The Healer's Art

(This is an extremely long post and I won't be offended if you don't have the time to read/comment on it. I've long regretted the fact that I haven't journaled much over the years as a newlywed, new nurse and new mom. So I'm making up for it here and there in this blog).

I came across this article online, written by a Wall Street Journal editor/journalist. The quick gist of the article is that the author decided, post-9/11, that he wanted to do more and help more than he could at his job writing for the paper. So he decided to go to nursing school as a 40-year old. It's about his experiences as a new nurse, his fears, his growth in the nursing field and that, ultimately, he had to leave it because it couldn't pay his bills. I sort of wonder if it was just a living, breathing research project for him. I wonder if he ever really planned to stay in nursing or just long enough to say he did it. But that's a heck of a research project and personal life change to go through just for an article. So anyway, i found the article really interesting and it made me think back to my days as a new nurse, fresh out of college. I wish i'd been better about journaling in those early days. I am certain i had fears and I certainly remember sleepless nights. I just don't remember it in any great detail to share much more than glimpses here. But I want to try. So here's an attempt at a journey down my own personal nursing career's memory lane...

I got into nursing sort of by chance. I went to college with thoughts of journalism. I then wandered into the conservation biology major (related, no doubt, to my tendency towards hippie-ishness and tree-hugging). After an epiphany of "What am i going to do? Live with wolves?," I went back to my true roots of healthcare. I spent a lot of time in high school involved in sports medicine. My high school had a fantastic program. I could tape an ankle and a wrist like a pro. I understood many different treatment modalities for sports-related injuries. But when I looked at BYU's sports medicine program, it didn't appeal to me. Too many classes revolving around body mechanics and kinesiology. Same when I looked into their pre-physical therapy. So i dug a little deeper and came up with nursing. Huh?...Nursing?...I'd never considered that one before. But when i looked into the program and classes, it really appealed to me. The diversity of it all was a big part of my decision (the fact that I could take classes not just about bones and movement, but about the heart and brain and community health; etc.). The only big drawback in my mind was the fact that nursing was such a stereotypically FEMALE thing to do. It's just a fact. And I wasn't raised to do such things. I was raised by a father who told me and my sis often that we could do anything we wanted to do. We could fly planes, drive tanks (can you tell he was a military officer?), we could be doctors, lawyers; etc. Nursing. Huh. Had to wrap my brain around that one.

Affected by my addiction to the TV show "China Beach," and with my proud heritage as an Army brat, I looked into an Army ROTC Nursing scholarship. That seemed the perfect way to balance out this feminine role--to be an Army nurse. Lieutenant McMurphy here I come (anyone else watch that show? It revolved around Colleen McMurphy, an Army nurse in Vietnam). Long story short regarding ROTC (that could be another incredibly long post in and of itself), I got the scholarship, did 2-years in ROTC while fighting the realization that it wasn't for me. I broke my wrist a week before my summer boot camp (which i viewed as the "point of no return." If i did my boot camp, I would complete ROTC and be an Army nurse). When I broke my wrist and my camp was postponed to the following summer, I took it as a sign to break my contract and so I did. So just a regular old nurse I would be...

I graduated from BYU's College of Nursing in December of 1997. I had no intention of staying in Utah so Doug and I headed back to the DC area to start our post-college lives. With about $1000 (from the sale of his 1983 Nissan 300Z) and the smallest U-Haul trailer behind my Mercury Sable, we drove home. I soon found that, unlike today's serious nursing shortage, there were no jobs to be had for new graduate RNs. Hospitals had zero interest in hiring and training a new grad. The few places I found were doctors' offices and nursing homes. When I went into nursing, I had no intention of working in a doctor's office. But an office is where I got my start. An OB office, of all places. Unlike the majority of my BYU nursing school cohorts, I was NOT interested in labor and delivery and other things cute and tiny. I wanted the neurological ICU or the trauma of the ER. But after working in this OB office for 8 months, labor and delivery was a natural progression. In November of 1998, the nursing shortage caught up to us on the east coast and i was hired by Arlington Hospital to be an L&D nurse. I remember my interview with the hiring nurse manager. I told her I thought I'd prefer to start in the postpartum unit to gain some skills and then cross-train to L&D. She told me flat out she thought I'd excel in L&D and that she thought I'd be wasting my time in postpartum. So I took her word for it and gave it a shot. And much like the author of the Wall Street Journal article, I was terrified! But SO excited to be getting "real" experience in a hospital as I didn't really see the value of office nursing (I can see it now, but as a new grad wanting "skills," well, an office job just wasn't where it was at.....)

I started on the night shift. I wasn't very happy about this initially. Night shift is such a hard gig. So hard on a body. It didn't work well for me. Sleeping during the day was nearly impossible. On the bright side though, i think it was a good thing as a learner to be on nights (aside from shear exhaustion). While L&D is still very busy, there are fewer scheduled procedures (inductions; etc.) and fewer doctors and administrators breathing down our necks. I was given a whopping 6-week orientation and then I was on my own. Six measly weeks. No organized class-time. Just 6-weeks with a preceptor for on-the-job training. I did a ton of reading and studying on my own. I actually felt sort of ready to be on my own after the 6-weeks. But really, that's just not long enough. It's almost laughable to me as I think of it now. And, yes, i said i was "on my own," but really had all the other nurses there to be a resource to me if I needed them. But still, it was my signature on the line. I was the patients' primary nurse. That was scary to me.

