The good and the bad of leaving home 

I’m off to my next assignment soon. Not heading far, as I’ve mentioned. It’s not at home, but it’s close enough to home that my mother is pleased as punch and is already planning visits. Other than pushing my start date back a smidge, it’s not been much that’s made me more worried than normal about beginning a new assignment. Except… 

One of the things I’m distressed/worried/wondering about is how my appearance will be received. My hair is natural and colored plus I’m proudly sporting a nose ring that I have no plans on removing any time soon. Will that cause issues? 

There’s talk of the appearance of the nurse affecting care, or the patient’s  perception of the nurse’s ability to provide care. I’ll save this topic for another post, but where I stand on that is if I treat you with the dignity, respect, and care you deserve, what does a nose ring and hair color have to do with it? 

This brings me around to the topic that’s been brewing in my head since I’ve been home. 

The Good and the Bad of leaving (and coming) home. 

Many new travelers struggle with leaving the first few times. One of the biggest issues travelers face is homesickness. You’re somewhere totally new with people who don’t know you or what your capable of doing a different routine than what you’re probably used to from home. Add to that being in a new city all a lone and you run the risk of spiraling into depression and succumbing to homesickness. Most people quit if it gets too bad. I’ve always loved being on the road so it’s never been too big of deal to up and leave. I battle the anxiety of a new routine, but have learned to remember what I’m capable of and that makes the first few weeks easier to get through. 

I’ve mentioned that I’ve been traveling for three years, and while I like being home, I find it exceedingly difficult. I’ve been examining why and settled on the conclusion that I’ve changed so much that being home reminds me how much. 

Some of the changes are great. I recognize my worth, I know what I can take on without getting overwhelmed, I know what I won’t tolerate, and I know I’m a good helper. I’m a good nurse. Even when I’m anxious about so many things, I know that. I also know I can be an independent person who goes out and explores without needing someone else there with me. 

Some of the changes haven’t been so good. I’ve grown impatient with others, I’ve fallen into some habits that aren’t healthy (physically or spiritually), I’ve developed a potty mouth 😳, and another of other things that I don’t feel comfortable splashing over my blog today. And let’s not talk about my backsliding as a women of God. Everything has consequences 

It’s also tough on relationships, traveling. I find it easier to move on than take a chance when dating is the way it is currently. It’s hard coming home and seeing everyone in solid relationships, having babies when not sure it’ll ever happen for me. Side note: I’ve wondering how my mother would do arranging a marriage for me. Hm… 

Working at home gets tough because I see clearly what needs changed and I can’t tolerate when I see how poorly the staff is treated by those high in leadership. Church is tough too because they know how I was before and I feel like I’m struggling too much to pretend I have it together like I used to. When you’re out in the world that’s when the test of who you’ll be is given. Who am I right now? Human. Admittedly, I know God can use everything and I need to let Him led. I’m still learning. 

Traveling has helped me become someone better and different. That’s what happens when you’re on the move. Am I where I’m supposed to be, doing what I’m supposed to be doing? Yes, I believe that in spite of the struggles I battle against on many levels. I’m stronger in too many ways and I feel like more strength (as a nurse, as a woman, as a Christian) are coming. 

Leaving and coming home is an experience every time. And while I’d much rather stay on the road, everyone has to come home to rest. 

Travel on, Road Warrior 

Bias, stereotypes, and prejudice. Oh my?

In case you didn’t know (and because I’m a closet selfish person who thinks it’s a holiday), tomorrow is my birthday. 

The older I get the more I contemplate things in my life. No need to recap my history, but I’ve been alive long enough to understand some things just by observation. 

Like we can be good, but the bent toward evil plagues us all. For all my backslid ways, I recognize and acknowledge the hand of God and our innate battle to do the right thing. I battle it everyday. 

I also recognize that many times there’s something good that crops up out of terrible situations even if we can’t see it until years later. 

Another thing that is always apparent to me is the role bias/prejudice can play in how we deal with people. We are human and mentally require a way to understand things in our lives. We are prone to classify things in boxes to keep things sorted and that sorting can end up with labels that affect how we interact with our world. 

