Nursing and Change

I’ve been a registered nurse since 1999.  Nursing is a very interesting and flexible career.

Starting out as an LPN, I cared for pediatric patients with a trach and ventilator at home.  As an RN, I started in labor and delivery because my ultimate goal was to become a nurse midwife.  However, that did not work out, so I changed direction entirely and went to a medical/surgical unit, then to an adult psychiatric unit, where I worked for 13 years.  Finally, tired of working nights, I went to work in care management five days a week, arranging complex discharges for pediatric patients.  

Now I am self-employed.

There are so many rules, guidelines, mandates, and constant changes in a hospital, additionally, very ill patients and complex treatments.  It is both stressful and challenging in a satisfying way, to assist and participate with patients and families to help them get them out of the hospital.  

Abiding by all the rules one hopes that there is a reason for the rule that is helpful to patients, for instance, to promote health and safety and prevent injury or death.  

Once a mandate is handed down, it is a normal response to wonder why.  There are questions.  Why does it have to be a mandate?  On what information was this mandate based?  Who made the mandate?  Who benefits?  Who suffers?  

For an example, all healthcare workers know that you must do hand hygiene prior to going into a patient’s room, but it is a superhuman feat to achieve 100% compliance, because we are all humans and things happen, such as emergencies or forgetfulness, in addition to technical challenges monitoring compliance.  

As far as I know, health care workers are not fired for lower than 100% compliance with hand hygiene.

It was the mandate that made me think critically about both health care mandates and working in the hospital.

I worked with wonderful people.  It was both exciting and sad to leave.  Exciting to plan and execute the change to self-employment and sad to leave a job I was really good at and also had great working relationships.  A very large number of co-workers were also sad to see me leave.

Change is constant in nursing.  Back to basics is really okay.  Hello, Florence Nightingale!