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Our friends recently started out on their own gypsy adventure last week. As it happens, they made the drive from North Carolina to the San Francisco Bay area and arrived just a few days ago. In anticipation of their future wanderings, I began compiling my own Spotify playlist titled “Gypsy Life” to share with them on their journey. You can check it out here:

When we started out a year and a half ago, Rilo Kiley’s “Pictures of Success” always seemed to be the quintessential song for my professional track, but there is one line that has actually gained a completely different meaning for me now. Right at the culmination and build up during the bridge, the lyrics are as follows,

“They say California is a recipe for a black hole. I say I’ve got my best shoes on. I’m ready to go.”

A year ago, I heard that line and thought “Yeah, I’m ready to go to California.” Now that we’ve lived here for a culmination of 9 months, I see it completely differently. When I listened to that line recently I thought “Yeah, I’m ready to leave California now” but I surprised even myself with that irony. California has an abundance of opportunity, but I see how easy it is to get stuck here. Really, it’s not just California, but ANY place. The truth is, you really can find good people, happiness and meaning anywhere.

I remember when I first started living in North Carolina, family and friends in Colorado would ask how long I expected to be living there. I always vaguely answered “Oh, probably no more than 3-4 years.” If I’m honest, I didn’t see myself settling down there in the beginning. I mean, I was sure I was only going to stay in North Carolina for a max of 5 years. 9 years later I found it really hard to leave because our roots were so deep.

There are so many things to love about California- it is, without a doubt, a beautiful state with some truly remarkable landscapes. The bay area is brimming with diversity and culture. But we just could not reconcile how expensive it is to live here and now, those lyrics take on new meaning. We’ve had our fill of California. We’re ready to go.

Where to next, you ask? What is the next adventure? This is where the twist comes in. We’re not talking M. Night Shyamalan caliber, but some people may find it a surprise that we have decided to end this chapter of our lives and settle down. Amazing as it has been to see so many different places, the frequent moving has taken a toll on all of us- cats included.

In January, I interviewed for a permanent position with Seattle Cancer Care Alliance, working with their Pediatric Bone Marrow Transplant team. This is an outpatient position focusing on post transplant care and (most importantly) education and support for patients and families. The Skype interview went really well, and I got that great, “Kristen Ammon” feel from the manager (I will always look for that vibe). Not to mention, their nursing satisfaction surveys have been in the 95th percentile the last few years. After some deliberation, I decided to hang up my gypsy shoes and take the job. I hesitate to call it a permanent location, because the only thing constant in life is change, but, for now, we’re making Seattle our home.

SOMEONE has to represent the Broncos in enemy territory!

I know originally I said we were doing this whole traveling thing to figure out where we wanted to settle down and we haven’t even lived in Seattle, but recently I realized that every place we’ve lived will feel a bit like home to us now. We were recently visiting friends in Phoenix while on our way back from a wedding in Tucson and I felt some hard core nostalgia- mainly for Phoenix Children’s, OHSO and Dan and Erin- but I was shocked at how wistful I was. Every place will have a piece of my heart and if I’ve learned anything from our travels, it’s that good people are everywhere. Here’s to finding our home. It’s been a wild ride.

 

 

 

P.S.- for those of you keeping track, here is my quick scoring of California life:

Outdoors: 10; Redwoods, Highway 1, Half Moon Bay, Yosemite, Monterrey.

Food: 9; Thai, Indian, SUSHI…expensive

Libations: 10; Wine and beer country! Mainly wine…but also beer. \

Transportation: 7; Caltrain, BART, Muni….traffic.

Job: 8; Coworkers- amazing, Doctors- amazing, hospital ruled by the bottom line.

Score: 8.8

Ore-gone

I don’t visit a lot of blog sites, but my favorite bloggers don’t post on a regular, predictable schedule. It makes things fun, I think; it’s almost like a present each time you wander back to their page.

A new post???? Merry Christmas to MEEEEE!!!
A new post???? Merry Christmas to MEEEEE!!!

That’s how I’m choosing to view this blog. I don’t want people to have to spend an entire afternoon catching up on what is going on in our life. The reality is that much of the same thing happens in each location. My opinions haven’t changed about many things and they likely won’t surprise anyone when I express them, so why bother sounding like a broken record?

But the nature of this blog is to keep our friends and family updated, so this post is going to be a very fact-forward. We spent four months in Oregon. As far as location is concerned, Oregon was AWESOME. I have to give it a fair shake and do the whole breakdown of point distribution, but I can tell you right now that, if the job had been more my style, I would have stayed there forever. For the Redditors out there, here is my TL;DR summary (the Reader’s Digest version, if you will). After living in Oregon for only a few months, my closet started to look like an REI catalogue (#win). There’s an excellent brewery in every town. I learned rather quickly that adult oncology is not for me. My sister lived less than 2 hours away and I saw her at least twice a month. That, hands down, was the best part of living in Corvallis.

This is pretty much how we greet each other. Every time.
This is pretty much how we greet each other. Every time.

Food: 9

In Denver, there were amazing restaurants but not a lot of local fare. In Corvallis, it was the opposite. There were a few good restaurants, but there was such an abundance of farm fresh food it made up for it ten-fold.

Produce! Produce everywhere!
Produce! Produce everywhere!

That’s not to say the restaurants were anything to sniff at. For such a small college town, Corvallis boasted some eclectic options, but a lot of the best food was actually at their numerous breweries…which brings us to the next category.

