A Lesson from My Bullies

I awkwardly picked up a patient’s blue chart, ensuring the EKGs and other loose papers wouldn’t fall to the ground as I made my way to the edge of the nurses’ station. I needed to not make a scene or mess up. I needed them to believe that I belonged there. Just as much as any other nurse. I inwardly sighed, thinking how was it that I felt I could go on to become a physician when I found the job of a nurse to be so initially intimidating?

“No!” I told myself. That was enough. I could do this. Those types of thoughts had to go. Because that was not how I was going to play the game.

Even still, there was so much to take in. So many new faces. Doctors, PAs, APRNs, nurses, patient care associates, physical therapists, social workers, respiratory therapists, nursing supervisors and so on. So many names to learn and people to get to know. More, it wasn’t just getting to know the various staff members. It was now dauntingly crucial to know specifically which doctor worked in which specialty, so that when a patient’s renal failure was suddenly worsening as noted on urgent labs, I would know which nephrologist to call. Or when a patient’s oxygen saturation status suddenly declined, I would know which pulmonologist to call. Or when a patient was becoming combative, biting and spitting at staff members (which I came to learn was not uncommon on my particular unit), I would know which psychiatrist to call.

How would I ever learn all of their names in such a short amount of time?

My saving grace during those first few weeks was my orientation period. While I had several months of nursing under my belt from my prior job, I was not treated as a seasoned nurse. And while I would have liked the recognition of having had prior experience, I found myself secretly grateful for the chance to start over as a novice. Because truthfully, it all felt so foreign.

It was as if I hadn’t changed specialties but had instead changed my entire career.

Gone were the toy trucks and wagons in the hospital hallways. And no more were the paintings of flowers and balloons spattered across the walls of the pediatric ward. The cheerful colors had been replaced with more solemn tones of beige and the occasional faded blue. And with the change in colors came a sense of gravity I had not yet encountered. An overall sense, deeper than the décor, that this unit encompassed a vast array of people, each with their own stories of brokenness that I knew nothing about, some having shouldered their secret pain alone for years.

I made my way to the break room, putting away my purse in preparation for my shift. As I passed the nurses’ station I was struck by the sight of a frail older man lying in bed in the middle of the hallway, which I immediately found odd. His bed was adjacent to the nurses’ station, and I was quick to note his cachectic arms were secured in blue restraints. I knew this only happened when a patient needed extra supervision for severe behavioral disruptions. As I walked by him he looked up at me, and I found myself retract inwardly, hoping he wouldn’t harm me in some way.

I immediately despised myself for feeling that way.

How was it possible that I could want to help others (and I knew I did), but then almost instantaneously react in judgment and not love, assuming he would hurt me?

It was a dreadfully eye opening juxtaposition of my ideals versus my current (and lacking) state of emotional maturity.

This new job of mine was going to be a different kind of hard.

Because it was going to unveil some things.

Some ugly things.

Not so much about others and humanity.

But about me.

I had much to learn.

I inhaled deep and made my way to front desk, immediately overwhelmed by the large volume of call bells that seemed to be simultaneously going off. It was change of shift, and I knew I needed to get report from the night nurses before I could start my day. I hated to make patients wait. I found the more I made them wait, the harder it was for me to bridge any sort of relationship with them. Even still, I stood with my computer on wheels, paper in hand, waiting patiently for reports to be given. All the while watching the secretary frantically page nurses and patient care associates to this room and that.

As I waited, I glanced at the white board, listing the patients by room number, diagnosis and attending physician. I sighed, noting we were full, again. I hoped my patient load wouldn’t be too much. A busy day on this particular unit was anywhere from four to six patients. But I quickly came to learn the number of patients one was responsible for often had little bearing on the flow of the day. It was the particular patients that a nurse had, how involved and /or sick they were that dictated how busy one would be. More, one had to be flexible throughout the shift, as there were always discharges, admissions and transfers to complete. So, one could easily go from four patients to six patients in a matter of minutes.

It had been a few weeks, and my orientation period was coming to a close. I had managed to find a way to organize my day despite the chaos that ensued all around me. I wasn’t used to having to think and chart in a loud environment with patients shouting, visitors and staff alike bustling by and codes being called. I was so thankful for those few nurses, two in particular, who encouraged me early on, showing me the ropes and telling me I was doing great. Telling me I was picking things up quickly. I didn’t know it then, but they would go on to become like second moms to me. And our friendships would extend far beyond the walls of the hospital.

But they weren’t all encouraging. Some were cold. And others were stressed themselves to the point that they just simply weren’t able to teach. But I found I learned even still, and in no time at all

I caught my stride.

