Wednesday, July 28, 2010

Patient advocate and so much more

If there is one thing I know about nursing it is that being a patient advocate is only the beginning of my job. This job has so many roles and because I work in critical care I think those roles are only expanded and magnified. Everything is intense...hence "Intensive Care."

In the process of feeling completely overwhelmed and burnt out, I had to step back and really evaluate a couple of things.... and the comments and responses I have gotten from people when I share where I am at as well. 

This month marked the end of my first year working as a full-fledged RN, and it has been quite a roller coaster, for sure. I think it is well known that in this profession, your first couple of years are the hardest and especially going straight into the ICU as a new grad, that inevitably throws a whole new mix of emotions and hurdles to overcome.

In the past month or so I have found myself dissatisfied with my job... disengaging from the things I once loved about nursing the most... patient care being the first thing to "take a hit" so to speak. I was increasingly frustrated and annoyed with everything that required me coming up with some form of compassion or understanding. I didn't want to deal with patient's families and I definitely did not have the patience to deal with people who were needy and difficult. Not in my character at all. And also really not good when you work in a place where everyone is very sick and very needy and therefore often times, very difficult to deal with.

Then, last week I was venting to a friend of mine, a woman older than I am and someone who has been a nurse for 12 years now. In the midst of the conversation she told me that I had a "bad temper." Not in a mean way...but in a "let me be a mom to you and try and help you way". I took it pretty harshly and in the midst of already feeling defeated I think it was a definite blow to my confidence and it made me question...

"Am I really supposed to be a nurse?"

Not that I was going to drop everything and decide to switch careers... especially after all I had gone through to get to this point... but it made me question whether the ICU was the place for me. So, I took a moment to step back and evaluate what she might have witnessed recently that would lead her to say this about me. I honestly don't see myself as one who has a bad temper and even my best friends agreed that while yes, I am a bit of a feisty, firecracker... I am not one to have a "bad temper."

Here is what I think I have come up with. In the process of being tired and overwhelmed and I think overworked... I lost something along the way. I got away from what I used to love about nursing and my job suddenly became about performances and tasks and not people. I have been focused on improving and not being the "flunky" new-grad that everyone dreads working with. The typical, work-place gossip began to overtake my job and nursing became more about bureaucracy and politics than it did about being a caretaker and an advocate. When you are tired, everything frustrates you and when I am frustrated... you see it on my face.

On the flip side of that I think there have been some real parts of my job that have been an external cause of my burn out. People have been calling in sick a lot and because of budget issues we often times don't get adequate staffing and because everyone from management down to the nursing assistants are feeling like there is a lack of support...everyone looses. The question I have been asking myself in the midst of this is...

If I am the patient advocate...than who is mine?

I don't fully know the answer to that yet, but what I do know is that I am supposed to be a nurse. My journey in becoming a nurse was something that was so divinely orchestrated... I just have to trust that I am in the right place. I have always believed that God gave nursing to me as my destiny and purpose and in the past week or so I have consciously taken a step back and literally prayed that I would be able to go to work with joy and not dread... That I would be able to love my patients and be their advocate and hope that God would be mine...

And you know what? Something did change... I consciously made the effort to give compassion and have patience and to listen, and I can honestly say that I don't dread going to work anymore. I am aware that I am in desperate need of balance... right now more than ever.... but I don't feel like it is completely unmanageable. It's a part of the journey into this crazy world of critical care nursing and I think its part of the territory for a new grad like me.... and really, in the end "this too shall pass" and for that I am so grateful.


  1. Glad you're feeling better about everything. :) Big E-Hug!

  2. "I got away from what I used to love about nursing and my job suddenly became about performances and tasks and not people." I love that line you wrote! Its so easy to get caught up in the performance, check lists, duties, and forget that this is a real person I'm dealing with...

    Yesterday I had my 4th year appraisal... I've been a registered nurse for 4 years! crazy! But walking out of my nursing manager's office it made me think. I was upset because I only got a "4/5"... I work my butt of and I only get a 4?!?! I want a 5! I asked, "what does it take to get a 5?" She explained, " you have to be perfect"...

    Well, the only perfect person I've ever known is Jesus so... oh well.

    But that appraisal doesn't really define who I am as a nurse... My work ethic does. And even when no one sees the kick ass job I do... God does. I think you're right. He is our advocate.