Lucky 13

The rest of the world was preparing for Christmas. I woke on the sofa in our living room after a night spent binge-watching Netflix the night before. On one side of the sofa was the twinkling of the lights of our Christmas tree, and on the other side was John, also asleep on the loveseat for the same reason as I was.

John.

Our thirteenth anniversary.

And I just stared at him for a while without his knowledge. I never took note of how his hair has started to thin at his hairline just a bit. I could see that the way his eyes have started to crinkle in the periphery when he smiles completely go away when he sleeps. He has Evan’s and Zach’s dark lashes, that curling, dark fringe women buy high-end mascara to achieve.

I found myself doing what I always do at any milestone: reflecting back. What our thirteenth year of marriage has brought us. It was just a few short months ago that I stood there with all of my medical knowledge flooding my brain while the cardiologist told us what he had found. When he said those words to me: “He really should have open-heart surgery, but my colleagues and I just do not think he would have survived long enough to get the blood thinners out of his system first.” He used my husband’s name and “survive” in the same sentence. And more than anything, I was afraid of that combination. For the first time in our marriage, John became a mere mortal like the rest of us and the idea that there will come a time when one of us will die entered my mind. That’s been hard to deal with from that day and beyond.

And the day they told us that some weird symptoms Evan was having were signs of a brain tumor. We each dealt with it in our own way—he with blind optimism and me with incessant tears— but we did it together. We seamlessly kicked into action as a team to get Evan the imaging studies, the appointments with specialists, and anything else we needed. And when Evan wasn’t looking, we held onto each other and we got through it to the news that Evan was fine.

He finished school this year. He belittles that in the face of what I accomplished this year. But it is what he wanted and he did it on his terms. He has spent years taking a class here or there, in the background while I was in the foreground doing something of my own. And he has started and stopped his classes with no complaints and no questions asked, based on what I was doing or had planned. Whenever it just wasn’t in the cards for both of us to be in school at the same time, he was always the one to drop out or put his on hold. He never would let me make that sacrifice.

And my MBA. Oh, John, my MBA. His MBA. The man has tirelessly chauffeured me around from this class and that class, this meeting and that meeting. he has rubbed my back when I studied and my shoulders were holding just too much tension. He has awakened from a dead sleep to run to the nearest 24-hour store when the printer ran out of ink for that big paper that was due in the morning. My favorite was, while I was pulling an all-nighter in preparation for my huge finance final at the end and my financial calculator died, he returned with both the replacement and a box of my favorite chocolates. And wasn’t it him, all of those years ago, who made that now-famous (in this family, anyway) statement to his dean? “My wife is too smart. What can I do to help her get back into school?” He saw in me what my mom once saw, what I had stopped seeing in myself. What I had given up on.

Those were some of the big things. In between, there were a million little things. And our marriage isn’t perfect. He pisses me off at times, breaks my heart at others. And at the end of each year, in the mashup of Christmas, our anniversary, New Years, and my birthday, I always wish for us to have an easier year next year. This year was no different. But the fact remains that we have been together long enough that our lives have become this intricately-woven tapestry, and you simply can no longer tell where his thread ends and mine begins. He understands me, and I understand him. We belong together. We will get through the bad, the trying, and will celebrate the good together. I cannot live without him.

Here’s to another year. And all it brings us.

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Lament of the Non-Nurse

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Healthcare is all about nursing. I understand this. With 77% of non-physician roles in U.S. healthcare being those of the nursing variety, I can understand. They are the backbone of our hospitals. I am not a nurse. I had the option years ago, and I decided that, with poop being my Kryptonite and all, it would not be a wise career choice for me. I opted, instead, to help people breathe for a living. Thus I became the respiratory therapist. That choice has come back to haunt me in several ways.

The first of these started when I wanted somewhere to go from here. Nurses have so many avenues they can take to do this: become an instructor, a case manager, management at their facility, become an NP. What can the respiratory therapist do? Well, aside from becoming a Registered Respiratory Therapist from the entry-level Certified Respiratory Therapist, which I did the month after I graduated from respiratory school, there is nothing. Bachelors programs in respiratory are just starting to emerge, but a BS in respiratory gets us no more job perks, no more pay. You just get to say you have it. The majority of my bachelors-having coworkers got theirs in “health sciences”. Whatever that means. So instead, I opted to finish my BS in business administration with the added concentration of healthcare management. But then what? If there are only a handful of BS programs, there certainly are no masters programs. But my BS is in business anyway, so the MBA was a no-brainer.

So here I am. I am one of the more educated in my department, even in the hospital. My MBA is complete. I did well. I did it. So now what? Now I find a job.

