I am going to start my final chapter of this book with a statement already discussed in a previous chapter. Nursing is all about flexibility. I stored this statement away in some lonely neuron in the back of my head somewhere, never realizing how many times it would come to play in my nursing career. Very few people end their nursing career where they started it, and it is usually a curvy road to the destination. One of the reasons for this is the virtually unlimited opportunities that exist for a nurse. Another reason is that many nurses transition directly from high school into the nursing program in college and then into a hospital environment. Hospitals are popular because they offer the most widely available positions. They also provide the most excitement for new nurses, many of whom are adrenaline junkies. My second ex-wife, who was an LPN, was one of these junkies. She would run off on a moment’s notice to help in a code. As an LPN, she couldn’t administer medications, but she could perform chest compressions, record the code, and serve as a vital gopher. It didn’t matter what she did as long as she was in the thick of things.

There are, however, trade-offs for the hospital. And one is that you will, in most cases, work harder in one of them than you will in most other facilities or positions. The only exception may be an LTAC. Another problem is that they pay the most for any position in the city. If you’re looking for big money, a doctor’s office isn’t the place to find it. I have made almost as much as a few doctors after malpractice insurance was paid. With the heavier patient load and the higher acuity of patients comes stress. Another thing that comes into play is that, in most cases, this job is the highest-paying job the individual has ever had or will ever have. Since we have already established that many young adults take up the nursing career right out of college, they enter the field at an early age. With youth comes immaturity. Immaturity and high wages in some cases spell disaster. They often buy cars that are too expensive for them, or they overspend on clothes and other items. I once worked with a nurse who wore a Rolex watch and shoes that cost over a thousand dollars. I worked with another nurse who drove a Lotus Emira. I have no clue how much it costs, but I am sure it hovered around $100,000 or more. Needless to say, these nurses were not just working their three twelve-hour shifts.

This is where burnout comes into play. I know many nurses who work two full-time jobs and do so for many years. This comes at significant costs, especially when they have families. In many cases, the father has to be the stay-at-home parent to raise the kids. This can happen to the male nurse as well. However, it is very common in the Filipino population. These young females love their cars and their iPhones, iWatches, and designer handbags. Something, of course, eventually has to give, and this is when the career paths usually change. Some nurses, to secure a bigger pay day, go back to school for a nurse practitioner degree. This new position not only gives them more money, but it also gives them more status because they can now write orders and prescribe meds, albeit with a Medical doctor signing off on the narcotic orders.

So why did this all happen? It is the American way; there are too many enticements. This became an issue in the late 70s and early 80s, with the advent of video games and home computers, designer shoes and clothes. I remember classmates walking around in Jordache jeans that cost $100 and Air Jordan sneakers that topped out way more than that. Not only did overtime become mandatory for the breadwinner, but in many cases, it took two breadwinners to foot the bill. It has only gotten worse over the years, as there never seems to be an end to it. Computers kept on doubling in speed, video games became better, and game systems kept on changing. Electronics became throwaways. At least with film cameras, there was some stability. But that changed as well when they went digital. Now you were playing the pixel game. Cell phones have been the most recent trend to enter the fray. Now, the damn things cost over $1,000.

So you can see how these temptations are affecting the new nurses. They finally have the money to buy all of these goodies. The next thing you know, they are either working a second job or, if available, they are picking up overtime. Once they start working overtime to make ends meet, they are stuck in it for good. So stop and think of these numbers for a moment. Your average nurse now gets a four-year nursing degree. So, that puts them between 21 and 22 years of age when they enter into their nursing career. What is the age at which they can get full Social Security, 68 to 70 years of age? At the very least, these numbers indicate that they are working for 46 years as a nurse before they can retire. Perhaps they are smart enough to invest in a retirement fund, allowing them to retire a few years earlier. However, this still means working from their mid-30s to their 40s as nurses. It is doable to work three days a week and still have a life. But it certainly is not if you are working two full-time jobs or are working extra shifts for overtime. Can we say burnout? I think so.

So whenever I meet student nurses, I give them my little two-minute spiel. I tell them to live within their means. The money is sufficient to live well, but not extravagantly. Only pick up OT for the short term with a specific goal in mind, like raising a down payment on a house or taking a trip. Paying for a car in cash is too hard and not worth the effort. Take the loan out and pay it off quickly to save interest. I once paid for a car in full with cash; you would’ve thought I was a criminal or something. I don’t know how many of them listen, but I see them all nodding their heads in agreement. However, I can see the light in their eyes showing that they know better, and that I am just an ignorant old man.

