Long, long ago (March 1981....I am smiling as I write that), I took a job on a rehabilitation floor of a local hospital. Most of the patients were post-head injury or stroke. I was a senior in high school, let out at noon everyday to pursue a job in my intended field. Working as a nurse assistant on that floor was an eye-opening experience, to say the least. I worked there until it was time to start nursing school in August. I grew up a lot that summer. My friends were spending the summer planning lake and concert trips, I spent my evenings feeding paralyzed patients and planning bowel and bladder training schedules. I learned how precious life is and how quickly it can be changed forever (and to wear my seatbelt). I watched as those hard-working nurses and orderlies lovingly cared for each and every patient. Many of them could not communicate their needs or wishes, but you could see it in their eyes, they appreciated us. Evening backrubs were a bedtime ritual for every patient, it took me hours, and I wasn't really happy at first at having to do that job. But over time I realized how important that small gesture was to them. For some, it was the only positive human touch they received after a day of therapy, IV sticks and phlebotomy. I stood in the background as I witnessed two "code blue" events and saw those heroic nurses bring two people back to life. I was amazed later when the patients would ask, "what happened?" and would reach to hold the hands that had done CPR on them just days before. It was impossible not to become attached to the patients that were there for months at a time. I treasure those memories, I think those events helped mold the nurse I am today.
As nursing school began, it was impossible to work evenings, so I became a weekend PCA. I often worked on the maternal child unit and found a new love. I enjoyed the work immediately. There was such joy on that unit, and there is no better feeling than bringing a new mother her baby and helping with the first feeding or bath. It was undoubtedly the happiest place in the hospital. I continued there for the next three years while I earned my RN diploma.
Now graduation was just weeks away, and all the graduate nurses were placing applications for positions in the hospital. When I started nursing school, just three years before, the hospital was offering $2,000 sign-on bonuses and begging the graduates to stay there. Now, the climate had changed. There was no longer a nursing shortage. As I was interviewed I was told that the hospital only had a few openings, and I would be hired only because I had already worked there as a PCA through school. I would not be given my choice of positions, I would take whatever was available. I later found out that only one-third of our class was offered jobs. I really wanted to work in the unit where I currently worked, but the only opening in maternal/child was a night shift opening in the newborn nursery. As I accepted that position, I also placed a transfer request to get to postpartum as soon as possible.
The night shift nursery position proved to be challenging for a new grad. It challenged my organizational abilities, but not really my nursing abilities. We worked 8-hour shifts, every other weekend, so to get two days off together, we had to work 7 days in a row. The nursery was set up as three small nurseries, overseen by one RN, working with one PCA in each nursery. We had up to 40 babies at a time in those three nurseries. The RN (GN in my case) was supervising the PCA's as they took vitals, did feedings and transported babies to and from the mothers' rooms. The RN had very little hands-on care, as we had 40 paper charts to open, chart on and close every night. The only time I really had patient interaction was if the PCA heard a murmur, I would have to confirm it before I charted it, and on admissions, the RN would do the first physical assessment. After a couple of months of this, I was feeling a little out of touch with my nursing preparations, I hadn't given a shot, started an IV or done anything really "nurse-worthy" since I graduated. I was a little disappointed. I asked about my transfer, and was told, "not yet, no openings there yet".
One night I was sitting at the desk with a pile of charts in front of me. A routine Saturday night, around 1am, I was trying to get these charts opened so I could run to the cafeteria and grab something to eat. The PCA's were busy transporting babies out for the 1 o'clock feeding and the door between the nursery and postpartum was left open slightly. From out on the floor, I hear screaming. A woman's voice is screaming, "@#$%, HELP, @#$%, HELP!" I relunctantly leave my nurseries unattended to go toward the voice. I walk into a dark room and flip on the lights. There, standing in the middle of her hospital bed, is a new Mom, in her hospital gown, screaming and crying. "I dropped him". I look into the corner of the room and see her little bundle of joy, on the floor between the bassinette and her overbed table. She had been trying to place her baby into the crib and it had rolled away from her. Her baby had landed on the foot of the overbed table. I reached for him, he was crying quietly. I ran my hand over the back of his head and there is a deep dent. I reached for the panic button in her room, activated it to get her help, told her to sit down and I told her, "I am taking him back to the nursery. I'll be back as soon as I know anything."
