What is normal, anyways, for nurses right now? pt2

the 'new' normal for HCW....

Even more Cassie ;) —

In going back and rereading the question that the subscriber asked (but after having already made my LOVELY PLANTS POST, because I love my plant-children) — I kinda missed their point, so here goes on that — let me quote KB here:

My question is really basic, I guess. I want to know how you guys are doing. This is an invasive question, I know, but battlefield medics and doctors often have a hard time “reintegrating” for lack of a different word. And there’s something about how the body reacts to long term stress hormones. Do you think that the frontline workers as a whole are going to experience emotional and psychological issues when this is over? I don’t see how you could avoid it. And if that occurs, how do you feel about the funding? Should there be a national program, federally funded, to help take care of the long term effects to our frontline workers? I feel as though your heroic efforts to pull is through such a nightmare deserve at least that much. And so much more. Drinks for life, for sure.

On the whole…

You know how when someone asks you how you’re doing, and you say ‘Fine’ because that’s all you really want to share?

I say ‘Fine’ a lot.

I find that, with the exception of what I consider to be somewhat therapeutic journaling here and elsewhere, and occasional pushes to get people to understand/behave, and flashes of anger because I want to yell — there’s not much to be gained in discussing what’s happening at the hospital with general civilians, even civilians that I consider to be friends. (Even close friends. Even sometimes my husband. So don’t take it personally.)

Like the post I made earlier where I talked about my ten IV drips for that patient who was destined to die…some people were all really horrified about that post and emailed me to make sure I was OK?

And I don’t know how to deal with that really.

I’m not telling you all stories here to have you sideline with me about my okayness and honestly it weirds me out when you do, because that means you’re clearly not okay with my level of okayness, and then I feel like there’s an even wider gulf between me and normalcy. (Don’t get me wrong, I love that people love me and worry about me, and I would do the same in your shoes, no doubt. It’s just another weird level of strange, amplified by me not actually having a working framework within which to accept personal kindness. It’s me, not you.)

As I said at the bottom of that post….

These things now just have to be Another Day At The Office for me.

That’s the only way I can continue to survive. Getting firehosed with loss and feelings would make doing my job impossible. If I sat around thinking about all the patients I’ve lost, in the abstract, or everything that I’ve lost (my ability to feel in discreet increments, for one, heh) it just gets to be too much, so better never to think about it (at least for while, while we’re still in the weeds) at all.

I’m lucky because I only have to work 3 12 hr shifts a week to be full time at my job. That gives me four days to reset (see prior post:re:gardening) in a way that battlefield medics and military personnel don’t. I’m even luckier that I can afford to live like that, and that I don’t need to ‘cash out’ right now. The temptation is certainly there, and I did more than my share earlier on, and I did far too many hours out of coworker solidarity in December….

But I am not the Saint of Being At the Hospital Because It Needs Me.

Do I still get three texts and emails a day, every day, begging me to go in?

Yes.

Do I feel bad about that?

Ehhhhhhhhhh.

I don’t owe them or y’all shit, really.

I’m not a nurse because it’s my magical calling, and in fact I don’t think anyone is, or if you started like that, it gets totally burned out of you by the time you work your third year.

Sure some moments still have magic in them, and I do hunt for those, for the strength to continue….

But it becomes increasingly obvious as This Continues that I Am Just Another Cog In The Machine and that my work satisfaction will be much better if I know my place.

This is about 40% because a ton of our covid patients die, so it’s better for my brain somedays to not think about healing people, so much as pretending to be a strange ancient Egyptian-style goddess, whose job is to lead people to the underworld with as much peace and dignity as I can manage.

And about 60% because of the management at my hospital who has, very aggressively, through assorted avenues (not the least of which is them dicking over our RT compatriots on their contracts at the end of last year) made it clear that we are all Replaceable And We Shouldn’t Forget It.

It’s hard to want to come in when there’s no one in management who has your back.

And so, my mental health is more important to me now. Plus, if I so much as look at a text from work about going in, my most excellent husband is all YOU ARE A WRITER, PUT THAT DOWN.

If you don’t know, I write paranormal romance books. I actually became a nurse to be able to afford to live in the Bay Area and work part time so that I could write, because that’s been my dream since I was like 8 yrs old. See? Not a magical calling, but a means to an end.

It’s that civilians thinking nursing is a ‘magical calling’ bullshit that winds up in us being treated like ‘heroes’ who should rise up to to the moment to tolerate inhumane conditions for extraordinary periods of time.

Suffering is not noble. Neither my patients, nor mine.

So being less physically present at work less helps, and even if it is crappy while I’m there, I’m able to fight to be normal more than most people who’re there more frequently. And frankly I feel like I started off tougher than some, because having been a burn nurse prior was already it’s own kind of lonely.

