Used Nurse: Part Deux

[VivaLasViejas]

Three fulltime nurses and a medication aide who once held secure jobs, now stand figuratively on the trapdoor of the gallows, shaking our heads in astonishment at finding ourselves here and wondering how the hell we're going to get out of this predicament.

It's not like we got fired. We're just not on the schedule anymore. Our facility's census, which can be as high as 135, has been hovering at around half that for the past year or so; now, thanks in part to Medicare cuts, our management has slashed staffing basically in half. In the blink of an eye, I went from 32 hours per week down to eight, with only a minimal chance for more during the course of any given week. The decisions were based on seniority; another nurse even lower down the totem pole than I has been placed on PRN status, and still another has been let go entirely, while the CMA's hours have been cut to one 7.5-hour shift per week.

Wait, it gets even better. This is a small town surrounded by other small towns. There are few nursing jobs open, if any, and most of what is available is either part-time or on-call..........no health insurance or other benefits, of course. That is bad news for anyone, but especially for a nurse with a bad knee (that's about to be operated on) and a couple of chronic health problems requiring daily medications.

Don't get me wrong; I'm not giving up THIS easily. But I can already see the possibility of winding up in a job where, instead of asking folks to rate their pain, I'll be asking them how they like their eggs.

If I were a better person, I would foreswear bringing up politics here; but since it's my blog, I'm going to say what I think. And what I think is, if this is the kind of "help" our government officials meant when they claimed that healthcare reform would benefit everyone, they can put it in a place that's accessible only by endoscope.

I was never unemployed when I was "helping" myself. Does anyone really think they have plans to "help" all of us who are losing our jobs, especially those of us in later life who find ourselves starting out at square one again? At fifty-one, I'm not even sure how many more times I should HAVE to start over; I certainly don't appreciate being forced to now.

But I have no choice: I can't live on one shift per week. I also can't afford to retire, not that I really want to (although I'd give my collection of hundred-dollar work shoes for a 3-day-a-week job that would let me eat AND pay all the bills in the same month). So I've got to polish up a resume that hasn't seen the light of day since 2006, dust off my one pair of dress shoes, and try to arrange my face AND my thoughts in more attractive lines before hitting the pavement.

This is, of course, not what I'd expected to be doing at this stage of life. And I'm alarmed at how rapidly my self-confidence has dissolved in light of these developments. Suddenly, I'm horribly depressed and anxious.....and here I'd finally gotten comfortable with who I am and where I fit in this world; I'm also experiencing that sickeningly familiar rollercoaster ride after having found the right balance between life and work. And while I'm reasonably sure I can find another job, the pickings are so slim here that I'm afraid I'll wind up taking anything just to put food on the table.

Just in case you're wondering: No, going back to school is not in the plan book. I'm still paying on my old student loans, and I have absolutely NO desire to tackle O-chem and statistics. Moving out of the area is also not the answer; our roots are here, and so are our grandchildren. I would be willing to travel a little to get back and forth to work---I've done it before---but with gas prices near $3 a gallon, I'd rather not if I can avoid it.

Now for the absolutes: I can't handle more than the very occasional 12-hour shift. I can't work Med/Surg for any length of time......both are far too hard on me physically. Nocs are not really an option either; I had trouble with mental fuzziness and confusion when I worked 11P-7A in my early 40s, so I can't even imagine how I'd perform now. And the types of nursing I will never, ever do in this lifetime are NICU, corrections and mental health/psych---I think I'd sling hash at Denny's before taking a job with critically ill babies or in any facility that locks the staff in with the inmates.

Other than that, I'm open to suggestions. ? Don't mind me if I just "hang around" for a while and see what you all come up with!

[rashana]

Hi Viva

You are in an awful situation but honestly its not the government's fault. It's been like this for much too long. Please let me explain.

In 1982 I wrote the bestselling book called "The Nurse's Story" where I outlined all the abuses nurses had to suffer in order to practice. I told the stories of heroic nurses and patients and what their sacrifices cost them. For me, nursing was a calling and I didn't love anything more. But after 16 years I just burned out. It wasn't just the patients and the disease and death that wore me down, it was all the fighting, the lack of recognition, the no benefits, the credit given to the doctors and not the nurses and all the notes to cover the "business" of medicine and protect them from malpractice suits.

