The First 90

Well hello strangers! March has come and gone and I’m still trying to figure out where the heck it went.

We are all moved. And by moved I mean out of one house and in another. I do not mean unpacked. Ask me about that around the end of summer. 😉

But we do have reliable Internet again (thank God!). Which means I should be posting much more consistently from this point forward.

Today marked the first 90 days of my new gig as a community health nurse. I have so many thoughts about this journey that my head is about to explode. So to prepare for my own 3-month evaluation, I thought I’d share feedback and advice as my own “probation” comes to an end…

  • Celebrate the small victories. Chances are you won’t see many big ones. When an insurance company steps up to the plate and approves that medication or clients keep their doctor’s appointments (even if you drove them there), be excited!
  • Despite the victories, accept the fact that your job will involve pounding your head against a wall. On a daily basis. Our health care system is a chaotic, fractured cluster and nowhere has that been made more clear than in my current position.
  • The chaotic, fractured health care system may sometimes require you to wait until someone deteriorates before you can provide the services they really need. It boggles the mind and makes absolutely no sense, but that is how the world works right now (so much for preventive health…). My clients with severe chronic disease and multiple co-morbidities who can still bathe, dress and feed themselves are SOL when it comes to getting comprehensive in-home services. And by the time they’re eligible they’re so far gone they usually require placement in a higher level of care. No wonder I saw so many exacerbations and acute manifestations of chronic illness when I worked in critical care! It’s depressing and draining, but you have to know how the current system works in order to be able to work around it (and sometimes to just suck it up and work with it).
  • Knowing how the current system works, I have come to a realization that has been simmering inside me all along: Health is political. As much as we would like to pretend that we can talk about health without discussing issues of policy, equity, access, and disparities, we are dead wrong. The system is a mess and it’s going to take a lot more than direct care providers to fix it.
  • Respecting autonomy will sometimes go against every instinct that you possess. But if your client has the capacity to make decisions (even ones that compromise their health), that autonomy reigns supreme.
  • Unless you are a pediatric nurse, brush up on your understanding of gerontology. Our population is getting older and we have a responsibility to better understand how medications and diseases affect the aging body.
  • Whatever kind of nurse you may be, PROTECT your back! Whether you’re transferring a patient or lugging around a nursing kit in the field, you’re gonna need it.
  • This one’s for the new nurses (and nurses to be)… Give yourself permission to try jobs and clinical rotations that you never imagined you might like. Hell, I was bound and determined to be a pediatric oncology nurse (and someday I still might be). But I’m happy where I am and I’m glad I gave this crazy job a shot.

So there you have it. Despite the multiple headaches and challenges, I continue to find that community health nursing offers a wonderful fit for me.

Despite the barriers, I still feel that I am part of the solution.

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