Life is Like a Wheel

Stephen King once said:

“Life is like a wheel. Sooner or later, it always come around to where you started again.”

And that is beyond true. 6 years ago, I worked as a staff nurse on a busy inpatient unit in one of the best hospitals in Boston. I was literally in the trenches working my butt off and learning so much about life, love and death. My problem back then was that I cared too much about what I did and the people I cared for. I still have PTSD from so many things to this day. Images of patients whom I cared for and passed away. Some memories are bittersweet, while one in particular, would make the most seasoned nurses’ skin crawl.

Before I left this place, I was burnt out. I was miserable and unhappy and the care for my patients ultimately suffered. I would do my best but I often beat myself up because I knew my best was not as good as it had been. I started to be assigned easier patients because even the resource nurses knew that I was not cutting it like I used to. And as mad as I was at them at the time, I understand now. Hindsight is 20/20 and that is true as well.

Well, I got my masters in Nursing Informatics and I was able to secure a job doing what I wanted to do which was build an electronic health record (EHR). I learned quite a bit during my first two years not only about the job I was doing but about myself in general. I became a runner, I started to run marathons and I lost almost 80 pounds. More over than anything else, I found that self-worth that I had lost in the years of caring for patients. Not that I blame the job for it but the reality is, when you give so much of yourself to care for others, there is little to none left for you to care for, and about, yourself. It is a harsh reality because I was not only a nurse at work but I was, and still am, a nurse at home. My husband has been sick for years and I had to choose where to be a nurse and where not to be. My job lost that fight because I was not leaving my husband over his illness.

And so the years went on. I left the first job building one EHR and found another at the corporate level of the hospital I worked for doing the same thing. And then I got promoted and started to work in the best practices and the real theoretical parts of informatics. Or as I was joking with a colleague the other day, I went from doing just math problems to working with rocket scientists. The people I work with now are no laughing matter when it comes to my field. They are beyond brilliant and I have found myself feeling a bit short. The only upside seems to be that my boss understands that I am at a loss and I have been feeling lost for quite sometime. But that is another story.

Anyway, I volunteered to be a super user for the go-live as it was my old hospital. I have known this place since I was a child. I have watched it grow and change throughout the years as my own mother worked there for over 4 decades. It so happened that I had mentioned that I worked on a particular floor and was surprised to find that they wished to have me back as a Super User. Which for those of you who do not know what a super user is, it is a person who is trained to know the new EHR and help those who don’t know the system as well. Sometimes, it is just giving the end-users a little moral support as they navigate the new system. Other times, it is actually figuring out where something went wrong and letting the builders know what happened and possibly how to fix it.

The first day back was surreal. In some ways it was like I never left. There were new faces but not surprisingly there were many old faces too. And although I got a dirty look from two of the more senior people by the end of the day, one of them was calling on me for help and advice. By the second day, I really felt like I had never left. I knew the unit so well. At one point, a new grad nurse came out of a room looking exasperated. I asked her if she needed help. She said “are you a nurse?” I said of course I was and she asked me if I could get an IV line to flush. Being a nurse is like riding a bike, you never really forget. I remembered a little trick and luckily, I got it to go. All the rest of the day, I often asked if I could help in other ways besides being a super user. More often than not, they were ok with what they needed to do. But the whole experience reminded me that life really is like a wheel, here I was back where I started so many years ago, but this time, I was there to help and not be in the mix of all the chaos. I said to an old friend who has worked there for years, “maybe I can comeback for a little while.” To that she said “no! You were miserable! Stay with all the other rocket scientists. You are so good at what you do!” And to that, I think she’s right. I think what I miss most about the job I work in now is the fact that I do not get to do the super user thing all the time. It was the part of informatics I love the most. Being a teacher, supporting those who need to learn and seeing problems that I could work on fixing. Or even trying to find solutions to make their work easier. I do not get to do that in my job. It is all about the data and the modeling of the data and how the data is going to get from point A to point B and how that will help clinical decision support. Don’t get me wrong, I know how important that is but I see a gap in thinking there. I have always been about the nurses themselves and what they do. Someone I work with wants to write a grant and thus she says to me “we are going to focus on the patient and patient safety because that is what the grant wants.” But I see it as, if you do not look at the person using the system, then you cannot fully look at the person receiving the care. It is at the end-user level that patient care gets affected the most. They are the ones making the decisions. Trying to do interventions at the patient level strikes me as that they are too late.

Being back on my unit, back where I started, helped remind me why I left. Why I love nursing informatics and why I do what I do. I realized I am lost in my current job only because other people are trying to steer me in other directions. They are trying to make me something I am not and for that, I had fallen in to a deep depression over the last several months. Some counseling and just some plain introspection has brought me to this point. I think here is where I stand to try to steer my career in my job to places where I want to go. My boss asked me to be honest with him when it comes to these things. I have tried but more often than not, I feel like I am going to be thrown out. Sometimes when I let a little of it slip, I see the puzzled or troubled look on his face. But at the same time, perhaps this time I do not try to run away but instead try to make this job my own. It’s not an easy thing to do. In fact, it is hard when you are surrounded by people who are definitely more knowledgeable than you but at the same time do not understand you at all. I may not be a floor nurse anymore but I still think like one and for 2 days, it was nice to act like one again. There are no pretenses and the honesty, no matter how much it may hurt, flows like a river. As I said to another old friend from the floor, “you might leave this unit, but the unit never leaves you.”

And it does not. No matter where I go and what I do. Even in the darkest days when I said I hated the place. A part of me is always there. It time to accept that and try to turn it in to an advantage.





Broken to a “T”

broken T

Once upon a time, in a far away land,

The MBTA chugged along, carrying every woman, child, and man.

We loved our “T” and for good reason,

It was dependable and ran during every season.

Then one day a snow fury hit.

Suddenly our T was frozen, it could not move, not one bit.

Stranded and angry, we all cried foul.

How are we going to get to work? We all asked with a scowl.

MBTA has no answers. Not for me and not for you.

They all said, we wanted to get bigger, not to fix a thing or two.

And so, the Red line has buses and the Orange does too.

It is clear, we can no longer look at the T’s finances like Mr. Magoo.

The Green line runs in places and the commuter rails are stuck.

And when we ask for a refund, all we hear is, “sorry man, you’re just out of luck.”

I know I can’t make excuses to my bosses about why I’m always late.

The T is broken they say, that’s just great.

Find a new way to get to work and get here on time.

Remember, no matter what the T is doing,

you are still working on my dime.

And so we carpool, fight the traffic,

and pray we don’t get killed riding our bike.

Heck, I wouldn’t be surprised if soon there is a line to hitchhike!

So my friends, one day the T will work, I pray.

Until then, we have to get in to work another way.

Pack your bags, bundle your coats.

Let’s hope that some of us will still be able to take the boat.

Face it, the T is broke in more ways than one.

It’s time to get things going,

and keep working until the job is done!