A Nod to NOC

There’s nothing quite like working past the time that the rest of the world has turned its back on the day, closed their eyes, and directed their thoughts on the coming day. For them, the day is over. For us, the day has just begun. 

Driving into work with the late afternoon sun low in the sky or under the canvas of purplish twilight, I feel ready to face another day. This is when it begins. The realization that the faces I see behind the wheel as I share the road with fellow motorists are the faces of those heading home after a day at the office, on the job site, or behind the counter. When they say goodbye, I say hello. 

I arrive at work greeted by warm smiles worn by those who are smug with the realization that they will be leaving soon. They’ve put in their time. They’re returning the look I likely gave them 12 hours earlier. Their eyes seem to speak of the anticipation of what lies ahead not what they leave behind. I nod as I acknowledge the fact that I will perhaps see some of them in what will feel like moments, but in reality marks another calendar day. 

As the evening gives way to night, the voices quiet. The halls darken. The energy changes. The low hum of productivity permeates the air.  

The clock ticks ever closer to another day. Another day to be present. Another day to cross off the calendar. Another day to accomplish something. Or nothing. 

I’m keenly aware of being a member of a very elite club. Working at night has its definite advantages. It’s a club that we don’t necessarily want everyone to be a part of. That’s part of the allure. We rally. We rise. We scrap. We provide for others when all our bodies want to do sometimes is rest. Sleep. 

Yet we push through. 

Night shift means you sometimes do things that day walkers can’t imagine. We stay awake when our bodies are begging for rest. We come home, get our children off to school, walk our dogs, do a bit of homework, and then we might lay our head down to rest. And then after only a few hours of sleep, we join the daylight world. 

I’m typing this after working two back-to-back 12-hour night shifts with a combined six hours of sleep since Monday morning at 0700. It’s not a complaint. It’s a fact. My eyes are itchy. My eyes are tired. But, my body and my brain are awake. And I feel a sense of satisfaction that no day shift job could possibly provide. 

Does this sound crazy?

That’s ok. 

The other crazies know what I mean. 

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Damn. Time Flies.

Well, there goes two weeks off. Just like that. In a blink of an eye, I have managed to piss away nearly two weeks. Now, granted, we had big plans. We intended on traveling to Boston for a long weekend in order for Julia to meet her paternal grandfather for the very first time. A vague and unknown viral infection put a stop to that, and, in turn, sickened daddy.

Ah, well. Reschedule, we must. Thankfully, Southwest Airlines will allow us to use the dollar amount on future travel until March 31, 2017. So, we’ve got that going for us…

I shouldn’t be too hard on myself. I did manage to complete a paper and a handful of discussion posts for grad school, so that put me a couple of weeks ahead. I am feeling pretty fucking fantastic about having completed nearly a year of my first year in the MSN program. I should preface this by saying that I NEVER envisioned returning to school, so this alone is a major feat. I am also somehow managing to be 3/4 finished with this latest 10-week quarter, and scoring a perfect 100%.

Shit.

How does that happen? Whatever. I’ll take it. Bragging? Hell yes.

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Tomorrow begins a newER journey for me. I have once again put on my leadership cap. A cap I thought for certain I would NEVER wear again. A cap I threw out over a year ago after vowing I would NEVER do management again.

Never is indeed a strong word, and one I should really learn to NEVER use.

In any event, I have accepted an assistant nurse manager position in my current unit, and while I was, and continue to be, excited about the possibility, I did harbor some feelings of uncertainty, doubt, and unease. Just as before, I will move into a management position in my current unit, and, well hell, I don’t know. I guess I just wasn’t sure how it would be received. It’s nerve-wracking to think your peers would give you the side eye when just months ago you may have said, “I’ll NEVER do that job again.”

There’s that damn word again.

But, I’m happy to report that the news has been greeted with congratulations, messages of support, and words of encouragement. I can’t really ask for more, now can I?

I think what surprises me most is that I’m actually excited to give leadership another go. I have those familiar feelings of anticipation to learning new things, meeting new people, and easing into a new role. For that feeling alone, I’m grateful. I think the biggest difference this time around is that I find myself in a unit that truly speaks to me. I am home there. Med/Surg just wasn’t my cup-o-tea, and I knew it.

Anyway, tomorrow it begins. Again.

