Monday, June 9, 2008

Nurses Who Love Their Jobs.

I talked to two nurses who love their jobs today. You know how great that is when you hear stories about somebody who genuinely loves what they do? Of course you do.

Laura is an ER nurse who happened to float to the unit today. She's a vivacious (no really, that's the word) brunette, a little shorter than me, bright brown eyes. Very cute, roughly my age. She doesn't mind these messy ICU train wreck patients, and she can obviously handle them. But what she loves best is "keeping as many balls in the air as I can at one time." That's her talent and her love: juggling this that and the other thing and taking care of lots of different people with unexpected medical problems. She talked with enthusiasm about managing chaos. That's what she takes pride in....the ability to think fast, think on her feet and to react quickly to things.

And it makes her happy. How cool is that?

Sariah is a nurse who was finishing up hemodialysis on one of my patients when I came on shift. Sariah has coffee brown eyes, and she wears a modest scarf to cover her head. Her manner is always calm and soothing, unhurried. She loves to teach...anytime I've asked her a question about the workings of the dialysis machines, she's been wonderful about stopping and thoroughly explaining things to me. Now, I've been sending out feelers for other additional job opportunities, so I thought I'd ask her about what she does. I love CRRT...maybe I would like doing dialysis on an occasional basis. She really perked up when I asked.

She's been doing dialysis for over 30 years, she said, having started in general ICU. What she loves is knowing pathophysiology deeply and understanding that when she assesses a patient pre-treatment and finds a K+ of 9.0, she watches the change in the T wave on the EKG lead as she treats the patient, watches it improve as the dialyzer filters. She listens to the patient's lungs after she begins treatment and hears improvement, sees their breathing become easier, more relaxed. Dialysis is easy, she says! You should apply! It's wonderful to be involved in watching a patient improve, and so many of them recover so well after transplantation. She just glowed and it was obvious the great joy she gets from directly helping patients get better.

That was just so. Awesome.

And you know what? I'm having a great night. It totally set my night. Because I gotta tell ya...I LOVE ICU. I love sick as snot patients, people that have complex crisis needs. There's not a patient I take care of that isn't in the midst of a big turning point in their lives. They're not only sick but afraid, and in the midst of hard decisions. I love that I need to understand extreme pathophysiology: not that I don't have volumes to learn, I most definitely do. But I know that the body is likely to break in a handful of ways, and I know how to start getting a handle on those things emergently. There's always ways for me to learn more deeply. The deeper I learn, the better care I can provide for my patient clinically, and the better help, reassurance and knowledgeable resource I can be for families.

Laura was telling me that I'm a "good ICU nurse" because I'm "obviously a control freak". I was telling her that I love doing CRRT, really enjoy tweaking this drip to change the central venous presure here, futzing with the dialysis rate to improve this lab here, focusing on ONE patient at a time, and understanding that patient comprehensively and completely. Knowing their history, understanding the messiest of pathophys. Love it.

I'm good in a crisis situation, too....last night both of my patients had severe respiratory decompensation within the first hour of my arrival: one got reintubated, the other CPAP. I can do that. But unlike the ER, I don't want to leave those patients after the initial crisis is past. I'm happy talking to the family members about what happened, how their loved one is, what to do now, how recovery will look.

It's silly, but I'm a clean freak, too, and I do like doin that nursey stuff and giving baths and providing that fluffy comfort too. Don't ask me to do it for seven patients in a night...(screw that), but for people THIS sick, THIS fragile and suffering THIS much... Years ago, I was in a car accident and I got a free trip in an ambulance. One thing I remember is that hours later, my parents had seen me, a few friends had seen me...and my then-roommate Kelly arrived late that night. She said, "You look like shit, man." And she wiped the blood off my face. Nobody'd even told me I had blood all over my face. I'll always remember that stupid kindness of wiping the blood off my face. That stupid kindness of You Look Like Shit Man.

I know now all about prioritizing: airway, breathing, circulation is what I do. The most important things I do. But when my patients are stabilized, none of them ever have blood on their faces or anywhere else.

(Don't tell anybody. I don't think that fussy stuff is fashionable among professional nurses anymore.) (Doesn't mean I don't love looking up new drugs I don't know to learn the pharmacological effects on blood pH and other neato stuff.)


I love my job, too.

Cool, huh? I hope you love your job, too, some days. Pass it on if you do.


