Becoming militant
I just finished reading a book I saw recommended on another (or should I now just say “an”) L&D nursing blog entitled Pushed: The Painful Truth Abouth Childbirth and Modern Maternity Care. Wow. It sparked so many thoughts in my head and I am sure I will be thinking about it for some time. Basically it managed to put into words what my gut has been feeling for months now, why I have been so uncomfortable in the labor & delivery arena. I have a lot of things going around in my head right now, too many to put into words. But the one thing I will say is that I went into L&D fearing that I would become complacent and develop the “that’s the way it is” mentality. Instead my original feelings have only been amplified. Maybe I’m quitting too soon, but quite honestly, I can’t practice in a way that goes against my own ethics. I don’t yet know how to join the fight for true reproductive rights in an effective way… but I am not giving up my fight just because I’m leaving L&D.
Meanwhile, back on the farm. After my breakdown on Monday I circled back. I had gone onto my Netflix account to see what was next in my queue and saw a banner saying “You’ve watched ‘The Business of Being Born’ before, watch it again, instantly.” So I thought, what they hey, and watched it again on my laptop. Slowly I began to feel that I had made the right decision. And when I woke up to the alarm on Tuesday morning and realized that I no longer had to do L&D a sense of relief washed over me. That relief was what ultimately signaled to me that I was in the right place.
The hardest part for me was the sheepishness. A phrase from “The Devil Wears Prada” kept going through my head, “A million girls would KILL for that job.” How many new nurses want L&D and have to pay their dues in med-surg? Meanwhile I got to skip all that and go right into a specialty… and then didn’t live up to my hype. I felt guilty. I felt like I screwed it up for some up-and-comer. Like they’ll always say, “Well, I dunno about taking a new grad… remember what happened with Rori.” On top of that, I don’t like looking foolish, and yet there I was feeling foolish for making the wrong choice of first job. I mistakenly thought that I could provide maternity care in an environment that went against my own convictions. After all, most of our nurses will admit that they don’t like the number of interventions that are done, but they strive to make the experience the best possible given what they have to work with. I give them a lot of credit for that. I thought I could do the same. I thought that feeling sick every day before work was normal new-nurse jitters. I didn’t want to throw in the towel without giving it my all. I have often used the phrase “just suck it up” when faced with unpleasant tasks. But one can only suck it up for so long before there’s no more room in the vacuum bag (sorry, dumb analogy, but it’s what I’ve got). I also wanted to leave on my own terms, rather than being told that I should consider other avenues. It was hard not to feel as though I’d been told that I failed, even though my manager assured me that I was a good nurse, that this was simply a bad fit for me.
I had another discussion with her on Tuesday and she asked whether my unhappiness was merely philosophical differences or whether I had issues with the orientation. While I did have issues with the orientation, I knew at that point that it wouldn’t have mattered if I had the best orientation program in the world. It might have postponed the inevitable, but ultimately it would not have changed my feelings. I told her, “I just don’t want to do it anymore.” I felt relieved to finally say that. After months of beating around the bush when people asked if I liked L&D (“well, it’s a lot to take in,” “I still need to work on some things,” “I have some philosophical differences”) it felt liberating to say that no, in fact, I do not like it. At this point I will say, however, that I am glad I had the experience of trying it. Sure, I feel guilty that they spent money orienting me and it’s turned out to be for naught. But I will never regret that I tried. I was able to bear witness to many births in my short stint and I feel honored to have been a part of them. I will never have to wonder if I was missing out.
In talking to my boss I did tell her that I am wary of jumping into another area without doing my homework first. As I’d mentioned in my previous post, she’d offered the potential of going to our level II nursery. I asked if I could shadow a nurse in there for a day and she offered one better… a few weeks there, after which I can tell her whether I want to pursue it. That’s a weight off of me, at least for a while. I have a feeling that I will like special care far more than L&D, after all, I’ve been on a sick baby kick since the one day I got to spend in a NICU during my maternity rotation over a year ago. But I want to make sure that this is the right choice for me. We shall see what the next couple weeks bring.
Until then, this week starts my increased role in quality and I’m looking forward to hashing out my new responsibilities. I am a bit nervous about taking on a more independence there, but I know that I will learn a lot from it, and I can’t think of a more supportive group to learn from.
