burnt by the sun

So. I was offered, tenatively, a job at Dream Hospital in Virginia, starting in April. CCU (coronary care unit) internship, which means more to learn, and more professional juju.

On the other hand, I was also offered a 41/hr travel job, but it's nights, and I don't know if I can do nights again. And I don't know if I want to gamble with a travel assignment that might end up as crappy as this one.
And, I'm really burnt out on nursing right now. So burnt out, I'm thinking of becoming a Cracker Barrel waitress (it's a service industry job without the unstable, coding people!) or a beer tub girl.

My fantasy job would be to blog for a living, and knit blankets for homeless orphans. And torture useless CEOs by making them lick the hospital floors in penance for screwing over their nurses so richly.

Maybe something good will happen, like the Magic Fairy Job Angels will grant me three wishes, and I'll be able to make money napping, or browsing the internet for more beer tub girl craigslist ads.

wild strawberries

Did any one else know that film director Ingmar Bergman was married five times, and had nine "recognized" or "acknowledged" children?

This makes me wonder about other, obscure Bergman progeny (would it be impolite to call them Bergman bastards?) floating around out there, but I digress.

My job lately has sucked ass. A lot of medical interventions smacking of, "Suddenly, nothing happened!" to quote Colin Hayes' tongue-in-cheek folksy, soulful piece, "Waiting for My Real Life to Begin." Just a lot of evil care, ranging from dastardly doltishness, eg of the Colonel Klink variety, to downright menacing madness, eg of the Colonel Kurtz variety ("The horror. The horror.")

The good news is Other Things in my life haven't sucked ass, and have actually been extremely pleasant and happy. Like this weekend, Someone gave me a big bouquet of flowers and freshly picked strawberries, apparently Just Because. And Someone walked Piper on a dog-friendly beach, apparently also Just Because.

Really, I couldn't ask for a nicer Someone, or a nicer weekend.

a jamie in winter

I wish humans would have evolved to hibernate (or estivate, depending on the climate. I'm an equal opportunity evolutionist that way).

Because sometimes, I think I need to hibernate. Just roll up in a little comfy ball in my bed, pull my down comforter over my head, sink my head into my feather pillow, and sleep for months and months.

I think this would be a good idea primarily because it would drastically cut down on the mental anguish and energy it takes to be me, and even I only got about four months of "not-thinking" a year, that would be one-third less psychic pain than I'm dealing with now!

Well, it's a thought.

nothing, honey.

Sometimes at work, I have moments with patients that absolutely humble me. They're these small, finite moments, almost inconsequential in the grand scheme of things, and the things I'm doing are usually just small favors, not big, life-and-death situations--washing someone's hair, or brushing someone's teeth for them.

This week, I was tucking a little old lady into bed--she was forgetful and kept trying to get up--and she was just as cute as a bug in a rug; a southern lady whose family hailed from Kentucky.

As I was pulling the covers over her, she suddenly sat up, and gave me a hug and kiss on the cheek and whispered in my ear, "Thank you so much; you are so kind and nice to me!"

I hate--and I mean truly hate--a lot of things about my job, but every once in awhile you receive gratitude from a patient that is so genuine it's almost heartbreaking.

Another gem: I had another patient this week, also elderly, who was a retired veterinarian. He was very chatty one particular night, and just kept talking and talking; about his wife, about his grandkids, about Wisconsin. He couldn't stop talking, it seemed.

I had to get some medication for him, so I said, "I'll be right back, honey."

Now, you have to understand, I call all my patients honey. Partially, it's because I can't remember their names at the time, because I'm too busy thinking of five things that need to be done simultaneously for five other patients. I don't mean anything offensive about it; it's kind of like being a waitress at the diner. Everybody's honey.

He said, "What did you just call me?"

I thought, Oh shit. Here we go. He's gonna get all pissed I didn't call him Mr. So-and-So.

I stammered, "Oh. I'm sorry. I don't mean anything by it; I call everybody honey. It's just... well, you know..."

