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.

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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.

What I’ve Dreaded Writing

Twelve days ago, we all watched the news and learned of the massacre of innocence at Sandy Hook Elementary in Newtown, CT. I did. I cannot even speak on the level of sorrow, the level of waste. We do not know which of those children would’ve grown up to lead out country, which could have held in their young minds the eventual potential to cure diseases. We’ll never know the future those young lives held because they were ripped from this world. I cannot imagine. Cannot. I looked at John, tears streaking my face, unable to put into words how heartbroken I was at that moment.

And how terribly frightened I am.

And now comes the part where I tell you some things that are not going to make me popular, but in my little space on the web, I can say this. Only here. I hope you will hear me out, that you will try to understand. I cannot speak these words to family, to friends, to coworkers.

When I read Liza Long’s post on her blog, “Anarchist Soccer Mom”, my heart dropped to the floor. Because I was thinking some of those things, but I never could say them. It is a terrible place to be in where you are truly afraid of the potential your child has to do harm. Not just harm to us, his family, but harm to others, to undeserving, innocent people. My child is not violent. He never has been. But I see in him a volatility that leads me to believe that the potential to turn that way is there, somewhere within him, if not managed appropriately. I have felt like this since Evan was very young, and so I have taken steps. No violent games. No violent toys. My husband, the veteran who has some valuable antique firearms, is barred from keeping them in this house. I’m not making a statement about gun control here. I am making a statement about my family. If the potential is there, why taunt it out of latency? People have hushed me when I have said this, citing that there are multiple ways to keep firearms in a home in a manner that a child cannot gain access to them. To those people, I will simply remind them of the time when Evan was really young and too independent (what I now know to be a sign of Aspergers) and we feared for his safety, as he would fail to wake us up before he would try to cook. No matter the solution, he would find a way to outsmart it. And that was to prevent him from wasting groceries or cutting himself on a broken glass. There is no way I will challenge his intellect to come up with a way around safety mechanisms that prevent him from gaining access to something as lethal as a firearm. And not only that, but I see how he gets interested in a topic almost to the point of obsession. So no. No guns. Not for my kid.

But this doesn’t help prepare us for the day when he will be old enough to do things without me, without my consent. Those days will come. So I do all I can. It is a constant uphill battle. I have good insurance. I have access to some of the best pediatric services in the world, and it is still an uphill battle. Look at the years his father and I have been screaming at the top of our lungs in a crowded room before someone finally heard us, before someone finally looked into the idea that what is going on with my kid is not simple hyperactivity, but something more. And after all of those years, when someone finally listened, saw what we saw, look how long we spent on the waiting list to get him help. And we still aren’t there. We’re getting there, but this is such a long process. Why? Why does it have to be? And if it is for us, with our resources, what is it like for the families at the poverty level, the families without insurance, the families in rural areas without access to the services to which we have access?

So then I find out that Adam Lanza, the gunmen, the cold-blooded killer of these innocents, had a possible Autism Spectrum Disorder, and I became flooded with emotions. All of the fears for my own child, given his history and what we are currently dealing with, came to the surface. Became palpable. And I want to label this Lanza kid a monster not fit for human life. But in his descriptions, I see my son, with his big brown eyes and his tousled hair that is always just a little too long. In the descriptions of his family demographics and his upbringing, I see my family, my neighborhood. So I begin researching infamous names: Eric Harris, Dylan Klebold…Monsters, right? Maybe. But maybe these are just more names of kids we have failed. And those failures have multiplied exponentially to where they are manifesting themselves in even more kids we have failed–their victims.

I am in no way advocating violence, but something in our system is broken. We are missing things, huge things, that are creating costs with which we are not prepared to deal. We cannot handle any more loss of children. And while Adam Lanza was of legal age to be considered an adult, if he was truly like my son, I offer you this: my child is, chronologically-speaking, eleven years old. Cognitively, he is an adult. Developmentally, he is about nine years old. Emotionally, he is stuck somewhere between a toddler and a five-year-old. Was Adam Lanza really an adult?