Libations: 10

I mean…it’s Oregon. There’s at least one brewery in every town; usually multiple breweries, actually, especially in Bend (a little slice of heaven). Jason is fond of saying that if you throw a rock in Bend, you will probably hit a brewery. Corvallis wasn’t a slouch with the beer either. Block 15 became our frequent watering hole and I don’t think it’s a coincidence that it was the first place we visited when we arrived in Corvallis. Combine that with Two Towns Ciderhouse, which has forever ruined all other hard cider for me, and we were pretty well stocked during our four months.

I'm so happy!!
I’m so happy!!

Outdoors: 9

Oregon is beautiful- from the coast to the mountains. The space, the greenery, the water- did I mention the mountains? There were plenty of places to explore the outdoors in Corvallis, and with Bend only 2 hours away and 1 hour to the coast, there was an abundance of natural beauty. Our first three months were full of sunshine and warm weather. Then October arrived, at which point the sun gave Corvallis the middle finger and was never seen again. That was rough. I never realized how much I don’t want to explore the outdoors when it’s grey, rainy and cold. Admittedly it seems harsh to give it a 9 just because of the rainy weather that it’s known for, but man if it didn’t affect me like crazy.

I'm not even sure what happened.
I’m not even sure what happened.

Transportation: 8

Bike lanes! Bike lanes for all! Getting around Corvallis was a breeze on a bike. The bus system was free, but unreliable. I actually had a bus driver yell at me because I rode my bike to a bus stop to catch up to the bus when he was 5 minutes late at my designated stop. I guess when people don’t pay to use the bus, you don’t have to worry about being a jerk to the people riding.

I'm not sure what I expected
I’m not sure what I expected

Due to the unpredictability of the bus system, transportation got a bit complicated when it got rainy and miserable. In the last month, I drove the car a lot. That being said, Corvallis isn’t a very large city so getting around via bike/foot is very doable, which is no small thing when you share a car.

Job: 5

I want to be very clear- my reasons for not liking my job had nothing to do with my coworkers or my patients. I truly enjoyed being able to have adult conversations and not talk about Bubble Guppies or Paw Patrol. And I certainly found several kindred spirits along the way. I don’t know if my emotional state influenced how I felt about the job, or if it was just the work flow. I do know that I really liked my coworkers, I loved my manager and the doctor was difficult to work with. I also know that I made some fast friends both with patients and coworkers- I’m thankful for that.

Average Score: 8.2

So I’m back at Lucile Packard for the next 3 months (YAY!) and this time we’re living in San Bruno (DOUBLE YAY!!!). More updates to follow. Hopefully sooner than this last break. Perhaps.

A Moonshot

September and October are always weird for me. On the one hand, you have Childhood Cancer Awareness, a cause I have dedicated time, money and even hair to. Close on its heels comes October and Breast Cancer Awareness month- something I feel equally passionate about for obvious reasons. I always feel a little torn, like I don’t have enough to dedicate fully to either month. Lately, I’ve been feeling a paradigm shift happening and it’s really come into focus today.

Back in February, my aunt emailed me while sitting in her infusion chair where toxic chemicals slowly dripped into her bloodstream. Vice President Biden was having another round table discussion at Huntsman Cancer Institute. “If you’re bored” she prefaced, with the link to the live video feed. I was currently out with the flu- feeling much better but certainly not well enough to be among the ranks of my fellow nurses yet. So yes, I was bored.

I watched as doctors, senators, family members, patients and nurses discussed the best ways to make our research more cohesive. That was a large part of the discussion- how can we bring our research together and make it more accessible and translatable?

Of course I heard about the “moonshot” initiative. Initially, there was a big push with the Pediatric Oncology community to try and get more focus for optimizing treatment in childhood cancers. For years I have railed against the lack of federal funding for childhood cancer research (a whopping 4% according to some sources).

But in the last few months, I realized that the reason behind such focus on research and treatment in adult oncology is because so many adults don’t make it. I haven’t lost sight of the fact that the treatment we offer children affects them for the rest of their lives; that more federal funding could actually help to tailor treatments to minimize permanent damage to these children. Working in Corvallis during this time helped me gain insight into the need for better treatments for everyone. The mantra keeps repeating in my head.

We are all in this together.

Yet, something Vice President Biden mentioned on several occasions struck me back then. What interventions could be made in order to make access to cancer treatment and research more available? Namely, are there barriers that could be either removed or at least minimized by our government? These past few months, it made itself plainly known.

Mr Vice President, I know of a barrier that continues to prevent patients from receiving quick and efficient cancer treatment: insurance companies.

When treatment is delayed-sometimes by precious, life-saving weeks- because the insurance company needs to “authorize” the treatment protocol.

When the insurance company refuses to cover BRCA testing for a patient because of the expense, even though this testing would help with prevention and surveillance of cancer in her children and grandchildren.

When a person who is dying from metastatic disease has to choose between hospice and palliative chemotherapy- because even palliative treatment is still, in fact, “treatment” and insurance will only pay for one or the other. Not both.

When research and pharmaceutical companies need to offer grant programs to help pay for life-saving treatments because insurance companies won’t.

These are the barriers to care that both adult and pediatric oncologists face. Yes, we need more research. We need people to get involved in studies, we need donations to Susan G. Komen, American Cancer Society, St. Baldricks, CureSearch– because we are all in this together.