So, those two weeks literally FLEW by, and while I vowed to read more for pleasure, I didn’t. While I vowed to get out with Julia and do more, we didn’t. While I vowed to get more accomplished around the house, I didn’t.

Oh well.

I can tell you one thing, though. When you find yourself playing with Snapchat filters to kill some time, it’s time to get back to work.

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Survival of the Fittest

I made it.

I did it.

I survived orientation in my new Postpartum job.

Whew.

All that anxiety. All those feelings of inadequacy snuffed out with a single kick-ass shift this past Tuesday night. All the thanks go to my final preceptor. She kept it real, no-nonsense, common sense, and put things in a way that made things logical to me. Her bedside manner is one I will do my best to emulate. I took lots of notes, made crib sheets, and put mental notes in my head to best prepare me for my first solo shift on Monday night.

Truth be told, I was basically flying solo last Tuesday, as well. My preceptor was in the background as a resource, but I did all the assessments, care, meds, teaching, follow up, rounding, and charting for four couplets/eight patients. For those who think Postpartum is ‘boring’, I challenge you to take care of two distinct different type of patients. One is adult, newly-postpartum, and the other is a brand new human being. There are different ranges of normal for each, and it’s YOUR job to remember that. The charting, care plans, and teaching is different for each type of patient, too. Your boring is my world, and I love it this way. Take your adrenaline-soaked self back to the unit from whence you came. I’m happy to stay here with my moms and babies and the occasional urgent issue.

So, after a short meeting with the assistant manager (how ironic that I used to sit in that seat just a short time ago), I have been released from orientation. I was told that the current staff is very happy to have me on the team. I don’t know if that’s the truth or a fluffy nugget of bullshit, but I’ll take it just the same.

Now, I just need to channel those positive feelings and vibes from my last shift, remember that I CAN DO THIS, and continue down the road. Bottom line: I will always do my best and hope that it’s good enough. If everyone makes it through the night intact, then I’ve done my job. I’m a nurse, not a magician.

I have to remind myself that Rome wasn’t built in a day and I am brand new to the world of Postpartum. Slap a telemetry monitor on any one of these moms or babies, and I’m your girl. I can still interpret a cardiac rhythm with the best of ’em. These eight weeks of orientation have taught me humility, gratitude, and respect. I had the distinct pleasure of working in a labor and delivery/postpartum unit back in Michigan as a unit clerk for seven years. Those seven years likely taught me much more than I ever realized. It taught me that indeed my true love in nursing and the field of medicine in general is women’s health, moms, babies, and new families. Those nurses and OB doctors are with me every single day now. I am happy that some of them are still good friends and have followed me on this new journey. If you’re reading this, please know that you helped shape me into the nurse I am becoming today. Thank you. You’ll never know how much I appreciate you.

So, I begin my next nursing adventure with my first solo shift on Labor Day. How appropriate. Labor Day in a Postpartum unit.

Stay tuned.

Nervous Nellie

Confession time.

Leaving the bedside as a nurse for a management job was quite possibly one of the worst things I have ever done.

Now that I have returned to the bedside, I feel nervous, anxious, worried, and doubtful. And it sucks. Big time. Things as simple as an IV push medication have become anxiety-provoking. I am afraid I’ll forget something, forget everything, forget to chart a detail, forget to draw a lab, forget my brain at home.

Yes, it’s true. I have forgotten how it feels to be a confident floor nurse.

Sigh….

I have bit my tongue for quite some time about my stint in management, but when I look back upon that brief experience, I don’t have much to feel good about. I felt awful going to work almost every single shift. I never once felt that I was making a difference.

I felt like I was checking boxes.

I felt like I was patching the bursting dam with bandaids.

I felt isolated. As a matter of fact, so much so that only working weekends and nights meant I never once met my direct manager after she had been on the job for six months. Not. Once.

I felt like I was espousing ideals that were no more rooted in reality than a magical unicorn.

I felt like I was becoming increasingly alienated at the bedside, through no fault of anyone but the job itself.

The biggest regret I have about that position is that it’s two years of my life and nursing career I cannot get back. To those who manage, my hat is off to you. You are better than me.

Fast forward to today, and I sit here awaiting my shift tonight. I am filled with trepidation and anxiety. Why? Well, because the bedside is all new once again. I almost feel like a new grad in some respects. The time management, the education, the feeling of being new once again sits front and center in my brain.

Sometimes I just wanna be a secretary again….