Nursing is one of the hardest jobs anyone can do but have you seen what we get paid compared to stock brokers? I toured with my book to 27 cities and I sold a lot of books (by the way it took 3 years to write that book and commercial publishers only pay between 7 to 10 percent -like $2.00 a book-worse than nursing!) but the point I want to make is that nurse's don't insist on rights given to other professions. We haven't learned yet to separate our need to help people and make a difference with our right to have a good life. We really do need to empower ourselves. I do understand that things have gotten somewhat better...but also worse, I'm afraid. In 1997 I updated my book and in doing the research I learned that as we got paid more and got more benefits, the "business" of health care began replacing us with others who were sometimes trained for as little as 6 weeks. They took us away from our patients and from the bedside. And those of us they left there were overworked and burdened with impossible work loads. So I know it seems like an awful thing to be laid off but maybe you should begin to write, and post and blog (I must have written hundreds of emails to the government during this health care reform) But maybe we have to make the patients aware that they can't even ask the right questions unless they know those questions, and only nurses can act as their advocates. Maybe the tool we need to use is our knowledge. Maybe we need to use the internet to let people know what's going on inside hospitals and maybe we should have patients help us fight for better nurse patient ratios. Maybe they need to know how much they do need us at their bedsides. But in order to do that we need to share with them what's really going on. So maybe V, you can start there. Let's just all begin to tell our stories. Let's tell them what our patients go through. And let's just begin to fight big business and empower ourselves and our patients. Remember we know things that the patients don't, and if we want them to help us, we have to help them and help ourselves! I hope everything works out well for you. xxx

[nursemike, ASN, RN]

Sorry about your situation, Viva. (Bleeding heart liberal alert) But I don't think it has much to do with healthcare reform. Medicare is always trying to cut costs, and while that's a pain for us, it's also pretty much inevitable. We're all getting older, and with more and more people eligible, it's either reduce pay outs or increase income (taxes). I'm afraid I have to agree that a lot of times too much "meat" gets cut out with the "fat," but my hope is that in the not-too-distant future, adding millions to the ranks of people with some form of health insurance will be good for business, and good for people. At my facility, we are pretty much always sitting on some patients getting weeks of antibiotics because they have no insurance for home care, or even LTC. It's bad for the patients, lying in an acute care bed so they can get vanc Q12, and it's bad for our operating margins, since they can't pay us, either. My biggest complaint about universal healthcare, so far, is that it's nowhere near universal. Not yet, anyway.

And I can't blame Obama for the economy going in the crapper. That's pretty much an inevitable consequence of de-regulating the banking industry. In the name of free enterprise, we gave them enough rope, and they hanged us all. So now we have lots of SAHMs reactivating their licenses, part-timers going to full time, and displaced auto-workers (or whatever--pick an industry) enrolling in nursing school.

I hope things work out for you, and I'm optimistic they can. But I'm less optimistic about the future of nursing. It seems to me like were heading toward a handful of executive RNs overseeing lower-paid technicians. I've never worked LTC, so I can't say for sure, but it seems like that model can work in LTC, if you have a really good team of CNAs, working under LPNs and RNs who are really engaged. But it isn't hard to picture a corps of people who couldn't get jobs at McD getting a few weeks training and working under people who rarely leave their offices. My impression is that may already be the case in some of the worst LTC facilities (and/or people who do have the knowledge and ethic, but way too much to do), and that sounds like a catastrophic model for acute care.

They only bright spot is I doubt many of us grey-haired nurses will live to see it. Except maybe as patients. And probably not long, even then.

[Doc Lori, R.N.]

You want to know seriously how crappy it is out there? You would never be hired to sling hash. You are over-qualified. How convenient it is that you were not fired. (I assume this means that you cannot collect unemployment insurance)?

I tend to get philosophical about issues like this. I believe that everything occurs perfectly, as planned, as it should in our life times. It is in the moments of our deepest anguish when we are closest to the light of possibility. Not sure if or who you pray to, God, Goddesses, that tree, those shoes, whatever or nothing or no one at all. Just have faith. Just believe. Just know that you deserve only the best, and that you only need to remain open to it. All will be well, all will be as it should. Keep us posted :)

[CranberryMuffin]

I'm sorry to hear about your situation. But I'm wondering what it has to do with health care reform. Facilities are slashing spending everywhere to save whatever money they can in this economy. It's not so much a health care reform issue as it is a recessionary issue that people's hours are being cut/laid off and new grads not being hired.

It's easy to place blame on politicians when the makings of this current recession have been a long time coming, and created by multiple factors. It's also easy to scapegoat our current politicians when it's actually many, many people to blame. Our health care system is a giant mess, and pointing the finger at one person or one moment in time really dismisses all of the other things that went into creating this problem.

I do sympathize with your situation and hope that you can find something that works out for you. Have you considered relocating close by temporarily? I know it's not ideal, but I know a lot of people displaced by the recession. What about consulting?

[Teamlangston]

OK so I've only been a nurse for 3 years but so what. I do know from that of which I speak. I am now in the position of transferring from an LPN position at an in house rehabilitation site for eating disorders into an RN position at an ER. Why not look into other options such as rehab facilities? I absolutely adore my position now, but because of the drive (55 miles one way) I have chosen a different route. The place where I am is mostly a pill pass or two, with the occasional PRN, and just being able to BE WITH YOUR PATIENTS. Sometimes all they need is an ear to bend, No biggy. It is THE BEST JOB I've ever had and I'm sad that I'm leaving it. Even though I'm going to a job that offers more skills and hands on..this is the best job by far. I hope you are able to find what you're looking for. it is out there...just keep hunting.