We need better treatments, but we also need a better focus on quality of life. We need insurance coverage for adjunct therapies that have proven to be effective in reducing pain and stress. Most importantly, we need insurance companies to stop dictating the quality of care that patients receive.

Don’t think that just because it hasn’t happened to you or someone you know or someone you love that it doesn’t affect you. Cancer affects everyone. Kids, teens, adults.

WE ARE ALL IN THIS TOGETHER.

And if the government wants to get on board…yeah…that’d be great.

Yeah-THATD-BE-1rlu82

Bloom Where You’re Planted

Sometimes I like to imagine that I can somehow prepare for the future. That maybe weighing all the possibilities will guide my decisions and that later, when I look back, I’ll think “thank goodness I thought of this in advance!” While Jason and I have been exploring various locations, I have been able to put some of this thinking aside and focus in the short term. There’s no stress about the long term goal, no question of “where do you see yourself in five years?” because our timeline lasts only about 3-6 months. But that nagging voice in the back of my mind always begs the question- is this our new home?

When I took this job in Corvallis, OR, I was excited for a number of reasons. Of course we were thrilled to get a chance to finally live in Oregon, and it most certainly has not disappointed us. Oregon manages to combine all the things we love about Colorado and North Carolina (specifically, Durham), like beer, mountains, water, farmer’s markets and hands down, the best cider I have ever had-I tell ya, folks, Two Towns is going places. Keep in mind, we still have yet to experience two very important parts of living here- football season and winter. Oregon State is just down the street from our apartment and winter is notoriously gloomy. So, needless to say, our opinion might be a bit skewed.

I could get use to this...
I could get use to this…

I was also eager for the chance to work in adult oncology. Most places wouldn’t accept a travel nurse with limited adult oncology experience and no certification. Being a private clinic, the requirements weren’t as stringent. They were just glad I knew how to administer chemotherapy -they weren’t too picky about the average age of my population. The pace is much slower than what I’m accustomed to, but I’ve come to enjoy the break. I really like the other nurses I work with; despite a significant amount of turnaround in the last year, they have managed to create a really positive work environment in the face of a lot of uncertainty. The clinic seems to be constantly on the brink of disaster (for reasons I am not at liberty to divulge), but the nurses truly care about their patients and want to offer the best care possible.

Even with all of these positives, I just cannot deny that my true passion remains in pediatric hem/onc and I said as much to my manager and co-workers. That still didn’t stop them from trying to convince me to stay permanently. I was flattered, but guilt gnawed at me when I thought of leaving them high and dry come the holidays. It really does make a difference having that extra nurse available. So I offered to stay through January to help cover vacations until they could find someone permanent. Then, I bit the bullet, paid the hefty sum, and signed up to take my certification exam for pediatric hem/onc.

Take my money

Something that has helped me keep my sanity through all this is looking at other travel jobs. It’s just a reminder to me that I can always go somewhere else and start new. But lately, I’ve found myself looking at more permanent positions, if only to assure myself that when the time comes I can find a job doing what I love. It was during one of these late night random browsings on Indeed.com that I came across, and eventually applied to a permanent job with Seattle Cancer Care Alliance. It was a great opportunity involving their infusion center, focusing on groundbreaking research between Fred Hutchison, Seattle Children’s and University of Washington. I think I was scared that another opportunity like this wouldn’t come along and I threw myself out there, thinking “there’s no way.” After all, I had applied to a few permanent positions in Colorado and only heard back once.

It turns out that I did get a call from Seattle…and to make a long story short, I had an existential crisis. For pithiness sake, I have included a diagram to explain why I began to feel daily anxiety regarding my next steps.

You're welcome
You’re welcome

 

I’m not really one to believe that everything happens for an ultimate purpose, but I do think that for all my worrying I am reminded of the many forces in our lives at work. One can only be open to the path that unfolds before us, rather than trying to predict what that path might be or where it might lead. I followed through with the interview, and discovered that they already filled the pediatric position internally. The remaining position was for adult infusion. Seeing as I already made my decision to continue with pediatric hem/onc, this seemed like a pretty easy fix. Luckily, the manager was very honest about their availability of pediatric positions and understanding regarding my decision to stay in pediatrics.

This experience did make me realize that if I truly want to stay in pediatric hem/onc, my options are going to be limited. We may not have the flexibility to move wherever our heart desires. In my dream world, I would work in a peds hem/onc clinic in Bend, OR, but life just doesn’t work that way. What I do have is a set of skills, a passion for my field and a wonderful partner to help us bloom wherever we are planted.

Traveling with cats- a cautionary tale

It’s been a busy couple of months for us. For those of you dying to know, Stanford Nurses did NOT, in fact, go on strike, much to my relief. They were able to reach an agreement that seems to please everyone for now, and I am happy for them. In the meantime, we had quite a few exciting opportunities come our way, including the opportunity to move to OREGON!!!!! I ended up getting an assignment in an adult oncology infusion center in Corvallis, Oregon, which we hear is very much like Ft. Collins.

#WINNING
#WINNING

Looking at our next drive, however, I’m dreading another day in the car with the cats. This goes beyond the usual “Tobi won’t shut up” bit and I’ll tell you why.

