Aug
15

Exploring My Options

So I quit my job. What’s next?

First, I plan to exhale. I’ve felt so suffocated the past several months, and submitting my resignation was like a breath of fresh air. As scary as it was, I knew it was the right decision. Rather than feel constantly frustrated and discouraged, I’ve decided to write my own ticket.

My goal is to assemble a mish-mash of PRN/part-time opportunities that will offer me the opportunity to learn new skills, as well as the flexibility to focus on my studies when I need to. For kicks and giggles I applied to a few full-time jobs, but after a lot of thought, per diem really is the way to go. S and I can get health insurance through school, which was really the only thing holding me back. Per diem pays better per hour and I now have the experience to make me qualified for these types of jobs. I’ve interviewed for two in particular that I am really excited about (don’t want to jinx it by sharing more details…yet). If I got offers from both, there’s no reason I couldn’t accept both. PRN jobs tend to have very loose time requirements, and I think it would be fun to mix things up a little bit.

I’ll also be diving into nursing education. My DNP is being funded by a federal program that covers my tuition in exchange for my willingness to teach full-time after completing my doctorate. As someone who has always loved the opportunity to mentor and teach, I am okay with this arrangement. So to test the waters, I’ll be a clinical instructor for the BSN students at my nursing school. I’ll start off with a very part-time CI gig once a week, and possibly pick up additional courses for the spring. I’m excited and terrified. Mostly excited terrified.

In some ways, my new options will make things more complicated. Balancing 2-3 jobs instead of one will not be easy. On the other hand, I’m also simplifying my life by saying “Yes” to the opportunities that make me love being a nurse and “no” to drama and BS.

Time to take some big leaps forward…

 


Aug
10

New Directions Indeed

I resigned from my job last week.

It was a long time coming, really. If this summer was about learning to say “No,” this decision was about saying no to drama. Since I crashed and burned last fall, I like I have been in an emotional tug of war with my manager and clinical lead. I’ve continually felt as if I had a target on my back, as if they were sitting back and waiting for me to screw up so they could fire me for performance. Unfortunately for them, I’ve done everything by the book and they haven’t been able to fire me. So instead they’ve reached out to make me as miserable as possible (or so it felt). And I finally said enough was enough.

I’ve been going back and forth about leaving for months, now. The only factor keeping me there was my night shift team. My wonderful, supportive team. But I was unhappy and they knew it. When I told them I was thinking about leaving they said “Good for you. We’ll miss you, but you deserve better.” Nothing like true friends.

Between my first PCU job and this experience, I’ve learned some important lessons…

  1. Enough with the night shift already. I thought I might do better in a job I loved, with people I loved. Turns out my body didn’t agree and I’m just not cut out for working all night. It was taking me longer and longer to recover. My neurologist finally sat me down and said my body needed a normal sleep schedule or I was never going to get better.
  2. Overcommunicating isn’t always wise. Throughout the past year, I made an effort to be completely transparent with management about my situation. I volunteered information about my health that I didn’t have to offer, because I didn’t want there to be any questions or doubts or gossip. Turns out the questions and doubts and gossip persisted anyway. And I ended up feeling vulnerable. One of my classmates said I just needed to keep my mouth shut and go to work and not let on what I was thinking or feeling, because it would be used against me. Turns out she was right.
  3. Nurses suck at taking care of nurses. I should have realized this the first time around. But when it comes to chronic illness, we judge each other as harshly as we judge our patients. I can’t tell you how many migraine patients I’ve admitted over the past two years and when I got report from the emergency department, it always started out with “These migraine patients…” As one of “those” patients, the complaints I heard from fellow nurses made me feel like a malingerer and a drug-seeker. I felt like the weakest link. I felt like whenever I called out (the reason for which was protected under federal law), no one believed me. My manager called me on days I was scheduled “just to make sure” I was coming to work. Is that even legal? When my reason for calling out wasn’t documented by the charge nurse I spoke with (even though I always gave the reason), he marked it as an unexcused absence rather than an FMLA absence, and gave me a verbal warning for having too many of those – you better believe I fought that tooth and nail).

Needless to say, I’ve become a little gunshy about trusting the people I work for and the people I work with. And that makes me sad because I’m a flipping nurse. And we’re supposedly the most trustworthy profession in America.

How come we don’t take care of each other?