A mixed bag
Good and bad news this week.
Bad: Awesome co-worker in quality left for a new opportunity. Sad to see such an asset to the hospital go.
Good: Her leaving is allowing for a couple of us to grow our roles in the department. This includes the offer for me to increase my hours in the department from 4 to 16, with a new title and added responsibility. I am very excited about this.
Bad: This change had to get cleared with my other boss on the unit. While she agreed to the change it prompted a discussion between the two of us about my feelings about that job. Which, if you haven’t picked up on the subtlety in prior posts, are generally negative. Okay, I’ll just say it: I don’t like what I do. L&D in a hospital is a bad fit for me. The upshot of the conversation with my boss is that I’m getting pulled off L&D orientation. My boss was very flexible in terms of what I will do now. I’ll just do postpartum for the time being while I figure out what next. She even offered to try to get me into the special care nursery which is a big interest of mine. But I am wary of jumping at that opportunity without doing some serious soul-searching first.
For one thing, I am not sure that my feelings are solely related to my philosophical views on birth. There is the culture to consider, as well. The unit and the hospital as a whole have distinct cultures and I’m not sure where I fit into this culture. This leads me to wonder whether I should look at a specialty unrelated to maternal/child health. Or even beyond that, whether I should look outside this hospital entirely. Not that my brief experience and the current economic situation make that easy. Not a ton of hiring going on around here.
I do count myself lucky for one thing… my awesome mentor (formerly my clinical preceptor). I was able to sit down with her today and bounce my thoughts off her. She understood my feelings of “how much longer do I have to do this?” that come with a job that’s a poor fit and validated many of the thoughts that have been rattling around in my head.
These past few months have been such a roller-coaster. At the moment I feel half-sick and half-relieved. Relieved to have this burden off my shoulders, sick to not have a defined next step and feeling pressured to make a decision. But I was able to think out some next steps with my mentor today, and I guess I just go from here. If only I could stop bursting into tears I’d be all set.
Three sets of initials
That’s right… I now have three sets of initials after my name: MS, RN, CNL. Added the last set this week after taking the clinical nurse leader certification exam. It was one of those tests that you can’t really study for, but at the same time we’ve been spending our entire time in school preparing for it. Passing that test felt like I’d put the bow on the whole package of the last two years. Now to build the skill sets to add some legitimacy to all that alphabet soup!
Unfortunately the last week or so has been a bit of a wash. After not getting sick for over two years I had developed the erroneous notion that I was somehow super-immune and would never be sick again. On New Year’s Day I had started feeling like I got sick, but after a couple glasses of Emergen-C I was back to full force again. This only served to bolster my immunity arrogance. But this past Monday I woke up with a vaguely sore throat and it went downhill throughout the rest of the week. I called out of work on Wednesday, but felt like I had to go in on Thursday… I was signed up to renew my BLS certification and had signed up for a mandatory code of conduct training, so I went in, did a couple hours in quality. I decided I wasn’t really feeling all THAT bad… even went down to Big City for an event with my local undergrad alumni group. Friday I woke up convinced that I felt better. I went to work since I’d only scheduled myself for an 8-hr day thinking it couldn’t possibly be that bad. My coworkers essentially turned me around at the door and sent me back home. It was just as well… I felt worse as the day went on. Saturday was more of the same. I’m finally beginning to feel slightly more normal today. Even dragged myself out of the house to go to the grocery store where I bought all sorts of yummy-sounding things only to find out that nothing I eat has any flavor to it. Dratted stuffy nose.
On the work front… I am hoping there might be some new developments. Nothing has been stated directly to me, but I know a coworker in my, um, preferred department of work, is transferring to another location in our network. My boss there asked me about my normal schedule on my, um, less preferred department of work. I am wondering if they are wanting to give me more hours, which I would gratefully snap up in exchange for fewer hours in the other place. As you can see, I’m still struggling with my transition to the bedside job and wondering whether I’d be better off in an area of nursing where I didn’t hold such strong personal convictions (particularly strong convictions that run so counter to the mainstream way of practicing in the hospital setting). For a while I thought that I’d want to be a midwife and I thought I would be able to do the L&D thing for a couple years to get the experience before I went back to school, but throughout school I found my interest in midwifery waning as my interest in leadership and administration increased. And with that interest in administration I am wondering if I would be better served by working in a more generalized setting (i.e. med-surg). All this swirls in my head. I know that I’m at the point in my career where I’m vulnerable to grass-is-greener syndrome because I’m still in the novice stage. That being said, I knew on day one of career #1 that it wasn’t what I wanted to do, and I ended up sticking it out for 6 years of generally feeling miserable about myself and my work ethic. I don’t want to go down that road again. Trying to find balance between being flighty and pursuing what I want. It’s a fine line to walk.
