The Grass Is Always Greener…

About four-and-a-half years ago now, I nervously sat on the smooth, gray bench seat. The smell of Cavi-wipes and plastic saturated the stuffy air. Our pediatric patient slept comfortably in his car seat while Mom dabbed tears away with a washcloth my preceptor had fished out of our linen cabinet. He consoled her throughout this 90-minute trip, reassuring her that all would be well. And I sat there, almost too stunned and nervous to speak. My brain was a mash of nervousness, empathy, and excitement. I was finally riding along on my very first ambulance ride—and I was hooked.

Not too long ago, I sprawled out on that smooth, gray bench seat. The air hung heavy with the metallic smell of blood. The patient was forced into a dreamless sleep with medications, and I wondered if he would ever wake up. Having nothing else left to do on this 90-minute ride, I dabbed a moistened washcloth at the dried blood and vomit at the corners of his mouth. The paramedic and I chatted quietly, discussing the patient’s health, vital signs, medication dosing, ventilator settings…and what places might be open for a quick bite at this hour. My mind buzzed with hunger, fatigue, and a curiosity about our unfortunate patient. I didn’t realize it at the moment, but I was on my last call as a full-fledged member of this department.

I found myself in the backs of those trucks. I knew so little then…about medicine, about my future, about life, about myself. I worked alongside some of the most incredible firefighters, EMT’s, paramedics, and human beings. I made some amazing friends. Sure, I’ve cried, considered throwing in the towel, and been angry with coworkers, with this department, with this profession. But I always came back for more. I truly felt at home in that brick building, in that red truck. Those people I worked with? Broke bread with, laughed with, argued with, cried with, goofed off with, learned with, grew with? They’re my family. God, or whatever is out there, did not see fit to provide me with any biological male siblings. But I was blessed with 40 brothers, and I wouldn’t trade that for anything.

And yet…it feels like I am.

Within the past month or so, I have accepted a position as an ER nurse. The job hunt for new grad nurses is excruciating in my corner of the world. To be offered any job—especially an ER job—was completely mind-blowing. So, even though it was far away from home, I had to take it. I packed up my few belongings and moved out of my parents’ house for the first time. I found myself in an apartment in the heart of a small town in a different state. I know nothing and nobody for an hour in any direction. I work a full-time job, with a bigger paycheck that has chunks removed from it for important and adult sounding things like “403b.” I wear scrubs in styles and colors of my choosing, and I don’t have to put on those God awful white clogs anymore.

But my new rotating schedule forbids me to work my regular nights in that ambulance that I grew up in. It is getting harder and harder for me to justify spending so much time and money to drive all the way back home to work on an ambulance for a day, and then drive all the way back to my apartment.

“We knew this day was coming,” A lieutenant told me. “Why don’t we bump you down to per diem status?”

And it was in that statement that I realized that no, I can’t have it all. I am slowly being peeled away from the department and field I loved so much. Going to per diem status may not seem like much. But it means giving up my regular schedule. It means giving up my time with those people I love, doing what I love.

Suddenly, I find myself asking, “Is this really what you want to do?” The decision is somewhat already made for me…I am an ER nurse now. I live in another state. I have been doggedly pursuing this for years. I worked so hard for this. Yet I find myself missing the confidence of being in a truck. I miss the synchronization of working with a good partner. I miss EMS, and the home and family that taught me so much.

“We really are a family,” The weathered nurses tell me at the nurses’ station. I smile and nod while my heart breaks a little. They very well may be a family…but my EMS family is going to be pretty hard to compete with.

November

Physically, the drive to Major Medical Center is a little easier when driving a car instead of an ambulance. There’s not nearly as much surface area for the wind to toss the vehicle around when I’m cruising down mountain roads in my car. The drive goes by a little faster when listening to loud music in the confines of my personal vehicle. Emotionally, however, this drive is a completely different story.

In the ambulance, I have protection. Occasionally, old memories start to stir in the back of my mind. But they’re easily buried beneath the more intense focus I have when driving this large vehicle. I can hide in the professionalism I put on with my uniform. I can drown it out when chatting with my partner. But in the car? I have none of those luxuries. It’s just me, the radio, and this long drive that does nothing but dig up old memories.

A year ago, almost to the day, I was making this same journey in this same small vehicle. The same jagged lines of mountains and valleys lay just beyond the metal guard rail. The same bare trees stood in the piles of dead, reddened leaves. The same enormous building sprawled out before me, patient windows glittering in the afternoon sun. The same road wound past the ambulance entrance, where I’d parked my truck many times before, and continued down to visitor parking. And an eerily similar sense of dread settled into my stomach when I put the car in park.