I’ve harped on stereotype and prejudice because they aren’t the same. One can be harmless and the other can lead to lynchings and shootings. I’m going to give a short, sparkly talk on what’s on my mind and perhaps one day I’ll do a better post on this. 

First my definitions of things. 

Stereotype: super simple view of a group. All women… All little girls wear pink. All men… 

Prejudice: when those views are morphed into something not found in truth leading to hostility, fear, and violence. 

I expect people to have some stereotypical views especially when you’ve never encountered that people group. What gets hard is when people refuse to recognize and let go of those stereotypes. When you can’t see how you may be biased, you can’t understand the struggles of the other group. 

Let me mention my own bias that I recognize. When I’m at work, I automatically see all doctors as nasty demagogues who treat nurses like crap. That’s my experience and it’s hard to shake that particular bias and how it affects my relationships with physicians. When I work with drug users who put their newborn at risk, I also struggle. I also see my own fear and bias when I live in a predominantly white/rural area. It was in a rural area that I had my run in with someone shouting racist epithets. Nothing is scarier and isolating than a true terror that comes when you aren’t sure if your skin color could result in someone attacking you. I’ve met many welcoming people, believe me! It’s not an unfounded view, but it’s hard to shake it when I’m somewhere more rural. 

I struggle against my bias. Mine is more of how the behavior of others can hurt me, but I’m sure I hold other beliefs that make me avoid helping those I should. 

Our current social climate is tense. We as a people group don’t realize how deep our collective bias/prejudice runs. We can’t see it so we don’t change it. In movies, it’s the automatic roles that those of color or women fall into and the way we don’t question it. The gangster, the bimbo, the ghetto queen. Those stereotypes stem from our own incomplete understanding of people.things rutted in age old beliefs. 

Bias can and does affect certain people’s ability to get a job. How many studies exist showing how equally qualified individuals are side by side and interviewers don’t even give the person with the more ethnic name a chance. People argue that it’s the company’s right, and I’m not disputing that. What I’m trying to get people to see is that the bias exists and people are ignored and put at a disadvantage because of it. 

We all like to believe we are sinless when it comes to sexism, racism, any ism but the truth is some of our isms are societal and taught. It’s engrained and subtle. We are not absolved just because we say “society made me think it”. We have a responsibility to recognize and change our prejudices. There is no free pass simply because you are a Bible believing Christian. You need to open your eyes and see if your bias is making you treat others as less than. 

For example…

If you ever said,”they should get off their butts instead of leeching off the government and support themselves.” What makes you say that? How is it changing your willingness to be a possible champion? How does it help you to ignore the need in this group? 

I’m no wrist slapper and I’m not here to shine a light in anyone’s eyes except my own. But… If your pupils dilate and you see a little better, everyone wins. 

So, back to traveling, huh?

Travel on, road warrior 

“I’m so glad you’re working tonight.”

Hello from New England. Summer has officially crept in, which means I’m down to 3 weeks remaining on this assignment. It’s all downward slide from here. For me, it means I’ve reached that point where I’m not quite coasting, but I’ve hit my stride and see the light at the end. 

This hasn’t been a bad assignment. Once my anxiety from the previous assignment diminished, I was able to see how this could be a good place to work once they fixed their staffing issues. Honestly, hands down the best physicians/clinicians I’ve worked with ever. Respectful, collaborative, and not condescending. It’s like a dream. I’d take these docs and midwives and add them to my dream hospital. Seriously, you should come work for me because my dream hospital is going to be Ah-Mazing. 

I’ve oriented a lot on this assignment, which is strange. I’m a traveler, how am I going to teach you what you need to know to do well at this facility? I mean, I can show you how to manage a labor, but the individual intricacies of your work place? I just know enough to make sure I don’t overstep my boundaries as a temp worker.

I have knowledge and experience specific to L&D, but I’m no teacher anymore. Okay that’s not true. Once a teacher, always a teacher especially as a nurse. I just don’t always feel comfortable teaching as a traveler. Telling you what I know to be true in labor and what your facility wants isn’t the same thing. 