Aug
03

Slowing Down

My summer semester turned out to be the hardest one yet (despite having the fewest number of classes). I won’t even begin to rehash the gory details, but let’s just say it was an exercise in learning to say “No”. Any activity or responsibility that turned out to be bullsh*t, I wouldn’t/couldn’t do. Which meant not going to one of my classes for the majority of the semester. Waste.of.time. And if that’s a step toward better self-care, then I’ll take it. Because unfortunately, that was the only step I took.

The highlight of my summer was far and away my oncology clinical in the bone marrow transplant clinic. I am IN LOVE with hem/onc … it just blows my mind. I feel like I learned a whole new language, and I want to keep speaking it. I also got to assist with (and perform) bone marrow biopsies and aspirations. I’m not a nurse who gets her jollies from procedures, but I have to say it was a pretty incredible experience. Especially when my biopsy produced the biggest marrow core my preceptor had ever seen. What a rush! Definitely an area I could see myself exploring professionally.

My oncology symptom management course was my saving grace. Not only is my cohort full of incredible, amazing friends who have kept my mind and heart intact, but our instructor has been equally supportive and has created a safe haven in the midst of a very difficult term. There is nothing better than having a community like that.

Another lesson learned this summer… Attempting to do 400 hours of clinicals this fall so that I could finish my NP training by December? Not worth it. Between the grief I got at work over my schedule, the anticipatory anxiety about balancing everything, and the continued migraines, I knew I was not setting myself up for success. So I shifted some things around and will now complete my NP training in either May or August of next year. I won’t re-start my DNP classes in earnest until Fall 2015 anyway, so there’s really no rush.

By spreading out my clinical hours, I was actually able to create a fall semester that I am really looking forward to:

  • Oncology Residency Rotation – In inpatient palliative care! Woot!!!!!
  • Genomics – I’ve been looking forward to this class since I saw it in the course catalog. The geek in me is doing a happy dance.
  • My first nursing education class (my doctorate is being paid for by a federal loan that requires electives in nursing education – in exchange I have to find a job as full-time nursing faculty within a year of getting my DNP. No problemo – I would love to teach.)
  • An elective in HIV (either pathogenesis or psychosocial dimensions) – Want to take both, but I’m waiting to hear when they’ll be offered in the future, so I can plan for one of them in a place where I need another elective.

Sorry I haven’t been great about updating this blog lately…I’ve been so burnt out this summer, and I really didn’t want this to turn into a giant bitch-fest. So I hunkered down, made it through, and emerged on the other end thankful that I haven’t completely lost my mind. ;-)

So 2015 has turned into a year of examining priorities and making changes. More news to come soon…


May
13

Baby Steps

One of the biggest challenges of walking the walk is knowing where to start. The ambitious “I will take better care of myself” proclamations can quickly turn into empty promises, especially when we bite off more than we can chew.

Yeah, that usually sums it up...

Yeah, that usually sums it up…

(Source)

I don’t plan to set bold goals such as I will lose xx pounds by xx or I will cook home made meals every night. For one, this isn’t just about physical health. And plus, I am my own worst critic, so when I set goals that I don’t meet (for whatever reason) or that are unrealistic/unhealthy (because, really, 30 pounds in a month?), I tend to spiral downward into a self-perpetuating cycle of inwardly directed hatred. It’s funny because I usually consider myself a pretty intelligent person. But when it comes to my own self-perception, the tiniest “failure” can lead me down a dark path. It gets pretty ugly.

There are plenty of plans and goals for The Holistic Nurse: Heal Thyself edition. They are marinating in my mind and will come to fruition when I am ready to share. But I thought I would start with two small changes I can make today. After all, this is all about today…

  • Improve my sleep hygiene. When S and I moved, we decided not to get cable/satellite TV, but we still have high-speed internet. So we utilize the myriad online apps to watch our favorite shows together and on our computers. An unfortunate consequence of this more personalized entertainment system is that I have moved my show-watching into the bedroom. I fall asleep to episodes of Numb3rs rather than to a good book. Not only am I reading less, but I’m sure my sleep patterns have suffered for it. And good sleep hygiene is key to migraine prevention. So today, I banish the iPad from my bedside table, dust off The Emperor of All Maladies (yes, I’m STILL reading it), and lose myself in a good story.
  • Drink more water. I’ve noticed lately that I constantly feel dehydrated. I’ve never been a big water drinker, but I’m fully aware of the health benefits. I even have an app for that. So I plan to use it. Excuse me while I take a sip…

water

(Source)

So there you have it. Two changes I can start making today.

