I Burned Out and Logged Off: Leaving Bedside Pt 1

After nineteen years of night shift bedside, I now work day shift in a clinic. You guys, hell has officially frozen over. Pigs do fly and Adrianne works day shift five days a week. I work from home one day a week. It also means that I have a two hour rush hour commute every day. One hour in, one hour out. Well it's like forty fifty minutes whatever. I still see patients the clinic, but by and large, a lot of what I'm doing is behind the scenes, very desky.

Because I am now a nurse clinical coordinator. I'm one of two in my clinic, and I've been working with a really lovely travel nurse because my permanent counterpart, and my preceptor had a very beautiful baby, like three and a half weeks into my training, so it was a little bit of a crash landing for me. But the team has been really supportive. Now that I've been doing this since like second week in November, I feel like I'm getting a grasp on what I'm doing, doing it

without as many fumbles. Every learning process is difficult at times, but let me just tell you the hardest part of this journey so far has been going from using the inpatient interface of EPIC to using the out patient interface for EPIC. Now instead of charting assessments and that endless spreadsheet that grid, now I'm searching notes, encounters, placing orders, sending facts is via EPIC and other things that are

like completely new to me, whole new world. I spend four days in the clinic, work from home on Fridays, but then.

my post COVID bullshit. But when I started this job in November, I caught I think virus, I don't know what, but it lasted for like nine weeks. It turned into it sinus infection. It has been quite the change because, you know, switching from nights to days, I'm switching from twelve hour shifts to eight hour shifts. I'm going from very physically to demanding on my feet work to like sitting at a desk. I had to do two rounds of antibiotics to knock out the infection that was plaguing

me for the first few months of the job. It was kind of it was kind of a rough start, but we're leveling out now. Anyway, back to the dayshift clinic work. I still wear my scrubs most of the time because I'm realizing I don't have any like business casual clothes, and I literally have not been out shopping since I started this job in November.

all sorts of things. And thora's are when the doctor poke people in the back to their lung sack and we drain out fluid they should not be there. In addition to give preop instructions, and I'm helping manage prescriptions for oxygen tunneled plural catheter supplies, refilling things that need to be refilled like Inhaler's steroids. You know, of course, there's all guidelines for this that I follow. They talk a lot about working at the top of your scope,

which is a longer conversation that I want to have. Also, I'm working more closely with a lot of physicians, more so than I did at bedside. At the bedside, I was generally only calling our paging and provider something was wrong or something was missing from my orders. Occasionally, very occasionally, I would help with a bedside procedure, like I've helped with lumbar punctures before and bedside thoras and stuff like that.

But those are all under predetermined parameters. And with the level of autonomy that I have comes you know, a lot of anxiety. So they basically feed me what orders they want me to put in. I put it in, I sign it. Our schedulers get them scheduled. When a patient is scheduled for a procedure, I call with like pre procedural and auctions, the usual stuff like NPO the morning of this is how long you have to be

off your blood thinners? Patients can't do Oh yeah, here's here's a good note for all of you doing GLP ones. You should not take that within a week of having anaesthesia. So if your providers are not telling you this, you should know this. If you're going to have surgery, talk to them about your GLP ones. So anyway, this is what I do. I call people, tell them how many hours to be here, you need someone to drive you home,

blah blah blah blah blah. Side note, you'd be surprised how many people think it's okay to come out of anesthesia, leave the recovery room and then hop in an uber or get on the CTA. No no, no, no, no, no no. I am not putting you in a downtown Chicago uber after you've just had a bunch of happy drugs because I want to make sure you actually get home. I don't want you to get kidnapped, fall down, go boom, not be able to find your apartment, lose your keys whatever.

So yeah, so I call and I give people these instructions. Sometimes I have to call them multiple times because they don't get through them. Sometimes people don't remember the instructions and they call back and they go, hey, nobody called me with instructions, and I'm like, I called you twice.

