Monday, September 8, 2014

Shitty Nurse, or, On Being a (Minor) Disappointment

September 8

It’s my father’s birthday. My dad is wonderful, basically the best person in the world, and I spend considerable amounts of my time trying to just find a way to deal with the fact of him. You’ve probably read the dismal accounts of how our generation is the first to accomplish less, socioeconomically speaking, than their parents; in my case, I’ve also accomplished less in the arena of Being a Human. 

Take nursing. Right now, as a career-changing nurse, I am here, exactly here: it appears that, while I believed I was a remarkable person capable of doing challenging things well, in point of fact, I was just doing easy things for the first fifteen years of my working life. It didn’t feel that way at the time. But as other new nurses progress, I am getting (what appear to me to be) pointed comments about how 

“[X younger, smarter] nurse is so hard working that [y borderline abusive tech] would never [publicly humiliate] him”

and 

“You are crap at IVs; so was I! Now, [z better nurse than you, still wrapping up orientation], she’s great at IVs!”

I don’t like this. And I also don’t like it about me that my response is to obsess and want someone to reassure me that I’m a good nurse, which seems unlikely given that 1. this is far from a stipulated fact among my co-workers and 2. I am, after all, fully thirty-one years old. 

I want to believe that these other elements of nursing matter: the call bells I answered knowing full well that the caller wanted something he or she could easily get for himself; the way I made a point of checking my demented patient for wetness while she slept, rather than waiting for the tech, and right in the middle of med pass; the time I took to explain each medicine and procedure to her even though she believed she was at Mary’s house and her chief concern bore no resemblance to the medical condition for which she was admitted and seemed to involve a plot line from the Lifetime movie she was watching when I came in. I want points for how before I failed to get this lady’s blood, I’d both successfully drawn her 12 am labs and then called the doctor to request a blood order she’d forgotten, knowing it’d come stat at the end of my shift, that I’d have to try to get it, fail, and get berated for incompetence by the woman I’d spent the night caring for — and then get smugly reassured that the oncoming nurse, too, once “sucked at IVs”, unlike her twenty-five-year old protegee. 

More than wanting to believe that these things make me a good nurse, I want to be the kind of person who just sucks it up and deals; the kind of nurse for whom my job is not about my hurt feelings or self-doubt or need to excel, but the painful tubes going into and coming out of my patient’s penis. 

IV struggles aside, I was that nurse last night. In almost every instance, I did my best to be kind, to be reassuring; to listen. 

It’s, like, really embarrassing to not do IVs well — though at least I have the cold comfort that the senior nurse I paged could’t get it in, either. I end up basically wanting all my lucid patients discharged, so I can start over, and also, feeling petty that I’m upset not because my patient got stuck four times before someone got her blood out, but because she called me on my lousy phlebotomy skills and I want to be the nurse everyone’s impressed with. 

My dad would be better. But then, easy for him, since in my mind, my dad does everything expertly the first time he tries it. In all honesty, I should have called him to try to start my IV. And he has nerve damage.  

This is one of a small cluster of intense needs that push me back towards God, that make the Gospel so intensely appealing to me (though it occurs to me that this theme is not so entirely unique to Christ’s story as Christians claim): the need to believe that my worth lies in something other than my skill set and competence. I am (relatively) good at resisting efforts to reduce my worth, and that of others, to their appearance or socioeconomic status or professional success. But I’m incredibly vulnerable to the concept of meritocracy.

“People who do things well are special,” my physics professor and dean told us honors students on my first day of college. I believed it enough that I started an entire career based on how much I loved doing things well and being special. It’s been very hard to give up. I want to see myself as a good nurse, to look at the strengths I have and the work I do. But every day, I leave well aware of at least one solid fuck-up I’ve managed to work into my “workflow”, as the kids call it. And while my actual boss isn’t the one giving me negative feedback, and I’ve yet to be written up or called at home — unpleasant experiences from which, I gather, the nurses belittling/“mentoring” me speak — it’s corrosive to be giving report and get a sequence of: “Girl, you know…” and “You need to….” and “Why would you….” 

I want to feel good about myself, and I want to feel good about what I do. But the terms under which I allow myself to do either may be unrealistic for someone just learning the ropes. And my preoccupation with my image of myself, makes that image appear increasingly graven. 

For a person who oscillates between the legitimately damaging messages I received about my worth, courtesy of someone else’s God (thanks, bitter elementary school teachers!) and the current cult of I Must Feel Great About Myself Always, seeing myself accurately feels impossible and pointless. It gets to the point at which I’ll believe in anything — Jesus, Buddha, the Spirit Within — that will deliver me from myself.

What matters is this: my patients needed care, and I gave it. Imperfectly. At times, inelegently. But I don’t have control over how skillfully I perform my particular small acts, only the love with which I perform them. I have to try every day to do better because nursing is hard, and important, and my patients do deserve the very best care I can provided, and by definition, doing one’s best never feels easy. 

All the other things I believe I’ve done well involved their own moments of struggling and doubting and being called to task, often in even more demeaning ways than I’m experiencing now (hi, sixth graders!) 

Am I a good nurse? Maybe I’m not the best, but I’m also not the one in charge, here. What I can do, all I can do, is show up and do my best and strive to get better, like I do. Certainly there are enough people already on the task of tearing me down. 


I believe that the more I focus on the love at the heart of why I’m nursing and not writing, the more a non-issue my Nursing Ability will become. Because if I became a nurse to get my self-esteem built up, I made a fatal error. If I became a nurse to help people through shitty times, well, I don’t need to be Ms. Nursing Diva McLovedbyall to do that. 

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