You tell other nurses even that you’re a burn nurse, and they’re all ‘Ooooh, I could never do that,’ and yeah, they’re right, we’re made of sterner stuff, but it’s also a very ostracizing feeling.

Rather like being a garbage man, I imagine?

Because people aren’t saying that shit because it’s ‘hard’ or ‘cool’ like they might if I was claiming to be an astronaut. They’re saying it because it’s notoriously gross and they assume (erroneously) that it’s sad.

So while sometimes I shared stories generically, I hardly ever got to go into specifics, especially since the ways and hows of people getting burned are largely so personal, and I never wanted to out my patients. (Also, there I got the chance to love my patients, because by and large they all survived. It came with a satisfaction that few other nurses will ever really know, I think.)

(I would’ve crawled over glass for my manager on that unit. I could’ve devoted my life to that place, more than the ten years I gave it, I loved it so much, but my commute was so bad :( )

I take Wellbutrin every day, and ativan and ambien on an as-needed basis.

I suffer from depression, and Wellbutrin helps boost me out of the spiral. For me, it’s been Good Stuff.

The ativan is for my panic attacks, and honestly I probably don’t take it often enough. I have that midwestern/calvinist suffering streak where I think bootstraps are The Answer and that I should be endlessly tough. But fuck that, ativan’s great.

Same for ambien. I try not to use it all the time because I don’t want to get too used to it, but sometimes I need it at night to turn my brain off.

I used to do therapy. I’m currently not sure what I’d say, other than the obvious, and I don’t think there are any solutions for what’s happening, seeing as it’s situational, other than getting through it.

Also, as I’ve mentioned before, I compartmentalize the FUCK out of things (see my PTSD post earlier). Imagine a factory that makes boxes 24/7, that’s my brain right now.

So oftentimes, I’m writing (and not all of my journals make it here) just to kind of hold up a day or a memory or an experience and give it one nice shake before I fold it up and box it up forever.

I have a friend who is very good at remembering things who has access to another place where I journal (even more messily, heh) and in the Before Times, she’d always ask me how I was doing, remembering a story I’d have written three weeks prior. She’d be all, ‘Whoa, that was pretty messed up — are you okay?’

And I’d be all, ‘Uh…which story was that again?’

And it wasn’t that what happened, whatever I was journaling about, wasn’t really bad at the time, generally they were. It was just that I’d already boxed it up and put it away.

I would genuinely Not Remember.

And that’s kind of how I’ve always had to live my nursing life. I can’t afford to remember all the sad shit I’ve seen, honestly. I gotta live my life, you know?

Is that healthy?

Well, kinda sorta.

It does build up, and if you box too fast you lose track of your own feelings and your connection to reality becomes tenuous.

But I know that, so I fight to reconnect. I make sure to stay as active as I can handle in other people’s realities.

I had a friend apologize to me yesterday for complaining about how messy her house was because compared to my work…. and I was all eff that, my house is a mess too, tell me more.

Because that’s the world I long to get back to, the one where all we’ve got to complain about is having too much laundry to fold.

That’s what I want. So badly.

I can’t bring people into my life, it’s too hard and sad — so what I want, I guess, is for them to bring me back to theirs. To remind me why going through all of this is worth it. So that I know that there’s people who love me who’re waiting somewhere on the other side and if I just push long enough I’ll get to be there with them too.

One of the very last fun things I did last year pre-lockdown was a science fiction and fantasy author convention in early March, like the first weekend in March. And they’re not going to have that again this year (obviously) so I’ll have to wait for 2022.

But I have such a clear vision of what that’ll involve when it gets to happen.

Me, sitting in the lobby like I always do, and people coming in and hugging me. I am not a Big Deal Author, but I like to think I’m Locally Well Known and Liked, and a lot of my writing community has held me particularly close this past year over assorted break downs elsewhere and in public on twitter.

One of the things I enjoy about that community in particular, is that We All Seem To Share The Same Reality. Like all of my writer friends are taking this just as seriously as I am. They’re masking, they’re staying home, they’re thinking ethically. I don’t see photos of them online doing dumb shit to make this — the worst year of my life so far — last longer, tempting fate to infect their friends and family.

And because of that, I feel safe around them, which is why finally getting to take my armor off among them all will be okay.

So it’ll be me, in the lobby, and everyone will come over and I’ll probably start crying halfway through the first hug, and I may not stop all weekend long. I’ll be so excited to see people again, to touch people again, all the people that I love and who’ve been rooting for me to make it through this — everyone who cheered when I got my vaccine — everyone who’s seen all my dark nights of the soul on twitter right before I wise up and take the ativan.

I will get to be the messiest of mess people, just sobbing with kleenex tucked up my sleeve like a grandma, and all of my friends who’ve seen me through this and who I haven’t had to worry about getting sick because they’ve all been so good, which I appreciate from the very bottom of my soul — we’ll all be at the end of this very long, very dark, very awful tunnel, happily vaccinated, together.

