Friday, July 6, 2007

Nurses eat their young

REFLECTING ON: Nurse burnout and the old school...

The last thing I wanted to do was make waves on my first week of clinicals. Oh well. But I swear this really had nothing to do with me…this time anyway.

So there I am, in the oncology unit’s nurse’s lounge, sitting down and trying to “play nurse” with my preceptor, Lee. I’m looking at the patient file and literally trying to figure out what “MAR” means (let alone its contents) when this mean looking nurse comes in and scolds me, or more appropriately put, tears me a new one. “You’re not supposed to be in here doing work—this area is for relaxing only.” Please meet Mildred, and for all terms and purposes, this is a fitting way to meet her.

Confused, I look to my preceptor who is now making a thorough examination of the ceiling. Mildred continues, “Not only that, the student nurse shouldn’t be taking seats from an actual nurses doing actual work.” Sweet. I just stepped on toes, got thoroughly trounced, and I don’t even know what MAR means. Since Mildred is belittling me and addressing me in the third person, I think it’s safe to say that I shouldn’t ask her.

So, wow. Okay. Let’s not lose our cool. Clearly there has been a misunderstanding. Let’s approach this logically and diplomatically. After all, we’re all professionals here. “I didn’t know”, I say, “my apologies…I’ll move my work somewhere else.” I’m a bit miffed that my preceptor hasn’t said anything to Mildred since she was the one that told me to sit in here, but I let it go. Completely resolved to avoid further confrontation, I begin gathering my effects.

“And maybe the student could clean up while he’s at it.”

No way. This is a power play and I am having none of it. I don’t care if I get moved to another floor or even if this is how students are normally treated. This woman has no manners. And if this is how nursing students are treated, I don’t want any part of it. Having worked with emotionally disturbed boys for nearly a decade, I’ve developed thick skin to insults that range from my manhood to my mother…but this third-person nonsense has got to stop. God I hate bullies.

Standing up, I look at Mildred, “Okay. I get it. I’m the new guy—and a student to boot. But the student’s name? His name is Nat.” Extending my hand in a manner of greeting I am more accustomed to, I stare at Mildred straight in the eye. “Nice to meet you.”

For all her bluster and braggadocio, Mildred crumpled like a house made of cards. Extending a limp wrist handshake, she mumbled, “Well you’re still a student to me,” and walked out of the room.

Feeling vindicated, I turned to Lee who sat there stunned. “Wow, way to stand up to Millie there. She does that to everyone. She’s of that old-school style of nurse. You ever hear the saying, ‘Nurses eat their young’, well that’s Millie.”

I hadn’t heard the saying and my first reaction was that it was just horrible. Nurses eat their young? Yuck. Just disgusting. I mean, I get it, some folks need to toughen up sometimes, but I’d rather not feel that I’m going to be consumed like the runt of the litter in some unspoken, pseudo-Darwinesque training program while learning a profession that presumably embraces compassion. I mean, there’s got to be middle way. Right?

The following week, I, yet again, inadvertently crossed Millie, but this time she avoided me altogether. You see, someone had “unknowingly” assigned me to her patient caseload because I had unwittingly done pre-lab on one of her patients. Instead of shifting me off that set of patients, they shifted Millie. When I realized what had happened, a very flushed and very angry Millie stormed passed me shouting, “Twenty-five years here and they treat the students better than me!”

Later I learned that Millie had thrown a magazine and then broken down into tears in the nurse manager’s office. Clearly, this had nothing to do with me. Another veteran nurse confided in me that Millie had been the “elephant in the room” for a while now. I just happened to be the last straw that blew in and broke her back.

Millie was clearly experiencing burnout, and was given some mandatory vacation. I never saw her again that quarter, but I certainly am reminded of her on a daily basis. Burnout is a common affliction in the nursing profession. There are tireless nurses and there are tiring nurses that are under the delusion that they are the former. Having seen first-hand the exhausting and emotionally jarring work that nurses do, it surprises me that there are not more Millies in the world. I feel simultaneously sorry for and leery of Millie. Sorry, because I later heard that Millie, in fact, was an excellent nurse. And leery because I am scared that I, too, have the potential to act like her and not know it.

If I ever act like Millie, you have full permission to put me in check. I’ll thank you for it later.


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