Moving Out; Moving On

“Home is where the heart is. Even if you can’t remember which box you packed it in.”

I can’t find who to attribute that quote to, but I found while looking up quotes related to moving. I am, as the astute may have gathered by now, preparing to move from my one bedroom apartment to a three bedroom house. I honestly can hardly wait for it to be made official . . . for the last boxes to be moved over, the last papers signed.

Truthfully, I’m actually getting a bit ahead of myself. The house that I and my other are moving into is still being renovated. We won’t be able to even begin moving things in for another two weeks – which is when the landlord expects everything to be wrapped up in terms of improvements. It is getting wood floors, fresh paint, custom cabinets, new appliances, and new windows. Though built in the 50’s, it will be new for us.

I didn’t anticipate being able to move this quickly. Technically, our lease isn’t up until the end of the year. That said, our landlords have already broken it in several small ways and we don’t expect a fight when we let them know we’ll be moving out. Worst case scenario, we will continue to pay the rent until the lease is up, because we really don’t want to miss out on the chance to rent the house we’ll be moving in to. It isn’t that the house is perfect for us . . . it’s just that there’s no denying the pros of it.

Here, by the way, is our pros and cons list.

PROS

  • 3 bed/2 bath – extra space for guests/office
  • Garage and paved parking
  • Shed and carport for extra storage
  • Wood/tile floors throughout
  • Open living/dining/kitchen floor plan
  • Dedicated laundry room with more storage
  • Screened in porch off the living room
  • Large, fenced back yard
  • Close to shopping and our jobs
  • We know and trust the landlord

CONS

  • The master bedroom is small, compared to what we have now
  • Despite all the upgrades, it doesn’t have central AC or heat
  • The next door neighbor is a hoarder and her front yard is . . . messy
  • While still close to where we work, it does add about ten minutes to our drive
  • It is at the high end of our price range and costs double what our current place does
  • We will need to actually move all of our furniture and belongings into it ourselves

Overall, I do think it’s plain that it’s an upgrade and a good choice, for us. I’m looking forward to starting to pack and to donating things that I don’t really need anymore. I know, for instance, that I have a lot of craft stuff that won’t be coming with me. Also, some school books and supplies, a bunch of cookware, some clothes and bedding, and god only knows what else that’s at the back of the closet.

Now, in order to help make up some of the moving costs and the difference in rent, I’ll be going back to working part time at the call center in addition to working at the hospital. It’s not something that I must do, but it will definitely help and lets us continue to save money back. In fact, I actually need to leave this post here, because I’ll be putting in two and a half hours at the call center this morning/afternoon.

More to come regarding our adventure in moving, later!

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Conquering Fear/Anxiety – pt. 3

I am inclined to believe that modern culture – at least in America – pressures individuals to seek fulfillment in all aspects of their lives. The concepts of sacrificing a career for a family, or friends for family, or personal time for friends are seen as ridiculous. Why sacrifice anything? Why not reach for it all?

The average American in their mid-twenties earns about $40,000 a year, lives with a significant other in a rented home in the suburbs, has some college education, and is likely to have had at least one child.

As far as I compare, I’d say I’m pretty average.

I do make about $40,000 a year – now that I’m working at the hospital. I live with my significant other in an apartment . . . but it’s in an urban setting, instead of the suburbs. I did graduate with my AS in nursing and am working towards starting school for my MSN in nursing education. I don’t have a child, but I do have baby fever occasionally.

Incidentally, I’m also one of about 4 million adults in America who suffer from anxiety. Hence, this post . . . the third in my Conquering Fear/Anxiety series. The first two are here (Conquering Fear/Anxiety – pt. 1, Conquering Fear/Anxiety – pt. 2), for convenience, but reading them isn’t necessary for this one. I am, essentially, reading through a book titled the Complete Idiot’s Guide to Conquering Fear and Anxiety. As I read it, I’m making notes and hoping to come to better terms with my own fear and anxiety, even if I don’t conquer it completely.

I started this post off the way I did, because something in the book struck me as being particularly true in modern American society. That is, the battle cry of, “Self-reliance! Independence!” I noted that I think most people of my generation are inclined towards wanting it all in terms of a career and family and personal fulfillment, but I also think it’s important to note that I think a lot of us feel the need to do so on our own feet. Asking for help is difficult and actually getting the help can seem impossible.

That said, it doesn’t surprise me that so many adults in America suffer from anxiety – or depression, or another type of mental illness. While my own anxiety issues are probably traceable all the way back to my early childhood, I can’t negate the fact that my day to day life also plays a role. Also, as much as I’d like to believe that I’ll find a magic cure within the pages of this book, I can’t say that I do actually believe that.

Even so, the second section of the book does go through a few different calming techniques and compares different types of therapy. The calming techniques are generic and I can’t help, but think of them as the “bargain bin” fixes to anxiety – sure, they look like a good deal, but the odds of them breaking five minutes after you get them home seem high. These techniques are also – the book notes – best for in the moment mild-to-moderate anxiety issues.

Breathing exercises, progressive relaxation, meditation . . . they are the triad of quick fix solutions to anxiety. I don’t know anyone who suffers from anxiety or panic attacks who hasn’t, at some point, had someone tell them they should try closing their eyes and counting to ten. Personally, I feel that both progressive relaxation and meditation are too much like work to be truly practical when I’m in the midst of anxiety. I can see the benefits of using them as preventative measures, but I tend to enjoy relaxing in other ways, when I have that sort of time that either of the above require (at least 20 minutes).

