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Just one year. Seems impossible that the time could go by so quickly, and so much could happen. But it seems like forever, really, like a distant nightmare. I was reading over some of what I wrote last year, and I am happy to say that I'm able to look at it without the emotion engulfing me. I've done a lot of healing in that time.
At first I missed the patients and some of my coworkers. But I've stayed in touch with the coworkers that mattered, and have more meaningful relationships with several. I've run into many of my former patients in town, and continue to work with a few of them, but in different ways now.
The work I do is so much more satisfying, I don't miss sticking needles in people or filling their veins with poison one bit. And I certainly don't miss punching a time clock so I could get a steady paycheck but feeling like I would have to sell my soul in order to keep getting one.
I have learned so much more since I left because I have more energy to read and research information on what's going on in cancer care far beyond the confines of a dingy little windowless cave subjected to the whims of toxic people who made decisions without considering the people they would affect most or asking for input from the nurses who worked with those people every day.
There are thousands upon thousands of nurses out there who have left what they felt were oppressive conditions in the workplace and moved on to something else. And I am just one.
Before I left corporate nursing I was surrounded by other nurses who were afraid. Some of them did not-so-nice things to each other, and to me. I no longer take it personally. Now my true colleagues are nurses who are not stuck in the system. They are not afraid. They have found a way out, and many of them have suffered great pain and loss to get to where they are now. Much worse than I did. They are a diverse group, some are employed in the profession, many are self-employed, many are out completely.
There is a common thread among most of these nurses, they love nursing and they would like the profession to change for the better, but there is a long climb ahead and it seems we lose ground on most days. Occasionally there is a bright moment, but then we fall back into the void.
There is a definite hum that's picking up in intensity, the misplaced blame on nurses in the Ebola situation fueled it, but that's only a glimpse of the problems. Nurses have HAD IT.
I've been listening to and talking with a lot of nurses over the past year, all over the country, and in other countries too. I've been thinking about ways to fix things, ways to improve things, and most of the work I've done has focused on individual people, which is good on my own, but always knowing that in the big picture of health care, most of the work nurses are doing in those workplaces is like building sandcastles at low tide.
And when the tide comes in, it's more of a rip current, a crashing of water with overwhelming force, an undercurrent that knocks you off your feet and threatens to drown your breath and silence your voice forever.
And the damage it does comes from all of the following forces and more...
1. A two-tiered system where managers, administrators and executives answer to money and quantitative data (numbers that are now called "metrics") that have everything to do with what they like to call "quality" but really mean more busywork for the people who are supposed to be doing patient care, but that data really translates to "reimbursement" aka money. Meanwhile the other tier, nurses, physicians and other health care staff, take seriously their professional oaths and training to not do harm, and the two tiers have little mutual understanding of each others' obligations to their own callings (money/boards/shareholders/stockholders vs. moral and ethical obligations to patients, oaths and licensure), each speaking it's own language not fully understood by or ever truly communicated with the other tier.
2. Lack of leadership in the highest ranks of nursing organizations, which consist of leaders from industry and higher education who protect their own turf which goes against the best interest of working nurses.
3. A great amount of fear among workers that has been exacerbated by the past three decades of eroding workplace protections, a mainstream media that fosters unrestrained hate and divisiveness and fosters paranoia and misinformation, ignoring facts in favor of hype. Attacks on free speech (in the craze over the second amendment, seems we've forgotten the first) and organized labor, and legislation that favors the big corporate money interests, giving them the rights of individuals.
4. A system on steroids that intensifies the poor people skills and lack of empathy held by a great number of those who advance to administrative positions and executive power, leaving the staff at the bedside populated by people who care about patients' best interests but without a voice or support to help them.
5.Lack of advocacy or assertiveness by nurses for their own interests in their workplaces in the face of strongarm tactics used to intimidate and dismiss their concerns.
6. Eroding job security as employers look to part-time hiring, reducing staff, decreasing benefits, and electronic spying on employees both in and out of the workplace.
