MY BITTERSWEET EXPERIENCE AS A NEW RN IN A PANDEMIC -PART 2

Originally published at http://joylinekitur.wordpress.com on July 20, 2020.

The Good Days

There are days I certainly felt like I was at the right place at the right time with the right people doing what I loved and my presence was valued. My best days were those where I made the right judgement calls and saved patients’ lives.

Some patients with a good sense of humor cracked me up and brightened the rough nights. Small talks with patients who were genuinely interested in my Kenyan origin would sometimes evolve into eye-opening moments for those who have always been misled by movies and mass media that portray Africa as an impoverished, disease-infested and miserable continent. Those who knew Nairobi as a home to the largest slum, Kibera, in urban Africa were mesmerized by google images of alluring buildings in the city. Some were amazed at the rich Maasai culture, beaches in Mombasa, the greenland of Kericho County and many more. There were veterans and adventurers who had travelled to Kenya and had gone on a safari at different game parks and just wished they could go back every freaking winter in Michigan.

Besides the patients, my colleagues were very instrumental in helping me polish my skills. The stellar teamwork in our incessantly short staffed unit always made a huge difference. Their fun stories about their kids, pets and trips during our breaks served to lessen the tension in our workplace.

The Arduous Days

I will be frank, there were poignant times. Some night shifts were longer and more stressful than usual. I developed chronic back pain because of having to be on my feet for at least 12 hours every shift. Yoga for lower back pain became a part of my daily routine. For the first time, I intrinsically understood why some of my patients needed Flexeril for muscle spasms. My sleep schedule was drastically altered. I lost about 12 pounds as a result of work-related stress, a messy sleep schedule and change in eating habits. Handling the attitudes of some patients and their families was exasperating at times. I was forced to learn to disregard rude and arrogant patients lest my sanity would be at stake. Other days I was inundated with countless needs of the four to six patients I cared for per shift.

I was irked during some emergency cases that needed prompt responses from the on-call physician assistants and residents who were often reluctant to assess patients in person and instead opted to ask too many questions or restate the content of my pages over the phone. It’s mind boggling how physicians are sometimes skeptical about assessments of nurses who spend more time with patients and are able to instantly notice any change in a patient’s status through their meticulous assessments skills.

To ensure the best patient experience in the hospital, physicians need to learn to trust nurses. Talking of trust, a caucasian male patient once told me that he didn’t trust me. I was baffled because it was my second night caring for him and so I paused and asked him, “why do you say so?”. His response was that because I am tiny. I told him my age and then he looked at me and said, “really?” I noticed his attitude gradually change and his worry faded away. He was at ease for the rest of the night. It made me wonder how people correlate age with skills in this era.

Sad to say, I was constantly on the receiving end of superfluous racist comments, implicit and explicit biases. No one deserves to be treated as inferior due to the color of their skin. We need to recognize our stereotypes and biases. Instead of asking if I am from Jamaica, because I supposedly have an accent, simply ask where I am from.

Reliving the times I perceived someone as being racist, I am amazed at how well I handled them with my responses. I made sure to drive the message home mostly by redirecting their questions and making sure they knew I understood their racist ideologies. While some white patients were openly racists, I met some that were anti-racists and overtly expressed their disapproval of the ruthless murder of the black community in the US. One particular patient was watching the news on Tv and was very infuriated by the murder of George Flyod, I could see it in his face, I could hear it in his tone of voice. He was disgusted!

The Scary Moments

One evening at 3pm in March, I woke up to a missed call from the assistant department manager. I figured it was urgent because she used to send text messages. I immediately called back. What I heard made me think I was dreaming. A patient I provided care to, three days earlier, had tested positive for COVID-19 and I was required to watch for symptoms and call the Employee Health Department if I experienced any COVID-related symptoms. For some minutes, I could not recall the patient but somehow I managed to recollect my thoughts and analyze my encounter. The only personal protective equipment I had during that 12-hour shift was a simple mask. Face shields were provided later.

The patient was asymptomatic and unfortunately our hospital was still very conservative on testing everyone who was admitted due to limited coronavirus testing kits. Luckily I never experienced any symptoms. If you still doubt the health benefits of wearing a mask, get it from me, WEAR A MASK IN PUBLIC! It is going to save your life.

Another notable but terrifying moment was when I was about to push medication to a conscious patient through a PEG tube (a tube through one’s stomach for feeding and medications when oral intake is inadequate or impossible). The patient suddenly became unresponsive. I quickly glanced at the identification band hoping that I could resuscitate them but I couldn’t because they were DNR (Do Not Resuscitate).

The patient was non-verbal and frail due to comorbidities but I did not expect anything of this sort. I had cared for about 20 palliative care patients, meaning their death was expected, but never had I experienced such a sudden death. Working in an oncology unit, we often had patients with terminal cancer and I learned to be brave in the face of death. I had to be strong, compassionate and supportive to patients and their families. It was the hardest part of my job but reading about this inevitable rite of passage equipped me with meaningful ways to ease the pain for both the patients and their families.

Recommendations for Effective and Efficient Nursing

Nursing has been ranked the most trusted profession for the 18th year in a row in the US according to the 2019 Gallup poll. Unfortunately, I consider it the most challenging as it is fraught with scores of stressful situations. Every life is important, every patient deserves the best care and when a nurse feels like the safety of any patient is compromised, he or she is affected in some way. This is why adequate staffing should be a priority in any hospital.

Nurses should also recognize that self-care is imperative and foregoing it poses a health risk not only to themselves but also to the patients. Except the one time that I feared for the lives of the two critical patients, I always claimed my right to breaks in the nursing lounge and sometimes I practiced a 10-minute meditation in the welfare room to help me destress.

The 12-hour shifts need to be amended to more reasonable schedules. A normal human being can only function effectively within a certain timeframe. Many nurses like being able to work full-time in only three days and have a long period of time off but the weekly burnout could culminate in health problems including chronic back pain. It always took me at least 24 hours to recover from a 12-hour shift. Studies have shown that caregiver fatigue increases medical errors. Hospitals and nursing homes should come up with creative staffing methods to avoid the long working hours that lead to fatigue, lack of job satisfaction and poor quality of care.

Additionally, there needs to be a collaborative nurse-physician and nurse-patient relationships. It is only until then that patients will receive the best quality of care. Prompt responses from physicians will avoid unnecessary delays in patient care and improve patient outcomes.

Final thoughts

Overall, my experience at Sparrow Hospital was transformative. I gained a myriad of skills including problem solving, critical thinking, cultural awareness, compassion, professionalism, attention to detail, time management, proper communication and many more. I have morphed into a more empathetic, patient, compassionate person and a better listener. Besides, I have come to appreciate the small but beneficial things in life like a good night’s sleep and good health.

In case you read part 2 before reading part 1, here’s the link to part 2 for your convenience: https://medium.com/@joylinechepkorir/my-bittersweet-experience-as-a-new-rn-in-a-pandemic-a8fa89412b83

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PhD Student @Johns Hopkins, research interests in breast and cervical cancer. Aspiring author. I write about health & wellbeing, personal experiences, poetry

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Joyline Chepkorir

PhD Student @Johns Hopkins, research interests in breast and cervical cancer. Aspiring author. I write about health & wellbeing, personal experiences, poetry