Brain Dump

/ Marjorie / Leave a comment

I woke up this morning with what I call “The Overwhelm;” the feeling of being trapped under the snow after an avalanche. I can’t dig myself out. I’m struggling to breathe. I can’t seem to find a way out. Outside the sun is shining and the birds are singing, a sign that Spring is around the corner. Yet, I am on the Struggle Bus.

I know this is temporary. The beacon inside me says, “Keeping digging.”

There is no rescue team. I must rescue myself…

Digging

Last October, I was optimistic about my new job. At this point, I am questioning my decision about staying in OR nursing and working for a large institution. Whatever I thought I learned during my two and half month sabbatical between jobs, I have quickly forgot. The Overwhelm has a way of taking over sometimes and I never know when it will hit.

The new gig has been challenging and frustrating, so much that I actually considered calling my old manager to see if I could do an agency stint down there. I left my last job because I no longer wanted to live in that city. I left because I didn’t want to see the parade of gun violence victims brought into our OR. Do I really want to go back to that even on a part time basis? I don’t know…

“Don’t it always seem to go, you don’t know what you’ve got ’til it’s gone.” ~ Joni Mitchell

I miss the relationships I had with people – my fellow staff members, physicians, ancillary staff, the trust that was built through difficult times. I miss having a supervisor who rolled up her sleeves and helped the people she led. I miss having a supervisor that encouraged my creativity and appreciated my contributions to the department. I miss having charge nurses that were on the same mission as the staff – not to just keep the schedule moving, but to put the right staff in the right rooms. I miss the resources we had that helped us focus on patient care: the equipment guys, the sterile processing runners, the supply chain techs that would fill our supply lockers in the rooms. I miss the layout of my last OR which was open and helped facilitate a relationship with the Command Center. After all, the people in charge should know the staff and their skills.

Reality

Yes, I’m mourning the Past and I am trying to accept my Present. BUT WHAT ABOUT MY FUTURE? I don’t believe that I need to accept my current situation as my future. I am actively searching and meditating on what is next for me. I don’t think it involves OR nursing. I don’t think it even involves nursing. After all the hard work I put into getting my nursing degree, the blood, sweat, and tears I poured into every OR nursing job I have ever had, I am ready to give this all up for a little less sorrow and a little more joy.

The Year 2023 has already been a hard one and it’s only the beginning of March. The Universe slapped me in the face with the deaths of three strong women – my aunt, my friend, and my partner’s mom. A question emerged from the heartbreak, “What do you want for YOUR LIFE?”

Search

I am looking for the courage to face what is and what could be. I know there is no easy way out. But what is harder is staying in a joyless situation. I have more questions than answers.

Has healthcare changed so much that I won’t be able to find happiness in my work? Or is it me? Have I been changed by what I have witnessed over 17 years of OR nursing that the passion and fire I once had is beyond revival? Is it selfish for me to want to take care of myself and relinquish the honor of taking care of patients? Do I still love nursing enough to find another role outside of a OR staff job? What has enabled long-time nurses to stay in this line of work for as long as they have? Do I really need to leave the OR, nursing in general, or do I just need a therapist?

Beyond

Sometimes work takes over my life. I have to remind myself about the things that bring me joy on the outside: my partner, my dog, my family and friends.

Why do I always forget about this? Why is my identity so tied to my work?

I am exploring a new venture: starting my own business. This is separate from me being an investor in my significant other’s business. This will actually be MINE. Well, technically “OURS” – my business partner (another nurse friend), and me. I am starting work on the business plan today. It’s going to be a secret for a while until we are, God-willing, ready and able to launch.

I need to stay in this job for now. I need to find a way to fend off The Overwhelm. I want more joy in my life. And I know that I need my family and friends more than ever.

The good news is they have always been there. I just have to ask for help.

Help!

Starting Over

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New city. New job. New life.

We did it. My partner P and I finally left Chicago and headed north to Wisconsin. It was bittersweet leaving the town I have loved all my life. So many great memories, yet that city is unrecognizable to me.

Is this what old people say?

I guess I am older now, but those memories feel like they were just a moment ago. Riding my bike along the lakefront path… Cruising down Lake Shore Drive… Playing touch football, beach volleyball, and floor hockey with the Chicago Sport and Social Club… Bars, music, dancing… All the activities of my youth! Then later, fine dining and culture… It all felt safe.