7. Increasing burnout due to the task-oriented nature of nursing work and increased demands to do more with less staff, working equipment, support, training, at the same time being faced with expectations to increase the amount of documentation time and checklists, taking away clinical judgment opportunities and interpersonal connection in patient care duties.
8. A work culture that values "yes-men and women" more than clinical skill or attention to safety, that provides disincentives to speak, disagree, or otherwise question the status quo, motives, or actions of "leadership".
9. A capitalistic system run amok where the distribution of wealth becomes more skewed all the time with no brakes to stop it.
10. A legal system run amok with power that works in favor of the wealthy white collar criminals who can afford to buy their own teams of attorneys, and can buy lobbyists to buy politicians who will work even more in their favor, with no brakes to stop it.
11. A health care system that enriches the top-end insurance companies and pharmaceutical companies, but makes no investment in the base of the pyramid: health education in schools to teach children how to manage their health from an early age, universal basic health education for people at all stages of their lives with and without disease, teaching chronically OR terminally ill people about palliative care, the options not to treat some illnesses, death education so it is accepted as part of life and not so feared and avoided at all costs.
12. A public health system that has been underfunded to the point of endangering public health by promoting misinformation and being embarrassingly unprepared for a crisis.
13. A for-profit so-called health care system (even though some of it calls itself not-for-profit but it is still working for profit) that results in competition to a degree that hurts patients' best interests by withholding information about options and resources available to them outside of an organization's domain. Health care is not at all about health, and it is not about caring. It is about making money off of chronic illness, of various types and trajectories.
14. The collective personality-disordered nature of "leadership": with it's insecure, narcissistic, sociopathic bent that has no empathy for patients or their families true needs, or the needs of direct patient care workers. This distorted method of leadership pursues matters in the interest of building their egos, power, status, bonuses, perks, and the ultimate perk of all, the insurance policy of guaranteed future personal economic security via outrageous sums of money upon leaving an organization regardless of the reason.
There's a lot to say, and I'm not done saying it. Just getting warmed up.
I'm not dead yet, and I won't be done until I'm dead. I don't know how long I'll live, but if I died today, I'd be okay with it.
Because at least I will know I tried, I spoke from my heart, I called out what I saw, and I felt the passion and the horror, witnessed the suffering and the relief, and I know I lived true to myself and my own principles.
And unlike those narcissistic shadows holding nooses around the necks of hardworking direct patient care nurses, I didn't look the other way knowing what I was doing, despite what I claimed and hid behind, was really not about caring for people but instead lining my own pockets and enriching myself at the expense of other people's well-being.
There are at least three differences now.
One is that I can say these things calmly, without the raging anger that I felt a year ago.
Two, I am on the lookout for solutions, and I know I am not alone, as I felt a year ago.
Three, I am pursuing my passion, and I have no one holding me back, I have lost the shadow and the noose of a year ago.
Every day I wish the same for my fellow nurses who are feeling alone, stuck, and fearful in those oppressive environments. I hope they find their way out of the dungeon, because they already have the key, they just have to turn it.
I've been listening to and talking with a lot of nurses over the past year, all over the country, and in other countries too. I've been thinking about ways to fix things, ways to improve things, and most of the work I've done has focused on individual people, which is good on my own, but always knowing that in the big picture of health care, most of the work nurses are doing in those workplaces is like building sandcastles at low tide.
And when the tide comes in, it's more of a rip current, a crashing of water with overwhelming force, an undercurrent that knocks you off your feet and threatens to drown your breath and silence your voice forever.
And the damage it does comes from all of the following forces and more...
1. A two-tiered system where managers, administrators and executives answer to money and quantitative data (numbers that are now called "metrics") that have everything to do with what they like to call "quality" but really mean more busywork for the people who are supposed to be doing patient care, but that data really translates to "reimbursement" aka money. Meanwhile the other tier, nurses, physicians and other health care staff, take seriously their professional oaths and training to not do harm, and the two tiers have little mutual understanding of each others' obligations to their own callings (money/boards/shareholders/stockholders vs. moral and ethical obligations to patients, oaths and licensure), each speaking it's own language not fully understood by or ever truly communicated with the other tier.
