The Workplace Blahs

Lately I haven’t been feeling as engaged with my work as I have been in the past. Each day feels like it blends into the other with the same staff members arguing over petty things and the same patients (literally – the frequent fliers have been flying in a lot more frequently recently) presenting with the same complaints. It’s humbling and frustrating to know that sometimes no matter how above and beyond my duties I go, I’m quickly brought back down to problems that just can’t be solved. It’s tiring arguing with the same floor about patient transfers, it’s tiring to have to turn away the same drug seeker three times in one shift. It’s tiring to have to work harder and faster to maintain patient flow while being left on the back burner by the rest of the department. Perhaps its summer and seeing people enjoying warm evenings while I trek it inside to the windowless department is getting to me more than I thought but things are definitely feeling – stagnant. I don’t know if I need a new challenge, more responsibilities or another job. I suppose for now I have to get dressed, go to work and give viciously dirty looks to the resident who complained to my charge nurse that I need to “smile more”.

This post is most certainly a downer so I’ll leave a link to Hyperbole and a Half. This site has been providing me with life sustaining laughs during night shifts!

Learning Plans and Yearly Performance Reviews

Nursing school was full of learning plans. Learning plans for a class, learning plans for clinical placements and learning plans for group projects. Now that I’m in the ‘real world’, learning plans continue to be made and revised each year – usually when there’s a yearly performance review scheduled by the manager. I’m somewhat torn on the issue of learning plans. On the one hand, I think they’re a useless waste of time. I always end up scrambling to write down something that might fit with learning goals that were written when I had no idea what I was getting into. However, they can also serve as a checklist for the things that I did want to learn and/or improve upon as well as documentation of ongoing professional development. Invariably, when I meet with my manager this year, I will have to justify why I didn’t accomplish a single thing on my learning plan written last year when I was not allowed to work in certain areas of the department that I do now. That is not to say that my professional growth has stagnated for the entire year – I have taken several courses, applied that learning to my work and have informally learned much more than can be summarized in 150 words. On top of all that, I have never been a very details oriented person. I like to have a general outline with lots of room for maneuvering and improvising because in my experience, things hardly ever go as planned. I won’t be too upset if I learned things that I didn’t know before instead of learning what was strictly written on my learning plan. Regardless of how I feel, I will be wasting a beautiful afternoon writing inane BS to appease the powers that be. And the real kicker – my yearly review is scheduled on the last effin hour of my shift before I scramble to get to the airport!!

Signature Drink at Last!

I was recently in a dilly of a pickle because I decided to give up my Starbucks addiction and could not think of alternatives. After a month or so of experimenting with different beverages during my shifts, I have to say that lychee pear green tea with honey has slowly earned its way into my heart and most importantly, my gut! I like that if it’s a mind numbingly hot, humid and hazy day, I can throw in some ice cubes and voila – it’s ICED lychee pear green tea! A close second for night shifts is a strawberry banana smoothie with pineapple juice – keeps me filled up and keeps the night shift bloaties at bay. The great thing is that I can buy a huge box of tea and honey and leave it at work so it’s a lot cheaper. The smoothie requires some planning ahead but worth the time. I’ll still visit Starbucks and get myself an iced coffee occasionally but our relationship has cooled considerably. My beverage choices are earning me some strange looks from the diehard caffeine addicts but the peace and calm of my GI system is far too great for me to care. Oh how grand my troubles have been…

Being Called into the Boss’ Office

I walk into my assigned area, take report and miss having my signature drink (which I still have not managed to replace just yet) and start providing excellent care (ie – making sure all is well and my peeps are breathing) when my boss asks me to come into her office. After visiting the loo to make sure I don’t wet my scrub pants in her office, I resign myself to my fate and prepare to accept whatever happens. I sat down shivering and realized that two of the charge nurses were in her office as well. Then I was really happy that I peed before. My boss’ steely gaze settled on the chocolate stain on my scrub pant and then she told me, “congrats Maha, you have the best attendance record of this year” and then she shooed me away to a violently vomiting patient. I was bewildered and then saddened because I didn’t get a gold star and a raise. What an odd day.

