The Good, The Bad, And The… Meh?

Another assignment completed. That means it’s time to hit the road and head off to my next assignment. Always to the next one with me.

I travel because being anywhere permanently makes even thinking about staying somewhere makes me break out in hives. While I’ve always known this, traveling has made it more obvious that there is no ‘awesome place to work’. Every place has its issues whether they are frank or hidden. The nature of the hospital setting lends itself to problems that aren’t easily solved. It could be staffing issues, management issues, upper management issues, or just interpersonal issues. Something always make it less than ideal.

Not every assignment is going to be amazing because every place has their issues. Not everyone is going to love me or what I bring to the table when I come there to help them. In their eyes, I’m simply another body where they’ve been incredibly short and as long as I’m capable enough they don’t need anything else from me.

Did I love this previous assignment? I started with mixed feelings and ended the same ways. This is one place that I didn’t have a party at the end. Not that a party when a traveler leaves is indicative of anything, but it’s obvious that you’re being there and leaving make a difference when they bother to have something for you. I know I was the only one of my group of incoming travelers that didn’t renew. That’s not necessarily reflective of the place as I always head back east, but I also didn’t want to stay where I felt so indifferent either.

It’s a reminder that you can still be the best you as a traveler even if no one else notices.

I’m rapidly coming up on four years of this travel nurse thing and I’m continuing to learn things. Mostly about myself and what I will tolerate, but also about my skills and abilities. I struggled at times this past few months with feeling unrecognized. As is typical of my personality, I realize I need to at least know someone appreciates me being around to help. That isn’t always possible so I need to remember who I am and what I know. Those things doesn’t change when I go somewhere that isn’t so excited to have travelers outside of filling vacated spots.

So every place, no matter how difficult, has a lesson or a learning point. Whether it’s something that boosts your skill set or something that increases your emotional awareness, every place will teach.

So I’ll keep on to the next thing as usual. Travelers gotta travel and I’m a traveler to the core.

Travel on, road warrior.

Is it too late now to say sorry

First week in da bag. It was looking iffy as to whether or not I’d start on Monday in hospital orientation. They are part of a large hospital system, which is fine until I’m hassled right up until Friday about minuscule paperwork. You’d think a big system would be less complicated and difficult, but what have we learned when anything gets too big? No quick movements and you tend to make a mess of things you won’t bother to clean up.

Anywho, I was able to start and did get to sit through the ever repetitive and ever boring Hospital Orientation. The upside is there was plenty of coffee.

I worried what with the snags I had leading up to starting that the floor was going to be where I’d truly regret my decision to work at the facility. So far (and this is day shift!), no one has been mean and I haven’t had to call my best friend to beat anyone up or my mom to come get me. Hehe.

In the course of my first three 8 hour shifts on the floor, I noticed something. I say SORRY an awful lot.

Now, some of that apologizing stems from my need to project an aura of perfection. Not good, but I want to be and seem more than competent at what I do. I’m always concerned there will be doubt when I start someplace new and I strive (overly so) to squash that perception within minutes of interacting with me. It leads to a certain level of constant anxiety that I have to work through and is a constant struggle. I notice that when it may seem I missed something obvious even when I may not have truly known, I say sorry.

I thought I was just me though. No, everyone says sorry unnecessarily. We apologize for behavior that is natural and doesn’t require it. I caught myself telling others to stop saying sorry. It was something that just stuck me as wrong.

Not that apologizing isnt a good response when you’re truly wrong, but perhaps we should change that to something else.

I’ll work on alternative phrasing, but in the meantime I’ll try not to work so hard at being perfect. No one is capable of it outside of God and I’m afraid I’m only made in His image.

Back at it for week two and off day shift. Waking up at 5:30am ought to be illegal. Hopefully this hospital gives me good experience in all its busyness. I’m here to help and learn so let’s get to it, shall we?

Travel on, road warrior

 

 

Jesus Take The Wheel

So begins my trek cross country. It started rather abruptly yesterday as the worry of snow and ice sent me out the door a day early. I’ll get to that in a sec, but first…

In case you didn’t know, I loathe the snow.

