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.

Still Alive

One day, I’ll return to writing for my own sake.

In the meantime, this is what is going on right now:

Evan is thriving in middle school. The girls are swarming. It’s bad. Last Thursday, after some really strange symptoms that had been going on sporadically, we were told that they thought he had a brain tumor. More about that experience on another day. I just can’t right now. He is seeing a pediatric neurologist in a few days and we’ll hopefully get to the bottom of it. In the meantime, I am trying not to unravel in my worry by focusing my attention on the fact that the head CT was negative. I am instead focusing on other things: that–for the first time ever–this kid has friends; that girls love him and I actually have to worry about what goes on when he is not supervised with a girl, that he is now wearing small men’s clothes, that he has that goofy ‘stache coming in and his dad is going to have to teach him to shave.

Zach is…Zach. He refuses to have anything to do with a toilet. I am tired of having to buy Pull-Ups. Or worse yet, diapers. He still sleeps in a diaper because Pull-Ups leak too much at bedtime. I would let him feel that discomfort with the idea that it would motivate him, but he just sleeps through it, thus we sleep through it, and we wake in the morning to a child with a rash and blue lips from sleeping in soaked pajamas. I cannot deal with neither the grossness factor or the health risk of that. We encourage. His preschool teachers encourage. We have purchased every toilet-learning device known to man, looking for the magic one. Currently, that is this cushie Prince Lionheart insert that seems so comfy that I wish it would accommodate adults.He has no desire whatsoever. But what is he doing? He is speaking plainly, counting, saying his alphabet, (crudely) writing his name, singing songs. (Please do not mix up the order of he verses of “The Wheels on the Bus”!) In May, this was the child who could literally say nothing that a stranger could understand. So I am not sweating the potty stuff. We’ll get there. He always does, doesn’t he? He’s still my little wonder–smart, cute,  funny, sweet.  He’s just Zachy.

John is making me proud everyday, He has lost over 50 pounds since the fateful day over the summer when a doctor I respect came to me to tell me that he could have died at any second from the blockages in his heart. His BP is down. He is down to only one medication for diabetes, and that dosage even had to be cut in half. His cardiologist cleared him to run at home after he outgrew the mild exercises at cardiac rehab. His cholesterol was actually low at his last check, so his medication for that was cut in half. The beta-blacker was stopped after he exhibited no need for it. He was wearing a size 40 waist in the summer. He is down to a 34, and those are falling off, but we’re holding off on shopping for more, since he’s built up to 2-mile runs daily–any little bit of weight he has left will melt off as his endurance gets back up there. His doctor says he only needs to lose 9 more pounds to be ideal body weight. If he loses 18 more, he will be back down to his post-boot camp weight from his Marine Corps days.

And me? I’m hanging in there. I have–wait, let me count–8 more weeks left of school. I start my capstone next Saturday. My paperwork for graduation is submitted. I am off of work. Blame some little boys who cannot seem to get their dirty laundry in a hamper. I tripped on some dirty clothes and fell down the entire flight of basement stairs on my left leg, with it ricocheting off of each step on the way down. They thought stuff was torn. Instead, I found out that every piece of cartilage in there is inflamed from the trauma. So it has been injections, PT, crutches (for about 5 weeks). I am finally to the walking stage, but only for very short trips and in transit. I cannot stand or walk for long periods at all. (Read: I can limp to my class and sit in a chair, I can walk to the car and get in it, but I can’t do shopping trips, etc.) I’m just hanging in. Also, I remember lamenting on here how I hated undergrad corporate finance. It has nothing on the 600 level.

That’s all.

I’ll be a blogger again one day, I swear,

My Obligatory Miley Cyrus Post: Requisite Blogging

I have to say something about Miley Fricken Cyrus because I have a blog. And my opinion may not be the popular one. I’m not even sure what my opinion is, exactly, but it’s late and I have to stay up all night so I can sleep tomorrow in preparation for night shift. So I have earbuds in, the coffee poured, and I am going to try to explain.

Evan used to have a little crush on Miley when she was this:RP9581

I remember John practically losing his shit that his son wanted to spend birthday money on a Hannah Montana poster and cd, because John isn’t as open-minded as I am when it comes to gender roles. But then Ev admitted he thought she was cute, and that made it okay. The Age of Miley didn’t last long. It probably would have if Evan had been a girl, so for that, I was grateful.

But then Miley turned into something else. Controversy followed. Undies pics, smoking, whatever the hell she did. It didn’t impact my family, so I didn’t care. Everyone else seemed to be enthralled though. Whatevs. I lived under a rock or something. I didn’t participate in MileyWatch.