There was, however, an unexpected toughness to the unit. Something about it that I couldn’t put my finger on. An uneasiness followed me through my shifts in those early days, as I began to pick up on subtleties that I had perhaps initially missed during my training period. While a handful of nurses had been welcoming and fun to work with, I found others to be difficult, showing little interest in getting to know me at all, making it all too clear that they ‘weren’t here to make friends’.

This was particularly evident at change of shift where I was to give and receive report from nurses of varying shifts. I often provided a thorough report including patient histories and past medical problems pertinent to the patient’s stay. However, some nurses were sure to give me wild looks of disapproval, wanting only the bare bones of information to get them through their shift which I often found frustrating and quite honestly unfair to the patients in need of good care.

More, some of the patient care associates proved to be challenging to work with as well. I felt their glares as I sat down one afternoon in the breakroom with a cup of coffee and a salad I had just grabbed from the cafeteria. My legs and feet were weary from having been on them for the past four hours, and I was thankful for a moment to rest. I knew exhaustion had been steadily creeping in, but I did my best to refute it by consuming one too many cups of coffee. I figured heart palpitations were an okay tradeoff so long as I could complete all necessary tasks. And while caffeine didn’t completely energize me, I did find it helped mask things for a while longer.

And I just needed to make it through my shift.

As I sipped my coffee, removing the lid and briefly inhaling the soft scent of French vanilla, I was struck by the manner in which conversations were directed away from me around the wooden breakroom table. It felt intentional, despite my efforts to engage. I exhaled, realizing I had entered somewhat of a hazing period among some of the staff.

Moments earlier I had overheard several of the patient care associates discussing a summer picture I had posted to my personal Facebook page months prior. My stomach turned in hearing their comments, feeling betrayed by these women I barely knew. Even so, it came as little surprise, recalling being faced with bullying since the very beginning in nursing school.

I knew a field predominantly run by women would be subject to the pitfalls of competition and bullying.

I knew I wasn’t the first and most certainly wouldn’t be the last to be faced with such frustrations.

I did however, find it ironic that the ones making it most difficult for me, a few of the patient care associates, were also the ones who were supposed to take orders from me and the other nurses. Even so, I felt no need to establish any sort of balance of power, despite what my nursing professors would have said. I only wanted to show them I was not the stereotypical self-absorbed and superficial tall blonde that they perhaps believed me to be.

Oh, if they could see where I had been!

But I knew they couldn’t. And quite honestly, I wasn’t sure even that would have made a difference.

I knew I couldn’t see where they had been either. I was sure they had been through some things. Some things I knew nothing about.

And given the difficult patient profile of the unit, perhaps these tough ones were needed.

More, perhaps being tough was something they had previously needed to survive.

They seemed to speak the language of the patients far easier than I.

Which humbled me, while also causing me to realize perhaps it was time for me to toughen up too.

Even still, I was determined to win them over.

And in time,

there were a few, I did.

Through My Grey

 

Over the next few days I scoured the internet for nursing positions. I was eager to learn of all possible job opportunities, imagining all sorts of exciting positions. Would I work in oncology? Maybe the operating room. What about the emergency room?

But my fantasies were short lived and met with the abrupt reality of a limited job market, discovered in only a few disappointing clicks of my mouse. More, the postings that were listed were for full-time work, some for night shift only. It seemed the only floors hiring were medical-surgical units, the one area of medicine I didn’t particularly care for.

I wasn’t particularly fond of tracheostomy care and suctioning secretions, and wound dressing changes were not a favorite task. Even still, I knew I needed a fresh start more than I needed a perfect fit.

I needed to prove to myself that I could do this.

That one woman’s perception of me wasn’t going to dictate the success or failure of my entire career.

More, I couldn’t deny the fire that still burned within me. Ignited all those years ago. With a passion for others. To help in some way.

Any way.

Two weeks later I made my way across the campus of a different hospital. The building sat tall, and people were rushing all around it. As I neared the entrance I quickly glanced down, noting my snow covered black heels. I bent over briefly to wipe off the white crystals and was instantly struck by the sight of a glorious purple crocus poking its way through the wintry terrain. I was immediately captivated by its beauty, contrasting the grey all around.

It was the first sign of spring. And a gentle reminder of the promise of new life.

And perhaps, a new start.

Moments later I entered the busy corridor, struck by the large number and variety of people going this way and that. I nervously made my way toward the elevators, adjusting my blazer just so, praying my interview would go well. Praying there wouldn’t be too many prodding questions.

