Challenges in Nursing

Sometimes life doesn't make sense. But I have concluded that it is my job to try and make sense of it. I will not always succeed in this area and perhaps I need to accept that it may be years down the road, maybe even after this life ends, before I understand why everything happens the way it does. Until then I will continue to try and make sense of the experiences I go through in life.

For some time now, I have been wanting to write a little about a very challenging experience I have had in my career as a nurse. It took until this past year to open up with several close family and friends about this experience. It happened years ago, but it has affected me so much and I am still trying to make sense of what happened. I am also trying to see all the positive that has come from this experience. I believe that by writing it down, I will discover even more good that has come from this experience.

When I served my 18 month mission in Ecuador, I was assigned to be the mission nurse. I was fairly new at nursing (I had worked part time in a special care nursery/postpartum unit for 16 months beforehand), and I was put into a new and challenging situation where another nurse and I were in charge of the health of about 180 missionaries from all over North and South America. Some of these missionaries only spoke Spanish so I had to learn Spanish in order to answer their health questions over the phone. The calls were literally at all hours of the day and night and some days were overwhelming with calls and medical concerns. It was tough! We dealt with appendicitis, gallstones, parasites, kidney stones, food poisoning, fungal infections, mental illness, accidents and much much more. We sent or had the missionaries pick up medications if we felt they were necessary (you could get most medications without a prescription in that country at that time). We would make appointments for sick missionaries with Ecuadorian doctors and accompany them to these appointments. We would even consult doctors from the States if there was a particularly hard case. I survived and so did those 180 missionaries. I know that I received help from above! I can't really explain it, but I know that I was able to succeed in this challenging assignment because God helped me use the knowledge I gained in school, apply critical thinking skills and develop confidence, perseverance and a hard work ethic, to take care of those missionaries. I look back on my mission as a humbling but positive time in my life.

Then came the really humbling experience. I was a very confident nurse when I came back from my mission. It was no easy task taking care of all those missionaries but I was successful. I felt like I was used as an instrument in the Lord's hands to help those in need and I believe I saw miracles on my mission. With confidence, I applied for my dream job in nursing and was hired right away. I dove into the orientation process with optimism. I was going to be the best nurse ever! But that was not to be. To this day, I still do not fully understand what happened next. A couple of months into the job, I made a huge medical error, giving a patient 10 x the dose of morphine he was supposed to receive by programing the wrong rate into an IV pump when the patient was on a continuous morphine infusion. It was at the end of my evening shift. Another nurse co-signed with the calculation and preparation. I hung the bag. It was not caught on night shift. He ended up being okay (just very sleepy and most likely a low respiratory rate if my memory serves me right) but I was not. I was very shaken.  I was also re learning how to work as a nurse in an English speaking country after so long in a foreign country and perhaps I was struggling to cope with a loved one who had just been diagnosed with a terminal illness. I do not know what my problem was.  The nurse educator started following me around which made me so nervous that I would often answer questions wrong when she fired them at me. Every wrong answer or little mistake (example, I accidently charted a leg measurement wrong)  took me further into a downward spiral of shattered self confidence, more wrong answers and more little mistakes. But I did not give up. Every day I anxiously got ready for work, said a prayer and tried my hardest even though it seemed like all my co-workers were against me. And then one day, it was over. I was fired. Perhaps I should have known it was coming but I was so busy fighting to do better that it caught me by surprise. I went home that day feeling defeated, alone and scared. In my mind, my manager looked at me as though I was worthless. She did not want anything to do with me after that day even though I wanted and desperately needed support in knowing how to move forward. How was I going to provide for myself? Did I waste 4 years of my life working so hard for a nursing degree (ironically, I did very well in school)? Would I ever be able to practice nursing again? Why did God allow this to happen when I worked so hard on my Mission? I cried myself to sleep many a night during that time.

But I could not give up! There had to be a reason that I was a nurse. I had something to offer. I knew I did. So the day after being fired, not knowing where to go from there, I did some research and signed up for some nursing refresher courses. I studied so hard and with faith and courage walked into a new hospital, selected a random unit and talked to the manager about doing a preceptorship there that would allow for me to complete the clinical portion of a course I was taking. I gave it my all during that time and after my clinical was completed I was hired for a temporary position on that unit.

The story does not end there. Due to being fired from my previous job, I was subjected to a disciplinary action from the nurses registering office that I was under when working at that job. It took over two years for this to be completed and I felt like I was on pins and needles that entire time awaiting an unknown future. I had to go through an investigation process involving an interrogation meeting and I had to have a lawyer support me through a Hearing/court type experience. I was newly married at that time and was very sick as I was pregnant with our first child. My mother was such a support to me and came with me to lawyer meetings and Hearings. My husband was an amazing support to me as well and loved me no matter what happened. My new manager and charge nurse were also very supportive and even showed up at a Hearing to offer support. At those Hearings, I had to swear on a bible before being questioned and I had to listen to old co-workers testify against me. It was so horrible to hear people talk about me like I was a criminal. I felt like I was the scum of the earth. And being so sick in pregnancy, I had to hold my urges to vomit while sitting for hours listening to a room full of people talk about me while deciding my fate in nursing. I know it is not the same as some people who have gone through much worse court experiences involving car accidents or other incidents where they are to blame. At the same time, I empathize with these people as I know what it is like to feel like I am the worst person ever. I know what it is like to ache for the ability to go back in time and change the past.

There is a happy ending to this story. The case was dropped and I was free to continue nursing with no restrictions. Perhaps the case was dropped as the unit I had worked for had some flaws and could be held accountable for some of the bad experiences I had there. I remember my lawyer looking at some of the things that were said about me like they were the most ridiculous concerns. Perhaps, in a way, my quiet, sensitive nature had made me a scapegoat. I am not one to assign blame to others. In fact, a downfall of mine is taking too much blame upon myself - I tend to soak it all up.  Regardless of why the case was dropped, I count it as a huge blessing in my life that I can continue working, especially now that I am helping to provide for our family.

And so I have been left to pick up the pieces of my self confidence and put them back together. I am not yet where I hope to be but I am getting there. I know I am a good nurse and I need to remember the moments that prove that to me. Last year, during one of my last shifts before going on maternity leave, one of my patient's told me that she thought I was "a great nurse." I was gentle and kind, knowledgeable and efficient in getting all my tasks done. Most of all, that patient knew that I cared about her and truly wanted the best for her. I believe my patients know that. A sincere caring attitude makes me the successful nurse that I am today. And although I still struggle with anxiety each time I prepare to work a shift, I know that when I enter the hospital, I will focus, the anxiety with disappear and I will do my very best. Even though I am not perfect and I struggle at times, I am the nurse that I need to be and I am good enough!

As for making sense of this experience, I believe there has been much good that has come of it. I am extra careful at not making rash decisions whether it be at work or home. For example, I do a thorough job of doing medication checks and of researching new medications before I give them. I will always ask another nurse for help if I am feeling overwhelmed or if I am unsure about something. I am more sympathetic to my patients' individual experiences. I also am more sensitive to my co-workers, friends and family and all they have to deal with. If I see a co-worker struggling, I offer advice or lend a helping hand because I know how it feels to be overwhelmed. I try to be understanding and give everyone the benefit of the doubt. I have more charity for those around me. I do not know what my future holds but I do know that I can let my experiences shape me for the better and I know that this experience has and will continue to help shape me into the best person that I can be.