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.

IMG_20160403_130312

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

IMG_20160301_142855593

  • 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

IMG_20160315_144257245

IMG_20160406_113813125_HDR

  • 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.

Into the West…

Obviously time has flown by in the great state of Colorado. Jason and I finally made it up to the mountains again! I mentioned how disappointed I was about not getting extended at Colorado Children’s, but what I didn’t reveal (because I wanted to build some suspense) was that the very same day I learned my contract would not be extended, I received my official California Nursing License in the mail. Call it Fate, God or Chance, but that’s a coincidence that cannot be ignored.

A sign

Getting your California Nursing License takes FOREVER. Of course you have to forward your transcripts, but you also have to get fingerprints done on their approved fingerprint cards using their approved abbreviations for eye and hair color. Apparently, BRN and BRO do not mean the same thing in California.

Okay, California, just get over yourself...
Okay, California, just get over yourself…

You have to go through a website that verifies your current nursing license and pay for that verification, along with the processing of the application, and the processing of your fingerprints and background check. Well, suffice to say that, along with everything else in California, it’s expensive. But here is the kicker- the majority of travel nurse needs are there. California is a gold mine for nursing, and there is almost always a need for a pediatric hem/onc nurse, not to mention it has some great children’s hospitals.

I started the process of getting my license back in April of 2015 and completed it in late July. I really didn’t expect to get my license until April of 2016-that is how slow moving the process is. So imagine my surprise when, downtrodden and depressed, I open my mail to find my California nursing license, and the adventure bug strikes again! I immediately forwarded a picture of my license to my recruiter, Aaron, with an overabundance of exclamation points and, as only an amazing recruiter–sorry, agent–can do, he delivered a great job opportunity.

I have heard from both travel nurses and regular hires that Lucile Packard is a wonderful place to work. So, when an opportunity arose to work on their Hem/Onc unit, I jumped at the chance! It also doesn’t hurt that Palo Alto is about 45 minutes away from San Francisco. But as Jason and I prepare for yet another epic trek across the western states, I’ve had some time to reflect on what makes this experience both awesome and difficult.

 

Moving every three months makes you really think about the difference between “want” and “need.” Jason and I both harbour a few packrat mentalities and we come by it honestly. But when you’re moving every three months, and everything needs to fit inside a Ford Fiesta, you get a bit unsentimental. Have you ever done a really thorough spring cleaning? You know that cathartic feeling you get by just getting rid of all that extra crap you don’t need and giving it to someone who does? We get to experience that every three months. It’s pretty rad.

You're welcome, Macklemore...
You’re welcome, Macklemore…

Starting over new every few months has really stretched me professionally. Not just skills-wise but learning the nuances of different policies and procedures. You’d probably think that administering chemotherapy to children is pretty standardized, and in general, things are pretty much the same across the board, but different hospitals actually function quite differently in the details. So I’m learning. A LOT. But the best part is the way that this has stretched me by helping me not sweat the petty stuff. You certainly want to fit in and make friends quickly when you’re starting out, but I’ve noticed that I don’t worry myself with any of the usual workplace drama. In fact, I would argue that three months is the perfect amount of time, because right as you start to get a feel for the workplace drama, you leave.

Having the knowledge that you’re leaving in a few months is so empowering. It’s so much easier to write off a bad day as just that and to move on- for those that know me well, this is a HUGE deal! I don’t let go very easily but since I started traveling, letting go is getting easier. 

batman

That being said, what is NOT easy is letting go of patients. When I hear about patients that I cared for at Duke that pass away, I don’t have my coworkers to help me through. There were so many times (too many times, truth be told) when we would grieve together, sharing funny stories and raising a glass to a patient’s memory. In short, we supported each other through the loss of someone we grew to love when we couldn’t claim the same status as family or friends. When you are on your own, and far enough away that you cannot attend the memorials, you are simply left with an ache in your heart and a profound sense of loneliness in your grief. Sharing memories of these kids with those around you just makes people sad, because they didn’t know them. All they see is the loss of a young child or teenager, which is never an easy thing to stomach. It’s not the best description, but it’s the closest I can come to how I’ve felt as I’ve watched from afar while two patients that I cared for and loved very much were taken from this world. As supportive as Jason is through all of this, there is no way for him to fully relate to how I’m feeling. I have to face the fact that letting go of my patients will never, ever get easier. I sincerely hope it never does.

