An Ode to PCH

I'm going to miss this view!
I’m going to miss this view!

I might as well just get the apologies for not writing sooner out in the open now. I am well aware of how long overdue I am in posting but before I do the great reveal of our next location (that most of you already know about) I’d like to take this time to pay my tribute to Phoenix Children’s Hospital.

When I started out on this adventure, I envisioned the difficulties I might endure as a brand new traveler in a job that was outside my comfort zone. At the end of my interview with the manager at PCH, she asked me how I felt about the job and I said, “nervous, but capable.” Couple that with the constant reminders from the travel nursing Facebook pages about how awful it could be and I was, for good reason, apprehensive.

No joke, this is posted in some hospital break rooms (not PCH)! Sure makes you feel welcome!!
No joke, this is posted in some hospital break rooms (not PCH)! Sure makes you feel welcome!!

That’s not to say I really felt like I needed to “belong” but…okay scratch that I did feel the need to belong. It’s ingrained in my psyche. I also felt an insane pressure to prove myself. It was challenging to start out on 7th Floor for a number of reasons- mainly, out of my 4 years of experience, only 2 months of it were spent training on an inpatient floor…as a brand new nurse. I’m sure it was a little nerve racking for my manager as well, knowing how little experience I had before she just tossed me in with two days of orientation.

But none of my challenges at PCH ever had to do with my coworkers, and I cannot fully express how grateful I was to feel like I was part of the team, almost from day one. Lynette, my preceptor, all bubbly energy and optimism, yet clear about expectations and honest with her feedback-perfect, in short. When I asked for an extra day of orientation, just to be safe, she encouraged me by saying she didn’t think I needed it but understood if I wanted a safety net for one more day.

From many conversations before, during and after our shifts on topics ranging from Portland, to Colorado, to the must-see places of Arizona I got to know some amazingly generous and wonderful souls. It is because of the friendliness of the staff that Jason and I were able to experience this little gem:

Why hello, you beautiful world...
Why hello, you beautiful world…

After a rough day, my coworker opened my eyes to the best taco salad. Ever.

Cafe Rio, where have you been all my life??
Cafe Rio, where have you been all my life??

I also enjoyed a few dance parties and maybe I even rode the toy cars around the unit with a few other nurses. Maybe.

This is the real reason why we are in pediatrics
This is the real reason why we are in pediatrics

In my second to last week I had an emergency situation with my patient that required a “Clinical Assessment Team” otherwise known as a Rapid Response Team. This gathers doctors, residents, nurses, respiratory therapists all in the patients room…rapidly. The idea is that you call this before the patient needs CPR. My patient wasn’t in horrible shape, but I wanted more eyes in the room to assess the situation and I wanted them yesterday. There are a lot of things that go through your head when you have to make this judgement call and almost first and foremost is, “what could I have done to prevent this?” Obviously it’s better to call a rapid response rather than waiting until the situation is more serious but even then, I would argue that it is in the nature of most RNs to question almost every decision they make. I was no exception.

I bring this up because it is a prime example of why 7th Floor is so amazing. Almost every single one of my coworkers, including one of my charge nurses, supported me through this. There was never any judgement about the situation, even though there could have been. There was nothing but endless encouragement that I made the right choice. Through the rapid response, there were nurses covering my other patients, nurses hanging around the door waiting to help if needed. Afterward, I was constantly being asked if I was okay and if I needed anything. The amount of support and reassurance was so….nice. I’m not saying it was any different than what I would have had at Duke, but it was so wonderful that I was able to experience that kind of support at multiple hospitals.

I guess the point I’m trying to get at is this- I know how bad it could have been. I have seen pictures and heard stories of travel nurses walking into very hostile environments. I can’t imagine how long those three months would feel if that had been the case. As it was, I landed in one of the most welcoming, helpful and brilliant floors at Phoenix Children’s Hospital. I learned so much from so many nurses and had a great time in the process. I felt free to vent if needed, I felt safe admitting when I was outside my comfort zone and I felt comfortable enough to open up and be me, in all my weird, awkward glory.

I didn’t feel like an outsider, and that is all any travel nurse could ask for.

I LOVE YOU GUYS!
I LOVE YOU GUYS!

 

S*** just got real

Parental Advisory

 

 

Consider yourself warned.

 

Cancer has a way of putting life in perspective. Up until this point I have felt content to write about my experiences with as much honesty and humor as I can muster. Please don’t misunderstand- there is a lot to be said for a hearty dose of laughter in the face of something as devastating as cancer. But last week I reached a new level of hatred and loathing for the disease that has claimed the lives of so many- young and old. More importantly, I am so pissed and sad that we haven’t found a cure for not only cancer but many other diseases.

