This morning as I stood in the hot shower spray prior to leaving for my job as a nurse in the ICU I prayed like I do every other work morning, and the petition was a familiar one at that.
“Help me to hear your voice, Lord, and do no harm.” I prayed. And while my words weren’t exactly, “help me not to kill anyone today,” let’s just be honest. That’s pretty much what I meant.
Nursing is one of those jobs where how you perform is pretty important, and having an “off day” mentally isn’t really a viable option. The margin for error is extremely small, and really you want to avoid mistakes period. Because when you mess-up real human beings suffer the consequences.
No, that’s not stressful at all.
So it’s not so much that I pray out of fear, but rather that I beg for strength for the difficult road ahead. After all, you never really can foresee what you will face when you walk in the door, and patient care assignments typically resemble Forrest Gump’s box of chocolates. You never know what you’re going to get.
But it’s not the uncertainty alone that makes it challenging. It’s not even the thirteen hour day. Sometimes it’s just the expectation of performance that makes it so tough.
Despite how you’re feeling personally on any given day, you will arrive with your game face on. You won’t be allowed to slip into the chaos slowly, but rather you’ll be forced to dive-in head first. That’s just the nature of the beast. You’ll perform quickly, proficiently, without error, and with a smile on your face. And if you happen to be short of staff, or find the hospital at maximum capacity, you’ll still perform at an optimal level. You won’t have a choice.
I know a guy who owns a restaurant, and he told me that when they get really busy, and absolutely cannot produce more than they are currently putting out then they take the phone off the hook. That sounded pretty good to me, and I’ve had days where I would like to do the same. But people don’t stop getting sick because my co-worker called in, and they don’t even take a break from their illness when I really need to pee.
As a nurse when you hit the wall mentally and physically of what you can do you aren’t allowed to take the phone off the hook. In life and death situations you can’t even walk away for a second to collect yourself. So when you reach the end of your rope you just magically find some more slack. You push, and push, and push. Without error. Without mistake. With a clear head and professional demeanor. This is the expectation.
Also, aside from the expectations of your employer and the general public at large, you are scrutinized by the worst judge ever. Yourself. You would think you’d give yourself a little wiggle room. After all, you are faced with the continuous interactions with some of the most difficult people in the world to deal with, and you must deal with them in the most difficult and stressful situation they have likely ever encountered. You’ll speak compassionately in the face of unnecessary and undeserved insult, and empathetically soothe even the most unsoothable of the population.
You’ll treat ten out of ten pain for someone playing Candy Crush on their phone, and feel the shame when the next day you’re given a different assignment per the patient’s request because you refused to give them a pain shot right when they asked for it.
You’ll answer as best you can questions outside of your scope of practice, but even then you may be undermined for your answers when they differ from “my brother’s girlfriend who’s a nurse.”
Yet despite your understanding of the challenging populace you serve, you will still not measure up in your own eyes. Regardless of the continuous and changing knowledge base you must keep up-to-date, you will feel like you don’t know a thing some days. No one will chastise you more for missing an IV than yourself, and no one will be more disappointed in your daily performance under stress than you. It’s true; your expectations for yourself go way beyond what even the most demanding patient could ever hold.
The weight of so much responsibility, the strain of being stretched beyond your limits, and the unrealistic expectations held by others, but especially by yourself, will make you wonder on the really bad days how you can hate something you love so much. How you can cry in supposed defeat, frustration, and grief over a vocation that on the other hand gives you so much joy.
On the days that end with you running off your unit, or dragging yourself from there, and eventually settling into the quietness of your car where you cry hot tears, those days you feel a little burned out. Maybe a lot.
But then something strange always happens to me. A coworker will send me a kind message, thanking me for all my hard work, and their appreciation for what I assumed was my failure actually takes my breath away.
When I encounter a former patient, and they tell me how I changed their life, or saved their life, or even meant the world to them during such a difficult time, I am left speechless. “Who me? The blundering dunderhead?” (That’s certainly how I feel after a code. No matter how many I’ve been through.) Yet they mean it. They really mean it. I am left blessed, and I am left lifted from my low places.
When a loved one calls me asking for my opinion and advice on health issues I am honored. If it’s 1 a.m. I am frustrated, but I am also proud to be part of a profession where others seek my counsel and assistance when they are frightened and unsure.
When a terribly sick patient, like the kind of patient that you are sure will die, pulls through and gets better, I feel elevated. I feel like I could fly when I realize that I held a small part in the healing and restoration of someone’s life. No feeling compares to that.
A smile, a laugh, a compliment, or a thank you are ultimate motivators to my weary body and mind.
And then I’m not burned out. Almost, but not quite.
So I go to bed early, and I wake up even earlier. I stand in the hot shower spray in anticipation of another thirteen hour day, and I pray. “Help me to hear your voice, Lord, and do no harm.”
And then I’m good.