For me, breathing exercises are the best of the three. I can do them anywhere and they take no more time than I would ordinarily spend breathing. I find that inhaling for a count of three and exhaling for a count of six is usually sufficient to stymie mild anxiety. Sometimes it will refocus me during moderate attacks, or even severe attacks.

Now, the book covers explanations of psychoanalysis, psychotherapy, humanistic therapy, systematic desensitization, and cognitive behavioral therapy.

Honestly, each of these could be a post in and of itself, but that’s not what I’m about to do. Instead, I am only going to note that both systematic desensitization and cognitive behavioral therapy are the two I find most appealing from my standpoint.

Another thing to note is that the book also discusses different anti-anxiety medications. One line, in particular, struck me as interesting though. It reads, “If you suffer from anxiety, one of your toughest decisions is to swallow the pill or to go drug free.” I don’t personally find this question difficult. I have tried taking anti-anxiety medications in the past and did not like doing so. The act of taking the medications makes me feel more anxious – side effects, judgements, trying to figure out if it’s working. Not for me.

In the final part of this section, the book mentions the relation of diet and exercise to anxiety disorders. Stress reduces your body’s ability to digest food due to the nature of the flight or fight response. Hence, some people with anxiety experience IBS. Additionally, food allergies and sensitivities can lead to increased anxiety. Exercise, on the other hand, can reduce anxiety. Cardio, in particular, is recommend by the book.

Truthfully, I can think of several things that I could incorporate to reduce my daily anxiety levels – healthier eating, more exercise, using the counseling session that are available to my via working at the hospital, maybe even trying a medication. I will, perhaps, find that something as simple as making time to do some yoga really makes a difference. I may also let myself take more time to do things I enjoy – like gaming and reading. Again, I don’t think there will be a quick fix.

Which is maybe okay. In today’s society, I think we’re inclined towards quick fixes, even if they’re temporary, but that doesn’t mean everything will line up with that all the time.

I’m going to end this post here. I am also going to aim for my next post to be unrelated to this “series,” because there are also other things happening in my life and it’s good to mix things up a bit, I think. So, until next time!

 

 

Conquering Fear/Anxiety – pt. 2

“The fears we don’t face become our limits.” – Robin Sharma

I feel like this quote is particularly relevant, to this post. This is – as evidenced by the title – part two of my Conquering Fear/Anxiety series. Here is part one: Conquering Fear/Anxiety – pt. 1. You don’t really need to read part one to appreciate this part, but be aware that these posts are reflections on a library book I picked up. The book is called the Complete Idiot’s Guide to Conquering Fear and Anxiety. I checked it out yesterday, because it practically jumped off the shelf as I was scanning titles.

Lately, I’ve been feeling more mentally unwell than I have in previous years. I started a new career as a nurse and landed a job with a busy oncology/med-surg unit at a large hospital. The position is amazing – great hours, supportive co-workers, amazing benefits, nice environment, ect.

It is also incredibly stressful to find myself responsible in no small part for the care of up to six patients at a time. My anxiety and depression are both reaching new heights.

As such,  I’m reading through this book. I’m not an idiot (at least, I don’t think I am), but I must admit that this book is already bringing new perspectives to my attention.

For example: we wouldn’t expect someone with arachnophobia to comfortably hold a tarantula, but we do often expect someone suffering from anxiety to continue to function “normally,” despite having an attack. Even the person suffering from the anxiety tends to hold themselves accountable for “getting it together” and can become distraught when they can’t do so as quickly as needed. I know, at least, that this is true in my own care.

Fears are usually straight-forward, relatable, and socially acceptable. What person doesn’t at least know one person who is afraid of spiders, or heights, or public speaking? Anxiety, on the other hand, isn’t generally viewed with the same leniency.

There is also anticipatory anxiety, which occurs when you get worked up over something prematurely and which is usually viewed with even less leniency than anxiety about something that’s actually occurring. People can sympathize, usually, with someone who is anxious the morning of a test. . . but it’s harder to sympathize with someone who is anxious about the mere thought of taking a theoretical test.

This is a concept I’m intimately acquainted with and is the reason I love a particular quote from the movie Fantastic Beasts and Where to Find Them. Newt Scamander, the lead of the movie, says, “My philosophy is that worrying means you suffer twice.” I can’t express how much that resonates with me. It is fundamentally true and I keep a little Newt Scamander figure on my key-chain to remind me of it when I’m out and about.

I have agoraphobia, so leaving the house generally makes me at least mildly uneasy. Which is an interesting juxtaposition to my love of traveling and seeing new places.

While it’s helpful to recognize that you have anxiety, it’s more helpful to recognize things that can exacerbate it. I think of it kinda like my allergies – I know I will begin sneezing if I pet dogs and so I try to avoid petting dogs. One of the things in the first section of the book I’m reading is a list of things that people have found trigger their anxiety or make it worse. Included in these are caffeine consumption, steroid use, balance issues, florescent lights, and heat . . . all of which are personal triggers, for me.

In the book, there is also a list of common fears and a rating scale. One represents mild fear, two is moderate fear, three is extreme fear,  and four is terror. I was actually surprised by the amount of things I labeled as “extreme fears” of mine. Those things are: being criticized, bridges, darkness, driving, falling, insects, riding a Ferris wheel, riding a roller coaster, speaking in front of people, and worms. In comparison, I only choose four things from the list as inspiring “terror” in me: dead bodies, deep water, losing control, and large open spaces.

No wonder I find modern life stressful, huh?

