Some True Words

And, as always, those that complain get their way, and those that are strong take the patients. And those who smile and chat up the manager the most get the kudos, all the recognition and the praise. Then the administration wonders why staff satisfaction is down.

This is from a comment an ex-coworker posted which I had to share because it’s true. Toxic workplace much?

Being unemployed has brought some true clarity to my career and it’s been good. I realize that I was (still am) pretty burned out and am taking steps to remedy that. Breathe. Meditate. Reflect. Exercise. Sleep. And while I’m stressed out about moving, finding a new job and starting over, I feel like I can go back to being the nurse I want to be (again). It will work out.

It’s Been A Week

It’s odd, I figured this unemployment thing would be like a vacation.  Sit back, relax, catch up on things left unread, do some housework while slowly getting things for the imminent move together.  I figured I would not miss working, prepping for work or the actual time spent going to work.

Yeah.  Wrong on all counts.

Admittedly I’ve done a fair bit of relaxing.  There have been many days of sitting around in sweats like some somewhat thinner suburban version of Jabba the Hut, dropping whatever snacks were within reach into my maw, ordering minions to do things (at least in my head).  I’ve spent some quality time on Twitter, on some blogs, scoping out new places to ride when we move, but have done little of anything constructive.  The place looks pretty much exactly like it did the week I stopped working.  Packing?  Psshh.  Attacking the list of things I need to accomplish for the week?  Did (the easy) 50%.

Never thought I would say it, but the hardest thing is not going to work.  I see the #nocshift tag come up on Twitter for all those headed to slay the dragon of work and while I may be there in spirit, I’m really just an impostor now.  I wish them luck and go back to doing nothing of consequence.  But it’s the odd things that seem to mean the most to me.  Not buying food specifically for work.  Not staying up ’til all hours to readjust my internal clock to stay up for the next three nights.  Not having the in-person interaction with my friends as we strive towards a common goal.  It has made me slightly off-balance and I don’t like it.  Coming from a long line of Scandinavian hard working folk, the need to work is etched indelibly into my DNA.  Go too long without and I become insufferable to be around, pacing like a wild animal trapped in an enclosure but unable to do anything.

Worst though it has allowed my fear of not getting work even more real.  It has allowed that nagging voice, the one that I used to continually tell to “shut the fuck up!” a little more volume.  That little voice has been very, very talkative of late.  Doubt, the killer of initiative, has been working overtime.

All this after only a week.  I’m going to be a psychic wreck by the time I get to Arizona.  And I will have probably driven my wife insane.

At least though, things are slowly coming together.  It appears we have a place to call home lined up.  There seems to be some jobs in the area that I could pursue.  I just have to realize that things will take some time.  This isn’t going to happen overnight, no matter how hard I want it to.  The last time I was unemployed was so painful, more for factors beyond not having a job/income, that issues I thought I had dealt with long ago are bleeding into the current discussion which makes this more stressful.  I have to remember that this is not like last time.  I have experience.  I have money coming in.  I’m not running from death, disappointment and despair.  Instead I’m running to something new, exciting and different.  And you’e all along for the ride!

The Strong Suffer

~this was originally written the week before my last day

We are in the midst of the transition that prompted me to volunteer to quit my job and it sucks. Each day makes me realize what a good decision I made, but makes me worried for those left behind.

One of the biggest issues is that we’re combining two different units, one a typical med-surg/renal unit, the other a progressive care unit. Two very different staffs with different skill sets. The tele nurses are all ACLS and stroke certified, the others not. The tele unit started and built an observation unit and got used to and accepted the turn and burn mentality where you admit and discharge like there’s no tomorrow. The folks coming in rarely admitted in the levels we did and came from a more laid-back mentality.  SO yes, it’s a huge transition, especially for the new folks on our staff, huge changes in both practice and mentality. Add to that increased patient ratios and people are already starting to question the status quo.

The worst though is for the nurses perceived as “strong”. You know the ones that can take anything you throw at them, rarely bitch and just take their lumps, the ones with the advanced skills. They get the more difficult patients, the sicker patients, and more of them.

