So this is what four-year-olds dream about…

“I dreamed I went to J’s house, and you were there, and I taked a pillow and blankie and put them on the couch to cuddle, and J taked one away, and I taked it back, and he taked it away again, and so then I fighted him and fighted him and fighted him, and finally I taked it back and he didn’t take it away anymore.”

A new week

It’s 6 am. I am dropping the kids off with my mother in an hour so that I can take an 8-hour class on how nurses shouldn’t be mean to each other. Honestly, I think this is kind of silly, since I have experienced much more “eating their young” behavior in other jobs than I have in nursing, but sure, if they’re willing to pay me for a class on the topic, then I’m game.

I will either drop in and talk to my boss about my desire to get back into NICU or L&D nursing, or if I can’t see her face to face, I may end up just leaving her a voicemail or email about the topic. Either way, it’s not like I’m giving notice or something; I plan to keep my PRN position on my current unit. I’ll just pick up way less hours, if I do find a part-time position on another floor.

Update: My class was actually pretty interesting. It even touched on some theories that nurses pick on newbies so much due to nurses being an “oppressed minority”, with a high degree of responsibility and a low degree of autonomy. I don’t necessarily agree with theory; it’s not like we give up our chairs or pull charts for doctors these days or anything. I have a HECK of a lot more autonomy now than I did when I was paid $8 an hour for scrubbing nasty toilets in a hotel, or $9 an hour for slicing lunch meat for impatient upper-class housewives. Now THAT was when I felt oppressed! As a nurse, I don’t feel “oppressed” at all. When I worked in the grocery store, I was treated rudely, every single shift, by either management or customers; however, in my past year as a nurse, I can count on one hand the number of times I have been treated unfairly. Personally, I think the nurse theorists that go on and on about nurses being an “oppressed minority” either haven’t worked a whole lot of other jobs previous to going into nursing school, or they haven’t worked on the floor in a long time.

I spoke with my manager yesterday, and she was very receptive to the idea of my getting cross-trained on the L&D/NICU floor at work, if the upper management will approve it in the budget (and she thought they probably would give the okay). Transferring departments within my own hospital would be very much superior to re-applying at my old workplace, or at an unfamiliar hospital, so I will stick around to see what comes of the cross-training idea.

More career rambling

Kids playing in the leaves

Took the kiddos to the park today, and on the way home, they both fell asleep. They stayed asleep after we pulled into our driveway, giving my husband and I the opportunity to have a nice long chat regarding my recent career conundrum.

After much talk, my plan is still pretty much the same. M. listened to all my rambling, and then threw in his viewpoint, which was mainly concern over how our kids and general family sanity level will be affected by my working two night shifts per week instead of one. There is also the crankiness factor that goes along with working more, the lack of time for homeschooling factor, the way that more than one night shift would eat up a significant portion of the week. This is all very realistic and I’m glad that he insisted that I consider these factors.

After our talk, and after writing a detailed pro and con list for working part-time on a different unit in my current hospital, as opposed to working part-time in the NICU where I worked when fresh out of nursing school, my plan is to talk to my bosses at work this week regarding my desire for them to keep me in mind for part-time positions that open up at County Hospital in the next 6 months or so. (Whew, that was quite the multi-clause sentence). Depending on how my bosses react to my request, I may or may not contact my former boss at City Hospital regarding returning to a NICU position.

If I do manage to transfer upstairs, I would get some Level II NICU experience again, as well as getting a taste of Labor and Delivery in a non-insane atmosphere (I saw quite a bit of L&D at City Hospital, but I am told by nurses that have worked elsewhere that births at other hospitals are not nearly as assembly-line as what I am used to seeing at the teaching hospital). I read through old journal entries and old blog entries all day today, just to assure myself that asking to go up to part-time is not insane. I ran across one entry where I dreamt that I was apprenticing with the midwife who delivered my first child, and that she was waiting out in the hall with the clients who I was supposed to provide prenatal care for. In the dream, I shuffled papers for so long that I was pretty sure that they had gotten tired of waiting for me to get my sh** together and left.

