The Ghost of Nursing

I am flying to Toronto in less than 12 hours, off to cover the American Psychiatric Association meeting for work. The trip has opened up an unexpected dilemma for me. I will get a lot of continuing education credits, which can help renew my certification as a Clinical Nurse Specialist in Mental Health Nursing. But I had forgotten that I have to acquire 1000 practice hours in my specialty between now and 2007.

After 11 years in medical-surgical, emergency, and psychiatric nursing, I left it all behind about 6 years ago. I saw dangerously short staffing, preferential treatment for the insured, and administrators who crunched numbers with not even a nod to compassion. There are ugly memories: patients dying in undignified ways, clinicians enrolling inappropriate patients in studies (for the money), uninsured psychotic patients being “held” on a stretcher in the cramped Emergency Room until they were just calm enough to leave. To conserve my strength, I chose my battles. But finally I just had to walk away.

I wrote about it of course. I can see how hurt and angry I was:

I am finally doing it. I am finally saying goodbye. I remember an innocent time when I thought my optimism, my cheerfulness, my willingness to help others would save the day. Now I see that it is a losing battle. My wellspring of caring is nearly dry, and I am saying goodbye before it is depleted. There have been too many years of fighting. Fighting for my patients when others didn’t care. Fighting to get them a room, a decent meal, a place to die. Fighting for some respect for the individual and for some semblance of health care coverage. Fighting for some sense of fairness, of ethics. Screaming for others to look at those who suffer. My heart lights up when I see another nurse who feels this way. I feel we are “brothers in arms.” But despite the fact that there are others like me, I am tired of caring. I am tired of feeling like the only one who cares. The system, the greed always wins in the end. I have fought the good fight, and now it’s someone else’s turn. I’m afraid there will be nothing left for my children, my husband, myself. I want to be greedy and selfish. Let someone else do the hurting, the worrying. I’m used up. I’m cold. I’m hungry. I’m shell-shocked. I’m old before my time. I hurt. You’re on your own.

Despite the obvious stress it caused me, I find myself wanting to rejoin nursing sometimes. While visiting someone in the hospital, I overhear the floor nurses chatting about a nasogastric tube or a new admission. I listen as an insider. I think, I was one of you. Sometimes I think, I am one of you.

Then I think again, about too many battles and not enough victories. I loved the patients but came to despise the system. How would I handle that stress now that I am a mom, now that I am a writer?

One thing that bothered me at first about writing was that I didn’t see it as a helping profession. And it’s not, not like nursing. But I have decided, having been helped by countless things I’ve read, that creative writing can be helpful in a much more philosophical way. Mostly I like that it can give people hope, or new ideas, or just a savored moment, reading descriptions that shine and create a new world right there on the page. But there’s a definite, lingering sadness in knowing I left my first calling behind.

I’ll be sitting in this conference with a lot of clinicians. I will feel like a pretender in that I no longer actually care for patients, just write about them for a living. It will be a good time to think about what to do.

It will be the longest period I have ever been away from Gavin, and I am missing him and Tom already.

But it’s not all heavy. There will a big, comfy hotel room and an endless supply of food. And, oh yes, maybe a few quiet moments to write, on the plane or before the first symposium in the morning. There is always that silver lining.