The other side of letting go of patients is about saying goodbye to the patients and coworkers that I connect with during my three months at each new spot. Let’s face it, there are some people you just instantly hit it off with and patients are no exception. So far, it’s been usually one or two patients that I connect with, and then have to say goodbye to at the end. One of my biggest regrets in Phoenix was not saying goodbye to my favorite patient. I said goodbye to his parents, but I never said goodbye to him. He was young enough that it would have been hard, but old enough that he deserved to know that he probably would never see me again. I think in a lot of ways I was trying to protect myself. Leaving Phoenix Children’s was already hard (just read my tribute here) and I felt like making a big thing out of it with this patient would have made it harder on my heart than I could handle. However, I found the same thing happened here in Colorado. I know that it is going to be hard to say goodbye, even though they know what’s coming (patient included, this time). But, as I said before, this is a part of my job that I don’t want to get easier. I never want to lose that desire to connect with patients and families, even if it makes the goodbye part harder.

So, as I sit here on my throne of cushions, with my laptop propped on a tupperware bin full of kitchen stuff, I am thankful. I’m thankful for the time we’ve had here. I’m thankful for the friends and family that we have been so lucky to spend our free days with. I’m thankful for the patients and coworkers that I have had the chance to get to know. But I’m also thankful for this next step- I’m thankful that I have my California license in my hand and the love of my life at my side. Now it’s time for a 19 hour drive with two cats. 

Let's do this
Preach it, Liz!

Happy New Year to all and to all a good night!

My sister and her husband made a bet over whether or not Jason and I would actually leave Colorado after I started this contract. I’ll admit, it was a fair assumption that we wouldn’t want to leave. However, I’ve realized that part of the reason I haven’t written a blog post in some time is that I’ve been trying to think of a way to express my feelings without seeming ungrateful or just plain pessimistic. There are some realities about living in Colorado that I enjoy immensely and some that I didn’t expect. For those who don’t want to waste their time with trudging through my pretentious monologue about first world problems, I included pictures to sum it up. 

You're welcome
You’re welcome

 

Let’s start with finding an apartment. We tried AirBnB (which is what we did in Phoenix), thinking that it would be a lot easier to just find a furnished place in Denver rather than haul our stuff up to an apartment from our “storage unit” in my parents basement. This proved harder than we initially thought. Apparently, finding a place to live anywhere near Denver is hard and overpriced.

We almost found a place near downtown but this woman was charging a pretty hefty price for an “apartment” that was more like a room in a boarding house. When we tried haggling with her, she acted personally affronted that we would even suggest such a thing!

What I expected:

They had the best apartment!!
They had the best apartment!!

What actually happened:

Awwww snap...
Awwww snap…

In the end, thanks to our friend Jen, we found a great apartment close to the hospital that I could either bike or take the bus to work. My in-laws generously let us use their guest bedroom furniture so we didn’t have to rent it, and we just hauled a bunch of our kitchen stuff up from my parents’ place. Really, Colorado was the best location for us to have problems with finding housing. I mean, it’s not like we have a shortage of people we know here. But still, that lady was kind of a jerk.

I guess we dodged a bullet there...
I guess we dodged a bullet there…

 

Being back in Colorado means MOUNTAINS and I have been so happy to see them on the horizon, but once we started approaching Thanksgiving, spending time in the mountains was quickly replaced by spending time wistfully looking at the mountains and wishing I were spending more time there. What we really spent a lot of time dong on our weekends was driving. Usually to Colorado Springs….but at least the mountains were closer to look at there.

What I expected:

Sound of Music

What actually happened:

You speak truth, Bob Ross
You speak truth, Bob Ross

I was also disappointed to find that I didn’t love the job at Colorado Childrens. Please don’t misinterpret- everyone is welcoming, I still love what I do, and I feel very appreciated. But I started travel nursing to really challenge myself and expand my skills. Initially, this job did just that. I learned a lot about how different hospitals treat different types of cancer, sedation recovery, and how sickle cell is managed for patients at altitude. Then, something totally unexpected  happened….I got bored. I thought for sure I would love being back in an outpatient setting and feel more in my element, but I surprised even myself when I started watching the clock day by day. Granted, the flow is completely unpredictable in a way that it rarely is in the inpatient world. Some days I start by watching the clock and finish my day running around like a crazy person, but I couldn’t believe how slow some days went and how much I missed having an extra day off during the week. Working four days a week is HARD! I think Phoenix Children’s may have converted me to an inpatient nurse!

What I expected:

Boom! Let's do this...
Boom! Let’s do this…

What actually happened:

Oh my gerd it's only noon???
Oh my geeerrrddd it’s only noon???

