Nurse's Notes--Should I Become A Nurse?

"I want you to--tell mama. All about it. And I'll make everything all right..." ~as sung by Etta James "Tell Mama"

We are less than one month into the new year, and already our newest team member, "the swear jar," is getting no respect. Filled to the brim with coins, dollars, and even a 5-dollar bill, (don't ask), the nurses have reneged on their promise to clean up the language. As a team, the swear jar has become the price they pay for being themselves--a toll if you will, that grants them permission to speak in ways that would make sailors blush.

"Ok, guys," I start, "Don't steal my idea, but if we change this to a pimp-slap jar, you can put me on auto-payroll deduction."

Laughter ensues.

"No, no. I'm serious. Hear me out. I think a pimp-slap should cost 20 dollars. And I truly believe 4 to 10 pimp-slaps to the right people per week would completely redeem the entire week. But there should be a cap on it. I'd go broke on pimp-slaps."

"Send administration an email, Shannon," the charge nurse responded after her giggling ended with her giving serious thought to my proposal.

I am a pre-recession nurse, but the economy has brought unprecedented interest in health-care careers. Nursing used to be the career almost no one wanted, ESPECIALLY after actually being hired and seeing what working as a nurse really means. In fact, when the job of "nursing" was first a thing, it was considered so menial and so degrading that it was done by prostitutes. Taking care of sick people was the punishment for the crime of selling sex, that's really what I just said. When I became a nurse, I received a sign-on bonus, and first year of completion bonus, and now the job-market for the same profession is saturated. It has somehow gone from the job most people never wanted to do, to a coveted career choice. I came home from work one day last week and looked at myself in the mirror. I looked exactly like one of the pirates of the Caribbean, minus the facial hair. I asked myself, "why the heck do I do this job?" Are you in between careers, or thumbing through college catalogues asking yourself, "should I become a nurse?"

My own experience: When someone asks me, "why did you become a nurse?" I almost always start stuttering. I usually want to say that an angel visited me at twilight and annointed me with 'the calling.' But in actuality, I was annointed by poverty. I liked the romantic idea of being a starving artist, but I have an extreme aversion to starvation. I had many dreams as a 19-year-old and still do. But even I, the reigning queen of denial, couldn't help but notice that I'd never seen any "Liberal Arts Enthusiast" or "English Literature Professor" jobs on Monster. I was a waitress in college, and completely happy to be one when I got the calling. Left to my own devices waitress/student/artist seemed like a perfectly sound plan for the rest of my life. My dad did not agree with this plan. He let's call it encouraged me to find a more reliable source of income. Though I'd argued that HE was my reliable source of income, he wanted me to able to fend for myself. A sign-on bonus I'd read in the paper, coupled with a bubble-headed girl I was acquainted with chatting about signing up for microbiology piqued my interest. I dug around. Science and logic contradicted everything I held dear--fantasy, unrealistic goals, impossible dreams--it was a very difficult time for me. But--sigh--I did know a lot of sick people, I've always been strong, and even though I didn't believe I was smart enough at the time, if a bubble-head could sign up for microbiology, I could probably do the same. With these facts I had the A-train momentum of--why not? Nursing could be my meantime job until "unrealistic dreamer" jobs posted online. I was all set.

I found the didactic of nursing to be demanding, but manageable. Nursing school is fast-paced, which is almost essential to those who learn the way I do. I hadn't expected to like what I was learning, especially since it was such a different direction than my previous studies. Having always been a groupie of truth in any form, I liked getting the facts about the body as best we understood them. I liked figuring out the problem.

Clinically, nursing was an entirely different animal. I was never much of a GPA tracker. I didn't mind not getting a 100 percent on a test, an unusual quality in a nursing student. I did, however, want to get 100 percent in taking care of patients--a vague distinction with no actual grade. An A+ clinically for me, at the time, and until this day, meant listening to the patients, careful work, detecting subtle changes, and assuring the person I would help them get better if there was anything I could do to make that happen. It did not mean having all the answers, especially as a student, but it did mean knowing where to find the best available answers. I still practice nursing exactly this way, eight years later.

What is Nursing? Nursing is real life on methamphetamine. I used to believe that I was already getting a hefty dose of real-life when I was working as a waitress--with all the single moms, the recovering drug addicts, the not-so-recovering addicts, the ex-convicts on the dish-line, the propositions to increase my pay working as an exotic dancer, as well as the fact that it took me so long to say 'no' to said propositions. Becoming a nurse made that look like going to church. I started nursing as a slightly naive small-town girl. One of my first patients in the ER was an older woman who asked me, "shouldn't you be skipping rope?" Today, I'd likely to tell her that if I brought a rope to work, I surely wouldn't use it to skip.

I am a nurse. I have no good boundaries. I believe your body belongs to me, that's just how I roll. If you're in my company for more than 2 minutes I WILL assess your veins. Nothing personal, I just need to know that I can get a line in you at a moment's notice, and then I can relax. You'll tell me at some point in our relationship that "you're not feeling well," and then you will confuse me for an agent of the Federal Bureau of Investigations due to the line of questions I've got coming for you next. You'll say you have a headache, and I will start my assessment at brain anuerysm and work my way down from there. Again, nothing personal. You'll tell me that you haven't seen a doctor for a significant symptom you've had for a while....and I WILL judge you. You will tell me that think you might have an STD, and I won't.

