Like walking down an unsteady path and having to curl your toes to steady yourself, the last six months have been a bit turbulent. Some may call it a midlife crisis, but I kind of went through that when I packaged up my family and moved to England. This period has been more of a career reevaluation. A turbulent one, but one in which I think I have come out ahead. Time will only tell. As any emergency room nurse in recent times will tell you, we are overworked and our light has been dimmed. Many of us have left the field. I did too, going into the field of anesthetics, then doing another a bit of a U turn.
But first,
Before I share that tale with you, I would like to share a conversation I had with a trusted friend years ago that is still fresh on my mind. I was talking with her on my commute home. Catching up after a tough day in the emergency department (ED), venting to her about not getting my break until 8 hours into my shift. It had been an especially grueling day. And now I had a scratchy throat and felt like I was getting ill. She said to me point blank, “Well maybe you love your job, but it doesn’t love you back.”
She was referring to the fact my job was not conducive to self-care. Regularly, I went six-plus hours without a meal and held my pee for ages, always putting my patients needs ahead of my own. By the end of most shifts, I was hangry, on the verge of a urinary tract infection, and exhausted. Talking to her, I got defensive. Didn’t she understand that I put my needs aside to care for others? To be there for them at the most vulnerable point. Didn’t she know how altruistic I was? Didn’t she get what it was to have a career, not a job, one that you’re passionate about, that you put your entire soul into. Why didn’t she see it?
Maybe, I couldn’t see how much of myself, both physically and emotionally, I was giving, and how it was breaking me. And she did see it.
Fast forward, ten years later
I am living in England, working in a smaller community hospital and thanks to better management, I do get my breaks. The work is still hard. I am on my feet for hours. My system is still on high alert waiting for the next emergency. And as research has shown, persistent surges of adrenaline is damaging on blood vessels and puts you at an elevated risk of heart attacks or stroke. Not to mention the toll of the night rotation every other week that is hard on this old mother hen. Even though it is rewarding being an emergency room nurse it comes at a cost, the cost of my own health.
I decided that I was ready for a new challenge, a career change, and it led me to anaesthetic nursing. It is a different field here than back home in the USA. In England, you are the assistant to the anesthesiologist, his helping hands, versus an independent practitioner like in the USA. (My next post will be about the lessons learned whilst an anesthetic nurse.)
A new way of life
The change in field also altered my hours and my way of working. I could be home for dinner most nights and on weekends. I not only had my lunch breaks, but additional tea breaks as well. It was easier on my body, and no more adrenaline surges. Then, as I settled into this new area of nursing, walking the sterile halls of theatres (operating rooms), I learned that the clinical educator in the emergency department was leaving.
Before leaving the emergency department, having been so recently in their shoes, I had taken on teaching and giving guidance to junior nurses and recently-arrived international nurses. I found myself falling asleep at night thinking about how to describe a second-degree heart block to one of the newbies. The language of medicine lives with in me.I realized I get a thrill being able to share that language with others. Thus, the U-turn: I took a chance and applied for the position.
A Chance
I was short listed and granted an interview, my first ever management interview. That is the moment I started leading a double life. By day I worked as a new anesthetic nurse, and by night, I prepared for the interview. It consisted of creating and giving a presentation on the topic of “linking clinical education to recruitment and retention.” Two weeks later, days before the interview. I found myself walking the English coastline, practicing my presentation, titled: “Empowerment Through Knowledge: A Culture of Education”.
The day arrived, my heart was racing, my breathing exercises did little to relieve the dripping sweat from my armpits, but I felt I did well. The interviewing team, unable to decide that day, requested a day to think about it, uncommon in England. Over the following twenty-four hours, I realize the immensity of what I had just signed up for. If I got it, it was going to be a challenging position, and a difficult one to leave behind at work, as any schoolteacher well knows. Was I again choosing a job that I loved too much?
The Quandary
In the middle of the night following the interview, sitting in an empty staff breakroom waiting for an emergency worthy of an operation. I put down the book A Promised Land by Barack Obama and let my mind wander. Thinking about a possible future as the clinical educator for the department I heard the echo of Obamas words: the importance of inspiring others, is a worthy cause. Was it my fortune to guide other nurses on their journey. Or was I about to take a position that would consume me? I live and breathe the nuances of being a nurse, but can I leave it at work? Will this impede the precious moments I have left in son’s childhood?
As I crawled into morning, I was still unsure of which future I wanted. Truth be told, at this point in time, it was out my hands. But those 24 hours gave me the opportunity to reflect on the decision I was making, and the life I was choosing. Was it time I choose something for my whole self, not just for part of me.
The day before this, my wise husband asked, “will you ever be happy?” It made me chuckle and think, when will I be satisfied? Back in the States, I had strived to be a critical care transport nurse, then a pediatric emergency nurse, then the move to England, and into the operating theatre, and now clinical educator. What am I looking for? What is it I was striving for? I needed to remind myself to stop, and soak in the moment after a goal has been reached, instead of looking for the next goal.