I thought this part would be easy. Well, not really easy, but not this difficult, either. Let’s discuss my situation: I have spent the past eight years of my life working in the toughest in my field–adult critical care, and eventually NICU. To the layperson, let me explain further: I am a member of a critical care team who responds the emergencies in the hospital. We are called in when you or your loved one is at their sickest. We bring our skills, experience, and knowledge to you, make recommendations to the physician based on all of the above. We communicate with other members of the team, with family members, with patients. We assess and decide, then act. Repeat as often as necessary to the point that it is second nature to us.

So what does this tell you about me? Well, it tells you I can effectively communicate with anyone. I have non-English-speaking patients, when I am most certainly unilingual. I have deaf patients, blind patients, patients who are intubated and cannot talk, trached and cannot talk. My job is to find out what is going on with them rapidly enough to act. I have become, over the years, a master lip-reader. But that’s not all. The people with whom I interact each and every day have been anyone from a PhD-holding professor who was ill, down to a man whose education was limited to elementary school before he was put to work out in his family’s fields. On our professional team, we have everyone from housekeepers and registration clerks, who may only have a high school education, all the way up to senior management and physicians with advanced degrees. I. Can. Effectively. Communicate. With . Anyone.

Now for my work. It may involve looking at lab values that seem to others to have nothing to do with the lungs, but actually do. Watching vitals. Seeing how the patient breathes. Assessing vital signs. Looking at patient history to see what clues I can find. Listening to family members who may not speak the same lingo I speak. Look at x-rays, watch for clues. And I look at all of this, and since the physician is not there, I have to decide when we need to be concerned, when to call for more help, what I can do to help. So in a split-second, I have to take in this information from multiple sources–complex information at that, compare it to the knowledge stored in my brain, and formulate a plan on how best to proceed.

And under stress. The patient is either having trouble breathing, or even has stopped breathing, when I have to do all of this. Maybe their heart has stopped. Maybe their oxygen saturation is low. Regardless, I don’t often have the luxury of being able to take my time. I need to make a decision and act now, now, now. And while nurses have anywhere from 2 to 6 patients to care for, when I go into work, I have the respiratory histories of at least a few floors’ worth of patients in the back of my mind or in notes in the margins of my printed work assignment. If you figure the average respiratory rate is 10-20 breaths per minute, and there are usually 30 patients per unit, that it 36,000 breaths for which I am responsible in one hour of work on just one floor of the hospital. And I May have three or four floors. That’s a lot of responsibility and a lot of stress.

And I have done this for years of my life.

And then I got an MBA. So I understand finance and strategy, management and business law, marketing and accounting. I have been educated thoroughly in all of the above from a nationally-ranked program at a well-respected university. Add that to the ability to communicate with anyone, the ability to work under stress, the ability to extract complex information from multiple sources to formulate a plan….Nothing should stop me, right?

Wrong.

Because I am looking through these jobs, and seeing that many of the leadership opportunities are asking for someone with a nursing background. Why? No idea. We respiratory therapists go everywhere. A nurse may be hired to work in one specific unit. I can go anywhere in a single night, giving me intimate knowledge of the work flow of every patient care area of the facility, from behavioral health up to the ICUs. And I know healthcare. And I know business. At first, I noticed this trend, and I was a little discouraged, but I figured that I would find the right role  But today, I came across a posting for a pulmonary unit. They need a director. Perfect. Except, as I scrolled down reading the job posting, toward the end, it listed a RN as one of the qualifications. They want someone with my clinical experience, an MBA….and a RN.

It is what we all deal with everyday–we non-nursing patient care staff. We are skilled, we are experienced, we are valuable to patient outcomes, but this is the hand we are dealt, and frankly, it sucks. Part of me wants to just go to nursing school for a couple of years so I can say I did. But I shouldn’t have to do this. I have worked hard. I have done well, completing all three degrees with academic honors. I have the experience under my belt. This is just ridiculous.

Nursing is the backbone of healthcare, but I have yet to see a backbone accomplish anything without limbs, without muscle to hold it upright, support it and ensure it can move and flex in the ways needed. And it’s high time that the rest of the body gets some respect.

The To-Do List

This is what I have to do this week, so you can understand my level of insanity:

For my health law and ethics elective:

  • A 12-page paper–I chose to do mine on the lack of OSHA regs in healthcare.
  • A matching presentation on the above to be presented to my classmates

For my social media marketing elective:

  • Plan a social media marketing for a local business with whom I have partnered, including an execution plan and integration with existing promotions and events
  • Read two books
  • Write a blog post and watch 2 2-hour videos
  • Present above plan to my class

For my finance class:

  • Get through another 100 pages of text
  • Get through a study guide and over 100 practice problems
  • A case study to be completed in a group
  • Get ready for what is sure to be the most difficult final exam ever.

For my capstone:

  • One more round of decisions for my fake company I have been running all semester (which has a 120% growth  in profits, thankyouverymuch!)
  • An online exam
  • 2 10-page papers
  • A review of the above operations of the fake company
  • Another simulation of a shorter duration
  • The ETS exam required of all MBAs from AACSB-accredited programs in the country

That’s this week. And I work two nights in the middle somewhere.

