No charge for me.

The other morning as the day shift was coming on, our unit manager (who was charge that day) pulled me aside. After the usual pleasantries she said, “Several of your colleagues have said to me that you seem like good charge nurse material. Interested?”

My first thought was, “Tell me who said this so I can go kick the crap out of them.” Luckily, in spite of the shift being behind me, my social filter was still intact. Instead I replied, “Ain’t ever going to happen.” Not my most eloquent moment, but it conveyed the point well I thought.

She persisted, “Are you sure? It’s a great opportunity, think it’s something worth looking into, don’t you?”

Me, “I’ve been in management once before, it chewed me up, spit me out. It’s not going to happen anytime soon.”

Her, “Well, at least keep it in mind.”

It’s not that being a charge nurse is all that unattractive. On our unit, charge doesn’t take patients. But they’re also the unit secretary after hours, the resource nurse, the go-to person, the decider of the fate of staffing and and patient assignments. I don’t want that kind of burden on my shoulders. Would it look good on a resume? Probably. Thing is I don’t want to do it. Not interested at all. At least for now. Let me get a couple of years under my belt, a little more comfortable with being a nurse before thrusting me into a leadership/management role.

This in many respects shows the fatal flaw however on our unit. Turnover. I know other units turnover nurses frequently, but I think ours does more than average. It seems like we’re losing at least one a month. That means we use more system resource nurses to fill our staffing. It also means we are relatively short staffed often. The reason I think my manager would even think of bringing up the idea of me being charge is that most of the other people who have more seniority than me are already charge nurses. Most of the staff on any given night has less than 3 years of total experience (average here). If not less. We burn people out or they leave to bigger and better things. None of which helps morale any bit. Many of my friends on the unit feel overworked, under-supported and alone. Not a good way to feel. Many of us feel that we were misled to the type of patients we truly get. We used to a cardiac telemetry floor. Now many days it feels like a nursing home telemetry floor. Out true cardiac patients, the ones many of us signed on to care for, are far and few between. Because we are a big unit, we get admissions as an overflow unit. We get patients that do not need to be on telemetry, but get sent there for a “remote history of A-fib (currently in NSR, last a-fib was 20 years ago)” or “r/o CVA (while on ETOH withdrawal protocol).” The joke has become, “If they’ve got a heart, send them to us.” It’s like being told you’re on a trip to Disneyland, but ending up at Wallyworld. I know that it is nursing. That is the deal I ultimately signed on for. Some days it’s just harder than I ever expected, made worse by the deficiencies of the unit where I work. I’m trying very hard not to burn out already, but each day I get a little closer. My favorite telling fact about my shift: a great majority of us are either: a: In therapy. b: On meds. c: In physical therapy. or d: all of the above. We’re about as dysfunctional as our patients some days…

Peace and love…

"I Believe…"

Inspired by of all things the “Blue Collar Comedy Tour”, my version of “I Believe.”
in no particular order:

I believe that at the start of every shift, you’re issued a syringe with the intranasal topper-thingy and 2 mg of Ativan. You can use it on whoever you want; patients, families, colleagues, administrators, even JHACO.

I believe in the aerial spraying of Prozac and/or Ativan in large urban centers.

I believe life, like the movies needs a soundtrack. At least then you know when things are getting better, or worse and when you just shouldn’t turn the corner.

I believe that if someone throws poop at you, it is perfectly OK to throw it back.

I believe that hospital administrators should have to work with above poop-throwing patients when considering cutting the budget for nurses, techs, aides etc.

I believe someone needs to invent insulin you can mix with Lantus, IV Tylenol and a medication that clears ammonia out of the system like Lactulose but without the messy side effects.

I believe that when admitted for chest pain, you would not be allowed to leave the floor to smoke, much less request pain medication after leaving the floor to smoke. (especially when you were just fine before you left…)

I believe that once a year you would be allowed to see your assignment for the shift and say, “Nope. Not this time. I’m out.” Or at least ask for a couple of new cards patients.

Most of all:
I believe I’ll have another beer.

Peace and love…