A year ago, I made that drive knowing that, once at my destination, I would play a part in making that ultimate decision for my grandmother: comfort measures only, or aggressive medical and physical therapies. I felt fleeting emotions in a numb, hollow space in my chest: fear, sorrow, grief, strength, anger. It was an awful experience I wouldn’t forget. I just didn’t realize that a year later, I’d be making this same journey.

This time, I’m driving up to go see my father. It was supposed to be a relatively simple surgery for a relatively simple problem. Instead of this quick, easy procedure and recovery, we were met with complications and phone calls, sleepless nights and unknowns, running nurses and worried doctors. A week-and-a-half later, time and progress feels as though it’s standing still.

Something about November, Major Medical Center, and my family. I hope with all my heart that we don’t have to make the same decision this year.

Please keep him in your thoughts. Thank you.

I Guess We’ll Find Out

I’ve officially passed in my last final. The backseat of my car still has my duffel bag full of extra scrubs. A dozen or so textbooks and study guides are still sitting on the kitchen table. A few beat up notebooks full of lecture notes are still loaded into my backpack. My laptop is still loaded up with old PowerPoints. And my brain is still guilt-tripping me for indulging in fun things. But, slowly, it’s starting to dawn on me that the year has come to an end.

I’m still reflecting over everything that’s happened. Obviously, I’ve learned a lot about physiology and nursing care. But, as cliche as it may sound, I’ve learned so much about myself, and I’ve grown into a much stronger person.

At the beginning of the year, I found myself crying. Like, a lot. There were two main reasons for this: academic work, and social challenges.

For the most part, school has just been something I’ve been fairly good at. Some people can learn in a classroom, and others can’t. I could, and without too much difficulty. For the first time in my life, I’ve had to really really work at something academically. I couldn’t breeze into the lecture hall on exam day and crank out a decent test score. I spent hours upon hours of studying, hoping to get a grade that would somewhat reflect all the work I’d been putting in.

Like I’ve ranted about so many times before, many of the students were just plain mean. As a pretty sociable person, I’d always been able to make at least one friend wherever I was. But for much of that first semester, I was struggling to even find people to be friendly with. Nursing school was far more cutthroat than I’d anticipated. It ranged from petty name-calling, to blatant verbal attacks. I’m a pretty sensitive person…and suddenly, there was all of this stress and drama, and I had no one to lean on. Well…no one to lean on but myself. But I didn’t realize that at the time.

Many all-nighters, tears, and near-breakdowns later, and I find myself almost finished with this year. One day, right before lecture started up, a few students asked the professor about an assignment that they felt was being graded unfairly. I’ll spare you the boring details, but it basically boiled down to a discrepancy in the rubric. I attempted to help explain the confusion to the professor. As I was the last one who had spoken, the teacher looked directly at me, and, in front of a lecture hall full of students, said this:

“You know, it’s a nurse’s ability to look at the tiny details and draw conclusions. It sounds to me like you’re unable to do this. I don’t know, but I’m not sure how you’re going to make it in the real world without that skill.”

The entire classroom went silent. The professor probably felt attacked, which was totally unintentional. A few months earlier, I would have probably teared up right there, and bowed my head in an ashamed silence, panicked self-doubts running through my head. But, for some unquantifiable, unnameable reason, the past few months had built me into a stronger person. I’m not sure how or when it happened, but it all culminated in that moment. The moment when a crooked half-smile pushed onto my mouth, and I evenly said:

“I guess we’ll find out.”

Somehow, my skin had gotten thicker. My doubts, while still there, were quieter. The process by which this happened was painful. It was exhausting. It was draining. Worse, it wasn’t just that way for me, but for anyone who knew me. Anyone who I trusted enough to share the details of my crippling doubts. To many, I boldly declared that I wanted out of this school; this program that I worked so hard to get into. I came up with a thousand reasons why I didn’t belong, why I couldn’t do it, why I’d never be good enough. I lunged at these opportunities to work in another field, quickly polished them up, held them high and said, “No, this is what I really want to do. I’d much rather do this. I’m going to quit nursing school and do this instead.” But these confidants, they knew me better. They calmed me down. They smoothed out my ruffled feathers. They pulled me into their strong shoulders and let me cry. They listened to me rant about all the “mistreatments” I’d been “enduring,” and spew out self-pitying statements. And, they gave me some little thing to hold onto. They gave me a little push, a little spark, to keep me going just a little bit further. Just when I’d swear I was through and wouldn’t budge one more inch, they’d convince me to take one more baby step. Soon (probably not soon enough for them), I was taking these steps by myself. I’d tell a story or two about school when they asked, but not much more. I learned to rely on myself. I learned to motivate myself, believe in myself, and get through this on my own. And I can’t thank those people enough for what they’ve done. You know who you are.