And what of his mother? We can judge her all we want from our safe distance. From here, I can tell you that, if I would never dream of having a firearm in my house, why would she? I want to tell you that. But in my mind, I can tell you that coming to terms that your child is capable of taking such a turn is terrifying to think of. It is not for the weak of mind or heart. It is terrible to admit. Soul-crushing. Because we parents internalize everything. If my child is capable of such an act, what does that say about me as a mother? Am I, too, a monster? What did I do wrong? I have worked much of my adult life to obtain higher degrees to provide my children with more, better, best. I have sent my oldest to private school when the public school system wasn’t working for him. I have pursued treatment when something just wasn’t right. I have read the parenting books, followed the advice of experts. I have tried every discipline technique known, every reward system to motivate him. I have done all I know to do, and I still look for more ideas. But if my child were to do something like this, I would be the monster, and you would be judging me right now.

So while the media, the web, everywhere you turn, is arguing over gun control, over whether teachers should be armed, it is painfully obvious to me that we are missing the big picture. Something is broken, and we have to fix it. We need services to identify this stuff before it happens. We need to create a safe place for parents to turn to truly help their mentally-ill kids. We need to interrupt the downward spiral before a firearm even comes in the equation. We have failed these children. Yes, even Adam Lanza.

I Can’t Afford It: The Inevitable Rant About PPACA from the Inside

I don’t usually get all political up in here. It just isn’t my thing. I have read countless comments on Facebook about the Supreme Court’s decision about the Patient Protection and Affordable Care Act. That shit is everywhere. And everyone has an opinion. “Everyone is entitled to healthcare…” Yeah, okay. Great. Kumbaya, and all of that jazz. If you are disadvantaged and need medical coverage, and there is a way for you to get it, I am all for it. We have programs like that in the U.S. We have for decades. Yes, they suck a little more than the insurance one pays for electively. If I am out of food, and I go to a food bank to get food for my family, the items I get, though appreciated, are not of the same quality I would buy if I went to the grocery store and shopped for myself. You take what you can get. I’m sorry to sound so blunt, but it’s true.

I’ve said it before and I am going to say it again: I used to not have insurance. John worked at a job that paid him $8/ hr. and the benefits were almost $700 per month. Evan was a newborn. So I took an eq\ually crappy job as a housekeeper at a hospital where the insurance was about $400/ month. I essentially  worked for the insurance When the income got to be too little, I went to work on a degree that would pay me what we need, both in income and in benefits. And I’m not afraid to give you the straight dope, though it is poor etiquette. I gross over 8 thou a month. I bring home about 4K of that. What???? Why? Well, simple, really. I pay over half of my income on taxes and pesky little necessities like medical, dental, and vision insurance. Right now, that is the lay of the land. It is how the shit falls.

So while I am not too keen on spending even more of my very hard-earned money to support those who did not have the wherewithal to go out and do what I did–find a beter job, better benefits—I simply cannot afford it. I am not living high on the hog. We have one car. My husband rides his motorcycle in good weather to save on gas. We try to limit our dining out these days. I clip coupons. We live in a house that is way below our means because it is cheap despite being in a nice, white-collar neighborhood. And though I am off for my neck and shoulder right now, I work every God-forsaken hour my employer will allow me to work in order to make more, to pay more in taxes…you get the drift. I cannot afford more of my tax dollars to go to support your healthcare. I will take care of you when you are ill. I will risk contracting any infectious disease you are carrying because someone has to. But I am not willing to sacrifice the well-being of my children to pay for you and yours. I’m sorry.

