Archive for category Blogging Navel Gazing
So, it’s been awhile, eh?
To everyone who emailed and texted and Tweeted, thanks. Everything is hunky and dory. I’m not dead, ok? Let’s get that out of the way. Nor am I afflicted with a Chronic Debilitating Illness, unless you count members of my family. (That would be the topic of long separate blog post + extended psychotherapy.)
So what happened? Much to my surprise and amazement (and frank gratitude if truth be known) I got a new job about this time last year. A job with a very steep learning curve and a fairly cool boss with an alphabet soup of letters after her name and about as far away from Emergency nursing as you can imagine without leaving the hospital.
It is true, friends.
I have walked away from the front line.
I have drunk the mystical Kool-Aid.
I am Management.
But not real Management. I don’t actually manage anyone. I make up PowerPoints (ugh), give talks, and do research. I write policies. I have projects. I educate patients and staff. I occasionally make recommendations to Important People many steps above my pay grade, When I do speak, the senior administration actually pays attention and sometimes will do this or that based on the words flowing out of my mouth. This is a bit of a revelation for a front-line nurse used to managers halfheartedly and reluctantly paying attention. OK, not really paying attention at all.
Nurse K once suggested to me that my ambitions for real management were probably misplaced. Having observed front-line managers from the other side up close for the past year, I have to agree. Being a front-line manager truly and deeply sucks. It’s far worse than being a charge nurse. (I say this as an embittered former old charge nurse, remember.) Awesome amounts of responsibility and no actual power. And navigating the snakepit which is hospital politics. And the risk of being walked off the property at will. Great job, right?
So first lesson: I think I dodged a bullet there. I really don’t want to be a manager.
Second lesson: This is the first job where I use all of the skills I have acquired as a nurse in a meaningful and effective way.
I’m not just talking about clinical skills, or therapeutic communication skills which are surprisingly important in my current position; I’m also talking about evidence-based practice, critical thinking, leadership, understanding hospital processes, effecting change, teaching and developing clear presentations and a whole pile of other stuff — a whack of skills I acquired along the way in my ED practice. The unfortunate fact is, the opportunities to develop and use all of these skill in front-line practice is limited. The fact I had to leave front-line practice to fully explore them is a telling, don’t you think?
Third lesson: Make the jump. I’m looking at all of you who think there must be more. Or better. Do something different. You won’t regret it.
Curiously enough a couple of days ago, someone named Darren Royds left this comment on one of my blog posts:
You need to get out and find a decent job. Have a life , live and reduce stress. I have quit nursing and was the best decision I ever made. You will end up as so many do.
Well exactly. I haven’t quit nursing, though. But as much as I loved working in the ED, it was clearly time to move on. It was the best job decision I have ever made.
Have you guys ever made a career change to/from/within nursing? Was the outcome good/bad/indifferent?
P.S. So what about the blog?
That, dear friends, will be a topic for another blog post.
So as J mentioned before, I was in a near catatonic state due to my VSA* computer which has fortunately been resuscitated. The hypothermia post resuscitation care was beneficial but it suffered an anoxic brain injury that may not be possible to overcome. Despite this crushing blow (more so financially really since I do not feel like purchasing a new computer) I am okay with the periodic laptop confusion for now. I’ll do neuro vitals qshift on the computer, continue monitoring and provide supportive care. (Sorry for the lame nurse humour; that I cannot fix.)
Aside from my near death computer experience I have been incredibly busy with working in the ER, updating necessary work courses, school work for a critical care course I’ve been taking as well as starting in Acme Regional’s CCU/ICU. It’s a very different world up there (literally not figuratively. . .it’s on the 4th floor). The pace will take some getting used to. On one hand I enjoyed just having one patient to dedicate time and care to, knowing their history and the pathophysiology of their recent admission and not feeling like I’m practicing unsafely or providing my patient with the bare minimum, however, at the same time, having only one patient is a bit boring. The ICU seems a bit tedious: lots of little details and new physician orders that my emergency brain isn’t wired for. We have a lot of autonomy in the ER, more then I think we realize. Either way, I welcome the change in general, be it pace, environment, meeting new people, learning some new skills and learning in general. I had been feeling stagnant in the ER for a while. I still enjoy the ER immensely and I am not leaving, simply picking up some hours in the ICU for now. If anything I hope the added critical care experience makes me a better nurse. I felt like I had hit a roadblock and I wanted to know more but I just wasn’t learning in my day to day work life, so back to school I went!