A girl I’ve oriented here told me the day before she was always glad to see me at work. She said she felt better because she knew I knew what I was doing. That made me feel… Like a grown up. Haha. 

I’ve turned into someone a younger/newer nurse could look to for advice? When did that happen?? 

What I am is an encourager. I like to cheerlead new hires or transfers to a floor. I like to tell them they can do it because they can. I like to offer words of advice and a smile that says go get ’em. I like to ask if they are doing okay and need help because it’s nice to know you have back up in a crisis. 

I’m still learning and my true teaching days are on hold, but (like I said) you’re never truly done teaching. It’s exciting and challenging to realize that 10 years in, I’m not a baby nurse anymore. Someone is glad I’m working that night because they know I’ll help. 

Here’s to teaching and being always teachable. 

Travel on, road warrior 

Acknowledging the past, not ignoring it. 

It’s the start of week 9 here and it’s been a lot of radio silence. I apologize for that. Some could be the result of residual indifference I feel on this assignment. 

Odd to be feeling that way because in many instances it’s really not been bad. Great providers! Shoot, many doctors expect to be called by their first names and seem to listen and respect both the nurse’s opinion and the patient’s desire for a vaginal delivery. They tend to hold out on surgical intervention until it’s absolutely necessary, which I appreciation. I’ve not encountered too many high risk instances here that feel outside of my particular level of expertise. Even faced with such a nice set up, I still battle some of the worst anxiety I’ve felt in a long time, don’t really feel that usual connection I get at work, nor feel any desire to remain there that I usually consider at this point in my assignment (when things haven’t been bad). 

I can’t put my finger on it, but I know with 5 more weeks remaining, I’ll be moving on to somewhere else soon enough. 

Ambivalence aside, I wanted to discuss something that I encounter a lot as a labor nurse. And no, it’s not the self-important anesthesiologist who seems to expect the nurse to wait on him hand and foot. That’s another post… 

I’ll get a patient for admission, someone at the end of their pregnancy and in a committed relationship with their husband/significant other. I’ll start to browse through their history and read something that goes a little like this… 

Patient has (an STI/history of drug use/something serious in their past), HUSBAND DOES NOT KNOW. 

Uh oh. 

This puts me in a spot where I have to attempt to get a clear history, including medications they are on and sexual history that may affect the baby, but I have to figure out how to do it with them in pain as their significant other supports them. 

I understand what it means to have a past you don’t want to discuss and how it would be hard to bring it up, but I question the level of trust you have with someone you’re married to if you didn’t feel safe enough to reveal a big part of your history that directly impacts them. 

The basis of a marriage is trust and adding a child to that is asking for more trust between the two of you. Opting to withhold things that could damage established trust when it came out later could be detrimental. Is it a matter of acknowledging you’ve picked the wrong partner or exploring why you don’t trust them enough to reveal yourself? 

Plus you’ve got me in a bind as your nurse in trying not to be the one to ruin your relationship by accidently spilling the beans. Revealing secrets and ruining marriages, I’d like to not to add that to my résumé thankyouverymuch. 

This makes me think of things I still keep hidden. It’s hard to open up, but holding back when you’re in an intimate relationship (friendship, family, love relationship, discipleship group) can definitely breed more mistrust when truth comes to light. I guess it’s a matter of creating that space in your relationship to be honest or asking what holds you back from honesty. 

Bottom line: don’t make me have to be your secret keeper in labor. I’m not a good liar. 

Travel on, road warrior. 

Skill set talks 

And laziness (sits at the desk and does nothing) walks. 

I’m holding off writing another post for… reasons, but something else is on my mind anyway. A little self reflection after being home for a bit. 

In case you didn’t know it, I’m a little bit of a perfectionist. I’d not go so far as to call myself type A, but I’m definitely an overachiever. Perfectionism, for me, has a tendency to devolve into personal nitpicking and self-criticism. Anxiety and depression are also symptoms. 

I say this because I’m really really sensitive to other’s talk and behavior. Which includes talk of other people. Who’s lazy or doesn’t pitch in or not a good clinician. I pay attention, wince, and force myself to work harder. 