Being a person that's honest to a disadvantage, I have been stunned by the amount of lying I've witnessed. Some of it has been very amusing once the dust settled. In one hospital I worked in, a patient had a friend who'd read a doctor's name tag and subsequently used that name to call revised doctors' orders to a new nurse on our unit for her friend, our patient. Our patient was morbidly obese, and despite the original order for her not to be fed for exploratory surgery for her own safety, she wanted a cheeseburger and morphine. She pulled it off, and those orders stood for a full shift before this FELONY had been uncovered. Liars annoy me, but even I had to slightly admire the evil ingenuity of what she'd done for a cheeseburger.

WE being us, took this in a stride. The nurses on my team at the time got shirts that said, "Trust Me I'm A Doctor" with Dr. Seuss on them, and the name of the doctor whose name was fraudulently used for patient care orders embroidered where a name tag would be. If you become a nurse, and you have no sense of humor, you will grow one, or change careers. Management might be a better fit, for instance.

I am a nurse. I have held hands, I have held legs, I have held my tongue. I have stood up for patients, I have stood up for other nurses, and I have stood up for myself. I have sat down and cried. I have zipped body bags--big and small. I have secrets. My coffin, or one of those creepy jars my mom has picked out for my entire family (don't ask), will not close easily for the amount of secrets that will go with me there. My day ends, and my neck hurts, or my feet hurt, or my brain hurts.

Why the Heck Do I do this job?:

"It's just plain tacky. Seriously," one of the nurses said this without disguising her disgust with the very idea.

The talk was heated, and the issue on the table was not a small one. We were all planning to attend the funeral of one of our own, one of of our best, Kathy, who'd lost her long and brutal battle with lymphoma. The topic dividing us as a team at this moment was whether or not to wear scrubs to the service to honor Kathy, or to wear normal attire. We had to do this as a team or not at all. We were divided pretty evenly on this one, with half of us believing this to be a tribute, and the other half believing it to be tacky and self-indulgent.

"We're calling attention to ourselves if we do that. I'm NOT going in to a church in scrubs. Won't happen," another nurse weighed in.

"I think it's Joe's call," was my contribution. Joe was Kathy's husband. He is also a nurse, and he would know what she would want.

"I'm gonna call her Dad," Ana offered, she being Kathy's best friend had already voted that we wear scrubs.

Ana returned later with the report that Kathy's choked up father had said that he would consider it a personal favor if we did. And with that we were all on the same page. For once.

And wear scrubs we did. We filled up the first few rows of the guest side of her church wearing our scrubs, and not fighting the tears. We watched her life and legacy on a big screen. The pictures we watched told the story of a caring, hard-working nurse, wife, and mother. We laughed at her bedazzled oxygen mask, and the picture of her twirling in her bone-marrow transplant gown. It was orange. I looked over in admiration and pride as nurses who took care of her in a few different hospitals stood up to make comments about how wonderful she was. Those nurses commuted as far as 90 minutes for her funeral. It was truly amazing. I laughed as Ana told all the attendees about how worried Kathy was that we might not come to her funeral for how annoying she was being while she was doing our chart audits when she could no longer do direct patient care. Patients she'd had showed up to pay their respects. We all cried a lot.

I do this job for the woman who comes in every month on the day her child was born to drop off a thank you gift for helping her have a baby after 10 years of fertility treatments. I do this job for the patient that looked up from her travel magazines right before she died and told me that I would go on to do something great. I explained to her that I was already doing something great. I do this job for the unforgettable three-year-old boy I met who made Leukemia look easy. I do this job because no matter how tired I am at the end of the day, I've done something meaningful before I go to sleep. So, should you become a nurse? In short, I'd say yes. But I'm biased.

LVN or LPN: Licensed Vocational Nurse, Licensed Practical Nurse Diploma or Associates Degree

RN: Registered Nursing Diploma, ADN (Associates Degree Nurse) BSN Bachelor's of Science in Nursing

RNC: A registered nurse with certification of expertise in a specific medical specialty I.E. Obstetrics, Neonatal, Maternal Newborn

Advanced Practice in Nursing:

NP: Nurse Practitioner. Scope of practices ranges in different states. NP's choose a specialty, i.e. community health, women's health, pediatric etc. Master's Degree and certification

CNM: Certified Nurse Midwife. May do low-risk deliveries, home deliveries, and routine women's health screenings in most states. Master's Degree and certification.

CRNA: Certified Registered Nurse Anesthetist. Provides surgical anesthesia, central lines, maintains airway, or provides airway when needed in CPR. Different scope of practice state-to-state, may function with minimal or direct supervision from an anesthesiologist. Usually independent or minimal supervision. Master's Degree and certification. Very intense post-baccalaureate program

*Options in Nursing also include teaching, administration, business management, and Information technology. Entrepreneurial opportunities abound in nursing. I have friends who own schools, laser hair removal facilities, lactation consultation centers, and nurses in my area have started and own hospitals.