Today marks my last day as a bedside nurse. Maybe. Who knows what the future will hold, but as for now, I am transitioning into software engineering since I’ve finished my computer science degree. And, I’m keeping my RN license active. After nine years of being a RN, I have to keep that baby going. Maybe one day it’ll be inactive, and I’ll have good tales at a dinner party, but for now, it is closely tied to who I am and where I’ve come from.
I have a few things I’ve thought about as I’m exiting nursing. I suppose you could consider this my exit interview since I suspect my past work place would not really care about what my lowly nurse self thought.
The state of American healthcare is in this weird teeter-totter state. I feel like it’s sitting at this precipice, waiting for greatness or waiting for a great fall. On one side we have medical advances, technology, and progression for health promotion, like wearables, big data for healthcare, remote patient access, imaging advances, and so on. People and companies are creating and implementing great stuff for patients and providers.
On the other side, we are seeing a lot of institutions suffering from great financial losses and mismanagement. My lowly nurse self suspects it’s from trying to operate a health system (under ever-changing regulation) as any other business, which is not sustainable, since a health system cannot be treated as any other business. In America, healthcare is treated as a service, much like Hilton, Jiffy Lube, and Wal-Mart.
Excuse me sir, how was your stay today? What could we do to make it better? Can I get you anything?
Does this sound familiar? Does this sound like any other retail survey?
Of course, we want to provide genuine, good, and compassionate care tailored to people’s needs. This is why most providers go into healthcare. We want to help. We want to give. We want to serve.
On the other hand, we cannot kiss your ass as we’re trying to save it. I literally have had someone ask me for coffee as I was running to get a crash cart. Yes, I will gladly get you coffee, but let me get this epinephrine first. Also, you just had surgery? Yes, it is going to hurt, and I cannot get your pain level to zero. If I did, then you won’t be breathing. It sounds crass and cold, but we’re really looking out for primary well-being (breathing and heart beat) and then we’ll attend to other needs.
Importance of Mental Health
The link between physical health and mental health is incredibly real. I often see broken, lonely, depressed, and anxious people. I’m sure part of it is due to being in a hospital. I understand it is stressful to be sick or injured, especially so for chronic illnesses. However, I often bear witness to projected long-standing, unattended anxiety and depression. And it really can take a toll on physical health in the form of hypertension, diabetes, thyroid disorders, and just overall imbalanced body homeostasis. For some people, coping takes the form of alcoholism, pill addiction, gambling, smoking, or whatever other vice. It breaks my heart to see people think that they are not worth the help, are so far gone that it’s too late for them, or are just plainly stubborn. Please. Please. Get support or help. Talk to someone. You have only one short life.
Caregiver Burnout and New Nurses Everywhere
Front line providers are getting burned out. Ask any nurse, doctor, medical student, PA, RT, etc. and I’m sure they have at least thought about what else they could do. Management’s ability to take care of the caregivers is supremely sub-par. I’m not sure where the disconnect is, perhaps it’s with the bottom line, but often times caregivers feel alone and have no resources to turn to in order to take care of themselves and their team. There is also this mentality of “Well, I’ve survived this long in this environment. Why can’t you?” Are you really surviving well?
Another aspect of caregiver burnout is the amount of new graduate nurses. Experienced nurses are often times given harder assignments due to their experience. While some may see this as logical, experienced caregivers can only take so many train wrecks before it gets tiring and old. The support of new graduates is lacking because the unit is short staffed, and the educator somehow took the unofficial role of assistant manager of five units. I don’t blame new nurses for their “deer in headlights” look. I was there. I was one of them. The main difference is that I had great support and could take those train wrecks under safe conditions. I learned from experienced nurses, and they outnumbered the number of new graduates. Healthcare systems are so apt to hire new graduates because they are cheap. I speculate there might be some sort of unofficial cost/benefit analysis weighing a sentinel event lawsuit vs. the amount of money saved with cheaper labor. The overall environment to train new nurses is dire, which breaks my heart because we need good, strong, competent nurses to act as advocates and be front-line caregivers.
If you’re a front-line provider long enough, you’ve been verbally abused and/or physically abused. No doubt. Verbal abuse takes the form of racism, sexism, ageism, and outright rudeness. Racism, yes, I’ve experienced that in my work place. Inappropriate sexual remarks also have happened. Some patients are under stress and are not in the right mental state, thus some remarks can be dismissed. But, for those that are rational and mentally capable, you’ve contributed to my leaving the bedside.
Physical abuse. My list:
I consider myself lucky in that nothing has been too damaging or fatal. Some caregivers are not so lucky. Google search #silentnomore for more information. Front line providers need more support and safety measures. No questions about it.
The Good Stuff
Admittedly, my list has been pretty dismal. BUT! There are some good things about nursing, like the teamwork and the potlucks.
First, the people I’ve worked with have been phenomenal. High-caliber colleagues in both ICU and PACU. A handful of my co-workers have translated into lifelong friends because there’s no better place to make a friend than a C. Dif. room. Nurses are a group of very loyal, friendly people with a dark and quirky sense of humor. It’s kind of like Fight Club.
Hospital potlucks are the best you’ll ever have. You’ll get home cooked meals, BBQ, waffles, pancit, cakes, brownies, pasta, roasts, ribs, potatoes, and everything else. Since we can’t have a mimosa at work, I guess really good food will have to do.
Going back to dark and quirky sense of humor… we can make a great poop joke at lunch while eating chili, and not be bothered by it. Prank jokes are the best too. With all the interesting hospital gear around, pranks are rampant. Sometimes the humor is sarcastic, witty, and just plainly dark, but to get through the day, we all need to laugh a little.
Overall, I’m going to miss my co-workers immensely. They have been my rock and escape when life was rough. We’ve laughed. We’ve cried. We’ve cleaned up shit together. It’s been a ride and an experience I’ll never forget.