Sometimes the Truth is Hard to Swallow


Self care

For All of Us


Betty B. RN

Human rights violations happen daily, probably hourly, to front line staff and nurses.  “Suck it up, buttercup- you signed up for it.” That’s the general consensus.

We signed up to give. We didn’t sign up to be sucked dry and abused by the same system that is supposed to help the community. Am I not also part of the community I give to daily? Apparently not when I’m in scrubs.

If I kicked a coworker or patient- spit on them or threw poop, pee, blood, or vomit, called them bitches and whores, backed them into a corner, threatened and said “give me what I want or I’ll slam your effing face into the wall!!” I would be fired and possibly arrested for assault or intimidation. SO WHY IS THIS ALLOWED ON A DAILY BASIS IN EMERGENCY ROOMS AND HOSPITAL FLOORS IN EVERY FREAKING HOSPITAL IN THIS COUNTRY?!

The last guy who threaten to punch me in the face? I took my glasses off and said, “Do it. I need a workers comp vacation.” I meant it, too. How the fuck do I get out of this hell hole without losing a body part or my sanity?

That was the beginning of the break of willfully standing in harms way and thinking it is NORMAL or ACCEPTABLE to be abused. You can only be bent so far until you are broken. There is an alternative option to being a victim or volunteer. It’s not suicide, although that can look pretty damn viable when it’s easier to wash off the c-diff than the hopelessness

Walk away. If all we know is abuse, then anything else is easy. I guarantee you, you will never regret not fearing for your sanity, your safety, or your soul, again.

I don’t know how long it will take for me to stop cringing when I hear my name called by management. I still assess a room the minute I enter it to scan for danger zones and safe escapes. I am working on my eye contact with other humans on my days off. I have fewer heart racing 3 am wake ups in a sweaty oh-shit-I-forgot-to-do 3-of-those-394759667-million-tasks-I-was-told-to-do-or-fear-for-my-job panic. I don’t cry every day from exhaustion or dread of another shift exercising my complete futility in a system that makes caregivers simply givers, or even worse, the sheer scariness of feeling nothing at all.

We save the world-who saves us? No one. That’s the most soul wrenching painful realization. Who will give everything to save ME, like I do to save others? Who will lose sleep if I don’t make it? No one. They’ll only notice if I miss my shift.

Except my kids. My husband. My widowed mother. My sisters. But no one I have handed my blood, sweat and tears, my best youthful years, my back, my spirit, my naivety, my life spark, my love of humanity, my need to make a difference-not one of those mother fuckers will stop and assess my pain and make a plan of care to save me.

Am I really contemplating increasing my life insurance so my husband can have a better nest egg before I off myself w a bottle full of prescription meds that I have received as consolation prizes for leaving the best parts of me in the wrong places? I want to die because I’ve given too much of me away.

I can’t unsee or unfeel or unknow all I have witnessed in this profession. I can not have back the pieces of my heart I have willingly given to my patients.  What I can do is refuse further abuse of my battered heart. My aching feet. My weary head. My sorry soul.

Part of nursing is saying no. No you can’t eat cake with a blood sugar of 500. No you cannot have sex in your bed with your boyfriend in a semi private room in the hospital. No you can’t lay in bed for days after surgery. No you can’t get up to go to the bathroom after you’ve had a heart catheterization and are at risk for popping in artery and bleeding out.

Sometimes saying no is saying yes. Yes you deserve better. Yes you are worthy. Yes you can live. Just as surgeons pull out tumors and dying tissue, so must we stop allowing the cancerous culture of a predatory system from metastasizing. No you don’t have to take it. No you aren’t weak for saying you are hurt, weary, and in need of your own good care.
No. This cancer taking over our professional and spiritual life is not okay.

We are so good at being patient advocates. Why is it so hard for us to advocate for ourselves? We are indoctrinated to believe that giving is selfless. Taking is selfish. Saying yes to ourselves is selfish. It’s hard to say “I’ve had enough.” Why? Why is it easier to say it when it means taking a stand for others? We are we so uncomfortable to do for ourselves what we would advocate for our patients!

