Never Enough

This week, I'm talking about Jodi Picoult's Small Great Things, a book about a nurse who was sued because a family member saw her performing her job and didn't understand what was happening. They saw what they thought was abuse and because they had already asked for her not to touch his son (because she was black), they thought she was hurting him on purpose.

On Wednesday, I talked about how this book made me think from a racial standpoint. Today, I want to talk about the nursing side of it. Ironically, this is the side that I'm more nervous talking about. Not because I don't have anything to say, but because I'm very cautious about what I say online about work. I'm very conscious about HIPPA, and about protecting the integrity and reputations of where I work and where I used to work.

Here's the thing, I've worked in multiple facilities, mostly long term, as a nurse and CNA. When people are sick, they're not themselves. I understand that. Patients are dealing with pain, dealing with a new diagnosis that has flipped their lives upside down, or with loss that they can't quite accept yet. In a way, it makes sense to lash out at the people taking care of you. They're right there, after all. But in many other ways, it doesn't make sense.

At least, not to me.

My typical workday consists of a twelve hour shift. I usually get to work half an hour early so that I can read up on charts. So that I can prepare myself and know the information necessary to properly take care of my patients. After my shift, I give report to the next nurse, so that they know what's changed, and to promote the best possible care for my patients. Some days, things get hectic. I might have to stay late to chart, or to finish my responsibilities. Maybe one of my patients had a sudden change in status right before I leave. Either way, my typical shift tends to be closer to thirteen and a half hours -- on a good day.

I'm there all the time. It may not seem like it, especially if I'm in someone else's room, but that doesn't mean I don't see what happens.

The problem is I'm only one person. Just one nurse, and even though most of the places I work have great support systems, a lot of the responsibility falls on me. I understand that and I accept it.

There are just too many days when I feel I'm not enough. With my knowledge, with the skills that I'm still perfecting, I'm still never exactly what my patients need. There's so many instances in my shift when I have to make a decision, when I have to choose between two patients who need me. Maybe it's more than two. I can't count the number of times I walk out of a room to see the entire hall lit up with call lights, and know that no matter how fast I work, no matter what I do, I won't get to them in the time that they want.

That's when it sometimes feels like it's too much. When I already know I'm doing everything I possibly can, it's hard to hear patients and families complain that I should be doing more. I'm not allowed to tell you what I'm already doing, or what the other patients need. There's no way for me to tell them that I have a patient next door that's going septic and might need more serious intervention in the next few minutes. Or a patient who's confused and jumping out of their bed, and I want to keep them from falling and getting seriously injured. I can't tell them about the patient who broke my heart because no matter what I do, I can't seem to control their pain. Or the patient who's detoxing from drugs and hasn't stopped screaming at me since I arrived on the floor.

Nurses carry a lot of what they experience in their hearts. I've seen it in so many coworkers. It's a taxing job, and there are times we snap. I know I have, though I've been fortunate that it's never been in a patient's room. There are moments when I have to leave the floor because I can't deal with it anymore. It's frustrating, and often not because of the patients but because of the situation.

My husband often tells me that either you cry or you laugh. He tells me that whenever I'm angry or annoyed. He says "Do you want me to cry or laugh?" That's how it is with nursing too. We have to get these emotions out. Often, it comes out in the form of jokes, in a way of relieving the pressure that we feel. It has nothing to do with what we're really thinking, it's a coping mechanism, one that helps us to be the best we can be with the circumstances around us.

I think the hardest part is knowing that often, the most memorable experiences are the bad. If a patient is upset with their care, it doesn't matter how much we've done for them. It's what more they wanted us to do. Often, I feel like I'm measured by my shortcomings, rather than by my actions.

Racism in Nursing

On Monday, I mentioned how I wanted to talk about Jodi Picoult's Small Great Things this week.

When I first started the book, I honestly thought it was from the 50's. The white supremist family felt off to me, because I don't deal with it on a regular basis. Ruth seemed to take offense with everything, and acted like people treated her differently because of her race.

The more I thought about it though, the more I realize that it still happens. I don't deal with the same kind of racism, just because I'm Asian, not black. Even so, I do deal with prejudice from my patients constantly. Not just my patients, but from my workplaces as well.

I honestly can't count the number of times that someone has said something that I've blown off. I heard them, and I always assumed that they didn't mean any harm by it. I've had patients call me the 'Little Chinese girl' and 'that Asian one,' and I even had one sweet patient call me his 'Little Indian' every single night. For me, it almost felt like a distinction. I am Asian, I'm not going to deny it. If they don't remember my name, then it's an easy way to describe me.

Then there's the ones who aren't quite so nice. I've been screamed out of a patient's room and as I left, her closing comment was "Get out of here... Yoko!" Which for me, didn't hold quite the same impact. I wasn't alive during the Beatles' time, and I have no idea if people actually hated Yoko Ono, or if it was the only Asian my patient knew. I've been called a Jap before, which, again, because I was exposed to very little racism growing up (I think in large part due to my parents), it doesn't sting the way I know it should.

I had one patient who was very sweet to me, but when I returned to work the next day, I was given all the same patients back -- except for her. Her family had stated that no Asians could take care of her. It wasn't put in the chart, I don't think, but it felt a little strange to me. She'd let me take care of her the night before, and I felt I had done a good job. Her family took me aside and told me that I didn't need to feel bad, because for some reason, seeing me gave the patient flashbacks to WWII.