When we started out talking about living the gypsy lifestyle, Jason and I had some pretty frank discussions about whether or not we should bring our fuzzy pals, Tobi and Monk, with us. For starters, Tobi is a holy terror when confined anywhere and this behavior is magnified by eleventy-billion when he is confined within his carrier in a moving vehicle. Our other cat, Monk, pouted for two days and would not eat after we moved a mere 15 minutes down the road in Durham, so we wondered how he would handle moving every three months. In the end, our hearts overruled our heads and we decided to take them both with us.

I discussed our impending trek to Colorado with our vet. She suggested testing out an artificial hormone called Feloway. Science is pretty amazing, so please allow me to take a moment and describe the awesome concept of Feloway. They have managed to artificially design the facial pheromone that cats use to mark their surroundings. You see cats do this quite a bit in the home, or on your hand. The scent tells them that wherever they are is safe and they should be there. A great concept for travel, we tried out the wipes provided by our vet prior to our drive from North Carolina to Colorado.

IIIIIIIIII don’t think it worked one bit. I think it’s a fabulous concept, but we seemed to be plagued with delays that added to an already stressful situation, and no amount of fake facial pheromone was going to help us. Since May of 2015, we have traveled from North Carolina to Colorado to Arizona, back to Colorado, then to California. Along the way we have learned some very important lessons.

Losing your keys down the rabbit hole…

I have been wanting to share this story and this is the best segue I will ever get. The day we left North Carolina for Colorado may have been the single worst day of my life. Obviously we were sad to be leaving but here is an account of all the crap that went south on that fateful day...**cue memory sequence**

Jason and I had planned to be on the road by about 5pm, with a goal of reaching West Virginia by the evening. We started the morning cleaning, only to discover that our water was shut off by 10am. This was our error, as we had accidentally asked them to shut the water off on the day we were leaving, not the day after. So we utilized our neighbors garden hose for buckets of water. We started packing the car at about 2pm. This took all our Tetris skills combined, and I discovered that my work running a food pantry and packing as much as I could into a small van really payed off. We managed to get the car packed, got the bike rack on the car, locked the bikes to the bike rack, and started the air conditioner. We loaded the kitties into their carriers, and hit the road about 5:30pm. Not bad, by all accounts and we were congratulating ourselves on sticking to our timeline when we stopped for gas about an hour outside of Durham and noticed that the open trunk light was on. This was the point that I realized I didn’t have my keys on me. My keychain not only held my keys to our car, but also my bike lock keys, with which I had locked our bikes to the bike rack. I searched everywhere I feasibly could in our packed vehicle; I called our landlord who had to unlock the house and look for my keys, all with no success. We decided to turn around and head back to Durham. We spent the next hour rummaging through trash, recycling, and leaves, only to conclude that I had NO idea where my keys were. The cats were freaking out and overheated, Monk was assaulted by our neighbors curious dog while trapped in the carrier, and then it started to rain. We decided to call it, and started back on the road by 7pm.

We only made it to a small town in the Virginia mountains called Wytheville. Have you ever heard of it? Probably not. Neither had we. But I did get to explore the Emergency Room. As it turns out, not a lot happens in Wytheville, VA, even in the ER. Either way, my problem was not traumatic, just urgent, and seeing as it was the middle of nowhere Virginia at 10:30 PM, there were no open urgent cares to be found. What a blessing that I still had health insurance! If anything good came out of that day, it was the fact that I was in an out of the ER in 45 minutes. Trust me, I know how amazing that sounds. Forty…five…minutes.

After that first day, our other days seemed mild by comparison! But that still didn’t mean they weren’t annoying. Tobi only STOPPED meowing for about 2 hours the entire car trip. All three days. 2 hours. I counted like I was counting the seconds until his demise. The end was nearer at hand than he realized. We landed in Colorado just happy that we all made it out alive.

Sedagives…

Yes, I misspelled sedative, and if you don’t know why, I want you stop reading this blog and go watch Young Frankenstein. Right now.

Seriously, I'll wait...
Seriously, I’ll wait…

We had tried out the Feloway spray in North Carolina and took Tobi and Monk on a little “tour” around town to see how they did. We didn’t notice a huge difference, but we were hesitant to try sedating him. We reconsidered after our drive to Colorado, but ended up waiting it out again, thinking that two days couldn’t be worse than three.

Then, we drove down to Phoenix. Tobi, admittedly, did much better, but he also tried to scratch and bite his way out of his carrier so aggressively that he rubbed his nose raw on the netting. Like I said, holy terror. I cannot tell you the number of times I actually considered leaving him on the side of the road. We finally secured some sedatives for him and thought all our kitty travel problems were solved. How wrong we were.

Zombie Cat

We were driving back to Colorado from Phoenix. We had checked out of our AirBnB at 10 AM, the doors were locked with no way of returning. Tobi was sufficiently drugged and we were 20 minutes into our highway travel, when Jason (who was driving) noticed a slight movement out of the corner of his eye. Apparently we failed to secure the door to Tobi’s cat carrier and he was now drunkenly stumbling all over our belongings with his third eyelid activated because of the sedatives giving him the “Zombie Cat” appearance and though he wasn’t meowing with the same gusto, he certainly wanted us to know that he was displeased with this situation. After some bouts of yelling and freaking out, we pulled over, secured Tobi, and continued on our way.

