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.
Thursday, May 21, 2015
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.
Thursday, January 22, 2015
working aboard the titanic
lately there's been another wave of people jumping ship, and i can't figure out why it's so upsetting to me. there's the fact that i spend more time with my coworkers than i do with my own family. the fact that we both laugh and cry together, that we bitch and vent and support each other. that we are a small, peaceful gang bound together by terrible shifts, mutual struggles, and 70+ hour weeks. so when someone decides to leave it's always hard. it changes the dynamic, and it's difficult not to feel abandoned.
yes, i realize that i cannot officially take it personally when people choose to change jobs. officially. but in the land of turnover, where i have lose 70 coworkers in the past 7 years, somehow all my angst feels justified.
but it's more than that. i feel like every time someone leaves the floor to go somewhere more glamorous or dramatic like the ED or the ICU, they have this air of superiority. they are going to DO SOMETHING THAT MATTERS. they are going to SAVE LIVES, all massively transfusing people and cracking chests at the beside while all i do is pass apple juices and push dilaudid.
and, yeah, i'm more than a little defensive about my job. floor nurses are hugely under-appreciated and taken advantage of. when the ICUs are short-staffed it's 'dangerous', when we're short it's 'busy'. they have a locked door and visitation policies, we have the whole damn fam. they collaborate with doctors, we go down fighting for our patients and are seen as an annoyance.
what i do matters too. being able to look at a patient and know how they're doing without a billion monitors is an unsung superpower. so is balancing the care of 5 different patients. and it's not as exciting as floating a swan ganz or running codes all the time, but it's still important.
but more than anything, the mass exodus from the floor has made me come face to face with my own insecurities. because is it really the people who are leaving who are making me feel inferior? or is it the fact that deep down, i know i should be doing more than what i am? i'm having a hard time figuring out if i'm happy or just comfortable. do i resent the people who are moving on because i'm just jealous?
in short, i know i'm being a hater but i'm tired of saying goodbye to people ALL THE TIME.
yes, i realize that i cannot officially take it personally when people choose to change jobs. officially. but in the land of turnover, where i have lose 70 coworkers in the past 7 years, somehow all my angst feels justified.
but it's more than that. i feel like every time someone leaves the floor to go somewhere more glamorous or dramatic like the ED or the ICU, they have this air of superiority. they are going to DO SOMETHING THAT MATTERS. they are going to SAVE LIVES, all massively transfusing people and cracking chests at the beside while all i do is pass apple juices and push dilaudid.
and, yeah, i'm more than a little defensive about my job. floor nurses are hugely under-appreciated and taken advantage of. when the ICUs are short-staffed it's 'dangerous', when we're short it's 'busy'. they have a locked door and visitation policies, we have the whole damn fam. they collaborate with doctors, we go down fighting for our patients and are seen as an annoyance.
what i do matters too. being able to look at a patient and know how they're doing without a billion monitors is an unsung superpower. so is balancing the care of 5 different patients. and it's not as exciting as floating a swan ganz or running codes all the time, but it's still important.
but more than anything, the mass exodus from the floor has made me come face to face with my own insecurities. because is it really the people who are leaving who are making me feel inferior? or is it the fact that deep down, i know i should be doing more than what i am? i'm having a hard time figuring out if i'm happy or just comfortable. do i resent the people who are moving on because i'm just jealous?
in short, i know i'm being a hater but i'm tired of saying goodbye to people ALL THE TIME.
Tuesday, July 8, 2014
kibbles
so i just had the kind of shift where i got completely slaughtered. people were having seizures, new admits came with terrible pain issues, ICU patients transferred out that had only been off the vent for a few hours...that kind of thing. completely. slaughtered.
i had already accepted the fact that the night couldn't be salvaged, so my orientee and i just had to hold it together for an hour until the night nurses took over. we walked into our total cares trached/PEGed patient's room and what did i spy upon the floor but a bowl of kibbles and a water dish.
sadly i didn't blink an eye.
so i asked the patient's daughter the first question that came to mind. "...is that cat food?"
and she nonchalantly replied, "no, it's dog food".
i suddenly noticed the zipped shut black duffle on the chair that was squirming suspiciously.
"ok", i said.
and then i finished my cares and left.
things i don't have time to deal with:
1. dogs in duffle bags.
and that, friends, is a prime example of choosing your battles.
i had already accepted the fact that the night couldn't be salvaged, so my orientee and i just had to hold it together for an hour until the night nurses took over. we walked into our total cares trached/PEGed patient's room and what did i spy upon the floor but a bowl of kibbles and a water dish.
sadly i didn't blink an eye.
so i asked the patient's daughter the first question that came to mind. "...is that cat food?"
and she nonchalantly replied, "no, it's dog food".
i suddenly noticed the zipped shut black duffle on the chair that was squirming suspiciously.
"ok", i said.
and then i finished my cares and left.
things i don't have time to deal with:
1. dogs in duffle bags.
and that, friends, is a prime example of choosing your battles.
