Home is where the tasty food is

Alternative title: I came to eat!

So, things I know about myself are while I don’t mind change (I travel for a living!), I do like a little bit of control over how things go. There are travelers who can wait until the last week of their current contract before they start looking for their next one. That can work to their advantage as they find the highest paying at the moment because the need is immediate. It can also be a disadvantage if contracts aren’t plentiful or they are looking in a specific place or, or, or…

Forget. That. Noise.

Did you note my panic just typing out the things that could go wrong waiting until the last minute? All the things. I like some control so I look (and book) early. Some say wait until 4-6 weeks before looking and securing. I’ve gotten my next contracts within 4 weeks of completing my current contract. It’s how I have a little control over what comes next and, if I don’t like where I am or have worn out my welcome, I can say I know where I’m going next.

I start my next 5 week contract in Plymouth shortly. Unfortunately, I have no idea where I’m going next. I thought I did, was sure if it actually, but life is funny, ain’t it?

Anyway, I wanted to talk about one of – and of course I have more than one – my favorite places I have to stop at when I’m home.

Provence Market 

I may only be home for a week, but odds are good you’ll catch me here for lunch one day that week.

Listen, I’m not here to advertise or convince you to like or go to a place, but if I’m home and I want to go someplace to eat, I’m going here.

I can’t say I’m a lover of French food. I tend to think it’s a bit… perfect, pretentious, pompous… over done. But I like the versions of the food they do here.

They do a delicious French dip with some Brie added. A side of house made chips with truffle dip and I’m set.

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Or their Croque Monsieur – American style

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Atmosphere has an upscale air, but it’s not stuffy. Colorful plates with paper across the table, it has a nice feel that’s not off-putting in the lest.

The part I most appreciate about this place is the prices aren’t crippling. That French dip? $9. I don’t know that may be more than most want to spend, but with my eating habits (and subsequent food spending habits) that’s a deal daggonit!

I’ve eaten at more expensive places, but something about this one always draws me back. The heart (stomach) wants what the heart (stomach) wants.

There are places in my home town that I want to boost up and this is one of them. Homegrown restaurants aiming for that big city is worth noting.

Man, I need to change my title to say “Traveling Nurse: baby catching with a side of traveling and eating.”

Next up? Boston Comic Con plus their restaurant week, and then back to work. As always, get out there and enjoy where you are even if socializing isn’t your strong suit. And eat the dang cupcake. Until next week

Travel on, road warrior

Changing Courses

I’ve been the height of negligence when it comes to the blog. I think it’s time to change courses a bit, but first…

My birthday is coming!

*cue confetti falling from the ceiling and balloons popping up!

My birthday has always been an interesting experience for me emotionally. Parts of me dreads growing older, always has dreaded it. Maybe because of fear what the future holds or how much closer it brings me to death. Life is fragile and uncertain. Birthdays can be a reminder that time is speeding along instead of creeping, and for some reason that’s always left me feeling breathless and scared.

I have to actively stop myself from checking for gray hairs, folks! I also comfort myself with the fact that neither of my parents grayed early, as well as the fact that I don’t always look my age. Growing older isn’t a bad thing, but I’m not always ready for that idea. Especially when my mother occasionally asks me when I’m going to have kids. 🤔

One of my traditions, something I’ve done since I was in college, is to dedicate my new year to God. It’s a chance to evaluate the previous year, look ahead to the coming year, and offer that new 365 to God to shape however He wants. It has always added a different perspective to my birthday by changing my outlook in a very purposeful way.

I also celebrate my birthday like it’s a national holiday! That can mean a big international trip or something as simple as a nice massage. It’s important to celebrate self where you can in life.

As for work, I’m finishing up one contract here in Plymouth and then returning for a few more weeks after. I have some travel plans in the works, including the travel nurse conference and a big international trip.

I want to do something more with this blog space. Not monetize it because that’s everyone MO as of late, but I want it to at least be more prolific than it is currently. I’m hoping to write more in general, including reviews for local places and restaurants.