The last segment in the first section of the book that I’ll go over relates to why fears and anxiety develops. The book views this matter from a behavioral psychology standpoint.   I was personally skeptical as to whether or not I’d find the magic answer to why I’m  anxious within a book that was selected at random from a library shelf, but I kinda did.

I know I did, actually, because typing it makes me feel oddly uncomfortable and exposed.

Insecure Anxious-Avoidant Attachment.

That is what the book categorizes the path that led to my anxiety as.

A major factor of this path is the development of emotional inhibitions – a sort of fear of feeling – that’s created by having one’s emotions continually criticized or negatively reacted to at a very young age. This path can lead to sleep issues, nail biting, rocking, excessive masturbation, nightmares, headaches, and undefined illnesses. Usually, people who develop this way end up being people-pleasers who never feel good enough. It’s not uncommon for anxiety to fully manifest for these individuals after high-school. Sometimes, they also develop IBS, TMJ, and chronic fatigue syndrome.

I would never have written the above paragraph about myself . . . but it does some me up pretty exactly. There is a certain guilt in admitting that, because I love my parents without reservation, but do have to admit that both of them treated my emotions as inconvenient and undesirable. I was made to feel, from a very early age, that sadness and anger weren’t appropriate. Also, that physical illness would bring more comfort than emotional distress.

I missed a lot of school as a kid due to “stomach aches” that just wouldn’t go away.

Now, this has, I must admit, been a bit heavy. I’m a little leery, honestly, about continuing to read this book. I’m only 68 pages in and already cringing as I’m investigating the cause of the cause of my anxiety. I noted, in the last part, that the majority of my anxiety comes from a core fear of the unknown. In turn, I can see that rising from a fear of losing control. And that fear, maybe, developed as a result of not wanting to display – or really ever become – angry or upset or sad due to the negative consequences of it.

It’s interesting, honestly. And I’m curious about the next section of the book.

The next section, by the way, is titled, “Making it All Better.”

Oh, the irony. Really, that’s all I want to do, after all.

 

 

Conquering Fear/Anxiety – pt. 1

Mental health and mental illnesses have both been hot topics in the media of late . . . understandably so. It seems that no more than a few days pass between highly publicized stories of celebrity suicides and school shootings. I’m sad to say, in fact, that one of the school shootings which took place in the last few months occurred in my town. While the details of each media-worthy story vary, they inevitably bring to the fore some of the same questions.

How can we, as a society and as individuals, address mental illnesses effectively? When will mental health get the type of attention it deserves? Who is responsible for breaking the silence and the stigmas that surround depression, anxiety, and phobias? Why do so many people struggle with these things? What can individuals do to lessen that struggle – for themselves and for others? Where does the line between personal and public responsibility get drawn?

I was diagnosed with depression when I was fourteen. I was diagnosed with generalized anxiety at nineteen. I was diagnosed with panic attacks related to agoraphobia at twenty.

These aren’t things I generally share. I’m the first one to admit that I feel embarrassed and guilty when I have to admit to them. What is wrong with me, that I am reduced to tears in the middle of Wal-Mart? Why can’t I just relax and stop obsessing over worst-case scenarios? How come I can’t enjoy things? When will this apathy pass? I still have days – a lot of days – when I ask myself, over and over, “Why can’t I just be better?”

As a nurse and an intellectual and an empathetic human, I know better.

Nonetheless, it’s hard to be patient with myself. Since starting at the hospital three months ago, my mental health has taken a bit of a dive. I am more prone to becoming depressed, my anxiety level is negatively impacting my relationships, and I’ve had two full-blown panic attacks. I recognize these things and know that I can’t continue this path indefinitely. I know that it’s not good for me, for my family/friends, or for my patients.

I also know that my introspection has given me a bit of an advantage in terms of finding a solution to this problem. It has been said by many people that the first step in solving a problem is recognizing that there is one . . .  I can safely say that I have done this.

The problem: I suffer from anxiety that relates almost entirely to fear of the unknown.

(Point of interest:  the word anxiety actually comes from a Latin word that means “worried about the unknown” and is also related to a Greek word meaning “strangle.”)

All of my anxiety, fears, and depression can be traced back to a core fear of the unknown. This fear makes life as a human in the 21st century somewhat difficult.

Where this fear arose from or what caused it to take root in my brain, but I do realize that I’ve come to view it as an inextricable part of myself. I speak of my anxiety as an entity that is separate from myself and think of it as something that I have little to no control over. I see it as a blackness that has the ability to rise up and cover me at whim.

I need to change that visual. I need to change that mentality. I need to take responsibility.

Today, I took a step in the right direction. I went to the public library and checked out a book called the Complete Idiot’s Guide to Conquering Fear and Anxiety. So far, I’m only literally one page in. It’s my intention to read this book mindfully. I don’t know if I will really have conquered my fear and anxiety by the time I finish it, but we’ll see.

As part of my goal to read it mindfully, there will be note-taking involved. I believe that it will be helpful to create a blog post per chapter or section (we’ll see how long they end up being), so that I can be sure I’m reflecting on what I’m reading. As such, this post is – obviously – part one of this mission. I expect that I will put out one or two posts related specifically to this mission per week. I will link back to previous posts, for those who care to follow them. For now, suffice it to say that I’m hoping for progress, not perfection.