Orientation continues…
It’s been a while since I’ve written about work, so thought I’d post an update on how things are going. It’s been hectic, as I anticipated. There is just so much to learn in labor & delivery that I know it will take years and years to become the nurse I would want if I were in the bed. Not that I’m a bad nurse now, just that my expert colleagues (rant about that later) can walk in a room and know what’s going on by what seems like ESP and I mostly feel helpless. I am feeling better technically. I am more comfortable with the documentation and the manual tasks, though there is still plenty of progress to be made. I am getting more comfortable with the fact that at the moment of birth all hell breaks loose and the nurse becomes a one-armed paper-hanger trying to make sure kiddo’s kicking and screaming appropriately, mom isn’t doing a human impression of Niagara Falls, physician is happy, and, oh yeah, dad isn’t passed out on the floor somewhere. I’m not good at this, not by a long shot, but I’ve stopped being quite so frustrated by it. To add to my learning curve, I started learning to circulate in the OR for c-sections. Gah. More one-armed paper-hanging. On the up-side, aside from the OR, I’m beginning to have that feeling of, “please just let me do this myself and bugger off” which means that I’m doing more independent learning and working out my own system.
I still need to get the damned IV sticks down. I was so pissed last week, I got one in beautifully, felt that gorgeous pop when I got in the vein (sorry for you non-health-care people, but it’s kinda cool), but managed to pierce the external part of the catheter when I was pulling the needle out, so we needed to do another one. Still trying to get my vag exams down, too. Cervixes (cervii?) are sneaky things that occasionally like to hide and my go-go-gadget arms are on backorder. Not to mention that there is a whole hell of a lot of subjectivity to the process. One doc will say, oh, she’s 90% effaced (thinned out) and the nurse will reexamine and say, well, I’d say it’s only 50%. In the end it really doesn’t matter much as long as, at some point, the cervix disappears and the kid comes out. But I guess we get comfort from numbers.
In terms of my orientation experience… well, I’d love to reorganize the whole process because at the moment it seems that there is no organization. I have a checklist to go through, but it seems that I only get a chance to look at it with a preceptor once every few weeks. There’s some scattered reading materials I’m apparently supposed to be doing, but again, no defined plan. I get a lot of wide-eyed, “You mean you haven’t done X yet?!” to things which I didn’t know I was supposed to have done. The more I go through this the more I consider that I’d like to get into education so that we can come up with appropriate programs that smooth the transition from new grad to nurse or from, say, med-surg nurse to L&D nurse. But that’s then, this is now. My other beef is that, despite my lack of interest in nursing theory, I am a big fan of Benner’s novice to expert theory which discusses the progression of the nurse from novice to advanced beginner and so on to expert nurse. Part of this theory is that the appropriate teacher for the novice nurse is NOT the expert nurse. It would be tempting to think so, no? Don’t you want the person who has seen everything to be teaching the newbies? But in fact, it’s the proficient nurse, the one who has been in the field for, say, five years or so, to be the preceptor. Whereas the expert nurse “just knows” from experience, the proficient nurse has adequate experience, but can still explain their thought processes to the novice. Instead I get a lot of looks from my expert preceptors which give me the impression that they think I am entirely stupid for not getting myself from point A to point B without pulling a Billy from Family Circus (you know, the Sunday comic where the kid goes all over the neighborhood in the process of going home from the next-door neighbor’s house). Yes, one of these days I’m going to do these things as if on auto-pilot, but that might take a few years. I have this creepy feeling that that damned PhD might be in my future after all, because the process of nursing education is a real passion of mine and I want to figure it out dammit!
