My husband and I decided that living in a town home was not in our long term plans. After 8 short months of living in our previous town, we went back in Zillow, contacted our realtor, and found our dream home. Beautiful home, 43 mile bike path along the river within walking distance, quaint neighborhood, cute downtown, etc. Even though I work 2x a week, it always seems I am scheduled to work on days that I have many things going on. I worked the weekend we moved and then I was scheduled to work again on that Tuesday. Luckily, someone needed to switch that next Friday with a day during the week. BINGO! I switched my Tuesday with their Friday to be able to move in completely before the next day of work. Seemed like a pretty good idea, right? Fridays are usually cozy and the patients are chill… not last Friday.
As soon as the shift started, I wished I had stuck with my Tuesday. I was immediately regretting my decision. As I was getting report on my four patients, I was told I had another patient en route from nearby hospital as a direct admit. No big deal. As report continued I found out that I have 3 NG tube patients and all were patients of one our surgical oncology MDs. What is the big deal with these? These patients are generally pretty sick and require way more attention than our typical surgical patient. The nurse that was giving me report stated that was not fair. I usually do not fuss about my assignment, but felt it was a heavy load and told my charge nurse. She stated they were “just NG tubes” and not to worry. I felt frustrated and ignored. Now do not get me wrong, we have amazing charge nurses on night shift. They are uber helpful and always go above and beyond to support their nurses, but at that moment I felt that my assignment was not fair and it would be difficult to juggle it all and keep everyone safe. I felt the tears well in my eyes, but I took a deep breath, a big gulp, and had to move forward. When patients’ have NG tubes they require more frequent vitals, I/O, pain meds, nausea medication, and a keen eye to make sure nothing goes amiss while they are getting their belly sucked out. To me, that is stressful and to do that x3 is even more stressful.
To top it all off, I had to rush to work and left in a fluster. Then as the night started I got a terrible migraine. Imagine taking care of 5 patients, 3/5 who are pretty sick, and to feel like your head is going to explode and you are going to puke your guts out. It is not a fun time. I do not even know how I managed to juggle it all.
The last few weeks I have been working I have hit a mental wall. Nights have been harder than ever on my body, I have had a lack of appreciation from my patients, my assignments have been less than stellar, and I find myself sitting down for a total of 1 hour out of the 12.5 hours I work. These last few weeks have left me wondering, is nursing for everyone?
I have always been a perfectionist in all trades that I have taken on. From school, sports, to now work. I find it even more imperative to be a “perfectionist” in the field of nursing because people’s lives depend on me looking out for my patients and being able to know when something’s not right. As I mentioned previously, most of our patients are not critical, but when we get surgical oncology patients, I would say they are a step down from critical. They are not just here for observation from their surgery to go home the following morning, but for constant monitoring. In a bubble, alone, this patients are probably x10 more stable than any ICU patient. But when we are given 3-4 more patients on top of these ill patients, my world turns upside a bit and I soon become overwhelmed. Are these still new nurse heebee jeebees, am I caring too much, can I not prioritize, am I not cut out for the job or is there a bigger problem here?
There are many nurses out there; ones who do not know what is essential and nonessential, and run themselves ragged making everything an “emergency/need to be done now” (myself), there are ones who do not care and perform bare minimum, and ones who can find a perfect balance between the two extremes and provide great care and still get a lunch break! Will this ever be me? After the last 8 months I felt things were starting to get better and I was adapting to my new role as a surgical RN, but these last few weeks have me questioning myself. Will it ever get easier? Or as nurses we will always be exposed to the roller coasters of good days, nursing is easy days, bad days, and horrible, running like a chicken with your head cut off, days? Is it me or is it the job…the type of nursing…the organization….? What is it?!
In my heart I know that patients benefit from having me as their nurse and I am good at what I do, but if I cannot give them my all, I feel as though I have failed them and they deserve better. And to top it all off, in order to provide exceptional care, I must forgo my self-care. The structure of healthcare, medicine,nursing, and the patients, makes it difficult to perform this role even somewhat perfectly. A major dissonance in my mindset and how I like to see things go. The only control I have in my role of nursing is what color pens I use, what order I want to assess my patients in, and how I want to type my note. And even some days, I have no control over most of that. As I write this, I know many people will say, every job has its bad days and negatives. This is true! I am not looking for a career that is perfect, but I question a career where I do not have time some days to go to the bathroom, eat my food, or drink some water. A job where somedays I feel like a robot going from room to room delivery medication and charting endlessly. Only stopping when 0730 hits and I am saved by the oncoming shift. Alas, I can pee, eat, and drink. Sigh.
Recently I have found that my passion for nursing is unsteady and I have many questions. Is it nursing, is it me, or is it the field of nursing I am in? I have no answers for this. In the hospital, it seems sometimes patient satisfaction= patient safety. I do not believe this is always the case, alas, it is still the major focus. If I explain in detail to a patient I cannot give them more pain medication because it is unsafe, patient satisfaction does not go up because I am keeping them safe, it goes down, and the patient fills out the survey saying pain was not well managed during their stay. If I have to be in their room Q2hrs over night to make sure the patient’s vital signs are stable and they are getting the right medication to help them get better, those scores go down, instead of up. When a patient fills out their survey, they state it was noisy at night, they were not able to sleep, and the RN/PCT were in their room every 2 hours. Are the patients to blame? Not at all. Yet, I think our performance should be rated first and foremost on safety and the end goal to help the patient become well enough to go home. After all, patients lives are at hand. Patient safety does not always = patient satisfaction.
Between the patient loads, demands of the job, tasks, charting, night shift, and so forth, I am wearing thin. A long time ago I wanted to focus on preventative medicine. I still would like to achieve this goal, but have not been able figure out a path that would lead me there. Recently I became a coach for Girls on the Run and have found a passion in teaching. I know with two degrees under my belt, probably not a wise idea to jump ship and study teaching…..so for now, I am finishing up my NASM CPT studying to become a certified personal trainer and I will see where that takes me. Definitely a step in the right direction for preventative medicine.
Gotta go study!