A Little Background

A little more about myself and my nursing journey. I went to Miles Community College in my home town in Montana, graduating with my ADN in May 2010. I started my humble career as a new grad RN in a 30 bed ED in northern CA where I was fortunate to have some nursing mentors who assisted me in landing my first job. My first day in the ED was 10/10/10...pretty memorable for me.

I never planned to be an ED nurse to be honest...not the typical story. I was convinced I wanted to be an OB nurse and eventually a midwife...my story isn't done yet...so who knows for sure. However, I did well in school and was encouraged to apply for a preceptorship in the ED/ICU at my local hospital the summer between my years of the nursing program. This preceptorship really gave me an advantage because of my extra exposure in the critical care setting. It was also probably the beginning of my love/hate relationship with critical/emergency care nursing. It's hard to get away from when it's what you start with and all you know.

I have a tendency to fondly and flippantly say things about my career so far like, "I somehow got trapped in the ED for 12 years..." Haha...however, it's 12 years I wouldn't trade for anything....EVER! The people I have met, both patients and colleagues, and the lessens I've learned are invaluable!

I worked for 5 years full-time in the ED I started in. At that point, I then met the man I have now been married to for 7 years. That coincided well with experiencing my first episode of burn out!!! The appeal and excitement of the ED had started to fade once I had things outside of work that seemed to peak my interest and demand my time/energy...like the 1st year of marriage! :)

I took a break from the full-time ED life and took what turned out to be my "first pregnancy job" as a community health nurse at the local rancheria clinic. It was a refreshing change of pace with a delightful crew of co-workers. It lasted precisely about 1 year, minus 3 months of maternity leave! After our first daughter was born, I was very eager to be closer to family. My husband grew up in the mountains of Northeastern CA, so we promptly moved to the tiny mountainous community where his parents are to start raising our family.

Naturally, after maternity leave, I went back to the ED in the remote critical access hospital where we moved. This was my first taste of true rural medicine. We had 3 beds, a triage room and an oversized "closet" we used for OB checks or pelvic exams. The nurse in the ED was also the designated Nursing Supervisor for the house which consisted of a 15 bed inpatient floor and a large LTC. My extra hands in the ED were initially the hospital-owned/run ambulance crew who were available to assist me as the lone RN unless they were out on a call in the field of course. I started to quickly question if my prior experience would be enough to carry me in this role.

When I first started there, the hospital still had an OB department. This was of great appeal to me as an ED nurse who always dreamed of being in L&D. They were happy to cross-train me which I started doing within my first 6 months of employment. But I needed to travel to a more populated area to train if I would get the experience I needed to be prepared to be an OB nurse in a remote critical access hospital 70 miles from the nearest NICU. So I travelled 3 hours away, 3 days a week for 8 weeks with my husband and 9month old (who stayed in a hotel while I worked 12 hour shifts), so I could be prepared. Sadly, the OB department closed before I finished training, so I just became the "OB expert" in the ED from then on. Believe you me, just because you close the OB department, doesn't mean the laboring moms and babies with an 1.5hr + drive to the next closest hospital are going to stop coming! I was very grateful for the OB training I got during that time even if I was saddened not to be able to do the work full-time where my family had just moved our lives to settle in.

I became the Lead ED Supervisor about half way through my 3 year stent there. It was amazing experience. I have countless stories, some of which I plan to share, from my time there. But boy do I have a new respect for any nurse who chooses to commit their time/energy to rural health care in the critical access settings across the nation. You wear many hats, always, never have enough resources or support, rarely get compensated adequately or recognized for your truly heroic efforts to overcome the nearly impossible obstacles you face in these settings! I quickly became passionate for this work because, like many nurses, I am addicted to feeling needed!!!! This can be a blessing and a curse (when boundaries are not maintained) which is also something I struggle with!

My inability to maintain a healthy work/life balance is eventually what moved me on to my next job about 6 months after my second daughter was born. I took a nice sign-on bonus to go to another critical access hospital about 90miles away to work at the bedside in their 10 bed ED. I quickly became a relief charge nurse (because I refused the full-time position) and had ambitions to cross-train to their OB department once allowed/opportunity presented. I loved the ED crew here, as most other settings I've been in. The ED attracts a rare breed, but a more diverse breed than I originally anticipated, probably because I never considered myself to be "one of them." (Turns out....I am!)

About a year and half into my work there, which I commuted between 1.5-3 hours to get to, depending on weather, up to 3 days a week, I was offered the oh so coveted OB job. By this point however, we were several months into the ever-evolving COVID crisis/pandemic. (I'm sure there will be many blogs about this chapter, as it continues to unfold.) I was very weary, and I was starting to question whether or not the commitment needed to take the OB job was worth the effort. It was what I thought I always wanted, but everything in life was shaking...it was hard to know what would help bring stability. And it was hard to feel excitement for anything at that time. (My first real season of depression...will be visited later!)

But I took the job gratefully! And I was determined to make the most of it, knowing my mood and spirits would hopefully improve. I didn't want to pass up the opportunity I felt I had fought for, but by this time I had been in the ED for almost 10 years...and change is still hard even for nurses who work in a "you never know what to expect" environment. I got to take a much needed 3 week vacation a couple months into my orientation in OB. The training process was one of the hardest seasons of my life. I was in a setting that was unfamiliar surrounded by nurses who were trying to figure out if they thought I could really do the job too. Not because I wasn't capable, but because they didn't understand me.

Less than 6 months into it, I decided to bow out, as gracefully as possible, still less gracefully than I would have liked! I attempted to go back to the ED right away, but they had filled my place. So it was time to find work closer to home again....this was a blessing. I had also decided, in my short time in OB, to start the journey of higher nursing education (mostly because I could get help paying for it!) Re-evaluating whether or not it would be possible for me to be an OB nurse, going back to school had other appeals for a brighter future that hopefully involved less driving!

I took a travel job, so I could work closer to home and have more flexible hours while going to school with two small children at home. Although, it also meant going back to the ED and working nights for a time which I hadn't done in nearly a decade! However, I had found a new vigor for life for a season! Unfortunately, that didn't last long because I acquired COVID three weeks into my first assignment....to be continued