Relief

I'd been at my new job as Clinical Program Coordinator for a hospital system's stroke program for nearly three months before I recognized a feeling that had been building for some time now.


Relief.


For the longest time I couldn't imagine doing anything but bedside care. Now, I can't imagine going back. After all, there is nothing I can do as a function of my current job that will endanger a patient's health, a patient's life, or my nursing license. I never really grasped what a burden that was and how tired of it I was becoming.

It wasn't something that was at the forefront of my mind whenever I clocked in to do bedside care. Well, not unless I was being floated to someplace like Orthopaedics or Spine: someplace I felt like I was practicing outside my competency. It's not a whole lot different when trying to run a floor short handed, or there are other confounding circumstances that kept me from giving my patients the best care I could.

When I was younger, I either wasn't fully aware of that burden or I was just better able to bear it. But years pass, times change, I've changed. I don't know how some of my colleagues continue on doing 12 hour nights in bedside critical care, for years longer that my 23 years. Perhaps it's a sense of duty, or feeling they have no other choice, or that is what they love about nursing. I already knew my care was degrading, and I had to get out of bedside care before I seriously hurt someone.

And it wasn't just my patients I was worried about injuring. In order to sleep during the day and function at night, I was resorting to unwise courses of action which I will not detail here. I can, however emphasis with Michael Jackson's desperation for sleep, and the lengths one can be driven to to get it.
But it was more than that. In the autumn of 2009, I was off for 3 weeks with the swine flu, and another three with plantar fasciitus. Fortunately, I had more than enough sick time built up. But it reminded me how vulnerable I'd be if I suffered, say, a broken leg (or worse, a broken back). How would I take care of patients? That's about the worse way to have to embark on a career transition, with the question of "transition to what?" not even yet asked.
I can do my job with a broken limb, even if wheelchair-bound. Not having to depend on my body in the same way is an immense relief. Of course, that doesn't mean I feel no obligation to lose the 10 pounds I gained since changing jobs, and then some. I want to enjoy this relief for as long as I can.

I don't regret the burden I carried as a bedside nurse, it was part-and-parcel of a career I continue to find rewarding on myriad levels, and helped me remember that what I was doing was important: "just a staff nurse" is a semantically null term. But it also became a burden that I knew I could not bear for much longer. It was time to pass it to younger and stronger backs.

Sometimes, you don't realize how heavy a burden was until you at last set it down.

Transitioning

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.