The next two hours I got to be a nurse. A head to toe assessment revealed a deep skull fracture, but no other injuries, and the baby was acting fine. Multiple calls to the pediatrician, neonatologist, lab, xray and supervisors, led to a paper chart with this entry becoming about ten pages in length. Incident reports filled out on carbons, another ten pages. A transfer to the NICU followed by hours of comforting this mother, who filled with grief and guilt, found it impossible to calm down and believe her baby was going to be okay. But he was, and he went home with her two days later. Wow, what a night. I was sorry that such a thing had happened, but it confirmed that I was prepared to be a nurse, not just a babysitter.
The next night I came to work, it was Sunday, the last in my long stretch. I was so looking forward to a couple of nights off. There was a note in my mailbox. It said, "Report to the supervisor's office as soon as you clock off Monday morning". Oh, great! I'm getting fired in the morning. I'm getting fired even before I get my state board results back. Great!! As I relay this information to my husband, on the phone, he says, "but that wasn't your fault, why would they fire you?' He doesn't understand, when you are in charge of the nursery, everything that happens is your responsibility. And a meeting in the supervisor's office......wonderful. She is great at her job and her enormous responsibilities, but not really a warm, fuzzy people-person. More of a military style form of leadership. I had never felt comfort or approval from her.
So, at 7am I clocked off and made my way to the supervisor's office. She welcomed me by saying, "Come in, I'm sure you know why you are here. We need to talk about your incident." Her desk was clear, except for a pile of papers that I recognized as my paper chart and incident reports. My intuition was correct, she called it "MY incident", it had become "MY incident."
She began by saying, "okay, tell me what happened." I was a 20 year old graduate nurse, not even an RN yet, still feeling a little sarcastic toward authority, and I wanted to say, "you have 20 pages in front of you that tell you what happened, do I really have to go through it again?". But I didn't, I went through the whole story again. She listened, nodded a few times and stared at me. When she finally spoke, she said, "I am transferring you." Fine, I'm getting a transfer, you can bet, it wasn't the transfer I had asked for. No of course not. Does this hospital also have a hospital in Siberia, is that my punishment? Sorry, as I mentioned, I am still fighting the sarcastic "me". I had received the "Leadership Award" when I graduated from nursing school. My family told me at the time that it really meant that I was the most stubborn student they had. I knew they were right.
"I'm transferring you to NICU. I know it's not the transfer you asked for, but give it a try for a while. If you still want postpartum when an opening comes up, I will move you into it then." NICU? NICU? oh, God, not NICU.....Baby HELL. I had spent two days in there during nursing school, two horrible heart-wrenching days. There is no way I want to work in NICU, never, never, never. But, I smiled, said to myself, "Meredith, you're not getting fired," and told my supervisor, "thank you" and left. I cried in the car all the way home. When I got home, my husband said, "so, did you get fired?" I said, "No, worse, I got transferred to NICU.........."
This did not fit into my "master plan". This was not going to work. I would keep my transfer request in place and be out of there as soon as possible. I had not learned to trust the insight of others. I had no idea what was about to happen.
I began orientation in NICU. By my second week, I found that I was falling in love with those preemies, and I was enjoying getting to use the nursing education that had sat idle for months while in the newborn nursery. I began to feel like a real nurse, and still got to see some happy times. More good days than bad, in the hospital, that really means something. Months later, that transfer bacame available. When I spoke to my supervisor, to decline it, I asked her, "How did you know?" She told me that she had poured over my charts and reports from that night, and knew that I didn't belong in the well baby nursery, "I have never seen charting like that come from a NBN nurse, I needed to put you where we could see your potential." She had seen something in me that I didn't know was there. Thank God she did. My "master plan" was shot all to heck, I have had to learn to trust, and have faith that doors open for a reason. It was a hard lesson for me, but I finally know where I belong. I've been a NICU nurse for almost 30 years.
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