“Helping People”
If you ask any nurse, they’ll *almost always* tell you they chose nursing as a career to “help people.” While this is true, there are a lot of other motivators. For me, it was always about “helping people,” but it was also about job security. Many nurses start out as LPNs (Licensed Practical Nurses), or ADNs (Associate Degree in Nursing). Both are typically shorter programs at technical schools, and will result in employment, given you pass the board exam. However, there’s been a shift in nursing education requirements, and many, if not most, employers want BSNs (Bachelor’s of Science in Nursing). Many places will hire ADNs, but stipulate they must get their BSN within X timeframe. My parents told us they’d help with undergraduate education, but higher ed would be all on our own. So, while I definitely wanted to “help people,” I also wanted a respectable job with little-to-no student debt.
My first nursing job was with a home-care company in my college town. I started as an unlicensed care aide while still in school, and transitioned to RN when I graduated and passed the NCLEX. I worked three 12-hour shifts a week, mainly with two families who sort of interviewed and selected me as their personal home-care nurse. I documented vital signs, made meals, helped with toileting and bathing, and occasionally gave a handful of pills. I loved my patients and their families, but wanted more excitement and clinical experience. I applied for a GA nursing license so I could try working in a larger hospital. I landed a job on a great step-down cardiovascular floor. (Like a “step-down” from ICU but more complex than a regular hospital floor.) Looking back, it was a great first hospital job, but it was TOUGH adjusting from working in private homes with only one patient to the hustle and bustle of a 36-bed cardiac floor.
One day while still on orientation, a Code Blue alarm sounded overhead. The bed assignment was close to me, and I ran to see if I could help. The bed flew down the hallway with a team swarming around, calling out orders. I remember a lively nurse about my age riding on the bed, kneeling over the patient, doing chest compressions. It’s funny, because she would later say I impressed her by jumping in, but I’ll never forget her dedication to saving that patient, though I can’t recall if she was successful. They say, “nurses eat their young,” but she later vouched for me and secured me a new job in a Charleston ICU. (We’ve both since moved on in our careers, but still keep in touch.) Once off orientation, I was responsible for 4-5 patients and walked (or ran) an average of 7 miles per 12-hr shift. I learned about IV drips and interpreting EKGs. I got scolded by big-ego’d MDs and hugged families when patients died. I became a “real nurse.”
My family and I relocated to my hometown of Charleston, SC in 2015. We literally moved into our new place during the 1,000 year flood…Google it! I started work in the above mentioned ICU. At this point, I was still a “baby nurse,” but had some confidence and hospital experience under my belt. 7am my first shift, I was overwhelmed by noise. Alarms dinging, bonging, and beeping incessantly. My preceptor was sitting, unfazed, getting report from the night shift RN. She looked at me and said, “aren’t you going to get that?” I stared back at her, and stumbled on my words. She jumped up, commanding I follow, and we went into my first ever ICU room. It was dark and small. The sliding glass door was open and vital signs flashed in all colors on the screen above the bed. The lump in the bed was attached to IV pumps, stuck-on ECG leads, and had tubes coming from all orifices. (I’d later discover all ventilated patients were also tied at the wrists to the bed—this prevented them from ripping anything out and hurting themselves.) Man, woman, black, white? No clue. The alarm was coming from the ventilator, or breathing machine. Again, my preceptor looked at me, eyebrows raised. I said quietly, “I’ve never worked with a vent before.” She pushed past me and shut off the alarm. Then she abruptly flipped on suction and threaded a catheter down the breathing tube, slurping up thick, colored mucous that collected in a canister on the wall. She didn’t say a word and returned to the desk to finish report. Welcome to your first day on the unit, only 11.5 hours to go!
Information came at light-speed in the ICU. Every day around 8am, the interdisciplinary team would gather for rounds. I thought this only happened on medical TV dramas! There was a critical care physician, usually a pulmonologist, who typically worked their ~8am-5pm hospital shifts for a week at a time before switching out with a colleague. A midlevel, (NP or PA), was present on the unit 24/7. We had our own respiratory therapy team as well as a devoted pharmacist and dietician. The crew would literally move down the loop of nursing stations and discuss; patient-by-patient, all aspects of care, for all 18 beds on the unit. The seated RN (assigned 2 patients), would start with a recap and the MD would break away to assess each patient. Issues were addressed, plans were developed, new orders were placed. Finally adjourned, teammates would scatter, rushing to workstations and supply closets. To me, this exemplified medicine and patient care. I was really “helping people” now. Right?