So stand for the nurse on the other side of the bed doing compressions with you. Take a stand for the nurse in front of you at the Pyxis machine taking out her hourly morphine dose for the drug seeking patient who is verbally abusing her. Take a stand for that crabby burned out nurse who will never look you in the eye, but is a well full of information, if you just get past her self protective snark. Take a stand for that mother-friend and all-around good person that resides within you.

You are worthy. You are an excellent nurse. You deserve better. Bend but don’t be broken. Be the nurse you need. For you. For your family. For that patient in the bed who isn’t trying to bash your head in. (Security can deal with that mofo.)

There is more to this nursing gig than just taking orders. More than chart checks, calculations, titrations and IV drip double checks and charting in triplicate. There’s more than meetings on your day off about productivity and why you suck because patient satisfaction scores aren’t in the range the CEO you have never seen thinks they should be. There’s more than being shamed for not getting your 19284 administrative tasks done-those same tasks once delegated to ancillary staff so you could do patient care. Now, thanks to “budget cuts,” your patients lives and their properly filed chart are of equal importance. You’re not a robot. You’re not supposed to be a robot.

Do not let them tell you this is all there is. Thieves, addicts and patients lie. So do hospital administrators. Say no so you can say yes. You matter. You are not replaceable. You are needed and loved. You deserve to be the nurse you set out to be.

Signs of a Toxic Work Environment

You flinch when someone says your name.

You only see management when something goes wrong.

It’s all about blame versus problem-solving.

You have diarrhea before your shift.

You have diarrhea after your shift.

You fantasize about ways you can get hurt and file a Worker’s Comp claim so you don’t have to go back.

You wonder how you can possibly get through one more shift much less another two or three decades until retirement.

You contemplate increasing your life insurance so your family will have a better nest egg once you’re gone.

You count your sick days like addicts count pills.

You take pills so you can get through your workday.

You think about starting a home lobotomy business and know your coworkers will buy into your MLM plan.

You fantasize about being homeless instead of worrying about being homeless.

You think moving to a Third World country would be a vacation.

You have two or more stress related illnesses.

The idea of talking to people on your days off puts you into a panic.

They tell you you’ll never get another job and you believe them.

You wonder if prison has a better work life balance.

Self Care


By B.P. Betty, RN

Self-care is an idea that sells a lot of books. It is the idea behind hundreds of workshops and is thrown around corporate medicine as a way to tell staff that if they are feeling sucked dry  and burned out, then it’s their own fault. It’s just one more thing they need to do to be a better nurse, because they aren’t good enough as they are.

Self-care is a difficult concept for people who are willing to empty themselves every day for others. Self-care is an afterthought for those of us who care more about the community than our individual well being. Self-care is just another tagline to make us feel inferior about our limits and capacity to give without breaking.

The tragedy is, nurses and other front line caregivers don’t tell other people how we feel because it is perceived as being weak. We are hopeful that they will notice and assess our pain the way we do for everyone else, but it never comes.

Heal the healer.
Physician heal thy self.
How many times have we heard this? How many times has it actually been encouraged in any of the institutions in which we work. How many times are we asked to work double shifts or overtime or be on call? How many times does “heal thy self” really matter when the unit is understaffed? How many facilities have dismal time off allotments? How many of us have been written up for taking too much time so we can can care for our children or spouses yet never take a day for ourselves without guilt.

Healthcare culture has nothing to do with healthcare. It is all algorithms and surveys and percentages and profit margin’s. It’s making sure our  i’s are dotted and out  t’s are crossed so state surveyors or insurance companies don’t come back and audit our institutions. Nurses are told they are good nurses if their charting is perfect. Few nurses are told they are good nurses when they spend their time in a patient’s room holding a hand or holding a patients hair back while they are vomiting, or spent crying with a patient who knows he is dying.

