Rising from the Ashes.....Once again!!

January 13, 2010

So, as of 1700 this afternoon I am no longer employed as an ER NP. I was in the middle of seeing patients when asked to go to the lounge with two of the doctors. I was released of my duties as an NP. I must say I was shocked that after only 33 shifts a decision like that could be fairly made. It seems that I am the only person that has been hired as a mid-level in the ER who has not done clinical rotations of some sort in the ER. My CNM/FNP background did not train me for the acute care and more detailed knowledge needed apparently to be able to jump right in without asking questions and asking for help (which I was specifically told the first day on the job was something to never be scared to do: asking questions was encouraged). I specifically asked if I had any patient complaints against me. Apparently not. I was told (in the letter that had been prepared for me) that the partners felt that the “amount of time it will take for you to become familiar with patient care in the Emergency Department, and to function at a level commensurate with the other mid-levels will be too lengthy to allow continued affiliation with our group.” I was told that if it took 3 months, 6 months or a year to train me, that was too much time and they simply could not do that.

I prayed the entire time for God to keep the tears from flowing. As the doctor was talking: I was thinking about the 2,500 monthly in student loans that begins in February, the rent I am paying currently, the bills due, the humiliation of having to tell everyone I was fired from a job after 33 days for not learning the skills as quickly as the partners desired (or at least that is what they told me, although I wonder if there is something more they aren’t saying). Somehow God gave me the strength to say “you have made a huge mistake”, “I love this job, and was in this career for the long haul, I turned down two job offers with contracts to move to Paducah to challenge myself in a field I was not trained for.” I was told immediately by one of the physicians that “no one loves their job in the ER”, people just do it because they have to. I completely disagreed and shared that I loved the pace (and was told maybe that’s what I loved, but again no one loves their job in the ER)!! WRONG, I told them that I am too old to work in a job that I don’t love. I did love this job and felt that I was never properly trained (2 hours of following another NP doesn’t count as orientation) and therefore I was at a disadvantage from the beginning. Not to mention that I came in with Women’s Health and Family Practice as my background. They understood that, but felt that with the understaffing issues that they currently battle with, I was basically only making things harder for the doctors (by being a new graduate and needing to ask questions, that I thought would make for good patient care) especially when there would only be one doctor and me scheduled. I was dumbfounded! And am still in shock…for many reasons!

I had been able to develop my own little niche of women’s health in the ER. It was often that when a women’s health issue came through I got the chart handed to me. And I loved treating those patients. And the patients loved me. I was thrilled to get to humanize the ER for a very short time indeed. I am finding comfort in the fact that even though I might have been fired today, I know for a fact (from patient’s mouths as well as from other nurses telling me) that I made a difference in the lives of my patients. Maybe I am not cynical enough for the ER, maybe I fall into some of the frequent flyers traps of wanting more pain meds, maybe I hugged a patient on occasion, or asked too many questions to the RN’s making me look like I didn’t know what I was doing (I am a new graduate after all, maybe I was to “touchy, feely” with the staff my first week on the job (touching is not encouraged, I was once told to stand “2” floor squares away from a doctor), I never missed a shift, came early, stayed late and spent hours putting together a “cheat sheet” of ER notes so that I could quickly try to know what 5 different doctors might want to order for different ER complaints (that work won’t be in vain, I will make sure students, new NP’s, and myself have that information to use in the future).

I have to believe that God is telling me loud and clear to take this time to spend with my daughter. Two days ago she somehow got confused when walking out of the house after dropping off her things from school (like she has done since November). Instead of turning left off of our porch to walk 3 doors down to the babysitter (and the woman that has been like a mother to me for years): she somehow turned right and began walking, she became disoriented and ended up near the middle school (about a ¼ mile away), phone in her pocket (that was dead), she was scared and trying to get to a gas station she saw: when a man and his family stopped to ask her what she was doing walking (in the freezing cold). She was apparently scared and disoriented and he told her that he was a firefighter and youth counselor, and thought he should call the police to help her get home. EK says she got scared and got into the car with him and his family and they brought her home. The babysitter was heading next door to get her because she wasn’t answering her phone and as she was walking out the door, EK pulled up in the car with a stranger!! He told her what had transpired and how worried he was for EK and “something didn’t seem right”. He swore he didn’t harm her and brought her straight home (she did remember where she lived). Apparently EK was so nervous, she was soaking wet and exhausted. She had her bag of books with her she was taking to the sitter. What happened to her? How could she not make it 3 doors down? I have been horrified and had her immediately (as soon as I found out about the incident) taken to the ER to be evaluated for any sexual assault or drugs in her system. Everything was clean. No signs of assault. Even if the man who brought her home didn’t harm her, who knew what happened to her from our porch to the moment she was picked up? I am devastated; she has been trained not to ever get in the car with a stranger. She said when he said he needed to call the police, she thought it safer to go with him and his family than to have the police involved!! I have cried more tears the last two days than I have cried in a long time. Anyone who knows my history with EK (read the Marching to the Beat of a Different Drummer blog) knows I have fought for her safety and security and advancement in school since she was in first grade. She was given a bit of freedom in the afternoons before she would walk to the sitter (the sitter had just spoken to her on the phone), to try to increase her self- confidence. Now, we are back to square one. Did she have a seizure, did she just get confused and not have the maturity to turn around as soon as she discovered she was heading in the wrong direction, is there an underlying process we aren’t aware of? Whatever happened Monday may never be known, but the first person I called tonight while walking out of the hospital with my tail tucked and humiliated was my childhood friend Margo who shared with me that possibly this is God’s way of telling me that the 1pm-1am shift is not conducive to raising a daughter that “Marches to the Beat of a Different Drummer”….maybe she needs her mom on a more consistent schedule. She showed up here tonight and listened as I cried about my pity party (still wearing my scrubs and nametag from the hospital). The she out of the blue said, “Dani, it could be so much worse”….we could be searching for my baby tonight, we could be in the hospital with her, or worse we could be at the funeral home tonight having visitation for her very short life. If that doesn’t bring my “firing “ into perspective, nothing does….

Therefore, 2010 has not at all been what I had planned (is it ever what we planned?), I have had some rather disturbing personal issues come to light, relationship issues (things are on the upswing in that department), moved twice (to have a better place for me to sleep when coming in from the ER (HA!), car broken down, favorite Uncle died this week, grandmother had a stroke (light one) this week, daughter disoriented this week and riding around with a strange family (my family is strange enough, no need to find another one to ride around with), got fired today….but guess what? My baby girl is lying beside me (snoring none the less) while I am listening to Nancy Grace, my cat is on the foot of the bed and my dog is on the couch snoring as well….my friends have called, come over, my dad and stepmom brought pizza tonight and two bottles of wine (still unopened)….and I am still alive (I know I am because I have been sobbing and my heart hurts as I type this). Damaged goods (yes Ralph it’s true), bruise, ego destroyed, confidence shaken, questioning my education, my decision to take on a challenge people told me I was crazy to do, my decision to move home and wondering what the silver lining is in the events of this week…..

Unbeknownst to me as to why, I posted this quote this morning on my Face book page: maybe a God thing huh?

"You are braver than you believe, and stronger than you seem, and smarter than you think." ~A. A. Milne

Dani