A little background on me (for those who don’t know me), I was born in Maryland and spent the first 10 years of my life in the D.C. Area. As a family, we moved to Bridgeport, WV when the FBI made the big transfer so I’ve spent the large majority of my life in WV. Love it, claim it, call the Mountian State my home. I went to college in the area and worked the first 7 years in a 30-40 min distance from my childhood home. It snows in WV. Pretty much can count on that happening every winter without fail. Most people cope with it well and for a long time I just worked to grin and bear it. Nurses are essential workers so…

And then I started traveling for a living. I love Boston, which is the first place I traveled, but it’s terrible in the winter. One of the worst places during winter months actually. So, when considering where to go next, of course I opted for a place that’s typically warm – meaning no snow. And a yearly tradition is born. The east coast is my place from April through December, but after the new year I’m a Cali girl for 3 months. This is year 4 of heading west

That means, I drive out every other year. So I beg my best friend to drive out with me, we try desperately to avoid the snow, and we sightsee. And eat all the good food. This year is Nashville, Oklahoma City, Sante Fe, Utah, Vegas, and up to San Fran.

As much as change doesn’t bother me, I like change under careful circumstances. Admittedly, when things change abruptly, I become grouchy, flustered, and incredibly uncertain. Yesterday’s abrupt departure definitely put a kink in all my plans for the week. Not only that, but once I arrived something went awry with the hotel and they had no power. That means I was sent to a different hotel. It was one little thing after another that kind left me extremely… not a nice girl.

I was trying to look for a lesson in it. Heck, I’ve been looking for a lesson in the entirety of this year. Here’s kind of what I’ve settled on.

Not a huge Carrie Underwood fan, and really I don’t like the song for a lot of reasons, but Jesus Take the Wheel is one of my favorite things to say when things get a little out of control. Sometimes I say it jokingly and others it’s a true prayer for patience.

Here’s where my Christian roots show even in the midst of my backslid ways. For all I struggle at times, I believe God has the proverbial wheel. I’m the queen of uncertain and right now I’m battling anxiety and obsessive tendencies, but I trust that even still God is working things out. That doesn’t protect me from death, disease, or pain, but it reminds me that His hand guides. This world isn’t a fun place and we can’t avoid the not fun parts even if we’re staunch believers who are kind, love others how they need it, and pray without ceasing. But His hand guiding is still a surety.

Things can go from great to awful in an instant. Life is that way and that won’t change. As much as we complain this year and our privilege in country had insulated us from many of the awful things that could occur. I never want to downplay grief, loss, change, or hard times. This year has been full of it. Next year may not be different, but I can set my mind where it needs to be in order to remind myself of the good. I’m thinking of doing a photo a day next year to help remind me to look for the good things.

As for this trip? I’m going to trust God with the things that make me uncertain. I’ll also keep my hands on the actual car steering wheel because we may run into *shudder* snow.

Travel on, Road Warrior

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 

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. 

Your first name is Dr. So and So

Two weeks over here in Plymouth and so far and cautiously optimistic about how this place will be. In review, this place is an LDRP similar to my home spot. They do between 600-800 delivers a year and have 10 beds, so far smaller than what I was doing in south San Fran. As usual, they are having a staffing crisis that started two years ago and has only gotten worse. 22 people have quit or gone per diem in the last 2 years. That number is insane to me for one floor considering how small they are. 

I had two 12 hour shifts of orientation of which there were no labors so I shadowed a nurse caring for postpartum patients. They were swamped with patients the few days prior to me starting so of course they drop down when I get there to orient. Which means I end up doing labor as soon as I’m off orientation. I can do labor anywhere, heck I can do postpartum anywhere. It just gets dicey when they have a mountain of paperwork I have to try to muddle through. I’m still trying to make sure I’ve crossed all my Ts and dotted my Is. 

I also find their relationship with their doctors interesting. 

After 10 years of nursing, I’m formed a distinct opinion of physicians as a whole. When you’ve been yelled at, belittled, questioned, or had things thrown at you, you allow that to shape your respect for those with DO or MD after their name. I’ve adopted a guilty until proven friendly approach with all physicians. They may be very nice outside of work, but the first time they treat me terribly, I only interact with them as far as work is required. We aren’t friends and we could barely pass as colleagues. I’ll advocate for my patient when we have to talk, but beyond that we don’t have much need to converse. 

This place is different because they have good relationships with their docs. First they happen to be really nice and willing to work with the nurses, and second, they let themselves be called BY THEIR FIRST NAMES. 

Wait… What?! 

I was talking to a fellow traveler and we both remarked on how bizarre that is. Not just that they address the docs by their first name, or that the docs introduce themselves as such, but this is the nicest group of physicians I’ve encountered in my career. 

Someone help me find a flat surface because I feel faint. 

It made me examine how I’ve allowed the bad behavior of previous doctors to make me use the title of Dr as a shield. Part of me understands the natural level respect for someone’s title. You’ve worked hard for that degree so you deserve to be addressed properly. Whether I like you or not, my mama raised me (semi) properly so those with a certain level of authority have earned a certain amount of respect. 

