Working on Holidays

I was at the receiving end of a comment recently, which was clearly intended to belittle, from an unlikely source… a parent of a sick child in the hospital… the remark was this “Who are you… you’re not important, you’re here working on a holiday”. In my nearly 30-year career, I can honestly say, that was a first. The world of healthcare is not a 9a-5p, Monday-Friday job… hospitals do not close down for summer vacation, snow storms, weekends, or holidays… they are always “open for business”. Nursing is a 24/7/365 job. In fact, during any type of disaster, emergency, or significant weather condition, nurses are considered “essential personnel” and are (strongly) advised to report for duty. While most others are warned to “stay off the roads” during a State of Emergency, we pack overnight bags in anticipation… and when the time comes, we search for an open stretcher in a quiet corner and (try to) sleep so we can work the next day in case others cannot make it in for their shift.

Nursing is a profession of dedicated service to the community in which it serves, just like police officers, EMTs, and firemen/women; and it’s not just nurses that keep a hospital running smoothly… it’s also the Doctors and Advanced Practice Nurses, Patient Care Techs, Respiratory Therapists, Security, Housekeeping, Food & Nutrition, etc. We all know the expectations going into our roles. I have worked many, many holidays in my long career…and yes, I still do. I worked on Christmas Day last year, and I will most likely need to do it again this year. I accept it, and I am grateful that I have a job that I love, with people that I have grown to love. We all have families that we would like to celebrate the holidays with… but if we can’t, we make the best of it; we post a sign in the staff lounge for a pot luck feast, and we all contribute to the festivities… we find ways to laugh through it, and we reschedule the time that we can spend with our own family so that we can take care of yours. Working on a holiday is not a measure of importance or title… it is just something that we know we must do to care for those who need us.

I wish that I was able to say what I was thinking to this parent, but I bit my tongue; I am in a position that requires me to de-escalate situations, rather than speak my mind. But I do wish that I would have pointed out that those he attempted to minimize (it was not just me), were there (on a holiday) taking care of his child… and that is not unimportant to us, and it shouldn’t be to him either.

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Celebrating Nurses

Every year around this time I receive a “Happy Nurse’s Day” card from my parents…today, my card came from my Mom; she always remembers. She reminded me how proud she is, and how proud my Dad was, of me being a nurse. The loss of my Dad always sneaks up on me. It is that constant flow of support and love that has been the driving force throughout my career, and completion of my Master’s degree. The journey that I have been on has not always been smooth sailing; there have been more than a few bumps and sharp turns (and U-turns) along the way, which have led me to where I am today…which is mostly a good place.

Nursing has been the one constant in my life. This amazing profession has helped me to grow in my career and overcome many challenges. It allowed me to support my daughter as a single parent, buy a home, and basically make “ends meet”. We are not paid nearly enough for the work that we do, but we get by.

I have worked with amazing nurses in my long career and they will always be my forever friends; the “job” connects and bonds you in a way that most other professions do not. We share similar stories, frustrations, heartbreaks, and challenges. Nursing is hard work and often we do not get recognized for having sharp instincts, endless patience, strength, and resilience…all with the sole purpose of keeping our patients alive!

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Nursing Supervisors    

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As a nurse leader, it can be challenging to perform your role while walking the line between Nursing and Administration; the rules change. We are held accountable to strictly adhere to staffing guidelines, ensure patient and staff safety, consider patient acuity with staffing that is balanced with expert, competent, and novice nurses so that those with more experience can teach and develop new grads. In most hosptials, there is an abundance of upper management/leadership support and resources for patients and staff during the weekdays; on the off-shifts (eves and nights), weekends, and holidays, the responsibility of “steering the boat” changes from “many” to “one”; this singular, fearless leader is the Nursing Supervisor, who has to make difficult decisions and know when, and who, to call for help. They are called to respond to patient/family complaints/concerns, patient and non-patient emergencies, and occasionally discipline/coach staff… all while knowing that some of the choices you have to make may not be popular or well-received. I try to make the best decisions that I can, with the information that I have at the time. I am imperfect. I have made mistakes. I have miscommunicated via email, and I may have been too busy to remember to count to 10, and think before I speak during a particularly stressful moment. I am acutely aware that during every shift, I have a ton of responsibility to many: patients, families, staff, colleagues, and administration. Not everyone can appreciate that perspective…some can only see what is happening in their own area, and not the other things that may be going on in the rest of the hospital that can sometimes take precedence. We only know what we know.