When the Patient Makes the Wrong Choice...

Informed consent is a tricky thing sometimes. The doctor and nurse can explain the risks in minute detail that would bore even the most meticulous of medical ethicists but the patient Just. Doesn’t. Get. It. The most visceral feeling is to smack them upside the head until they start making sense but that doesn’t work because that might precipitate a head injury and create more work and the nursing licensing bodies frown upon that sort of behaviour. So what is a nurse to do when the patient has multiple facial fractures from a bar fight and a broken arm that needs to be surgically repaired but won’t stay for highly necessary treatment because “I’m not sitting around here all day bitch”? He stayed for a head CT and there weren’t any signs of cranial bleeding – asshat was probably his baseline. Many nurses and doctors told him and his girlfriend that he would be at risk for some pretty serious complications if he didn’t allow himself to be treated but our advice was not appreciated. He ripped out his IV and left. Much of the staff (including myself) was happy to let him rot away somewhere when he kicked a chair as he left the department and expend our efforts and energy on patients who wanted our help. “Whatever, we told him the risks, he’s a big boy” was the common phrase heard for the next half hour or so. Now this particular patient was informed of pretty much everything that could go wrong with him but he still chose to leave. After I calmed down and decreased the use of highly creative expletives, I actually felt pretty bad about he was treated. True, he pissed the entire department off and his attitude left a LOT to be desired. But I feel that had I held onto my ‘nice nurse persona’ a little longer, he might have agreed to stay and be treated – or at least revealed why he was so unwilling to stay despite his serious injuries. It was hard to watch him leave the department knowing that he would be in a lot of pain and face many complications but he was aware of the risks. I still wonder though if he was truly listening or heard, “blah blah blah you suck stay and get better” from us. Hopefully he did come back and get treatment even if he was a jerk.

Giving Up and Moving On

No, I’m not quitting my job. However, what I did quit is my outrageous addiction to Starbucks’ grande lattes. What motivated me to quit was not the delicious and soothing caffeinated warmth that my beloved lattes provided me with, but rather their after effects. I begin to realize that my lattes were the gastronomic equivalent of frenemies. I was constantly nauseated, bloated, gassy and sometimes if the combination of espresso to dairy products was in perfect proportions... well, let’s just say gastric distress cannot be ignored. My warm hug from a Starbucks cup was beginning to feel like an uncomfortably tight embrace. Since giving up Starbucks, I feel like I’ve given up a part of my identity. How can I manage to be the same nurse without a Starbucks cup affixed to my hand? It would be like Dr Grumpy sans Diet Coke. It just doesn’t seem right. Having said that, it has only been 6 weeks – in terms of Starbucks sobriety, I’m still in the infancy stage. Maybe I’ll have one bad shift or a sleepless night and I’ll go running towards the shiny green logo. But because I’ve made my attempt to give up my Starbucks dependency somewhat public, I feel obligated to continue to tread the path of less caffeine for as long as possible. Plus, my wallet is beginning to feel a bit heavier and I’m liking that better than my midsection doing the same!

The question remains, what should be my new (and healthier) signature beverage?

Secrets

I’ve probably treated hundreds of patients and each one of them tells me their secrets. Some people tell me their secrets inadvertently and some tell me for the relief of confession. Some secrets are relatively benign and others have been carefully hidden for decades to preserve a family. Some secrets are spoken aloud and some are revealed when a patient is changed into a drab hospital gown. Some secrets hit me like a ton of bricks and it can take days to recover (if not weeks) and some just float gently away from me. There is no rhyme or reason to what I remember and what I forget. Sometimes I find myself thinking about the elderly patient who has been abused and neglected by her family for an unforgivable amount of time just as I start to think about the teenager who does not want to call his mom because he knows he was not allowed to get his tongue pierced, much less infected. At the end of the day it can be sobering to think about the countless people who have entrusted me with their secrets and how on bad days acknowledging those secrets can feel so mechanical.