______________________________________________________________________________________________

I do also want to note that I have a couple other posts I intend to put out this week. I would like to do one this upcoming Saturday to follow-up with the one I did last night (Grocery List: Expectation v. Reality). I also want to do a second Stitch-Fix review, because the boxes I’ve gotten since my first review (First Stich Fix Box) have been better and better. Additionally, I do feel a bit like I’ve been putting off writing another relationship update (15 1/2 – Rated R Update was the last, I think).

Lots of goals, but we’ll see how many I actually manage to check off this week!

As always, thank you for reading, and I hope you got something from it!

 

 

 

 

Grocery List: Expectation v. Reality

I decided to be an “adultier” adult this afternoon. I did what I’m sure countless others do on a weekly basis. I grabbed some pretty note paper I keep on my nightstand and I sat down and I wrote out a grocery list to take shopping with me this afternoon.

This is something that I’ve been threatening to do for months, but somehow never actually do. One of those things that sounds good in theory, but that strikes me as tedious in reality. Of course, the benefits of a grocery list are quite extensive – better meal planning, shorter shopping times, more mindful spending. I’m sure there are many posts that break these things down and expound upon them more effectively than I could, given how rarely I actually use grocery lists in my personal life. A point of note, however, is that I couldn’t really think of any down-sides to making a grocery list.

My original list included 28 items. I shall list them now, because I don’t know about anyone else, but I’m personally intrigued by the thought of seeing what other people buy during their weekly shopping trips. Not sure why, exactly, except it is fun to see differences and knowing what people are eating/buying is somehow an intimate thing.

Here are the items on the original list – in the same order and groupings that I wrote them in on the paper, for what that’s worth.

  • Bananas, Apples, Squash
  • Broccoli/Cauliflower, Cherry Tomatoes
  • Deli-meat + Cheese, Soup, Canned Tuna Fish
  • Breakfast Burritos, Breakfast Strudel
  • Orange Marmalade, Muffins, Bread
  • Cookies, Trail-mix, Sprinkle Cheese
  • Steak, Meatballs, Chicken Nuggets
  • Water, OJ, Milk – 2% and whole
  • Shampoo + condition, toilet paper, tissues

Keep in mind, too, that this is a list meant to feed two people for more or less a week. Some times – like the household stuff – will last more like two to four weeks. Other stuff – like the cherry tomatoes – are meant for one meal during the week. I also wrote the list knowing that my other would add to it when we shopped, because there were things that he had on his own mental list. Here are those things, in the order he added them to the cart as we moved through the store.

  • Epsom salts (three 1lb bags)
  • Pimento cheese w/ jalepeno
  • Canned pears, sliced
  • Veggie Oil and Fryer Mix, Mini Ravioli, Instant Potatoes
  • Hot Dogs and Buns
  • Frozen meals, Pizza
  • Celery, Blueberries
  • Sweat Tea (single serving size)

Overall, he didn’t actually add too many things to the cart that I didn’t already have on my list. Some of the things – like the veggie oil and hotdogs – I’d just forgotten we needed. Others – like the celery and tea – I wasn’t sure whether or not he’d want.

I do also need to note that I added a pack of pens to the cart, when I saw them and realized that I was down to my last working one. We were also unable to find a pepper grinder to replace the one we just finished using. As we shopped, I also decided against buying steaks and meatballs, because I can get fresher cuts/fresh made ones from another store. The deli section of the store ended up closing early, too, so the deli-meat and cheese weren’t purchased either.

All said and done, we spent about $60 each on the trip. This is more than usual, because we did get some household stuff that needed to be replaced. We generally keep our totals under $100, but we both felt comfortable exceeding that budget. I have to admit to not using any coupons. It’s just not something I actively think to do and I’m okay with that, honestly. I’m sure I could save oodles of money, but the time spent doing so negates some of the effect, for me. I also imagine that the way my other and I literally split the grocery bill in half isn’t necessarily typical, but it does work for us and usually keeps us from buying too many “personal” items when we’re grocery shopping.

For instance, I don’t get tempted to put clothes in the cart and he doesn’t go wandering through automotive isles. If one of us does decide to buy something “extra,” we make sure to consider that, when dividing up the payment, or we buy it separately.

In general, I do feel that making a shopping list made the trip go by more smoothly. Instead of asking me every isle whether or not we need anything that was down it, he trusted that I would say if something on the list was down it. The trip itself was a little faster, despite the additional items we got. And, most interestingly, having the list reduced the anxiety I usually feel while shopping for groceries.

I think that’s due largely to the increased focus it provided. I could check things off to mark our progress through the store and search for things I’d written down. It lead to decreased frustration, too, because he didn’t ask me twenty questions every time we went down an isle. As we left, there were no last minute concerns that we’d forgotten something. Even putting things away felt smoother, because I was more mindful of what we’d bought and already knew where it needed to go.

So, being an adultier adult paid off, in the end, but I definitely have room to improve when it comes to crafting a grocery list that actually hits all the right items. Perhaps, next week, I’ll do this type of post again to see if I’m any closer?

 

Night Nurse Newbie

Long awaited, much anticipated, only slightly dreaded . . . my first night shift as a nurse!

(Que the drum roll, please. But quietly, because I’ve now been awake for almost 24 hours.)

I was able to pick up a 12-hour night shift on my unit due to some scheduling conflicts and eagerly looked forward to it for about a month. Now, just about two and a half hours after finishing it, I’m struggling to make sense of it. Part of that is due to my current level of sleepiness – getting rest yesterday was good in theory, but I was only actually able to take two naps for a total of four hours of sleep before my shift. Another part of it is due to the fact that my mother picked me up from work and I’ve spent the last two hours happily chatting with her about life in general while eating a fast-food breakfast, sipping coffee, and catching the morning news.

