Pros and Cons of a Non-Bedside Job

Well, I've been away from the bedside since June. This transition has been strange, and certainly filled with highs and lows:

Pros:

• Comparatively, this new job is not very stressful.
• I know whether or not I'll be working, even months in advance. You want to have dinner 5 Tuesdays from now? I get off at 5 p.m. every night, so it's no problem.
• At times, I still feel like I'm helping people. It's just that I'm now helping doctors, NPs, and other staff, rather than directly helping patients.

Cons:

• Still, missing out on the stress of patient care means I'm also missing taking care of patients. I'm a good RN, and I do miss patient care at times.
• I'm not crazy about working 5 days a week. Yes, the days are shorter, but I feel like I'm working all the damn time. I think it's the consistency I want, not the 5 days a week. If I could find some job where I could work 3-12s, where it was, say Monday, Tuesday, Thursday every week, that would be ideal. Hey, a girl can dream.

So, that's what's on my mind right now. Still learning the ropes of the new place and trying to really listen to myself about what I want out of my job/life balance. 

Bedside Hiatus

Since returning to the Hoosier State, I've made a big career change. I recently took a job that has no clinical contact; it's more of a health informatics position. Was this a big mistake? Only time will tell. I sure feel a lot less stressed at work right now, and I think working with electronic health records could be a resume boost...to a point. 

However, how will this move affect my ability to travel in the future, if I would decide to do so? One of the companies I am signed up with states on their website you must have clinical experience within the last year to apply for travel contracts. I noticed this caveat when I was updating my profile (hey, I like to be ready to hit the road at a moment's notice!). I tried to call my recruiter from that company to see if a year away from the bedside but within a healthcare/documentation role will preclude me from traveling with them; she's on vacation this week. I'll check back with her next week. I like to leave as many doors open as possible.

You can't leave every door open all the time, though. 

Having a patient be really rude to me right as my 12-hour shift was beginning was actually helpful to me today, because it helped me to remember to keep an emotional distance from my patients and therefore helped me to survive the day. Bedside nursing can be rough stuff.

Local Food Love

This winter has been brutal in Indiana, as it has been in many other parts of the country, too. This past weekend my boyfriend and I took a quick trip to Las Vegas, to escape the freezing temperatures and relax a bit. The drinking, gambling, and walking in the sunshine were great, but probably the biggest treat was eating at In-N-Out Burger. Living in LA during a travel contact really gave me a taste for those delicious cheeseburgers! Are there any foods you had loved on an assignment but now don't have access to?

Does the travel bug ever go away?

Maybe it's because the weather here in Indy is dreadful, or because I'm disappointed with my new staff job, but the idea of taking "just one more" travel nurse contract has been niggling at the edges of my brain. There's a computer conversion at SUNY in Brooklyn that's coming up soon; I've never been to New York! That particular assignment is coming up too soon for me to realistically be able to go, but it does put thoughts into one's head.

Tonight I'm feeling like I'd rather be from Indiana than in Indiana. I miss Seattle.

So I've Taken My First "Permanent" Job After Traveling

"Permanent" is in quotes because there's no such thing as a permanent job, right? Downsizing happens, people stay home to raise kids, nurses burn out in one specialty and learn another, and workers leave a job for any of these reasons or one of a hundred others.

But...I've taken an RN job that I have assumed will be a job I'll work at for at least a year or more. For me it's been strange to orient at a permanent job after working as a travel RN. My anxiety level is much higher! When I was traveling, if I didn't like the charting system or didn't feel the MDs were available enough, I could always console myself with the mantra: "It's only 13 weeks!" Now, when I'm finding less-than-desirable aspects of my new job, I'm forced to recognize that I'll be dealing with those aspects for the duration of this job. And there's no "Hey, it's only 39 shifts" to make me relax.

Priorities in Hospitals

One of the truly eye-opening parts of travel nursing is seeing how differently hospitals around the country are run. A friend and fellow travel RN has just started an assignment at a New England-area hospital. She was shocked to discover that although each lovely private patient room in her new facility has a 42" flatscreen TV, the nurses still administer and document meds using a paper MAR system. "Sometimes I think, 'How can all these hospitals be in the same country and be so different?'" she remarked to me.