Another jewel of wisdom that I picked up from my nursing instructors was to work 2 to 3 years on a telemetry unit before working in a more advanced unit or taking on a supervisory position. Trust me, your inexperience will be all too evident when you try to tell your staff what to do. In my way of thinking, you can never say too much about experience. Experience requires repetition because the more you do something, the better you will get at it, and eventually, it will become second nature. There are numerous skills that a Registered Nurse (RN) must possess, and even more that an intensive care nurse (ICU) needs to know. The patients in the unit are a lot less forgiving, mainly because they are just too sick. It takes an RN a minimum of one year to start feeling comfortable on the floor. Once you reach that point, you can finally begin to improve your skills. Each unit requires a different flow or tempo for the nurse to learn and practice with. That is why they don’t have an ICU nurse float to a medical floor; they lack the skills to care for that many patients. It is even worse if you went straight into the ICU. Once you have mastered your skills and feel confident handling any situation on your floor, you’re ready, in my opinion, to take on a charge position or advance to a higher acuity unit.

To be a nurse, you need to like people and feel comfortable being around and touching them. It sounds simple, but it is true. If you’re not comfortable around people or don’t want to be around them, you might be in the wrong career. In regards to touching people, you have to be comfortable doing this, because you will be touching them in ways they have never let anyone touch them except for a significant other. You put tubes in their bladder and their rectum. You bathe them and by necessity you also clean their private areas.

You also need to have a strong stomach, and having a poor sense of smell is on the plus side. Nursing is not for everyone. People who don’t mind sputum but dislike cleaning patients often become respiratory therapists, while those who prefer not to handle cleaning tasks often become radiology techs. There seems to be a position in the medical field for everyone.

Although I didn’t start my career as a nurse, I believe I wasn’t in the right frame of mind at the time. Many nurses started in other careers before migrating to the medical field. I think that life experiences shape who you are. Having struggled a lot in my life to make ends meet, I tend not to take my good-paying job for granted. Those who have never known any other work and are used to making a good salary from the very beginning tend to take their career for granted. They are also the first ones to call in sick when things get tough, thereby making it even harder for their colleagues. If people continue to call in sick and quit, things will not improve at your workplace. Sometimes you need some faith, if the conditions never seem to change even after several years go by, they will most likely never improve, and it is in your best interest to leave.

Nurses need to be self-motivated, hustlers, and hard workers. You also need to be observant and have some level of common sense; problem-solving is another skill that comes in handy. You also have to have a strong sense of moral justice because there will be times when nobody is watching, and are you going to give the patient that pill you dropped on the floor? Not only does the patient deserve better, but so does their family. They need to know that you have their best interest at heart.

When you meet the family of the patient for the first time, act interested in their loved one and become engaged with them. Also, take a moment to tidy up the room. The family will appreciate it and will think a little more highly of you. They also tend to feel more comfortable going home and leaving their loved one under your care. Patients tend to sleep better and thereby get more rest when their loved ones are not in the room. It is also easier to work on the patient if you are not tripping over visitors.

I guess I am rambling a little, but this chapter was included so that I would have a place to write down some of my little jewels of wisdom. I never used to raise the bed when I cared for the patient to try and save time. Do yourself a favor, raise the damn bed, take the time, your back will thank you. It may sound stupid, but I did it for years, and I am now paying the price. Another thing that will save you is to do some exercises to strengthen your core. If you have strong stomach muscles, they will help to support your back as well.

When I was in nursing school, I became a telemetry tech. I believe this was one of the best things I did in my early career. If you have the chance to do this, take advantage of the opportunity. Every minute you spend in front of those monitors will pay off in quicker rhythm recognition and troubleshooting in your patient’s cardiac condition.

Get help to turn or pull patients; you only have one body. We are not cars where a broken part can be replaced. Again, how many nurses treat their bodies like they have spare parts lying around?

Finally, to be a successful and caring nurse, you must genuinely care for people. You can’t just go through the motions. Please do it for the right reasons; money should always be secondary. Besides, like I said before, the more money you make, the more you will spend. How many toys do you need? If you don’t think this is true, take this little road trip exercise. You don’t even have to go into the boat yard; you can see enough of them from the road. Just spend a few minutes, but put in your memory banks (even better, take a photo with your phone) the boats you saw. Come back a year later, and I guarantee that all but one of them will remain untouched. All those people just had to have those boats, now they are paying good money to store them. It is easy to tell the ones that haven’t moved, because their boat trailer tires are still flat. So ask yourself, was that purchase worth all that extra work and lost family time? I speak from experience, I owned a boat for 10 years. The happiest day of my life was when I sold it. I took the boat out about a dozen times in those ten years; it would have been cheaper just to rent a boat when I wanted to use one.

The years you have lost working all those hours are genuinely lost; you will never get them back, especially when you lost out on family events. Work is merely a means to earn a living so that you can enjoy life; don’t let it dictate how you live. Eventually, you won’t be able to do it anymore, then what?

I hope you found this book to be interesting. I packed it as full as I could with all kinds of information and stories.