Writing is something I love doing and I just want to offer more of it even if it’s only in weekly doses. So here’s to more traveling, more writing, and birthday celebrations.

Travel on, road warriors

Hospital: a business with a cult mentality

Happy Nurse’s Week

I’m doing my favorite thing in the world; sitting through hospital orientation. It’s difficult not only because I loathe orientation, but also because it’s one I’ve sat through under a year ago. *cue internal screaming*

I’ve come to many conclusions about being a nurse and being in the hospital setting.

1) this is a business.
While healthcare, the administration of care, the care of patients and families shouldn’t be a money making scheme; bottom line is it is indeed a business.

While I don’t like it, hospitals have to make money in order to keep the lights on. Frankly, I’d like to get paid for what I do, so the hospital has to bring in cash (however that looks) in order to pay their bills on time. Part of that is part satisfaction and jumping through hoops to accommodate government entities that control reimbursement.

The unfortunate thing, in my humble opinion, is it makes the conversation more about money as opposed to giving good care. It always comes across as doing something so the doors stay open. Perhaps that’s me being jaded.

There have been so many strides and improvements in healthcare in just the decade I’ve been a nurse. Great advances that I’ve seen in my travels that make me excited for how they increase the health and well- being of patients. Healthcare has to morph to accommodate, but I can’t help feeling that some of the brokenness of the system comes down to how much money may or may not be made. It makes it tough to want to continue in the hospital setting because the last person receiving consideration is the nurse.

Which leads to my next point.

2) nursing is a cult.
Or maybe nursing is a cult because hospitals molded us into it? Stop me if you’ve heard this before…

I remember teaching and thinking that. Like the military, we have rules and a way of thinking far different than laymen. We use terms foreign to most people and process that would make no sense outside of the context of nursing. Even within the different specialties, there is language and behaviors we do. I know a little bit about hearts, but if we start talking arrhythmias then I glaze right over. I know some ICU nurses get weird when you start talking about the fundus.

Where I get kinda, antsy is the loss of self or total disregard of person that comes with stepping into a hospital.

You must do this for patient satisfaction and this to keep the doctor happy. What about me as the nurse? We make up the large majority of the hospital work force, but the once yearly recognition of Nurse’s Day with the occasional gift thrown in doesn’t make me feel valuable or important.

I know, I know I talk about this a lot. Part of why I continue traveling is because no where treats nurses with any kind of respect outside of what must be done to make the hospital happy. For all our knowledge base, no initiatives are geared toward making us important components of the process. Not do this, but you are important.

Maybe this has little to do with cult mentality, but maybe it does. It does have everything to do with satisfaction of nurses. We exit the hospital in large numbers and the shortage is real. Why is that? Why is retention and attrition a continued issue in hospital settings? Why is no one really trying to fix it beyond handing out sign on bonuses?

You want longevity and good patient care? Take better care of your nurses. The hospital that gets me to stop traveling will be special and if they have a good retention rate, I’ll call out all the reasons why.

I can’t help coming back to this point over and over. It seems to bother me more than is should and is part of why I’m constantly debating leaving the hospital setting all together.

Back to orientation. Always back to orientation.

Travel on, road warrior

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.

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 End

Sorry for the radio silence over the last few months. As time has ticked by from week one to week 17 of this last stint, I think I have a great idea for something to say, but then life would get away from me. In the end, what started out as something I wasn’t so sure about ended up being an assignment that I found enjoyable. Having not worked with the demographic common to my home state in a long time, it was good to be closer to home and get reacquainted with the issues of Appalachia.

But being done, the approaching end of the year, and life in general has had me thinking of ending.

Things always end. Always. The recent death of someone I knew drove home how sudden the end can come. Life is finite in ways I forget until confronted with death. How we don’t consider meeting our maker until we are step out of this life into the next. It makes me take account of how I’ve led my life so far. 32 years is long enough to make mistakes, have regrets, have great accomplishments, and joys. What can I say about myself in the end?