Friday, June 20, 2014
six years
yes, it's true: i've been a nurse for SIX years now.
thoughts on this include:
1. i've survived (!!!)
2. i am old
3. it took this long to feel like i've kind of got it together
something magical has happened in the past year, something i can't really explain as i don't understand it myself. one day i just realized that all i have to give people is my best. i came to terms with the fact that people will do well or people will do poorly and that i don't get to control that. all i can do is be vigilant and competent and the best nurse i can be, but people will still get sick and code and even die and that is NOT MY FAULT.
so long i lived with the fear of feeling the terrible guilt and depression that i felt after my first code and death, and it crippled me. the weight of that has lifted this year and i finally have some perspective.
i'm only human. i give everything i have and some days that's enough for people, some days it's not. but that's all i have to offer. i care about my patients, i fight for them daily, and i try to be encouraging and kind and sympathetic. but my other patients have needs, and my coworkers require my help, and i've finally learned that giving everything thing i have until i'm empty and emotionally drained isn't good for me and ultimately doesn't help anyone.
some days patients aren't going to like me. doctors are going to think that i'm making a big deal out of nothing. management isn't going to want to hear my opinions on a new policy. my coworkers are going to think that i'm overreacting to something.
and that's ok.
a long time ago when i first started nursing and it was hard, we came up with a motto: "you know the truth". it still applies. i know that i'm doing the best i can to give my patients great care, to support my new coworkers, and to make my unit a better place to work.
that's all i have to offer
and it's taken me six years to realize it, but
that's enough.
thoughts on this include:
1. i've survived (!!!)
2. i am old
3. it took this long to feel like i've kind of got it together
something magical has happened in the past year, something i can't really explain as i don't understand it myself. one day i just realized that all i have to give people is my best. i came to terms with the fact that people will do well or people will do poorly and that i don't get to control that. all i can do is be vigilant and competent and the best nurse i can be, but people will still get sick and code and even die and that is NOT MY FAULT.
so long i lived with the fear of feeling the terrible guilt and depression that i felt after my first code and death, and it crippled me. the weight of that has lifted this year and i finally have some perspective.
i'm only human. i give everything i have and some days that's enough for people, some days it's not. but that's all i have to offer. i care about my patients, i fight for them daily, and i try to be encouraging and kind and sympathetic. but my other patients have needs, and my coworkers require my help, and i've finally learned that giving everything thing i have until i'm empty and emotionally drained isn't good for me and ultimately doesn't help anyone.
some days patients aren't going to like me. doctors are going to think that i'm making a big deal out of nothing. management isn't going to want to hear my opinions on a new policy. my coworkers are going to think that i'm overreacting to something.
and that's ok.
a long time ago when i first started nursing and it was hard, we came up with a motto: "you know the truth". it still applies. i know that i'm doing the best i can to give my patients great care, to support my new coworkers, and to make my unit a better place to work.
that's all i have to offer
and it's taken me six years to realize it, but
that's enough.
Sunday, June 1, 2014
how am i gonna be an optimist about this?
today i had my ass handed to me. twice.
the first time was by this pregnant patient with a bowel obstruction who refused to see reason and systematically tortured me all shift. halfway through receiving an MRI to determine what exactly is going on in her belly, she decided she had enough and demanded to go home. and she remained dead set on this terrible idea even though her entire family and all of the hospital staff told her it was a horrible idea. after literal hours of trying to bargain and reason and threaten the very real possibilities of sepsis and death, i just couldn't handle it anymore. she made her decision, i pulled out all of her lines and drains, and she left AMA.
and it really sucked, because i didn't agree with her decision, yet i was the one that had to take out the PICC line giving her the nutrition that is keeping her baby alive. and i had to get rid of the NG that is keeping her distended bowel from exploding. and i had to pull the foley that was showing us her terrible urine output and let us know just how sick she was. she made me do things that would ultimately harm her and her unborn child, and it made me feel kind of terrible.
so after this emotional abuse, i was treated to 10 rounds of fighting with an overprotective daughter who refused to let me put a catheter in her elderly father. the guy is super old with a bowel obstruction, and i couldn't tell how his urine output was because he's incontinent. i explained to the daughter that we need accurate I&Os to tell us how his fluid balance is, and that we don't want to give too much fluid because of his bad heart, but also that we need to perfuse the kidneys. i explained that catheters don't stay in as long as they used to, and how there are initiatives to DC foleys asap to avoid UTIs. and then she basically told me that if we put a foley in him we would never get it out again and "i'm not taking care of a 91 year old with a catheter".
and she went on and on about how we need to give him a bunch more fluid and she can tell when he needs it and he won't go into heart failure because she can tell and she knows and she watches him because the nurses are too busy, especially the last time he was in the hospital and did i tell you about 12 years ago one time after he had surgery and we had to stay for a few extra hours because he wouldn't pee and i had to have a catheter last year and i would never wish that on anyone because it was so painful and terrible and blah blah BLAH.
and i know she wanted me to agree with her, BUT I DON'T. and even after i told her like 12 times that i would have her discuss her concerns with the doctor, she JUST KEPT TALKING.
and then it was shift change, i was way behind with report, and guess who's getting readmitted?????
yes. so it turns out that when you have a bowel obstruction you will go home and vomit and then go directly to the nearest ED, who will do nothing but place an IV and send you back from whence you came a short 5 hours ago because YOU NEVER SHOULD HAVE LEFT IN THE FIRST DAMN PLACE AND YOU HAVE NOW WASTED ALL MY TIME AND EMOTIONAL ENERGY AND I AM SO FRUSTRATED.
and in sitting here trying to find some sort of moral to this story, i'm coming up empty.
may tomorrow be better. goodnight.