New job fun: having my millionth PPD this year placed today. Settling into a job will give me the benefit of only having to do this stuff once a year or so, right? If I can stand staying in one place that long!

Could I have picked a worse time to come back to the midwest?

As a nurse: no, I don't think so. With big hospital system layoffs happening both here in Indiana and in neighboring Ohio, it's been hard for me and many others to find RN work here in the midwest. My old hospital was unable to hire me due to a hiring freeze they're on right now. After almost 2 months of searching, I've landed permanent day shift job here in Indy. What a relief!

Day Trip

One of the best things about being a nurse is the flexible schedule. Right now, I'm in the middle of a four-day-off stretch. I've used my time off for such glamorous things as a trip to the dentist and runs around the lake. But I also took a day trip to Leavenworth, WA with another nurse to go tubing on the Wenatchee River. It was so great! In the summer, the weather is hotter in the middle and eastern parts of Washington than it is in Seattle. So what was a pleasant day in Seattle was a hot one in Leavenworth, and floating in the cool water of the river felt great. My friend and I met and had beers prior to (and after) our float with two nice kids from California; one was working as a whitewater rafting guide in town for the summer, and the other was celebrating her recent college graduation by traveling around the country.

As a traveler, there are so many adventures waiting for me on my days off. Some may be in the actual city I'm working in, and others may be a few hours' drive away. Having new and different entertainment options every few months will be something I'll miss as I once again take a permanent position.

"Back Home Again...

...in Indiana" is where I'm headed. I've decided. I'm headed back to Indianapolis to test out my relationship. Will it last? Will it be worth giving up the West Coast for?

These are questions I just don't know the answers to. I had a crying, panicky fit a little more than a year ago, before I left for Seattle. I was extremely worried that I was making the wrong choice. I never give into this feeling anymore; my chronic anxiety makes every choice seem like a potentially terrible idea. Still, it would be nice to be able to trust one's instincts. 

My instincts are saying that going back to Indy is a losing game. But to quote John Cusack in High Fidelity, "my guts have shit for brains."

So, here goes nothing. After 12 more shifts here in Seattle, of course. 

Float On

If you work in an inpatient setting, you've probably floated to another unit when census was low on your unit. In some hospitals, nurses float frequently; in others, it's fairly rare. Some RNs really dread floating. I've learned that here on the west coast, some hospitals have an hourly premium for floating to another unit: you make a few dollars more an hour for working on another unit. That wasn't the case at my Indianapolis hospital. 

In Indy, I worked day shift, so if I had to do the split shift float, I floated to another unit for the last 4 hours of my shift, from 3p-7p. In a way that seems easier, in that you're not scrambling at the beginning of your shift to pass meds and assess everybody and chart within four hours. 3p-7p isn't usually the busiest time in a day shift, while 7p-11p is usually the busiest time in a night shift. And so now that I'm a travel nurse working nights and I'm the first to float, I do frequently float to another unit from 7p-11p, and then back to my home unit from 11p-7a. It's a chaotic way to start my shift, and it's a pain in some ways, but at least it makes the shift go fast. And it's increased my flexibility and my ability to streamline my charting.

If you're intimidated by floating, being a travel nurse will cure you of that for sure. And if you like seeing a variety of units in addition to a variety of cities, then that's another reason to take the leap and try a travel job. 

Decisions, Decisions

Travel nursing has been a cool way for me to try out new cities, meet new people, and become less rigid in my work life and personal life. Always moving and never really feeling settled isn't the life for me, though. I'm ready to take a "permanent" (hey, it doesn't come with a ball and chain, you know) job, at least for a while. But where? I love the city of Seattle, and I have a great job here. My unit has openings. What's the catch?

My boyfriend and my family, to whom I am close, live in Indianapolis. My job there was okay. The jobs and insurance are better on the West Coast, at least in general. And Indianapolis has plenty to do, but no mountains, no Puget Sound, no constant grunge band vibe.