But then things got worse – the violence and cost of living… What the hell, Chicago???

I don’t know when the wheels started falling off. With the exception of my first year as an OR nurse, I have been an OR nurse at a Level I Trauma Center for 16 years. Trauma call was bad, but then it got WORSE. (Or maybe the PTSD was rearing its ugly head? The jury is still out on this one…) My last hospital was THE PLACE where ambulances brought victims of gun violence, stabbings, and motor vehicle accidents. In the last year especially it seemed like every day my department saw something catastrophic.

The decision to move was not made overnight. It fermented for months. How could we leave family and friends? And then we just could not take it anymore. For the sake of our mental health and our relationship, it was time to do it. Besides, we weren’t going far away and we had family and friends in Wisconsin.

One of the hardest things to do was resign from my job. It wasn’t perfect – no hospital is… But in the grand scheme of things, it was one of the best places I have ever worked. I felt respected, even loved, by my colleagues and friends. I was in my comfy, cozy, comfort zone. Deep down, I knew it was time for a change, a new challenge.

Hello, Wisco…

I asked the Universe for a challenge and I got one. Moving was stressful. Every day for the first month we discovered something that needed to be fixed in our rental home. My Wisconsin license was pending with no word of any progress. I had applied well in advance of the move. The plan was to take one month off between jobs. One month turned into two, which then turned into two and a half. It took a little political help to push it along. But I needed the break. Desperately. I’m still processing everything that bubbled up during my sabbatical. More on that topic later…

Getting an operating room nursing job was easy with 17 years of experience, including scrubbing, circulating, management, and exposure to all the surgical specialties, especially trauma. The hurdle I am facing now is orienting to a huge hospital with different processes, surgeons, staff, and all the personalities that come with that… Ah, the weirdness of an OR!!!

I’m three weeks into the job and so far so good (at least in my eyes). OR nurses are Type A, each in their own way. For me, I want to know everything about everything NOW. Enthusiasm is good, but I need to stop myself.

Slow your roll, girlfriend…

One of my nurse preceptors could not believe that “at [my] age” I am making this change, as if I am running the gauntlet.

Ummmm… What???

My mind is still sharp. My body is still strong. Comfort zones can be a death sentence. Sometime somewhere in my life I became fearful of stagnation. Even if I get comfortable at my new hospital, I know that I will always be looking for opportunities to learn something new. I’m even looking into how to make my own YouTube videos. Totally not kidding… But that’s for another post!

So many things I’m still processing, still mulling over, still figuring out. This is good. It means that I’m not done yet. Ah, Life!!!

Return To ME

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For eight months, I have been silent. It’s not that I don’t want to write… When I am just about to pull out my laptop, something gets in my way. It’s my To Do List, the telephone, the need to tidy my surroundings before I do something that requires sitting. More accurately, I get in my way. The excuses are really my tendency to procrastinate. I know that this will be good for me – to write and get everything off my chest.

I am so much better than before. Truly. Seriously. I promise I am.

What has helped me over the last several months, is that I finally put myself first. I leveled up my meditating game and have been making breakthroughs thanks to Dan Harris and crew at Ten Percent Happier. I have been doing MORE – more yoga, more listening to music, more cooking, more sitting down and doing NOTHING. It was a struggle not to feel like I should be doing more and being more “productive.” Thankfully, I came to the realization that, even if I was doing “nothing,” that that was actually SOMETHING for me and my mental health.

Meanwhile, things at work are interesting. COVID brought on different challenges, but then we all got used to the way we had to live our lives (N95 masks, all the PPE, negative pressure rooms, etc.). In the last six months, came another change – the loss of staff to lucrative agency contracts. My former co-workers have not been traveling out of state, just staying local. In fact, it feels like all the big hospitals in the city have just exchanged staff. We have been lucky to get some talented nurses who are very nice and fun to work with. Agency work isn’t for everyone, so we have added new staff as well. As a result, I have been teaching – A LOT. I actually enjoy it, but it doesn’t hurt that we get extra pay for precepting.

Watching my friends leave to pursue agency contracts has been hard. I completely understand why they are doing it, but still… It feels a little like breaking up.

