Tag: Nursing

It Was Time To Leave Healthcare

My last day was very surreal. With each task, I’d think “Oh, this is the last time I’ll ever do this”. I’ll never start an IV again. I’ll never pull out another Hemovac drain. This is the last time I’ll hang antibiotics. It’s the very last time I’ll dispense medications. It was an odd feeling.

It was time to leave healthcare for a lot of reasons. Healthcare has changed, and not for the better. Healthcare workers have been leaving the profession for a while, but Covid turned that exodus into a stampede. Hospitals are facing a crushing shortage of workers. That lack of staff is making working on the hospital floor unsafe. The patients are sicker, more demanding, ruder, and more violent. At the same time the near-daily onslaught of new rules, regulations, and charting/documenting requirements leave little time to actually connect with your patient. It’s sad, and I don’t see it getting better.

As an RN, I’ve been hit, kicked, spit on, yelled at, threatened, peed on, vomited on, and cleaned up more poop than you can possibly imagine. All while working a 14-hour day, sometimes without enough time to take a lunch break. We worked the Covid floors without enough supplies, being forced to wear the same dirty mask for two and three days because there was such a shortage. It’s been interesting times the last few years.

At the same time, it’s been an amazing experience. I saw and did things I never thought I’d be doing. I was able to connect with people at a level you can’t do at a cocktail party. I’ve held the hands of people as they drew their last breath. I spent time consoling people who just received devastating news about a tumor prognosis or were newly paralyzed. I sat quietly with people whose loved one was going to pass away soon. I also got to hear some fantastic stories from old folks about growing up in the depression, war experiences, and traveling across the country before there were interstate highways. I made some good calls that probably resulted in people living vs dying. I responded to codes and performed CPR on folks. I’ve had several people stop me in a store and tell me that, “you won’t remember me, but you took care of my father. He was so grateful for your care.” I have enough stories of crazy, wacky patients, gruesome injuries, and blood and gore to last a lifetime. In my pre-healthcare life, I never would have imagined that one day I’d be chasing a crazy, naked old lady with dementia as she ran down the stairs towards the parking lot. They definitely skipped over that part in nursing school.

I’m grateful I got to experience all of it. The good and the bad. (ok, maybe not the poop) It’s made me more appreciative of the blessings I have in my life. It’s also made me realize how important it is to try and be a good human. At the end of the day, that’s all you have. When you exit this world, how do you want people to remember you? Healthcare reminded me on a daily basis that you don’t know when your time is up. Slow down a bit and enjoy life. Make sure you take the time to see and do things. Because you never know what’s around the corner.

So, it’s time for the next chapter. I’m not entirely sure what that is yet, but I’m looking forward to it.