 

People who don’t work in the Oncology field often comment how hard of a job it must be, usually followed by how “I could never do something like that.” In nursing, it truly takes all types and that is why I love it. There are nurses who wouldn’t dare touch pediatric oncology. On the other hand, you couldn’t pay me enough money to work in an ER, ICU or psychiatric floor. I have plenty of friends from nursing school who work in those fields to make up for my absence and believe me, the world is better off because of it. 

 

Working in the field of pediatric oncology you see a lot of optimism. That is just the nature of the field. Kids are easily distracted and focused on living. Life in the hospital becomes their new “normal.” Admittedly, it’s sad, but it is also what makes them so resilient. As a nurse you want to make the whole process not so scary and unfamiliar. That is easier to do with a 5 year old than a 25 year old, which is why the real challenge lies with the parents. To watch their child endure the endless treatments that destroy their kidneys, liver, gut and even their skin- it’s heartbreaking. I’ve watched this process for almost 4 years now, so what brought on my new rage against cancer?

 

Cancer has dealt a blow close to home. Even when you work beside these families to help them recover, you don’t really understand until it involves your own family. What I’ve been dwelling on these past few days is the fact that I really have it easy. I go to work, do my best to keep my patients safe, pain free, nausea free and hopeful. Then-and here is the most important part- I go home. I drink a glass of wine, take a shower, watch Scrubs and try to process my day. I get a break, a chance to step outside of the scenario and see it with fresh eyes the following day. My patients and families don’t have that luxury. What I experience 36-40 hours a week they are living 24 hours a day, 7 days a week, no lunch breaks.

 

I was spared a lot of heartache and worry when my mother underwent her own battle with cancer. I was only 11 at the time, so naturally she wanted to protect me from the brutal honesty of it. What my aunt endures with a seemingly effortless amount of optimism and grace is something that her daughters are now old enough to fully witness. There is no curtain, no veil to protect them from the reality that cancer is a bitch. It sucks on so many levels. The fact that the very treatments you receive to rid your body of cancer can actually give you more cancer. The fact that once you get cancer once, the fear of relapse or recurrence never really leaves you. These are things that I never had to witness as an adult. These are the things that, until now, I tried to forget on my days off.  I fucking hate cancer and it can go to hell.

 

Fuck Cancer

 

I wish I could say that this thought makes me more sympathetic and a better nurse. I truly hope that, on some level, it does. The reality is that I still get irritated with the demanding or rude parents. They lose sight of the fact that their child is not my only patient. I lose sight of the fact that they have only one to worry about- and no reprieve from that worry. When you are in the trenches, there is a tunnel vision that doesn’t bring out your best self. You get pulled in so many directions, interrupted by the minute and the stress of making sure you chart EVERYTHING you do is enough to drive me up the wall. Parents, in a similar but different scenario, just want any and all information you can give them, and they don’t want to see their children suffer for even a few seconds. Both sides have their own perspective, but I wish I could say that my perspective is easier to change.

 

But this post is not supposed to be about me. This post is about the gritty reality of cancer and our country’s focus on “awareness” that so rarely leads to the life saving research we need. My mother shared the following article that beautifully illustrates how we have become so focused on awareness we lose sight of what cancer really looks like- in all its disgusting and brutal glory. There is triumph, strength and beauty in these real stories. There is also heartache, despair and loss. While we don’t want to expose patients and families unnecessarily to the public, I feel like we are hesitant to show this side of cancer because we don’t want to scare people. Well guess what? Cancer is scary. It’s fucking terrifying. People who have never had cancer, myself included, cannot possibly understand what it is like. Until we are faced with the possibility that we have cancer or the likelihood that we will get cancer, we won’t understand. I know that I’m not going to change the entire funding of cancer research with a blog post, but we do have the power to do our homework. Find the organizations that work hard to raise money for research. There is plenty of awareness in the world-what we need is funding for cures. This extends far beyond cancer. There are multitudes of diseases that need better treatments and better outcomes- HIV and Cystic Fibrosis, for example. Most of all- remember those who are living this daily. Listen to their stories, walk a mile in their shoes. You will have more awareness than you could possibly imagine.

 

Square One- First Impressions of Travel Nursing

I get a lot of questions about what exactly it means to be a travel nurse. Granted, this is my first travel assignment so my understanding of the concept is that of a novice. There are a few experiences that I have encountered thus far that really illustrate what the travel nurse experience is, and more importantly, what it is NOT.

Being a travel nurse means you are a contractor. A medical mercenary, of sorts.