Inevitably, I think that I will be going the agency route too. My boyfriend and I have been talking about moving to another state, so for now, I am putting agency opportunities on hold. Thoughts about leaving my current job make me sad, but things have changed so much that one way or another, it will never been what it once was.

Yes, change is inevitable. I have to accept this and be willing to let go of my comfort zone. The way I choose to look at the state of nursing and the uptick in agency staff is that I am increasing my network of nurse friends. Operating Room Nursing is such a small world. There aren’t many of us out there, so it stands to reason that I will eventually work with my friends again! And I’m good with that.

With all the changes in my personal life, professional life, and the world in general, it feels like I found my center and ready to ride whatever wave comes next.

Sinking

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It was the beginning of the COVID-19 pandemic when last I posted. To summarize where I have been over the last year feels impossible. I have not quite come out of the Pandemic Funk. Actually, I’m not sure I know anyone who has. People may say it has been quite the roller coaster ride; to me, it has been more like traveling through the Swamp of Sadness in the Never-ending Story. In order to get through it, “you must not let the sadness overtake you.”

I’m not winning…

At work, we went from stopping elective surgeries in April 2020, to having a committee decide which surgeries we could do, to finally opening it up to business as usual by June 2020. We started vaccinating staff in late December 2020, which I was part of the lucky first group of staff to get a shot. The vaccine clinic was happier than the happiest place in the world, Disney World, everyone said. Masks have been required in the hospital since the start of the pandemic. Only recently has my institution changed its policy, now requiring surgical masks onsite instead of cloth ones. Thank you, Delta variant…

Last year I thought that the OR staff would be redeployed to other areas of the hospital. It never happened. As it turns out, we have a very particular set of skills (think Liam Neeson, but opposite): saving people via Trauma Surgery. I never thought about this before, but it is true. As challenging as it is for med-surg nurses or other unit nurses to go to the ICU, they would be able to handle that. Going from floor to surgery? BAD IDEA. Covering trauma surgery? WORSE IDEA! Our OR staff can set up in 4 minutes or less to take care of a trauma patient. The upper leadership concluded that it would be wise to keep those of us with these crazy but necessary skills out of COVID units, so that someone can take care of victims of gun violence and other traumas.

Gun violence in Chicago… Sigh. That is one thing that did NOT stop during this pandemic. And it seems like it is getting worse. Honestly, I thought it was just me who thought this. Today I asked my OR crew of friends and everyone agreed: things are getting scarier in Chicago. We don’t need to look at the stats… You can actually see how many patients with gunshot wounds are rushed up to surgery. Who knows what the city’s Powers That Be will do, IF they do anything, about this violence. All I know is, my desire to leave the city that I love is growing each day. The shootings, the taxes, the traffic, the cost of living, The Cubs; this city hasn’t been the same for me for a long time.

This is all too much…

I feel like I have been in a constant state of mourning since the beginning of the pandemic. So much has been taken away from me….from all of us.

Sadly, days after my last post (March 24, 2020), I lost my Auntie C. (my mom’s sis-in-law) to COVID. She was an ICU nurse for over 33 years in Florida. Auntie C was taking care of patients infected with the virus until she couldn’t anymore. By the time her COVID test results came in, she was already at death’s door, unable to breath. COVID-19 was so new, so many unknowns, that doctors were unsure of interventions. She died on March 27, 2020. Auntie C’s funeral was live streamed via Facebook. I watched on my laptop while Facetiming one of my cousins who could not see it via her computer at work. No one in my family could go down there and stand beside my uncle as he laid her to rest. It was so surreal and made an already tragic moment worse for my family.

I watched as other family friends went through the same thing. They lost loved ones to COVID and were not able to properly lay them to rest.

My personal list of losses, other than my Aunt, have accumulated. I realize they may not be terrible in the grand scheme of life; however, if added up, weighs heavy on me mentally and emotionally.

I am mourning what I once knew…

My family has changed. Over the last four years, the family dynamic became uncomfortable, even hostile, because of political views, Democrat/Independent versus Republican. In comes the COVID-19 pandemic and then it became Science versus Nonsense/Politics. My family has never been so divided… I mourn the loss of joyful family gatherings focused on food, music, dancing, laughter. I am sad that I have to step on eggshells and think carefully of how I phrase things when speaking to certain family members for fear of triggering an argument about truths and non-truths, leading to anger, frustration, and hurt feelings. When a conversation starts going down that path, I try to pump the breaks before it ends up in a family feud.