I Got Yelled At

  • People in the hospital are rarely happy (ok, maybe in the maternity ward). I’m generally not seeing people when they’re at their best. I accept that and knew it going in. I understand if someone gets a little snippy, or forgets to say thank you if you go above and beyond to do something for them when they’re in significant pain. This week however, was a special low point when it comes to patient and family behavior. It started with a schizoaffective patient constantly screaming at me to stop playing mind tricks on them, and then having to be brought back by security after running amuck through the hospital hallways. That’s a mental illness, so I don’t take it personally. Then there was a family member accusing me and anyone who came in the room of not caring about the patient and ignoring them and their needs. Constant very passive aggressive loud muttering about everyone having their heads up their asses and waiting 30 minutes after pressing the call light (it was 5, our system shows us exactly how long it’s been). Sigh… deep breath, their family member doesn’t look to have a good outcome. I’ll cut them some slack.
  • But then there was the real humdinger. A patient and family member who were both serious meth-heads, combined with a rainbow of other illicit substances, with no money, resources, or insurance, who were there for a trauma. For two days straight the patient yelled, screamed, cried, manipulated, and generally behaved like a flaming asshole to anyone unlucky enough to go in the room. The patient was getting enough pain medication to tranquilize a horse, yet screamed and cried that we were inflicting intentional torture. The family member would show up, hear this, and begin the litany of demands to see everyone from the charge nurse, floor supervisor, hospital president, and city mayor. The family member would then announce they couldn’t take their level of anger and had to leave before ripping someone’s head off. They’d return an hour or so later and it would begin again. This pattern repeated all day long. Any attempts to engage, refute, or otherwise point out they were being unreasonable only resulted in additional yelling, just at a louder volume.
  • Twelve hours a day, for two days is a lot to take of that sort of behavior. I was pretty angry and frustrated each night when I got home. Upon reflecting on those days, I think I’m most angry at myself for putting up with it. At the time it seemed easier to mostly ignore it. All three scenarios were verbal battles that I wouldn’t win. These were not people who’s minds were going to be changed. It’s often less stressful to simply nod and say mmm-hmm and get out of the room as fast as possible so you can get on with the thousand other tasks you have to get done. But I didn’t realize how much the cumulative impact of continually taking the verbal abuse would affect me. On the drive home after day two I briefly thought what the hell am I doing? At my age I don’t need to put up with this crap. But I still like the job. It’s rewarding in many ways that working as an engineer for mega-corp never was. But it seems like the hospital population is more and more the mentally ill, the indigent, and drug users who are not capable of dealing with life in general. The bad behavior has become so common that when receiving report on the rare, “nice”, patient a nurse will make a point of letting you know, “you’re lucky, he/she looks like a normal person”.
  • I’m not sure what the answer is. I could move to a clinic of some sort, but just taking blood pressures all day would be like watching paint dry. Besides, I’m in a spot where I have the perfect schedule. It would be hard to replicate it working on a different floor. I think I’m going to try an experiment. For the next few weeks I’m going to be a semi-jerk. There will be no shit taken from anyone. You want to be an asshole? I’m going to be one right back. Of course, in a professional manner. This may make my day more difficult (and certainly the charge nurses – people LOVE to escalate any perceived wrong at the drop of a hat), but I’ll be curious if my mental health will improve? Will I have an overall better outlook if I go home knowing that I didn’t accept any crap from people? Nursing is such a hard balance. How do you continually be compassionate for people in a bad situation, yet not let yourself become a doormat? If you know the secret, please let me know!

Song of the day: Twisted Sister – We’re Not Gonna Take it (Extended Version)

I Had A Bad Day At Work

Cool things, random thoughts, advice, and independent thinking from someone who’s been around the sun a few times.

  • Everyone has a bad day from time to time. For most jobs that’s no big deal. As an RN, a bad day has consequences. Yesterday was one of those days. Nothing bad happened and there wasn’t any one thing that caused it. Just one of those perfect storms of events. Short staffed, a super complex patient, a bunch of last minute discharges and transfers, multiple missing lab results, and some ridiculous bureaucratic decisions from management that make everyone’s life difficult for no apparent reason. The result was that I wasn’t a very good nurse. I barely kept my head above water all day. I’m sure my patients did not have a good experience. I think I stressed out the CNA unnecessarily. My documentation sucked. I was pretty rude to an EMS transport crew for showing up early. I caved in an ate a doughnut someone left in the breakroom (ok, two). Fortunately I have great coworkers and they kept me from drowning. It was one of those days that I drove home almost two hours late due to all the charting I never got to finish during the day, and wondered why I was even doing this job. You start questioning if you even have the skills to be a decent nurse. This morning I casually looked through job openings, wondering if it was time to make a change. Fortunately I have a long break through Thanksgiving to recharge and think critically about what I could have done to make that day go better. I still like the profession… I just worry that I’m running out of the mental energy it takes to operate at such a high focus level multiple days in a row.
  • Shortly after the beginning of the great China Plague, my hospital decided that all employees need to be screened as we enter. At first it was a long series of questions about symptoms, travel, and people you’ve been in contact with. Then they added swiping your badge at the entrance. Next, temperature checks. Now they also have someone entering your name and unit into a database. We’re given a different colored sticker for your badge each day to prove you’ve already been screened. There’s often now a line of employees waiting to be screened so they can get to work. So as a contrarian I have to wonder – with all that cost and effort over the last 7-8 months, has the hospital identified a single employee who may have had Covid and prevented them from entering? Does anyone from management ever ask if the outcome is worth the cost? Or is the appearance of doing something more important?
  • For reasons unknown to me, I’ve become addicted to car crash videos. YouTube collections of crazy drivers and crashes. It’s reinforced several things. First, I don’t trust other drivers. Second, I will never drive in Russia or third-world Asian countries. That’s where 90% of these videos come from. Clearly traffic laws in those countries are merely suggestions. I don’t think you can appreciate the degree to which we’re rule followers in the US until you see how people drive in other places.
  • I’m desperately looking for a news channel. Just plain news. I don’t want opinion, spin, or bias. I just want someone to report the important things that happened in the world today. Why is that so hard? Anyone have any suggested channels or sources?
  • I was talking to a co-worker about food and the conversation sparked a memory from years ago when I lived in San Diego and a favorite post-surf meal. Roberto’s Taco Shop and a Machaca Torta and rolled tacos (hey, I was young and burned a crapload of calories). Research has begun. The quest to make my own machaca has started.