He smiled, took my hand, squeezed it tightly and kissed it, then looked up at me and said in all sincerity, "Thank you so much for that; it's been so long since someone called me 'honey'."

This profession has such a curious way of pervading your soul--the good, and the bad. And it's an ironic, unexpected gift to find out what matters the most to people isn't that we caught a heart attack before it could get any worse or double and triple checked their orders; half the time, the life-saving things nurses do, no matter how critical to the patient's well being--such as catching a fatal med error before it gets to the patient or arguing with the attending to get appropriate orders--are completely irrelevant to their perception of the care that's being given.

And so we go in expecting people, if they thank us at all, will thank us for saving their lives, when in fact what they end up most grateful for isn't the medicine, or the science, it's simply making the effort to connect on a human level.

Patients probably have no idea how grateful and humbled we are by their gestures of gratitude.

I walk a thin line between love and hate every day I'm on the job. Eighty percent of the time I'm working with end-stage population, I lean towards getting the hell out of acute care nursing all together, but when a patient says thank you, and means it, well, crap, just pushes me right back over that line towards the bedside again.

I've come to believe a sincere "thank you" is a patient's way of telling me she thinks I belong at the bedside, even when I think I don't.

if it feels good... do it.

I'm sure everybody's done something completely gratuitous in their lives. Something you did not because you had to, but because you wanted to, and something, moreover, that didn't need to be done again.

This morning, I had two bagels, sesame, toasted just right: light brown. Crispy, with the crunchy goodness of sesame seeds, and slathered with artery-hardening margarine.

I didn't need two bagels. I just wanted two bagels. And I thought, "Why not? You never know when you might eat your last bagel."

The hell with my waistline, to hell with high cholesterol levels, transfats and heart disease. Nobody ever dies wishing they'd eaten one less bagel, or put less multi-colored sprinkles on a third scoop of icecream, or had one less afternoon of crazy-good sex, do they?

And, a corollary:

While there may be such a thing as "too much of a good thing," I'm convinced there's never too much happiness in the world.

Happiness is self-limiting, for one thing. Start to feel happy about one thing, and something else goes haywire. It's like, an unwritten law of the universe.

Also, I've never understood why people are always yammering on about the "mystery of life" and "mystery of love," but not the mystery of happiness.

Happiness, whatever else may be said about it, is mysterious. It works in subtle, almost magical ways at times. It isn't necessarily the same thing joy, or love, or hope... although it may be some of those things, some of the time. Happiness is a funny little gnome, really. If you look at it directly, it seems to disappear, and if you look at it indirectly, it always seems just a little further to your left--or right--than you expected. And when you try to explain happiness to someone else, they don't really understand what you're talking about, just the way I suspect no two people see color the same way.

But you know it when you feel it.

And if eating two bagels at five thirty in the morning is a good thing that makes you happy--I say, do it. After all, mysteries are rarely that easy to catch and solve, especially at dawn, when you're still tired and need to walk the dog.

no ordinary life.

Well, it's storming outside, in a freakish, icky way that makes me wish I didn't have to battle traffic--and geriatric drivers who, even in the most ideal of driving conditions, can't drive worth shit--to get to work tonight. It freaks the dog out--he's hated thunderstorms for awhile now--

I took the night off of work last night. For one, I haven't slept properly in two months, and I really haven't slept properly in about two weeks. I finally slept all day yesterday and last night, and woke up at 6 a.m. feeling mildly refreshed, and amused I wasn't going to bed at the time most people are getting up and getting ready for work.

It's been tougher than usual to be me lately--I blame a lot of it on sleep deprivation-burn out cycle. It's brutal! All I really want to do is get to the end of this assignment, take a couple of weeks off, sleep during the night and be awake during the day like my body and that of other diurnal creatures was meant to function, and get some perspective on what it means to be happy, and not hate yourself because you're so damned tired you can barely function.

And part of me wants to get done with this exercise in hell so I can have some time to reevaluate, rethink, and process a couple of issues that have come up in the past couple of months: like where I want to go with nursing, and if I really want to stay at the bedside forever. If the answer is no, do I really have enough stamina and money to go back to school? How long can I hang out at the bedside before I totally burn out on the system? How do I prevent myself from burning out?