Was that symbolic for the way I have farted around for the past year and a half, working in positions that involve moms, positions that involve babies, but not striving to get into a position in Labor and Delivery, despite the fact that my desire to become a nurse midwife was the main motivator in my decision to go to nursing school? It surely can’t hurt to try for an L&D job. If I end up not liking it for whatever reason, then the logical next step would be to re-apply for NICU at City Hospital. And I would have recent NICU experience, which would work in my favor when it came to my chances of being re-hired.

In my shuffling of papers, I also managed to find the card that my NICU manager sent me after I left that position. She apologized for not being able to come to see me on my last day at City Hospital, and then wrote, “Give me a call when you are ready to come back.” Followed by a smiley face. Maybe she sends those cards to every nurse who quits, but reading it again made me feel fairly confident about how she would respond to a phone call from me.

Looking back, I was very stressed during my time in the NICU, but I think that most of my stress was due to being a new nurse, and to working full-time. I am no longer a brand-new nurse, and I have no plans of working full-time again until my kids are much, much older. At the time, I thought that a lot of my stress was due to being in a department that wasn’t a good fit for me. But reading back, I totally loved NICU until it came closer to the end of my orientation, when I realized, “Oh crap, I will be expected to take care of these tiny little babies independently! Yikes!” And you know, that wasn’t totally a NICU thing- when I was coming off of orientation on the peds unit at my current job, I felt a very similar terror when I contemplated that I didn’t feel at all comfortable with prepping a kiddo for emergency surgery or with caring for postop patients, and I actually requested an extra week of orientation as a result, in order to get a bit more experience before I was on my own.

The occasional cranky coworkers? These exist in every nursing job.

Exhaustion due to weird hours? Also in any nursing job (at least as a newbie nurse- only nurses who have been there a while get day shifts).

Terror of things going wrong? Ditto. At least in the NICU, there was always other nurses and docs around to help, 24/7. My current job, the patients are often pretty low-acuity, which is good and bad. It’s bad in that the docs and house supervisors sometimes get complacent about the fact that a scary event has not happened on this unit in years. They do things like not listen to nurses regarding their concerns, or leave only one nurse on the unit when the census is low in order to save budget. The second one is especially scary. I work with great nurses and docs at my current position, but I am ready to move on.

The point is, I need to get out of my current job. I wanted some more general, med-surgy nursing experience, and I have that under my belt now. And now I am ready to specialize in what I feel passionate about, which is babies and their mamas. No rush, but within the next six months would be ideal.

Plan of action

So, after my long rambling post, here is the gist of it: I am certainly not in any rush to work more hours. Mainly, my concern is getting back into a nursing specialty where I belong, before having another child. And we do plan to have at least one more biological child, and possibly adopt after that. Once I feel established and comfortable on the unit where I want to be, I may well go back to per diem nursing. Because really, per diem like I’m doing now is very ideal for someone like me who wants to mostly stay at home with kids, and homeschool even, but also wants to have an identity outside of Mom and Wife.

My plan is to email my boss at work, assure her that I intend to stay in my current PRN position, but that I would like to be kept in mind if any part-time positions come open on the childbirth floor. Nurses on that floor are all crosstrained for special care nursery, postpartum, L&D, and OR. So if I landed a spot there, I would get a chance to learn L&D, and also get back into NICU a bit. A part-time spot on the childbirth floor would thus be ideal. I know that most of the OBs and midwives there have great reputations, several of them will do vbac’s, and a goodly number of women at my hospital have unmedicated births. Definitely not the assembly line care that women get at City Hospital, where I worked NICU.

In my email (or I might go talk to her in person, since I will be there all day for a class one day this week), I will also be up-front about the fact that I am also planning to contact the NICU manager from City Hospital. Same basic thing- “I want to come back. Please keep me in mind if any part-time positions open up in the next few months. I regret leaving last year!”

So, I’m going to throw these requests out into the world, and see what comes of them. Maybe I’ll still be doing exactly the same thing six months from now, or maybe I’ll be orienting on a baby-centric unit six months from now. We shall see, as my grandma always says.

“A person’s a person, no matter how small”

I have been having a work-family crisis, which apparently I am very prone to. I have been working PRN on a Peds unit for the past year, and it has been a great balance while pregnant and newly postpartum. However, the past month or so I have been very restless. Wanting to have a work identity again. I am not a part of my unit anymore, not the way that I was when I was a student nurse, or when I was orienting as a new RN and working more hours than I am now. Everyone is nice enough, but it’s not that family feeling like I get when I am working somewhere a lot. Friendly but not close.