It was pretty much like this
It was pretty much like this

A mere 5 minutes later, Monk began to holler in a panic, something that was so out of character for him we were taken aback, until the smell of feces wafted to the front of the car and we realized we would have to pull over, yet again. Luckily I kept some baby wipes and paper towels in the car, and after doing a very rough cleaning of Monk’s carrier, proceeded to wipe him down on the side of the road in the blistering Phoenix sun. When we finally arrived at our hotel in Sante Fe, we gave Monk a bath, took his carrier mat to the coin laundry, ordered pizza and popped open a bottle of prosecco. I felt we deserved a pat on the back for surviving all that and nothing says “celebrate” like pizza and prosecco in plastic cups.

Puke Skywalker and Dookie Howser

Since then, Tobi has started to puke in his carrier while Monk has consistently defecated approximately 30-45 minutes into our trip (only on the first day, thank goodness). On our drive out to California, I once again wiped Monk down, this time in the snowbanks of the Colorado Rocky Mountains, with a windchill of probably 20 degrees. PoopThis has brought them the good fortune of some pretty classic nicknames such as Puke Skywalker and Dookie Howser. Others have included: Barf Simpson, Spew Jackman, Puke of Hurl, Dumpfrey Bogart, Upchuck Norris, Vladimir Pooten (complements of The Inbetweeners), Joseph Stoolin, Crappy Gilmore, and Bradley Pooper.

We’re still open for suggestions. Feel free to comment.

 

 

 

 

Tribute

A little bit late for Mother Nurses Week but oh well!

I don’t think it’s a coincidence that Mother’s Day often coincides with Nurse’s Week. At least, not for me. For many mothers, exhibiting the caring aspects of nursing comes naturally. What makes a good nurse, however, is grit, organization and a desire to always be bettering yourself. The signs were all there for me, even in childhood. So many memories to choose- playing with the empty syringes you would bring home for me; listening to my heart with your stethoscope; dissecting the organs of the chicken that was roasting in the oven for our dinner.

So many times I thought you were pushing me to be something else. I accused you of putting too much pressure on me to perform- projection, all of it. In retrospect, I know you saw so many possibilities for me that you never had and you only hoped I would find something I felt as passionately about as you did nursing. I get it now. How hard it must have been to watch me blunder along, not wanting to force me to follow in your footsteps. Despite all your best efforts to guide me along other paths I might take, I doggedly wove my steps in and out of your own, eventually ending at the same destination.

What I appreciate the most is how my love for you is now inextricably linked with my love of nursing. You brought me to this place and I feel so much of your presence with me every day. Each time I make a good catch that prevents patient harm, every time I question or explain or make a mistake. You walked this walk, you fought this fight, and you (perhaps unknowingly, perhaps not) guided me to one of the most meaningful life choices I’ve made thus far. I only hope I become half as tenacious and brilliant as you are.

 

Happy Nurse Mother Week, Mom. I love you.

Happy Nurse’s Week

I’ve always felt a little weird about nurses getting an entire week of recognition. In many ways, nurses are overworked, and often unappreciated, but so are a lot of professionals in this country. I mean, I feel the same way about the hospital housekeeping staff and they don’t get a week of appreciation.

But there is a lot of pride in the nursing profession, and also a lot of humor. I love every minute of my job for a lot of emotional reasons, and some logical. I have found that nursing is best expressed in the multitude of hilarious memes that pepper the interwebs. So, in honor of nurses week, I’m foregoing all the feels and opting for the giggles. Here’s to all my nursing peeps, and those who know and love nursing peeps.

Sometimes our family is so happy to see us when we get home…

All we can think about is the variety of patient’s bodily fluids with which we are covered….

isolation

And pooped all over their central line...at change of shift...
And pooped all over their central line…at change of shift…

Autoclave

Healthcare brings out some interesting personalities- from parents and family members to surgeons and residents, you can count on having some choice encounters.

Perverted ptWTFFamily DramaExpert

Of course the patients themselves can make or break your shift

Call bell
image

Documentation, coming to work during a blizzard, malfunctioning machines- it’s what we signed up for…

snow dayExtra shiftPump beepingDocumenting

And without a doubt, our family and friends can have a tough time shocking or impressing us…

image (2)

Gross story
Everyone has their thing…mine is broken bones and fingernails.

Happy Mother's Day!

In the end, we all know that the little things make this job worth it…

penNurse coworkersNext-Shift-Coming-InNurses Week

Happy Nurses Week!!!

Check out the following for some more belly laughs:

http://scrubsmag.com/the-nurse-life/

http://www.nurseeyeroll.com/2013/12/19/a-day-in-the-life-of-nurse-eye-roll/

 

 

And the world will know!

Everything I ever knew about strikes I learned from Newsies. From the spontaneous musical numbers to the violent fistfights, I’ve been preparing myself. That’s right, people. Stanford Nurses may be going on strike. I’m not officially a scab….yet. But I was led to believe otherwise by a staff nurse one night during change of shift. Maybe I was reading into it, but she kept referring to travel nurses as “scabs” and asked if I was thinking about taking a bonus from the hospital for working the strike, subtly implying that I would burn in hell for doing so. First off, none of your business, second, why would you call the people covering you while you strike a nasty name?? I’m making your strike possible, so how ‘bout you be a little more careful with your choice of words and tone of voice.

haters

In Nursing School, strikes and unions were commonly discussed and debated. Even then, I was of two minds on the issue. On one hand, it seems to go against the spirit of the nursing profession to abandon the care of your patients because of your working conditions. Yet, most nurses are striking because (and this is the most important point) the health and wellness of your nursing staff determines the outcome of your patients.