Will my family ever recover and go back to the way it used to be?

Recently, I moved from one home to another. It is a big change, exciting in many ways, but very stressful. My partner of four years, aka The Bear, believes that the move triggered ALL the feelings I have swept under the carpet. I have been more irritable, moody, negative, and impatient. That isn’t my baseline emotional state and it is scary.

When I feel like my world is out control, I tighten up the reigns on whatever is mine: my things, my time, my compassion. I can’t share. I close up shop. Knock, knock. No one is home. This doesn’t bode well for all my relationships, especially the one with the love of my life.

Things finally came to a head the other day. The Bear had a “Come to Jesus” talk with me. He was brutally honest. But he was right. I knew he was right. I have been sinking in The Swamp of Sadness and have not been myself lately.

Tears, tears, tears. Then more tears.

I decided and he agreed: tomorrow is a new day with a new mission — Saving Myself.

Nurses, like many healthcare workers, are not good at taking care of themselves. We advise our patients on better health but completely ignore our well-being. Now, more than ever, we need to stay healthy – mentally, physically, emotionally. This pandemic is far from over.

“The woods are lovely, dark and deep,
But I have promises to keep,
And miles to go before I sleep,
And miles to go before I sleep.”

No more sinking… I promise.

Living On The Edge

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It looks so calm outside. The sun is shining. There are cars on the road and people walking around. It looks like any other spring day in Chicago.

It’s not any other day because here I am, at home, feeling like all the worry and anxiety I suppressed about this virus bubble up. I should limit my social media time. Really. The private Facebook group for my fellow nurses at my hospital is informative, but sometimes it takes me down the dark, winding path of despair. Issues are brought to light that are familiar in other institutions across the country, even the globe. The same pressing issues are at my hospital.

Not enough Personal Protective Equipment… Inadequate Personal Protective Equipment… Not enough COVID-19 tests… Not being notified if you take care of a COVID-19 patient… Not being tested after exposure to a possible COVID-19 patient… Changing guidelines from the CDC based on availability of supplies in this country and not because of science… Finding out that someone you worked with was just diagnosed… Worrying you might bring the virus home to your loved ones…

I try not start my day on social media, but then the fear of missing important information sucks me in. Then the stress… Why do I do this to myself? And on my day off no less…

Do nurses ever really get a day off in a crisis even when they are not at work?

I am also in a Facebook group called COVID-19 FOR HEALTHCARE WORKERS. Based on posts from frontline healthcare providers in Italy and other parts of the world, I am anticipating that our situation is about to get worse. I’m gearing up by seeking out Best Practices. It is so sad that I may benefit from the horrific experiences of my fellow nurses. May God have mercy…

I wonder, is everyone awake and ready? I hope so…

Calm Before the Storm

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Unprecedented has to be my least favorite word these days. It feels like every news report (over)uses that word. Basically, what I’m hearing is that no one – not our government, the CDC, our hospital administrators – really knows what to do and is figuring it out on a day-by-day, hour-by-hour, minute-by-minute basis. I was hoping was that, at the very least, our elected officials had an emergency plan in place. Makes sense, right? There has been sufficient warning by epidemiologists in the past about possible global pandemics. When I am in a procedure, I have a plan for emergencies like a cardiac arrest, excessive loss of blood, etc. The likelihood in most cases is low, but I am always ready. Why aren’t our elected officials held to the same standard when their decisions affect the lives of many?

I am frustrated and frightened by the whole situation….but I press on.

Over the last week, I have tried to stay as updated as possible by trying to find reliable sources about the prevention, diagnosis, and treatment of COVID-19, the challenges shared by frontline healthcare workers all over the world, and the developing situation in my home city. Needless to say, it is difficult and completely overwhelming. And !@#$-ing scary.

The first time I heard about COVID-19 in a work e-mail was in late February. At that time, no alarms were going off. It felt more like a head’s up than a warning. Then information went from a slow trickle to a continuous flow. Currently, e-mails are packed with paragraph after paragraph of what the hospital is doing, what the city is doing, what we should do in various scenarios, what numbers to call, etc. All this makes my head spin. Ugh. How am I managing all this information? I created a COVID-19 folder in my work account just so that I could track the updates and make sure I know what’s what.