On a less morbid note…

I talk often about leaving a legacy. Even if I never return to a place I’ve worked at, I hope I leave behind the impression of a person who works hard. More than that, I hope I leave the idea of kindness in some form. I admit I gripe at work, but I hope my attitude with my patients and coworkers overall is one of helpfulness and giving.

There’s joy and sorrow in endings, but life continues on even in the midst of both emotions. 2016 (a not so fun year) will end. It’ll usher in a new beginning with its ending. It’ll have left its mark, for good and bad.

Remember me fondly even when my mistakes are unearthed. Remember my care, my compassion, my concern, my humor, and my smile. When I’m gone, remember those things because that’ll be all I can leave behind.

On to new beginnings. San Jose after the New Years! Too soon to be worried about anything except vacation.  I’ll try blogging a little more often now. Until then, thinking on your legacy.

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 

The Canea C Family Birth Center

I’m ready to start at the new place, which means I made it safely to Massachusetts after a few minor mishaps. One of which included losing my wallet at the welcome center clear on the other side of Connecticut. But prayer is a pretty miraculous thing because not long after my fruitless searching, someone called saying they found it and would mail it home. Yay!

Starting at the new place also means it’s orientation time again. Seriously, after 3 years, I’ve sat through so many orientations I could run them myself. I stand by my theory that every orientation is the same. “We’re a great hospital, you should feel privileged to work here, listen to all the important people talk”, times two days. I’m just hoping I get a free voucher for the cafeteria. I’m also hoping for no surprise tests and coworkers who treat me well. Fingers crossed.

With the start of orientation, I always think about floor set up. What’s my ideal hospital? Aside from one that treats nurses like they are the backbone of the system and includes them in decisions? Well, when I inherit a windfall of money, purchase an LDRP floor, have it dedicated to me, and design it how I see fit, this is what I’m imagining. Picture it!

The Canea C Famil Birth Center or the CCFBC for short.

My ideal floor would be situated so the nurses can actually navigate the floor and not run down multiple corridors in the event of a staff emergencies. I already walk 5 miles at work, there ain’t no need to add 5 more miles to that because the floors are the length of a football field.

Pods would be acceptable with desks at each one, but i require a better central monitoring system so everyone can see on large screen when patients are having decels. And on the topic of monitoring systems, I need one that’s actually user friendly. What’s that mean? Stop with multiple tabs, charting in a bazillion places, and clicking around forever to find the box or test I need. Lab results should be easy to locate and print. Everything should flow over. Labs, vitals, doctors notes. I shouldn’t have to hunt for that consult. In other words, I need to you actually consult the nurses who work the floor on how to set up the computer system and I shouldn’t have to retype vitals signs so many darn places

I want tub rooms and a home like set up for those who want a natural birthing experience, with the ability to quickly transfer patients to traditional hospital set ups if necessary. I want in house doulas who understand how the hospital works and behaves accordingly. Lobby for your client but meet halfway on how things should go.

What about staffing, acuities, and set up? I don’t think the floor should be split, because patients have the right to remain in the room they’ve delivered on. I believe the staff should be split and rotate. Labor and postpartum. Minimum staffing is 3. Someone to triage/charge, a labor nurse, and a postpartum nurse. Four would be ideal, but I know that’s not feasible in non-ratio mandated states. You staff up as the number of labors increase. You can run two labors if they are early or do two inductions at nights. One becomes active so you hand it to the free nurse, labor/deliver/recover that more active patient, transfer her care to the postpartum nurse, and then take your previous labor back over or open yourself up to assist with triage/take a new patient. The free labor nurse can triage (if needed to help charge), assist with breaks, take postpartum patients. So if you have a scheduled section, an active labor, 2-3 couplets you’d staff 1 for charge, 3 to do labor, 1 to do postpartum = 4. Your section has a buddy in the free nurse, you can have charge be present for immediately after the vaginal delivery (until baby is out and okay) or have your PP nurse second the vaginal if the charge is busy. Everyone gets a turn as postpartum or labor, and you don’t get out of helping!