The other night was a perfect example of that for me. I started with 4, a decent mix of patients. (yes, I know, our ratios are low compared to some, but we have minimal support staff, it’s all about perspective too). Charge nurse comes to me with a proposition: drop one of my patients to take stroke admit. She figured it was easier for me to do this instead of giving the only other stroke nurse a 5th when she had never taken 5 patients before. This is a full on stroke, large MCA nastiness and there are a lot of things to do since we’re in the acute window. What choice do I have? I’m not gong to be a dick and say “no, let ’em suffer” am I? Not really. So I admit the stroke and considering now the CT looks, I lucked out. Then she comes back asking me to take a chest pain admit since the only other nurse just “can’t”. Whatever. They ask because they know I will only say no if I truly can’t. They ask because “you’re strong and can handle it, the others can’t.”

The last night I worked it happened again, I get the admit while the others don’t because “they haven’t done it.” And it’s not like I don’t want to work, I take my lumps but I believe it should be fair, at leadst to an extent. Give an equitable load, don’t dump on the strong nurses because you can. What comes out of that? Burnout. Demotivation. Animosity.

A good friend of mine who is staying mentioned all of this to me the week before we changed over.  He’s a guy who never complains, I mean NEVER.  And he was upset, worried and generally disaffected.  Did I mention he is a guy who always has a smile on his face, even when glove deep in poop?  To see him so upset truly shows me the folly of the madness being inflicted on us.  Here’s a nurse who smiles through everything, who gets every single LOL to love him, who’s clinical skills have grown immensely since hire to be a very competent, caring and effective nurse who will be put through the wringer because he’s “strong” and they run the risk of losing such an employee. But in the end “they” don’t care, it all comes down to money.

That is why I feel bad for my former colleagues.  It’s going to get worse before it gets any better, if it ever does.  The unit we spent years building was destroyed in one fell swoop and is reverting back to a mire of poor management, burned out nurses, massive regular turnover of nurse, disaffected staff and a manager who is crushed by those farther up the food chain.  Sadly it all lands on the patients and while there will be nurses who strive to keep the level of care the same, you can only fight the tide for so long.  Hopefully the worst of my prognostications doesn’t cone true.  One can only hope.

~disclaimer: I know there are places with far worse ratios and worse conditions, we’ve been incredibly lucky for a long time.  Leave it at that.

A Little Nostalgia

The wife picked me up a couple of beers last night at the corner mart, a Rainier and an Olympia.  Both were huge regional favorites in the Pacific Northwest growing up and I vividly remember the commercials growing up.  When I used to drive up from school home to Seattle I would pass both of the breweries on I-5, you can still hear traffic guys refer to traffic on I-5 being “backed up at the brewery.”  Sadly, they’re both gone, although the beers are still being brewed by powerhouse SABMiller.  The old breweries have still stand though,  one is an artist’s rental space, however the other is empty.  It’s odd though, for a region where craft beer really took off to have forgotten about these old monuments to brewing.

But thanks to YouTube, the commercials still exist.  (these bring back childhood memories!)

First, Oly (it’s the water)

Second, another classic from way back (not a “local” though, but I remember it well)  From the land of sky blue waters…

Last, the best use of the doppler effect in advertising ever.  The Rainier motorcycle commercial…

Now, go have a beer!

The First Day

Yesterday was the first day of a new adventure.

I no longer have a job and I’m OK with that.

I volunteered to be part of a “reduction in force”, business speak for “laid off”. Why? Many reasons, but mostly it was beyond time to leave. Also because I things have become clearer to me with regards to what is important in life. It’s like the axiom goes, no one lays on their death bed saying, “Boy, I wish I worked more.” Work was overwhelming my life, permeating every nook and cranny and luckily I had the clarity to realize that wasn’t what I wanted out of my life and this was the first step in doing something about that.

I woke up yesterday though with an odd feeling of freedom. Nowhere to be I just sat around in my sweats and relaxed. Then the reality set in. I had a momentary burst of panic of when I was going back to work, then realized it was never.

I then had another more sustained burst of overwhelming panic realizing that I no longer had a job.

Then came the calm realization that it was going to be OK.

Things would be OK.

…more to come…

Whoa.

http://www.pinkbike.com/v/241986

Nothing says fun like racing through city streets, down stairs, cutting your handlebars to ensure you fit the narrow confines around you. Whoa.

-Wordpress doesn’t like the video linkage with Javascript, but trust me, it’s worth it.