Needless to say, there has been confusion, anger, and anxiety among my fellow staff members in the OR. Totally understandable. We are accustomed to knowing what to do, even when a trauma comes in. We are used to seeing the worst of the worst. We are at a Level I Trauma and Research Center on the south side of Chicago, for Pete’s sake! Our preparation for COVID-19 was nothing like our Trauma Readiness Training two years ago. The hospital was all over it. But now? Why is this different?

Go ahead… Say it… UNPRECEDENTED.

So there have been a lot of What If discussions floating around the unit. Personally, I try not to participate. It is not helpful unless the What If’s are followed by a plan. I want to hear a plan.

Can someone PLEASE give us a plan???

Last Tuesday, St. Patrick’s Day, was the first day of the cancellation of elective surgeries. Our whole Ambulatory Surgery OR was shut down and the staff sent home on Low Census with a possible re-open date of April 15th. It was a shock that rippled through every OR (and we have 3 different OR units – Adult, Pediatrics, and Ambulatory). So many question followed… I still have questions.

The cancellation of elective surgeries also impacted the Adult OR (the Main OR) where I work. It has slowed down so much, that adjustments have been made to our schedules to low census some of us on different days. Still, we are “on reserve.” All of us in the OR know that it is just a matter of time before there is a need to float us to other areas of the hospital. Already some of our surgical techs have been asked to go to the units to monitor providers while they don and doff (put on and take off) Personal Protective Equipment (PPE).

Instead of sending us home, why don’t they set up training for other possible roles? Why aren’t they taking inventory of skills? They should be asking the OR Nurses who have experience in the ER, ICU, or MedSurg Floor. Unfortunately, I have no such skills, but I am willing to learn. How about organizational and management skills? Isn’t that good for crisis management? I’m just wondering…

Practicality Not Panic

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These are strange times…

As I was getting ready for work this morning, it dawned on me that I was one of the few residents that would actually leave this 40 unit low-rise condo building to go to WORK. This gave me a sense of purpose that I hadn’t felt in a long time. Or was it just a heavier weight on my shoulders?  Yeah, that’s probably it.  Since COVID-19 started making its way through my city, my neighbors, family, and friends have been working from home, even having to self-quarantine after an exposure to the virus.

Not me.  Not yet.  I’m a nurse.  This crazy pandemic is calling.

Hello, Nurse…  I’m waiting for you.

When I arrived at the hospital, it felt like I was in a new world.  The vibe was intense.  The normal glut of visitors at the security desk were missing.  No medical students rushing past me running late for rounds.  It was almost like a lockdown.  Almost.

As of today, our ambulatory surgery center was officially CLOSED.  All those nurses and surgical techs sent home until April 15th.  What the…..???  Our main operating room OR (where I work) cancelled all elective surgeries per the recommendation of the American College of Surgeons and our government (I’m assuming).  The monitor with our status board was depleted of its normally extensive list of cases.  Instead, a teeny tiny list.  It was so surreal.  We are talking a BIG surgery department that typically performs a lot of procedures now down to a select few.

Makes you want to rub your eyes to make sure you’re not seeing things…  But no…  Hands away from your face!

Because of the small number of cases, some nurses and techs had already been asked to stay home.  We called this “being low censused”.  Basically, this means that there isn’t enough work for them so they are being mandated to stay home, and use their vacation time if they want to get paid.  One day here and there isn’t bad…  But what if the hospital does the same thing to us as our ambulatory surgery colleagues who are off for a whole month?  I hate to even think about this…

I was assigned to circulate three orthopedic cases which kept me busy most of the day.  During slower moments, my mind kept spinning different scenarios on what would happen to me and my co-workers should the number of COVID-19 patients rise in our institution.  It is too soon to say.  Many nurses want answers as if this virus was planned or as if our administrators had been through this kind of crisis before.

NO ONE HAS EXPERIENCED THIS BEFORE.

What a scary thought.  We are looking for guidance, but sometimes those above us cannot figure out the best course of action fast enough.  I would like to believe that everyone is doing the best that they can.  The only thing any of us can do it take it one day at a time, be practical and not panic. 