I was super excited to be living so close to our families during the holidays, but what I didn’t expect was the amount of time we would be spending every weekend (and sometimes weekdays) at a family function. I always get a little stressed out during the holidays. Since our families live so close to one another, it’s important to me that our time is equally split. In the past, this stress is usually concentrated over 1-2 weeks. It never occurred to me that this stress would start at Thanksgiving and extend into Christmas. It also never occurred to me that the effects of it might turn me into Scrooge. Me. Buddy the Elf.

What I expected:

Buddy

What actually happened:

HUMBUG!!
HUMBUG!!

Let me perfectly clear- I don’t want it to seem like our families put any kind of pressure on us. I take full responsibility for stressing myself out. They were just excited that we were here, and we certainly didn’t want to say no to the opportunity to hang out with them. After all, we were finally close enough to visit every weekend!!  So that is what we did. From Thanksgiving to Christmas. Every weekend. 

So much driving
So much driving

I did try to extend my contract here at Colorado Children’s. I wanted to extend because I thought we could use another month to see if things settled into a normal routine after the holidays. I honestly can’t pinpoint exactly when I started to get bored in my job, but I do suspect that it happened right around the time I found out my they couldn’t extend me. Not getting my contract extended kind of threw me for a loop. It was hard for me to extract my feelings about my job performance from the fact that they simply did not need another traveler past the end of my contract.  I felt as though I was doing a good job and I wanted to believe that this would influence their decision. The reality is that hiring a travel nurse is expensive, and there is no point in keeping me if I’m not needed. The people that work there have been there for a while with no plans of leaving any time soon. The nurses that are on maternity leave will be coming back to work by the time my contract is up. Really, it’s a testament to the unit that everyone stays there as long as they do. 
I would be lying if I said I wasn’t disappointed. For all the stress of the holidays, we have really enjoyed living in Colorado. We just wanted more time to do all the things and see everyone. But…if there is anything I’ve learned this year is that all things must change in some way, shape or form. It’s time for us to move on to the next exciting location (more on that later)! As much as I wanted to do Christmas cards this year, I thought it more appropriate to do a picture montage of all the exciting changes we experienced and adventures we had in 2015. Interestingly enough, I found my feelings of gratitude, joy and love to be more profound during the New Year holiday than any other this season. Thank you to all who have been a part of this exciting year!

 

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!

 

On the road again…and other great road trip songs

We are heading back to North Carolina for the weekend!!

**Commence crazy, ecstatic dancing**
**Commence crazy, ecstatic dancing**

 

 

Our dear friend is getting married!! And in case you can’t tell, we are ecstatic- of course we’re excited for him, but really we just can’t wait to get back to Cackalacky country. Partially, our excitement stems from the multitude of delicious restaurants we plan on patronizing on our return (more on that later). Our true joy, however, will be visiting all the wonderful friends we have made out there.

Reunions are the best!!
Reunions are the best!!

 

But seriously, we know the coolest people in the Triangle area, just sayin’. Need proof? I’m glad you asked.

Flashback to May 2015. After eight years of calling North Carolina home, we have decided to hit the open road for adventure. We asked some of our friends to make mixed CDs for us to listen to (and drowned out the sound of Tobi’s incessant meowing) during our many road trips across the country. What resulted is a collection as varied and beautiful as our friendships. Some of them came with a track list, others without; one titled “The Fox and the Owl”; a few were a mystery and came in a plastic bag without the author’s name and titles like “Name That Musical” and “Happy” (we still haven’t figured out who made those ones); one was the audiobook for “The Guernsey Literary and Potato Peel Pie Society.”

 

Our journey, to make a very long story short, started at the end of May, when we loaded everything we could into our small Ford Fiesta and made a four day trek out to Colorado. We could have made the drive in two days, but it seemed cruel and unusual to expect our cats to hold their urine for longer than 9 hours.

amiright??
amiright??

We mainly stopped in small towns to keep the hotel rates low, which means we stopped in such tantalizing locations as Wytheville, VA, Evansville, IN and Salina, KS. The locations along the way were less important as we didn’t have a whole lot of freedom to explore with two cats and car full of crap. What proved more important was getting to our destination while still maintaining some shred of sanity. This proved true as well when, three weeks later, we hit the road for Phoenix. Our friends truly rose to the occasion- we had music and memories accompanying us all along the way. Here are some highlights:

 

Songs that made us dance

Minus the orange mocha frappuccino
Minus the orange mocha frappuccino

Jitterbug- George Michael

Busy Earnin’- Jungle

Footloose- Kenny Loggins

Came Out of A Lady- Rubblebucket

Pretty much anything by Michael Jackson

Ghostbusters Theme Song

Electric Love- Borns

No Diggity- Blackstreet

Take a Walk- Passion Pit

Happy- Pharrell Williams

Can’t Hold Us- Macklemore and Ryan Lewis

Stayin’ Alive- Beegees

 

