trauma drama.

I know this this is gonna come as a shock, but I am seriously considering a job offer in a Surgical Trauma ICU at a level one reigional trauma and burn teaching hospital.

I know, I know.

What happened to CVICU Bitch Goddess dreams, Jamie?

Well, you'll be happy to know that those dreams haven't really gone anywhere, they just might need to be delayed in favor of Mega-Awesome Hardcore Trauma ICU Job That Will Kick My Ass.

I really hadn't given serious thought to changing my specialty. Believe me, I was like, 'CVICU or Bust' last week.

The problem is, CVICU at Happy Hospital where I currently work (and despite the bitching, actually really like) was dragging their heels about an interview, and Lofty University Teaching Hospital 's CVICU isn't hiring.

So, I decided to go for what I thought was a second choice, and interview at a hospital I like to call 'Crack Ho's Evil Twin's Inn'--the facility best known for its sexy, hardcore ICUs on the one hand and "charity care," on the other."

Nota bene: "charity care" is hospital corporate speak for "We treat all the crack/meth heads in town." And "sexy, hardcore ICUs" is Jamie speak for "And then, all the crack/meth heads go directly to stepdown or MICU, so TICU doesn't have to take their crappy overflow.")

Suffice it to say I wasn't stoked about that patient population (we often get this hospital's overflow "fake chest pain for narcs" at Happy Hospital, and we begrudingly joke, "Why couldn't Heroin Addicted Bitch go have her totally fake chest pain in [Crack Ho Hospital's] ER?")

Not a place I ever thought I would consider in my ugliest nursing nightmares, in other words.

So, how did I get lured over to the Dark Side?

Well, it certainly wasn't the money (ugh, staff wages again!) nor was it the opportunity to become, once again Vampyre/Shift Work Disorder Bitch Jamie (night shift, alas).

It was, however, a pretty impressive interview and tour, and the unit manager talked up this unit, and every single nurse I've talked to thinks this is the sine qua non of ICU experiences in the metropolitan area.

Plus, the Mega Geek, Mega Type A Bitch in me got seduced by the elitism of it all. This is the floor for which the hospital built a brand new wing! This is the floor that typically has a waiting list of RNs! This is The Floor.

Any way, that was the schtick and schmooze I was sold on, and believe me, that manager must've had my number down when she looked at my application and saw what a dork I was, going to all that school.

I like sick hearts and open heart surgery better, but, I think I'd kick myself in the ass later on if I didn't take this job.

And, I knew, no matter how painful and sleep deprived next year is gonna be, that I was meant to be an ICU nurse when I saw intubated, vented sedated patients on a dozen drips, with more invasive lines than Jesus had disciples, and the first thought I had wasn't "My God! Run away! Run far, far away!" but rather, "RAWK! Patients who can't talk to you or get out of bed! No ambulating those poor bastards to a commode! Beautiful!"

Don't get me wrong. The sight of patients more complex and sicker than any other patients I've ever seen terrified the shit out of me.

But, sick bitch that I am, it was also kind of... well, my version of interesting nursing, where the focus of nursing care isn't a stroll around the nursing unit for a post CABG patient, it's the patient's illness and management of their comorbidities, period.

I feel I'm a better nurse when I don't have to talk to the patient, and can focus on things like memorizing their lab values. I'm not a good "talk and teach" nurse, who's into stepdown type activities like progressive ambulation and breathing exercises. I find I don't care that much about coordinating their discharges with social work to skilled nursing facilities, or any of that psychosocial crap.

On the other hand, give me the medical side of the nursing bullshit, especially on a patient who's about to go south, and I'm all over it.

Like, if I were a patient on stepdown, and I somehow had some version of me as a nurse--I'd think I was kind of bitchy and perhaps, even a bit clueless about stuff I wanted to know about, like whether or not I'm going to get my dinner tray on time, or if I can get up and go to the bathroom.

But, I'd want a nurse like me around if I was on a stepdown unit, getting acutely sicker. Sure, I'd probably remember to thank the sweeter, nicer nurse who arranged my pillows in exactly the geodesic dome shape I had taken the trouble to diagram prior to my hospital admission. On the other hand, I'd be around to thank her because Bitchatolla Jamie Nurse--who I only vaguely remember as The Bitchy Nurse who barely took the trouble to conceal a sigh of deep annoyance when I asked to be ambulated to the commode--was around to get me back to the unit before I respiratory arrested, or something like that.

I'm not saying ICU is gonna be bullshit free, because if anything, it's gonna be more bullshit. But, at least it's gonna be highstakes, hardcore bullshit, and not some lame drama over a patient who didn't like what the brand of yogurt that had been brought up on the dinner tray.

And, I'm going to probably suck at my job, and feel incompetent for at least a good year after orientation, and this is probably good for me, so I can remember those sweet, innocent days of stepdown nursing and all the complaining I did over largely stable patients.

Well, any way, all this is outloud talk. I reserve the right to tuck tail and pass on picking this particular professional poison, and stay at Happy Hospital, on Friendly Fun Unit, with my peeps, all hanging out and joking for at least part of the shift. After we ambulate our patients and tuck them into bed for the night, that is.