Why did you leave your last job?

What didn’t you like about your prior place of employment?

These weren’t questions I was ready to answer. Not on any real level. I knew talk of prior discrimination and chronic illness would not bode well, particularly on a first encounter. Nonetheless, I knew I had to come up with a satisfactory response. One that was truthful but perhaps a bit vague. I swallowed hard, silently assuring myself it would be okay.

As I made my way to the unit I was struck by how unimpressive it appeared. The walls were worn, and the floors were outdated. More, there were paper charts and a host of nurses of varying ages. I quickly entered the office of the floor manager, surprised to learn he was in fact male. I hadn’t expected that, given his gender-neutral name in a predominantly female profession.

Perhaps it was a good sign, I told myself.

Perhaps different was good. Different would mean not like my old job.

And I needed for things to be different.

Within only a few moments of talking I was put at ease. He shared at length about the unit and the type of staff on the unit. There was only brief mention of my prior employment, to which I replied I was “simply looking for a change”. I was relieved to note my reply was satisfactory.

As he continued on, our discussion began to feel less like that of an interview and more like that of a sales pitch or even an orientation to a job I had already acquired. Relieved, I in inquired about the types of diagnoses I would encounter on the unit.

It was a general medicine floor.

Or so I had been told.

He paused for a moment and went on to share that while it was a medicine floor, there was a particular focus. I leaned in, curiously wondering what the focus would be.

Nephrology?

Pulmonary?

Cardiology?

I hoped it was something exciting.

He went on to say it was infectious disease.

More specifically, the floor was known as the “HIV unit” of the hospital.

While they did take the overflow general medicine patients, it was generally known for infectious disease which in addition to HIV/AIDS included things such as tuberculosis, PCP pneumonia (pneumonia commonly seen in AIDS patients) and clostridium difficile. There were also a good number of psychiatric patients and the occasional patient from prison.

I was stunned, not expecting to hear those words. I tried my best to steady my face. I needed to not have a reaction to this information.

I swallowed hard, wondering if this was something I wanted. Wondering if this was something I could handle.

Was I willing to put my health on the line for this?

Moments later I left the interview. He told me to take a few days to think things over, as this was not the typical hospital unit. As I made my way onto the elevator, I recalled my time in Kenya and working in the HIV/AIDS prevention clinic. Exposure to infectious disease was not a new thing for me. I recalled being mocked by those I knew, some my own family members, for taking such risks. I heard those same voices again in my head as I pondered this new opportunity.

But the more I thought about things, the more I realized there was something about the unit that intrigued me. Something about taking care of the people that others wanted nothing to do with was attractive to me.

Maybe it was because I knew what it felt like to be alone. Really alone.

Or maybe it was because I found I could most identify with those whose lives have been wrecked by the sweeping chaos of debilitating disease.

Two days later I called the hospital to speak with the floor manager. My heart nervously beat in my chest as I attempted to quickly gather my thoughts.

There was one final piece that needed to come together in order for me to accept the position.

And it was a big one.

I needed to tell him about my lupus. More, I needed to tell him I would not be able to work a full-time forty-hour schedule, despite the original job posting for such. I did not elaborate regarding my lupus, nor did I share of my prior job experience. I went on to say I would need to work part-time and would be unable to work night shifts, and if that were a requirement then I would need to pass on the opportunity.

I knew I was asking a lot. I knew I was essentially asking him to create a position for me.

I knew it was gutsy to have even gone to the interview in the first place knowing full well I couldn’t work forty hour weeks.

I nervously paced the hallway of my parents’ home, marching back and forth over the outdated blue carpet as I awaited his reply. While I knew it was only for a few seconds, the silence on the other end of the phone haunted me. I involuntarily began walking faster over the matted rug. I had always hated that rug, with its loud red and gold outdated pattern.

I quietly exhaled, pretending the manager’s response wasn’t about to dictate my future. I silently assured myself that I would make it somehow with or without this particular job. And while deep down I knew that to be true, there was a part of me having recently endured such deep rejection at my prior job that just really needed for this to work. And needed for this to be okay.

A few moments passed, and to my surprise the manager was happy to accommodate my requests, assuring part-time would be fine and that I wouldn’t have to work a single night shift.

How was that possible?

I knew there was only one explanation.

He was making all things new again.

Orchestrating behind the scenes.

Setting out the path for my future which would lead me down roads I could have never imagined.

A wave of thankful relief swept over me as I hung up the phone.

I knew I had no idea what I was getting myself into.

But something told me it would be big. And probably a little scary.

A purple crocus had begun poking its way through my grey.