Snark Alert! Nursebots' Week: Humanity is a Doormat

lion image credit: Nathan Nitzky

We now interrupt our regularly scheduled programming for this important public service announcement:

Readers, consider yourselves forewarned: You knew I couldn't possibly make it through a Nurses' Week keeping my mouth shut. So here it is, my thought for the week...

I haven't been on my soapbox about health care in a while, but this is a time of year that always lights a fire under my butt. I'm not having to deal with it directly anymore, which has done wonders for my physical and mental health, but I have many friends and colleagues who are still being rocked seasick on the tsunami of health care reform in the age of corporate dominion.

You've read my other posts and rants about nursing, I've said these things before, as have so many other people. Here's my take this time.

Patricia Singleton's excellent blog about abuse and healing from incest has much that is applicable to the corporate workplace. In a recent post she was writing about healing and educating, and stopping the abuse.

She writes, "It is through silence that...abuse has been allowed to continue and flourish for so long and become an epidemic in our world."

She further states, "If we don't educate people, who will...Abusers thrive in the silence. They count on the silence of those that they abuse. They count on the subject to continue to be taboo in society. The silence gives them free reign to do what they want. I refuse to be silenced again."

Workers are scared, they want to keep their paychecks, they have seen how the system handles dissent or differences of opinion. Retaliation is rampant, I experienced it the minute I opened my mouth. When the powers that be don't get blind allegiance and compliance, they do things to try to get rid of people. They threaten them with unsavory working conditions and force them to quit.

Someone has to talk about it, former coworkers tell me the old trick of writing letters doesn't seem to get any traction, and these people are so exhausted and defeated that they have no hope that their efforts will work. Conditions keep getting worse. Staffing won't get any better thanks to the dumbasses at the top, who cut regular staff and then have to hire expensive travel nurses to replace them, so that they can slide their Teflon-coated tactics just under the wire of getting dinged for dangerous work conditions. On what planet does this make sense?

The privileged and tone deaf executive class's planet. To be a fly on the wall at an ACHE conference...

It's outright abuse of health care workers. But it's part of the big picture of what we're doing to people everywhere in this country, the old, over-repeated story of the rich getting richer and the average people getting squeezed to death. People accept it because they feel powerless to change it, because they are too exhausted.

It's not a "caring profession" like the nursing school instructors tried to impart to us in their pathetic attempt to sell us a line of bullshit. Nursing schools are part of the problem, they keep the dysfunctional cycle going.

What kind of caring profession allows it's members to be lucky to make it through a work day without making a mistake? Who can care when they don't have time to look at the patient because there's so much charting to do? Not being able to take time to pee or eat for a 13 hour shift? Throwing pills in front of the patient and running out of the room? Clocking out and working for free after 12 hours because you didn't have time to chart everything but you'll get in trouble if you go into overtime?

I ran into a former coworker from the ICU in Starbucks last week. She was getting off night shift. She gave me an earful and she's always very animated and expressive about what's going on. Nothing I hadn't heard already from the others I keep in touch with.

I saw another hospital worker in there recently, early in the morning. I can remember those mornings, going in for my shift and walking across the bridge from the parking garage, seeing the downtrodden body language and frowns of people who used to smile and greet each other.

It was interesting listening to my former coworker talk. I was able to keep a detached and very occasionally amused distance from it, that means I am healing and not so personally wrapped up in it anymore. But I still feel the anguish and the frustration. It is a horribly stuck feeling. I see it in the twisted foreheads and heavy shoulders of these defeated, exhausted people. This is what we're allowing to happen to our fellow human beings. The same ones we expect to take care of us when we're sick.

Is there anyone out there who sees this and will take a sane approach? I will not see that in my lifetime, I doubt it. Elizabeth Warren talks about the parallels in the banking industry and how the little guys are getting abused by the way the system is stacked against them.