Song of the day: Surf Punks – My Beach (Live at the Whiskey A Go Go)

Notions Of Cool V.018

A random list of things and shower thoughts that an old Gen X dude finds cool or worth pondering.

  • This is a perfect example of what’s wrong with news today. I like to think I’m reasonably plugged in… and I had absolutely no idea this happened last week. 1000+ people dead and 1.5 million at risk of water-borne disease or starvation. Meanwhile, Bob in Ohio was outraged at something someone said. We have a fantastic panel to discuss…
  • A neat video about cycling. I couldn’t do it, but a great reminder that we’re only here once. If you get hit by a bus tomorrow, are you happy with what you’ve seen and done?
  • Speaking of bikes, my town is installing this in one of the downtown parking garages. Yay for bicycle friendly!
  • Jim Acosta is the very definition of douchebag. I get it, he generates equal love and hate traffic. And yes, there are Acostas on all sides of the political spectrum. Sad that this has become the new norm for “news”.
  • I did not hit my weight target this week. It’s mostly meaningless… just a goal. Next week for sure.
  • Bullet Journal update: it went strong for a month, then faded. I still like the idea. I resolve to resurrect the habit.
  • A patient was unhappy with his diabetic menu choices, so his wife brought him Burger King and a supersize chocolate shake. When his blood sugar was 320 he was shocked. He was actually angry and accused us of giving him some “pill” that was making his blood sugar go up. It was a battle to convince him I had to give him insulin.
  • “This will be your favorite patient. Super nice and rarely calls for anything”. Sadly as a nurse, I hear that in report maybe once every three or four weeks. The vast majority of the hospital population are grumpy, sour, demanding people. They’re also in the worst possible health – much of which is due to lifestyle choices. I see a clear correlation between your upbringing, mental attitude, emotional stability, and overall health outcomes. It’s not rocket science, but it’s striking when you see it in front of you every day.
  • My internet went down for approximately 7 minutes today. It was a terrifying vision of the pending zombie apocalypse.

Song of the day: Charlie Feathers, “That certain female”

Notions Of Cool V.015

A random list of things and shower thoughts that an old Gen X dude finds cool or worth pondering.