I know in my heart, we will get through this…  We just need to hang on to hope and find a way to be kind to each other through this frightening time.

 

A Heartfelt Letter

/ Marjorie / 2 Comments

Recently, the nurses at the University of Chicago Medical Center (“UCMC”) have called for a one day strike for the second time this year.  This is the result of unsuccessful bargaining between the unionized nurses and hospital administration over safer staffing, safe working conditions, and benefits.  A hospital-wide e-mail was sent out by one of the administrators depicting the nurses as cold and heartless.

The message made its intended impact as UCMC nurses expressed hurt, upset, and outrage on social media.  One nurse posted a response on Facebook which activated overwhelming support from her fellow RNs.

Here is that eye-opening, heartfelt letter from the UCMC PICU Nurse….

********************************

WRITTEN BY A PICU (PEDIATRIC INTENSIVE CARE UNIT) NURSE AT THE UNIVERSITY OF CHICAGO MEDICAL CENTER IN RESPONSE TO AN INSTITUTION-WIDE E-MAIL FROM A HOSPITAL ADMINISTRATOR.
Dr. Polonsky,

We’ve never met, but I recently heard you speak at the service awards in October. I was there celebrating my five year anniversary at UCMC. It was quite a celebration for me; I’ve worked at UCMC for five years, I’ve been a nurse for five years, I’ve lived in Chicago for five years. That night, I thought the University of Chicago did an incredible job of making me feel valued, appreciated, and immensely proud of the work I do, and the place where I do it.

Tonight, receiving your email has undone all those feelings. I am a dedicated employee of this organization; I am a natural rule-follower, I hate being in trouble, and I hate conflict. However, I feel compelled to write to you, someone I’ve never directly met, and someone who sits well above me in status (and pay) at our organization, in order to convey some sentiments and facts that I feel you have grossly misrepresented in your earlier email.

“Once again, rather than stay at the table and engage in the hard work of reaching the compromises that will produce a new contract, the Union is ordering nurses to walk out on their patients and their co-workers during a holiday.”

This is simply false. The union has called a strike on Tuesday, November 26th. Thanksgiving is Thursday, November 28th. While the union has called for a one-day strike, it is hospital administration that is choosing to lock the nursing staff out for the Thanksgiving holiday. Additionally, “walking out on their patients” is hyperbole, and spins a narrative that paints the nurses, the backbone of your organization as heartless and unprofessional. I can assure you that no patients were walked out on during the last strike. I can promise you, it broke every single RN’s heart to leave that building, knowing that unqualified, inferior and, at times, incompetent replacements were going to be attempting to deliver the unmatched quality care we provide at UCMC. As a PICU nurse, I didn’t have any patients to walk out on! I worked the night before the strike, completely alone in an empty unit, because the hospital administration had shipped out every last PICU child to a different hospital. So, you’ll understand if I take offense to this comment.

“This is not a strike against a nameless, faceless institution.”

This comment is quite ironic: You are correct; this strike is not against a nameless, faceless institution. However, I’ve been a nurse at UCMC for five years, and your email has made me feel like a nameless, faceless pawn in this organization’s bottom line. I know your name, I know Sharon O’Keefe’s name, and I know Deb Albert’s name, but I’m sure none of you know mine. The nameless and faceless members of society are not typically the ones whose paychecks end with seven 0s.

“This is a strike against our patients and their families. This is a strike against our community — one of the most vulnerable in Chicago where residents face high rates of serious conditions and life-threatening diseases. This is a strike against neighborhoods that rely on us for life-saving emergency and trauma care.”

Trust me, the people at UCMC who truly understand how vulnerable and critical our patients are are your nurses. If we didn’t care about our patients, we wouldn’t want more nurses, more IV pumps, more resources, and a safer work environment. The people who care the most about our patients are the ones who are willing to lose money to defend them. On September 20th, I walked out to picket line to find many former patients and their family members earnestly supporting their nurses at the strike. We are the face of this organization. We are what makes the care at UCMC excellent. Our patients and their families know that better than anyone.