Just for Fun

Still reeling from my momentous decision of last week, I’ve sunk hours and hours into YouTube, Twitter, Batman Arkham City and MW3 trying to forget, all the while realizing that shit just got very real.  I’m safe in the knowledge that it is the right thing, but the prospect of no longer having a steady paycheck freaks me out.  These got me back on track though…

Seeing the Writing on the Wall

There are days where the obvious course of action is just that, obvious. But some backstory.

My facility is facing financial issues of an extreme variety. Between reduced reimbursement due to Congressional inaction, higher amounts of Medicaid and flat-out charity care we’re millions in the hole and it is necessitating drastic action. Layoffs are definitely in the picture. We thought that nursing itself would be spared, reduced to not replacing retirements and unloading PRN/part-time nurses. But no, the emergency reaches further than that. It won’t be calmed by those measures and there are only so many non-nursing auxiliary positions to cut. So it comes down to this: layoffs of bedside staff. This means increased ratios at the bedside, less staff on the floor and a general reduction in our ability to care for patients, while still being required to deliver the same care, check the same boxes and generally carry on, doing more with less.

This was not the facility I came to 5 years ago. It is not the same floor I came to 5 years ago. We’ve devolved, reduced to essentially a nursing home with telemetry capability. No longer being challenged except for the nightly herding of cats I knew it was well past time to move on. And I had been waiting for the right time to do so. When this unprecedented financial morass emerged I had a feeling that things would be changing. Being involved as a charge nurse, I knew the enormity of the changes and how it will effect the staff. And I wanted no part of it. Plus, I was scared for my own job.

So when the offer for a severance package for those willing to leave voluntarily came by email, I saw it as my sign. It took a bit to realize it was my sign, but in the end both my wife and I came to same conclusion: this was our impetus to move on into our next adventure.

So I took it.  So did quite a few other staff, which is telling to me in that folks would rather leave than endure the changes slated to happen.  There is a bright side, because so many opted to do so, no one had to be involuntarily laid off on the units I’m a part of.  We saved jobs and found a new path.

I didn’t want to write anything of this until it was for sure, but I signed my papers yesterday and have a firm end date.  It’s official.  When I signed the papers there was a rush of conflicting feelings, fear, excitement, sadness, peace all fighting for attention.  The last couple of days have been a huge upper as person after person comes up to me and tells me how much they’ve enjoyed working with me and will miss me when I’m gone, it validates the hard work I’ve done over the years.  Still it’s freaky.  It is a huge step into the unknown.  But there is a precedent.  When I went to nursing school, we did much the same thing, pulled up stakes, packed the truck and headed out into the world and things turned out OK.  While finding work could be a problem, I’m confident with my experience and knowledge it won’t be a problem for long, plus there is a little cushion thanks to severance.  I’m not leaving nursing, just finding a new place to practice it, new things to learn, new people to meet, a new start one that will hopefully help pull me out of the burnout ditch I’ve been stuck in for the last year or so.  And you all have a front row seat to it!

Weather Follies

One thing I love about living in Portland is how much people freak out at the thought or forecast of snow. It’s like the outbreak of a zombie apocalypse, hurricane arrival or other weather/Act of God shenanigans. People flock to stores buying supplies like it is the end of the world. They hit local tire shops to put on winter tires and buy chains. It is madness.

C’mon people, it is snow. It falls, sometimes it sticks, you slow when you drive, don’t act like an idiot and things turn out OK. But no, people drive like crazy, common sense goes out the window and folks get hurt.

I went to northern Arizona over Christmas and encountered real snow (yes, snow in Arizona), not this puny wannbe snow that we get in Portland. But there people acted normal, drove responsibly and everyone got home safe. Then I come home and 3 weeks later and deal with this stupidity. Oh well.

Here’s what I’m talking about:
Arizona 1:

Arizona 2:

Portland 1:

Current Weather:

Don’t Call it a Comeback…

Like LL said,”Don’t call it a comeback, I’ve been here for years.” But really it is a comeback. Back to mine, back to my roots, back to what is important to me. I realized that even if it would mean a pay cut, somethings are more important than money. Call it karma when an offer came through for extended severance in light of looming lay-offs. I’ve been thinking about all of this quite a bit and while I haven’t arrived at a full decision, the beginnings of a plan has emerged. If things go like I hope, big things are transpiring in the next couple of months.