Thursday, April 25, 2013

Does Nursing make me a better father?

Seven months ago, give or take a few days, my wife and I became members of a not-so-exclusive club referred to as Parenthood.  We did so willingly and, contrary to common practice for our area, we did it after we were married instead of getting married because we were pregnant. This is a meaningful distinction for us and it speaks volumes.  It says that we made this decision as two adults and were prepared for the consequences.

CONSEQUENCES shown below:

 Not bad for my first try. Wait until I get some more practice.

{Quick background on my wife because I'm pretty sure I've never really mentioned much about her. We met while taking pre-reqs for Nursing school but we had both went to high school together. I started Nursing school a semester ahead of her at the same school. Which led to a very rocky first few years of our relationship. However, we saved a bundle on books, or at least she did. We married in nursing school and she spent her last semester pregnant. Now back to the story.}

I started thinking soon after we found out we were expecting our little bundle of joy (see above) and aided in this thinking by current parents who relish the opportunity to tell you the hardships. Some of the more common things were as follows:
  1. You would no longer sleep-in and possibly may never sleep more than a few hours at a time.
  2. The amount of stress you will encounter is unlike anything you have ever felt before.
  3. All the crying.
  4. All the pooping.
  5. All the diaper changes.
But then after the horror stories they would a the caveat... but it is SO worth it!

I made the correlation immediately!  I flashed back to my first year or maybe even first week in nursing school. When all of the seniors would see us and tell us of the horrors that awaited. Such as:

  1. You would no longer sleep-in and possibly may never sleep more than a few hours at a time.
  2. The amount of stress you will encounter is unlike anything you have ever felt before.
  3. All the crying.
  4. All the pooping.
  5. All the diaper changes.
  Look familiar? My wife and I agreed that if we could both survive nursing school, at the same time no less, that this baby business would be a breeze. So, we went in to the final stages with very little stress about the imminent changes.

We discovered that raising a child is more difficult than nursing school in many ways, but it is also easier in many ways. 

Here is what I know, I know that my ability to function on 3 hours of sleep is legendary, and a newborn sleeps approx 20 hours a day. Unfortunately, my newborn did this sleeping 15 min at a time for the first 2 months. 

Baby: 1 Nurse Parents: 0

Despite a near disaster in the sleep department, I had developed the ability to perform everyday tasks without sleep. This is where performance enhancing drugs came into play. I'm not talking about anything illegal like cocaine, hell, I'm not even talking about Adderall these youngsters depend on to tie their damn shoelaces now-a-days. I'm talking about Caffeine. The real Vitamin C... I'm talking Monster, Coffee, Espresso,  Red Bull... you get the picture. I drank so much coffee the first week I gave myself an ulcer.  

Baby: 1 Nurse Parents: 1

Diapers? Seriously? I can change these little things with just my non-dominant hand while peering out of one bloodshot eye! I don't even need to go into the diaper thing.

Baby: 1 Nurse Parents: 2

Poop goes hand in hand with the diapers thing but I felt I should address it separately.  My baby didn't poop much the first month and a half. While at first this seems like a blessing, to a nurse is spells certain ileus! There was about 50 hours of research done in my household before finally asking a Dr. about this "Condition". We were given specific orders and followed them precisely. Every 5 days we produced a BM. It was nerve racking. 

Both sides get a point. Baby: 2 Nurse Parents: 3

Crying. I didn't cry in Nursing school because I am a Man and we have rules. Don't roll your eyes at me and say "Real men do cry" Because I will tell you that I am not imaginary and am very real, and I DO NOT CRY. However, my baby does, frequently, and I am told she gets it from me. I consider that to be a great injustice and resent even the slightest of comparisons. Regardless, crying is noise, and I can tune out noise.

Baby: 2 Nurse Parents: 4  

This brings me to stress.  There is no comparing the two events and the stress each one creates on its own massive level.  I will say this. When you leave Nursing school and go home, even if you have homework, you are still away from Nursing school. With babies, you are stressed all the time and coming home provides no refuge from the stress. Not even mentioning that Nursing school even if taken to its most extreme wouldn't even make it to puberty in the lifespan of a child.

Baby 3...  You know what, I'm sick of keeping score.  Nursing school is hard. Raising children is hard. Doing both is unimaginable, and yet I was in school with new mothers, old mothers, and single mothers.  My hat is off to you, ladies. I am in no way equipped to take that on. 