What personal sacrifices have you made recently in service to the patient population at UCMC? When our PICU patients were shipped away to hospitals throughout the Chicagoland area, I went and visited one of our patients who didn’t have family members in the area. Each time I went, I stopped to pick up his favorite toys and coloring books and movies. I was out of work, not receiving a paycheck, but I didn’t care. In fact, my coworkers often bring clothes, food, and toys to work for their patients, using their own money. Can you honestly say you have a similar connection and responsibility to the patients we serve? If not, maybe you shouldn’t have included these comments in your email.

Finally, the heart of your email was read as an expression of frustration that you, as well as other hospital leaders and middle-managers, may now be forced to work more than you were planning around the holidays. Dr. Polonsky, I have worked 4 holidays at UCMC every year for five years. I am not from Chicago. It is an eight hour drive for me to get home to see my family. I have missed Thanksgivings. I have missed Christmases. I have missed funerals and birthdays. I have family members who are ill. I have family members that are elderly. And until now, I have never really complained or resented this aspect of my job. Nursing is a 24/7, 365 profession. I’m sorry you are now having to experience ¼ of what 2200 of your nurses experience every year in the rescheduling or cancelling of holiday plans. Maybe this will be beneficial to you and your colleagues; you may walk away with a greater appreciation of the sacrifices your nurses make for our patients and our organization, and a greater understanding of how valuable our profession is (and why we deserve to be valued and appreciated in the manner in which the Union is asking). The reality is that every holiday where you are home spending time with your family, thousands of employees are at UCMC away from theirs. Attempting to belittle my profession and my character by making me feel responsible for “robbing” you of one Thanksgiving with your family has opened my eyes to how out of touch you must be in your current role with the reality of your employees.

I understand that you are also in a difficult position. You are a leader at an organization that has to deal with a strong union that is pushing their agenda against yours. That can’t be easy. I imagine the past eight months have been stressful for you as well, trying to negotiate a fair contract for 2200 nurses. Well, take a moment and put yourself in my shoes. I work in the PICU; I do CPR on infants. I help police officers take pictures of beaten and battered babies. I sing Frozen songs to frightened 5 year-olds while trying to put in an IV. I hug parents after the doctors give them the devastating test results. I guess we both have tough jobs.

Dr. Polonsky, you have the privilege of earning a lot of money to make decisions that impact thousands of people’s livelihoods. The next time you find yourself at the bargaining table with NNU, I hope you can remember your own words. We are not nameless, faceless nurses. We have names, and faces, and families and friends and lives outside of work.

We do this for our patients. We do this for our patients’ families.

That’s why I come to work. Why do you?

Happy Thanksgiving.

A Not-So-Routine Routine

/ Marjorie / Leave a comment

During the Monday through Friday work week, I work four ten-hour shifts.  On those work days, my alarm goes off at 5:00 AM.  And the routine starts…

5:00 AM – Jump out of bed and get ready for work.  Brush my teeth, blah, blah, blah.

5:30 AM – Feed the Doggie and take her out.

6:00 AM – Drive like a bat out of hell to the hospital.  [CUE:  Upbeat dance music.]

6:25 AM – Arrive at work, throw lunch box in one of the overstuffed refrigerators, get scrubs from the scrub machine, change into scrubs and OR-use-only Sanita clogs, put my hair up and put on one of my cute scrub caps.

6:40 AM – Grab a quick coffee in the lounge with my co-workers.

6:53 AM – Clock in and head down to the OR.

7:00 AM – Check for my assignment at the Command Center/Charge Desk.

And this is where the routine ends.

Operating Room Nurses are typically assigned to one room where there are several cases scheduled.  These are usually procedures that fall under their primary specialty (e.g., Orthopedics, General Surgery, Urology, etc.).  However, most operating room nurses are cross-trained in the other specialties, therefore, the assignment may not be in the primary specialty.  Or maybe it’s a room with a variety of procedures that fall under a variety of specialties.

Not only does the assignment vary in specialty, but it varies in role.  There are two staff members needed to set up for a procedure:  A Circulating Nurse and a Scrub Nurse/Surgical Technician (a.k.a. “Scrub Tech).  Operating Room Nurses can either be a Circulator or a Scrub.  A Surgical Technician can only perform in the scrub role due to their training and licensure.

