Tuesday, August 23, 2011


After 23 years night shift bedside-care ICU, it was time for a change. I wasn't sleeping well enough during the day, and staying adequately alert through my 12 hour shift was becoming a dicier proposition. Worse, direct patient care was becoming less fun, less interesting, and less personally fulfilling. I didn't like how jaded I was becoming, the person I was becoming, and the nurse I was becoming.
This discontent was augmented by my fifth, and most miserable, Minneapolis winter. I've heard Garrison Keillor wax lyrical about Winter in Minnesota: its austere beauty, its realism...it reminds me of C.S. Lewis's Screwtape describing Hell. I don't think it's a coincidence.
So after much searching, several applications, and a handful of interviews, I'm now in Portland, OR, helping a multi-hospital system run its comprehenisve stroke program. It's a substantial transition. one that, on many levels, is still underway. On others, it has yet to begin.
Patricia Benner's seminal From Novice to Expert is very much my lived experience, except right now, it's going the other direction. I went from being an expert bedside critical-care nurse to being a novice clinical program coordinator. It's much like wandering around a blacked-out sports arena with just a flashlight to light my way. I have no idea what the entire interior looks like or how to make a contribution in its operation.
My role is very different from direct patient care. Instead of working in a system, I'm working with a system and on a system. A daunting challenge, especially in that I only marginally understand the system. So my "sports arena" isn't laid out like any sports arena I've been in, and with my "flashlight," I can barely guess how it's laid out.
This is on top of re-learning how to live in an apartment and find my way around Portland (a really cool city, by the way). My wife and I are building new relationships and learning how to live with each other with this different schedule. It's a little more difficult for her to "nest" in bed with her knitting until the wee hours if I'm there having to sleep.
But it will all work out. We both want this change, and we tried to "be careful what we wished for." We have confidence in ourselves and each other that we will meet the challenge of this transition, and prevail against it.
That doesn't necessarily make it any easier or any more fun.

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