I did not get the job.
A sense of relief laced with disappointment seeped in. I heard the universe telling me to focus on life in England, on home, my family, so I jumped fully into anesthetic nursing, no longer having to lead a double life.
The role expanded my perspective as a nurse, but it removed some of my best skills, IV starts (cannulation) for example, or thinking on my feet during an unexpected critical situation. But I had the space to let my mind wander, and the time and energy to learn new things. I found myself being thrilled during the first hours of an operations, but then I would just get on my phone and let time slip through my fingers. I became very good at Wordle and discovered Quordle.
With spring in full bloom, we headed on holiday. While soaking in the sun on the Costa del Sol, I got a call from Mobile Medics International, an NGO, to go to Romania and help with the refugee crisis stemming from the war in Ukraine. Still in training for anesthetics, I easily slipped out for a week and went to help.
On one of the days there, walking the streets of Galați, looking up at the tall cement buildings and the blue sky, my phone buzz. I had an email. It was from a fellow ED nurse at Winchester, letting me know the clinical educator assistant job (a part time, fifteen hours a week) had been posted. There I was in another country, helping to treat minor ailments, but using my skills. And teaching the local volunteers first aid as they prepared to go into Ukraine. Was the universe giving me a nudge? I put aside my fears of rejection and as soon as I got back, applied. And I got the job.
Facing the Fear
So, after five months of anesthetics training me, with only weeks to go until I was practicing on my own as an anesthetic nurse, that I put in my notice. The conversation with my manager was one that caused a tight knot in the pit of my stomach. I knew I was jumping back into the madness of the emergency department, working there part of the time, and the rest as the clinical educator. Was it the right choice?
That day, as I cycled away from the hospital, there was a group of monks chanting, a calming hum overtaking the traffic noise. It felt right. I was taking a risk in the right direction.
Learning to care for myself amidst chaos
So, I was back in the craziness of the emergency department. I felt a flutter in my chest but one of joy. A comfort to be back in a familiar environment. A feeling that any ED nurse knows after they have left the ED only to be drawn back. My first day back in the ED I was thrown right into the trenches working in one the busiest areas. The pressures could have easily overwhelmed me, but I kept telling myself to breath. And my focus for the day was to keep everyone alive. I might not complete the hourly observations/vital signs right on time, but I would provide level of care that goes beyond the numbers.
These two positions gave me balance. The two twelve-hour shifts as a staff nurse giving me an accurate pulse of the department. Then the two eight-hour shifts as the assistant to the clinical educator where I could I provide hands-on teaching and create education material for the department.
The Unexpected
Then the day came when the clinical educator and emergency department matron (director) pulled me into their office. The matron was going on maternity leave for a year, (the standard in the UK) and her position was being filled by the clinical educator which left a vacancy. One they asked if I would fill.
My current balance suited me, even though I rushed around to provide the education I wanted in the 15-hour weekly limit. I was not sure how I would handle teaching full time. Should I take another chance?? My mind replayed all the chances I had already taken, from going to the visa department when the country was shut down to moving to England. The hard part was done.This was another chance that had to be taken. The new goal was not to lose myself in the chaos of my work.
I applied, I interviewed, and I got the job.
How do we learn to give it our all without losing ourselves?
There are a couple components to the question. First, to remember to care for yourself, otherwise you will not have the energy to care for other. Second, learning to be uncomfortable. Whether it be caring for patients or working with colleagues, we need to empathize and be uncomfortable with them, without losing ourselves. As Brene Brown famously states: to be able to connect with other we first must be brave enough to get in touch with our emotion. I also like to remember that a moment of uneasiness for us, it just that a moment. A moment for us to connect, but for the other person it is a permanent mark. So, by learning about ourselves, our emotions, we can hold on tighter and not lose ourselves.
A fellow nurse once told me a story of an elder woman whose husband had just passed. She was a young nurse then, and it had hit her hard. She was crying. The woman told her “Darling it was my husband, it is my loss. You have your job to do. It is not your grief to carry.”
Back to the beginning.
I started the year looking for a change in my career, something that brought more balance to my life, and in a roundabout way, it found me.
I am breaking in this new position, learning to be uncomfortable with unfamiliar tasks and duties. Advocating for staff to be given time off to attend courses in a department that has no funding. And in my spare time I am learning about male catheterization the English way so I can teach it to the department.
All with an effort to leave it behind at work and not bring it home. I have been pulled into nursing again, and pulled away from writing.
I am about to turn forty-two, and a goal in life, a purpose, it is to leave something behind beyond myself. To cause a ripple that surpasses my existence. Education fulfills that purpose. I am still figuring out the nuances of my teaching style but now it is a full-time job versus two shifts a week. I am learning as much as I am teaching, growing humbling.
Straight lines in life do not allow you to see things from different angles. I do not know what this year will bring, but I am learning to care for myself a bit better, challenging myself in a new role, and learning to let go of work on my ride home each evening.