This Parenting thing is just starting and I'm sure will evolve from here as will my perspective on this whole thing.  Am I a better father because I'm a Nurse? Absolutely! Is the inverse true? Am I a better Nurse because I'm a father? I'd like to think that it adds a level of empathy. So, yes I am.

Well, I hear my little one starting to cry now. 

Thanks for reading,


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Wednesday, April 10, 2013

Who are you callin' a Burnout?

We've all seen it. It starts in their eyes. They begin to have that "1,000 yard stare", then they begin to stare holes through their co-workers, maybe even their patients. Next they start to grumble under their breath, or start letting a few bad words slip at the Nurse's station. Then they start showing up to work late and their quality of work begins to degrade. Eventually they start calling in sick or in extreme cases they no-call no-show.  It's not long after this point that they call it quits. They will leave that job for another or some may leave the field of nursing forever.
You might say to yourself, "Burnouts are people who got in to this field for the wrong reasons, I won't burn out because this is my life's work, my calling." If you say or think this your are not only wrong you are at risk. "The individuals who are most vulnerable to occupational burnout are ones who are strongly motivated, dedicated, and involved in the work in which they partake." [1]  Add to that that we are in high risk career for occupational burnout and the odds are not in your favor. 

We call them "Burn outs" or say they have "Compassion Fatigue" and consider this the diagnosis. Well, I see it as the signs and symptoms of a bigger problem. A more systemic problem in nursing as well as many other health care professions. One reason is an epidemic of Nurse Managers, losing their identity as Nurses and focusing more on the management aspect. The only problem is that they are piss-poor managers and don't realize it. Case in point, my manager recently went back to school to get her Master's degree... In business administration!! I suppose she really needed that degree as it most likely helps her when she sits in her office and listens in on conference calls or attends meetings. In gaining this degree, however, she lost touch with her people, her brothers and sisters, her fellow Nurses. Now she can't see that all of the good Nurses that were the back bone of their respective units transfer out from under her grasp or leave the hospital completely. Leaving fewer and fewer of these, smart, experienced nurses trying to keep it all afloat. 

So, how do we prevent/treat "Burnout"? First you must perform a Root Cause Analysis to determine the cause of the Burnout. Some major causes of Burnout include: [2]

  • critical boss
  • perfectionism
  • lack of recognition
  • inadequate pay
  • under-employment
  • tasks with no end (This one ring any bells... or call lights?)
  • impossible tasks / nearly impossible problems for solving
  • difficult clients (Patients)
  • incompatible demands (many demands that may not be achieved together)
  • bureaucracy (This is a big one in hospitals)
  • conflicting roles (home, family)
  • value conflicts (personal / workplace values)
  • meaninglessness of achieved goals (the success type of burnout)
  • social and emotional skills deficit

Prevention is probably easier than treatment. You need to understand your limitations and set realistic goals. If you are a baby Nurse then you need to take baby steps. You will not be in charge of the unit/floor/hospital in your first year. At least you shouldn't be. So, set a goal you can achieve. Many hospitals track statistics such as bar code scanning compliance or pain reassessment times. These are great goals that have a quantifiable and measurable outcome. My favorite is total number of medications administered, I lead the entire hospital for three months in a row this winter in this category and maintained a 97-98% scanning compliance. That one felt good. Like I was getting recognition for always having the patients with the most medications.  Remember that you too need days off and that other people can work instead of you. When they call you in, you can say no. If it wasn't a choice they wouldn't ask the question. My hospital gives 3 weeks of paid vacation after a couple of years and no one uses them. Its like a damn contest to see who has more PTO. 
New Nurses, as you start in your new role/job as an RN at times you will feel like you are the fresh soldiers coming in to reinforce the shell shocked and war hardened troops on the front line.  A lot of times that is exactly what is happening, budget demands may have put a hiring freeze on certain units or the entire hospital for an amount of time and they had to fight with what they had. Some of them may look down on you because you weren't there when times were hard because they are looking for someone to blame. Some older Nurses have developed that "Eat their young" mentality and see you as a threat to them. You have to have the strength and the perseverance to withstand all of that and press on. 

No one started Nursing with years of experience under their belt.

Accept the fact that successful outcomes are not always achievable.

Repeat after me... This is NOT my emergency.

Find an escape or a hobby that is not Nursing related.

And practice saying NO to your boss.

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1van Dierendonck, D., Garssen, B., & Visser, A. (2005, February). Burnout Prevention Through Personal Growth. International Journal of Stress Management, 12(1), 62-77.
2. Beverly A. Potter, Overcoming Job Burnout: How to Renew Enthusiasm for Work, Ronin Publishing, 2005