I’ll have some new posts soon on more phrases junior nurses and most staff do not care to hear, as well as some other burning ideas and issues (with possible sarcasm and complaints) that have been on my mind. I have a few patient stories I’d like to share also. So, I hope to be more active soon, sorry for the absence!
*VSA – vital signs absent
*ROSC – return of spontaneous circulation
… and other examples of nurses eating their young…
A few statements I’ve heard in the last few years that I shall share periodically.
“It is more important that I get all of my breaks than you young folk because I’m older and need to rest more often”
I fail to understand how one person’s break is more valuable than anyone else. I realize that to-the-death cage matches can occur for which nurse goes first when it’s crazy busy, but seriously, just because you are senior staff does not make you superior and priority when it comes to a moment to stop, eat, go to the bathroom, etc. I like to think we are all the same as department staff members (obviously not including experience or department responsibilities for example…) but everyone is entitled to their break. Years of service to the hospital should not, in my mind, make you first up for every break. I often see the charge nurses getting fewer breaks than the rest of the staff (which is unfortunate) because they are trying to see that everyone else is getting a chance to eat. And for the most part, the charge nurses are all very senior staff. If you cannot keep up with the pace and demands of a busy emergency department or other job area and feel you cannot miss any breaks because of your age then perhaps you need to work in a different environment. Or retire. Missing breaks sucks no matter what way you look at it, but we have to work together to ensure we’re all taken care of.
- I do make the exception however for those with medical conditions, such as diabetes or a pregnant staff member (which is not a condition albeit) who is carrying/growing another human being inside of them. I have never personally grown a human, but from what I have observed, it’s tiring and your body needs extra food and having your lower legs elevated for a period of time in the day (that may have become the size of my thighs) is important too. So I personally would not have any issue with offering them the first available break.
- please also note that this does not in any way encompass all senior staff. Just the few that can be particularly nasty.
I’d like to start off by saying how truly flattered I was and am to be asked to write with this blog. I’ve admired the diversity in content and the nursing/healthcare related issues this blog has brought to my attention that I wouldn’t likely be aware of otherwise. I never mentioned to J Doe that I knew about the blog as I wanted to respect the desire to remain anonymous as had been written about and I didn’t want to skew or change the material if J knew someone knew. I also liked trying to figure out who the nurses behaving badly were! I’ve worked with the J Doe since I was a pre-grad nursing student. The early years where I once called a code blue for a patient peacefully sleeping with a lengthy run of reperfusion V-Tach post thrombolytic, and I neglected to actually check the patient and shouted (I mean shouted) CODE BLUE, as the patient woke up and looked at me, then I yelled, pleading after to “CANCEL CODE BLUE, I DIDN’T MEAN IT” as it sounded overhead through the hospital. I must have come a long way!
I’m nervous in many ways but excited to finally put “pen to paper” or fingers to keys, the thoughts, feelings, and sometimes discontent you could say, that can surround Emergency Nursing and discuss issues that I’m sure transcend all of our careers no matter where we practice. I often just let those ideas float away into the depths of my brain never to be shared or only to discuss them with my spouse and close nursing friends. The idea of sharing them with the internet blogging world is pretty amazing and equally terrifying.
A few things about myself:
I grew up in Suburbia and went into Nursing directly out of high school, starting at 17. I still look 17.
