Thursday, October 22, 2020

From the home front, swan song part two

I have not worked since mid March.

My last shift was preceded by 10 days of the busiest I can ever remember.   The waits were hours long, it being high season for colds, flu, pneumonia.  I did 5 straight shifts in triage, much of it alone.   One week we had no COVID19 suspects.  Then, a patient with cough, fever, SOB.  The travel to Asia was not mentioned until I specifically asked about it.  Then it started to blow up.  Biogen conference fallout.  COVID suspects were isolated, most not sick enough to need immediate care, so delay in being seen, delay in turning over the room.  Over the weekend, the  COVID condo tent had been erected, staffed by useless people like department heads who never, ever did anything clinical... but they were pretty proud of themselves, high-fiving each other and planning their celebratory drinks after the tent closed at 5 PM.   We got a kick out of watching them congratulate themselves for remembering which end of an electronic thermometer to use, as evidenced by the high living and group congratulations.  They were having their butts handed to them in that tent because the ER was chronically understaffed and we regulars couldn't be spared.   

Then, nothing.  Patient numbers dropped, the tent dwellers dealt specifically with the hundreds of patients who, as usual, were sent to the ER by their PCP.  Most had no symptoms.  The only ER patients were actual ER patients.  No visitors allowed, which was actually....great.  Ghost town.  Not a soul in the waiting room.  

From crazy to eerily quiet.  I worked another couple of shifts.  Then I got sick.   

 BTC (Before the Time of Covid) I would have probably worked my next scheduled shift,  but...with the cough, I was feeling crappy enough (and just a little scared) to go to Urgent care on a Saturday.  I stopped just inside the door and announced myself to the masked nurse in the empty lobby, standing at the ready to intercept and direct the infectious public.  "I have a cough and I'm an ER nurse".

I was given a mask, asked one or two particulars (none of which was "are you short of breath") and sent back to wait in my car.  They would have the PA call my cell phone. 

After 3 or 4 minutes, I was beckoned to a side entrance, shipping door, whatever.   Not through the lobby.  Straight to a room where the PA did the intake, VS, exam, tested for flu and ordered a CXR for pneumonia.  Both negative.  Since I was an ER nurse with symptoms, to my own ER I was directed for Covid testing.  My.  Own.  ER.

I was taken to a negative pressure room.  "I feel stupid", I muttered to my colleague.  From outside the room I read her my VS from my urgent care sheet.  She handed me a portable pulse oximeter since that reading was not documented.  "It's 88", I called out.  "What?!"  "Just kidding, it's 98".

I tested negative for COVID-19.   I waited 4 days for the results.

While I waited, quarantined, I got worse. The cough was relentless.  And the fatigue.  I have rarely had an illness wherein it was necessary to stay in bed and pretty much sleep for three days.  When I wasn't coughing and dizzy, and short of breath from coughing. 
I didn't go back to work. I was way too fatigued.  Simple tasks around the house required prolonged rest periods.  This lasted about a month.  Employee health called me every week until the end of April and asked me the same questions about the timeline of my illness.  I'm not sure they ever wrote any of it down.  

Mid-May I wasn't sure I wanted to go back. But I felt guilty.  And worried about money, although  there was no place to go to spend it.  "We're fine.  You don't have to go back to work if you don't want to" , said Mr. Ednurseasauras.  

In early June I was sure I didn't want to.  I still felt guilty.  

By July it was certain.   An impersonal letter from HR removed any doubt.  If I wasn't going to work the minimum required hours as a per-diem, I was done.  I never bothered to respond. 

I was fine with that.  

It took me another month to declare that  I was actually retired from Emergency Nursing after 40-plus years.  

I'm fine with that, too.  

But...would I recommend nursing as a career??

Tuesday, October 20, 2020

It just isn't funny anymore...a swan song in two parts

I started this blog a long time ago with a post about my husband's experience with his cardiac stent.  A bit over a year ago, he underwent a 4 vessel CABG by way of some mild chest pain and shortness of breath while bicycling.  AFTER we cavorted around Italy.  He has healed quite well, thanks, although not quite up to his own ridiculous standards of physical activity for a man 73-going-on-55.  For anybody else who routinely does not hike mountains and do strenuous bicycling, he is a superstar.  

I have always said as long as I still need the money find humor in the job, I will continue to do it.  The last couple of years have been a tough sell for me, as evidenced by the paucity of amusing posts.

If I thought I was a dinosaur nearly 13 years ago when this blog was born, well....what's older than a dinosaur?

 License on the line every day, every shift.

ER nursing just keeps getting tougher, and I don't mean just the physical aspects, which have certainly taken their toll.  Most of  my coworkers at Satan's Waiting Room for the last 6 years are no longer there.  Many have chucked beside nursing altogether to become nurse practitioners (a lot).  Some retired.  Several excellent nurses have been fired or forced out over some pretty minor shit.  There was an exodus of staff to Gigantic Mega Medical Center, for big bucks, a long commute, traffic, and no free parking.  All in a state tax state, which, to my mind, merely adds a boat-load of headache for even money.   My middle management boss:  a total upper management marionette of stunning uselessness  My upper management boss:  a troll with doctorate.  Neither of them would be safe to give a patient so much as a bed pan.

This pandemic has put the cherry on the turd sundae.

Once upon a time I thrived on learning new things, taking care of really sick patients, knowing how to do all the tasks, run all the machines, anticipate all the meds, trauma, codes, train wrecks of all description.  I loved to be considered a resource for other nurses, a leader, mentor and team player.  I didn't mind the physical aspects so much.  Then.  I've worked for employers good and bad.  Some who valued me for my commitment, or work ethic.  Or comic relief.  A few who saw and cultivated  my leadership potential.

But...the job has changed drastically.  The priority is not the patient.  It is a numbers game, about the money.  Always.   Documentation is directed toward charges, which is not litigation friendly.  Nurses have become chess pieces, more specifically pawns.

As a nurse who has been an advocate of what is best for the patient, I found that I was having to pick my battles.  I had to, you can't fight every minute of every day.  Exhausting.  Providers are gonna do what providers are gonna do.   You can beg, or take a hard line, try to move further up the food chain in time to prevent a really big error.  Others have done that, with predictably poor results for them.  Fortunately, I never had to take things to that level.  

Would I recommend nursing as a career?

To be continued....