To all of you who stayed with me throughout this crazy year, to all of you who posted an encouraging word, to all of you who liked or shared one of these posts, and to all of you who contacted me privately…thank you. You’ve helped me grow, strengthen, and change in ways I’m not sure I could ever truly explain. You guys are the best.

As I decompress over the next few days and start to soak in my newfound freedom, I’m sure I’ll come up with more self-examining posts. It’s been a hell of a ride so far, and I haven’t beaten this dead horse nearly enough.

So, again, thank you.

Finals Week

 

 

 

Chocolate

 

Why, yes, it IS finals week! How did you know?

This, incidentally, is just the junk food I have left over. I’m hardly even mildly ashamed of this. What can I say? I like to give all that stress-related cortisol something to work with.

Anyone, posts will be kind of spotty until I have officially survived my first year of nursing school. I know, spotty has been kind of my new norm lately, but I hope to change that soon. I’ve got plenty of things I’m looking forward to writing about.

Anyway, thanks for your continued support! Wish me luck! See you on the other side 🙂

Saving My Life

I need to hear that shrill tone. The one that pulls me from my day and thrusts me into that of another’s. The one that orders me into my little car, and sends me to the station. The one that sits me on the bench of the ambulance, soaking in the smell of plastics and chemical cleaners. The one that captivates my attention for an hour or two.

I need the illusion that I belong. That what I do matters. To justify my reason for being. I need the excuse to keep me here another day. I need the time to think about something other than whether I should stay or go. Other than if my mistakes of yesterday outweigh my possibilities of tomorrow.

I need to feel like I’m part of something bigger than just me. Bigger than the emotional storm clouding my thoughts, raging in my head and my heart. I need to be given a few hours where I can stop worrying about yesterday and tomorrow. Where the only thing that matters is right here in this moment. The only thing that matters is the person whose hand I’m holding; the life that I’m caring for.

I need that tone to go off. Just one more time. I just need one more day to figure this out. Just get me through today.

EMS is saving my life. Hopefully, one day, I’ll be able to say it’s saved my life.

Healing Is Not A Linear Process

I’ve learned plenty of things as an EMT. I’ve learned what the top and bottom numbers of a blood pressure mean. I’ve learned how to splint a fractured bone. I’ve learned the proper way to talk on the radio. I’ve learned how to start an intravenous line. I’ve learned that real life is nothing like the textbook. In the textbook, you see calm, cooperative patients, neatly packaged in controlled, well-lit environments. Ask anyone who’s ever run an EMS call, and they’ll tell you the real world is nothing like that. But, there’s a quieter, more subtle difference between the textbook and reality; one that might not be realized right away. Once you experience it, however, you’ll never forget it.

You see, there are no pictures in the textbooks of EMT’s lost in thought, laying wide awake at night. There are no images of paramedics waking up with nightmares. There are no illustrations of providers crying, or torturing themselves with “Why?” and “What if?” These things are mentioned, though. But in real life, you only hear about it quiet whispers, if at all.

I’m willing to bet that most EMT’s and paramedics who truly love their work, and have some time under their belt, have had at least one call that stays with them. It could be a nasty trauma. It could be a medical call that got out of your control. It could be subtle details in an otherwise routine call that trigger something else. We don’t talk about it too much, though. Maybe we’re afraid, or we think we’re alone. Maybe we’re embarrassed. Maybe talking about it just isn’t helpful for some.

Everyone deals with their demons differently. Go do whatever you need to do to help yourself. Talk about it. Meditate. Write. Lift some weights. Paint. Run until you can’t feel your legs anymore. Shoot some targets. Spend time with loved ones. Play with your dog. Do whatever it is you need to so you can help yourself.

But, what if you’ve done that? What if you’ve done everything you can think of?

This is the other thing I’ve learned in EMS: healing is not a linear process. There are good days, and there are bad. You reach your peaks, and you think everything is fine…and the next day, you wake up to find yourself in a trough again. It doesn’t mean you are broken. All of your work is not undone when you find yourself hurting again. The ups and downs of your progress aren’t as important as the direction: forward. You may be down today, but you are further forward than you were yesterday. A straight line may be the quickest way to get from “unwell” to “well.” But there’s a reason why it’s called the “healing process” and not the “healing race.” There will be days where you will soar, and there will be days that you will falter.