2. Lack of leadership in the highest ranks of nursing organizations, which consist of leaders from industry and higher education who protect their own turf which goes against the best interest of working nurses.
3. A great amount of fear among workers that has been exacerbated by the past three decades of eroding workplace protections, a mainstream media that fosters unrestrained hate and divisiveness and fosters paranoia and misinformation, ignoring facts in favor of hype. Attacks on free speech (in the craze over the second amendment, seems we've forgotten the first) and organized labor, and legislation that favors the big corporate money interests, giving them the rights of individuals.
4. A system on steroids that intensifies the poor people skills and lack of empathy held by a great number of those who advance to administrative positions and executive power, leaving the staff at the bedside populated by people who care about patients' best interests but without a voice or support to help them.
5.Lack of advocacy or assertiveness by nurses for their own interests in their workplaces in the face of strongarm tactics used to intimidate and dismiss their concerns.
6. Eroding job security as employers look to part-time hiring, reducing staff, decreasing benefits, and electronic spying on employees both in and out of the workplace.
7. Increasing burnout due to the task-oriented nature of nursing work and increased demands to do more with less staff, working equipment, support, training, at the same time being faced with expectations to increase the amount of documentation time and checklists, taking away clinical judgment opportunities and interpersonal connection in patient care duties.
8. A work culture that values "yes-men and women" more than clinical skill or attention to safety, that provides disincentives to speak, disagree, or otherwise question the status quo, motives, or actions of "leadership".
9. A capitalistic system run amok where the distribution of wealth becomes more skewed all the time with no brakes to stop it.
10. A legal system run amok with power that works in favor of the wealthy white collar criminals who can afford to buy their own teams of attorneys, and can buy lobbyists to buy politicians who will work even more in their favor, with no brakes to stop it.
11. A health care system that enriches the top-end insurance companies and pharmaceutical companies, but makes no investment in the base of the pyramid: health education in schools to teach children how to manage their health from an early age, universal basic health education for people at all stages of their lives with and without disease, teaching chronically OR terminally ill people about palliative care, the options not to treat some illnesses, death education so it is accepted as part of life and not so feared and avoided at all costs.
12. A public health system that has been underfunded to the point of endangering public health by promoting misinformation and being embarrassingly unprepared for a crisis.
13. A for-profit so-called health care system (even though some of it calls itself not-for-profit but it is still working for profit) that results in competition to a degree that hurts patients' best interests by withholding information about options and resources available to them outside of an organization's domain. Health care is not at all about health, and it is not about caring. It is about making money off of chronic illness, of various types and trajectories.
14. The collective personality-disordered nature of "leadership": with it's insecure, narcissistic, sociopathic bent that has no empathy for patients or their families true needs, or the needs of direct patient care workers. This distorted method of leadership pursues matters in the interest of building their egos, power, status, bonuses, perks, and the ultimate perk of all, the insurance policy of guaranteed future personal economic security via outrageous sums of money upon leaving an organization regardless of the reason.
There's a lot to say, and I'm not done saying it. Just getting warmed up.
I'm not dead yet, and I won't be done until I'm dead. I don't know how long I'll live, but if I died today, I'd be okay with it.
Because at least I will know I tried, I spoke from my heart, I called out what I saw, and I felt the passion and the horror, witnessed the suffering and the relief, and I know I lived true to myself and my own principles.
And unlike those narcissistic shadows holding nooses around the necks of hardworking direct patient care nurses, I didn't look the other way knowing what I was doing, despite what I claimed and hid behind, was really not about caring for people but instead lining my own pockets and enriching myself at the expense of other people's well-being.
There are at least three differences now.
One is that I can say these things calmly, without the raging anger that I felt a year ago.
Two, I am on the lookout for solutions, and I know I am not alone, as I felt a year ago.
Three, I am pursuing my passion, and I have no one holding me back, I have lost the shadow and the noose of a year ago.
Every day I wish the same for my fellow nurses who are feeling alone, stuck, and fearful in those oppressive environments. I hope they find their way out of the dungeon, because they already have the key, they just have to turn it.
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