Despite my current sleepiness; however, I do want to make at least a “first impressions” post regarding my first night shift. I’m talking bullet points, people. Probably short and sweet ones that will need to be elaborated on to some degree later. I already did a post about some possible disadvantages of working the night shift (Carpe Noctem), but I want to go over the realities/thoughts I encountered in a roughly chronological order.

All the better to go back over them and reflect on things, later. When I’m not a zombie.

  • I ate dinner (breakfast?) with my other before work. My nerves started rising and I was feeling rather queasy by the time I actually got to work and walked in.
  • Instantly, the quieter atmosphere was noticeable – far fewer people meandering downstairs in the halls and lobby area. Plus, no music from the overhead speakers.
  • On the unit, seeing familiar coworkers from day shift. They wished me luck and told me to have a good night. My night charge nurse welcomed me.
  • Got report, passed evening meds. So far, so good.
  • Wait, it’s only 9:45 PM? Everyone is already medicated and settled in. What now?
  • Might as well chart . . . that’ll kill some time, surely.
  • Oops. Charted too efficiently . . . now it’s 11:00 PM and I’m wondering what to do with myself. No more charting, no current meds, too early for lunch.
  • *insert an hour of thumb-twiddling and employee education modules here*
  • “Guys, I’m gonna walk down to the vending machines. Get a snack.” Perhaps this is why people say night nurses are more inclined to being overweight. I never have time for snacks on day shift. Unexpected benefit, noted.
  • Uh-oh. A patient crying in pain, with only Tylenol available? Now she’s having an anxiety attack! No, wait, I’m having an anxiety attack! Gah, we both are! Ah, crap.
  • Here, wait, I can fix this! (Maybe. . . oh god, I hope so . . . )
  • Called the on call doc and got morphine ordered. Thankfully, night shift is slower than day shift and I am free to spend 45 minutes holding my one patient’s hand while the morphine slowly works. I watch her face turn from purple to red to pink.
  • “Deep breaths. Smell the flowers, blowout the candles. Just like that, good.” Is this what labor and delivery nurses go through everyday? I hope not . . .
  • Now, it is somehow 1:30 AM. A reasonable time for lunch (dinner?).
  • Damn. The cafeteria is closed. One mark against night shift. Vending machine sandwich and candy bar for me. Next time, I pack more noms.
  • Back upstairs and I walk into the break-room where another nurse is settling in with his lunch. “Why are you here,” he asks, perplexed. “I picked up a night shift,” I explain, wondering if I’ve been invisible for the last six hours and everything was just a hallucination. We eat in an awkward silence.
  • Well, the shift is more than halfway over. Geez, it’s quiet without all the hustle and bustle of the day shift. Nice though, I think.
  • . . . is there anything else I can chart? Does anyone want meds? Ice? Pillows?
  • Everyone is asleep. All of my patients. It’s 3:30 AM and I am desperately trying to create things for me to do. The other night nurses seem unbothered by the lack of direction and chat while on their cells.
  • I read every single note that has been entered for each one of my patients. It’s now 5:30 AM and I am going downstairs for more snacks simply for something to do.
  •  I finally get to pass more meds! Yay, tasks! I love 6:00 AM meds.
  • Huh? It’s 6:15 and I’m already done passing the meds? There were only six of them?
  • At least my chair spins. I spin and spin and spin. Slow, lazy circles. My charge nurse laughs when she catches me and one of the techs promises to slap me, if I say I’m bored or that it’s quiet. I promise not to say either. I continue to spin.
  • 6:45 AM and I am answering other nurse’s call lights, offering to pass meds, pacing up and down the hall as I wait for change of shift to arrive. I can see daylight, out the windows, and it makes me impatient to leave.
  • Finally! 7:05 AM and I am giving shift report. Only takes half an hour.
  • I had so much free time that all my charting got done. I am able to actually leave once report is finished, instead of hanging out to chart for another hour or so.
  • Peace out, everyone! See you in four days!

There you have it. An outline – more or less – of my first night shift. Lots of down time, a few nerve-wracking moments. Much more laid back than a day shift, but the night passes more slowly than the day does. Interestingly, my Fitbit tracker says I only walked 4,015 steps during the shift. On day shifts, that number usually exceeds 10,000 by a fair amount. I am glad, because my feet aren’t sore.

I am also, inconveniently, dozing off while I work on this. I believe I am going to go forward with posting it and present more cohesive/meaningful thoughts by and by.

(Just caught myself staring blindly into space and realized five minutes have passed since I typed the last sentence. Was I sleeping with my eyes open? Maybe.)

 

Common Questions

I’ve been asked two questions more than any others since becoming a nurse and being hired at the hospital. The first question actually started when I announced my decision to go to school for nursing and it is, “Why do you want to become a nurse?” The second question started only after I started at the hospital and it is, honestly two questions itself. They are, “Is working only 12 hour shifts hard or do you like having more days off?”

Now, most of my family and friends don’t know that I blog. I tell them I journal and I do tend to keep this blog rather like a journal. I try to consider things from a content perspective, but I do also write about things that are predominantly on my mind or that I feel are personally beneficial to me or that I need to work through.

The above questions fall into all those categories rather nicely and I felt that now was a good time for me to craft this post, because I’m also having something of a “quiet” day . . . I work tonight (a 12, no less), but I couldn’t force myself to sleep any later this morning. As a compromise, I’m at least spending my time awake relaxing with light activities, rather than bustling around cleaning and such. Blogging counts as light, in my book.