Trust me when I say that you will have good days. You will have calls that make you smile, fill you with pride, and lift you up. These troubles that bother you so much now, will one day serve to strengthen and teach you; not haunt you. We all have those calls that we will never forget, but I promise you, they will not always cause this kind of pain that worries you right now.

 

For My Dear Friend

What might possibly be my strongest skill set as an EMT is my ability to comfort people. I’m not a paramedic, and I don’t have much at hand to make the physical pain go away. My strength is handling emotional pain. I’m good at sympathy/empathy, and I tend to have a good idea of what to say when someone really needs to hear it. Maybe, in a weird, twisted way that only another similarly afflicted individual can understand, I was somewhat blessed to suffer from (and, I’m proud to say, mostly overcome) depression. Maybe that’s what gave me the skill set I so value. Who knows.

But sometimes, I’m at a complete loss. I don’t know what to say, what to do, or how to help. And, my friend, I’m sorry that that’s what is happening now.

You’ve listened to me whine and fight my way over the mountains I had made out of molehills, and never once did you berate me for it. You have a way of combining compassion with straight-forward, practical advice. Hear me when I say that I’m very lucky to have you for a friend…hell, I remember the first time you wrote to me, my jaw dropped in utter disbelief that you would want to have anything to do with me. You’ve helped me through so much. And I’m horribly disappointed in myself that right now, I don’t know how to help you.

You are one strong person, and I hope you know that. I can’t imagine ever working through all the things that you are handling with an enduring, silent grace. I am both proud and in awe of you. You are carrying on, much in the same way you gently tell me to, despite all of these reasons that would break lesser men.

I won’t doubt you when you say you are fine. It’s not my place. But I want you to know that if you ever are not…if you ever find yourself in darkness and can’t find the light, if your back is ever overburdened, if your head and heart are too heavy to take another step forward, or if your tongue is bloody from constantly biting it and swallowing your words before they can escape your lips…

I want you to know that I will grab a flashlight for you (with extra batteries). I will try to help you carry the load on your back. I will give you a shoulder to rest or cry on. I will give you an ear to listen to what you are tired of holding back. I will be your friend, and I will do my best to repay all the kindnesses you’ve bestowed upon me.

Keep eating that elephant. And should you get a stomachache, I’ll sit down and share a meal with you.

Or at least give you Zofran.

Unprofessionalism in Education

We’re gonna play a little game today. Yep. You and me. I’m going to write a quote here that took place at school the other day, and you’re going to guess who said it. Okay? Great!

“So Elise emails me this question the other night, asking me about complications of placenta abruptio. (laughs) Seriously? How do you not know this? Like, really? How about bleeding out, Elise? That’s gonna be a pretty big problem pretty quick if you don’t see what’s so wrong with having placenta abruptio. I can’t believe she asked me that.”

You probably have a decent picture in your head. Some mouthy nursing student (similar to ones I’ve previously posted about here and here) that has nothing better to do with her time than put down the others, most likely because she’s insecure herself. But you’d be wrong.

That quote was from one of our teachers.

That really grinds my gears. I am somewhat shy, but I used to be much much worse. Speaking from experience, shy people can get incredibly uncomfortable about asking questions in a public forum (ie, a classroom.) Why? Because we’re afraid everyone’s going to think we’re stupid. At least that was my fear. So emailing a question is a nice, private way of learning while successfully avoiding judgement. Right?

Wrong, apparently. I guess now it’s okay to make a mockery of a student by name–who fully intended to speak with you privately–and flaunt it to other students. I’m proud to say that none of the students in this room so much as chuckled. No one said anything. We all just stared at her, occasionally exchanged glances with others, and waited for her to finish her rant. When she was done, there was an instantaneous understanding amongst all the students in the room. We could never feel comfortable asking her questions without fear of her making fun of it to other students. Creating an environment that discourages questions from being asked is to essentially kill off the possibility of gaining a full and comfortable understanding of subject material. Inquiries are at the heart of learning. And now, everyone is afraid to ask. Super.

I’m completely disappointed and continuously discouraged every time something like this happens. To any of you educators out there, I am begging you…please never do something like this to your students. Ever.

Are You Taught To Hate Your Field?

Why on earth is the healthcare provider education system so hell bent on burning people out before they’ve even got their license in hand?

