Nursing

Yesterday, we had to clean-out a storage room in the clinic I manage. I had no idea what was in this storage room. In the grand scale of things that I worry about, what is hidden in the back of the storage room is way, way down on the list.

So, one of the medical assistants and I decided to dig in. The storage room is small. How bad could it be? We asked the janitor for a garbage bag. Clearly this man has seen this sort of thing before. He gave us about a dozen big garbage bags. We ran out.

This storage room had the most terrifying collection of random things. There was stock from the 60's and 70's in there. There were parts of electronic equipment that didn't even make sense. There were things we had looked for and given up on a long time ago. But, the amount of paper was astounding. I am now convinced that no one has thrown a piece of paper away in that clinic in 10 years. On top of that, there was a lot of stock. A LOT of stock. For example, we occasionally use red rubber catheters. Maybe once or twice a month, we use one. The level we keep in our machine is 5, I think. We currently have it stocked with 10, but we don't really need that many. In the storage room, we found 400!!!!

We found stock that was expired and stock that was so old it didn't have an expiration date. We found plastic things that were so old, they had browned and cracked. We found an ugly old chair. We found a lot.

Well, after the stock room, we were on a roll, so we kept going through some of the other things. We have a cart with dressings. We have a room with overstock. We have a medication room. We went through those. I can't believe how much stuff we have. There are needles that we needed a dozen or so, but could only order them by the case. We have syringes that I have no idea what we would possibly use them for. We have catheter bags. Enough catheter bags we could build an office building out of them.

We threw a ton away. We filled the hallway with garbage and we had to have the dumpster come multiple times. Then, we put things in my office that we needed to figure out what to do with. These are the things we will never use. We have way too many. We can't figure out why we have them in the first place, etc.

Gotta love it.

Well, I knew it was coming. After all, in certain areas of the country, hospitals have been closing all over the place. As a nurse, though, it is hard to see the end of health care as the golden child, the cash cow.

There was a time when I could honestly believe in my ability to go anywhere and do anything with the awesome power of the nurse label behind me. But now, we are just as vulnerable as the average human.

Last Friday, my department laid off 6 people. In addition, my favorite workaholic construction guy got laid off. He was the single force keeping my clinic remodel on track. I miss him dearly.

I'm somewhat amazed I didn't get laid off. After all, I am still on my probationary period. Plus, I am something of an idiot.

But, I guess there is intrinsic value in absolutely loving financial reports when you manage a clinic. I think I'm having a love affair with those reports. I carry them with me everywhere and snuggle them close. I just love them. How strange is that? But, it gets results. The contribution margin (profit) for my clinic is up from 19% to 28%. Remember, I'm still on probation.

Alas, nurses are not in demand the way they were just a short time ago. I still firmly believe that a good nurse can get a job anywhere. There may not be a nursing shortage anymore, but there will always be a shortage of intelligent people.

Now would normally be the time I would move on. After all, I bailed on computer programming at the dot com crash. I should be moving into the next big thing right about now. Is that China?

But, I seem to have fallen into an operations manager role. Having just (say Congratulations, damn it!) finished my Master's and MBA, I find that the business end of things is somewhat thrilling and managing a clinic allows me just enough nursing stuff to keep me engaged.

How much of an idiot am I that I can rave like this, but when my boss asked me what I liked best about my job, I couldn't think of anything? I've never had test anxiety before, but there it was.

Okay, it seems to be a strange twist of fate that I often find myself working with nurses that do not care for patients. I understand. Truly I do. Patients can be irritating, rude, pushy, whiny, hateful, clingy, and desperate. Patients often come to nurses at their worst.

I have to laugh and be a little ill at the same time at the beautiful patients on TV. The nurses and the doctors carry on affairs with patients on TV. This would never happen in real life. The nurse fantasy is truly relegated to the fantasy realm.

Sorry guys, when you come into the hospital with your hair all matted and your face pinched from whining in the car, then you put on that oh-so-hot hospital gown that ties in the back, and ask me for pain meds because your splinter hurts sooo much, I just don't find you remotely attractive.

Nurses aren't there to fulfill fantasies. They are, however, there to care. So, when someone tells me that they left a patient waiting for hours because they were busy or that they are going to tell off a patient for not understanding that they have other things to do, I want to scream at them. They make all nurses look bad.

We are there to care. Try doing a New York Times crossword puzzle sometime. The answer to anything involving nurses is "TLC." Nurses care. Not one of us went into nursing because, "God, I just love counting narcotics at the end of a shift." We didn't go into it for the money, no matter what lies are spawned because California nurses are unionized. The rest of the nation isn't buying a Lexus on a nurse's pay. We went into nursing to care for people.

Honestly, I don't even much like people. As a species, we are dirty and irritating. But, when a woman's husband just died in my ER, I am going to sit with her for 2 hours and hug her, hand her tissues, and try to avoid answering "why" until her family gets there. Yes, the entire time I may wish that I was anywhere else, but then I will remember that she wished she was anywhere else far more than me and I will stay and hug her even tighter.