And there are other misgivings I have about PPACA. This part is coming from a healthcare professional who works in the trenches, from someone who is wrapping up a degree in business \with a concentration in healthcare management. Hospitals rely on reimbursement. They do. The naional average for Medicare and Medicaid reimbursement revenue is around 60% of hospital revenue. The hospital I work for receives about 80% of their revenue from Medicare and Medicaid. That’s a big ol’ piece of the pie. The pie that determines the amount they can do for their community, the services they provide to their patients. And guess what! For added fun, those coffers are getting pretty shallow. Hospitals are fighting harder for less dollars. And we can expect more and more of these patients. This would seem like even more reason for the PPACA, right? Nope, and here’s why:
The PPACA also has implications for providers. More stringent guidelines to provide more cost- effective care. Nothing wrong with that. One of the yardsticks with which providers will be measured is their readmission rates. Currently, there are a few diagnoses where hospitals are penalized for excessive readmissions. As a part of the PPACA, four more will be added by 2015. One of these is COPD.

And that is whete the respiratory therapist in me gets all fired up.

COPD. The bain of my existence. My livelihood. But these are the worst patients that CMS can use to penalize hospitals for readmissions. I understand the concept: if we’re doing our job, the patient won’t be readmitted within a certain time frame. The problem is this: while some COPD patients are dream patients, I would say the majority of my patients are non-compliant. They won’t quit smoking while their alveoli fight with each other for every breath. They pick and choose which of their respiratory meds they take and when. (No, inhaled steroids are not going to work if you only take them as needed, and you should not stop taking them just because they don’t work as rescue inhalers.) And toward the end, they could be in and out of the hospital every week. So if hospitals stop getting reimbursed adequately for these admissions, they lose progressively more money as time goes on. That is the same money they use to attract and recruit higher-credentialed staff. The same money they use to provide indigent care. The same money they use to obtain equipment. To maintain equipment.

But my other problem? We all speak of the access to care. Well, if you live in the U.S., you have access to care. If nothing else, you can go to an ER where we have to evaluate you. That is access. What is truly lacking is a way to pay for it.

Is the U.S. healthcare system having trouble? Yep. I don’t blame hospitals or providers. I don’t blame insurance providers. Thete are many pieces of the puzzle, in my humble opinion. Lawsuits. Malpractice insurance. ER abusers ( by this, I mean drug-seekers, etc.). Doctors being forced to practice defensive medicine. (And if you don’t buy that, ask me and I’ll tell you the crackhead story.) Drug patents. And us. Yes, us. We want the latest and best. When a standard x-ray is sufficient, we still want the CT. When a cheap generic drug will work, we want the brand. And doctors are stuck. Patient satisfaction is a reimbursement buzz word, and if they don’t give us what we want, we get upset and don’t stop until we get it. Whatever it is, it may not be the most cost-effective, or even the most effective. We need to leave doctoring to doctors.

So, yes. I am a healthcare professional. I am hopefully a future hospital administrator. And for all of these reasons and more, I am completely against the PPACA. And I will vote accordingly in November.

It’s What I Do

Ya’ know, when I was 19 years old, my mom passed away. At her funeral, there were these strange women there, crying along with the family. None of my brothers and sisters knew a single one of them. It turned out that they were from the respiratory therapy department at the hospital mom always went to when sick. It was a little hospital. And I remember thinking “how awesome is that to be able to be that invested in your work?”. I guess it stuck wih me. And then later, John talked me into going back to school. I was too smart to not finish my degree, according to him. And so I did. I just wanted something that would support my family. I was going to try nursing, but I couldn’t handle the poop part of it. And I found out my college had a respiratory therapy department. I applied for admission into it. I didn’t think about the times mom’s cough would be productive and I would gag when she would cough into a tissue. I just remembered her funeral, her life, her demise. Along with my interest in medicine.

I became a respiratoty therapist. I never gave any thought to it. I had straight A’s, so how could they deny me admission into the program?