So triage, that's another skill that does not come naturally to me, because in the bedside world, if something was happening, I mostly knew it to look at, listen to what monitors to hook them up to. But when you're triaging someone over the phone, you can't see them. You can only only go off of what they tell you, how they answer your questions. This was a routine I had down at the bedside. I couldn't manage that shit like nobody's business. And if things got worse, I'd call in

like rapid response or a physician or another team. Now I'm in a completely different world. The land of outpatient business is a little is different. I can't just be like, you know, here's here's a clean brief and an oxy codone, go to bed. I'm gonna abstain at this time from ranting about how people with terrible, scary symptoms always seem to call at the end of the day when I'm alone in the office without a provider to consult. So

triage has been hard. Basically, you're not only trying to help the patient, you're trying to cover your ass from missing something that could be emergent. It's those of you that triage.

but I didn't know all the intricacies of it. I didn't know what went into it, all the hands behind it. And I had never seen a bronc with my own eyes. Well since his job started. I've been able to witness broncoscopy, thora's tunneled plural catheter insertion. There are plenty of things I would love to have the opportunity to see, like a rigid broncoscope, which is what some physicians I've heard

not so affectionately called swords following. Instead of having like a flexible tube like bronchoscope, it's a long, rigid scope. I'll talk about that another day when I've learned more about the procedures we do. The things that I've learned have been so eye opening, and actually seeing these procedures happening in the in the Bronx suite feels like I'm a nurse for a first time in some ways, because I still have this awe of like, wow, that's really cool.

I can't believe they're doing that. Can I see? What are you doing? What are you doing now? And unlike on the unit, I was like I've seen a lot bar or some other bedside, I've seen an LP like I don't need to watch this, I'm gonna go get some charting done. And now I have this whole other part of my brain that's lighting up because you know, I'm learning from providers, from books, from the pas.

for them. So it's a coincidence. Now it hasn't been a long stretch, like it hasn't been six twelve months without a migraine, but it's been what like going on four That's unheard of for me historically. Now, I'm not saying that night shift was the reason for my migraines.

didn't have to barter out of my shifts. I didn't have to trade and rearrange holiday dinners, and for the better part of the time between Christmas and New Year's I was working at home a lot. So I felt like I had fucking died and gone to heaven, like for real. When I get frustrated, like when I have a caller that's agitated or a doctor that's rud to me on the which by the way, is never one of my docs. The docs on my team are wonderful. They are not rude to me. It's like a whole

separate thing. I'll talk about that in a minute. But there are frustrations, But I have to check myself and remind myself. You don't have four or five six collites going off. There's no one screaming for you. You don't have the overstimulation of alarms and beeping of phones and monitors, compewters. So I remind myself to sit in gratitude in this job because it would be very easy to become locked

into the same negative mindset. So early in the game, trying to keep myself very aware that I am now in a place that I dreamed of being for years and I didn't think it would happen. So let's back up for a second. I'll tell you a little tale. How did I get this job? Okay, it was an accident, but it was on purpose.

is interventional pulmonology. Now, at the time, I thought this was the same clinic that my coworker had gotten into, And I thought, wouldn't that be great, not only if I applied for this job, but had someone that I know already there. They can potentially put in a good word for me, and I'll have a familiar face when I start this totally new world. So at the time of applying, I didn't know if the job was still available,

if they were still interviewing for it. The way the system is set up, it's not that easy to tell those things. But I couldn't hold back. I was like, fuck it, I'm going to apply. I have a resume. I've got the resume in my Google drive been working on it for a while, which, by the way, side note not sponsored and I'm not at all affiliated with her, but I use Nurse Fern's resume template and let me tell you, two o'clock that morning, I don't remember what it was. It was like a Thursday or Friday or

something like that. Submitted my resume to the website, and by Monday I had a phone call in an interview scheduled. I could not believe it. I got they want to hire me? Are you serious? This was totally accidental. I didn't expect to hear shit from them, let alone like two business days later, so you know, like you do, I have no discretion, And I tell everyone, oh my god, I got an interview. I'm so excited, told everyone that would listen. I was talking about how the education portion

of this job was like right up my alley. The hours are great, still here at the same hospital. I don't have to go through onboarding again. Everything appealed to me. When I finally in land at the interview, I could not shut up about it. And then a few days into the non stop talking about this role, which I knew little, very little about at the time, I thought, what if I don't get it. What if I'm telling every person under the sun that I applied for this job and that I want to get the hell out

of here, and then I don't get it. I'm always telling my friends, keep your shit close, brag once it's done. But I did not follow this role, not even for a minute. And it reminds me of a phrase that my.