I do have hope that the millenials will turn things around. They will have to, or they will be doomed to a miserable existence. No one is investing in their future, instead, the older generations are sucking them dry, making money off of their futures. You can't prune the tree and expect it to bloom when you don't water the roots.

I am constantly amazed by the fact that the health care industry has no leaders who recognize that in taking all these steps forward, then panicking over missteps, staying focused on cutting costs, they are killing the workers and that leads to worse health care.

From physicians to nurses to techs to the people who take out the trash and serve the cafeteria meals, if they take the fast track to overworking everyone and burn them all out then what will we have? Richer CEOs and no health care. Mistakes. Injuries. Deaths.

The whole thing makes no sense whatsoever. Nursing doesn't even make sense anymore in this health care debacle. Keep on burning out physicians and making them leave medicine or preventing the brightest ones from entering it. Keep on grooming nurse practitioners, until there's a glut. Keep on relegating registered nurses to the status of court reporters.

Not that court reporting isn't an important job. It's just that when you're dealing with people's life and death situations when they are sick, you need to be able to focus on the sick person and not the transcription process.

Hell, court reporters make about as much as nurses do, with a lot less stress. They don't have to worry about killing someone.

I am sad to say that I no longer recommend that anyone take up nursing as a career. Recently someone asked me if I would attend a middle school career day to talk about nursing. I couldn't attend due to a prior commitment, but after thinking about it I realized I couldn't live with myself if I contributed to the lie.

The next time someone considering nursing wants career advice, I know what to suggest!

We will now return to our regularly scheduled program...Adventures in Iowa...

Detox Day One: Healing from Health Care

I survived the weekend. Thankfully everyone there this weekend was cool. We actually had enough staff and we were able to get through our days without being impossibly rushed. As soon as I got there Saturday morning and saw who was on I was able to relax and enjoy the weekend. I thoroughly enjoyed the patient care part of it.

I'm looking forward to the real detox, though I know it will be difficult to make it through those last two weeks when I go back in November. I look forward to having some breathing time, do a little healing, though I know how fast that can be reversed! At least when I go back, I will know it is my final stretch. So this is sort of a pre-detox session, and I will do the real one when I'm completely done after November 16th.

I woke up Sunday night hot flashing and came into the extra bedroom office and tried to cool down. I wish I felt like my life was mine again. I want to get back to feeling better physically so I can move forward too.

I went back to the pool this morning and started my workouts again. I won't be working too hard, just getting the relaxing effect of a long workout in the water followed by an easy run on land. Running in the pool and swimming are both physically and emotionally therapeutic, and the water supports you. It's almost like getting an all-over hug.

Last week again I was too stressed to do anything substantial, I ran an hour each on three different days. I'm starting to envy all the people posting about their marathons and workouts on Facebook.

So this morning in the pool I ran for an hour with no problem. I even did some intervals to break up the monotony. I planned to swim 1200 meters after that. I got in the pool and began to swim. On my very last lap before I hit 800 meters, I got a killer calf cramp that made me stand straight up in the pool and I almost screamed out loud. Fortunately I was in shallow water and I was on the lane next to the edge of the pool so I grabbed onto the side of the pool and stood there until the cramp let up, but it never really did. Every time I thought it was easing up I started to move and then it would seize up again, just as painful as before.

I knew I was done for the day. I was probably dehydrated from my work weekend- I never drink enough during my shifts, and I've been drinking beer at night and coffee in the morning. I knew I needed to get out of the pool, go home, and rehydrate. But first there was the problem of moving without cramping.

Finally, I used my arms to pull myself to finish the lap and waited for a few minutes, stretching, before trying to climb out of the pool. When I got myself up there, I got two more cramps- this time in my gracilis muscle- my inner thigh- and the arch of my foot. All the cramps were on my left side. So I sat there on the edge of the pool, I couldn't get up. I had to pull myself up by the starting blocks and slowly limp toward the locker room.

Later I had lunch with a friend who used to work with me, she went through a remarkably similar experience to mine before she left. It was good to talk with her, and I know that I will move on beyond this, as painful as it's been.