I know it will happen.

I absolutely cannot wait.

I’ve been thinking about this particular scenario a lot, now that we’re rounding the bend into spring. I started taking care of covid patients on 3/14 — that’s the day I drove into work early to volunteer to take care of the first of them (not because I’m a good person, but because I’m a thrill seeker with a deathwish who is wired wrong, heh. The good person part is beside the point. In an alternate reality I am a very happy rollercoaster engineer or something.)

I will likely be having feelings next month, whether I like it or not. I’ll see if I share some of them.

In regards to HCW’s mental wellbeing as a whole — yeah, we’re fucked, we’re all fucked, and we all know it.

Everyone I know is looking for a side-gig.

Even if the Biden administration turns things around (and I have great hopes for that) — the psychological damage is done.

We were treated like garbage by the Trump administration. They stole our supplies and let our patients die and then made us watch it happen. They lied about what they were doing, they lied about masks, they lied about drugs.

Everything we thought we knew as a profession, how we were treated, how we thought we were viewed by our communities, turned out to be bullshit.

The rug didn’t just get pulled out from under us — they took the goddamned top three layers of soil with, and left us to fall into the Earth’s molten core.

I’m gonna tough it out because I already have a side-gig, which is occasionally lucrative, and I have managed to figure out some work-life balance.

But why would anyone else, who had any other options — going back to school, heading into tech/research, going into education, becoming a SAHM instead — keep working?

Will people be sad when they leave? Heck yeah.

But…after this past year…why on earth would you stay?

There’ll be a fleet of young people coming in (possibly? I don’t know. Would you want to sign on for what you just saw us do? When you could be a rollercoaster engineer instead?) which’ll be great, and they’ll replenish our ranks some, but they won’t have the breadth nor depth of experience that older nurses do, and that brain drain’s gonna hurt hospitals badly.

As for ongoing psychological issues, oh, no doubt.

As for the government’s ability to help us with those?

I laugh very hard at that and point to the dearth of programs for veterans of actual wars.

I think a lot of HCW are just going to be deeply fucked up.

And they’ll deal with that in different ways. Some will spend thousands of dollars and hours on a backyard encompassing garden…. Others will start drinking, others will yell at their wives or do drugs…I dunno.

I’m hoping that the rebound of freedom and normalcy at the end of this will help — kinda like the roaring 20s. I imagine there will be some epic parties and epic benders. Some of my most emotionally healing moments have been while I was intensely altered hanging out with my closest friends, and I would dearly like to get to have those opportunities again. To fall and be caught by those who love you is a really good feeling, you know?

I suspect it’ll reprioritize a lot of people’s lives, having been so close to death for so long — people are going to want to do things that are important to them, and not put anything off ever again, and more power to them. I’m a big proponent of living your life as authentically as you can. And it harm none, do what ye will and all that.

But I don’t actually want drinks for life, and after awhile I don’t think I’ll ever want to talk about all this that much again.

Wallowing’s not healthy. As a former burn nurse — I know that to be healthy, you’ve gotta make sure you only pick the right scabs.

I get now why people say their grandfathers never talked about the war, because the experiential gulf of having been in the trenches versus having a conversation with someone who wasn’t there and can’t contextualize the moment is almost insurmountable.

It’s fucking hard for me to explain here to you — and I’m a writer!

And then my writing evokes your feelings, which is great, that’s its job, but like I don’t want those feelings really pointed at me.

I don’t want people going through life thinking I’m wounded because of all of this (though that might partially be the case.) I am tired of being strange, and there will come a time when I don’t want to talk about having been strange anymore because it is exhausting.

I don’t want people thinking they need to treat me differently, and I definitely do not want your pity, and at this stage in my atheism game I’m frankly insulted by your prayers (because if God exists this certainly is SOME BULLSHIT, NO?).

So when all of this is said and done, I just really want to go back to being normal.

I want to live my life again — just like all of you do, I’m sure.

I want to wander around garden centers aimlessly and buy plants I almost certainly do not need.

I want to go out to dinner with my girlfriends and laugh until I snort.

I want to take drives that actually go somewhere, like on trips, away from my house.

I want to go on so many writing retreats (!!!)

I want to go on hikes, and get pedicures, and hang out at coffee shops both with and without friends.

I want to see other people’s smiles again.

I want to go dancing — and I want to see shows. So many shows! (I tell you, after this, I will never, ever, skip a show I want to see, ever again in my life.)

So, yeah — I don’t want this episode to be the sum total of who I am, even if it may be the reason you currently know me. I want there to be more to me than just this, and I don’t want to be anchored by this event in the future either, if that makes sense.

When this is the past — and we will get there, even though it’ll take time — I want it to be in my past, too.

This version of me that I’m being forced to be now is not truly who I am. But I have great hopes for the version of me that I get to be in the future.

Just gotta get there is all.

— Cassie