got the job, they hired me. I had been told continuously throughout this process interviewing that this team was like really possessive of their culture and don't want some bad apple coming in and fucking up the friendly vibes in the room. And that made me want it even more. Are you kidding me? People who get along, there's no cattiness,

there's no toxic nurses. They basically made me sound like they had been restructuring this particular department for years and they had finally got into a sweet spot where like everybody gets along, everybody does their role really well. And I thought, oh God, please, I want this so bad, so when they hired me, I would have agreed to anything, even a pay cut, which I was expecting a pay cut. You know, I don't love hospitals. I don't love healthcare as a business. But I am so glad they didn't

cut my pay. They actually increased my pay a little bit, not tons, but it was enough to mean that my paychecks haven't really changed it all since, even bedside, even though when you stack up night shift weekend shift, in theory it's a little more, but it's kind of even doubt. So I'm really grateful. And on top of it, I'm not crying after every shift. My body doesn't hurt. It's just it's one of those things that those of you that still are working at the bedside getting ready for work.

While you're listening to this, you're like, a, yeah, shut up, shut up. We still have to do the hard work. But after all those years, it's the change I needed to keep me from ditching nursing altogether. I've been at the bedside for a long time. My first hospital job was started in two thousand and five, and I've been continuously in hospitals ever since. I don't think that I wouldn't change my profession. I wouldn't change all those years

that I've done. But man, I'm glad that challenge is over, because I was getting to a point where I was like, I don't know how I'm going to keep doing this. So there are two final topics I want to touch on. First. I'm going to say, just briefly, the providers with whom my work are wonderful. I've worked in hospitals and on teams and places where I've been yelled at, spoken to like I couldn't find my ass with both hands, and also treated like my very valid concerns for my sick

patients were invalid. I've been talked to you in so many disrespectful ways by providers of all titles. During the last few months of me learning my new role, my providers have been happy to answer questions guide me, even

when they are clearly overburdened with their own work. Their behavior illustrates to me that they do view us as a team, and I'm not just some underling that they can order around, which is really refreshing because I've had people basically say, do what I tell you to do and don't question it, when my job as a nurse is to question it make sure that everything is above board for my patients.

This is just what I've seen. I know other places may be different, better, worse, whatever. We just came off the winter holiday season and one random day before Christmas, I'm in the workroom doing my thing and somebody's like, oh, hey, there's food in the other room, go grab some. And I'm like, what food in the other room? So I

go in the other room, Shit you not. The consultation room has tables with chafing dishes on them from a wonderful steakhouse, tender sliced beef, mashed potatoes, caramelized onions, cake, capri salad, beautiful layout, three different kinds of cake. It was like, I ate that food. It was so delicious and it made me think about all this shitty pizza, dried out cookies, unripe bananas offered to me as a bedside nurse. And this is not to say that I'm not grateful for every time someone fed me on a

twelve hour shift. But let me tell you, the amount of catered, excellent food I've had just from being in the proximity of physicians and conference rooms and meetings has blown my mind. I went to a training a couple weeks ago. It was just for nurses transitioning from bedside out patient. No physicians, no pas, nobody else. And I someone said, oh, at least he'll be breakfast, and I said, you don't understand. This is not going to be the

kind of breakfast. I get there and it's literally some green bananas on the table with a basket of those granola bars, you know, the ones that disintegrate into sand when you bite into them. Everybody makes jokes about them. Yeah, that's what we got. The difference was stark and sad. Oh, and they have like, I think, bottles of orange juice. Hardly anyone one took any of the meager offerings, and at the end they were like, take as much as you want take a granola bar. Nobody wants your sandy

granola bars. I'm sorry. This is like a theme in nursing. This is like, you know, you see the catering tray go by as it rolls into a conference room, and then you get some hot chocolate packets and a care off of a water. Good job on meeting our metrics. Here's your shitty hot chocolate that's probably less desirable than whatever you brought to drink from home. Okay, I keep telling my friends at the bedside, apply for clinic, come to the other side, come get these perks, come eat

the beef, so to speak. So I don't really know what to do with that emotion.