The thoughts that go through my head these days are about nurses who get out of nursing, and there are so many of them, there is so much support and validation from those who got out. I'm discovering a whole world out there of nurse entrepreneurs, independent nurses, people who either couldn't deal with the oppressive environment of hospital and corporate nursing, or got out on their own for some other reason.

It makes me wonder, what is it that keeps people in hospital nursing, in these toxic environments, for twenty or more years? How can anyone stomach that? But they do. Do they love it that much? Scared to change? Scarred by compassion fatigue from lack of time to debrief after traumatic experiences? Slaves to a paycheck? I suppose there are people who are able to separate themselves mentally from the environment so they can go on. And there are others who are sensitive to it and stay and become sick.

I know I look sick. I am washed out, wrinkled, overweight, my eyes are sunken into my head, I don't even feel like I have an athlete's body anymore. I want to get back to taking care of myself. The past six months I haven't even been able to stick to a consistent routine of working out and eating right.

Sunday my coworkers were talking about one of the nurses we used to work with who was in a different department from us but used to come to our area to help us a lot. She left about a year ago. They said she looks great, she lost 60 pounds, she looks younger, her face doesn't look drawn or stressed anymore, and she's happy.

I had some pictures taken last week by a professional photographer, for my business website, and I couldn't believe how bad I looked. I really do look awful, pale, older, matronly. Not healthy or athletic or anything resembling active or vibrant. I don't even recognize that person in the photographs. I need to wait until about 6 months after I leave the job and then get them re-taken.

I wrapped up the day by going out with another former coworker. As we talked, there were a few things that came up in the conversation that validated my decision to leave even more. I got home by 9 pm and went to bed, and slept pretty much straight through the night...

Got the Belt Buckle This Time!

As every ultrarunner knows, the belt buckle for finishing is one of those perks. It's never about the buckle, it's about the satisfaction of finishing and succeeding at what you set out to do. There's a lot that goes into that belt buckle, not just in the race itself, but in all the preparation, dedication, discipline, focus, and pure enjoyment along the way to holding one of these in your sweaty, sticky palms after being up all night and into the next day.

About a month and a half ago I tried to do something and failed. I tried to quit my job but somehow came away with a DNF, did not finish, I didn't quite accomplish the task. Somehow I ended up taking on a relief position. Well that was a mistake. I should have gone with my gut the first time. I'm paying for it by having to do another 4 weeks of work, but today, I finally got the buckle. I turned in my letter of resignation and in 30 days I'll be gone for good.

Why? There are multiple reasons why, and as you've read through my tirades about nursing over the past months, it's obvious that I am completely burned out. I'm burned out on the things that are wrong with both nursing and health care. I'm burned out on the things that are wrong with corporate dominance and our ruined legislative and judicial systems. It happens everywhere, and I just don't want to be a part of nursing in the corporate world anymore. I'm not going somewhere else, it's the same everywhere. I'm getting out.

I am tired of spending maybe four times more time in front of a computer than doing actual face-to-face, hands-on nursing care with the human beings who come in. I'm tired of watching an endless parade of nurses marching out the doors, I'm tired of them eating their young, and not-so-young. I'm tired of watching nurses (mostly women nurses, unfortunately) backstab each other, playing the dead even rule, attacking those who shine in some way, are recognized, or have skills or talents that make them stand out. I'm tired of those evil little passive aggressive games like in junior high. I hated every minute of junior high. It sucked. It was traumatizing. I don't care to relive it.

I'm tired of executives and administrators who live in their own little self-contained world and don't speak to nurses, and don't include us in making any decisions about how things are implemented that will affect patient care. I'm tired of watching the Peter Principle in action and people trying desperately, and sometimes viciously, to hide their incompetence from anyone who might question or threaten their qualifications to be in their comfortable positions. I'm tired of knowing about the well-padded lives these people live as they play games with the bone-on-bone lives of those who do physically and emotionally draining work for long hours to directly support the needs of human beings who are sick, scared, and vulnerable.