That’s on one hand, but on the other, titles can be used as a way to distance yourself from understanding or caring for someone. They are a doctor so of course they’re prone to arrogance, outbursts, disrespect, and disregard. I’ve been taught to give the barest level of respect, but you’re nothing to me beyond my interaction with you in caring for my patient. Terrible behavior on my part. 

Look, even though these docs seem very nice and personable, I don’t anticipate most physicians to be friendly or willing to be addressed by their first name. I don’t see myself doing it either, but I should try to stop letting my preconceived notions of how docs have behaved to turn me cool to all docs. 

Heaven help me, I’m entering into a new era. I’m going to need some time to make this attitude adjustment/change. 

12 weeks to go. And it’s felt fast even with me working 40 hours a week. Of course I’m already thinking of where I go next… 

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. 

Revisit: What makes a good traveler?

Nearing the end of week 4. Out of the blue, I was required to attend new employee orientation yesterday. This is contract two, by the way. You know my feelings about hospital orientations so I won’t revisit it. I will say my brain can’t handle 8+ hours of listening to someone talk. I’ve always been sympathetic of students in a class room setting because of it. 

Anyway, I wanted to redux a topic. I ask the question what makes a good traveler in the title, but what I’m hinting at is something else entirely. 

What makes a traveler well received on a floor?

Some places you go, no matter what you do people aren’t going to like you. You could be the best nurse and traveler, but they’re in the middle of contract negotiations and travelers (somehow) become a threat to their jobs (not really). That can mean no amount of ability or friendliness will endear you to them. 

The above situation sucks, but isn’t always routine. I’m referring to normal more relaxed assignments. There are ways to ease into the floor without much push back. Here is my short list 

  • Don’t come in spouting talk about how xyz hospital did it better. Not on the first day at least. Most people are used to how they do things and can get defensive with talk about how someone else does it better. Make it a casual comment or a topic of conversation, but don’t make it a way to put the place you’re working down. 
  • Keep your voice (and head) down. Some people are boisterous so I’m not saying dim your shine, but be mindful of tone. The place you’re at may not be the loud jokey type and it can be off putting. Go in cool until they get know you and then shine bright like a diamond. 
  • Don’t brag about the money. No one likes a braggart. Permanent staff already view travelers as cash cow, money hogs out to take take take. You may be there for the paycheck, but don’t make that all they see or hear from you. 
  • Be open to ideas. I mean, everyone does it different, but you may learn the best practice at this place if you’re open minded. 
  • Show your best from the start. People have a perception of travelers. They believe we don’t always give 100% because we don’t have true ownership. Show them you’re serious about your craft out the gate, willing to jump in, and you’ll get respect (albeit grudging initially). 

This is just my perception from what I’ve seen after almslt 3 years of traveling. You can usually tell who won’t survive and who will. Be the traveler who survives. 

It’s not always easy. I’m learning a lot still. Namely when it comes to making more money and being in the best places in the country. This, traveling can be as rich as you want it to be so keep your mind open and you head above water. 

Travel on, road warrior. 

End of the year reflection 

I’m set to potentially work a 16 hour shift this afternoon into the next day plus I work New Year’s Day night. Happy New Years to me, right? Nothing like spending the end of the year and the beginning of the next at work. 

  
But I’m in decent spirits. Every shift ends just like every year ends. Days pass quickly so that even the difficult ones are forgotten after a while. So no matter how trying, it’ll pass. 

   
 I was reflecting on how the year has gone as a traveler. I’ve worked at 4 hospitals (5 if I count starting back per diem at home), I’ve driven back cross country with my family, I’ve taken up a language, I’ve learned a lot about how to navigate the travel world a little better, and I’ve learned that I can be a resource. I’m becoming more well rounded I hope. 

Traveling for a living isn’t easy. I’m recovering from a housing snafu just before I returned for my current contract. While frustrating, it wasn’t overwhelming like it could’ve been. I’m getting better at rolling with it. I can’t say I would’ve been so calm last year. 

  
The biggest thing is I still love what I do. Bedside nursing isn’t fun by any stretch of the imagination and traveling doesn’t change that at all. If anything, I love traveling for the continued freedom I maintain. I can do my job and know it’ll be a fresh, new experience in 13 weeks. If these sets of docs are unbearable, I’ll wait and get a new set to try. I’m not tied to a place and the idea of change has become more comfortable than the familiar. 

  
So, how will 2016, year 10 of my nursing career and year 3 of my traveling career, be? I can’t say I know, but I’m working to add a few important things to my life. Spiritual, physical, and emotional improvement. I guess we’ll see. 

Happy New Years and travel on, road warrior.