Saturday, December 22, 2007, 7:56 PM
This has been the week from hell at work (one of many past and many more to come).
I've often encouraged others to take care of themselves. Reminded them that an individual can't be all things to everybody. To be mindful of the present and don't worry about what one can't control.
Now if I can only follow my own advice.
I've stressed myself at work to the point of having chest pain (again).
I know, I know, all chest pain is cardiac until proven otherwise, and this is transient and situational. The doc's checked me out. It starts when I drive up to work and ends when I go to sleep.
I work on a Medical-Psychiatric unit (a hybrid unit that takes care of the acutely medically ill that also have some psychiatric/cognitive/dementia/substance abuse issues). I'm proud of my quirky little unit. We take care of the folks that no one else wants (the psychotic/ the demented/the sometimes manipulative/the sometimes violent).
The nursing shortage means getting nurses to work in the hospital is tough enough much less trying to get some to work on my unit.
I've been orienting nurses pretty much non-stop for a couple of years now. We hire them, I orient them sometimes two nurses at the same time, they quit, hospital hires another: revolving door.
I haven't been happy with my level of nursing care for a long time. Much of my time is spent filling out paperwork. I've even developed a checklist to help me keep track of what forms I still need to fill out on a daily basis.
My shift ends at 3 pm. It's been as late as 6:30 pm this week before I get out of the hospital after going to hide and chart.
You may ask "samhain, you idiot, why do you stay at your job?" Believe me, I've been asking myself that for some time.
My coworkers would have to be the reason #1.
I can't abandon them. They struggle to do the best job they can under tough conditions and if I left, the only thing that would be accomplished is that they would be another nurse short.
I can't say my patients are the reason because 1) I've taken care of them out on the unlocked units before Med-Psych was established, and 2) I haven't been happy with my level of nursing care in some time. Nothing unsafe or unprofessional, just not enough of it.
Leaving my unit wouldn't be an answer because I listen to the other nurses on the other units and other hospitals. I've been a nurse for 13 years, in this hospital for 15 years. I know it's not any different anywhere else, and worse in some places. (There's a hospital in my area that's nicknamed the "salt mines" by some of the nurses that have escaped).
I've worked as a clinical educator for a couple of years and I was miserable away from the bedside. It was the same no-win paperwork mill but without the sense of purpose that I had (sometimes) at the bedside.
It's becoming more and more difficult to encourage our nursing students that come to my unit for clinicals. I feel like I'm lying to them. I teach them every trick I know how to manage their time, keep up with the ever increasing paperload, anything to make their day easier and their patient care better when what I really want to tell them is "RUN AS FAST AS YOU CAN, GET OUT WHILE YOU CAN".
My social worker on the unit fed one of my patients the other day, and instead of feeling grateful to her for going above and beyond the call of duty to care for my patient, I felt ashamed that I wasn't able to do it and jealous of her for being able to do that (yes I did thank her profusely and kept my shame to myself)
We are beginning to implement a computerized charting/medication system that will probably take two years of hell to implement. There will be much knashing of teeth and wailing to which I want to respond "just shut up and do it or get out", but that won't help so I'll nurture and teach as best I can.
This is the one hope I have that will save the career of nursing for me. It's a slim hope because I'm old enough to know one doesn't solve problems, one only trades off consequences. If this doesn't free me up to do the patient care I want to do, then I'll need to leave nursing all together.
I've been practiceing: "would you like fries with that?"
peace (more broken-hearted than peaceful)