Two topics for today

Resolutions
My thank-you-note resolution is not going perfectly. I made it 5 weeks at one thank-you note per week - then, I stopped. I had written one to someone at work and brought it in for her. When I pulled it out of my bag, I saw I had spilled coffee all over the note. That's no good!

That discouraged me, and I haven't written since. Until today, that is. I wrote a note to the person who held the wine party and another note to a friend with whom I played a clarinet duet at a church service.

I have not given up on the resolution; it's still a good idea. One per week is the goal I hope to achieve...but if I miss a week, I will persevere anyway. Missing a week or two is no reason to give up entirely!

Work

I have had a struggle at work over the past two weeks. I have written in the past that at times I

feel abandoned at my job, that I feel unsupported and alone. Our unit recently had a policy change in the scope of work for the technicians. They are to concentrate on certain aspects of their jobs and leave many other tasks to other people.  The ubiquitous "other people" who take over these tasks are, ahem, me. I feel even more abandoned.

Our techs used to meet our patients at admitting and bring them up to the unit. No more. Patients come up by themselves now. 

Our techs used to take vital signs some of the time. No more. The nurse is responsible for all vital signs now. There is a technical reason why: techs don't have the ability to download the vitals from the monitors, directly into the electronic charting system. It's a pain in the butt (as well as error-prone) to copy it down on paper then log in and type it in. So, now they don't have to do it at all.  Nurses can do the download.

Our techs used to assist with transport of patients when they are discharged. No more. Now we call the hospital transport team to wheel the patients downstairs. This is fine, except that transport is not speedy.  It can take 30-40 minutes to get a transporter to the unit to pick up the patient. Meanwhile, the patient is sitting there twiddling his thumbs.  Oh, and guess who has to call the transport team? Yeah. It's me.

Our techs used to help out any nurse who needed the service of the techs. No more. We are assigned a tech for each patient now. That's the only one who is supposed to help for that patient. If your tech is busy with another patient, but another tech is sitting around doing nothing, you can't ask the other tech to help. You're on your own.

In my opinion, the first few changes are poor choices for superior customer service, but otherwise benign. The last one really bothers me, so much so, in fact, that I cried all the way on the drive home the first day I was faced with the changes. I felt abandoned again. I feel like the nurse is expected to help everyone at any time, but the techs do not have to. I feel like this places a division between techs and nurses. I feel like it is a poor choice for teamwork.

Now, I really "get" why people leave nursing. There is no one who supports me. I am responsible for making sure all the work gets done for the patient, from ordering lunch to drawing blood, to making sure the consults will get done. I am responsible for checking up on the doctors orders for patient safety (Silly doctor! Surely you didn't mean to order morphine for this patient who is allergic to it??!). I am responsible for the accuracy and completeness of all the data collected on the patient during my shift. I am responsible for making sure every order gets entered into the system correctly for the patient, particularly the medications. I am responsible for making sure the patient isn't in an abusive relationship and if she is, I need to arrange her help. I am responsible for moving the sleeper chair into the room so his wife can stay over night. Indeed, this is necessary. 

What "gets" me is that it's so hard to complain about any of these things. After all, each little task is "just one thing." Or "just a phone call." Yeah, but multiply it times 50 incidents times 3 to 5 patients a day, and that gets to be overwhelming.

Despite all of this, I still like my job.  This post is a way of blowing off steam, and I'm sure my descriptions above are biased. After all, I'm angry about the changes; I had a comfortable way of working, and now I need to develop a new way .  I wonder if I'll get as deeply exasperated with the nursing field as I did with software development, or if there will continue to be enough emotional goodies to feed my soul all the way to retirement.