Now you get it, right? Because nobody in my life right now seems to understand what I am talking about when I try to explain my current stress level.

These are the Days

16 Days. Of course I type that while I am supposed to be awake putting together a 45-minute multimedia presentation on integrated marketing practices for class tomorrow. My final project for a marketing elective to round out my requirements for the almighty advanced degree. John, in his awesomeness, brewed the strong coffee for me before turning in for the night. And I can’t quit thinking. I can’t quit thinking, not of integrated marketing as I should be, but of the uncertainty of my life right now. Have you ever been in a place where the things you spend your days doing no longer feel like they are what you should be doing? Where you feel like maybe your real life awaits you, if only you can survive this short little interim? That is this place. These are those days.

My views may possibly be skewed. I realize this. There are people who have devoted their entire lives to do what I have done for the past eight years. They keep doing it, content with their contribution to the world. There is absolutely nothing wrong with that. It is honorable. I’m not selfless enough. I feel like I have spent the past eight years paying dues to the world, to my being in general. To the spirit of my mother, who died from lung disease. I’ve been a good girl, and I have been good at my job. There are, in all honesty, people who are breathing today because of the work I have done. I have been there to help babies who could not help themselves. I have been there when families have said goodbye to parts of themselves. I have wiped brows of the dying, delivered tough love when necessary, compassion when it was needed. I have put myself and my family last. And now, after all of these years of doing that, I want to do something different, and in my warped mind, I have earned that. Not because I will, in just 16 days, have a piece of paper with my name in beautiful calligraphy saying I have completed some requirement set forth from society, but because I have paid my dues in other ways.

People ask me what it is I want, and I always answer with a “we’ll see” kind of shrug. I love healthcare, am passionate about healthcare. And I want to leave some sort of mark on this industry that is on a higher level than the one I am currently leaving. And I want to do so in a way that allows time for me, time for my family.

Lately, I have been thinking a great deal about my path through higher education as a non-traditional student. Evan was about 2 when I put on a  backpack for the first time since my mom died, which was eight years before that. Evan is 12. I will finish this long road about 2 weeks before the ten-year anniversary of that first time back. And I have thought about it. I have allowed myself the luxury of pondering just sucking it up, reaching deep, and going straight into a Ph.D. program or a JD, even. And then I think of them. Of Evan and Zach, of John. And what I want is no longer about a higher degree or prestige. Now, when I think of what I want, it isn’t grandiose at all. It’s simple stuff. Little things that aren’t luxuries to most, but have been to me in these years where I have tried to do it all.

I want to come home and not have to rush off to class, be able to eat dinner with my family at a normal hour around a table with food we prepared at home. I want to watch a movie with John without worrying about homework I should be doing or, better yet, am actually trying to do with said movie playing in the background. I would love to take the boys to a movie or park on a weeknight for no reason at all. Maybe even go on a weekend hiking trip. Maybe John and I could have a real date once in a while. Or I could read a book that has not a damned thing to do with academics at all. I want to blog more. Maybe I could revamp this one a little bit with all I know about social media marketing and content creation these days. I want to join a gym and be able to go–and not some lame attempt a a resolution where I don’t have the follow-through because, hey, thinking I would even have the time for a workout each day was optimistic at best, even closer to being the world’s dumbest idea. No, I want to actually go. And work on myself a little bit, and not just on cramming my brain with as much knowledge as possible.

It’s so strange to me. When I started this, I thought, “MBA: the CEO’s degree. I’m want to be loaded.” It isn’t about that anymore. It’s about enjoying life and having the means to do so comfortably. There is only one material possession I even want, and it is going to sound worse than it is: that new Mercedes CLA 250. Sounds greedy and ridiculous, right? No, because in reality, it is only about 3K more than I paid for our current car and I bought it used. And the current car is too big for me to feel comfortable driving with my vision issues. So sounds crazy, but really isn’t. But anyway, here I am at the end, and the salary isn’t the thing anymore. The job is, the career is, the comfort is, but the money isn’t. And I am saying this about 2 days before I have an interview for a position that would pay more money than I have seen in my life–about 5 times my current salary. And now I suddenly don’t care. Well, I mean, I care in that there is a minimum I can take. I worked hard and paid a lot of money for my MBA. I can’t just give it away. But money isn’t the key determinant.

So here I am. Sixteen days from the big finish. And it feels like everything in my current life is winding down so I can start the new one. So these are the days. The days of excitement, of anticipation. Of anxiety and uncertainty. Of endings and new beginnings. Of wrapping up and starting anew. Of sheer panic mixed with resolution and calm.

These are the days I have to let go and hope it all works out, that it proves to have been worth it.

And if it does work out, these are the days I get to lean back, prop up my feet, and tell myself that after ten years, I earned every damned bit of it.