I have been having very conflicted feelings lately. Some days, I wish I could stay at home full-time. I know my kids would love this. However, weeks when I don’t work at all, especially this time of year when it’s crappy outside and we’re shut up in the house, I tend to get very grumpy and not be a very good mom. Also, staying at home is simply not an option for us at this time, so why wish for something I can’t have. Without my income, we would go back into debt, simple as that (unless someone magically bought our still-unsold second house for the amount that we still owe on it, that is). A SAHM is a luxury that we cannot afford on my husband’s income, and I’m mostly okay with that, because I think I would go crazy being home all the time with no identity other than ‘mom’ and ‘wife’.

So I have been inquiring at work regarding making the move toward being a lactation counselor. This is a big interest of mine, and my director was enthusiastic, saying that they need more LC’s. I am tentatively planning to go to a one-week training out of state next year (bringing along my entire family to hang out in the hotel- this passes for a vacation in my twisted household).

A couple months ago, a position came open at work, two nights a week. My husband at first thought I should take it, but then talked me out of it. Now I find myself jealous of the girl who took the spot, even though I was OFFERED the same position, but passed it up. Apparently, I like working- who would have thought. But I don’t like working full-time. I like being good at something other than being a mom, much as I love being a mom.

There have been all these ads out recently for my old workplace in the city. I worked in the NICU. I liked it. It was terrifying, but very rewarding, and it was a wonderful atmosphere for a new nurse, since there are always lots of experienced nurses around willing to pitch in and help or answer questions. NICU is very rewarding, seeing all those tiny babies fatten up and get off of their IV’s, off CPAP, out of their isolettes into regular cribs. And there is a lot of interaction with the families, which is something I sort of like. It’s a specialty that I never thought I was interested in, until I was thrown into it for a few weeks for my management clinical my senior year of nursing school. Then I was head over heels fascinated with it- intellectually, it is a very rewarding field for someone with my mindset who likes to delve in and study and piece things together like a puzzle.

So, the temptation to return to my first hospital has been there for a while. It’s been in the back of my mind. I looked at the hospital website, and what do you know, one of the three nurses on that hospital promotional video was a nurse that I worked with in the NICU. Then, last week, while I was driving to work, I thought to myself, maybe I should go back to NICU, I miss the babies. And when I got there, what do you know, both our patients were tiny six-pounders. But the last straw was last night, reading to my daughter in bed, Horton Hears a Who. “A person’s a person, no matter how small.” This repeated verse called to mind the special feeling when caring for a tiny little three-pound baby, supporting their family as they bond with their hospitalized baby, encouraging the mom to breastfeed if she can. Seeing the baby fatten up and eventually go home with their mommy.

I think I will be giving my old boss a call next week. I think maybe I want to go back to NICU. Yes, the vents and the apnea/bradycardia spells terrify me, but I think I need to go back.

NaNoWriMo

I’m giving NaNoWriMo a try this year. And oh boy, am I having fun with it. I had no story ideas whatsoever, just randomly grabbed an idea for a scene and went with it, and so far so good. It’s total crap, of course, but it’s crap with potential, I think. And I’m having fun.

You don’t have a soul. You are a Soul. You have a body.

-C.S. Lewis

Should I stay or should I go?

My current place of employment has been going through some negative changes lately. Don’t get me wrong, I feel blessed to have a job at all. However, the hospital is seeking Magnet status, and while this sounds nice in theory, in reality, it means that each week the hospital adds five more minutes of charting to the nurses’ workload. All of this new charting is aimed at proving to the Magnet certification people what top-notch care we provide to our patients, but each five minutes of additional charting is five minutes less that we can spend actually face-to-face with our patients. It’s frustrating.

Some of my coworkers fear that the hospital’s atmosphere is swinging back in a negative direction, with less and less autonomy and respect for the nurses, after many improvements in recent years.

Lately, I have felt compelled to look at the job postings at City Hospital again. City Hospital is a teaching hospital, and is the county’s “charity hospital”, and therefore the culture is very different from that of a smaller, community hospital.

I left for multiple reasons, but not because I didn’t like working there. When I left my job there, several nurses predicted that I would be back eventually. They said, “Once a City Hopsital nurse, always a City Hospital nurse.” Same sort of pride in their careers as military people seem to feel.