Pay is almost always one of the reasons for a strike, but it is usually the smaller point among some much larger issues, such as high ratios of patients to nurses, required overtime and unrealistic staffing demands. In the long game, changing these factors makes for better and safer patient care. Temporarily leaving your assignment for the betterment of patients down the road seems like a noble cause to me.

You can read up on the whole strike here. There are some things that aren’t really clear in the article so I’ve been talking to a lot of the staff nurses, trying to get an understanding of what the big issues are. Don’t feel obligated to read it, I just thought it prudent to provide the source material for fact checking, etc. Luckily, we have several union board members that work on our floor so I’ve been able to get a clearer picture over the last week.

I’ll try to sum it up as best I can. Stanford Hospital (which includes Lucile Packard) is currently in the process of expanding to a much larger building, slated to open in 2017. As part of their expansion, they will be hiring a large number of nurses. However, CRONA (the union) wants Stanford to fix the current issues that are already causing nurses to leave Stanford in droves. Issues like:

Pay: Cost of living is so astronomically high in Palo Alto and surrounding areas that nurses have been leaving Stanford to go work for other bay area hospitals like UCSF and Kaiser, where pay is far more competitive. The union has proposed a pay raise that is, admittedly, very high over the next three years. In theory, this pay raise would catch Stanford nurses’ salaries up to the surrounding hospitals and make it possible for them to live closer to Stanford. Which brings me to the next point.

On call hours: I’m not positive how “on call” works for OR nurses, but from my understanding, it is required for nurses to be on call for a certain amount of time every week and within a certain distance from the hospital. At Stanford, on call requirements are 24 hours and you must be within 30 minutes from the hospital. Combine that with the high cost of living and that means you have nurses sleeping in their cars because they can’t afford to live or stay 30 minutes from the hospital for that long a period of time. CRONA wants Stanford to reduce on call hours to 12 hours per week to make this more manageable.

Reporting for duty!
If you want your OR nurses looking like this…just sayin’….

Flexible working hours: One of the most important issues, according to staff I’ve talked with, is flexibility of hours. At Stanford, RNs do not have the option of working decreased hours. You’re either Full Time or PRN. There is no in between. I think this might be different for outpatient, but I’m not positive. So, say a nurse has small children, wants to continue working inpatient, but would rather work one or two shifts a week instead of three. Not an option, so that nurse goes to PRN. That means staffing can call that nurse in for 8, 10 or 12 hour shifts as needed, when their available. That also means that nurses are constantly being shuffled around the hospital throughout the day based on needs and handoffs are being made multiple times to multiple different nurses. I was literally called in one day for FOUR HOURS. 3pm to 7pm. I received report at 3pm, did my assessment of my patients, gave a few meds, then turned around and gave report to the night shift nurse. In the hospital, nursing care is a 24 hour job, and each time the next shift comes on, you have to report the patient’s progress (or lack of progress), the plan of care and pass along any duties that you weren’t able to get done on your shift. If you split the shift up too much, the effect is like the game Telephone- information gets misinterpreted, or missed altogether and patient care suffers, as a result. By giving more senior nurses the option to work 24 or even 12 hours a week, they might be able to retain nurses and save money, not to mention provide safer care and require less support from travel nurses.

Aaaaannnd that's how rumors start, kids!
Aaaaannnd that’s how rumors start, kids!

As a travel nurse who has already extended my contract, I’m not sure what this means for me. Some people have suggested  I cancel my contract and sign on to work the strike so I can make more money. Admittedly, if I continue working for the same pay while the strike nurses are making significantly more, I will be pretty pissed. On the other hand, it just feels ethically wrong for me to break my contract like that. They need nurses that know the patients, the floor and how to give chemotherapy. I expect to have some sort of compensation, don’t get me wrong, but I would rather keep my contract and get compensated accordingly. What scares me is the idea of having to be one of the “experts” while they call in reinforcements to staff the hospital. I’m scared for the patients and, to be honest, I’m pissed at the hospital for letting it come to this.

In the end, I called my recruiter, A-Aron, and he shared some stories he heard from other nurses working at Stanford that made me realize just how awesome this unit is. Some nurses are telling travelers that they will lose their contract if they work the strike, and some managers are requiring their travelers to strike with them. Aaron assured me that a) I will not lose my contract and b) I will likely be compensated in some way. Regardless, the message I continue to receive from my unit is “you have to do what is right by you.” So kudos to the nurses of the Bass Center at LPCH for being so amazing. For those of you who plan on participating in the strike, I leave you with this:

My better half

Most people are curious to know what Jason is up to during our travels, and I am ashamed to say that, until this point, I’ve failed to mention his endeavors. It’s easy to get caught up in my own experiences through all of this. If you would like to read up on his most recent musings, you can catch it on his blog here. I was a nurse for maybe six months before Jason started asking when we could start travel nursing. As a fledgling RN, when my hands still shook with every port access and IV start, I didn’t feel capable of venturing into a new environment every three months. I told him to give me some time to feel competent before I throw myself into that scenario. The biggest revelation I’ve had about myself is that I will always have areas to grow and learn. Originally, I would have said that I take a long time to learn new skills and feel comfortable, but with each assignment, I find I’m more at ease with hitting the ground running and learning as I go. That being said, I still show stress and frustration all over my face all the time…

You can't change a tiger's stripes...
You can’t change a tiger’s stripes…

Jason lacks the luxury of having everything in place for him upon arrival. He has to put himself out there with each new location in a way I never experience. I’ve seen him change his approach with each move, too. Now in our third locale, he hit the pavement right away and within two weeks, he secured two jobs teaching music through different schools/companies. As is the nature of all things extracurricular, they must fit around school and work, so although he doesn’t work many hours during the day,  he teaches lessons every single day. Much like my experiences, some days are better than others and he is also learning the pros and cons of each company. Last week while I lounged by the pool enjoying my day off, he struggled through an afternoon of teaching only boys. Really, the text he sent me is too hilarious not to share and this is more for posterity than anything.

