RC/RN

There have been some questions lately about my nursing career and I thought now would be just as good a time as any to answer them. How did I start? How long have I been in the ER? And, maybe most provocatively, what is it that I like about nursing and that keeps me in it? I'm going to try to explain the whole tangled mess. Bear with me. This is going to take a while.





The whole time I was in nursing school I knew two things - I wanted to work in the ER and I wanted to be where the helicopters landed.


This is the story of how I got both, just not at the same time.


When you grow up in an urban area you take it for granted that there are hospitals everywhere. World class hospitals. If you get hurt or sick you go to one of them. Simple. In the Midwest it's not that simple. So much of the area is rural and the hospitals, while not exactly hard to come by, are not usually going to be where you find a neurosurgeon or a burn unit. If you get hurt or sick in most of these places they fly you out to where those specialists are.



And that's a Level One Trauma Center. Simply put, this means that there is 24 hour medical coverage from a wide variety of specialists, including a comprehensive trauma team. Not coincidentally, these also tend to be teaching hospitals, almost always associated with major universities. There are various trauma designations. Level One is the gold standard. It's the end of the road, so to speak. It's where nothing is too critical, too catastrophic, too unusual to be treated. It's where the helicopters land.


I knew exactly the hospital I wanted to be at. It was the hospital I had fantasized about since the day I had gotten up the nerve to apply to nursing school. The problem was getting the in the door.


Toward the end of my last semester of school I "shadowed" for a day in the ER at this hospital. Shadowing is a really good idea. You get to follow a nurse around and really see what the unit is like, without the pressure of providing any medical care. You are only there to observe, nothing else. I had a great experience, other than the fact that I felt like Naive Nelly barely ten minutes in. I lost count of how many times I thought (or said) "Oh, my god. Is this for real?" over the course of the six hours I was there. And like a good adrenaline junkie rising to the lure of a caffeinated piece of bait - I was hooked.


This hospital had a program designed to train new grads in different areas of critical care nursing - ER, and Burn, Peds ("peeds"), Neonatal, Medical, Surgical, Neuro and Cardiac Intensive Care Units. The idea was that you would go to the unit that you were the most interested in and commit to a two year contract. In return the hospital would pay a (very) generous sign-on bonus and, for the next twenty four months, train you to within an inch of your life. You would receive every certification you could possibly want or need - all on the hospital's dime. Competition for spots in this program was tight, and they absolutely used that to their advantage .


But here was the problem. My nursing program had a December graduation. And someone had slipped up and all of the ER new grad spots for the year had been filled with the May graduating class. Every other area was, of course, still open. I met with a very nice HR woman who asked me a bunch of questions about what interested me and then suggested I apply for a spot in the Surgical ICU. She explained that this was not only a trauma ICU, but also took care of patients from every surgical specialty, so was quite varied in the patient population. I said I wanted ER. She said I should think about SI (as they called it). She even persuaded me to tour the unit with her, and even though I thought it looked fascinating, I left the interview disgruntled and completely unconvinced.


My best friend in Nursing School, who was a major reason I survived a program designed to stomp the life right out of you, had always wanted to be an ICU nurse. I, of course, wanted to be an ER nurse. We spent hours, in the blissful ignorance that is so prevalent in students, debating the pros and cons of each. We tried in vain, wanting badly to work together when we graduated, to sway the other to our point of view. It never worked. I had badgered her relentlessly to get her to apply at "my" hospital, as I thought of it, but it would have been an unmanageable commute for her. Against my will I was in this alone. And to make it worse they were trying to talk me into trying out for an ICU job - a compulsive, no excitement, anal, chart keeping, med passing, boring ICU job.


I felt a little sick to my stomach walking to the parking lot, the feeling you get when you have built something up so big and realize that it simply isn't going to happen. My brain was bouncing around like a tennis ball - whup whup whup - as I mentally fumbled with a Plan B. As I reached my car I realized that my tennis ball whup whup whup was getting louder, and I looked up to see a helicopter lazily landing on the roof of the building I had just walked out of.


And as the engine cut out and the blades slowed down, I realized exactly what my Plan B was going to be.


To Be Continued...