Saturday, September 17, 2016

On Doing That Thing I Do

There was a time in my career when I would walk out of the Emergency department at the end of my shift on top of the world. Actual physical excitement, and I remember thinking on several occasions, 'I can't believe I get to do this job!' I was the luckiest girl in the world. This was all I had ever wanted to do. And now it was here and it was everything I thought it would be and more. Fast forward a few years and the enthusiasm wains. But I've become damn good at what I do. And I'm still proud of what I do. I tell people, I save lives for a living. And it's true. Fast forward a few more years and I'm crying on the way in to work and sitting in the parking garage for ten extra minutes trying to force myself to go it. I get home and can't wait to take my scrubs off. Because I'm so excited to not have to be a nurse anymore that day. I'm tired.

A couple more years. A new state. More sunshine. More freedom. I no longer cry on my way into work. I don't hate my job most days. The fact that this feels like 'success' the fact that I don't loathe my job anymore feels like a win? That's depressing af. I see new nurses and student nurses in the ER and they're so excited. So passionate. And I tell them to hold on to that for as long as they can. They smile because they think I'm joking, but I'm not. I'm not mocking their enthusiasm. I'm giving honest advice.

My uber driver this morning asked me if I liked my job and I told him, "Some days. And some days I wish I'd gone to beauty school." This is not a knock to people who have gone to beauty school. Those who know me know that the people who do my hair are two of my most favorite people, and people that I hold a great deal of respect for. Both for the amazing work that they do and the hard work they've put into their careers, their art. It's something I'd thought about doing once upon a time however briefly, and sometimes I wish I'd done something else. Anything else.  But what I told my uber driver this morning wasn't wrong. I do like my job some days.

I just got home from the Emergency Nurses Association Conference. Three days of classes, mediocre food, and a whole lot of free pens, lunch bags, water bottles, and even a reusable ice pack. I have only been once before. A few years ago in Tampa, FL. The conference is annual, and after the first one I was so rejuvenated and loved it so much that I wanted to go every year. But life happens and work happens and I haven't been since. The thing about the conference is, it kind of feels like church for your job. You go to church on Sunday, you get spiritually fed, and you feel like you can make it another week.

You go to ENA conference and you get your shriveled, blackened, jaded little ER nurse soul revived. You feel like you can go to work another week. Because there is a reason you wanted to do this. That reason gets lost sometimes. twelve years of being yelled at, spit on, verbally abused, threatened, and belittled by patients contribute to that. But that's not the only contributing factor. Even through all that, most of us got into this business because we wanted to help people. We have a skill set and we have the determination to help people even when they're at their worst and most vulnerable. One thank you from a sweet little old grandma can undo a week's worth of abuse from other patients and their families.

The thing that's harder is the 12 years of being understaffed, under appreciated, reprimanded for not checking the right box on a chart, for charting but not scanning the motrin that the 18 month old spit all over your hand. Treated like a petulant child by management and administration. Nurses and doctors are no longer resources. We are commodities. We are disposable operators of the electronic chart robot who exist to click the right boxes so that the hospital can get paid. Oh, and hand out narcotics and turkey sandwiches. So that the hospital can get paid. That's not healthcare. That's not what we signed up for.

And so there's a disconnect. There's conflict. You get tired. And I don't want tired to be my story. Instead of coming to work excited every day to see what I got to do and then leaving feeling like I have the greatest job in the world, I just come to work. Sometimes excited to see my friends. I survive a shift. I fake a smile. I fetch all the turkey sandwiches and narcotics. I do the ordered tests that are unnecessary because it doesn't matter if we as doctors and nurses all think they're medically unnecessary. That's not what we're paid for. We're paid to make sure the hospitals and insurance companies get paid. And to not get sued in the meantime.  Does anyone know the ICD-10 code for holding the hand of the young woman who just got told she had cancer? What about for hugging the 95 year old man who's going home without his wife for the first time in 60 years because she died? What about the ICD-10 code for watching a patient walk in and knowing to put the crash cart outside their room because something isn't right, and you know that just from a glance. Where's that box to click?

What do you do when you 'like' your job 'some days' but you can't imagine what else you'd rather do with your life? I don't have any permanent answers. I can tell you that one thing you do is you go to these conferences. You read books. You watch TED talks. You realize that your issues are not only your's. There are people from across the country, and even Sweeden and The Netherlands who feel the same way. You listen to talks from physicians who feel the same way and have a Facebook following of hundreds of thousands of people who feel the same way. You learn new skills to cope. You get the strength in your ER nurse soul revived, and you get the strength to try again.  And then you go back to work and you take care of the people. You do what you got into this business for. You do it for those people. And you try to check all the boxes to make the desk people happy, but you take care of people for the people. You do what you can. And that's all I have for now. But it's enough.