I'm tired of the people who talk out one side of their mouth about cutting budgets, staffing, and unnecessary spending, then out the other side dictate decisions that enrich the executive class like huge extravagant severance packages, or slashing staffing based on the bean counters of some expensive consulting firms. Adopting their suggestions that don't have any basis in the reality of what goes on in the patient care areas.

I'm tired of watching them backpedal and pull themselves back from dangling over the edge of a cliff because they put too much faith in those bean counters and now, they have to hire expensive travel nurses because they got rid of too many of their staff. Putting tons of money into building up their public image while providing less care for the real people who use the services, because they cut staffing.

I'm tired of hearing people talk about concepts like leadership and accountability when they couldn't lead their way out of a cardboard box, or account for which box they'd been in. And the list goes on...

What's hardest for me? I wish it had been more satisfying, more understanding, more caring, more empathetic, more supportive among nurses themselves. It creates toxic work environments that leach waste into everyone and invade the deepest crevices of their lives in every possible way, on their days off, during their sleep hours, into their family lives, and more.

Oh yeah, and I made quite an investment of my time, almost the last 10 years of my life have been devoted to this. I went back to school at 41 and got my first nursing job in 2006, and almost exactly seven years to the day after starting that, I am done. That's all it took. Seven years to burnout.

Now I'm trying to salvage my health, aware of my increasing age, knowing what stress can do, in the back of my mind knowing my family history of breast cancer and leukemia, and who knows what else, hoping that I haven't done irreversible damage to my body, and lately my stomach feels like it's getting a hole in it. And trying to keep track of my own mental health, too, making sure I'm not falling into a pit of depression.

The main reason I'm leaving corporate nursing is simply stated by the bumpersticker I happened to see on this car in front me as I drove over to the hospital to deliver my letter of resignation to my boss this morning.

There is a great need for more kindness. In life in general, in workplaces everywhere, yes, but nursing could use an infusion of this stuff, at least twice a day. Corporations might have certain rights as human beings, but they are not human, and certainly not humane. The larger they get, the further removed they are from being able to recognize the real needs of people who are served by them, or work for them.

So it's time to heal again. This nurse is healing herself. I'm healing from health care.

And more fall pictures. This year has been so colorful. Maybe it just looks that way against the dull backdrop of my mental state lately, but I know it's real. This is the world I'm returning to.

Goblin at the No Goblin, and Silence

Signed, sealed, delivered. Not that I had any question about who I would vote for. I don't expect any magic solutions to society's ills in the next 4 years as a result of this president or any other, but I vote with my conscience, and I can only vote in the direction I'd rather see us moving. Now if I could just get the phone calls to stop, it would be delightful.

Tomorrow I'm headed to Denver to hang out, not run, with a group of ultrarunners I've known for many years. We're all old fart ultrarunners, except me of course, most have been in the ultraworld for at least the past 20 years, and the premise is "No Goblin Gas".

There usually is a race in Utah that is a day's drive away for most of us, called the Goblin Valley 50K, and it has been cancelled indefinitely, so this year they are staying home and doing a 50K training run in southwest Denver. And what would an ultra be without a party, food and beer afterwards?

I'm going to walk with Steph for a couple of hours, then we'll set up for the post-run BBQ. I plan to do a lot more of the goblin than the no goblin. I will also get to meet Sylvia, who is my friend Ed's new girlfriend. That's Ed who ran with me in the Black Hills this summer. He was just starting to date Sylvia when we were there in June, and things seem to be working out.

I survived another two days of work. Thought I would never make it through the first 12 hour shift, but I got 9 hours of sleep afterwards, a rare event for me on a work night, because I didn't have to go in until noon on Thursday. Then I only worked 9 hours because I had the closing shift. It was nice to not feel exhausted at work for a change.

