I can work with that

And I’m a year older!

We’re post birthday (welcome to me in Year 33), and I’ve already veered off my tentative blogging schedule. My original intention was to have a twice a week posting, and last week didn’t produce said activity.

Look, I’m not going to sweat a schedule. I’m just going to be happy I manage it at all. We can’t be picky when we’re out here seeing the world. I’m conquering town, cities, states, and countries over here.

In case you’re wondering, my weekend was filled with pickles and lots of food. Picklesburgh, set on the Roberto Clemente bridge near PNC Park, was an interesting experience that reminded me of why I love the opportunities that traveling provides me. And why I’ll never have pickle lemonade if I’m ever offered it  🤢

You can see a lot by going not so far from home.

Pittsburgh is a short jaunt up the road (hour and some change depending on how long it takes you to drive), and the short drive brings you into a city with its own culture. Steel City, the home of Heinz, a city with a history rooted in industry that’s shown itself to be far more.

It’s interesting to cruise around a city that at times feels like it’s struggling to grow out of its industrial slump. I’m not going to lie, it reminds me of D.C. and it’s constant struggles with gentrification. The rundown houses butt right up to the hipster breweries. That’s any major city though, so I can’t fault Pittsburgh for the pains it feels at times.

East Liberty has a huge Target that seemed to draw people from far and wide into its doors. You pass the orchestra house and the ballet, both tucked into buildings that appear to have one time held factory work. Lawrenceville is home to many a hipster restaurant, and is the setting for an ice cream place whose idea, I was informed by someone, originates from Thailand. Check out NatuRoll, if you’d love some ice cream with a side of fanfare. Head over to the strip district for cool bars and a great (and wicked busy) Argentinan place. Gaucho, oh Gaucho, delicious food that makes your little heart sing. Stuck near the airport? Head to Settlers Ridge for Giant Eagle… I mean, a strip filled with stores and food to keep you entertained.

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Stuck at home? I believe every city has its strong points. There are things I do like about home and I’ll have to express that in a post sometime. The thing to remember is getting out. I don’t know how many native dwellers have told me they’ve lived somewhere their whole lives and never visited any of the major landmarks.

If you can’t travel, explore where you live. There’s simply no excuse. Festivals, farmers markets, parks, trails. Free, free, and free. When you know it, the city leaves its mark on you, so let it leave its mark.

In the immortal words of Stephen Stills, if you can’t be with the one you love, honey love the one you’re with. 

I’ll take my own advice every time I’m home.

Travel on, road warriors

Week 9: “So do you plan on doing this for long?”

4 weeks left! Time flies when you’re having fun, and in all honesty I can say I’ve enjoyed Ventura. It’s a gorgeous area! Not so close to LA that you’re battling terrible traffic every day, but a place with plenty to do. I’ve gotten in quite a bit of exploring and a whole lot of eating. I sent lovely beach pictures to the fam to help them through the winter. I hope they’ve appreciated my efforts! 😋

Anyway, I’d like to discuss a question I get a lot as a travel nurse. It’s one that I find a little weird, but maybe it’s because I get wanderlust quite badly.

“Do you see yourself doing this for a long while?”

Why, yes. Yes I do.

That’s the short answer and the long answer is just as easy. I’ll travel for as long as I’m able, and to stop seems silly when historically I get antsy every few months anyway. Travel nursing is equal parts thrilling adventure and intense comfort zone stretch. What else can I do that allows me to care for a diverse variety of people, learn new skills regularly, improve on old ones, all while exploring a new city? It’s always fresh, always exciting, and that bit of anxiety pushes me to be better in my practice.

I pick up the best ways to do things because I’ve seen a lot. I learn evidenced based practice, techniques for decreasing discomfort, excellent ways to assist in descent of the baby, great pushing methods, interpersonal skills, conversational skills, and so forth.

There’s no chance for stagnation to get you!

It’s a fresh start just when I’m staying to get comfortable. Travel nursing requires you to be okay with change because this is rife with change. I find the change scary and energizing I need it to a certain degree. It stops that frustration and dissatisfaction the occasionally rears its head from getting the better of me.

I realized a long time ago that I was the type who thrived on seeing or doing something different. I’ve been a traveler with that need to explore for years. For a long time, that only played out in my leisure travel. Once it because an integral part of my travel life, I wondered why I hadn’t started sooner.

In many ways, I’m trying to prove to myself that I can do this. I can go anywhere and work. I can be a capable no matter where I am. My abilities and skills aren’t restricted by location or patient demographic or socioeconomic status. It’s proving to myself that I am a good nurse in general.