Until this shit happened:Miley-Cyrus-2224429

Even if you had no interest in MileyWatch, you got thrown into this shit this past week. It’s everywhere. Being somewhat normal, I had to see what the fuss was all about. Oh holy hell. Really? The whole thing was just weird. The giant teddy bears tethered to the backs of twerking girls, the teddy bear bustier, which really looked more like Chuck E. Cheese. The twerking, the hair. It was an attempt  to turn the juvenile to the racy, but it came off as trashy. I was appalled, and I can see how some parents would be up in arms that it was on prime time tv. But….

Have these parents watched anything else that is on MTV? Any of these videos? How was what Miley was doing any worse than what anyone else has done? And if you have seen what is on MTV, why the hell is your kid watching it if they are too young? So really, the air time is between you and MTV. Miley, I’m sure, was not given a choice on when it aired.

So that brings me to the whole sexuality thing. Miley is not Hannah Montana. Hannah Montana was a character. Miley was a child when she played the character for Disney. Miley is not a child anymore. She made that point a long time ago. Justin Timberlake used to be a fresh-faced cute little kid on Disney, and now he isn’t. Same for Brittany, Christina Aguilera…I’m sure there are more. Child actors grow up. We cannot expect them to stay kids forever. Just like our kids who once worshiped them no longer do. If that act was performed by Gaga, Britney, Madonna, we would have still thought it was weird and embarrassing, but there wouldn’t have been such an uproar. Quit being hypocrites, people. (In fact, I’m the reaction to this whole thing is kind of reminding me of the reaction to Madonna’s “Like a Virgin” shenanigans of my childhood.)

Now, before you think I am letting Miley off the hook, let me tell you that I am not. The performance was weird. The hair was weird, though I think (maybe) she was trying to emulate teddy bear ears with it. The whole set was weird. The strategically-timed sticking out of the tongue, the awkward look-at-the-camera-stick-out-the-tongue-now-walk-down-the-stairs. The posing. Then there was the whole humping of the foam finger, mor tongue sticking out. Gettin’ down with Robin Thicke, whom I continue to confuse with the dad of Growing Pains. Miley is a pretty young girl, and while I don’t personally love her music (“La-da-da-da-Deee, we like to par-Teee”? Really?) she seems to have a knack for creating buzz. In celebrity status, it seems any attention is good attention. I heard somewhere that her iTunes sales skyrocketed the next day, but I can’t remember where I heard it, so it may be inaccurate. And she can certainly create a following, as she did it before. She shouldn’t have to resort to that God-awful getup and scheme. She should have more pride in herself, more self-respect than that.

And for shit’s sake, Miley, what is up with the tongue? Put it back in your mouth. You’re creeping me out.

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That B-Word I’ve Been Waiting to Hear

frumsWith the start of middle school for Evan came the option to enroll in band.

I’ve been waiting for it. Ready for it. Of course, it ultimately came down to what Evan wanted to do, but I secretly hoped he would. And he did. He chose percussion–drums. Of course all band parents hope their child does not choose drums, and many nix it. I wasn’t afraid in the slightest. The kid wants to play drums. So be it.

The start of this new thing has not been uneventful. First, I had to get an instrument for him. We went right away. I was going to just buy him a snare drum, which is what the kids always started out with when I was in school. Nope. They have to have a bell kit, complete with a drum practice pad, a xylophone-type instrument, a stand, mallets, and sticks. And because this was Evan, I knew he would likely quit in a couple of months when he realizes that I intend to make him practice. So I opted to rent to start us out. So they hand me this form to complete. The rental fee is a whopping $22 per month. Nothing to break the bank. So I fill this form out. It consisted of my name, employer, social security number, address, employer’s address, how long, etc. Then she hands me this other sheet–5 references. Okay, I guess, just to ensure I’m not going to skip town with an instrument. Of course my phone was dead, holding within its lifeless body all of my contacts and their numbers. I had to dig deep to come up with 5 people whose addresses and phone numbers I actually knew. So I finish and start to get my wallet out to pay the woman for the first month and the book that Evan needs. Not so fast. Next she hands me a sheet of paper with more detailed information–my last 3 employers, my occupation, highest level of education. Now, mind you, all of this is duplicated for John. Then she needs my driver’s license. At one point, I looked at her and asked her how much it would cost to just pay for the damned thing. I know a snare is only a few hundred. Nope, this is over $1000 worth of stuff. So I am just waiting for her to ask me to bend over for the body cavity search while she runs my credit. But she doesn’t. Instead, I reach for my wallet out of my purse, now ready to pay her. I never dreamed. They tried to decline me!!!! I have purchased 2 new cars in the past few years. I can walk into my bank and ask for a great deal of money on credit and they will give it to me. I have multiple college degrees, a good income, and decent time on my job. Why in the hell would they deny me for something that only costs $22/ month? Well, because I have a medical bill that went to collections that I am still making payments on–for Evan’s autism diagnosis. It was thousands of dollars, and I just didn’t have the funds to pay it in full at the time. So I have been paying $250/ month for it and still owe about 2.5 more months of these payments. That is why. The good credit didn’t matter. Now if I were trying to buy a $100,000 car or something, I could see them being that particular, but this? So I was about to call my bank and arrange to just buy the thing when the woman came back and told me that it was okay, that she called their credit department, who told her to apologize to me and put it through. But then I thought about what this meant.