Scrub Nurses/Scrub Techs are responsible for preparing the sterile field.  She or He performs a surgical scrub on both hands and arms at a scrub sink (just like on TV), then puts on a gown and gloves with proper aseptic technique.  The sterile field consists of a sterile drape covering a large table with a setup of items that are needed to perform the procedure (supplies and instrument). The Scrub sets it up so that instruments and supplies can be passed to the surgeons when they need it.  Knowing how to set up for a variety of procedures is a skill learned on the job – starting with an intense orientation.

In the role of Circulator, the nurse performs a patient assessment in the pre-op holding area.  It involves a checklist of questions that have also been asked by other providers.  It is our version of Checks and Balances.  Patients get an overview of what they can expect when they are brought to the OR.  Family and friends of the patient can also ask questions.  I call this, for my readers of a certain age, my “Julie McCoy, your Cruise Director” moment. In the OR, the Circulating Nurse’s work continues with helping the Scrub, sometimes the Anesthesiologist/CRNA, and works around the sterile field (circulator = circulate = circle = around) supporting the surgical team throughout the case.   Eyes and ears are always alert.  Circulating means helping coordinate and facilitate case progress, documentation, and whatever else is needed to provide safe patient care.

Anyway, back to getting my assignment…

Wait, what am I doing?

Every day, my assignment is a surprise to me. The Charge Nurse/Manager/Team Leaders put together the initial draft of the assignment sheet the day before, but it always seems to change the morning of, based on call-offs and schedule changes.  I have learned my lesson to avoid checking the day before because I don’t want to get myself unnecessarily upset or excited about the next day.  Pointless, really.

On the days I am in my specialty, I am in my comfort zone:  Orthopedic Surgery.    In the Main OR of my hospital, the procedures we perform the most are total hip or knee replacements, repairing broken bones, fixing someone’s spine, and even taking out cancerous bone and tissue.  I work with the surgeons and residents that I know well and my partner is usually someone from my specialty team (nurse or scrub tech).  When you have the “regular team” together, there is a flow that is like….a symphony.  I love that feeling.

Outside of my specialty, I am fine, but I am on extra alert for any nuances that are unfamiliar.  While this sounds scary to some people, the beautiful thing about working in surgery is the amazing teamwork we have with our staff.  My co-workers are excellent resources when I am in a bind or when I just want just-in-case information.  It is reassuring to know that someone has my back!

Today is my day off which means I return to work tomorrow.  What will I be doing?

I have absolutely no idea.

All I know is that there definitely will be coffee in the morning.

 

Healing

/ Marjorie / Leave a comment

Since my last post, I have been on a search to find healing in this crazy messed up world. I knew I needed help when I found it difficult to talk about the trauma without my eyes welling up with tears. It was then that I decided to open myself up to different ways to recover from all the terrible things that I see on the job.

I started meditating and practicing yoga. I also started planning more gatherings with family and friends. Improvements in diet and sleep have helped, although this is more challenging to do. If I focus on why I am doing this, it becomes an easier task. Baby steps…

Months later I am not completely “fixed”, but it’s not like I will ever be. Life is messy. I have acknowledged this fact for a long time, but yet it is still a difficult pill to swallow. Our experiences make a lifelong impact. The only thing I can control is how I choose to handle it.

So here I am. Still trying to balance work life and personal life. The messiness continues. At work the traumas keep coming in and so do the really sick people. At home, I am supporting my significant other as he tries to find his way in a new industry at a startup company. In the last week, my dad just had open heart surgery. He is doing great, but it’s a long road to recovery. On top of this, my aunt is in kidney failure and is receiving hospice care. And now, one of my childhood friends is facing the fact that her mom might not survive after a bad fall.

It’s a lot. But I know things could be worse.

I could drown in negative thoughts, but what always brings me back to the surface is gratitude. The first thing that comes to mind is how lucky I am to have so much love in my life. I truly mean this. When shit is hitting the fan, the reinforcements appear – my family and friends! Even though I am so independent, they allow me….no, they remind me….to lean on them. I don’t have to hold back tears, force a cheerful hello, or hide my feelings. How lucky can one person be?

My experiences over the last year have reminded me that healing is an ongoing job. I am reminded by something an old boss said to me when I was feeling overwhelmed:

“How do you eat an elephant?

One bite at a time.”

Bon appétit!!!