We are supposed to be patient advocates, not self advocates. However even that advocation for patient “care” is only important when it comes to length of stay, or planning discharges before the admission paperwork is even completed, or the risk for readmissions is measured more for reimbursement than the care of humanity.

Self-care only matters when it affects the bottom line. We put ourselves in harms way every day for strangers while our families suffer and our own health suffers. We keep waiting for someone to care for us. We keep waiting for someone  to look at us with the same type of assessment and empathy we do when we look at our patients. We keep waiting for someone to say, “you look tired”. “When was the last time you had a day off?” “How are your kids?” “You’ve been working a lot, lately. How are  you holding up?”

We keep waiting for someone to assess us, to hold our hands and acknowledge our suffering, yet it never comes. So, we continue to suffer in silence. We continue to believe the lies that unless we are working extra shifts, unless we are charting in triplicate and it’s perfect, unless we are doing pain assessments every 15 minutes, pleasantly agree to an admission while still recovering from a code that’s gone badly, we are bad nurses. We cannot be human. It makes us weak.

There can be no weakness in healthcare. We must be strong for the weak. Without strength there can be no healing for others. So we continue to push ourselves until we crack and break. We continue to down our own handful of pills before we go to our shift. We continue to smoke and drink and isolate. We stop trusting our instincts because we are told that they are wrong.

Our biggest mistake is believing them. We are advocates for so many.

We advocate for the homeless.
We advocate for the addicted.
We advocate for the poor.
We advocate for the uneducated.
Who advocates for us?

We are too tired and too broken to save ourselves. We are bleeding out. We are told to transfuse ourselves, start our own iv, hold pressure and keep moving. We are desperate for someone to save us. We are desperate for someone to acknowledge our pain. We are nurses, we are supposed to not need anything.

Instead of throwing us a life jacket or safety ring, they throw us more pills. They throw us more classes. They throw us bullshit taglines about self-care when we all know it’s a big fucking lie.

They don’t care if we are well. They only care that we are upright and breathing. They don’t care that we are abused daily. Our suffering is inconsequential. Go to a therapist. Go to your doctor.When all those things are supposed to happen on our  one day off between 3 back to back to back 12 hour shifts, who actually has the energy to go? It means we actually have to get out of bed.

When we  don’t even have the energy to  move, how can we be self advocates? Especially when we know the therapist is just going to tell us we need to take another pill or that we  need to take a day off. When that day is requested, we are chastised for not being a team player. We also know that, by taking a day off, our  coworkers are going to be short staffed. (Remember how they tell us we are replaceable? Well they sure as hell don’t replace us on a daily schedule, do they?!) We know at least one or two nurses  that have confessed to feeling the same way; the idea of leaving them stranded gives us enough energy to drag our  broken selves from our bed. We drink our coffee. We take our  pills. We stumble to work wiping the tears from our eyes, hoping the jagged sobs that come in waves on the  commute will get us through one more shift. We hope nobody notices our  swollen eyes but all the same, hope someone does.

We need a nurse, but can’t have one -we are nurses. We are suppose to be infallible and unflappable, so every last ounce of self-care we  could possibly have is funneled into a half a dozen patients who may, or may not,  be worse off than us.

The Extinguishable Flame


By P. Pharm, RN

The flame that ignites passion
Born deep in our souls
Can burn out rather quickly
If left out in the cold.

I’ve lost much that I loved
In a combustible mess
That flame kept on taking
And left me with less.

It traveled from my hands
To my head and to my toes
It turned my pink to gray
My heart was last to go.

The thumps turned into nothing
My blood into messy ash
Tears evaporated in silence
My essence left as trash.

We are not garbage to lose
To forget and to be thrown out
We give everything until nothing
We are priceless no doubt.

I am experienced and tenured
Jaded and sweetly sour
Beaten and abused
Forced to apologize and cower.

We are not a special piece
Of a workable puzzle
We are replaceable and silent
Wearing a professional muzzle.

So when someone looks fresh
Like moldable new clay
Their flame can die out quickly
To be forgotten and blown away.

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