We have decent credit–decent enough to get credit when we need it. The only real mark against us, aside from that bill, is that we don’t own our home. That is intentional because of my education. I have no idea where I am going to be 6 months from now, so it is a convenience to just rent. I have a decent middle class income, own late model cars that I pay for on time. What about all of the people out there who earn less, have lots of medical bills, or are just pieces of crap and don’t pay? Those kids are deprived the opportunity to play an instrument, to learn music? So that leads to the next thing.

Music education is not a luxury. I know because I was a student of music. I wanted to play an instrument and, tired of buying expensive instruments for kids who would ultimately quit, my mom was hip to the game and made me choose from one our family already owned. I got my sister’s flute. And I was good at it. I played for years, with the school teachers always recommending private lessons. Mom got those for me through the local music store for a whopping $8 per hour. But within a year, I quickly outgrew those. She had to find someone from the Cincinnati Conservatory of Music to teach me–someone who was good. Those got more expensive, but Mom paid the $72  per hour each week. And I got good at it.  Good enough to win awards, have articles in the paper about competitions I won, honors I received. By the time I was in high school, Mom was ill. They had to file bankruptcy on medical bills. And I outgrew my sister’s flute. It was time for a professional model. The one that worked best was over $4000, and my parents simply could not do it. Of course I couldn’t either. Knowing I wanted to go on to major in music, the band director at my high school cosigned for the huge purchase and I got a job at McDonald’s to pay the payments directly to him so he ensured they were paid. And I paid the last payment right before I left for college. Mom, continued to be my biggest fan, though. She followed me around to all of the concerts, competitions, solos, honor bands and orchestras in which I was invited to play. She would always have to sit in the back with her oxygen tank, and she would cry as I would play my solos. At home, when I would practice, she would listen through the air vents, knowing that I would get nervous and stop if I knew she was listening, She doesn’t know that I knew.

So I went to college. They went to great lengths to break me down, knowing that in the music world, only the toughest survive. I rolled with it, but it was emotionally draining to take something I loved so much and make it into so much work. And Mom got even sicker. She couldn’t be there anymore. And then she passed away. And I would try to play and would come across sheet music for a piece she had wanted me to learn or for a song she loved to hear me play, and I would break down, unable to play through the tears. I eventually gave up. When I fell on financially hard times in my early twenties, I sold that expensive flute. I have not touched one since. But the lessons I learned–about finding what you love, what you are good at, and throwing yourself into it; about hard work in exchange for goals reached, about the bonding power of music, about the value of a support system–I took all of these with me. They are still here and still influence me daily. I want the same for Evan. I want the same for Evan’s classmates. This is why it made me so sad that some children may not be able to participate because of their parents.

Evan may never be a rock god, a virtuoso, a prodigy when it comes to music. But I will encourage him. I will be there. I will remind him of the value of it all. My mom served as a great role model in that.

This Could’ve Been My Kid: Toddler Boy Called A Faggot At WalMart For Wearing Pink Headband

http://www.mommyish.com/2013/07/31/toddler-boy-called-a-faggot-at-walmart-for-wearing-pink-headband/

Anyone remember Evan and his affinity for all things pink and sparkly? I didn’t really care, but I was worried for him simply because of people like the man in this article. Because people are ridiculous. And dumb. And virtually intolerant of anyone or thing different from themselves.

I remember those days. I remember having to tell my son that, while there was nothing wrong with him wearing or choosing whatever he liked, that there were people in the world who didn’t understand that and would be mean and cruel to him as a result of his different tastes. That didn’t make it okay, but as his mother, I felt it was my duty to protect him from any potential threat. I would rather he learned that lesson gently from me at home as opposed to the way this innocent little boy learned. So he expressed himself in the house, but not out in public.

Right or wrong, it was such a story as the one above that motivated me.

If I reflect back on that time in his childhood, I feel guilty. His personal preferences have always reflected his quirky, spunky nature. He is not the same as everyone else. He knows it, we know it, everyone knows it. He may have outgrown the pink, sparkly phase, but he has shown other differences. That’s fine with us. His unabashed exhibition of who he is for all who care to get to know him reflect a comfort in his own skin that many of us only hope to have at some point in our lives. I hope that time all those years ago didn’t quelch any part of that within him.

