labor nurse has been reborn and shares her experiences as a new nurse-midwife, woman, and blogger

Tuesday, April 8, 2008

Being Reminded I'm Not This Miserable

I am finding myself so burnt out with school and clinical that I need frequent reminders to myself that things could be worse. I could be miserable, like I was in this past Thanksgiving Day post from Life & Times.

Happy Thanksgiving, everyone!
In honor of the day of "thanks", I thought I'd share what I was thankful for. Actually, I am thankful for lots of things, but to keep things blog related, I am thankful I don't work at this place anymore: Big Bad City Hospital. No, not it's real name, but it might of well be as far as I'm concerned.
For whatever reason, I was talked into applying for a position at the Big Bad City Hospital by a former coworker. She said what a great place it was, everyone was great, the shifts were great, the pay was great, everything just was so great. I had been finding it difficult dealing with the management at the place I was working at the time, another of the big city hospitals, that I was intrigued. Yes, I must go work for the Big Bad City Hospital.
The interview was smooth and I was offered the job. It was a 36 hour day/night rotation. I'd have to work 1-2 night shifts per schedule. Didn't seem too bad, as I was working all three shifts at the time, and the pay was better. And just 3 shifts per week was enticing. The orientation was 12 weeks long, which was another selling point.
My first day on hospital orientation didn't feel right. I felt like I didn't belong. Every person who spoke sounded as if they were Charlie Brown's teacher. Things seemed confusing. The day felt like it would never end. The next day was on the unit.
Apparently no one was informed that I was joining the staff, and management did not ask any of the staff nurses to precept me. When I showed up on the unit I was met with suspicion. The assistant nurse manager asked one of the staff nurses to be my preceptor while I was standing right there. This nurse made it very clear that she did not want to do so, but because I was standing there said, "Fine".
I was worried at that point how this nurse would treat me, especially since I was going to be with her for 12 weeks. As it would turn out, she was very nice to me, but also very lazy. It was the other staff nurses that I had to be concerned about, because every single one of them had a stick up their ass. They were not kind, ignored me in lunch break conversations, looked down their noses at me when I asked a question, and generally were miserable.
So the 12 weeks goes by (it dragged, actually) and now I was on my own. This was my very first labor and delivery nursing job, so I was very wet behind the ears. Everything about what my job entailed gave me anxiety, and the fact that I worked with a bunch of Nurse Ratchett's made it a million times worse.
Even with 12 weeks of training, I felt like I was never going to be able to get on top of the job. During the orientation I had come to the conclusion that the amount of duties the labor nurse at this hospital was expected to perform was unsafe. They were not to call for another nurse once the delivery was going to be imminent, and something about that just didn't seem right to me. How could the nurse safely care and attend to the mother at the delivery if the baby was also her 100% responsibility? What if that baby needs resuscitation and at the same time the mother is hemorrhaging? That stuff happens, and the nurse can only deal with one of those things safely. So do you attend to the bleeding mother and give her the meds the doctors are yelling at you to give, or do you resuscitate the baby and call for the NICU? As far as I was concerned, you can't put one over the other. But I was going to have to, and I was scared.
So this scared, green labor nurse begins her shifts on her own, completely off orientation, all strings cut. And every morning as the other nurses were choosing their assignments, someone would always mark my name next to the absolutely worse patient. I never had a say in what my assignment was.
So I took care of a sick severely preeclamptic mother at 24 weeks gestation who was on a high dose of magnesium sulfate, IV labetolol, and so obese it was impossible to continuously monitor her fetus; several sets of mothers laboring with twins; a paraplegic with epilepsy who had 4 seizures during labor; and countless non-English speaking women who distrusted the white girl from the suburbs. Rarely was the patient a healthy woman with a singleton. All the other nurses took those patients. After every shift I came home and crashed, dreading the next shift. Suddenly having those luxurious 4 days off a week didn't seem like enough.
Not only were the patients difficult either personally or medically, the medical staff was rude and condescending. No matter how awful or sick my patients are, I do not want them treated the way this medical staff treated these people. Both attending and resident physicians at this hospital treated these patients like they were invisible, objects to discuss and do as they please, and generally ignore. Many a times the doc's would walk into a patient room, not introduce themselves, not even look the patient in the face, continue talking with the medical student or other resident they were with, and do as they pleased with the patient. Off came the patient's sheet, up went the johnny, and wham! Hi, nice to meet ya! Up their hand went into the patient's vagina for an exam with out even once asking or telling her what they were going to do. And after the assault... I mean "exam", they would just leave, never once telling the patient what their finding was or letting the nurse know the plan. And forget about covering them back up. They could have been flopping in the breeze in the hallway for all they cared. I was disgusted.
One of the last things I witnessed helped to push me over the edge. I was caring for a young girl having twins. She had no support with her and the father was not involved. She was difficult to care for because her pain made her a mad woman, and looking back so was her nurse because she was beside herself with the environment she was working in. When she was ready to push I wheeled her down to the OR, a protocol in place just in case the second twin decides they want to come out via c-section, by myself. The others in the room watched me struggle as I maneuvered the bed through the doorway, and then further fight with the stirrups that were to attach to the bed. She delivered both babies vaginally, and as soon as the second baby was out, the staff in the room took off. I looked around to make sure I wasn't missing someone, but no, it was just me and the patient. She was left in the stirrups with dried blood on her thighs and her johnny up around her belly. I cleaned her up and put the patient and the bed back in the right positions. She thanked me later when I was transferring her to the postpartum unit, and it further made me feel terrible about her care. I didn't feel I deserved the gratitude.
Then I just couldn't do it anymore. I woke up one morning, and made it to the shower. I noticed that even though I was through with all that I needed to do in the shower, I wasn't getting out. I just stood there, letting the hot water run over my body like a shield. And so it was decided at 6:15am: I was not ever returning. Never again. As a matter of fact, I was done with nursing.
I called the unit at 6:30am and told them I was not coming in for my 7:00am shift. Then I emailed the nurse managers and told them I was never coming back. I quit!
It was very unprofessional of me to quit the way I did, but I didn't care. I remember the friend that convinced me to work there in the first place calling me up several weeks later and telling me that I was going to regret it. "You know, it's a small world, you have no idea who'll you'll run across or whose going to be connected," she warned me. But I didn't care. As a matter of fact, I still don't care because it was the best decision I made for myself. I ended up taking a 6 week vacation, which did wonders for my mental state and for my nursing career. Obviously I did get another job in nursing, and even returned to labor and delivery. I just know that Big Bad City Hospital sucks, and the labor unit I work at now is the place I belong.


Joyce said...

Hang in there!!! A couple more months and you'll be done with school.

Sheridan said...

Wow, I love reading your blog because it reminds me how IMPORTANT it is to talk to my CBE students about picking a GOOD birth location. They need to ask questions and now I have some new questions for them to ask.

Good for you for quitting a job that did not mesh with your values. I know I couldn't have gone back either.