So, the first question. Why did I become a nurse? It’s not a simple answer and I’m the type of person that can’t justify making a big life change without having mounds of reasons to back it up. I first thought about becoming a nurse just a few months before starting school for it and it was the result of some light peer pressure . . . one of my friends was about to start school and he essentially wanted my company. In listening to him talk about the benefits of it, I started to recognize that it was something I was interested in and may be a good fit for me.

The benefits that I saw included a flexible schedule, the option to work nights, the pay, the short degree completion time, job security for the foreseeable future, a variety of possible specialties, the ability to get advanced degrees, and the focus on helping people.

You’ll notice that most of those things are practical and that the last is, perhaps, the most commonly anticipated answer. Answering the question, “Why did you become a nurse?” with, “To help people,” is – for lack of a better word – conventional. People expect people who become nurses to have a drive and a desire to help people. They also expect that to be their primary reason for having become a nurse and they tend to be put off when it isn’t the first reason that’s brought up.

I knew that on an instinctual level and I think it’s related to the issue of quality of care. If a nurse become a nurse to help people, she is then more likely to provide high quality care. If a nurse become a nurse for the money, she is more likely just to go through the motions. . . . Now, I don’t personally believe that. Not at all. But some people do and I can see where they’re coming from, too.

Those things said, I do also have a strong desire to help people. Since becoming a nurse, I’ve caught myself talking of my patients and saying, “My people had a good day today,” or “I’m sad that I couldn’t do x,y,z for my people.” While my patients are under my care, I do think of them as my responsibility. They are unwell, stuck in their rooms, going through an emotional roller-coaster, sometimes on the verge of dying . . . and if I can get them a juice cup or a pain pill or an extra pillow, then I feel a moral obligation to do so. If I’m not able to, I feel what I’ve been told in an inordinate amount of guilt over it.

I am naturally submissive and helping others is what I do without thinking, no matter where I’m at or what time of day it is. It’s not the only reason I became a nurse, but I don’t think I would have chosen nursing, if I didn’t care about helping people.

As for the more practical reasons, those are kinda more self-explanatory. The hospital I’m at functions on a bi-weekly pay schedule and I work three 12-hour shifts a week, including two mandatory weekend days. I was able to get my A.S. degree in 18 months. I live in Florida and our aging population means that care-takers/nurses will continue to be very in demand. If I get bored of the oncology/med-surg unit I’m with now, I can transfer to one of the dozen other units in the hospital or go into a private practice or teach at a college. I can go as far as getting a PhD in nursing.

Essentially, I became a nurse, because the pros outweighed the cons.

(There are cons, but this post is already getting a little lengthy, so I’ll save those.)

The second question(s) also happen to relate to my reasons for becoming a nurse. Not all nurses actually work three 12-hour shifts a week. Not even all nurses who work in hospitals do – though my hospital does require at least 3/12’s a week for full-time nurses.

Personally, I really like working three days a week . . . even though I work 12 hours on those days. I enjoy having near constant “long weekends.” It’s good for my peace of mind to know that I only have to make it through two shifts before I get at least one day off. For example, I worked yesterday and will work tonight . . . and will then get four days off. This schedule has allowed me to get caught  my apartment in order and renew my work on my novel and spend more time with family.

I do feel that, from the perspective of a day shift nurse, I don’t think I’d be able to be as productive during an eight hour shift. Most mornings, I arrive at 6:30 AM to review my patient group (including their labs, medications, and histories). I take report from the night nurse from about 7:00 – 7:30 AM. In the half hour between 7:30 and 8:00 AM, I look up any medications I’m unfamiliar with or any conditions I don’t know about. 8:00 AM to 10:00 AM is dedicated to passing medications . . . and that time can easily extend to almost 11:00 AM, depending on my patient load and their medications.

After the medication pass and until I take lunch (usually around 1:00 PM), I am placing calls to physicians, working with PT/OT to get my patients up and moving, talking with my patients and their families, orchestrating discharges with case management, and asking my coworkers a dozen different questions as I try to learn more.

In the two or three hours after lunch, until about 4:00 PM, I am doing more of the same. This time is also usually when admissions arrive, assessments get charted, and patients need to be transported for procedures or testing. At 4:00 PM, afternoon med passes start and they generally take about an hour and a half. Evening charting can begin at 5:30 and includes documenting the patient’s intake/output, reviewing recommendations from their specialists, and putting in last minute orders.

At 6:30, I go around to all of my patients and let them know shift change will occur in about half an hour. I check to see if they need any pain or nausea medications, make sure that they have full water pitchers and snacks, check their IV fluids to make sure they won’t run out during the night nurse’s first hour or two, and let any family know that visiting hours will end at eight (they can stay later, but won’t be allowed back in until the following morning, if they leave the facility).

From 7:00 PM to around 7:30, I give report to the night nurse, wrap up any charting I didn’t finish, and make sure that the night nurse has a fully stocked cart for their shift. Thankfully, I live only five minutes from work and am usually camped out on the couch by 8:00 PM at the latest.

It makes for a very full and busy day, but it would be hard to accomplish as much in four fewer hours. Passing medications literally accounts for up to four hours in a 12 hour shift. Prep time, for me, equals another hour. Charting takes up to two or three hours. The other hours in the day are dedicated to other patient care tasks. It’s daunting, no lie, but I do like the concept of having a full 12 hours to work on things. Sometimes, it feels like all of that is spent with just one or two patients who are critical or mentally unstable. A lot of the time, a problem that happened at ten or eleven in the morning is forgotten by shift change and I don’t think of it until I’m already home.