I'm ready to feel rooted again, but where?

Adar Nurse Scrub Top Review

The hospital where I'm currently working in Seattle is the first facility I've worked where employees aren't required to wear specifically-colored scrubs based on their roles. In my Indianapolis hospital, RNs wore white and royal blue, any brand we wanted to buy. In California, the RNs wore branded scrubs provided by the hospital, although staff laundered them at home. Here, as long as your scrubs are clean and in good shape, anyone can wear any scrubs. Some people do wear green or black or patterned tops, but most everyone, from transportation to RTs to RNs, wears the hospital-provided ceil blue scrubs.

Sure, it's great to have free scrubs, and it's nice to not have to launder them yourself if you don't want to. However, my two major issues with the hospital scrubs are: 1) They seem to be one-size-fits-almost-no-one and 2) They have almost nothing in the way of pockets. The bottoms have one back pocket, and the tops have one small breast pocket and one small pocket at hip level. Come on, this is not sufficient, especially for a person like me, who likes to have scissors, alcohol swabs, and saline flushes on hand.

So, when a representative from Uniformed Scrubs, a company that sells medical scrubs, sent me an email and asked if I'd be interested in reviewing an Adar Uniform scrub top, I thought, "Awesome, maybe this will be a chance to wear a top with enough pockets." I agreed to check it out, and they sent me a top to try out:

                                                                 

Here are my thoughts:

Indeed, the top they sent me had two nice roomy pockets in the front. During my shift I was able to squirrel away all the supplies I needed into my pockets, just the way I like. The material is structured and seems durable, but it's also soft. The fit was great. I'd never had to order scrubs without trying them on before, but I just emailed my usual top size, and it fit well.

The only drawback for me was the style of the top. I normally buy Landau scrubs in what I think is a gender-neutral style. This top was definitely a more feminine cut. More flattering, sure, but do I really care about that at work? I generally expect my nurse scrub tops to be functional rather than fashionable, and the tie in the back made me feel a little self-conscious and kind of rubbed against the back of my chair (of course we only sit down one or two times in a shift, so that's not a big deal). A few co-workers asked me if I'd lost weight, so I guess the look was slimming. If that's important to you, that's a big pro.

The next time I'm working at a facility that doesn't provide scrubs, I'll definitely consider ordering Adar scrub tops, although I'd choose a different style.

Uniformed Scrubs is offering 15% off of orders through July 31st with the coupon code "trueblue." Here's links to their Facebook page, their blog, and their Pinterest. They're on Twitter as @UniformedScrubs.

Uniformed Scrubs provided me this scrub top to review but did not compensate me in any other way. It was a fun experience. I'd love to get the opportunity to review their scrub pants, too...as you can see from the pictures, my hospital-provided scrub bottoms have neither fit nor flattering style going for them!

Can You Commit?

You might say I have a problem with commitment. In fact, you could say it right out to my face, and I wouldn't really be able to take offense (just then I wanted to type "offence;" I've been reading a novel by a British author, and I guess I can't even commit to UK or US English).

I don't own a house, I'm not married, and I don't have children. Whenever I start a sentence with one of those statements, whether I'm talking to another person or just thinking to myself, I'm quick to add "yet!" As in, "I don't own a house yet," etc. But let's be real. I have a problem with commitment, and that "yet" may not have any place in a sentence about my future.

That's part of the reason why I'm travel nursing, right? Because even though the cons of being a travel nurse can be a pain --no PTO, not much say over my weekly schedule, currently working nights when I prefer days--the big pro is: no commitment. I'm committed to the terms of my contract, and that's it. If I don't schedule myself to be on assignment during a certain holiday, I don't "owe" my unit working it or any other holiday. I'm not on a hierarchy to determine when I get vacation; I can take an unpaid vacation between assignments, or not at all. I'm not stuck in any one city.