That wasn’t so hard, was it? ;-)


May
12

That Whole “Self-Care” Thing

As I’ve gotten deeper and deeper into school, my self-care practices have been … well, lackluster (and that’s a generous descriptor). I pointed out in my 2013 year in review post that self-care got replaced by survival because I had little energy to do much else. But my pea brain has started figuring something out: the less I take care of myself, the less energy I have, which leaves me little energy to take care of myself. It’s a vicious cycle. (Yes, I know that this realization probably occurred to you already…probably years ago.) I’m sure I’ve heard multiple times throughout my nursing career (and before) that exercising/eating right/sleeping well/making time for leisure is key to a happy, healthy life. But what I know intellectually to be true has been harder to come by instinctively. I’ve fallen prey to the myth of self-martyrdom – I’m too busy caring for others to care for myself. It’s a common mistake.

image_nursing

(Source)

It’s also the reason why nurses are overwhelmingly overweight, why more than 50% of us suffer from low back pain, why we suffer from levels of exhaustion and fatigue that should be sounding alarm bells, not only for our sake but for the sake of our patients’ safety. It’s ironic that the professionals who work the hardest to promote healthy living are so bad practicing what we preach.

I’m the typically well-intentioned woman who says “I’ll start this journey tomorrow”. Today is my last hurrah, so I’m gonna eat that cheeseburger/pizza/ice cream and veg out on that couch for one more night. Trouble is, “tomorrow” quickly becomes “today” and we live a series of last hurrahs that never turn into action. It’s easy to make goals for tomorrow when it’s always one day away.

yesterday_tomorrow

(Source)

Since I went back to school, I’ve promised myself that when this is all over, I’ll get back on the wagon.

nursing student

 

(Source)

Trouble is, the light at the end of the tunnel is faint. And knowing my addiction to school, who knows when “this” will all be over. I’m turning 34 in less than six months and if I keep putting the rest of my life on hold, I’m going to end up looking back and wondering what I was waiting for.

So today is today. I’m planning to share this journey with you for three reasons:

  1. Accountability. Making it visible takes away excuses. I can keep moaning about how stressful my life is or I can buck up and own it. I choose to own it.
  2. Realism. There will be ups and downs. That doesn’t mean I’ll be making excuses (see #1). But it means I’ll have moments of self-doubt along the way. I won’t pretend otherwise.
  3. Walking the walk. I’m a nurse and I am ROTTEN at this self-care stuff. Time for a new path.

So, there you have it. A new series…or perhaps a continuation of The Holistic Nurse, just along a slightly different wavelength. I’m still formulating how it will look on the blog, but I’ll keep you in the loop as it comes together in my mind. One thing this site will not do is become a healthy living/cooking/fitness blog. There are plenty of good ones out there and this is about nursing. But if part of being a good nurse is being good to myself, then hell yes, I want to share the journey with you.


May
07

Badge Blooms: An Update

Over a year ago, I posted a review about my lovely “RN” badge holder obtained from Badge Blooms. I thought it might be time to update y’all on the condition/status of my adorable Badge Bloom.

BadgeBloom

I am happy to report that 15 months later, we are still going strong! The clip is still intact, the badge reel still retracts like it’s supposed to, and I have lost none of the decorative adornments. In short, I am one happy customer! And I continue to receive compliments about it on a daily basis.

I’ve been staying in touch with Melissa on and off and watching her Etsy shop like a hawk, and I continue to find new designs that delight me. I fully intend to buy out her supply for graduation gifts as friends and colleagues start becoming nurse practitioners over the next year. I also intend to collect some of her holiday-themed badge holders to increase the festive factor. And since it is National Nurses Week, I should also mention this is also a great and affordable gift for your employees or co-workers.  We’ve been working on a personalized bloom for a good friend, and she has always gotten back to me within 24 hours (usually less). I’ve been nothing but pleased with her good-natured professionalism!

If you’re looking for a personalized badge holder to spiff up your professional wardrobe, I highly encourage you to check out Badge Blooms! Tell her Nurse Teeny sent you. ;-)


May
06

Nurses’ Week Giveaway!

I may have been off the grid lately, but I would never neglect wishing you all a

HAPPY NURSES WEEK!

I hope your workplaces and nursing schools are giving you some love this week. Our hospital has some activities planned, although none during night shift (again).

