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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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.

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,

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

Doing It

f8d17c34937d9c3215bfbbe00f6c78efI would love to give credit where credit is due for the above, but I have no idea where I got it. But this is the post where I finally talk about the other side. Of course, from the title of the post, you probably envisioned a juvenile describing the loss of their virginity, a la American Pie. Well, though I have my childish moments, I am not a juvenile and, though I hate to break this news, the whole virginity thing  went out the window a long time ago, folks.

No, this one is about setting a goal. One that seemed massive at the time. One that seemed highly unlikely. And then it is about reaching that goal. Or at least having the reaching of that goal so close that its taste is on one’s tongue.

I’m going to start the discussion off by telling you (or perhaps reminding you, in case I have mentioned it before and have just forgotten) that my first attempt at higher education was less than successful. My mom was sick. No, I mean, she was really sick, but she didn’t really reveal this to any of us.  So I spent my senior year of high school noticing how Mom was in and out of the hospital more and more. Somehow she convinced me to go to college anyway, but she kept getting put in the hospital.I was the first one in my family to go to college straight out of high school, to be labeled “the smart one”. She was proud, I think, and so I went. On several occasions, I would call home to discover that she was in intensive care. So there I was, a coddled kid away from home for the first time; a music major trying to study something I loved so much when really, I just loved to play and my mom was my biggest fan. And my mom was a home, dying. I couldn’t handle it. I didn’t do well at all. My grades were barely passing. I had gone from the smart kid in honors classes, to the one who couldn’t hack it. When mom finally dies about 2 weeks before final exams, I just dropped out. I couldn’t do it.

It scarred me. Mom’s death did, but the whole experience did also. When my life was calm enough, when I could look back on that time, I wondered about many things. Was I really just stupid? Was it the circumstances of the time in my life? Maybe I wasn’t college material after all. But I saw my life as it was unfolding, and I knew I could do so much more. And I met John, and he saw it, too. And he talked me into enrolling in some classes.

Just a couple of classes. I read that line to him just now. He smiled. He knows what he did just as much as he knew what he was doing then. Just a tiny spark. At a tiny community college where they do more training for careers than anything else. But I had been to a large university before, so I could tell that the classes seemed to be of the same caliber. Still, self-talk does weird things to us. But I enrolled in their respiratory program. I took the weed-out classes that all nursing and allied health students have to take. These careers, these jobs are stable, so these programs are usually turning applicants away. They make some of the prerequisites really difficult to separate the candidates by who will most likely be successful. And I had to take those classes. I aced them all. My classmates would hate me because I would wreck the curve. I literally scored greater than 100% for a couple of them because my professor curved others’ grades and didn’t feel it was fair to not give me the same point advantage. Still, the self-talk continued.

“It’s just a community college, Andrea. When you were at the real university, you sucked. You’re not really smart.”

And so I finished that program. With honors. I was recognized at graduation. I took my boards. I got my license. I started working in my field. And some part of me wanted more.

I wondered if the old dream of medicine could really take flight. I wondered if it was just because it was a community college. And so I enrolled in pre-med classes, to finish my bachelor’s.

And I got pregnant with Zach. And put on bedrest. I had been doing well, too.

More self-talk. Telling me I was silly. Telling me I was foolish. And then I didn’t want to do it anymore. I wanted to ensure my children would grow up in complete financial security with their mother present. I realized I had been given a gift with each of them, and I was taking that for granted. So I did some soul-searching, determining what it was I wanted to do. What I really wanted.

And I enrolled in an undergraduate program. Straight A’s. It was community college all over again. I nailed everything I touched, and I finished summa cum laude. But I did it online. And so I thought to myself, “Yes, but was it really hard? Was it really a challenge? It was just an online program!”

And so I told John that I wanted to go on to my master’s. To my MBA. And I remember when I was telling him this, that my heart skipped a beat. I really wanted it. I meant what I said. But thus far, every attempt at what I have really wanted has either fallen through or been derailed by my own shortcomings. To speak of this out loud was unimaginable, because it gave life to what I wanted. It gave me some accountability to myself. So I looked, and I discovered that the university practically in my backyard had a nationally-ranked MBA program. I applied.

They weren’t supposed to actually accept me.

And on the eve of my first class, I was so nervous. Walking into my first class, I got butterflies. They were going to laugh me out of there. I wasn’t smart enough. More self-talk. That girl needs to learn when to shut her mouth.

Because I have nailed it. In a few weeks, I start my last semester, which includes my corporate governance capstone. On December 19, I will be able to put MBA behind my name. And for the first time, I can try and try to self-talk myself out of this all I want. The logic counteracts it. I am doing this. I am doing it. And as I prepare to enter my last semester, it is becoming more real. I hope my mom is watching. I hope she can see. Maybe what she saw in me all that time ago was more accurate than what I saw in myself. And I can kind of see what she was seeing.

This’ll Be My Year

So my 36th birthday is coming up in few days. Blech. I feel like this is the year I need to start going backward on my age. How can I be that old? That’s, like, a grown-up. That cannot be me. But with my birthday comes the dawning of a new year, and I am excited for 2013. We may not see huge changes here, but there are some good things coming out of this year, barring major complications. First of all, we will finally get some answers about Evan. This has been such a long time coming, and even though I will probably be upset when the other shoe drops, I know this is what is needed to get him some help. I’ll need someone to remind me of that when we finally get the official diagnosis.

And I will be finishing school. Me. Finishing. With my masters. No more school for me after that. I swear. I’m finished.

And John will be finishing school. We won’t even go there. Big source of frustration there.

So I hear this song by Train. Yeah, Train. I know they aren’t considered cool by many, but I can actually listen to their music with my kids in the car, which is something I cannot say for most of the music I like. But anyway, this poppy, annoying song gets stuck in yuor head, and I cannot help it–it makes me smile. Because A) it recaps most of the major events in my life. I can remember everything in that damned song. And B) Why yes, Train, this WILL be my year, damnit.

So on New Year’s I will be working. It’s my holiday. I’ll be taking care of patients when the ball drops (wow, for the first time in my life without Dick Clark-sad!) , when I turn 36, when 2013 starts. So in advance, to you and yours, Happy New Year.