I worked on a very busy unit that was unfortunately quite understaffed. I was hired at a time when the nursing shortage hit and when this specific unit was undergoing a mass exodus of experienced nurses. Some were retiring, some were fed-up with hospital politics, some saw greener pastures and different opportunities. I very quickly became one of the more experienced nurses on the unit and very quickly found myself in charge almost every time I clocked in. This was maddening. I was a new nurse, new to this specialty. I still needed time to hone my skills and gain confidence. Yet more often than not, I was to be in charge of the unit for the 12-hours of my shift. Meaning, I had my own patients, but ultimately, I also made the assignments for the other nurses, was the go-to-nurse on the unit for any and every problem that came up, triaged patients. I prayed a lot. I cried a lot. This made me so incredibly stressed that the little sleep I got during the day became less and less as i fretted about work. I think i was a good charge nurse. I was very fair. I looked after the nurses and their patients. But who was looking after me?

At about my six month mark, I became the preceptor. Now, does that sound right? It was actually a relief to do this instead of being in charge (although at times I was in charge AND a preceptor. NOT COOL). But, I was a good preceptor, a good teacher. I'd figured out how to take good care of my patients and I liked passing this down to my orientee. I was efficient and had a system (as much as you can have a system in a job where anything can happen). So much about nursing is about being organized, systematic and prepared. I learned to respond quickly and calmly to emergencies, unhooking patient equipment while explaining to them what was going to happen on the way to their STAT c-section. I can still see the way I ran through things in my head. Checking a patient in, assessing her as I walked her to her room, going through the emergency equipment in the room, setting up IV pumps for a quick blast of magnesium for the pretermer, teaching to alleviate anxiety, distracting, setting up the baby warmer and delivery table in a flash if it seemed like she'd definitely stay or that delivery was imminent (those were my favorites--I loved when women came in and didn't diddle around. Just came ready to push!!!). In my mind, I was constantly moving--sort of fluid, constant motion. Walking, talking, sometimes running. The more I taught new nurses on our unit, the better nurse I became. BUT, i really do feel that i was given a disservice in not being given adequate time to just be a nurse and take care of patients without having to worry about the entire unit or another nurse's learning. I should have been given that so i could feel that my skills were there and that things gelled. It was a very stressful time in my life. I wish some of those older, more experienced nurses had stuck around so I could have picked their brains a bit and gained from their knowledge. There were a few that did and I took as much as I could from them. There is a saying in nursing. Maybe it's in other professions, too? It's that "nurses eat their young." For the most part, the nurses who did stay were very willing to teach me and share with me. Very few were the type to leave me on my own or hoard their knowledge. Such a silly thing, but there are people out there like that. Doesn't really do much for the good of the unit or the patient, eh?

After about a year I went to the day shift. And soon after that I went PRN or per diem, meaning i was no longer a full- or even part-time employee. I decided to forego benefits (since I had them through Doug's work) and work on an "as needed" basis. Luckily for me, "as needed" was as much as I wanted. But a minimum of 32 hours in a one month schedule. So I still worked full-time, but made more money and was able to detach myself from much of the day-to-day stress and politics involved in working at a hospital. I could work fewer weekends and holidays. I could work 8's instead of 12's if I wanted. It was a very very good decision. I needed to pull away a bit as I was on the fast track to burnout. Yes, with just two or three years of working in L&D, I was burning out. That's how hard nursing is. That's how hospitals can chew you up and spit you out...

All in all, even with the stress and tears and fears and even some very negative experiences, I have many incredibly FOND memories of my work in labor and delivery. I've mentioned before that I was never more assertive or sure of myself than when I worked full-time in labor and delivery. I'm not always a socially adept individual. Meeting new people can make me nervous. But when I entered a patient's room to introduce myself I was surprisingly comfortable and self-assured. I gave good patient care, was a patient advocate to the best of my ability. I bonded with lots of women and their families. The best feeling was when I would get a letter from one with a picture of their new family, or of me holding their newly-delivered baby. There weren't a lot of kudos from our bosses, but those that came from our patients were priceless. Sometimes those thoughtful cards were what kept me going. I actually still keep in touch with one special patient--just Christmas cards--but she still means a lot to me.

I had the opportunity to work in an area that helps with families most incredible life experiences--most very positive and exciting, some devastating and incomprehensible. I had the chance, on a daily basis, to touch people's lives, hopefully for the better. I know there were times when I was exactly the person that a patient needed as her nurse (and on the flip-side, yes, there were times when i clashed with a patient or two). But all in all it was an amazing ride. Yes, I was stressed to the max at times. I would dread going to work. I had bad dreams. I fretted over whether or not i had documented something adequately. I knew I was giving good care, but the liability and paperwork to prove that if necessary was at times overwhelming. The expectations without the resources felt impossible. I could go on and on and on and still not really get to the point of this post, I suppose. I've rambled on a lot. But I like getting these thoughts and memories down.

I did leave labor and delivery back in 2004, after seven years. I have no desire to return. Sort of a "been there, done that" attitude. I loved my time in labor and delivery. I know I'm sugar-coating it because I also remember so many tears, anger, worry, frustration and fear. I remember weekly conversations with Doug, me in fits of rage saying I was quitting and how completely worn-out I was. But, the years I spent in labor and delivery, I grew exponentially. It was there that I learned to be a healer, a helper, a guide, a guardian, a soother, a calmer, a whip-cracker, a teacher, a learner, an advocate--a nurse.

It sometimes surprises me that I became a registered nurse. But I'm so glad I did. It's a really good fit for me. When I decided to leave L&D behind, I knew there were all sorts of other areas to explore. I worked a bit in home health for high-risk pregnancies and now I'm back to outpatient surgery. I will always be passionate about women's health. I like the idea of pursuing work in the pain management field. See, always something new to learn and do...