At least that’s the way it seems. Maybe it’s just a regional thing. Maybe all the schools in my area are teaching using similar techniques, and all the teachers subscribe to a similar mindset. Or maybe I’ve officially lost my mind (I am certainly not ruling that out).

This post is going to mostly be about nursing school, because that’s what I’ve experienced. But, any new-grad paramedic I know has talked about similar problems.

For any of you that actually read my rambling, babbling, nonsensical drawl, you know that I am unhappy in nursing school. Yes, I do feel absolutely miserable. Every week, I find myself up in the wee hours of the morning on the verge of a mental meltdown. Every drive to school is filled with anxiety, and every drive home is filled with discouragement. It feels almost like a trap some days. The further into the program I get, the worse I feel, but the more obligated I feel to finish it. At my worst, I find myself panicky, physically sick, unable to sleep, and waking up with horribly graphic and disturbing nightmares. Sometimes I start wondering why I ever decided to go into nursing. In my stress, I start to look for other careers I could do. Maybe I’ll find my calling in something else. In the past, I’ve considered going to paramedic school. Currently, I have some wild aspiration to go into law enforcement…which I’m sure would be greatly discouraged by anyone who actually knows me. I have to stop and wonder if these aspirations are real, or if I’m just looking into them because it’s something other than what I’m going through right now.

I’m in an associate’s degree program, so it’s only 2 years long. Most paramedic programs are about that long as well. It’s a short amount of time in which to learn a lot of important things. It’s not like earning a typical degree…after we get out of school, our decisions could greatly impact the lives of others. The stakes are very high, and it’s incredibly important to learn as much as we can in the short time that we have. Maybe these programs are just too short to be reasonable. I find that students in these shorter healthcare degrees/certification programs are just so stressed out and inundated with schoolwork that they find themselves discouraged or disliking the career they are about to enter. It’s heartbreaking to work so hard towards something, and then to be almost directed to hate it.

Maybe I just don’t love my potential career enough. Maybe I’m not dedicated enough. And like I mentioned before, maybe it’s purely a regional thing. Regardless, something should change here. Maybe it’s just me. Or maybe it’s the healthcare system. Or perhaps something in between.

Are any of you having problems similar to this? Or did I really just plain old lose my mind.

Instead of asking, “Why?”

You don’t have to be an EMT to experience tragedy. Although, we tend to bear witness to it more often. We are professionals at maintaining a level of calmness in the face of crisis. We were called to help, to fix, to save, to salvage; not to participate. We protect our bodies with gloves. We protect our psyches with adrenaline and “it’s not my emergency.”

After the adrenaline subsides and the call is over, you’re left with the aftermath. Sometimes the stories can’t be stripped off with your gloves, or the memories thrown away with the syringe wrappers. Sometimes they stay with you. In this messy and hectic career, you’re bound to get some of the shards of people’s lives embedded in your skin. It doesn’t necessarily have to be something massive and catastrophic. Your partner on that call may not even remember it today. These stories stay with everyone for different reasons.

Eventually in your career, you will find yourself carrying around a few faces, names, dates, or addresses forever. And they will not all be war stories you will flaunt or boast.

With many of these stories comes a simple and powerful question: “Why?” It’s a big impenetrable wall between you and (what you assume will be) peace. If you ever find the answer, it may not be good enough to excuse or explain what happened. More often than not, though, the answer will never come. It will never be clear.  “Why” will haunt your dreams and shadow your days. You will bludgeon yourself with it over and over in dizzying circles, searching for answers that may never come, only to find yourself exactly where you started–if not even worse off. You will kill yourself with “why”.

I try to make peace with my “why’s.” In fact, I try not to ask the question at all. Instead of asking, “Why?” I try to say “Thank you.” Thank you for giving me the chance to help you. Thank you for letting me learn from this, and using it to help my patients in the future. Thank you for asking me to be there to do the best I could at that time with those resources. Thank you for allowing me to look at what I have.

I have a warm bed. I have a roof over my head–and a fairly nice one at that. I live in a safe community. I work at a job I love, and one that challenges me every day. I work with awesome coworkers that I care very much for. They make me laugh and grow, support me, challenge me, and encourage me. Although I complain about it, I’m well on my way to a great and exciting career as a nurse/paramedic. I have a knack for writing. I have a blog that people read, and has allowed me to make connections and friends I never would have dreamed of. I have a wonderful family that cares about and for me. I have friends that love me. As for the things I do not have: I have tomorrows to earn and attain them. I am not perfect, but I am better, and I am enough.