“You want me to help you turn a patient? Please don’t make me help you. I am so tired of touching strangers.”
I didn’t dare voice this feeling when one of my co-workers approached me—the charge nurse—to help with a simple but potentially life-saving task. The second after this thought went through my head I was devastated. This beyond burned out. This was the end of an almost thirty-year career at the bedside. But my fatigue wasn’t just with the patients, it was with the endless worries about patient safety/perception of care; the ever-widening gulf between futile measures and what is best for the patient; management’s obsession with the Next! New! Shiny! Theory!
It wasn’t that I didn’t care for my patients. It’s that I cared too much and everything felt so broken around me. It didn’t help my work environment was perhaps the most toxic I’ve been exposed to in my long career. I felt completely discounted by the driving forces in nursing leadership: my decades of experience were meaningless without a BSN.
It was time. Time to go.
I was “that” nurse. The nurse I never wanted to become. You know the nurse. Let’s call her Barb.
She was once a great nurse: never missed an IV, always had a ready answer for a pathophys question; could recite the correct dosage of any given medication even if she were aroused from a deep sleep. But over time, Barb losses her mojo: she sleepwalks through her care. She pastes on a therapeutic smile in the room, but a grimace and growl promptly replace it at the nurse’s station. And nothing is ever good enough. No matter how hard you work with her,
It’s not enough. Somehow you’ve failed Barb . . .
I’ve worked with plenty of Barbs and it was my biggest fear—since 1981—that I would be her.
Luckily for my patients and coworkers, I only had hours rather than whole shifts where I felt and acted like Barb.
But it was still hard to admit and face the nurse I was becoming. I had an equally difficult time admitting it was time to leave the bedside. It felt like a failure. I was trained to work at the bedside, and my calling was to care for patients directly in an acute care setting. To walk away from the bedside was walking away from my calling. I was discounting the Universe’s gifts given freely to me if I stepped away from the bedside, spent sleepless nights last winter, and a few tearful days battling hopelessness that came dangerously close to a major depressive episode. I had walked away from the NICU years before because caring for neonates had become overwhelming. If I couldn’t take care of adults, who could I care for? Was I ready to completely walk away from nursing?
But this time, it was real
Like most veteran nurses, I had about a billion moments when I threatened to burn my license or work at Wendy’s. “Want fries with that?” is a favorite tagline I use when things are bordering on disaster. And I was usually over it by the time my next shift rolled around. But this time, it was real. If the thought of touching a stranger repelled me, it was time to move on. What I couldn’t get around was the emptiness I felt: how could I leave behind a career that allowed me to advocate, troubleshoot, assess, and educate people? The heart of nursing. These things are what make being a nurse different from being a med tech or even a doctor. Do they necessarily need to be performed directly in the patient’s room in a facility? No.
I couldn’t move away from my own feelings of grief and loss to see this. I needed help, and sometimes we have to hire people to help us. But it was more than hiring a career coach.* I trusted my career and my calling to her. It was a profound investment. And I believe it will pay off twenty-fold over the course of the rest of my career. Shari (my career coach) taught me to trust my intuition.
The next place
I would have never allowed myself to see the next place or the best place for my gifts was case management. I think I hesitated to wish for this at first because many of the case managers I had been exposed to over the years were an assortment of Barb’s: brittle and angry. Or worse, they were dangerous at the bedside, so they were parked behind a desk where they could do the least harm. Like most of my preconceived notions, this one was just as wrong.
I love being wrong. Because many of the case managers I’ve worked with are great nurses, they just aren’t posed beside medications and dressings. Turning my own notions of this role on its ear helped me see what a perfect match my gifts and strengths are. Shari, my coach, also helped me realize and tease out all the opportunities in healthcare for case management.
Keeping patients safe outside the hospital
In my opinion, when I became a nurse, nursing was largely about keeping patients safe in facilities. Now it’s keeping them safely out of facilities. I want to be a part of that. I’ve worked in hospitals for years, and despite best practices and perfect intentions, facilities can be dangerous. I want to help people stay home as long and as healthy as possible.
When I realized this, my nurse’s heartfelt lightness and passion hadn’t felt in years. My professional mission statement had been: “Allow me to guide and care for you through dramatic and complex illness.” My new mission looks more like this: “I will guide you towards the highest level of wellness you can achieve.” Just typing that statement makes me a little emotional, so I know it must be true.
This is my end-of-shift report. I’m just beginning a new phase in my career, and I feel like a twenty-two-year-old new grad: a little scared, a little unsure, but passionate about taking care of people.
I’m also relieved I will never be a Barb.
*Big thanks to Gypsy Nurse for introducing me to my job coach. If you are interested in the process I underwent with Shari Sambursky; please email me at email@example.com. I will be happy to share with you my experience.
Edited by TheGypsyNurse: You can also reach out to Shari Sambursky via her website Career Esteem.