Lately I've talked a lot about work and work hangovers and I vent because I do get tired, 12 hour shifts are hard, especially with the psychosocial components of the work I do. That's why nursing is a profession in which it is so easy to burn out.

It's easy to hang a bag of chemo or a liter of fluids, but taking care of the patient's needs demands not only attention to their physical condition, but also to everything they need in their lives when living with a serious illness.

One of the things you see in nursing, that is more the norm than the exception, is the propensity for people's past life issues to come out when suddenly they are faced with a life-threatening illness and the rigorous treatments that go along with that.

So many people have not worked through their past traumas to the point where they can consciously identify them, and have the awareness that something they are experiencing in their body during cancer or other treatment is a result of their past psychological history, and not the current physical condition.

When they experience the trauma of cancer treatment, all the unresolved issues come charging to the surface and it can be a huge obstacle for them as they struggle through the intensity of staying on track with medications, appointments, procedures, follow-ups, treatments, side effects, and dealing with the issues that come up in their own families surrounding their illness.

I'm not even going to delve into it here, but who knows how much the trauma of past experience affects the immune system to the degree that genetic mutations that happen at the cellular level are allowed to flourish unchecked and become cancer.

I had my review at work yesterday. It went well, there's always an element of anxiety before you go in to find out what they think of you and what your peers have to say. I am so thankful that I work in a place where I can get useful, valuable input and support to go along with it, that truly helps me professionally and personally. I think I work in one of those rare workplaces, which I attribute to careful, consistent, and conscientious management for many years. That is rare these days in the workplace.

Which is the exact opposite of what I experienced in my previous workplace. How fitting then, that Patricia Singleton posted this post on her blog yesterday.

If you feel like reading her blog, there is a link at the bottom under "blogs I read" on the right hand side of this blog as you scroll down. A blog about sexual abuse doesn't really fit in to a running blog, but I find Patricia's blog applicable to everything in life, because of the theme that underlies her writing. It's about ending violence and abuse, and shedding light on the forces that perpetuate abuse. And that applies to all kinds of violence, not just sexual abuse.

The way I found Patricia, was way back in the days when I was a new nurse working in ICU, I was having one of my sleepless nights and dealing with a lot of the workplace violence that nurses often experience, called "eating their young".

When I worked there, there was a culture of abuse, not only directed at new nurses, but at anyone who failed to kiss the narcissistic boss's ass along with her minions. Almost everyone was intimidated into silence, except for a few of us who spoke our minds, and we became the targets.

Eventually, after a large percentage of the staff turned over within a year, the administration got wise and got rid of that boss. The reason it was allowed to go on so long was that there was a person in a high level administrative position who was protecting her and looking the other way, and until that person left the organization, nothing happened.

Justice was served in that case, but not before many of us experienced a lot of physical and mental stress that was costly not only to us as individuals, but to the organization.

I stumbled on Patricia's blog with a Google search on some topic related to violence or abuse in the workplace. I found Patricia's insights to be enlightening and perceptive, and since someone important in my life is a sexual abuse survivor I also found the insights on sexual abuse and its consequences to be valuable and eye-opening for me.

I think this blogpost from Patricia and the links she includes within the post are excellent and thought-provoking reading material, they are short and easy to read, but worthwhile. The violence associated with silence affects everyone, in some way. There is no person who is immune to any type of abuse. Perpetrators of abuse don't just become that way by themselves, they have experienced abuse in order to learn how it's done.

I think it's important to bring silence to everyone's attention because we are all indoctrinated with compliance at an early age, don't make waves, don't speak up, keep a low profile. It's easier to ignore injustice than to act on it.

There's much work to do, it's a political issue as much as a personal issue, that could be a whole blog in itself. I think it's a good idea to check ourselves every so often. Am I speaking up about issues that I care about? Am I serving someone's best interest, or am I hurting them by being silent? Silence that allows violence to continue, is violence itself.

I thank Patricia for the reminder, and the inspiration. She's an amazing woman and if you're interested in these issues, I highly recommend her blog.