Songs that made us…I mean me…cry

That's right, #uglycrying
That’s right, #uglycrying

Sister Winter- Sufjan Stevens

God Only Knows- Beach Boys

Eyze Sheleg! (What Snow)- performed by The Women’s Voices Chorus

Carolina In My Mind- James Taylor

Because I Knew You- Wicked Soundtrack

Sisters- performed by The Women’s Voices Chorus

How Far We’ve Come- Dawes

Fire and Rain- James Taylor

Lay It All Down On Me- Barefoot Movement

Stubborn Love- Lumineers

Juliette saved the day

While listening to The Guernsey Literary and Potato Peel Pie Society, we noticed something odd. For those of you who have not read the book, it is written in letter format, with each character writing letters to other characters so the story unfolds from many different viewpoints. Read aloud, with a different voice depicting each person, it paints a very vivid picture. We listened to the book on our trip to Phoenix and started to notice that whenever the main character, Juliette, spoke (Susan Duerden is the name of the actual reader), Tobi stopped meowing. This was a HUGE blessing, seeing as she had a considerable amount of speaking time. Something about the lilt of her lovely, British voice must have put Tobi at ease. We weren’t about the question the oddity of it all- not if it gave us reprieve from his relentless vocalization of displeasure.

Ohhh I get it, your unhappy??
Ohhh I get it, you’re unhappy

Through our first trek to my first assignment, we were left with such mixed emotions. We know so many amazing people in North Carolina and our sadness at leaving them was only matched by our gratefulness for their support. That is one of many reasons we are so thrilled to see them again! As the Avett Brothers put it so aptly…”Carolina, one day I’ll, Someday I’ll come home…” (and for the record, what they say about Salina in that song is completely true).

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:

 

And so it begins…

Phoenix, Arizona. Land of ten thousand suns. Land of blistering, unyielding heat. Home to scorpions, tarantulas, rattlesnakes and all manner of creatures that thrive at ungodly temperatures. At least, that’s what I imagined. I intended to start the blogging process sooner, to discuss the path that lead to travel and, ultimately, Phoenix, but seeing as I failed to do so, I’ll have to do this Tarantino style. Here is what we have learned about Phoenix in 24 hours:

1) There isn’t a big difference between a hot day here and a hot day in North Carolina. Both locations boast a sweltering midday summer heat that sends you running and crying for the next air conditioned facility. In both locations, Tobi insists on going outside to explore and doesn’t seem the least bit hindered by the ridiculous temperature. I also still consider anyone exercising outside midday to be insane in both locations, and yet I see people doing it all the time.

Running was a bad choice
Running was a bad choice

2) Phoenicians are proud of their city. No joke, we already have a laundry list of things to do in Phoenix from both the bartender at the Mejicos (no joke, that is really how it is spelled) and the lady at the membership counter of CostCo. From tubing down the Salt River to microbrews at Ohso’s to First Fridays (!! like Raleigh!!)- I was struggling just to write it all down so I wouldn’t forget.

Slow down, Professor!
Slow down, Professor!

3) They take their tequila VERY seriously. Upon entering CostCo, we saw a large display of various types of tequila, most of it 100% Agave, much of it higher end. Chris, the bartender at Mejicos, concocted our margaritas from tequila, agave nectar and freshly squeezed lime juice. Perfection. He even told me where to find the best agave nectar for mixing margaritas. Chris is a pretty stand up guy.

Give or take the cuantro
Give or take the cuantro

4) Phoenix gets rain in the summer! I am aware of the monsoon season, but I didn’t expect a drop of moisture until then. A pleasant surprise to get caught in a sprinkle of rain on our walk back from the coffee shop. It was too small to be called a shower, but the smell? Incredible. All this in the same day as a haboob. Seriously, I just got a warning on my phone to avoid travel until 8pm. Don’t worry, Weather.com. I won’t be leaving my air conditioned apartment unless forced to do so.

Yep, that looks like a big old pile of nope. Not going outside.
Yep, that looks like a big old pile of nope. Not going outside.

5) I miss North Carolina and all the people in it terribly. Initially, our move out to Colorado just felt like vacation, and the finality of leaving North Carolina didn’t truly set in until we arrived in Phoenix. Since then, my heart literally aches for my dear friends and coworkers back in NC. But in remembering all these wonderful people we know, it has also sparked excitement at the new friendships on the horizon. Probably with Chris.

Truth
Truth