The tough part of this process has been the fact that birth is my other passion and I am struggling with the way birth is handled in the medical setting. The nurses are great, don’t get me wrong. They do the best they can for their patients given the orders that they have to follow. I just don’t know if I am up for following along when I feel that my job is at odds with my own beliefs. I have no plans to up and quit my job (especially seeing as there aren’t really any jobs around here to be had), but I wonder what time is going to bring for me. I’ve got lots of possibilities swirling around in my head, but I know that realistically I need to just give myself more time. Some of my struggle is surely simply because I am new and, darn it, naive. I know the grass isn’t necessarily greener anywhere else, but I wish I had more days where I felt like gloating to my ex-coworkers in career A that I am doing this now. Instead I’ve had a few moments of wondering what the heck was so bad about sitting in my cube, surfing the internet and popping out the odd spreadsheet here and there. I do still love spreadsheets. Now rationally I know that I made the right move and I wouldn’t change it for the world. I just wish I felt more glee than I do.
On the upside, I still get my 4 hours a week in quality which I love. It’s like detective work going through the charts and I would love to do more of it, but all in good time. At the moment I’m just happy that my four hours weren’t cut during our recent budget crisis.
So, I’m sorry that this post hasn’t been entirely happy-happy-joy-joy, but I will admit that it was quite cathartic to get these ideas typed out as they’ve been swirling around in my brain for some time. Please don’t think that I’m regretting the choices I’ve made, because I don’t. I give thanks every day for my new career and the fact that I was able to start it in a specialty of nursing that means so much to me. I am thankful for being able to be part of such an intimate moment in a family’s life. And I am thankful that my coworkers really are wonderful people and have welcomed me fully without some of the nasty rumors I’ve heard about eating of young. I am well aware than much of my struggle is the normal first year transition as a new nurse and that I won’t always feel this discombobulated. But I think that it’s important to recognize that not all parts of the journey are pancakes and sunshine and that’s okay.
Out with a bang…
Sadly not the bang of firecrackers, but the bang of tree branches falling under the weight of ice. A storm blew our way Thursday afternoon and didn’t let up until mid-day Friday at which point much of the area was without power. Our professors had already sent out an e-mail on Thursday night cancelling our final classes of the program. At 10pm that night I lost power here. Friday morning I was still without power, as were many of my classmates, including the one who was hosting our end-of-program party, so that got cancelled. It was truly a bummer of a day. I wasn’t planning a big celebration anyway, but I really wanted some sort of event with my classmates to provide some closure to the past two years. Hopefully we can reschedule something, but I’m still in a snit that things didn’t go as planned.
On the upside, I am thankful for the fact that I somehow still had warm water 16 hours after the power went out (I kicked myself for not checking this before!) so I could take a shower. And I was thankful that my gas fireplace still works even without electricity and I was able to at least keep the main room toasty warm. And at 2 o’clock this morning I was thankful when the lights, furnace, and refrigerator kicked back on. Twenty-eight hours without power is more than enough, thank you.
So there ends my nursing school journey. It’s not quite the ending I was hoping for, but I’m trying to keep some perspective and remember that it’s not how it ended but the fact that it did end. I might remain a little grumpy for the next few days, though!
Positively giddy
Well, friends, I am about to turn the last page of this book. I have a bound copy of my final paper ready to turn in tomorrow (assuming the weather doesn’t cancel class!). I have nothing left to do for school other than to show up for the last day. It feels so, so nice. The stress of the past few weeks has evaporated and I can finally breathe a sigh of relief. Assuming passing grades in my two classes (which I dare say is a safe assumption at this point), I am done. Now on to the celebrating!
One paper away…
The final presentation is a thing of the past! All in all I think it went well. I felt good about it, got positive feedback… but more importantly: it’s done, it’s done, it’s done! Now all that stands between me and the end is writing my final paper. Not that I’m feeling particularly inspired. After being part of the collective glee of my classmates yesterday it’s hard to remember that we’re not quite done yet. They presented us with carnations at the end (I managed to behead mine accidentally before I even got it home… oops) and we had cake and punch. A few of us headed to the bar downtown that we occasionally haunted during our time in the program. It felt very celebratory. So it’s hard to get back in the mode of doing work.
But do it, I must… so that we can continue the celebrations this coming Friday with our last classes and final party! I have a good start… I just need to somehow inspire myself to barrel through the end. So close!