This means, no gyno patients. It also means you’d increase staffing for the number of labors/couplets. 6 couples is two for postpartum, 3 couplets a piece with them free to take a 4th each. 3 labors is 4 nurses for labor. You’re always one labor nurse over to buddy or take a patient. Anyone in early labor can be doubled if you’re busy and staffing is short.

I want CRNA’s on the floor, rounding for epidurals. They are sooo much easier to work with than regular anesthesiologist. I also want all doctors (OBs and anesthesia, also surgery in some form) present in the morning and at night for board report. So you know who’s a possible c/s, epidural, rapid progresser. Everyone is in the loop.

I want a modified bedside report. Report the brunt at the desk and then go together to greet the patient and examine lines. Off going nurse writes names on the board.

I’d love a better reward system for nurses who excel. Something that really breeds ownership. Meetings that are convenient for all the staff. An opportunity to grow with mentorship programs. New staff orienting to all aspects of obstetrics. Start by making them the second nurse for deliveries so they are more comfortable handling neonates at delivery, progress to monitor reading and caring for laboring patients, then recovery period, lastly postpartum. Then training sessions/ didactic that fills in the learning gaps. Learning PPH, Mag administration, preterm labor, etc.

I also believe that sending staff to training outside the hospital is imperative. AWHONN conferences, Lactation consultant seminars, or whatever educational things would enhance both the nurse and the floor.

And no more than 2-3 groups of doctors with 3 doctors in each group. I don’t have time to figure out who is on and when. Keep that mess simple. Also, more midwives! Good ones who understand practice and their limits. I’d love for there to be a midwife in triage or a OB hospitalist. They’ll be in house at night, available for precipitous deliveries, and just to make it so I don’t have to wake up that doc I dislike talking to all the time. Can I have an in house pedi to attend deliveries when needed??! Yes, I can have that.

Whoa! This got long, didn’t it? But seriously, I could go on and on. And on and on. This is just my quick ruminations of what it would be like if I was ever in charge of anything other than myself. A girl can dream, can’t she?

Here’s to a world where i dream big and get what I want.

Travel on, road warriors

The struggle of work 

I’m down to 8 more shifts and I’m ready to move to the next thing. 

Lately, I’ve been overwhelmed by feelings of work fatigue. More accurately, I was wondering if maybe I should give up nursing all together. I’ve truthfully considered being a bartender or a travel agent because after 10 years this has stopped feeling good to me. 😣  I’ve been frustrated, irritated, anxious, and unhappy. I’ve also felt less than confident. 

On the topic of confidence. I’ve always needed affirmation in order to feel sure in what I’m doing. A lack of it tends to be what breeds dissatisfaction in me and the need to leave whatever job I’m in. It’s not a matter of not being sure about what I’m doing, but internalizing even the smallest criticisms and letting them chip away at my confidence. Traveling has been amazing for my confidence in that experience has proven I know what I’m doing. I can transport what I’ve learned anywhere. 

But there are some jobs that wear you down. Some that no matter what you do, you can’t do enough. 

I realized my fatigue is both a combination of not enough breaks between assignments just to be, too many coworkers who are critical (in a classic example of nurses tearing down instead of building up), and the high mental requirements of my speciality. 

I’m burnt out and that’s dangerous to my mental health. I can’t fix critical colleagues. Only thing fixing that is a completed assignment (soon). A full break may not be possible for a few months yet because I have a PRN job I have to go to between assignments. But… But I can find some mental focus to achieve renewal. 

It’s impossible to not let everything get to you. The questioning of my practice, every difficult labor, every difficult family, every difficult shift change report, very snippy comment from a doctor. They dig deep and leave more marks. I go home and stew over it instead of shaking it off. 

I have to remember my personal practice and stop letting every comment or mean colleague bother me. I’m not perfect and get it wrong sometimes. So I’ll work on staying humble, staying aware, staying calm, and staying in the game. 

To remembering the joy of the job, 

Travel on, road warrior.