Several years ago I worked with a really strong and brilliant Nursing Supervisor, Jackie; she did not mess around….she knew everything that was happening in the entire (very large) hospital, even if she wasn’t covering those areas. She could work the staffing numbers like a mathematician, and quickly move people where they needed to be to balance the numbers. In a crisis, she was calm, cool, and collected. She taught me a lot and never gave up on me, even when I made the decision to return to staffing and not stay in that role; I just wasn’t ready at the time.

We all have our own leadership styles, but the most important thing is that we lead with authenticity; we do the best that we can, practice the values of the organization, develop trust, and show compassion for others.

Happy Nurse’s Week! Enjoy the recognition from your family, friends, colleagues, and the organizations in which you work. You have earned it! It is the best job in the world!

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Defending your Life: A Nurse’s Story

defending-your-lifeheaderI recently watched the movie Defending your Life (again, for at least the 10th time), which is a romantic comedy that came out in the 90’s starring Meryl Streep and Albert Brooks. In the movie, Meryl Streep plays someone who lived an exceptional life on Earth; she was brave and generous in her life, giving of herself, and her love without fear. Albert Brooks, while a good person at heart, was someone who made some bad choices because he allowed fear to rule his life. The concept of the movie is that all who pass (with the exception of children and animals), must stand trial in Judgement City to defend their actions in life; both good and bad. More importantly, the ability to overcome one’s fears was examined in order to be deemed worthy of advancing into the next phase of their existence… or, be sent back down to Earth for a do-over. The plot is complicated by both characters falling in love during their brief time in the afterlife; and Meryl’s character, who was brave and faced her fears in life, was judged to be able to move on; while Albert’s character, was not. Not to worry (spoiler alert), in the end, good ole’ Albert finds the courage to fight to join Meryl in her tram ride to Heaven; and those who had judged him not worthy, saw this act of bravery, and decided to let him stay with Meryl. The end.
This movie always makes me wonder if I would ever be deemed worthy enough to pass into the next phase of existence. I am basically a good person; I’ve made mistakes, sure, but let’s face it, who hasn’t? If I were put on trial today, would I be able to prove that I overcame my personal fears? I would say no, not even close. My fears and anxiety have only grown as I have gotten older. Let’s be honest, we are in trying times right now; between our twitter-happy commander-in-chief, the potential for war with North Korea, the questionable future of the Affordable Care Act in healthcare, climate change and the environment, and having to wait until 2019 for season 8 of Game of Thrones, our future is uncertain. Of course I realize that losing sleep and worrying over these important issues isn’t actually solving any of those problems, just adding to my neurosis. The best thing that I have going for me is the work that I have done/do as a nurse. Surely, that has to hold a lot of weight for the big guy, am I right?
Nursing is a very demanding and sometimes, thankless job. We care for all patients equally, risking our own health (mental and physical) to work long shifts, 24/7/365; missing holidays/special events/dinner with our families/sleep/bathroom and meal breaks, etc… and that’s just touching the surface. Each day is an unpredictable adventure that brings new challenges and struggles: short staffing due to sick calls, train wreck admissions from the Emergency Department, patients “crashing”, c-diff, isolation precautions… fill in the blank. Are we perfect beings, no, but we work really hard and try our best every single day to care for those in need. Heck, just showing-up is half the battle and deserves some form of recognition; three 12-hour shifts in a row should be bonus points for earning a place in Heaven for sure. But are nurses brave? Abso-freakin-lutely! In New York and New Jersey, nurses were some of the first responders that were in a state of readiness after the 9/11 terror attacks at the World Trade Center; all employees were called into action, waiting for patients that never came; this realization was the most difficult to accept. We were greatly affected after Hurricane Sandy as well; many hospitals were running on generators and managing to run safely to care for patients with limited supplies that were delayed in being replenished due to the inability to receive new deliveries for several days. Many staff were unable to get to work; those who were already there, stayed, praying that their own families were safe and sound at home. A few years ago, nurses were trained to safely care for Ebola patients; that took a lot of courage. Many were nurses who volunteered to be trained, even after a nurse in Texas contracted Ebola after caring for an infected patient. That is what nurses do; we care for those who need us. We must always be in a state of alertness and ready to be called for duty to provide care in any situation. I believe that nurses overcome some degree of fear every day; you walk into your unit never knowing what the next 12+ hours will bring. It’s always a surprise, good or bad. I also believe that nurses help their patients through their fears; when patients are their most vulnerable, and most afraid, it is their nurse that sits beside them, holding their hand, and letting them know that they are not alone. Nurses truly defend and advocate for their patient’s lives every single day. I like to think that in the end, if and when we are called to defend our lives, that is what is most important.