But honestly, why give up seeing new parts of the country? Why give up the freedom to vacation when I want? Why give up learning new things? Why give up trying the delicious foods?!

Mon brainer here.

I see myself doing this for as long as I can because how else am I going to get my travel fix? Wanderlust is a serious ailment and the only remedy is more frequent flier miles.

If you could travel, wouldn’t you??

Travel on, road warrior

Your granola is extra crunchy

This is going to come across as scolding or judgmental, but it’s more an observation born of years of nursing practice.

It has no bearing on the care I deliver.

No, it just makes me roll my eyes hard enough they threaten to fall out of my head sometimes.

In recent years there has been an increase in the special breed of folks I’ve labeled the crunchy granola crowd. The movement toward natural methods and care isn’t new. We all try, in some way, to forego western medicine or seek a natural way of stabilizing health. I’m a fan of yoga though at the moment I use it for its dual fitness/relaxation benefit.

Let me say this much first: when it comes to the labor process, everyone has the right to have the experience go how they feel it should go.

I stand by that fact. It’s your health and the health of your child. Ask the right questions. If you’re not sure why you’re being induced, speak up. Many people don’t and inducing a cervix that just isn’t ready means your baby is more likely to come out from above than below! If something isn’t medically necessary, ask why it’s being done. Educate yourself, ask good question, and work to understand the answers given. It’s your health here.

But leave your birth plan at home

The hospital is the Mecca of western medicine practice. While labor and delivery has moved to more hands off methods like kangaroo care, gentle c-sections, birthing centers with jacuzzi tubs, and rooming in/couplet care, it’s still big on intervention.

By coming in, having a doctor, being hooked to a monitoring system, you’re consenting to us taking steps if things appear to be going wrong.

Electronics fetal monitoring is a wonderful thing, but it’s also a double edged sword. It increases our rate of possible unnecessary intervention not decreases it! You’re walking around with low AFI (amniotic fluid index), or the baby has a cord around its neck, or contracting a ton. Not being hooked up to a monitor means you don’t know these things. They aren’t necessarily indicative of poor outcomes either. Many times you go the entire pregnancy and deliver and never know these are issues, but coming in and getting hooked up means we intervene. Just stating fact.

The trouble comes when people step in to a place ruled by western medicine and expect a natural, home birth experience. No intervention, no IV, labor in tub, walk, no medicine, no c-section, no shots, pills, nothing. They arrive with a birth plan typed up on card stock paper with a detailed description of what will happen.

To that I remind you… You are still just a layperson. I know medicine better than you do and WebMD surfing will not change that fact. I’m not saying that to offend but to remind. I don’t come to your office pretending to know how things work, do I?

I’m not the only person who see these people and shake my head. Because you’re so rigid with your expectations, you’re guaranteed to experience the exact opposite of what you wanted.

This is even more likely for the first time mommy who has never gone through the labor process. Labor pains are next level so unless your pain tolerance is amazing. Do. Not. Rule. Out. An. Epidural. Leave yourself open to it in case things become too much. Utilize your methods of pain control until that point, and ask good questions!

Epidurals are generally safe and carry no greater risk of injury than any other procedure.

I’m not saying this to discourage a detailed birth plan only to remind people that as your nurse, I have certain responsibilities.

*I must monitor you a certain amount of minutes every hour.
*I must start an IV especially if you’re GBS positive
*I must ask you about your pain level
*I have to make you sit down if your baby indicates it’s not tolerating labor

Patient advocacy is my aim, but I’m caught between obeying the patient’s wishes, following the doctor’s orders, and striving for good labor outcomes. Those who don’t come in with an open mind (and a 3 page birth plan) make the situation challenging. Don’t forget the odds of serious medical intervention increases the longer your birth plan is.

What about after delivery? There’s this movement lately with refusing shots and care for your child in order to remain natural. I’m not going to open that particular can of worms because it’s hot enough without my two cents. I will say this…

Living in a society as we do comes with a certain global responsibility. It’s very easy to believe the things we do only affect us, but we know that’s not true. We interact with others on a daily basis and that means we are responsible to each other to a degree. Immunization is a topic a feel strongly is group responsibility. We expect others to due diligence when it comes to not spreading sickness, right? We certainly rail against nurses who pass potentially deadly viruses around, but we aren’t the only people in this society with a certain responsibility to the whole. Think on that.

See? I didn’t make fun. Just observations.

I can only do one birth plan patient in a week. Bottom line: they are demanding, both medically and in general. More individual care is required to assist in the labor process and that’ll wear you out!

So have a little flexibility in your labor plan. Be as realistic as possible, ask good questions, and -most importantly- leave your birth plan at home.

Travel on, road warrior