Here's the thing. I never feel guilty. If someone has an issue with my race, or the way I look, I'm not going to apologize. I'm not going to assume that it's my fault. It's such an odd way to look at things, to think that the person who's receiving the prejudice might feel guilty.

Along with the obvious signs, there's also some odd things that have happened with some of the management that I've worked for. I remember very clearly arriving to work one night when a patient had been admitted. No one had started the admission, and they decided to give the patient to me. The reason? He didn't speak English. Which is fine. I speak Spanish, but it turned out the patient didn't speak Spanish, he spoke a very rare dialect from a South Asian country. He couldn't mime because he was blind, and it was assumed that I would have an easier time doing his admission.

Why?

Obviously because we're both Asian.

I'll admit, I joke about it a lot. I don't get offended. I tried, about a year ago, and it was exhausting. To assume that everyone has an ulterior motive, or to assume that everything that someone says is a jab at my race or said to be rude. My husband and I enjoy being different, and we accept that we are. I believe that's why, when I started Small Great Things, I was confused. I didn't see racism because I didn't focus on it, even though it's all around me.

I'm sure there's a fine line. I do need to recognize when it's inappropriate, but in the workplace, a lot of times, there's nothing I can say or do to change it. My patients... well, they still need care. In a day or two, I'll probably never see them again. Besides, I need them to like me, just so that I can get good reviews and avoid the situation that played out in small Great Things.

Small Great Things

This week, I want to try something new. In February, I started reading a book called Small Great Things by Jodi Picoult. When I was in college, I read her book My Sister's Keeper, and I was quite fascinated.

My tastes tend toward fantasy and science fiction when I read or watch movies. I also like crime shows, like Bones and Criminal Minds. One thing that I don't tend to read or watch is anything medical related.

That's what I do on a regular basis. I've been a nurse for six years now, but even before that, I was a CNA and I was in nursing school. I know what it's like behind the scenes. I deal with death and sickness and on really difficult days, the whole spectrum of human emotions. I know what it's like to be talked down to -- by family members, by patients, even my coworkers at some point. I understand more than I want about the politics behind every decision made.

When I read, or when I'm watching a movie or TV, I want to escape. I want to leave the world that I know and enter a world that I don't.

When I read the description for Small Great Things, I was intrigued. It sounded like something I would be interested in, and after some recent misses in books, I wanted something I could connect with. I just didn't expect to connect quite so well. Small Great Things is a book about a nurse who is black and has to deal with prejudices of a family who is incredibly racist. At first, while I was reading, I thought the book was set in the 50's or 60's. Ruth speaks about racism in a way that made it feel real, that made it feel like it still happened. But then there were small references -- to Tiana from the Frog Princess, and even to Elsa from Frozen.

Suddenly, instead of reading an interesting book, I felt like I was reading about my life. I've been in her situation before. Not to that extreme, but I've been 'fired' by patients before -- just because of how I look. Because I'm not white. I've never stopped to think about what could have happened if an emergency had arisen like the one that Ruth faced.

I'm going to be honest, I had to stop reading. It was horrific to read, and mostly because I'm a nurse, I'm a minority, and I know exactly how she felt. I know what it's like to be treated like that by patients, and I've lived with the terror that maybe I didn't do enough, or that a family member would take me to court for something that I did. I didn't want to know how it ended. Good or bad, I knew that it could be me, and I didn't want to live it if I didn't have to. Maybe that's the coward's way out, but I'm okay with that.

But it made me think, which is exactly why Ms. Picoult wrote the book in the first place. It's supposed to make us reexamine our lives, and the society that we live in. So this week, I want to look at myself, at my race and at my profession, from the eyes of this book. I'd love to hear your comments, especially if you have stories to share as well.

I Like Secondary Characters

I’ve been a slacker when it comes to reading. I think it’s a combination of a lot of things. First, I’ve been trying to finish this revision of Hooked. Then I started a new job, and I took several vacations. And add to that, it’s just so pretty and nice outside! Oh, and I started binging Criminal Minds.

I decided to try and remedy that a few weeks ago by reading a book that was written by someone I know. I read about half of it, but the entire time, something just didn’t quite sit right with me. I kept trying to figure it out, but I wasn’t sure what it was. The main character was strong, determined, and definitely not waiting for anyone to make decisions for her. She had proper motivation, and I could root for her goals.

It took me several days before I realized it.

The character was in a bubble. There wasn’t a single secondary character for the first half of the book. And that’s about the spot where I decided to leave it. I just couldn’t relate with her. There was no one that she interacted with, and the only time there was another character was when she was fighting them while she was trying to get some magical ingredients.

I like secondary characters. They give me a better idea of the main character. I tend to fall on the side of too many secondary characters, but that’s because I can’t imagine living a life where you have no friends or family or coworkers.

An author I think does a really good job with secondary characters is Natalie Whipple. Her books always have multiple characters, and the main characters aren’t stuck with just one friend. They’re in a group of friends, like most teenagers are. Plus, her secondary characters bring so much more to the story. It’s not just about the main character anymore.

I like secondary characters. I know that sometimes we all feel alone on our journey, but that doesn’t mean it’s true.