And, so, I’ve answered the questions and now must seek out some brunch. Hopefully, I will be sleepy enough to rest for another couple of hours, so that I’m fully functional for my shift tonight. And, hopefully, it will go well and tomorrow morning, I’ll come home and be able to post something insightful about the differences between nights and days.

Carpe Noctem

There are many different fields of thought on what makes a person nocturnal or diurnal. It’s quite undeniable that, in our current iteration, humans mostly fall into the diurnal category – awake during the day and asleep during the night. There are different theories that explain why and I’ve read just about all of them. Like other things, I feel the truth is probably a complicated mixture of all of them – evolution, psychology, personal preferences, etc. I also think that, given the odds, it’s unsurprising that some humans are actually nocturnally inclined.

Currently, this is on my mind, because I’ve picked up a night shift for the first time.

I’ve said, from the start, that my desire to be a nurse is partly fueled by the fact that it’s a 24/7 job and gives me the opportunity to work nights. I am, I think, a night owl . . . but I don’t say that with the same certainty I did at 8 or 18 years old. Now, at 26, I’m actually not sure about that. Largely because I haven’t had the opportunity to put it to the test in the last few years.

As a kid, I was home-schooled and my parents never attempted to enforce a particular “bed-time” or a specific “awake-time.” That said, it was typical of me to go to bed at around 9:00 AM and to wake up by 5:00 or 6:00 PM. As a teenager, my schedule shifted a little, until I was going to bed around 7:00 AM and waking up by 4:00 PM. Entering the working world was a struggle. My first job was 8:00 AM to 1:00 PM. When I was promoted, it changed to 11:00 AM to 8:00 PM. At my second job, I worked essentially a typical 9:00 AM to 5:00 PM job. Now, for the last three months at the hospital, I’ve been working 6:45 AM to 7:15 PM. I’ve been functioning more and more as a “morning lark.”

Still, despite that, I feel that I’m more prone to being a “night owl.”

And I’m looking forward to my first shift as a night nurse. But, that hasn’t stopped me from doing some research into the perceived pros and cons of it. I’ve found that people who dislike the night shift seem to dislike it based on one or more of the following.

  1. They have children/family members who function during the day.
    • This is understandable to me. People are basically social animals and not being on the same schedule as those in your household can be problematic from both an emotional and a practical stance. From trying to attend school events or schedule appointments to missing out on quality family time, I see why it would be hard for some to justify having to sleep all day.
    • I don’t foresee this being problematic for myself. My other’s work schedule alternates between 7a-3p and 10a-6p. Either way, this puts me sleeping during what is essentially his work day and leaves me time to see him for breakfast or dinner, depending on which of his schedules he’s working. We also still have weekends free together. The same is true of my friends and other family.
  2. They do not like the differences between day shift nursing and night shift nursing.
    • In a way, it’s harder for me to understand this. Some nurses who dislike working nights say their reasons include the lack of doctors/managers, lack of family members, and lack of overall activity associated with day shifts. They feel that day shifts are busier and go by more quickly/productively.
    • I know they aren’t wrong, but I don’t see the lack of “excitement” as a bad thing. I agree with the night nurses who say they enjoy the increased sense of free-time they have during most of their shifts. It gives more opportunities to focus on patient care, to learn new skills, and to work autonomously.
  3. They just aren’t “night owls” and working night shift is hard for them.
    • Several of the nurses I know who shun the night shift fall into this category. They say that they just don’t feel “awake” at night and have trouble getting into a good groove. Also, they feel that they don’t rest/sleep well during the day – no matter how many sleep aids they use in how many ways.
    • This is the part that I’m most concerned about, personally.  It’s been so long since I was able to be nocturnal that I’m no longer convinced it’s my natural setting. I think it still is – based on a few different things – but I’m by no means sure. As a person who likes surety, this bothers me, a bit.

All in all, it boils down to trying it out. Which is what I’m looking forward to doing. It won’t be an ideal trial, but it will be an example. I will work tomorrow during the day, stay up as late as I can afterwords, sleep as much as I can the following day, and then work my night shift. After my night shift, I will have four days to reverse back to a standard schedule before my next day shift.

We’ll see what happens, I guess.

Mandatory Meetings

I am admittedly a newcomer to the pseudo-white-collar realm, but I have to admit that I didn’t expect quite as much red tape as I’ve encountered. True, nursing school tried to prepare me by stressing the amount of documentation that nurses are expected to do, but I’m not talking about that. No, I’m talking about – you may have guessed it! – mandatory meetings.

I may have already reflected on the meeting that was my 30 Day Evaluation. I don’t truthfully remember and don’t currently wish to spend the time looking back over my past posts. It would have been a while ago, at any rate, because I’m currently still recovering and processing the meeting that was yesterday . . . my 90 Day Evaluation.

*dun dun dun*

I can’t say that it got off to a great start. My director scheduled it for noon – caught somewhere between the rush of morning med pass and lunch, it can be an unpredictable time, to say the least. In yesterday’s case, for instance, I got a call at five til, because one of my patients was finished with their dialysis treatment and I needed to go get them from the third floor. That being what it was, I dropped off my skills check-off packet on my director’s desk as I darted by with  some quick explanation and a promise to be right back. And it actually didn’t take long to pick up the patient and get her situated again.

However, by that time, my director was no longer in her office.

She was no where to be found, in fact.