  • The dermatologist took one look at my sunburned, peeling, self and deadpanned “well, I guess we don’t need to have the importance of sunscreen discussion do we?”. Other than that, got the all-clear. I feel better having been checked out.
  • I mentioned before that I spent a ridiculous amount of time watching YouTube videos on travel bag reviews. Unclear why, since I rarely travel. I had settled on the Aer Travel Pack 2. Anyway, I used a simple duffle bag for this last trip. I realized that carrying stuff on your back sucks. For the little travel I do, I’m going to find a minimalist wheelie.
  • I got my passport photo done. Like an idiot, I let it expire. Renewing it, you know, in case I need to flee the country.
  • I loved this quote from David Goggins. “People ask me how I lost so much weight… I didn’t hire a trainer… I didn’t go to Jenny Craig… basically I just stopped eating so much fucking food.” Made me laugh. It’s simple, but true. People make weight loss too complicated. Speaking of which, unless there’s a nacho blowout I’m about a week away from my weight goal. So there’s that.
  • I gave Instacart a try for grocery shopping. Loved it. I’ll certainly be using it again. I’m a busy guy you know.
  • One of the hardest things I do as an RN is care for a patient who is a truly horrible human being. Spending twelve hours making sure I give the same quality of care to that person that I’d give to a sweet grandmother sucks the life out of me.
  • Rebecca Rusch was the first woman finisher in her first attempt at the bike category of the Iditarod 350. That’s badass. I wimp out after shoveling the driveway for an hour.
  • No further Instagram stories. The Twitter experiment has yielded exactly 2 followers. Good thing I’m not in marketing.

Song of the day: “Im gone, Joyryde”

Notions Of Cool V.011

A random list of things and shower thoughts that an old guy (who still thinks he’s 20) finds cool or worth pondering.

  • I was fluctuating between 200-205. Hit 173 this morning. With a good poop I might hit 172. Not that I’m counting.
  • Listened yesterday to someone being told that if they continue the current lifestyle choices their lifespan will be measured in months. The response? “What time is dinner?” Hard to fathom.
  • We’re seeing the dimmest sun since 1978. The current solar minimum is trending towards the century-class minimum of 2008. Also, for the first time in 132 years, LA did not reach 70 degrees in Feb. No point to that other than you can find extremes on both sides of the thermometer at any day someplace in the world.
  • A baffling recycling program. Now take this and imagine the rules on medical waste. We have four different tubs that various wrappers and things must be disposed into. Nobody can figure out how to open the tops so all wrappers just end up in the trash or placed on top of the container.
  • No idea why I thought this was interesting. “The International Space Station is passing over the Idaho State Capitol Building on March 02, 2019 at 06:38AM, for 614 seconds.” More importantly, why someone took the time to figure it out.
  • This is my MTB ride. Not sure why I’m thinking about cycling. There’s some kick butt spring skiing pending.
  • I still scan tech blogs. I’m realizing that I still really like systems. I started wondering if I should migrate that way in healthcare? I’m not sure I could give up the three day work week though.
  • If you ever wondered where the US navy is currently operating at any given time, here you go.

Song of the day: Agent Orange “This is the voice”

Notions Of Cool V.009

A random list of things and shower thoughts that an old guy (who still thinks he’s 20) finds cool or worth pondering.

  • As an RN, my day looks like this: Wake at 0500 (or 0400 if working out). Out the door at 0620. End my shift and leave at 2000 or 2030 (8:30pm). Walk in the door and decontaminate and change. Inhale food. Watch approximately 15 minutes of news then bed. Repeat x3 days.
  • The flu season has not yet peaked.
  • The Grand Canyon has a new Junior park ranger. She’s 103. I’ve only seen the Canyon once and it was identical to the movie Vacation. We were driving to Oklahoma in the winter. My sister and I begged to detour to see it. We litterally pulled in, got out of the car and looked for fifteen minutes and left because it was so cold.
  • Netflix is usually a wasteland of straight to DVD films, but we stumbled upon this one by accident. The Way with Martin Sheen. Excellent.
  • I’m in search of a small (pocket sized) penlight that has a low lumen level for eye exams. Every one I’ve used so far doesn’t survive being dropped or dies within a month or so.
  • I’m fasinated by how massive the diet industry is. People literally are desparate for someone to tell them what to eat. And what they seem to really want is the magic bullet – “Eat this super food for 12 days and loose 25 pounds!”
  • I’m not making fun of a sad mental health issue (well, I guess I am), but if you’re going to end it all by jumping off a building… make sure it’s tall enough. The end outcome may not be what you wanted. Pro tip, five stories isn’t high enough.

Song of the day: Kid Rock “Bawitdaba”