The desire to get it right every time can make me overextend myself. I never ever want to be spoken about by others as the lazy/unsafe nurse. They’re always talked about at work because they do more talking than actual work

I fear being seen that way, but know I’m not a perfect nurse. 

Every shift ends with me remembering something I forgot to do that I promised I would, me rehashing events and seeing ways I should’ve done better, or me feeling inadequate because I failed to measure up to my personal standards of care in even the smallest thing. That can be crippling and it’s something I struggle against daily. 

I always say I’m open to gentle correction. If you think I’m lazy or missing critical thinking steps, please tell me as nicely as you can. I don’t want to continue on in a way that puts myself or my patient at risk. But while I’m open to it, I also fear it for the same reasons. My mind can’t help thinking I shouldn’t have missed the mistakes anyway. How critical we are to ourselves at times, right? 

I’m sure I’m not alone in the struggle. It’s a double edge sword in that it makes us strive to be better nurses/people but it also traps us in a cycle of anxiety at work. 

In case no one has told you (or has told you many times and you refuse to believe it), hear me right now when I say this to you… 

You are a good nurse. 

Let go of that attitude that says you have to kill yourself mentally in order to be successful. Do everything you can to make your shift safe and a good experience for your patient, but don’t take every little mistake home with you. You are valuable, important, and offer things that make the floor better. See your potential and personhood for what it is, a way to be light to others. And in case you missed it, here it is one more time: You are a good nurse. 

Read that again to remind yourself, okay? I’ll try doing it as well. No one’s perfect, bottom line, and we all have missteps in our career. Own it, but don’t let it unravel you. 

Travel on, road warrior. 

The good, the bad, and the goodbye 

That’s all, folks. 

6 months total and it ended faster than I thought it would. It also surprised me with how warm this group truly is in spite of some… hiccups. 

It got me to thinking about the last few assignments I’ve been on. Politics exist in every hospital and I’ve really started to come to grips with the fact that I cannot avoid politics. There’s going to be something at every place I dislike. There’s also going to be nurses at every assignment who will rub me wrong. It doesn’t/shouldn’t change my perception of my ability or the care I deliver. 

I realized, too, that in spite of my occasional annoyances, I’ve never truly been on an assignment where I worried about delivering safe care. And while many were slow to warm up, I never felt like I wasn’t liked by the large majority of the people I worked with. Looking at it from that perspective, I can say I’d come back if the opportunity presented itself. No promises because traveling is as changeable as the wind, but there it is. 

I find that assignments that give me the hardest starts tend to be the places I make the deepest connections. I’ll miss a lot of people I’m leaving in the Bay Area. 

I always come to work and that won’t change as I gear up for my next assignment. I’m headed back to my beloved Mass. Plymouth, specifically. Admittedly, I have my usual new place anxieties to work though, but I live for new beginnings. 

So to those I’ve crossed paths with thus far, know you’ve made an impact and I’ll see you soon. 

On to the next big thing. 

Travel on, road warriors. 

Hello, how are you? 

I almost went for an Adele joke, but stopped myself. Frerer Jacques came to mind also, but that has more to do with my attempts to learn another language. 

That’s your random fact of the day. I’ve been attempting to learn Spanish since like June. I’m using the apps duolingo and Memrise. Both excellent, free apps that let you listen/repeat/spell/learn any language. I’m not sure I’ll ever be fluent, but I’m getting better at listening to my Spanish speaking patients and deciphering what they’re saying. 
Why is that even important? Because every person I take care of has a right to be understood and communicated with in a manner that respects them and their health. I hear some nurses say they shouldn’t need to know it, but I challenge that notion. You’d want to go somewhere foreign and know at least one person could understand you and help you navigate the hospital. I want to be that nurse for someone. My current issue is I get embarrassed when I try to speak, but I’ll keep at it. 

Which kinda links to today’s topic. 

I was home recently for a short while around Christmas. Working and keeping my mother from being sad with me being away a lot. Usual stuff. 

