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 go from high school right into the nursing program in college and then right into a hospital environment. Hospitals are popular because they are not only 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 moments notice to help in a code. Since she was an LPN she could not administer any of the meds, but she could do chest compressions and record the code and function as an all important gopher. It really 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 maybe being an LTAC. Another problem is that they pay the most of any positions in the city. If you want big money don’t work in a doctor’s office, you just won’t get it. As a matter of fact, I have made almost as much after malpractice insurance was paid as a few doctors. With the heavier patient load and the higher acuity of patients comes stress. Another thing that comes to play, is that in most cases, this job is the highest paying job the individual 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 tend to buy cars that are really too expensive for them, or they spend way too much money on clothes and such. I once worked with a nurse who wore a Rolex watch, and wore 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 a $100,000 or more. Needless to say, these nurses were not just working their three twelve-hour shifts.
This is where burnout comes in play. I know many nurses who work two full time jobs and do so for many years. This comes at great costs, especially when they have families. In many cases, the father has to be the stay 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 i-Phones and i-Watches and their designer handbags. Something of course eventually has to give, and this is when the career paths usually change. Some nurses, in an effort to secure a bigger pay day go back to school for a nurse practitioner degree. This new position not only gives them more money, 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 simply 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 a $100 and Air Jordan sneakers that topped out way more than that. Not only did overtime become mandatory for the breadwinner, it in many cases took two breadwinners to foot the bill. It has only gotten worse over the years as there just never seems to be any end to it. Computers kept on doubling in speed, video games became better and game systems kept on changing. Electronics became throw-a-ways. 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 a $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 it they are either working a second job or if available they are picking up overtime. Once they start working overtime to live their lives they are stuck in it for good. So just 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 that they can get full Social Security, 68 to 70 years of age? At the very least of these numbers, they are working 46 years as a nurse before they can retire. Maybe they are smart enough to put money into some retirement fund, so that they can retire a few years earlier, it still means that they are working from the mid 30s to low 40s in years as nurses. It is doable when you work three days a week and 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 spheel. 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 cash is just too hard and is not really 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 actually 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 repetitions because the more you do something the better you will get at it and eventually, it will become second nature. There are a lot of skills that a Registered Nurse (RN) has to know, how to do and even more that an intensive care nurse (ICU) has 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 just to start feeling comfortable on the the floor. Once you get to that point then you can finally finish improving on 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 just are not skilled in taking care of that many patients. It is even worse if you went straight into the ICU. So, once you have all your skills down and you feel comfortable that you can handle anything that might happen on your floor, now in my opinion you are ready to either take on a charge position or advance to a higher acuity unit.
To be a nurse you have to like people and you have to feel comfortable being around them and touching them. It sounds kind of simple but it is true. If you don’t like people or are not comfortable around they, you are in the wrong career. In regards to touching people, you have to be comfortable in 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 in 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 definitely falls on the plus side. Nursing is not for everyone. People that don’t mind sputum but do not like cleaning patients become respiratory therapists, and those that don’t wish to do any cleaning become radiology techs. There seems to be a position in the medical field for everyone.
While I did not start my career as a nurse, I feel that I was simply not in the right frame of mind to become one at that time. There are many nurses who started out in other careers before migrating to the medical field. I feel that life experiences make you who you are. Since I had to struggle 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 where you work. Sometimes you need some faith, if the conditions never seem to change even after several years go by, they will most likely will never improve and 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 really going to give the patient that pill you dropped on the floor? Not only does the patient deserve better, 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 spend a little time fussing around in the room to tidy it up a little. The family will appreciate it and will think a little more highly of you. They also tend to feel more comfortable in 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 body 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 trouble shooting 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 it sounds stupid but how many nurses treat their bodies like they have spare parts lying around.
Finally, if you want to be successful and a caring nurse, you actually have to care for people. You can’t just go through the motions. 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 really 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 will guarantee you that all but one of them will not have been moved or touched. 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 really 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 to just rent a boat when I wanted to use one.
The years you have lost working all those hours are truly lost, you will never get them back, especially when you lost out on family events. Work is nothing but a way to make money so that you can enjoy your life, don’t make it the reason you live your life. Eventually you won’t be able to do it anymore, then what?
I hope you found this book to be interesting. I packed it full as I could with all kinds of information, and stories.