Oh well, another discussion for another day… This is a week to be celebrated for all of the ridiculously hard work y’all do every day and every night! Whether you’re at the bedside or teaching the next generation of nurses or engaging in the front lines of nursing research, you are leading the way in making our profession the most trusted in America.   We all know we don’t do this work for the kudos. But it’s sure nice to be recognized.

nurses_week_2014

In honor of Nurses Week, I have a fun giveaway planned!

The folks at CharMED (see my original review here) have been continuing to roll out new designs to “bling” out your stethoscope. Their latest and greatest is a stethoscope charm made especially for RNs.

 

Nurse Teeny wants one BAD!

And to celebrate nurses, one of you will be the lucky winner of this oh-so-coveted charm!

To enter the contest, leave a comment below in response to the following question:

What do you love most about being a nurse (or nursing student)?

Deadline is next Monday, May 12 at 11:59 PM EST. The winner will be randomly chosen from among respondents.


Apr
28

One for the Books

Semester #2 of my career as a  nurse practitioner student is a wrap! I turned in my clinical paperwork yesterday, which was my final step. I can’t decide which semester was more hellish – #1 or #2. To be sure, I worked my tail off for both of them.

I have three weeks off before we start up again. I honestly have no idea what to do with myself. We still have TONS of unpacking to do in our new place, but I can’t motivate myself to do much more than lie around and watch HIMYM on Amazon Prime. I figure I’m entitled to a few days of absolute nothingness, right? S and I also have our long-awaited weekend in the mountains coming up. On the agenda: relax and spend some much needed time just the two of us, sans books, dogs, and responsibilities.

Summer term will feature two courses, both of which have clinical requirements. My second adult health class is focusing on management of chronic disease (this spring we emphasized acute treatment in primary care). The clinical for that one is THREE.HOURS.AWAY. But I’m told it’s worth the drive, because the site and preceptor are supposed to be amazing. Another student is also placed there, so we’ll be carpooling out every other week and doing two days at a time. As much as I dread the drive, at least I will have company and we’ll be near the ocean!

My oncology clinical is the one I am really jazzed about. I’ll be working with an NP in an outpatient bone marrow/stem cell transplant clinic. This is an area that I don’t know much about, but the idea of it fascinates me. We got to practice bone marrow biopsies and lumbar punctures in our learning lab this spring, and it sounds like I’ll get to do my fair share of actual procedures during clinical.

And since I’m “only” taking two classes this summer, I signed up to take a review course for the OCN exam at work. The class will meet every other week until late August, and then I’ll plan to take the OCN exam in September. Assuming I pass, that’s a $1000 certification bonus headed my way. The jury is still out on whether I go for the next Clinical Ladder step. I have a project idea in mind for improving outcomes, but I just don’t know if I have the time or energy to follow through. Although the additional bump in pay for my last 6 months as a bedside nurse wouldn’t hurt. We’ll see…

We’re already registered for fall semester as well. In addition to my last required course and my oncology residency, I’ll be taking two electives: one on HIV management in primary care, and one on genomics in medicine. I have to say I’m pretty jazzed about both. After December, all I have remaining is my adult health residency and then I will be qualified to take my NP boards. Eeps.


Apr
02

Home Stretch

I swear that I have every intention of updating this blog more than I do.

But you know what they say about good intentions. So I’ll keep doing my best and ask those of you who have stuck around to have continued patience with me.

Spring semester is winding to a close and I couldn’t be more ready for a tiny break. Pharmacology class alone is enough to kill a grad student. Our exam today covered the following: antibiotics (enough content for one test by itself!), seizure meds, headache meds, weight loss/smoking cessation/erectile dysfunction meds, thyroid meds, GI meds (GERD, PUD, nausea/diarrhea/constipation), oncology meds (“just the basics”), AND medication safety. No big deal, right?

To celebrate the end of this cognitive torture, S and I are going to the mountains in a few weeks. We were supposed to go over Spring Break, but then we had to move.

Yes, the dreaded “M” word. We were doing a rent-to-own arrangement at our previous house but decided for a multitude of reasons not to exercise our option. We felt like jerks for doing it because the owners were fantastic people, but it just didn’t make financial sense. So they invited us to stay as tenants indefinitely but also made it clear that they wanted to sell. We spent the better part of January and February deep cleaning the house on a regular basis for showings (in the middle of a less-than-desirable roommate situation), and they got an offer in late February. We scrambled to find a new place, signed a new lease and two days later found out the buyers had backed out. Too late now. We moved two weeks ago. Which threw my life into a tailspin until my amazing mom flew out to help (Moms = Superheroes).