Ideally, I'd work part time, or even per diem. I could be a saner, happier person if I was only committed to a couple days a week, or even three eight hour shifts. These twelve hour shifts are just too much for me, and for every brutal, back-breaking shift I encounter, I need a couple of days off just to get out of that stressed out, manic headspace.

After awhile, you start getting traumatized by even thinking about putting up with more bullshit at work; you start thinking, "Dude! I can't go to work and have another fucking shift like the one I just had, or I'm gonna lose it!" You're already physically and emotionally tired, and just the thought of going in, and having to put up with that bullshit one more day makes you want to pack it all in. When I get like that, I know I need a break.

It's not the kind of job where you can go in and be half-assed. Even if you are doing a half-assed job, it's not good for anybody. And even if you don't want to go in and be Super Nurse like usual, you know deep down inside that if you have a real, true emergency--or even five fakey, bullshit situations--that you can't just sit there and ignore it. You gotta get off your ass and deal with it.

And there are definitely some days when I wake up and think, "I can't be that person. I can't be a good nurse today." There are some days I wake up and think, "I've got to sleep, I've got to eat, and just today, I've got to have one day where I don't have to be The Nurse, or Your Nurse, or Anybody's Nurse. I have to take care of myself, today."

The problem is, I don't take care of myself every day. I can't. It's just too hard, and too much some days. So I don't sleep, or I don't eat properly, because I'm too stressed out, and so tired the thought of food nauseates me. I don't exercise, because I'm just too damn ass-dragging exhausted. But I still drag myself into work, and if I don't, I feel guilty, and worry about the money.

The sad thing is, no one thinks they're going to end up this way--work weary, beleaguered, wishing they had done something else with their life.

We all want to believe we are going to be happy, and have satisfying, fulfilling careers.

Sometimes you don't get everything. Actually, most of the time, you don't get everything, and most of what you do get is crap. But then there's that one thing that can make you feel human and real and capable of feeling again.

We spend most of our lives looking for that one thing, and the sad thing is, most of us haven't any idea what that one thing might be until it's far too late.

crispy critters

I know I'm sounding horribly tiresome, but I'm so burnt out on work, and not sleeping at night! This is the fourth night in a row I haven't gotten sleep at all, and the last two days, I've had off of work. I go back to work in about twelve hours, and I just don't know how I'm gonna make it.

I wish I had a better job, and I even went so far as applying for ICU positions at That One Good Hospital From Last Summer, where they had real evidence based medicine and practice, rather than, "Huh, it seems the attending flushed his pager down the toilet, so I can't give you anything for any of your emergent cardiac issues, anxiety attacks, profuse bleeding through a new dialysis port, dementia, or blinding pain!"

As I said to several of my nurse friends: it's hard to be a nurse who's better at being a nurse than the doctor is at being a doctor. Doctors should, in some respects, be better practitioners--they should be the people nurses trust to get appropriate and timely interventions ordered. There is rarely a time I call a doctor any more that I don't anticipate an order set, and unfortuately, at this particular institution, there is rarely a time I get exactly what it is I think the patient needs.

This isn't me being "too big for my professional britches." Believe me, I ask questions all the time of my colleagues. This is a case of doctors practicing indifferent, harmful medicine, and it scares the shit out of me, because that could well be me lying in the bed, close to death, without appropriate pain medicine, or whatever.

Sometimes I wish I did something less morally questionable with my life, and I know I need to get a job a hospital that is more in line with my own professional ideals and ethical standards.

I personally would think it less morally bankrupt, and a lot more dignified, if I worked at the local strip club as a cocktail waitress. I'd probably make more money, for significantly less stress and moral trauma. And I already get goosed on the ass by demented old men--what's the difference?

As one of my nurse friends said, "Who cares if we're selling our asses out on the street, we're all getting fucked [in the hospital] any way!"

(And we don't mean fucked in a pleasant, recreational way, either.)