Well, I'm not stuck in any one city due to job responsibilities, that is. But I've given my word that I'll come back to the Hoosier state when this job is done. And I'm looking forward to it. My old unit will likely be happy to have me back, if I so choose. Still...hmm. It's hard to commit to a permanent job again. I keep dragging my feet on sending that email to my old manager, confirming that I'll be back for sure. Because once I do, and once they offer me a job if one is open, I'll be in the position of making a commitment. And I don't relish that.

Fighting that Lonely Feeling

Unless a nurse is traveling with a spouse/partner or friend, moments of loneliness on the road are inevitable. In general, I enjoy solitude, and I need to have time alone to recharge, especially after the constant interaction that is being a floor nurse. Still, I'm human, and I like to socialize. Fellow travelers can be a lot of fun to hang out with; on both my last contract in Seattle and during my time in LA, I met other cool travel nurses who were great companions with whom to explore, hike, or just grab a beer.

This time in Seattle, though, I've been hired before the wave of travelers that will come in during the summer months. I didn't need to attend an orientation, because it's been less than a year since I left the same hospital, so I didn't meet any new travelers that way. The three RNs I hung out with the most last summer in Seattle are all on different assignments currently (in Alaska, Delaware, and Florida, respectively). The other nurses on my floor are very welcoming, and they have included me in group outings, but they have their own permanent lives here and aren't necessarily looking to form a friendship with me.

One resource that's worked for me is Meetup.com. It has groups for so many interests: book clubs, running, hiking, wine tasting, singles, volunteering, and anything else you can imagine. So far I've found running buddies using the site, and it's helped stave off the feeling of isolation that can hit any one of us.

Back in the Emerald City

It's a been a while since I've posted. No excuses, just trying to survive LA.

I hung in there for my entire 13-week assignment. It was rough, a lot of the time. I never really did get the hang of the disparate paper-and-three-separate-computer-programs charting/MD orders. The support systems of the hospital were not as...um...supportive as I would have liked, due in part, I think, to their being understaffed and overworked. And while the beach and the weather and my apartment and some of the other (travel and permanent) RNs I worked with rocked, overall, life in LA wasn't for me. Tough three months. 

When a former co-worker from my Seattle hospital called while I was still on my assignment in LA and told me she thought they'd have a need for me due to some upcoming maternity leaves and RNs leaving, I called both the unit manager and my travel company. At the same time, I asked my recruiters to continue submitting my application to other hospitals, including a teaching hospital near San Francisco where I've really been wanting to take a contract. The Nor Cal teaching facility called me back the day after I accepted the offer from the Seattle hospital. Bummer, sure, but it's great to be back at a great facility, working with professional, hard-working, pleasant staff and up-to-date computer systems. And I love Seattle. If it weren't for home obligations, I would definitely think about making a permanent move here. 

Local Flavor

Yesterday I went to a theater near UCLA campus and watched of all the Academy Award-nominated (live action) short films. Of course, this activity would be available to me in indie theaters around the country, but being in this industry town spurred me to check them out for the first time. So, I'll have an opinion about the short films come Oscar night. One of them ("Henry") had me sobbing like an idiot in the theater, but "Death of a Shadow" is the one I hope wins.

If You Don't Have Your Health...

...you don't have anything, right? Isn't one of the benefits of bedside nursing to force us, almost on every shift, to silently given thanks for our own health? I know I sometimes find myself thinking things that non-healthcare-professionals might find strange, like, "I'm lucky to be able to shower on my own, whenever I want."

So, when taking report for my upcoming night shift the other night I became SOB and dizzy and had to be taken down to ED (dx: elevated WBC, probably a virus making its way around the hospital, and a heretofore undiagnosed heart arrhythmia), I was forced to take a hard look at my own health and its impact on my ability to provide for myself.

It can be scary out there as a single person doing contract work of any kind. If I don't work, I don't get paid. I've never had any significant health problems, and although I'm scheduled to follow up with a cardiologist, I'm (naively?) hopeful the EKG change will turn out to be nothing. Still, this work incident has reaffirmed my belief that health is the greatest of possessions, and it's caused me to consider: is traveling still a financially reasonable option for me?