I can only hope that as I wind down this orientation that I’ll have that epiphany, that moment of clarity where I realize that it’s all gonna be ok, and that I’ll muddle through these moments only to emerge on the other side a better, stronger, more confident floor nurse.

One day at a time.

Dear Mamas

Only three more shifts remain before the powers that be unleash me on to unsuspecting families and babies in the Postpartum unit. Am I ready? I think so. I mean, there’s really only one way to be sure, and that shift will come on Monday, September 7th, 2015.

In my very brief time on the Postpartum unit, I have made some observations. Some you may agree with and some you may not. I’ll share them anyway.

Safe Sleep

Now, let me preface this post by saying that while I am a co-sleeping, bed-sharing mama, I must beseech you new mamas to please be safe while in the hospital. Being safe means you put your new bundle of joy in their open crib/bassinet when you’re not cuddling, cooing, sharing time skin-to-skin, breastfeeding, bottlefeeding, or otherwise staring in awe at the new human being you just pushed out of your nether regions.

Why?

Because moms drop babies.

Yes. They drop their own babies. Moms are exhausted from the trials and tribulations of labor or surgery or the hormonal shift that begins in the postpartum period, along with medications. You may think you would never in a million years drop your baby, but yes, people do. And it’s sad. And it’s preventable. So, do your nurses a big favor: when you feel exhausted and your partner is across the room snoring in his/her fold out chair or bed, please put your baby safely into the confines of the open crib/bassinet, or better yet? Call your nurse. We will be happy to do it for you.

Not only do moms drop their babies, but they fall asleep with them in their beds. Hospital beds. Beds filled with unsafe linen, quilted pads, sheets, pillows, blankets. Babies can become trapped between mom and the side rail, mom and excessive sheets, and yes, mom and her breasts. Bottom line: please, PLEASE take care when you feel sleepy and tired. When in doubt, take them out…….of YOUR bed and into their own.

As your nurse, I implore you: be safe. Be cautious. Be mindful. When you get home and you can provide a safe family sleeping environment, go for it.

The Milk Maid Cometh

No, mama, you don’t have any mature milk right now. I can’t tell you how many new moms, young and old, experienced and new think that milk is coming immediately after the birth of their baby. Nope. That’s not how it works. That is a fact. I know it may seem that you are putting this newborn to breast for no discernable reason, but believe me when I tell you the importance of it. Every time you bring your baby near, let your baby nuzzle you, let your baby sleep doze safely skin-to-skin, you are sending your milk makers some serious messages. Those boobs are waking up, mama, and before long you will channel your inner Bessie and be the milk maid. It WILL happen. Trust me. I pull up a chair to your bedside at 0300, hold your hand, guide your baby to breast, show you hand expression, gently explaining that this liquid gold you are now producing (colostrum) is all your baby needs right now. No. Really. I promise. Don’t be discouraged. I am here for you. Put your call light on every time you wish to bring that new squish to breast, and I will help you. Why? Because I won’t let you give up quite yet. I’ll look you in your tired eyes and tell you to take it one nursing session at a time. Make it to two weeks, then make it to a month, and you’ll see the elusive breastfeeding silver lining. I know you can do it, and sometimes in the middle of the night when it seems the whole world is sleeping, you just need reassurance that you’re doing ok. And you know what?

You’re doing ok, mom.

Safe Transport

Do your Postpartum nurse a big favor. When you pack for the hospital, please do NOT bring the car seat base. Really. We don’t need to see it. We DO need to see the seat in which you will be transporting your baby, but the base? Leave it in the car. Better yet, make sure it is installed correctly by visiting a local fire station, AAA, or car seat technician. But, please, don’t bring it up to the hospital. Yes, this means you’ll actually have to take it out of the box after the baby shower.

Rooming In

As a newer mother myself, I was amazed at how much had changed from the time I had my son 16 years ago. Back then, rooming in didn’t exist. Now, it has become the norm. Why is rooming in so important? Well, if you’re breastfeeding, the best thing you can do is keep your baby close by to initiate feeding, learning to read their subtle cues. Rooming in promotes bonding as well. Now, all this aside, please don’t be afraid to put on your call light and tell me that you are absolutely exhausted and need a break. Just an hour or two. Sleep is elusive in the hospital. You’ll never get the opportunity to have a break like this when you go home, and in my humble new Postpartum nurse opinion, a couple of hours away from your baby while you sleep isn’t going to make or break your bonding experience and likely won’t mean costly therapy for your child, either. It’s ok, mom. Need a break? Put on your call light. Don’t worry. We WILL bring your baby back to you when your precious bundle begins to root at your nurse’s breasts or tries to eat their hands.

