Last week, I gave an update of my life over the past few months as I recovered from surgery. I mentioned that I went back to my job as a nurse on the burn unit in early December. What I left out is that I resigned from my job in early January.
I graduated from nursing school (Rush University) in December 2008, just a few weeks after the financial crisis started. It was tough to find a nursing job, especially since I was moving out of state from my nursing school. If you’ve been reading this blog for years upon years, you may remember that I had a very rocky start to my nursing career. My first job was on a medical/surgical/oncology/hospice unit at a small community hospital, and it fit just about every horrible nursing stereotype you’ve heard. We were constantly short staffed, constantly floated to other units, got in trouble for clocking out even one minute late – even when doing everything for our patients, including having to physically take patients’ blood work down to the lab and sometimes emptying the trash cans. I cried most days (and if it wasn’t me, it was another nurse on the unit) and didn’t eat dinner for my first six months. I really hated my job, questioned if nursing was for me, and probably could have been diagnosed with depression.
I started applying for other nursing jobs, mostly at the urging of nurses I went to school with or who read my blog. I wanted nothing to do with nursing, but others convinced me that my situation wasn’t normal and that I should try another job before calling it quits. I applied all over the country, although I had hoped to move back home to Chicago. I ended up interviewing at one hospital in Philadelphia and one hospital in Chicago, and I didn’t end up getting either job. It was devastating because all I wanted was to get away from my job, but looking back, neither of those jobs were really what interested me outside of being anywhere else than where I was.
Once I hit my one year anniversary as a nurse (and I mean down to the day), I expanded my applications to just about anywhere – having one year under your belt makes a big difference in your chances of being hired, especially when the market isn’t in favor of new graduate nurses. I applied to the burn unit in New York, and they called me for something like a screening interview the very next day. A couple months later (because getting a job at a hospital takes forever), I came in for an in person interview. I had read a book called Burn Unit before I ever thought about becoming a nurse, and it sounded like somewhere I would like to work. I’m a terrible interviewer, but I really didn’t have anything to lose – no huge desire to move to New York or anything. My interview with the nurse recruiter wasn’t that great, but the interview with the managers went really well.
Before all of this interviewing, I booked a trip to surf camp in Costa Rica with plans to totally avoid my phone/the internet/real life, but I wasn’t sure when they would call to say whether or not I got the job. I checked my internet a couple times during the trip. Coincidentally, my roommate for the week happened to be a CRNA – it was actually the first time I’d ever heard about CRNAs. We chatted a lot about nursing, especially how much I didn’t like my job/nursing and how she really loved being a CRNA. We’ll call this foreshadowing.
I came back from Costa Rica a little happier and refreshed, but beyond not thrilled to be going back to work. I was still waiting to hear back from the New York hospital, and I hit a breaking point. I had moved east to be in a relationship that I later chose to end, so it was a very lonely and depressing time. I even reached the point where I was just going to quit my job and move back to Chicago to figure out the next steps without being so miserable. (I recognize how privileged I was to have this as an option – but I really don’t think I can explain just how low I was.)
As you may assume, that didn’t happen. A few days later, I received a phone call from New York offering me a job. I was so happy that I almost started crying on the phone, and I definitely burst into tears as I called my mom. She thought I hadn’t gotten the job and reassured me everything would be okay and we’d figured it out, but somehow I squeaked out – “I got the job!”
I resigned from my job – I was very, very happy to be leaving, but very thankful for everything I learned there. The nurses I worked with were excellent and supportive, especially given the toxic environment we worked in. A month later, I left Pennsylvania and moved to NYC!
From the start, being a nurse on the burn unit was a complete 180 degrees from my first job. My orientation was even longer than at my first job, management was supportive, and no one yelled at me! (After being criticized weekly at my first job [and not constructively, mind you], this was a nice change.) Adjusting to the ICU and learning burn care was certainly a learning curve, but it was so exciting and I immediately knew I was in a better place.
I worked night shift for four years and then (finally!) got the coveted day shift. Night shift was a beast of its own – often fun because of the nurses I worked with, but also left me so exhausted and convinced something was medically wrong with me. The burn unit is a fascinating place just because of the nature of it. We take anyone with a burn – babies, kids, adults, the oldest of old. Small burns, 100% burns. Homeless, rich. Super involved families, people who have been totally estranged. Burns tend to happen to the young and the old, people with lower incomes/who are homeless, and many with psych/drug issues, although no one is actually exempt. The hospital itself is a world I don’t think those who don’t spend a lot of time there really understand, and the burn unit is an entirely different place on its own.
I remember my very first day on the unit during orientation – a patient with a sizable burn (50%-ish?) came on the unit, and I remember thinking we would be able to save this patient. Months later, that was not the case, but it was my first introduction to what the burn unit was really about. I think every unit talks about their “work family,” but the burn unit family is really something special. Burn care that takes hours, someone just walking into your room to help you out because they can tell you need it. Ordering you lunch or picking up a coffee. It’s not a perfect place, but it was a really, really good place to work. My unit had many, many nurses who had worked there for over twenty years, which is mostly unheard of in nursing – that says something.
A few years later, I put thought into moving on in my career. Nursing can be particularly draining (especially on the night shift!), and given I had 35-40 years left in my career, I wanted to look to see what else is out there. I started a family nurse practitioner program, but after one year of a part time program, I decided it wasn’t for me. We had a summer that was full of especially critical patients, and I remembered how much I liked taking care of patients like that. I remembered my time back to surf camp when I learned about nurse anesthesia, which seemed to encompass the things I loved about nursing without many of the things I didn’t like (patients’ meals never seem to come up right, and guess who takes the brunt of that…). I took steps to work toward the goal. I talked about this last year, but I originally applied to start in 2015. I was waitlisted and didn’t end up getting in.
I was very sad at the time, but I also didn’t feel like I was quite ready to leave the bedside. Bedside nursing is a really special place – you’re in the trenches with the patients, for better or worse. People count on you, people tell you things you’d never thought someone would feel comfortable sharing with you. You help with the most mundane but intimate things – using the bathroom, showering. You nurse them through what might be the hardest time in their life. I haven’t worked in any other profession so I may be bias, but nursing gives you such an intimate relationship with total strangers, and I’m not sure that can be replicated elsewhere. Although I looked forward to moving on to something else in my career, I can’t say I was really ready to leave.
Fast forward another year when I was accepted to school. Life worked out pretty well in that I did a semester of school in the summer, then I had my hip surgery in the break between summer and fall semester. My work has excellent health insurance, so I was lucky to keep that and go on medical leave. (Had about six years worth of sick time, so I got paid for most of it!) Before I went on medical leave, I felt like I was ready to move on from the bedside and the burn unit. I had gotten a small taste of my new career, and I was ready for it.
Once recovered from surgery, I headed back to work. (The first thing a patient said to me was, “Did you vote for Trump?” Ah, welcome back.) I had intentions of staying for a few more months – using some vacation time to stretch it out. Fall semester in school was pretty rough for a variety of reasons, and I decided it was in my best interest to stop working before the spring semester started. It wasn’t worth the extra money for the few months I could work. So basically, five weeks after I went back to work, I resigned.
You know the lyrics, “You don’t know what you got till it’s gone?” That’s just about how I felt. Returning to the burn unit after a few months off reminded me what a great place it was to work. It’s not perfect, but it’s a really, really good job. (Well, until I had a patient with an enema crisis right at the end of a shift. Note to the world: an enema is never a crisis. Unless you make it one. Hellloooo, anesthesia!) I wrote my resignation letter and cried as I gave it to my manager. None of this was a surprise – everyone knew I’d be leaving eventually because of school, but putting it in writing was really hard. I had been so excited to take this job, and I’d be lying if I didn’t say that part of me wondered if the grass is really greener. (CRNAs say it is!)
I recently read Lauren Graham’s book “Talking as Fast as I can: From Gilmore Girls to Gilmore Girls (and Everything in Between).” She talked about returning to film the four episodes of Gilmore Girls that were released on Netflix last year. Part of it really struck me as I was coming on my final shifts. She wrote, “Through it all, the emotion I felt most was gratitude. I treated every experience and savored every scene in a way that was different from when I did the original show. Partially this had to do with being in a different place personally and professionally. I wasn’t new to the business anymore, and I had a much more acute sense of how lucky I was to be part of this cast and crew. I treasured the chance to speak words written by the Paladinos once more. And I now understand in greater depth how rare it was to have had the opportunity to be part of something this special in the first place. In the flurry of the first incarceration it was hard to have much perspective. This time I was thankful for every single day.” (Emphasis mine.)
When I went back to work, I realized how lucky I was to work in such a great place with such great people. It wasn’t totally perfect, but I realized I missed people and the unit. Every time I did something – whether it was placing an NG tube or Foley, changing a dressing, or helping someone to the bathroom – I wondered if it would be my last. Is this the last time I’d walk into a patient’s room, write my name on the white board next to “Nurse” and say, “Hi, my name is Susan, and I’ll be your nurse today. How was your night?” (Vitals signs + pain assessment, full assessment, check for Ambu bag and suction, morning medications, refill water and Replete, discuss plan for the day. Check check check check and check.) I remember how scary that was when I first started nursing – wondering how long it would take someone to realize that I was faking it until I made it. (I also remember almost being paralyzed the first time I had to take a patient’s vital signs in nursing school. VITAL SIGNS. In my defense, we used manual blood pressure cuffs, which was definitely a little more nerve wracking. But oh man, how far I’ve come.)
As each shift passed, I got a little more sad. One of the perks of shift work as a nurse is that when you leave work, you leave. At 7:30pm, someone comes in and takes over no matter what is happening. I don’t bring work home with me. When I’m on vacation, I’m on vacation. When I call in sick, I don’t get behind. I think that’s a nice perk (especially in this always-be-hustling world we live in), but it has also made me realize how replaceable I am. I think about amazing nurses who have left the unit for one reason or another – a loss you think you will definitely feel, but everything just continues as normal. When I came back to work, some people asked how it felt – to which I said, “Well, some things never change!” And it’s true. I don’t expect anything to crumble simply because I’m not there, but it’s still a little sad.
I remember many times when patients or families would ask me if I like my job – my answer was always, “Most days!” (Because anyone who you tells you they like their job every single day is most likely not telling the truth.)
I had a wonderful send off from work on my last day. I brought bagels (so everyone remembers me on a high note!), my manager bought us a gigantic pizza lunch, we had cake and coffee later in the shift, and I got the true burn unit good bye – being wheeled in the shower. I gave my last report and cried as I said goodbye to people. And as I turned in my scrubs. And then as I walked home.
I’m very excited for the next step in my career, and I’m so happy that I was so sad to be leaving the burn unit. I didn’t love nursing when I started there, and it was a wild ride for 6.5 years. (6.5 years – can you believe it??) Nursing isn’t perfect, and neither was the burn unit. But it is such a special place. It feels a little weird to not say I’m a burn unit nurse – you can take the girl out of the burn unit, but you can’t take the burn unit out of the girl. (…right?)
Looking forward, I’m glad that being a CRNA means that I will still be at the bedside, just in a different capacity. I enjoy working with patients, and I’m thrilled to be able to do that in a new way. Almost 8 years at the bedside. I feel a little like I did when I first started as a nurse – a little nervous, not 100% sure what to expect, hoping I do a good job, and excited about what the future may hold.
I’ll see you on the other side, nursing.