Anyway, I’d be out shopping or at the mall or at Kroger and someone would say hello or start talking to me. I’m not super approachable if you don’t know me, but I do smile and reply with a hello back. 

I noticed it happening a ton though. One day at the mall some random older gent started talking to my mom. I asked her who he was and she replied, 

“I don’t know. Just some guy saying hello.”

Then it hit me. I’m not in a big city where people barely look at you when you pass them let alone say hi. I’m in small town USA where everyone says hello to each other and your neighbors will watch your house when you’re gone on vacation 

Living in large cities for the majority of my traveling career means I’ve forgotten that was a thing people do. Speak to strangers. I’m used to mass transit where you stand close, but don’t speak. Where wearing headphones is normal. 

Honestly it was a moment where I realized how different I am. It was nice seeing it but also super odd. It’s no longer familiar to me. I also noted the other things not so good about small towns, but that’s for another post. 

I’ll leave it at it being a nice thing seeing and hearing all the warm greetings. I don’t get that when I’m away and it’s pleasant. The perks of traveling is seeing different things and knowing you can always come home.  

Until I’m home again (in March) 

Travel on, road warrior. 

Stop me if I’ve said this: nurses who aren’t satisfied leave

Actually, just go on and let me talk. 

Day 4 of orientation and I’m still processing my feelings about day 2. Day 1 or 2 tends to be the day upper management and administration speaks so you know what was discussed as per the last post. 

Anyway, one thing I got stuck on was JOB OWNERSHIP. 

My loose definition of that is a sense of pride that comes from doing what you do, feeling valued enough in it, that you remain and are retained and produce out of your satisfaction with your work. You promote your business as though you’re the CEO and draw outsiders in because of your love. 

Fancy terms thrown around here are attrition, retention, and recruitment. You hear these terms in hospitals, colleges, big business. Everywhere that numbers play a huge role in the health (and wealth) of an institution. 

So why do people leave? Why do specialized, skilled individuals who went to school specifically to help people leave? It all starts with job satisfaction.

To save myself and you the extra read, check out this article on Why Employees Quit. Go on, I’ll wait. 

That says everything I’d say anyway, but I want to put some emphasis on value. I’ve worked so many jobs and I always think about why I’ve left them. It comes down to value.  My first year out of school I had few coworkers who cared if I sank or swam on a shift. By the subsequent years on OB, I found a family I loved working with, but wasn’t satisfied anymore just working the floor, school followed, and then I started teaching. I left because I felt under appreciated by administration. Yea, the students drove me nuts, but no support and no push to be more burned me out. 

So now I travel and I’ve learned to detect staff dissatisfaction quick. Some of it’s selfish because dissatisfied employees will make terrible coworkers. 

Let me say it again: people who hate their job will not be good team players. 

I don’t have time for that mess so I try creating as much camaraderie as I can. Help me and I’ll help you. But that’s just my own thing. 

They complain about staffing. That the manager won’t come in. What do I hear? No one cares if we put our lives or licenses or patients’ lives in jeopardy. Inadequate staffing sends a message. 

They complain they aren’t valued for their skills. They hear things like “we can train a monkey to do your job.” Comments about people being replaceable send a message. We don’t care about you in your current position. 

Soapbox: First, nursing is a skilled profession and second we suffer from a shortage. You take me with nearly a decade of experience who can hit the ground running or the new grad you have to train. Or you get no one. Pick. But stop treating me as though I’m expendable when I’m not. 

You can tell the satisfaction by the rate of turnover. If you’re losing 14 people in a month and replacing them with 8 you have to train from the beginning, you’re losing. You want to know how you lose? By being forced to spend more money to recruit. Bonuses get people but don’t keep people. You’re also losing knowledge base. It’s your seasoned nurses who leave, leaving brand new nurses with no one to raise them up. 

I could go on, but I won’t. Shoot, I’m not even scratching the surface of what goes into keeping people. Know that employee value is important. Caring about your employees above patient satisfaction is important. If your employees know you care, they will go above and beyond for you. If not, they leave and you’re left with no one to run your business. 

Again, you are valuable. 

Travel on, road warrior.