I wrote this in December, and decided to finally post it and share a life update. Hooray for some vulnerability. Also, to not ever cross the whole HIPAA line, names and specific details have been changed, but you’ll still get the picture…
If you are the one reader [this may even be an overestimate] that read my rant on working in the realm of surgical rehab facilities, you may know that I loathe them and would not wish that fate on anyone I know. This goes for both being a worker and being a patient in that heinous nightmare.
Recently my job has had a lot of staff turnover [read: people quit all the time], which is not really a surprise. And now that I care for 12-15 people a night with half of the normal staff, I want to light my hair on fire and run screaming from the building. Indulge me when I say I am working as fast + efficiently as I possibly can while trying very hard to not make any errors, and I still leave feeling like an absolute piece of shit. I probably feel like that because on any given night 1-2 patients or their family members will in various combinations of words tell me that I am doing a shitty job. Gr8 thanx. Yes, a thick skin is important. Yes, half of the patients [and family members perhaps?] are delirious and I shouldn’t take it too seriously. But they don’t even have to tell me, I know I am becoming a shittier nurse and hate it.
I spend my days rushing around as quickly as possible with a grimace/snarl. I’m not able to actually engage with patients and their families – all I can usually give is a curt pleasantry and a clipped answer to any question BECAUSE I CAN HEAR BETTY SCREAMING DOWN THE HALL or because a nursing aid is the room saying Joe just fell again and is bleeding from the head.
I realize now that the way most nurses get stuff done is by not doing it! Awesome. The big stuff gets done – most of the medication pass, IVs, insulin administration, etc. But most nurses there don’t actually do the obligatory head-to-toe assessments on their patients. If the patient is behaving at an approximation of their baseline, there must be no other physical changes of note! In addition, I’ve had patients tell me their [supposed-to-be] daily dressing changes haven’t been done in days and I pull off the dressing and it smells like a sewer and looks like one too. Or they say they haven’t been showered for 6 days. And they are incontinent. Or they never got their breathing treatment that they need for you know, not gasping for air like a 75 year old with COPD.
Side note: don’t smoke. Watching people die from COPD is pretty distressing to me the observer, and I can’t imagine the torture of actually having it.
Also, can I just recount this error that happened recently? Errors do happen, but this was a I-feel-ill-that-this-could-ever-happen type of error. A patient admitted one evening and the admitting nurse used another person’s medical record to transcribe that patient’s medications onto a paper MAR for the new patient.
Let me first enlighten you on a MAR. Since many of these surgical rehabs are not a bastion of cutting edge technology, you get to use paper charts and paper MARs. A Medication Administration Record (MAR) is the long list of physician orders that you use throughout your shift to know what medications or therapies a patient needs. It’s almost unbelievable that paper MARs still exist since they depend on being able to read what the nurse with crappy handwriting wrote and because of the little known fact that COMPUTERS ARE A THING. And electronic MARs are widespread and reduce medication errors.
So anyways, the new patient received the WRONG MEDICATIONS FOR THREE WEEKS. Jesus. I can’t even wrap my head around that. She was receiving multiple strong blood pressure medications and the doctors couldn’t figure out why her blood pressure was so low and kept trying to titrate her dose down. The error was finally noticed when she discharged home and her regular doctor read her chart [including her medications] from our facility and called with a big ole WTF.
So needless to say I feel like I’ve already outstayed my welcome at this place. If I were to continue for another 20 years like a good lil employee that I know I’m not, I would probably need a partial lobotomy so that I could become an emotionless robot.
I got sidetracked and read this little snippet on Wikipedia about lobotomies:
The purpose of the operation was to reduce the symptoms of mental disorder, and it was recognized that this was accomplished at the expense of a person’s personality and intellect. British psychiatrist Maurice Partridge, who conducted a follow-up study of 300 patients, said that the treatment achieved its effects by “reducing the complexity of psychic life”. Following the operation, spontaneity, responsiveness, self-awareness and self-control were reduced. Activity was replaced by inertia, and people were left emotionally blunted and restricted in their intellectual range.
Yep, sounds like the appropriate prescription for my malady.
So now I’ve jumped around to enough jobs to know many of the things I dislike and cannot tolerate. And thanks in part to Mark Manson’s excellent question, I know what types of pain I can let into my life and not want to rip my skin off. You can’t choose all of your pains, but you have more control over your daily troubles than you think.
After waiting around in the purgatory of unknowing, kicking rocks and hoping an answer would magically bloom in my mind, I thought to apply to this one hospital that is known to be great. And it had one non-night shift opening that had been on the website for a few weeks. After one particularly bad string of shifts I threw my vulnerability [and caution] to the wind and just applied, thinking it was probably already closed and I’d get an automated “duh, it’s closed” response.
But I got an interview! And then a second one! And then I shadowed for half of a shift. And it was so amazing. Everyone seemed genuinely happy to be at work. It was a strange thing to witness. I almost wanted to touch their faces and ensure that they were people and not just good-looking robots. Everyone was helpful and supportive of each other. And the nurse I was with had time to actually listen to each of her patients for more than 1 minute. And it wasn’t absolute chaos. It was almost unbelievable that a place like this existed all along.
It’s kind of like dating crappy people over and over and you start to think it’s just you (note: it partially is). But then one day you meet a person and they’re just as weird and silly as you but they are also loving and honest and supportive and you feel like you found home. I know I’m fast forwarding a lot here, but that’s what it felt like.
And so I say to you, I’m GETTING THE F OUT!! Cheers to salvaging my self-respect and professional integrity!