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Of course this is all from my perspective, but it is obvious that after working manual labor and driving for Uber, Jason is much happier teaching on a regular basis. Some people are lucky enough that their talent and career seem to join together harmoniously. We should all be so lucky! I envy Jason that he started his career so much sooner than I did. That’s not to say teaching is the only thing he wants to do with his talents, but he clearly enjoys it- at least most of the time. He’s discovering new facets about his passion for music education with each new experience, just like I am. I was discussing the possibility of returning to school with my mother. I currently have no desire to return to school (the accelerated nursing program really took the ginger out of me there). Jason, however, would like to return to school, but he doesn’t know what he would return for. I realized that while I will likely need to return to school to further my career, Jason chose the school of hard knocks. He is learning, through trial and error. It doesn’t provide him with a masters degree, but it is shedding light on how he would or would not run his own business while perfecting his creative writing and building up his portfolio of compositions. He is a Renaissance Man through and through. 

Not that kind of Renaissance man…

 

I started this post with the intent of writing about California and our experiences thus far. But I have gone too long without acknowledging how lucky I am to have Jason here, and how much more challenging this journey is for him. So I’ll give you the brief:

 

  • California is breathtaking

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  • San Francisco is lots of fun and only an hour train ride awayIMG_20160213_152402774_HDR
  • There are bike lanes everywhere and lots of opportunities for outdoor adventure

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  • Palo Alto is super expensive and kind of hoity toity but we have some great neighbors
True....hence, funny
True….hence, funny
  • Mandated 45 minute lunches are the bomb-diggity. Being scheduled nearly every weekend because I’m a traveler is not. So the jury is still out on Lucile Packard.
  • I tried to get to the Pacific Northwest but both jobs I applied for didn’t work out. Long story, but it’s the third time Portland has screwed me over. I’m pretty sure I’m cursed.
    Hi, Portland! I meet all your requirements for this job and I think I would be a great...okay
    Hi, Portland! I meet all your requirements for this job and I think I would be a great…okay

     

Finally, since nothing else really popped up for me this month and my contract was coming up in May, we decided to stay in Palo Alto until June! Come visit. It’s lovely here.

Denver Report Card

It’s been a month since we left Denver so I think it’s about time to release the infamous “Report Card” for Colorado. In reality, neither Jason nor I have lived in Colorado for over 8 years, not to mention the last time we were living in Colorado, it was with our parents. So, needless to say, we were excited for the opportunity to see what it was like to live in Denver…on our own…as adults.

And I just can't hide it!
And I just can’t hide it!

Some aspects-beer, for instance- proved plentiful and delicious. We also enjoyed the food scene immensely. But there were things I expected to be better established- like public transportation or bike lanes. I know we technically lived in Aurora, which is very different than Denver proper, but I still feel that certain aspects about Denver were not what I expected at all. So, let’s delve a bit deeper, shall we?

Food: 9

Don't judge
Don’t judge

During my first month of work, I got into a discussion with one of my coworkers about food in the Denver area. She and her husband-huge foodies- frequent the Denver food scene, so she bequeathed a list of recommendations that, along with our own discoveries, blew us away. We truly enjoyed all that the Denver (and Aurora!) food scene offered. Some of our favorites included Il Posto a classic, upscale Italian restaurant, The Yak and Yeti for Indian food and beer and The French Press for breakfast. There was Kirk’s Soul Kitchen- they make the best fried okra, even though it hurts the Carolina half of my heart to admit it. Their fried chicken was also pretty damn incredible. Our neighbors, Eric and Jennifer, took us out to their favorite Korean restaurant where I fawned over my spicy Kimchi soup and we stuffed ourselves with all sorts of unique and flavorful dishes. Eric also shared his cooking expertise with us by making Japanese curry- words fail to express how delicious that was. We enjoyed some tasty thin crust pizza at The Walnut Room with my cousin Carmen and her husband CW. We didn’t try Tacos Seline until a few weeks before we left, which is unfortunate because it was  just down the street from us and serves up some mean street tacos. But the ultimate experience, the cou de gras of our food exploration, was The Populist. A small plate themed restaurant with a unique assortment of ethnic and classic dishes. You know those mind blowing meals that leave such an imprint on your psyche that you remember every single succulent item that you ordered? Yeah, that happened. It’s happened only a handful of times for us, most notably at Nana’s in Durham but also at Nosh in Colorado Springs. After Jason and I left the restaurant and for weeks afterward, we kept talking about that meal. I eventually came to the conclusion that The Populist was best restaurant experience I ever had. (For the record, it is not the best meal I’ve ever had. That credit belongs to the notorious Mama Malone-chef, artist and Italian queen. Grazie!) The food in Denver, though, was remarkable, variable and thoroughly enjoyable! So why not a 10? Call me picky, but I was disappointed by the lack of farm to table fare. I am aware that Colorado doesn’t boast the same growing season as North Carolina, and I certainly can’t expect the same variety, that’s simply ecology. Still, I expected a lot more Colorado livestock offered in restaurants and I was kind of disappointed. I mean, isn’t that what Colorado is known for? Beef? Well….okay Colorado is known more for beer (and other vices). Speaking of beer…