I finished my degree and I ran with it. My first resuscitation after graduating was a 6-month-old baby boy. They found him submerged headfirst in a bucket of mop water that had been left by a bed. We had no idea how long he was submerged. He was supposed to be taking a nap at the babysitter’s house. Of course we didn’t get him back, and I came home from work that day and told John that I had made a horrible mistake, that there was no way I could do this job. Nobody with a heart could. But I went back to work the next day. And the next. And somehow, I stopped being able to keep track of the resuscitations in which I have participated, except for a select few that hit particularly hard. Like the mom who died in childbirth and almost took her baby with her. We were successful at saving the baby, but not the mom. My last picture of that was the NICU door closing on the new widower cradling his new baby girl with a bewildered look as he sobbed for his dead wife. And then there was the little boy who was 3 days older than Evan, who tried to help his stressed Daddy out by taking his ADHD meds himself. Only he took the whole bottle and his heart stopped. And his mother wailed as I stood at the head of the bed, breathing for him until they told me to stop. Or the 35-year-old breast cancer patient who had contracted necrotizing fasciitis after having her lymph nodes removed. Someone thought it was a good idea to let her daughter come back and say good-bye before we called it. Her daughter was Evan’s age, and I can still hear her wailing, “Mommy, don’t leave me.” Those? Those I kept right here with me. They have never left.

It’s interesting isn’t it? For every one we couldn’t help, there were probably 2 that we did help. I don’t remember those. Their faces blur together and disappear into this infinite mosaic of faces that have wafted into and out of my life. My work. Evidence? The grandmother who ran into me and remembered my face as one that did CPR on her newborn grandson. Or the lady who ran into me at the grocery store and remembers me as one who responded to a code on her father. I was just standing there in the produce aisle with my family, with this blank smile on my face because I couldn’t very well come out and say, “I’m sorry, but I haven’t the foggiest who you are.” The successful ones become the equivalent as another Big Mac sold by the McDonald’s worker: I did my job. I’m so sorry I do not remember, and I never dreamed when I started this career that I would reach this point. Pretty much the best I can do is assure you that while I was there, I cared deeply. I still do. But when you are standing there sobbing while we do CPR, I have to block you out. I have to concentrate on my job. And when it was over, I don’t want to remember your sobs because then they stay in my head as a constant reminder of how fragile we all truly are. That it could’ve been my husband, one of my children, me.  And while I am sorry that it is happening to you, to your loved one, I’m truly appreciative that it is not one of mine. I can be selfish like that. I’m sorry. I’m so, so sorry.

But I am not the only one. There is a whole profession out there of people who do what I do. And this week? Well, this is our week. National Respiratory Care Week. The hospital and the physicians, the drug reps and vendors, will shower us with food and freebies. And they’ll say thanks for what we do. And we will pat each other on the back for this week. But next Monday, it will be business as usual. People will live. We’ll help them. And some won’t make it. I’ll see an obituary with a familiar name and it will drive me crazy, serve as evidence of our failure. And then I’ll hate my job, but I’ll still go in the next day. And the next.  And the next.

Somewhere along the way, I became a respiratory therapist.

It’s what I do.

It’s who I am.

Role Transition

So what’s happenin’? Well, A lot and yet not so much.

The NICU stuff is winding down as we get closer to the day where we will start keeping the really sick babies. When you have a baby at my hospital, they warn you to not let anyone without a specially marked badge in to take care of your newborn. OB staff and NICU staff, as well as Peds staff all have these badges. The core NICU respiratory team is o be no different. So today, I had to go and get a new badge. The special marking? A bright pink stripe. Mine used to have a lime green stripe. How did they know pink is my favorite color? Actually, when I got it, I was appalled. my title is written all extra ginormously and the pink is glaring. Proof?

Pink means "Gimme yo' Baby!"

So not a big deal, I know. it’s the little things. I also renewed my NRP–Neonatal Resuscitation Program for those of you not in the know. It’s the fourth time I’ve taken it and it won’t be my last, as it expires every two years. The video for it cracked me up. They actually included RT’s in the scenarios with the rubber babies. As in, “Call Respiratory Therapy STAT.” And the guy who is supposed to be the therapist shows up and says, in utter robot fashion, “I…am..the…resp-ira-tory ther-a-pist. How…can…I…help?” Yeah, whatever, Dude. That is so not how it goes. I don’t wait to be told what to do. I know my role and get to work immediately. I’ll throw elbows if I have to. Same as wih the adults.