how to say it. I like spot spawn spond aliosis. My back is breaking down. I've got arthritis in both knees. But now I feel as though I will never leave clinic nurses and I want to bring all the nurses that I love with me because it's kind of bomb. The perks have been outstanding. I wish like we're doing a happy hour next week, like just the team, We're just going to go to a place nearby for a

happy hour. There were a couple other parties that I missed during the holidays because I was sick, and nobody wants somebody with a sinus infection sitting next to them at the dinner table. Anyway, the perks have been great.

luxurious compared to what I was doing before. I'm like listening to audio books on the way to work, drinking my coffee, thinking about nice things instead of being like, oh my god, oh I don't get the patient thirty six, he's so mean, or I don't want to be cleaning up shit all night and getting yelled at by my patient's family member. I mean, those are the kinds of thoughts I had driving into work, like what is my assignment going to be? Am I going to inherit a

shit show? Am I going to be working with people that have my back? Which for the most part, I felt like my team has always had my back, But like you get floated, you don't know people, they may or may not want to help you. I didn't listen to a single audiobook last year because if I had downtime, I was sleeping, or I was just completely shutting off my brain, or I was just burned out and not willing to do anything for myself. So now I think

I'm on my seventh book of the year. Seventh eighth book because I have uninterrupted time to sit and listen to books as I sit in traffic, and bonus points. The books make me not hate being in traffic so much because I'm usually laughing at some comedians, memoir or something. I listened to Kelly Bishop's book, The Third Gilmore Girl. Oh my god, I loved it. I haven't loved a

book and so long. It was so good. I used to feel like all I read were nursing journals and studies, which I still do, but it's nice to read things for non academic purposes. I feel like now I have the brain waves to focus on something else besides my own stress. Whatever. Okay, hold on, I feel like I'm sit talking bedside. Bedside wasn't all horrible, Okay. I love the team that I worked with. I have valuable friends that I have gathered from all the different hospitals I've

worked at, and I wouldn't trade them for anything. I also wouldn't give up the experience that I've gotten as a bedside nurse, because, of course, it allows me the clinical knowledge that makes me qualified for the role I have now, even though my confidence and expertise and imposter syndrome are all like quaking a little bit in this new role. I am gonna stick with this and I know I'm going to get better at it and I will eventually be as good a clinic nurse as I

was a bedside nurse. That's where we are, and I don't know what the future of the podcast is. I've talked with a few different people about a few different iterations. I would love to say that I will get back to regular posting for many, many more years, but I'm just taking it as it right now. So doing interviews when I'm working five days a week and I'm not getting home till like six pm may not be a reality.

But that doesn't mean that I can't Stele moth Off on the blog or in little random episodes, so that will still be happening. I'm if I completely.

send me. I still get some. I'm still making waves with episodes that already exist. So for those of you that have been with me this entire time, this whole like almost eight years, thank you. For those of you that are new to the podcas, I have episodes going back seven or eight years. I've tried my best over time to listen to feedback, improve my equipment, improve my quality, so the content that I'm bringing to you is actually good and you want to listen to it.

be back up and running. I don't know when, you guys, I work on it. I'm still a one woman show. I'm gonna get my ass back on the patroon pay oh my god, Patreon as well, because I got a couple Dozney you hanging out in the breakroom and I want to make sure you stay in the community grows. So h that's a very long goodbye, per usual, but I'm done for now. We have a long road ahead full of who knows what, and we have a lot of shit to talk about, a lot of serious shit,

some fun stuff too. Over the next few years, It will be more important than ever for us to speak up in the face of tyranny, disinformation, confusion, false news. All that be an advocate, be a disruptor, be uncensored.