There are still boxes and suitcases everywhere, but my commute to work has been cut in half, while my commute to school is only 10 minutes longer. S works close enough that he can come home for lunch and let the dogs out. The owners of our new place want a long-term tenant. So hear this…until we leave this state, we.are.staying.put. Do you hear me, universe????

Work has been…odd. I was out of regular staffing for almost three weeks to help with “Go Live” on our new records system. Then my migraines took a turn for the worse (midterms + Go Live + moving = BREAKING POINT), so I was out of work for another week. Goodbye, remnants of my PTO that I was just starting to rebuild…it’s been real. The good news is, my manager approved my request to reduce my schedule to 0.75 FTE, which basically means I will work five shifts per pay period instead of six. It doesn’t sound like a lot, but it is a huge mental break. And mental breaks are key. Especially when HR still considers me “full time” and doesn’t take away my benefits.

In the past three weeks, I have also registered for both summer and fall semesters. I really feel that I’ll be diving into the meat of my program over the next several months. Hopefully with good results. Plus I’ll have time to take some neat electives. Only one more year until I’m done with this part of my studies and studying for boards.

That, my friends, is a terrifying thought.


Feb
17

The Neverending Semester

Is it really only mid-February? Looking back at my last post, I feel like it should be April already! All these snow days haven’t helped…the Southeast has basically been shut down for the better part of three weeks due to a couple of unexpected “blizzards” (and by blizzard, I mean 6 inches on the ground. It IS the South!).

This term has been interesting so far. Clinical has been super-interesting and it is honestly where I feel that I am learning the most from day to day. My preceptor is brilliant (I swear I’ll ask him a question and he’ll give me an answer that without fail turns out to be evidence-based and up-to-date. Every.single.time.). And his bedside manner never fails to impress me. It took us a few weeks to get me to seeing patients on my own, but one day he just turned to me and asked me who I planned to see first. And that was that. Giving verbal report is super intimidating even though he’s kind and patient, because (in true Nurse Teeny fashion) I expect myself to be a lot further along than I actually am. I will forever be my own worst critic.

School itself has been a mixed bag. My adult health class has been discouraging, to say the least. They expect us to watch hours of online lectures and take an online quiz two days before our class even meets. For those of us who work weekends, this gets complicated trying to fit everything in. Not to mention that our actual class time is spent discussing case studies with 70+ advanced practice nursing students, which feels anything but productive…the class time itself is kind of pointless. Hopefully the second part of the course this summer will be better.

Oncology, on the other hand, rocks my socks off! The professor is a hoot and I am learning SO MUCH. I am really looking forward to my first oncology clinical rotation this summer. Our little crew of 13 has bonded like you wouldn’t believe…we’re the annoying group in the adult health class who are always diagnosing patients with a chief complaint of “headache” with a brain tumor ;-). It’s been comforting and affirming to feel like I could perhaps actually be headed in the right direction.

Work is…work. Still frustrating. The migraines come and go, but are definitely less frequent and less severe lately thanks to acupuncture. I’m trying to make the best of it. I interviewed for a couple other positions, neither of which have worked out. But when I mentioned to my manager that I was interviewing for other jobs, my request for a reduced schedule, a request he had been sitting on for MONTHS, suddenly got approved. Imagine that. ;-) So I will be 0.75 FTE starting in March. Still technically full-time, but that one less shift a week is going to do wonders for my mental health (not to mention my marriage).

Speaking of which, S is rethinking his own future. I’m trying to convince him to write a post of his own about his current thought process, so no spoilers, but let’s just say he’s staying in the same ballpark, just looking for a different position… I’m excited for him, regardless of what he decides. He passed his EMT exam (with flying colors), so he’s looking for new jobs that will give him some direct patient care experience. Still taking prereqs four nights a week but we’re making it work.

We’ve actually been brought closer by a sticky roommate situation. We invited a friend of a friend to live with us when she moved across the country to attend nursing school here, but it’s turned out to be (another) failed experiment. Let’s just say I’m tired of being portrayed as the Wicked Witch of the East for wanting things like her laundry not to sit in the machines for three days straight. Apparently the “highly structured environment” I am seeking doesn’t jive with her lifestyle. She gave notice today. And I’ve felt a huge weight lifted ever since…

So that’s my life in a nutshell. Nothing too exciting. I’ll be crawling back into my hole as my hospital prepares to go live with a new health records system next month. Time to don my Super User hat once again. But oh, the sweet, sweet overtime…

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