If it did, I am no better than the oaf in this story.

We all have our heads crammed full of what we should be/ think/say/do…
You’re a girl. You can’t throw a ball.
You live in the city, so you have no values.
You’re rich, so you must not know what it means to work.
You’re a man. You aren’t worth shit if you don’t solely support your family.
What do you mean, you can’t cook? Aren’t you a real woman?
You’re poor so you must be lazy.
You’re straight, so you hate homosexuality. You’re gay, so you’re a deviant.

We are who we are. That’s the world I want for my kids, in a nutshell. A toddler in the midst of discovering he is separate from his parents can wear a damned headband-pink, green, sequined, lacy-if it makes him happy. Evan can be obsessed with history instead of XBox. We can choose for my husband to stay home if it works for us. And, yes I suck at cooking anything aside from 3 specialty dishes, but I can rock out some corporate finance while keeping you alive, so that’s okay, right?

Our preferences don’t make us better or worse people. We are not less simply because we have our own strengths and weaknesses that are distinct from the person sitting next to us.

Someone needs to teach that man a lesson.

Bitchypants

I’m Having a Heart Attack or I May Just Be Bat-Sh*t Crazy

Okay, so given John’s recent fiasco where my perfectly fine husband’s heart ended up being most definitely not fine, we are pretty sensitive to anything in our house that could indicate impending death. Call us oversensitive.

10 days ago, I started having this chest pressure. It kind of comes and goes with no logical pattern at all, really. So I hemmed and hawed and mulled it over before finally just going to the ER, since it was a Sunday.

Normal EKG. Negative troponin. Negative d-dimer. Normal chest x-ray. It was deemed muscular in nature, and I was freed with a script for muscle relaxers.

Except for one problem: I am incaple on any form of consciousness on those damned things. So I have taken 2 of them in 10 days. And still, the pressure/pain comes and goes. It isn’t severe, but instead just there. Occasionally it will get bad enough that I have to stop and focus on my breathing.

So today I go to my family doctor, simply because it got bad enough that I couldn’t catch my breath and it felt bad enough that I couldn’t even focus on anything. Honestly, it reminded me of the massive squeezing done about 40 times a minute by my dysfunctional uterus just a few years back. Only not really, because it didn’t stop. And it was in my chest, just left of center.

But my tests were normal, so I have to be fine. Maybe it’s just stress. But it won’t go away. But I am under a lot of stress. But then again, I live in stress and have for my entire adult life.

But, but, but….

So the doctor asked me how I would like to proceed. And I don’t know, because the logical side of me who spent years studying all things cardiopulmonary knows it isn’t likely to be my heart. But then there is the part of me that doesn’t know what the hell it is and wants to be sure. So I told her I didn’t know, to jyst do what she feels is best.

I ended up on a proton pump inhibitor to ensure it isn’t something GI-related, a steroid to ensure it isn’t inflammation, and a stress echocardiogram just to be sure.

I’ve never had anxiety issues unless it involves John behind the wheel of the car. Now, I am questioning my sanity.

Bitchypants

Mastering the Art of Suckage

I suck at life right now. No, really, I do.

I woke up this morning to tackle the day. I was ready. Quick shower, yoga pants, hoodie. Ready. To. Go. And then I sat down. And I started reading Justin Halpern’s Shit My Dad Says on my phone. And before I knew what was happening, I had finished the damned book. And then I was exhausted, and we all took a collective nap. I was so hell-bent on not procrastinating on the finishing of the economics, and I suffered a massive failure on that one. (More on the econ in another post-that class is going to drive me into an early grave.)

So lunch came. And went. I didn’t eat a bite. Nothing sounded good other than a pint of black raspberry chip ice cream. And, well, that isn’t diet-friendly. Before I knew what was going on, it was time for dinner. Chipotle. And I ate the whole fucking bowl. With chips. How much more Fatty McFatFat can you get than shoveling heaps of rice and chicken and salsa onto chips to eat it? To use chips as flatware, for shit’s sake! So I’m not exactly feeling all svelte/ bask-in-my-hotness. On the contrary, I can practically feel the cellulite building up on my thighs just in the 45 minutes since I ate the last chip.

So now, the coffee is brewed. I’m ready. I am going to study.

“Andrea, I set a reminder for you, baby.” Awww, my husband is so thoughtful. A reminder for what?

For the season kick-off of Project Runway. Tonight. And suddenly, I can hear my resolve to study screaming in agony as it withers to nothingness.

Summer has entirely too many distractions.

And also, I am kind of tired of being a student.

Bring on the fall semester. Let’s get this shit done.

Fatty McFatFat's Flatware

Fatty McFatFat’s Flatware