Saturday, May 3, 2014
if you don't want to hear me vent you should skip this one.
hey management and associates, why don't you GET OUT OF MY LIFE.
first of all, you are not even real nurses. you have no idea what i go through, and could not do my job if you tried. if you spent one day in my shoes, the tiny blackened piece of your soul that is left would shrivel up and die.
you don't know me. you don't know my life.
also, i could care less about your administrative BS, or some script you want me to read to introduce myself, or your opinions about how often i should be in my patient's rooms, or where i should give my report to the oncoming shift, or how i teach about medications, or your thoughts about how i should magically be able to infer how each of my patients would like to be treated.
i am tired of you looking over my shoulder. i am tired of you following me around to listen to me parrot exactly what you want me to say like a good little soldier. i am tired of forging my signature of one of your thousands of check off/audit sheets.
you. are. dead. to. me.
and here's looking at you, wanna-be floor nurse turned leadership team member!! you are terrible. how about you actually read the policies before you spread a bunch of misinformation about what they say? too much to ask? just so you know, i will not be following the ideas you pull from the air at a whim. and when i call you on your stupidity and you have the audacity to suggest that i don't take good care of my patients? you are lucky that the lord is working in my life and that i'm practicing controlling my tongue, because the wrath that i have for you is bottomless and when i sleep at night i dream about you getting hit by a bus. what ever happened to clinical assessment skills? to critical thinking? to professional nursing judgement? no, i'm just supposed to shut up and go along with your idiocy. no thanks.
and you, terrible manager. you bring nothing but pain and sadness and i am convinced that there is a small trap door in your office that you use to dump the bodies of the people who are "fired", aka disappear and are never seen or heard from again. you have single-handedly destroyed my will to go on and have made a piece of my soul die.
and you may think that you have won, but I WILL NEVER GIVE IN. because i have learned the secret, which is to stop caring about the opinions of people who don't understand you and whom you don't respect. and also:
i just don't care anymore. i will be fabulous at my job and i will take good care of my patients and i will do it on my own terms. and you may be able to make me fall in line for awhile, but know that i think you are cold, empty, terrible human beings, and that i kind of hate your guts. and what you think about me? :
RIP.
first of all, you are not even real nurses. you have no idea what i go through, and could not do my job if you tried. if you spent one day in my shoes, the tiny blackened piece of your soul that is left would shrivel up and die.
you don't know me. you don't know my life.
also, i could care less about your administrative BS, or some script you want me to read to introduce myself, or your opinions about how often i should be in my patient's rooms, or where i should give my report to the oncoming shift, or how i teach about medications, or your thoughts about how i should magically be able to infer how each of my patients would like to be treated.
i am tired of you looking over my shoulder. i am tired of you following me around to listen to me parrot exactly what you want me to say like a good little soldier. i am tired of forging my signature of one of your thousands of check off/audit sheets.
you. are. dead. to. me.
and here's looking at you, wanna-be floor nurse turned leadership team member!! you are terrible. how about you actually read the policies before you spread a bunch of misinformation about what they say? too much to ask? just so you know, i will not be following the ideas you pull from the air at a whim. and when i call you on your stupidity and you have the audacity to suggest that i don't take good care of my patients? you are lucky that the lord is working in my life and that i'm practicing controlling my tongue, because the wrath that i have for you is bottomless and when i sleep at night i dream about you getting hit by a bus. what ever happened to clinical assessment skills? to critical thinking? to professional nursing judgement? no, i'm just supposed to shut up and go along with your idiocy. no thanks.
and you, terrible manager. you bring nothing but pain and sadness and i am convinced that there is a small trap door in your office that you use to dump the bodies of the people who are "fired", aka disappear and are never seen or heard from again. you have single-handedly destroyed my will to go on and have made a piece of my soul die.
and you may think that you have won, but I WILL NEVER GIVE IN. because i have learned the secret, which is to stop caring about the opinions of people who don't understand you and whom you don't respect. and also:
i just don't care anymore. i will be fabulous at my job and i will take good care of my patients and i will do it on my own terms. and you may be able to make me fall in line for awhile, but know that i think you are cold, empty, terrible human beings, and that i kind of hate your guts. and what you think about me? :
RIP.
Subscribe to:
Posts (Atom)