NNR said...

I like my patients clean, and I'm kind of poked fun at because of it. As a general baseline, I want my patients (a) breathing, (b) not falling, and (c) clean. It is a peeve of mine to walk in a dark, cluttered room and smell dirty laundry and B.O. How can a person get better in such an environment? I know it's all Florence Nightengale, but I firmly believe that hygiene is important!

Kat said...

I am in my 10th month of working in ICU, just out of nursing school. Its really hard. I work in a crazy-busy >40 bed ICU on the west coast and so far I know that the things I love most are 1) working through the patho "puzzle" 2) making my patients and families as comfortable as possible--although that sometimes backfires with the blood pressure gods...3)focusing on one patient (as in, one-to-ones). I come originally from a business background and ironically, I still have a long way to go on my time management skills and the whole "expedient ball-juggling" thing. Many times I get very frustrated, anxious and very discouraged. A lot of times I find myself still stuck in the "get it done" phase, and I get to savor the whole puzzle only when I get home. Luckily I work with a great team that likes to teach and is very patient with me. I may not stay in Adult critical care, but the learning experience has been great. Its nice to hear about people who love what they do...(you give me hope!)...thanks for sharing.

audrey said...

I just found your blog and love it! I actually linked it on mine. I work in a nursing home as an aide and it's tough. I don't love my job, like parts of it, and I can tell you for certain my future is NOT in geriatrics. Your post definately made me sit and think!

RehabNurse said...


You can really tell you're a former rehab gotta love the whole patient, including getting the dirt off him/her.

I may never make it to the ICU, but I'd be happy to have someone like you as my nurse. If you're stable and the nurse can do it, you should be clean, too. No questions asked...clean skin, clean linens, whatever clean stuff it takes.

There is enough cr*p hanging out in hospitals, we certainly don't need to provide it a place to live on dirty patients.

Those people who are too dignified or degreed to clean need to find another job in my book! My people are not dirty if I can help it...they can refuse, but I'm gonna keep asking. Sometimes they just want to say no.

Everyone's got the right to change their minds.

Trauma Diva said...

Yeah, it is nice when you kind find some RNs who aren't completely burnt out. I know, I have been there too. When burned out in the ED, rotate off and come back!

I enjoy your blog, would you mind posting a link to my little world?


overactive-imagination said...

It's so awesome that you (and the other two nurses) love your job so much. I think alot of nurses (sadly) get caught up in the "I'm at work, let's get it over with" that they don't take the time to really enjoy their job.
I graduate in 28 days and have been extremely fortunate that the pediatric ER fell in love with me and has taken me under their wing. Like one of the nurses you mentioned, I thrive in chaos and am at my best when pushed to my limits so I enjoy the ER environment.
I've had good days, bad days and downright boring days during my clinicals...none that I hated but also none that I loved until I got to the ER setting (adult and child). I ended up spending so much time in the Peds ER that they requested me to do my preceptorship there (which I am doing now) and I absolutely LOVE it.
From a students point of view, I think it's very important as nurses to find somewhere we are happy and enjoy what we do and not just somewhere to get through the next 12 hours.
Now I can't imagine working anywhere other than the ER.
Great post! One that I am SO happy to read because I cannot not tell you how many nurses in the last 2 years of my training who have told me how much they hate their jobs and many who have actually told me that "it's not too late to change my mind" (about becoming a nurse)
I didn't intend this to turn into a novel but Thank You!!!

Lisa said...

This post is exactly what I needed to read! I have been feeling a little, okay alot, apathetic lately. But my past 2 days at work has started the fire again. I do love what I do but some days I just am too tired to remember that. Thanks for a great post that I feel I could have written but haven't had the energy to!

Tex said...

Just found you.

I love my job, too.
I hate nurses that complain about their job.
Don't love it? Leave it!
Besides, I'd never want a nurse to care for me or a family member if they didn't enjoy their profession.

Phil Baumann said...

This post should have a Digg button. I think a lot of Diggers would love this post.

I'll be returning to the ICU in a few weeks. Your post re-freshed my interest in critical care.

Nursing can be rough, under-appreciated work, so I'm glad to hear stories about happy nurses.

Cool post! Thanks.

Anonymous said...

I hate nurses with a passion! They are such perverts! My God, I can't believe they get away with all the perverted things they do. I truly wish they would all die! I'm serious!

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