luxury of looking at that man as pure evil, as less than human. but i know the haunting truth. that man is scarily "normal". and i can't stop thinking about how that could be possible. about what it takes to turn an average person into a monster.
last week i took care of a murderer. now a lot of my patients aren't exactly saints. and i've definitely taken care of people whose poor choices meant that they killed someone. but there's a big difference between driving drunk and hitting someone with your car and stabbing four people, two to death.
i guess that i don't know what to think. once again, nursing school never prepared me for this. i'm a strong believer in being kind to people despite what they've done. in treating people the way that they treat you, even if they are a drug dealer or a pedophile or a manslaughterer. never before have i felt guilty for being nice to someone. but last week, i did.
the first time i met my patient, he looked like any other post-op patient. he was young. vulnerable. but he was also covered in the blood of the people he'd killed. and somehow, it was my job to wash that blood, the blood of his murdered baby, off of his hands.
it was surreal. disturbing. and it made me feel like somehow i shouldn't be taking care of him. like he should have to sit there and think about what he'd done, and i shouldn't be giving him blankets or offering him food or having him rate his pain. but that is not a thing. people don't get cared for based on whether or not they deserve help. i believe that everyone deserves to be treated well, and that what they've done has nothing to do with the care that i provide. don't i? i thought that i did.
so i treated this patient like any other. then i went home and couldn't sleep. i can ALWAYS sleep. i just can't help thinking that we got it wrong. society believes that evil has a face, some sort of tell. that you can see it in someone's eyes. and while i'm pretty savvy, i bought into it. to me, killers fell into a few categories: people who do stupid things without thought of consequences, mentally ill people who don't know what they're doing, cold calculated serial killers who actually like that kind of thing. reckless, crazy, or defective. but this patient was none of those things. he was basically a kid. he looked scared. he cried. i actually somehow felt bad for him. and it's still upsetting to me, because that's not what evil is supposed to look like. and try as i might to figure out how someone can be so human and still do something so horrific, i can't.
the day after, i got to work and everyone was in a panic. the surviving victims had ended up on the floor as well, and their families were out for blood. the news had informed them that my patient was at the hospital, and they wasted no time in scouring the doors looking for his name and knocking on windows trying to draw him out. my coworkers who were caring for those patients heard the plan loud and clear: they were going to find him and kill him.
sadly this is not the first time that i've felt like i could be in danger caring for someone. but to cut down on the risk of more violence, the decision was made to transfer the patient off the floor. unfortunately, we were literally backed into a corner, and the only way out was past the victims and their families. i ended up pushing my patient through a usually locked back door, wearing a surgical cap and mask, wrapped completely in blankets and accompanied by a 5 person police and hospital security detail. and once again, i somehow felt that i was doing something wrong. i was helping a murder escape vigilante justice!! but clearly, diffusing the situation and getting the patient off the floor was the right decision for everyone. so i no longer had to care for the patient, and i tried unsuccessfully to put him out of my mind.
the week after, he was formally charged and his face was all over the news and social media. as usual, everyone felt the need to throw their two cents in and post things like "fry him" and detailed descriptions of how they wanted him to get raped to death in prison. and somehow, i felt like i should DEFEND him. enter more guilty feelings. what this man did was horrible. unforgivable. he should receive whatever punishment he gets, and it still won't be enough to even things out. people are justified in their outrage, and i understand why they would say those things when they heard what he did.
but they didn't have to look into his face. they didn't see him cry. they have the luxury of looking at that man as pure evil, as less than human. but i know the haunting truth. that man is scarily "normal". and i can't stop thinking about how that could be possible. about what it takes to turn an average person into a monster.
Subscribe to:
Posts (Atom)