I’m sort of nervous about the change in roles. I’ll still be taking care of adults, too. But I will be on my own with the sick preemies and it worries me. I will see what could have been with both of my boys, and I will be crying a lot. Maybe this makes me less fit to care for this patient population. Maybe it makes me more fit. I guess it’s a matter of opinion. But someone saw me fit to be placed on the team. And so I shall do my best for the little ones while I see Zach’s and Evan’s faces the entire time.

Addicted…

To ugly running shoes.

Yeah, I am. It started a couple of years ago. I had worked a gazillion 12-hr shifts in a row. Plus, by day, I had been traipsing allover the University of Cincinnati’s campus for pre-med stuff. (PS-how in the blue hell did they design that campus to where literally everyplace you walk is uphill??? It defies the laws of reason.) The end-result of twelve days of work in a row, assigned to the ICU during the perils of flu season, plus school-schlepping all day with only brief bursts of sleep when I was absolutely about to die of exhaustion was that my poor feet were swollen and painful to even touch. I limped into a sporting goods store and told a bewildered salesman that I didn’t give two shits about the shoe’s looks or price–if it was comfortable, I would buy it. he reached somewhere up toward the heavens and procured this hideously ugly pair of running shoes. They were mesh and pleather, and the pleather was silver–not dull, matte silver, but mirror-like silver. They had big black stripes down the side of some sort of rubber and huge patches of pink gel-like shit in the inch-thick soles. The pleather trim was white–with fucking pink paisley designs. They were the ugliest shoes I have ever seen in my life. And I put them on. And I literally teared up because they felt so good on my feet. John was jabbing me in the ribs with his elbow and hissing, “Andrea, damnit, stop crying. You’re embarrassing me!” Yeah, whateves. So I told the guy to give me the other one, I was going to wear them out of the store. And I gasped when I saw the price: $190.00 with tax. For those ugly bastards. So I tried the cheaper versions of the same brand. Incidentally, the cheapies were cute, not ugly–why is that? But none of them worked. And I finally just paid the money. Best money I ever spent, I swear.

I wore the hell out of my ugly shoes. They were Asics. Very high-end running shoes. And they worked for about 8 months or so before the sheer amount of running I do at work made the insides of them die a painful death. The outsides still look like new to this day. As ugly as the day I bought them. But since then, I have devoted my time to finding the proper replacement. And no pair of Asics I have bought since has ever lived up to those ugly mofos. They all do fine for trips around the block or to the aprk. Even for long walks, runs, or hikes. But never to my hellish work environment. Never.

Until now.

I was googling “ugly running shoes” in the hope of finding them online to buy another pair. And I encountered something that made me gasp with their ugliness. Another pair of Asics. High-end. $140. And though they weren’t the same, I figured their price and brand gave me a better shot of finding something comparable. So I ordered them online. The mens and womens’ versions were both equally disturbing.

I am not kidding. Excet that the photo doesn’t do them justice: the yellow is less green or yellow and more that painfully neon color of a yellow highlighter.And the Asics stripes glow in the dark. Really. John, having not seen them until they arrived at the house, gasped in horror when he saw them for the first time. And he hates when I wear them because you cannot miss them. So people stop and comment.

Turns out there are scads of people out there who love ugly running shoes as much as I do. At work, at the grocery store, at restaurants…People love my shoes. Or are lying to me, and making a big production out of stopping my and offering unsolicited lies. Either way, it doesn’t matter. Because these shits are as comfortable as if I swathed my feet in clouds. And the mesh top is actually so airy that you can see my socks through them.

So I will never buy cute running shoes again.

And John can bite me. Because my feet don’t feel like they’re breaking anymore.

And I am a respiratory therapist.

And it is flu season.