Yeah...maybe that’s giving the wrong idea.
Yeah…maybe that’s giving the wrong idea.

 

 

 

 

 

 

 

 

These days, there are a million and a half reasons why a hospital might need a contracted healthcare worker such as: they can’t fill their positions fast enough and they need a qualified person yesterday; Someone may have a medical emergency that requires a long period of recovery; they may have multiple people on maternity leave (or paternity leave, if the hospital is awesome).

Three cheers for equality!
Three cheers for equality!

They may also be in a state where nurses are unionized, so there may be a staffing shortage due to a strike.Whatever your feelings on that last issue, the point is that people still get sick, and hospitals still need to have enough staff to function safely. That’s where travel nurses come in.

The concept is pretty much the same as any other contract position. You sign on with a company, they find you work, you sign a contract with the hospital, hash out the details, sign your contract and boom! You’ve got a job for the next 13 weeks, or however long the contract is. The details, however, can be a bit more hairy. Here are a few examples-

I signed on with four different companies. That’s right. Four. Here was my logic- I had a very specified niche of healthcare that I had experience in. If you are looking for travel nurse positions, they are loaded with jobs in areas like critical care, emergency medicine, surgery and general medicine. Most of them are inpatient (read “in the hospital on a medical floor”). A few of them are pediatrics. Even fewer of them are pediatric hematology and oncology. Still fewer of them are outpatient. Every company contracts with different hospitals. Some of them contract with the same hospitals, but I figured if I can cast a large net, I was more likely to get the right kind of job.

A good plan, eh?

That one’s for you, Julianne!
That one’s for you, Julianne!

 

 

 

 

 

 

 

 

Turns out I just made the process that much more overwhelming.

When you sign on with a travel company, you are assigned a recruiter. I prefer to call them my “agents.” It sounds fancy, and everyone knows I am fancy.

Really I just love that song.
Really I just love that song.

My “agents” would get an idea of where I wanted to travel, look over my resume and talk about my past experience, then they would scour their job requests for a good match. For a few weeks, I felt like I was fielding calls, texts and emails from my agents almost daily, gauging my interest in places like Portland, OR (YES!!) and Corpus Christi, TX (NOOOOOOOPE). I remember doing three phone interviews in one morning ranging from a pediatric hem-onc floor to adult outpatient oncology clinic. What I certainly didn’t expect was to have more than one option present itself, but that is exactly what happened. I turned down three other positions to take my current job. One of those interviews was so awkward it made me uncomfortable (and that’s saying something) and yet they still offered me a position. what

 

After the dust settled, I realized my first truth about travel nursing: there will always be jobs out there, it just boils down to how much I am willing to challenge myself.

Sure, people told me that I would never want for a job as a nurse, but I’m not ashamed to admit that I was picky. This was my first assignment, and I wanted it to be a good experience. I wanted a travel friendly hospital, a position that would push me outside my comfort zone but not so far outside of it that I felt unsafe. That’s a tall order. I’ve been working for about a month at Phoenix Children’s Hospital. PCH, particularly the floor I am on, is truly wonderful. Everyone is very friendly and helpful, but there is a reason that they need travelers; they are BUSY. This is probably the hardest I have ever worked as a nurse…ever. It’s like the hardest days I had at my old job, except every day.

The biggest change is that I feel like a brand new nurse again. I am struggling just to get all the charting done by the end of the day, constantly asking questions, making mistakes, and not knowing what to do first.

Pretty much how I feel every day
Pretty much how I feel every day

It took me about a year at Duke to finally feel competent enough in my job that I could develop close relationships with my patients and start to think outside the box. Now, I feel like I’m back at square one, and I’m frustrated that I’m not the same caliber of nurse I once was. My only consolation are the few marketable skills I retained from my old job. My first week, I was able to help another RN out by starting an IV on her patient. Selfishly, I needed that- to remind myself that there are skills I have that make me an asset and not a liability. Yet, I am so busy just trying to keep up with it all that I rarely get the chance to use those skills and make myself feel worthwhile again. I feel like I’m just barely getting by and still staying late charting.

The part that really gets me is realizing that just as I’m getting comfortable with everything it will be time to go through it all again!

And yet, through these challenging days, I’m still learning, and I am seeing small improvements. Outside of the job arena, I get to spend my days off hiking by natural mineral springs in the middle of the desert

Yep, this is quite the life
Yep, this is quite the life

OR watching my husband rock out with his friend’s band (check it out here)!

Even with rough assignments, when I feel like I’m not the level of nurse I want to be, I still love taking care of kids, mainly because of stuff like this: