Friday, December 12, 2008

The Hard Way Pt. 2

Taking me a while to update my posts. Apologies. The learning curve is keeping me busy. Collecting excellent stories to share. Give me more time...

:“That’s right. I did nothing all day. I fake added up my I/O’s. These numbers you see here, they’re fake.” I was adding up the last hour of I/O’s after report had been given to night shift. They come on at 1830, I leave at 1900, that leaves a half hour gap for me to take care of.

Preceptor: “Ha. Ha. Okay I see. Because if you hadn’t added up your I/O’s I would be VERY angry at you.”

Friends, my nerve got hit. Hard. I'm learning. I make mistakes. I make a lot of mistakes. Dumb ones. I don't profess not to. BUt I'm here to learn, not get verbally or brow beaten. Unlike some nurses, I throw back verbal punches. Maybe bad for the career in the long run, but my fists land. And they leave marks. And sometimes they land hard enough where I don't have to go home hating myself.

Me: “I DON’T GIVE A SHIT if you get mad or not. If I had neglected to add my numbers up until the last minute then I would be disappointed in myself for not using my time properly which, apparently you haven’t noticed, I did.”

Preceptor: (Not really sure that he had just got told off): “Uh…ha-ha.”

Sorry friends. Preceptors can be jerks, micromanage, hell they can even be disrespectful. But getting angry over not adding up I/O’s as a threat of some sort, sorry. Needed to put him back into line. The blowback? I’m sure he told anybody who would listen how terrible I am but I’m not really too worried about it. For the last few days other nurses have been coming up to me and saying, “How’s M------ abuse treating you today?”

Repercussion for my words? I don’t know. I don’t care. His preceptor, 3 years ago, was a notoriously abusive bitch, it’s too bad he hasn’t figured out he doesn’t need to act that way anymore. My preceptor is a good ICU nurse. Obsessive, detail oriented, gives a shit about the patients. He is somebody I have learned a lot from, and he has helped be focus on areas where I need work. Certainly I can be a stubborn fucking mule. Dangerous qualities as a new grad in the ICU. I am aware. But I don’t believe in fear based nursing. I see how my preceptor is afraid of management. He doesn’t understand that kissing their ass has brought him no respect, just more responsibilities that he doesn’t get paid for taking on. The ICU day shift supervisor told my preceptor to “drill instruct me” and have me ready to be solo in 2 months. Well, I’m ready to be solo. Scared shitless about it but ready. But I aint in the military. Call it pride, ego, vanity, stupidity, whatever. I got boundaries and they will not be crossed, as a matter of self preservation. So much disrespect and dehumanization burned me out as an E.M.T. the first time around. I’m not going to let it happen again.
As my best friend, who is a S.I.C.U. nurse told me, “Dude, just make it off probation.”

Has to be on my terms. This is why I write about my one confrontation as a new grad. Because it has to be done to change nursing. I write to remind myself and other nurses that being disrespected, patronized, condescended to, yelled at, or humiliated in any way is unacceptable by any medical personnel. That HORIZONTAL VIOLENCE is behavior that is truly unbecoming of a nurse. Not having a fucking opinion that differs from the general consensus should not be the impetus for school yard behavior.

The Hard Way Pt. 1

This is a long ass post, my apologies. I know shorter posts are easier and more fun to read. But I don't have much time these days, so I crank it out when I can. I seperated it into two parts so you can take a break, go to the bathroom, make some pop-corn, grab a beer, make love to your signifigant other, WHATEVER YOU NEED TO DO, so you can read the whole thing. Tally Ho!

Hard thing, to be a new graduate in an I.C.U. Trying to acclimate to steady stream of new information, theories, styles of practices, sometimes mellow- sometimes brutal clash of personality. It’s a hard thing. I’ve grown a lot these last few months. It’s been a wholly healthy experience, trusting a hospital unit to mold me into a functional nurse that can be trusted to take care of a very sick human being. So many defenses pop into my head when I trust my unit. I work for a corporation, it’s image or brand is that of Catholicism. I am precepted by various instructors, of all nationalities, sexual preferences, mentalities, experiences, I am open to their criticism, their warnings that something I may be doing is not working or will lead to more trouble down the road. I am even open to the ever stinging and painful attitude adjustment. I put trust into my I.C.U. that it’s interests are getting me up and running, not degrading my worth as a nurse and person.

I don’t know why nurses feel it is so important to remind newer nurses that they are new. I know only a tiny fraction of the over all incredible tidal wave of information required to run an I.C.U. I mean, I know this. This realization occurred to me my first week: In my career I will never learn every condition and procedure in great depth of detail enough to be masterful in all workings in the unit. This truth was stunning and provoked fear in me. That in itself as humbling as hell. More experienced nurses, however, are so threatened by the fleeting moment of recognition that every new grad has, when training comes together, when that smile comes on our face, “Hey, I learned this. I know this. I know why it happened, I have enough background knowledge and theory to manipulate this situation to favorable outcome because I’ve seen the outcome of this situation before.”

My preceptor with 3 years experience says to me, “Yeah, well, I think you just got lucky here.”

Then I go into my patient’s room and the noise by the charge’s desk drops. It gets eerily quiet. Cuz they are talking shit. That is the attitude adjustment. Not that I have done anything wrong but the attitude adjustment lies in the fact that the words that come out of my mouth reverberate around the unit and can leave a favorable or unfavorable impact, depending on the disposition of the nurse gossiping. I can control some of this, I must retain the attitude that I know so little and am awed by the skills of those more experienced. Sadly, my true feelings are threatening and infuriating to the more experienced. By claiming some victory over a situation I have hit a nerve with any nurse with more than 3 years of experience. Some of my preceptors let me have opinions let me make the mistakes that change those opinions wisen me up while most are too insecure to let me do so. To the insecure nurses, my attitude has changed. For the sake of peace, and career longevity, I swallow it and oblige their weakness. My attitude has changed.

Well sometimes. Mostly, I’ve been good, kept my mouth shut. I know better than to point out the 5000 contradictions that preceptors have amongst each other. I did try to point this out one time out to a preceptor that while I had no problem doing the task they asked of me or the way they asked me to do it, my previous preceptor the night before felt just as strongly about doing it completely different. That never chills ‘em out though. They just feel more threatened and insecure. Secure preceptors don’t give a shit about minute differences. Insecure ones cannot fathom that one single task can be done safely and appropriately 20 different ways. Especially when it comes to charting. That night’s preceptor kept saying, “But do you understand why I do it this way?” I was like- fuck, I understand you rationale is perfectly understandable but DO YOU UNDERSTAND THAT IT CAN BE DONE THIS WAY?
Preceptor: “What’s this?! You haven’t tallied up any of your I/O’s? You’ve already gave report. You’re behind.”

The following is my response after 2 months of my 27 year old preceptor acting like a cocky ass, making nothing but negative comments, criticizing my questions as repeats and therefore-stupid, not making any attempt to communicate, looking only for inane mistakes in my paperwork ( I put the MD’s name after the telephone order as opposed to putting the MD’s name UNDERNEATH the telephone order), all around being pretty worthless. Acting as if my dumb mistakes are somehow a reminder of my total failure as a new nurse. Each “Tssk" and deep sigh pushing me closer to the edge. Each day he’s got closer and closer to being out of line.