Libations: 10

Why is anyone surprised by this? Colorado’s beer scene is incredible, and I’m not just talking about New Belgium and Oskar Blues. I’m talking about the small microbreweries that are everywhere. Everywhere. One of the first things we did in Colorado was venture to Jason’s favorite brewery in Ft Collins, O’Dell. We hit up Dry Dock in Aurora (delicious and creative), Left Hand (a classic favorite), and Lowdown (also delicious). We spent most of our time at Coda, and I am so very glad we did. Coda, a small brewery that opened only a year or two ago, happens to be located in a small apartment/condo area right behind the hospital. One of my favorite memories from working at Colorado Children’s involved a horrible day and a general invitation (by me) to drink beer at Coda after work. We gathered, drank beer, told stories, got to know one another a little bit better, and I hope they continue to gather there after work, because it is so, so incredible. One of the things I love about Coda is the variety and quality. Maybe one or two beers are constants on the menu (Sleepyhead and Dogcatcher are two all time favorites) but most of the time it constantly changes, and it is all really good. They don’t serve food, but you can order from the pub across the street and they will deliver it to you at the brewery. I can’t be the only one who thinks this idea is five shades of brilliant. Colorado just keeps surprising me with the beer scene. Cheers to the Rockies.

**While writing this blog post, I received a text from my friend informing me that Coda is no longer. I guess there was a founder “divorce” and now it is a new brewery with sub-par beer. RIP Coda, I hope we meet again someday…

Outdoors: 10

After spending 8 years in North Carolina, the people in Colorado seem a little cold by comparison. There is an exception to this. Example: while enjoying a picnic with our friend Jen, a lady walked by and immediately struck up a conversation about her son and her love of Japan. We had no idea who this lady was, but she was amazingly friendly. Something about the outdoors makes Coloradans super friendly. We are at our best when surrounded by nature. I have to say, there is undeniably something in the air in Colorado that makes you want to be outside- even in the snow. It’s just refreshing, almost cleansing.

Though we didn’t get up to the mountains as much as we would have liked, we did get to revisit some favorite hikes along with a few new experiences like a snow shoeing adventure in Grand Lake. I spent tons of time on the Highline Canal Trail which ran behind our apartment complex and connected with the myriad of trails in the Denver area. Even though that trail was surrounded by residential areas and highways, I still felt like I was far away and on most days you could see the Rocky Mountains in the distance. I can’t help it, those mountains soothe my soul.

COLifeZones_Panorama

Transportation: 7

Let me start by saying that Denver’s bus system was so much better than Phoenix. Infinitely better. Light years ahead. That being said…snow can really mess up your commute and buses are no exception. Now, we lived right along a main bus line that took me straight to the hospital, which was beyond wonderful. Normally the bus ride took me about 15-20 min. What I didn’t realize is how little they plow the streets in Aurora. As in, they never plow them. Even buses need plowed roads to get anywhere. So to say that the bus system was sub par would be unfair because the only time the bus was unreliable was when it was snowing. Which, as it turns out, happens a lot in Colorado during the Winter months. I thought for sure Colorado would be one of the more bike friendly cities but biking- even on the nice days- was surprisingly challenging. In order to safely get to the hospital, I had to weave through neighborhood streets in a very roundabout way because none of the major roads have bike lanes. Construction was always impeding my route as well, so on several occasions I had to take a detour, sometimes taking me a half a mile out of the way. I eventually came to the conclusion that until the light rail is completed, Denver will be a difficult city to navigate by public transportation. We may just hold out until then.

This could be promising...
This could be promising…

Work: 8

Children’s Hospital of Colorado is beautiful and has some really cool features, like their very own blood bank. When you transfuse blood and platelets to children on an almost daily basis, there is something so powerful when you realize that they may be receiving your blood or platelets. It connects you to your work in a very concrete way. They also have their own radio studio that plays music through the television and hosts Bingo games for kids to play in their rooms.The hardest thing about the job was getting readjusted to being an outpatient nurse. When you work on an oncology floor (inpatient), patients and their families usually grow accustomed to having a different nurse every night. There is the occasional patient that spends so much time in the hospital they request their “favorites” but generally speaking, families are pretty cool about switching care providers every 12 hours. In outpatient, you don’t spend as many hours with these patients but you see them on such a regular basis that they grow very familiar with who the nurses are and they can sniff out a newbie very quickly. Pair that with the fact that this location hadn’t had a travel nurse in seven years. I was surprised by the amount of suspicion I was met with by many parents and patients. Understandable, as I am sticking your child with needles, but it is unnerving to walk into that, even with four years experience under my belt. My coworkers were wonderful, helpful, supportive and amazingly awesome. I just missed inpatient. I think that, while we don’t have children, working as a floor nurse might be more my style.

Yep, I totally just admitted that. Shocker.
Yep, I totally just admitted that. Shocker.

So the score is… 8.2

Not bad, Denver!! But we’re not done adventuring, yet.