[ANnot4me]

Hi Viva--

I hate to hear that anyone is suffering financially: I hope it turns around. On the other hand, I feel like in blaming health care reform you are skipping a few steps in your reasoning. For instance, you mention medication aides. It would seem to me that the loss of your job might have begun when that position was introduced. Many nurses who were just passing through nursing were all too happy to sacrifice the integrity of the profession. Unfortunately, many have had to come back and face the monster they helped to create. Most of what has happened "politically" has nothing to due with health care and everything to with greed combined with a nursing workforce that didn't feel their profession was worth the hassle.

[carolmaccas66, BSN, RN]

Hey Viva

The same thing has happened to me. I was doing combined reception/some nursing at a doctor's surgery, went back to work after lunch, and was told to my face that I wasn't needed anymore - so the doctor could get family members to work for her for nothing. I was angry & annoyed but I put my anger to good use, & marched over to the nearest employment office. I have done jobs that weren't nursing to pay the bills. I have worked in a factory packing and grading fruit (where the temperature was 50cC sometimes), reception/admin work, packed supermarket shelves, been degraded by managers cos I needed the work, have got up at 4.30 am for some jobs, and generally done jobs that no-one else wanted to do for crap pay. The point I am making is you may have to swallow your pride (not easy I know) & your years of nursing experience to do something else. Of course you don't want to - but you may HAVE to.

Can you do something like giving nursing advice over the phone, or work in a doctor's surgery? Get your resume and make it short, sharp, sweet and to the point - see an employment consultant if you can't re-do your resume yourself. It doesn't have to be fancy: just easy to read. Apply for everything and anything - you may get something you don't want, but we can't always be fussy.

Get on the web job sites and apply from there, even better I have found is cold calling people and after chatting for a bit say, " and what is your email address so I can send you my resume?" Also in your job applications stick to the facts, emphasise your strengths and experience, and say at the end that you look forward to seeing them at their earliest convenience at an interview - it seems to work for me.

Harsh words but unfortunately my opinion is this is a harsh world. Management does not care how long you have worked in one place, and people soon forget you when you have left a work place. And yes, I do blame management for many workplace problems, the ones who sit in front of computers most of the day & don't get onto the floor to sort out any issues.

And no I don't believe things happen to us in this lifetime for a reason: crap just happens to everyone. You have to take control and feel like you are in control, or nothing will happen. You can't afford to sit around, get out there tomorrow and start cold canvassing. I am sure something will turn up.

I am praying for you!!

[354alpham]

I'm sorry, but you just can't blame health care reform like that. Take some time to actually learn what has changed. Good luck in the future.

[VivaLasViejas, ASN, RN]

Of course I can blame healthcare reform. It's my blog; I can blame whomever I please.

I know things are a lot more complicated than that, although Medicare cuts hit skilled nursing homes and hospitals especially hard.

Sometimes, though, when you're hurting and there is absolutely NO ONE to blame for it, you just lash out at the most convenient target, and for me that was Obamacare.

And as for actually 'learning what has changed'........even Nancy Pelosi said no one really knew what was in the reform bill, so they had to pass it to find out what was in it.

[felixfelix]

Yea, I feel you, Viva. I just got out of nursing school at 50yrs. old and worked in mental health for 1.5 yrs. Left after an incident/accusation and am now leaving nursing. I can't find a job to save my life in this field. But I'm ok with it, it's good knowledge to have under your belt. Too bad the system is shrinking and not expanding right now, so that's the way she rolls. I wish you luck.

[SmilingBluEyes]

I am just so sorry my dear. You are a brilliant writer, however,and a wonderful mother and friend. REINVENT YOURSELF and your life. Take some time to think about where you want to go. I say writing is a good direction. NOC may be better after 50 than 40. I have heard that before from others....

Point is, I love ya; you are one of my favorite members here. So does your family. Do what works for you. Keep your eyes and ears open and remember, when a window shuts, Often God opens a big door for you to go through. You just have to trust in faith and take that leap....recognizing an opportunity when it presents itself. There IS something greater and better for you, I feel it. Good luck my friend.

[noreenl]

Viva I just wanted to offer my heartfelt support and love for one of my favorite educator-entertainers on this entire site!!!! You have helped me see the lighter side in some of my roughest days in the past year!! Just wanted you to know you are loved and if you are ever in NYC and want to be a school nurse I would hire you in a second!!!!:redbeathe:redbeathe:saint::hug::hug::hug::flwrhrts::tku: