Learn to prioritize, people, I beg you.

I don't know how many times I've written "In order to provide holistic care, a nurse must remember to consider the needs of the patient along with the current priorities of the healthcare providers." in all sorts of BS essays.

Oh I understand the point. I know that patients are not going to pay much attention to what you're saying if they're worrying about who's gonna pick up their kids from school while they're getting chemo. I get that. That's important.

I want to rant here, because I learned the other day that some people are so afraid of losing their hair during chemotherapy that they acquire certain ridiculous looking "cooling caps". The idea behind these cooling caps is that they shrink the capillaries in your scalp so that chemotherapy drugs can't reach the hair follicles and make your hair fall out. You have to put them on at least 40 minutes before the infusion begins and change the ice packs every 20 minutes to keep the scalp at the ideal temperature.

If that was all, I would just chalk it up to silly vanity and not bother writing about it. But do you know where tumour cells just LOVE to go? The scalp. Especially with breast cancer. They freaking love it. The cooling caps are basically preventing the chemotherapy from getting to the places where tumour cells want to hang out. This is such a problem that when we see these things in the chemo clinic, we have to check if the doctors know about it and notify them so they can talk some sense into the patient.

Sometimes, the patient decides that keeping her hair is more important than the terrible risk of scalp metastases. That's when the nurses are supposed to think back to that blee-blah-bloo sentence up there. It's kind of like Frank Costanza screaming "Serenity now!" , isn't it?

So I did my job. I asked if the doctor was aware that she was using that contraption. She replied that the doctor knew but she was going to use it anyway. My poker face was awesome. I charted. I hung up the meds. I stayed completely uninvolved in the massive ridonculousness of her relatives measuring the temperature of ice packs, figuring out how to put it all together and strapping that thing onto her head.

One nurse muttered in passing, "Her hair isn't even that nice." It was a catty comment trying to hide the genuine frustration that we were all feeling, I suppose. What a terrible waste of money, energy and resources.

Your hair? It's not as important as your health. I thought that was pretty much a common sense kind of thing. Obviously not.

Serenity now.

Me? You want me?

It took months of polishing up my resume and getting all sorts of extra certifications, but I finally started getting some calls about job interviews in March. It was a huge difference from last fall, when I got one measly interview and then ended up not getting the job anyway, because I wasn't experienced enough.

Between March 23rd and April 10th, I applied to 151 positions at 17 different hospitals. It didn't matter if the positions were temporary or part-time. I applied for everything listed after January 1, 2012 that I felt that I could actually do. For instance, dialysis scares me, because I have practically no experience in it. If I learned to do it step by step, I'm sure I could, but I'm not going to apply to a dialysis unit and pretend that I can do it from the very beginning. Also, no OR, because I've never had much interest in surgery.

I went to 4 interviews in 3 weeks. I started feeling slightly discouraged when I didn't hear back from them when they said I would. Meanwhile, I booked 3 more interviews. I finally heard back from Sunnybrook 3 weeks after the interview and they offered me a position (my first choice!). I also got offers from 2 more places, which I have now declined.

Words can't express how relieved I am. I start my new job in June and I plan to stay at my current job in a casual position.


Lessons learned:

1) Get certifications in everything.
I was a community nurse. There was no reason for me to get certified in anything beyond BCLS, but I knew that I wanted to get into a hospital eventually. Hospital people LOVE it if you get certified in things before they hire you and have to pay for it themselves. Right now, I have my ACLS and PALS. I'm also registered to start Coronary Care 1 in a couple of days.
If I hadn't gotten the job at Sunnybrook, I would have signed up for NRP, ENPC, Coronary Care 2, lactation course, fetal monitoring, etc. etc. I might still sign up for those things, because why the hell not? If you have the money and the time, sign up for the courses and get them done.

2) Don't believe the timelines that interviewers give you.
Sunnybrook told me I would hear back in 2 weeks. It took 3.
The first interviewer at Brampton told me 1 week. It took 2 and a half.
The second interviewer at Brampton told me a couple of days. It took 1 hour.

3) Store up the most interesting stories from your past internships and jobs and spin them like crazy.
Most nursing stories aren't that interesting to laypeople, but people involved in healthcare love them. They love hearing about frustrating/disgusting/insane situations. Show them how coolly you dealt with equipment malfunctions and difficult family members.

4) Read over your old nursing essays and use key phrases from them.
I once used the line, "helping people help themselves" during an interview and scared myself. I thought, "Oh god, no one's gonna take that hokey line seriously", but guess what? They loved it. I am now realizing that all those tedious essays were to help us prepare for job interviews, because no one talks like that outside of those situations. Yeah, I just said that. It's a matter of memorizing the McGill Model of Nursing and incorporating it into every other sentence that you utter. Bite back your laughter and say it.

Huh, I've been an RN for more than a year now...

Yeah, I've started writing on this blog again so that maybe Robert will stop making fun of me for watching terrible television.

Clients always ask about what sort of things I see in community nursing. I guess since they're being treated at home, they're curious about whether there are other people who are equally unwell, if not more.

The other day, I was doing changing a dressing on someone's pilonidal cyst incision and she asked me, "Doesn't this gross you out?" It's a question I get quite often.

Believe me, incision wounds are a cakewalk. I LOVE pilonidal cysts. I could pack drained abscesses all day long.

Do you know what's surprisingly yucky? Tracheotomies. Oh sure, it's easy to think of it only as a tube in the throat to help you breathe. But people need them for a reason and that reason always leads to coughing and secretions. If one coughs hard enough, secretions can and will shoot out of the trachs like horrific projectiles of mucousy death. I will confess right here that when I used to suction trachs in the hospital, I had a silent scream frozen on my face under my mask every single time. Even disimpacting people's colons is less disturbing to the soul. Still, I've never actually dreaded doing trach care. I hid my face with a mask (and face shield, if I could get one) and got on with it. No one has to know that I did a little private shudder after it was over.

In the end, it comes down to the individual nurse's personal brand of heebie-jeebies. Eventually, you can get used to almost anything and will only feel a slight tingle running up and down your spine. The nightmares will only last a few weeks, tops. =P