I bopped over to the City Hospital website this morning, and they have a video posted showing nurses that I used to work with speaking in glowing terms about their jobs. And truly, City Hospital has better nurse retention than just about any hospital I’ve ever seen. I did have to chuckle at their glowing descriptions of births in the hopsital, when I know from experience that their births are typically quite assembly-line fashion. However, though it’s not the perfect workplace, a big part of me craves to go back. I had just gotten approval from my (wonderful) manager there to drop down to two nights a week when I rather impulsively quit my job there, to come back to the hospital where I had worked as a student nurse. What was I thinking? I fit in so much better with the nurses in the city than with the nurses in the suburbs. Maybe I didn’t fully think my decision through.It seemed right at the time, but now I’m not so sure. Fortunately, I left on very good terms, and I know that I will be welcomed back when/if I decide to return.

So, all of that writing to admit to myself that -

1. I want to work at City Hospital again. Screw the commute, it’s worth it to feel like I’m working in the right hospital.

2. I need to wait until Jake is at least a year old, because I hate pumping.

3. I need to be back in mother-baby.

4. And not full-time ever again, not even during orientation.

Not right away, but eventually.

I don’t ask for much, do I?

Good to have all that out of my system. Now to clean this house!

Torn

My son is sitting between my feet on the floor, waving his red plastic telephone around, chewing on it, squealing to himself, and slamming it into his sister’s toys which are scattered on the carpet.

I feel pulled in about seven different directions at this point in my life.

Right now, I work on a unit that handles both pediatric and GYN cases. In a typical week, I only work about 10-12 hours. Working part-time is nice but also weird. Just enough to keep my skills up, but not quite enough that I feel like I am really part of the unit. Everyone is friendly enough, but people don’t see me enough to really consider me more than an acquaintance. Working little enough that I am still able to be home with my kids most of the time, but just enough that my home still feels chaotic part of the week, with the kids being shuffled to grandma’s or next door to my in-laws’, or else someone coming to my house to watch the kids while I sleep for a few hours after working a night shift, or passing the kids to my husband the moment he walks in the door at 5 pm, so that I can hurry into my scrubs and out the door. Working enough that I have a hard time pumping enough milk for my voracious five-month-old to eat while I’m gone, without having to resort to the can of formula in the cabinet that my husband has had to give the baby in a pinch on a week when I was too lazy about pumping on my days off..

Working full-time nights at City Hospital, as I did last year, exhausted me and made me a grumpy mama on my days off. However, I also loved my job and loved feeling like I was part of the unit culture and that I was making a positive difference on a daily basis, corny as that sounds. I miss the excitement of being part of what goes on in the hospital. And I really, really miss working in mother-baby.

Being a mom is more rewarding than anything else I have ever done, but the pats on the back and financial compensation is certainly more sparse than as a full-time worker outside the home. I love being a nurse. I also love being home with my kids. I have a really hard time trying to split myself between the two. I suppose that is just the way this season in life is supposed to be. There will always be jobs for me as a nurse, but my kids will certainly not always be little; they are only babies and preschoolers once, for a brief span of years before they start to branch out into more activities in the community outside of our little household.

I was crunching numbers for our budget the other day, and realized, strangely enough, that my husband’s average income plus mine (both are variable) adds up to exactly one dollar less per month than our expected expenses. In other words, we are just making it, just barely. Staying home full-time is most definitely not something we can afford, not without going deeply into debt.

I was interrupted while writing this by my sweet little baby waking up from his nap. His dark eyes found me as I opened the bedroom door, and he gave me a gummy smile when I leaned over his crib to pick him up. We walked into the living room, where my daughter is cozied up on the couch under a blanket, eating a caramel apple and watching The Sword in the Stone. She makes silly noises at the baby to make him laugh. It’s a lazy day today. We are all still in our pajamas, although it’s almost noon. But I know that, despite my insecurities, I am right where I need to be right now. There will always be nursing jobs. I have plenty of time to dive deeper into my specialty as a nurse.

Bare minimum

Wow. Being a mom to two kids is hard. Really hard.

I need to start rising earlier in the morning so I can have a few moments to myself without a child on my lap.

Something in my routine needs to change.