I’m sure that as I make my way down the Postpartum road, I’ll have other nuggets to share, but for now, these are the big ones. Most of all, new families, be kind to yourselves. Allow yourselves to take a collective cleansing deep breath. Slow down. Rest. Tell the rest of the world you’ll see them later. You just built a family and that takes a lot of energy.

Don’t worry. Your mother-in-law will be waiting when you get home to remind you of all the things you need to do. Until then?

Put on your call light if you need me.

180 Degrees

What’s that trite saying about teaching an old dog new tricks? Well, this old dog is about to learn a few.

I have officially re-entered the nursing workforce. I’ll admit, it is a bit sooner than I anticipated, but when an opportunity comes knocking, and it’s one that you’ve been waiting for, it’s usually best to open the door, greet it with a smile, and let it in.

I am returning to the bedside.

I thought long and hard about what I wanted out of my future nursing career, and after a nice break, I thought long and hard about what I didn’t want as well. I think it takes a strong nurse to know what he/she wants, and an even stronger nurse to know what he/she can never do again.

I can’t do geriatric nursing anymore. I just can’t.

And I definitely can’t do management. No. Fucking. Way.

Those two combined were enough to make me seriously consider leaving the profession entirely. I wasn’t even sad at the prospect of never feeling my stethoscope around my neck again or wearing a white management lab coat. I wanted out with a passion. At the very least, I knew I needed a lengthy mental and physical break from both of those pursuits.

Geriatric nursing is its own animal, and that animal isn’t always inside the walls of an assisted-living facility or nursing home. Geriatric nursing likely resides in just about every area of adult nursing, but when it came down to brass tacks, I just couldn’t be the nurse to care for these patients.

I realized I could no longer face a shift where my patient was unable to either communicate or comprehend teaching. I could no longer allow myself to be used as a punching bag. I could no longer watch these patients in the wee hours of the night hang on yet slip away. I could no longer manage the compassion needed to deal with unrealistic familial expectations. As a manager, I could no longer look my nurses in the eye and feed them a line that I felt was complete bullshit. I could no longer allow myself to spew the corporate tag line as a way to justify the bottom line. I felt my nursing self slipping away bit by bit. I very literally nearly lost my nursing soul. I lost the will to survive as a nurse. I hated every second of it and didn’t care if I ever returned.

I was blissfully happy as a mom and a housewife, and I still derive great enjoyment out of it. I didn’t miss nursing one single bit, but there was this small part of me that wondered if there wasn’t something out there that was meant just for me. The nurse was in there gnawing at me to find my sweet spot.

Back in mid-April I applied for a Postpartum nursing position at a local hospital. I told myself that if I were to return to the bedside, it would only be in THIS capacity. I was finally beginning to feel those pangs of anticipation and excitement that can only be found when applying for a nursing job that I REALLY wanted. I realized quickly that THIS nursing, THIS population, THIS position was the one I desperately wanted. Time moved slowly, but finally I got the call I had been waiting for.

I got the job.

I. Got. The. Job.

Shit.

This changes everything. I am re-entering the nursing world in a brand new capacity. I am doing a complete 180 and will now be caring for new moms and babies. It’s rare when life and career meet, but I feel that this is exactly what is happening now. I’m going to get paid to help new moms with what is possibly the most important event in their lives. Postpartum nursing just got its newest nurse.

And I couldn’t be happier.

To the nurses and managers I leave behind, I thank you. Thank you for being some of the best I have ever worked with. You know who you are. To fellow managers who survived many a corporate meeting with nary a side-eyed glance or heavy sigh. I salute you. I hope you institute powerful, much-needed, positive change in the organization, and you know what? If you don’t, that’s ok, too. Sometimes it’s just enough to survive the bullshit and come back for another day. To the bedside nurses I had the pleasure of working with at the geriatric bedside as both a nurse and as a manager, I will miss you, but I won’t miss the kicking, spitting, shouting, expletives, falls, unruly families, Care Experience, Rounding for Excellence, GRASP acuity scoring,  shenanigans.

Okay, maybe a little….