I did my Bachelor of Health Science Degree in Nursing in an Ontario University and thought most of it was a waste of time, not focusing on the core courses and skills we would truly need. I once petitioned for more clinical time each week (2-3 days/week instead of 1 in our 2nd year) and was informed I needed to stop being a trouble maker. I think I was labelled from then on.
I’ve been working at Acme Regional in the ED since I graduated. I had an exceptional preceptor and mentor and feel thankful for learning from someone who truly enjoys teaching. I truly admire those who can be great teachers and hope to teach at the bedside myself one day once I feel that I won’t create a monster.
I look forward to meeting new and interesting individuals within the nursing blogosphere with various backgrounds, views and opinions. You are all an inspiration.
A few weeks ago, I was talking with a colleague, whom I will call Jean Hill, and by-the-by the conversation fell to nurse bloggers. Several prominent ones were mentioned, like Crass-Pollination and Emergiblog and Nerdy Nurse.
“Oh,” said Jean Hill innocently. “I wish I could write like these guys.”
At which point your humble blogger’s eyes began to sparkle rather a cat’s contemplating a mouse. Come in my parlour, said the spider to the fly, I thought. You see, dear readers, I have been contemplating the addition of a co-blogger for some time. *
But how to lure the prey?
I told Jean Hill to meet me in the ambulance bay after shift. I told her portentously I had something I needed to ask her.
So later, in the ambulance bay, I told Jean Hill about this blog, my anonymity and whether or not she would like to come aboard the Good Ship Those Emergency Blues as a co-blogger.
She would, she said. She would be pleased. She had, she said, been reading the blog for a long time.
“So you knew about Those Emergency Blues?” I asked, secretly very pleased that someone from Acme Regional was reading it.
“Oh yes,” she replied. “And, you know, I knew it was you all the time.”
Oh crap. “Really?”
“Well, you sometimes talk like the blog, so I figured it out.”
By which, I suppose, she means I speak in a pedantic, self-important, pompous manner, but was too kind to say so. At any rate, I am very pleased Jean Hill has come to write here. I think she will be writing once or twice a week (hopefully more!) beginning in a few days on topics which interest her. Since this is her first time publicly writing a few small words of encouragement will be welcome.
*For mostly selfish reasons, i.e. to ensure there is more content consistently posted, to free up time so I can write better for this blog, to work on some other writing projects, etc.
Don’t know if it’s the crazy weather, but just feeling a little whacked today. Got up this morning, all burstin’ to write an epic post about the RNAO’s new best practice guidelines on restraints, wrote about three paragraphs and went bleh. Didn’t care as much as I thought. So maybe Sunday, if at all.
Other stuff: I made the Sunshine List — one of 79,000 —for the first time ever. For those out of province and out of country, the Sunshine List is the provincially-mandated disclosure of salaries over $100K for public and near-public employees. It makes for hours of entertaining reading. Really. Some of my colleagues made near $150K — and I thought I did a lot of overtime! ( I was a few thousand over.)
Also, some big changes coming soon to this blog. Are you excited yet?
Also: I know the great March heatwave is over, though its still 15C (60F) here as I write — about 8C (18F) above normal. More normally abnormally warm, if you know what I mean. I went out a couple of days ago to take some pictures to document the tremendously early arrival of spring. Not great pics, but you get the idea something is strangely amiss.
Daphne mezereum. Usually blooms here first or second week of April.
Maple blossoms. Maybe a month early, at least.
Maple blossoms en masse
Magnolia bud break. About a month early.
It would be foolish to attribute one weather event to climate change, the way anti-science types and assorted denialists think snowfall in Toronto in winter invalidates climate change science forever and for all time. However. . .
UPDATE: Minor syntactical fixes, because my hobbit-editor I bought ran away shouting some crazy talk about a magical ring.
OK, not really famous, but published on Kevin Pho’s site, KevinMD.com. Check it out, and Retweet/Like/comment as you will — it’s all in a good cause. I’ll repost it here sometime next week.
I am this morning getting an uptick in visitors from KevinMD.com. Welcome, and free to poke around.