If a nurse doesn't care, who will? In this world, we are all so separated. Families are long-distance. Relationships happen on the computer. Friendships exist on the cell phone. In your worst moments, who will hold your hand and be kind if not your nurse?

I am not the most social person. Nothing drives me crazy faster than a person trying to talk to me on a plane. If you interrupt my reading-a-book time, you may get injured. But, when I am working, I am there for my patients. There is nothing more important.

So, when people act like their patients are in their way or taking their precious time, I just want to scream, "what do you think you do for a living?" There are plenty of jobs out there where you don't really have to deal with people at all. Go find one. But, if you are going to show up for work as a nurse, you better be ready to comfort, assist, and care. After all, if you were all alone, if it was you in that bed, if you were in pain, if you were scared, wouldn't you want someone to care?

So, I got a new job. My old job was great. I loved what I did. I loved the people I worked with. I even loved the hospital. I just wasn't heading anywhere there.

For some crazy reason, I figure that mortgaging my soul to earn a master's degree should result in some career advancement. I would like to use my shiny new degree at some point. So, I will be moving into management.

Nursing management is for the truly inept at math. Nurses can work extra money into their lives. Nurses regularly work overtime - extra pay for that. Plus, if you work nights, you get extra pay for that. If a nurse works weekends - extra pay. Nurses also get asked to work extra shifts - you got it, extra pay. So, a nurse has the ability to get a lot of extra pay. If you are willing to work all the time, you can really change your financial demographic.

Nurse managers, on the other hand, are on salary. No extra pay. And the extra that they pay you to move into management is pretty small. Sometimes nonexistent. Plus, as a nurse manager, you end up working more anyway.

Yeah, truly, those nurses who can do math, do agency nursing. Extra pay and a better starting rate. Agency nurses aren't doing as well right now with the economy, but c'est la vie.

So, I have hung up my ability to do math and have taken a management position. As a result, I had to change my look. Remember, I'm a nurse. I wear scrubs to work. As a manager, it isn't really possible for me to wear the equivalent of my pajamas to work everyday. I had to buy clothing, shoes, a belt, a scarf.

This is a whole new world for me. I will have to learn to walk all over again. Those shoes with heels are so far different from my comfy nursing shoes, I may not make it.

Then, there's the whole professional "look." I had to go to the mall and get a two-hour class on make-up. I have newly purchased little containers of things I don't really understand. Strangely, I spent almost $200 on make-up that makes me look like I'm not really wearing make-up. Who comes up with this? The expensive stuff is the stuff that really doesn't show, but the cheap stuff really announces itself?

No, wait, I get that. Its like women at a bar. Nevermind.

But, I also had to get a lesson on how to style my hair. This, I may never learn. I'm not even sure I understand why I would do some of this. My understanding of the "diffuser" is that it is intended to make my hair look more messy. Couldn't I just forgo styling it altogether and get the same look? You should have seen the look on my stylist's face when I told her I had heard of a diffuser, but didn't actually know what one looked like. I think everyone at the shopping mall is convinced that they made-over an alien that just landed.

Honestly though, I really look great. I didn't realize how much difference all of this could make. I didn't realize I looked so old and blah. That's what a make-over will do for you. Suddenly convince you that you need these things.

I have to say, however, that the two things I now really like are the two things I almost didn't buy. All of this stuff was expensive. I am hurting for the cash, but I see it as a long-term investment. To do this transition, though, there were a lot of things that I looked at and didn't buy. So many cute blouses, nice pants, stylish shoes, etc. Anything above the bare minimum needed didn't make the cut. Except for two things. I bought a red blouse at the Eddie Bauer outlet store. I was in the process of putting it back when my husband stopped me. He liked it. I wore it for the first time Wednesday and wow. I love it. I'm glad he talked me into it.

Then, there are the boots.

Boots are everywhere right now and I think I have tried on every pair of boots in the state. They are uncomfortable. They are strange looking. They are expensive. I don't understand why so many of them look like they are made for women with really fat calves. I was ready to give up. As I was leaving the store I tried on one more pair. They weren't even with the other boots.

Oh my.

Okay, I finally, finally understand the whole shoe thing. I have never before in my life understood the woman-shoe-love thing. I just didn't get it. Shoes were either uncomfortable or too expensive. I am the person who bought a pair of Danskos 6 years ago and I keep wearing them everyday because they don't hurt.

But, these boots. I think I am going to wear them to bed tonight. I love them with a passion. They are comfortable. They look amazing. They fit my legs. I can wear them with a nice skirt. I can wear them with jeans. They have a heel, but I could walk forever in them. I really love them. I didn't want to take them off. Then, the guy in the store told me the price. I carefully took them off and put them back in the box. I picked up my purse and turned to leave.

Then, I grabbed that box and my credit card. In that moment, I was a real woman in some sense that the people who stood in line for the Sex in the City movie understand. I wasn't the old me anymore.

The good news is that I like the new me. The bad news is that my credit card is grounded. But, with this shirt and these boots, who cares?