I went ahead and got started on my lunch-time med pass. When she still wasn’t back, after that was finished, I decided to go forward with my own lunch break. I was five minutes in to it when I got a call that we were having an impromptu education session on our new chair alarms.

Impromptu does not, interestingly, mean that the meeting is not mandatory. I huddled with my coworkers around the man giving the presentation and thought longingly of the hamburger waiting for me in the break room. The meeting was brief, thankfully. I finished my lunch and was immediately immersed back in the endless circles of physician phone calls, IV maintenance, and paperwork.

Probably, I walked past my director’s office a dozen times, before she was actually in it. We both made our apologies for the meeting’s delay and I filled out an employee satisfaction scale sheet while she reminisced about when she was a new nurse.

All in all, it was not a bad meeting, as far as mandatory meetings go. She reminded me that my biggest challenge area, at my 30 day mark, was time management. She also said she saw marked improvements in that area, even if I didn’t (which I sometimes don’t). She told me that she recognized that I still sometimes get overwhelmed (ie, cry at the nurses station), but that I work through it and am doing surprisingly well for a new grad on a busy med-surg unit where we regularly get six very sick patients to look after at a time. She explained that my coworkers are pleased with my performance and that none of the doctors have made any negative comments about me.

My only problem, she noted, is that I lack self-confidence. I made an entire post about this point, some weeks ago. Confidence v. Competence – in case you’re interested.

I agreed and we decided that my goal for the rest of the year is to become more comfortable with the notion of trusting my abilities. I went to school for nearly two years and have been working at the hospital for three months. I have not killed or injured anyone. People are not suffering, because I’m their nurse. My patients have been known to hug me and thank me and ask if I can be their nurse again (makes all the moments I’m feeling overwhelmed worth it, by the way).

Anyway, back on topic, in my time in the hospital, I’ve been in almost more meetings than I can count. Two evaluations, two falls meetings, one new hire breakfast, three or four education meetings for new products/procedures, and a morning huddle for every shift I’ve worked. I find these meetings interesting, because they are so far removed from my past job experiences.

I have a limited work history – two jobs over the course of eight years, not counting the hospital. Both of my other jobs were blue-collar, without a doubt. I worked as a hostess at Chili’s and as a customer service rep at a call center. In both positions, there were mandatory meetings, but they weren’t treated in the same way.

At Chili’s, we had staff meetings once a year. Everyone showed up in their pajamas (or uniform, if they worked that day) and we pretended to pay attention when our manager started talking. The meetings had no bearing on anything that actually came after them. It was like a commercial break in the middle of a movie – boring, but expected and worthwhile to those making money off them.

At the call center, a little more effort was made, but that only caused the meetings to be treated with an odd mixture of humor and annoyance. The employees talked about them sarcastically and management acknowledged that they kinda sucked. We all wanted them to be better, but none of us was committed to changing anything. As a result, the meetings were sporadic and largely dependent on what was happening on any given day. While mandatory, the meetings weren’t planned and were thus often met with trepidation, because everyone assumed we were being gathered to discuss a fuck-up.

In contrast to those, the meetings at the hospital – even the impromptu ones – are done with purpose. Evaluations to reflect on triumphs and challenges, fall meetings to discuss facility-wide issues, education sessions so that we know how to use new products, morning huddles to review things of importance to the shift. Even employee breakfasts help are guided by an underlining system meant to foster teamwork, show appreciation, and give employees a chance to vent their concerns.

I hadn’t expected these things, these differences, when I started working at the hospital. I should have though, just based on the interview process – which could, actually, be considered the initial mandatory meetings. At Chili’s, I was interviewed in a rear booth by the kitchen manager who admitted that he didn’t know good qualities to look for in a hostess. At the call center, my interview consisted of a typing test and sitting in with another employee while they made two calls. At the hospital, it involved a formatted series of questions and checks that were done with intent.

I like the intent better, myself, but I can see why some of my coworkers don’t.

__________________________________________________________________________________________

And now, my train of thought keeps being derailed, so I’m just going to go on a detour and continue on with my chores of the day! Dishes and bills and laundry, oh my!

Retrospection: 58 Days Later

Hanging IV antibiotics, giving report, having three patients, drawing blood from PICC lines . . . I was worried sick about those things when I made my last post. Which, as indicated by the title of this post, was 58 days ago.

Damn, a lot can happen in that amount of time.

I finished my preceptorship at the hospital and I’ve actually worked seven shifts without my preceptor. There have been tears, anxiety attacks, and missed meals . . . but there have also been triumphs, thankful patients, and compliments. I hang IV antibiotics multiple times a shift without batting an eye, have had six patients more often than not, give report without a hitch, and draw blood from PICC lines with actual grace. Now, of course, I have new concerns – like just about everything involving time management and delegation. Yesterday, I had a really good day at work . . . Friday was an absolute mess.

The point is – well, my point is – that time really can make a measurable difference . . . if you take the time to reflect. Had I not logged on here, reviewed my last post, and compared it to where I’m currently at, I would feel a lot worse about the now. Knowing that, I also have a sense of hope for the future, because it may also be better than now.

And, as another point of note, my personal life is also better than it was 58 days ago.

I renewed my annual passes for Universal Studio/Islands of Adventure. I started learning to ride my motorcycle. I have nearly $3,000 in my savings account – more than ever before, though this reminds me that I need to pay some bills. I am thinking of editing and publishing one of my novels as an e-book. I lost ten pounds. I kept the apartment clean.

Granted, I haven’t managed to blog, but I guess that’s acceptable (sorta).