Crawling towards the finish line
Wow, I can’t believe I started this blog two years ago as I was just embarking on my nursing school journey. Now here I am less than two weeks (God/dess willing) from being el-done-o. The 14th can’t come soon enough, it really can’t. I am tired of my project, I am tired of trying to juggle learning a new job with school, and I am tired of my home being merely an annex of the classroom. I can’t wait for my time to be my own again.
Right now I’m supposed to be finishing up my presentation for this Friday (eek) and writing my draft of my final capstone paper. I have made some progress on it today. And I realized that my work for my other class is done, so that’s good. But ugh, my attention span is awful. I did talk myself out of going out for coffee in favor of drinking something from my own kitchen. But I’m daydreaming while staring into the flames of the fireplace. Staring out the windows into the dark to see if I can see Venus and Jupiter. Staring at the cats. Wandering around the kitchen looking for unneeded snacks. Mentally making up my Christmas card list. Coming up with random questions and googling to find out the answers. My pattern seems to be: five minutes of productivity followed by 45 of mindless nothingness. Geez, if I’m going to take these long breaks I could at least be cleaning. Then I could at least say I accomplished something.
The sad part of all of this is that I know within a month of being done I’ll start missing school. I’ll probably complain that I’m bored. Never satisfied, me.
Check back in a couple weeks when I’ve gained some perspective. For now it’s Captain Complainer, over and out!
Yo-yo-ing
So I was on nights, and then just like that, I was back on days again. But it’s all good news.
First of all, I really enjoyed the nights far more than I ever thought I would. The tone of nights is so much more relaxed than days. Not to mention that by coming in at 7pm I was able to get the bulk of my work done in the first four hours, then spent the rest of my shift putting out whatever fires came up. It was nice because I generally felt like I had plenty of time to spend with my patients. It felt good to be on my own and I think the three weeks I did nights did a lot for my comfort level with providing postpartum care.
Then I found out that the staffing issues on nights weren’t going to last after all and my manager felt comfortable moving me on to labor & delivery. I am very excited to take this turn in my orientation since L&D is what really excites me about maternity nursing (that and sick babies, but I am not sure if I’ll get to orient to our level II nursery or not). Today was my second day on L&D, although my first day didn’t really count since I went home sick. Don’t know what was up with that. I started feeling woozy in the OR (I’ve seen lots of c-sections, so I can’t imagine it had anything to do with that). I felt better after a bit, but then started feeling gross again a short time later. I came home and slept a lot. Feeling mostly good today. No labor, but my preceptor and I had an antepartum patient and helped out in the triage room, so I got to practice Leopold’s and tried (unsuccessfully) to start an IV. It was a good day, even if I didn’t get to see labor. To top it off, despite the fact that I really don’t need any more scrubs, I found a set of corduroy scrubs at our hospital’s uniform sale today. Cute!
School is still going. I got invited into Sigma Theta Tau, so that was exciting. I have a feeling all the grad students are inducted, but still, it’s nice to actually have an academic honor to my name. I think I should have final IRB approval for my project tomorrow hopefully, so then I can finally start making some serious progress on my project. I cannot wait to be done. Have I mentioned that already?
Working on my night moves
I’m going on nights tonight. Not quite sure what to think of it… I’ll let you know in 24 hours. I’m not happy about going on nights, I’ll admit. I know I’m the new girl, so I kind of have to suck it up and deal. But I am nervous about how I’m going to do being up all night. Part of it is fear of what my body is going to do when I throw my circadian rhythms off. The other part of me fears what it will be like to work with this new bunch of people who I usually only see for a few minutes as they are heading off their shift. Hopefully this new schedule will be short-lived. There are a couple people who should be going onto nights (voluntarily) soon, and my manager said after that she’d put me back on days so that I can learn labor & delivery (woohooooooo!!!).
This will be an adventure, then. But I am looking forward to the paycheck! Love those shift differentials.
Still plugging away at my school stuff. I am feeling frustrated with how the school organized various aspects of our curriculum. I feel very behind. I only have two months to get my capstone project done and so far not much has happened with it. Ugh. I just want to be done. I am already thinking of what I will do with all that free time I’ll have. It will be loverly.
