Brie Gowen

Savor the Essence of Life

PTSD in Nursing

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Last night my family and I drove to pickup dinner. I had asked my husband if he still felt uncomfortable taking our young daughters into a public restaurant, and he had been quick to say, “yeah, I don’t want to do that.”

The numbers had gone down, but that did little to change the routine we had carried since April. I’m very honest with my spouse about my work, and as such, he suffered from the same problem I did. We knew too much. There was no way in hell we could be blissfully ignorant, and I don’t mean that offensively. I truly wish I could forget this year.

As we pulled up to the restaurant to get our curbside pickup I noticed the large group of people sitting outdoors. The tables weren’t spaced like they had been just a month prior, and people milled about inches from other groups, laughing, smiling, not a mask in sight.

“That doesn’t look like continued social distancing to me,” I said to my spouse, pointing towards the outdoor dining.

The thing was, I didn’t want to be the social distancing police! I didn’t want to see pictures of church gatherings on Facebook and wonder why no one wore a mask. I didn’t want to cringe at friends starting to gather again, throw parties, and enjoy life. I didn’t want to be wary of strangers. I didn’t want to worry about my daughters drifting over to play with some new kids at the pool. I wanted everything the way it used to be, but I couldn’t for the life of me forget the past four months. I just couldn’t.

For nurses and other healthcare professionals who have been in hotspot areas of the COVID-19 pandemic, I think we’ve received injuries that are invisible. We’re nursing wounds no one can see, and the scars we carry are still raised and angry. So while a large part of society has basically forgotten a pandemic was here, nurses are still trying to catch their breath.

I think of a skittish cat, jumping with shackles raised at every tiny sound. I think of someone who has been abused, how they’re always suspicious for when the next hand will be raised to harm them. It wasn’t fear that griped me, but rather an awareness of what the virus could do. For so many people COVID-19 was like a really bad cold, or maybe the flu, but for the hundreds of patients I had seen in an inpatient, critical care setting, it was a death sentence. All that people with no hands-on experience could say about the virus was that its mortality rate wasn’t that high, but you know who I never heard say that? Those of us at the bedside the past four months, sweating profusely in our respirators, while we pumped aggressively on someone’s chest to help their heart restart. The reason you didn’t hear that from us? Because 90% (or more) of those patients did not live. Last I knew, our hospital had tried to save over 200 people, without success. We did everything humanly possible. The virus is that bad. For the families of those two hundred and something lost, statistics for survival rate meant very little. For those of us who had cared for them, it meant even less.

So, here we are with case numbers declining, but I still don’t feel comfortable allowing my children to go to a restaurant or play with other kids in the neighborhood. To me, it’s life and death, and until someone can tell me what makes one person just get a scratchy throat, and the next guy (with similar age and health) be unable to survive, I must remain the way I am. I cannot help it. My poor husband, who has seen my defeat amidst so much death, he cannot help it either. We’re still over here self-isolating, wearing masks in public, and social distancing when we do get out.

Today my husband said, “I hope they’re wrong. I mean, it doesn’t have to get bad again, right?!”

You see, the healthcare field, based on their knowledge and models, has their own predictions for the next few months. Those of us knee-deep in the muck of this novel virus are like the skittish cat I mentioned. We’re waiting for flu season 2020. It will be like the two tropical storms converging, but when COVID couples with flu, it will be a level 5 we fear. I don’t want to listen to projections, but I try to be realistic.

Y’all, I don’t know if it will ever be the same. I don’t know if I will ever be the same. I’m so aware of germ transmission at this point, I’m surprised the skin on my hands isn’t falling off from hand sanitizer and washing them. Today I let my daughters play with two little girls at the public pool. Then I spent the next twenty minutes praying silently for God’s hedge of protection around them, worried I had made the wrong decision. I don’t want to be that mom, but I’m that nurse. I just can’t seem to be any other way.

I’m not alone, y’all. I cannot unsee the frightened look in a patient’s eyes before we stuck a breathing tube down his throat. I cannot forget the fact that although I wanted him to live, he didn’t. I can’t erase the images of the handful of critical care patients who did leave my floor alive, but did so forty pounds lighter, unable to do the things they had done prior to being a COVID survivor, some with holes in their neck to keep breathing. I think back to when I was active duty military after 9/11. At some point, as we continued to receive soldiers from The War on Terror, I grew so very tired of seeing young men (boys, really) with only one limb remaining, or their face mangled. I just wanted the war to end. I think your civilian healthcare workers of 2020 are feeling much the same. We’re tired, we’re anxious, and we’re depressed. We’re overly protective of our families, but we’re also happy to be alive. We’re in need of a break, and even though the case numbers are on the downtrend for now, we don’t really believe the end is even close. We can’t catch a break, and our patients can’t catch their breath. It’s an ugly scene for bedside nursing, and so many of us will never be the same.

When you say your prayers tonight, try and remember your frontline workers. We feel like we’ve been forgotten. And although we’d keep doing what we do even without accolades or good vibes, I personally covet your prayers for my team. This year has been traumatic, and I don’t think it’s something we can ever forget.

Check On Your Nurse Friends. We Are Not Ok.

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I took a survey from my employer today, and as I went through the questions I was surprised by how easily I could answer one way or another. It was a survey for how the pandemic, COVID-19 was affecting us, and as I clicked each bubble I understood even more just how much things had changed. One question that stood out to me asked if I thought about work more when at home. The fact was I had always been proud of my ability to leave work at work. I am an extremely compassionate person, but after twenty years in healthcare I had learned that to keep my sanity intact, patient care needed to stay at the bedside. It would be there waiting when I returned. But today, as I pondered the question on the survey, I realized that had changed. Everything had changed.

It had really started to hit me, the weight of it all, a few nights ago. I sat in bed the night before work and I prayed. I felt so down, and the fact was I had for weeks. There was nothing wrong going on in my life. I wasn’t financially stressed. My marriage was amazing, my children healthy and adorable. I had absolutely nothing to be upset about, yet I was. The only out of place factor I could pinpoint? COVID-19.

Years ago I had come to a place in my nursing career where I absolutely loved my job. I considered patient care to be a privilege, and even on tough days I considered it a wonderful vocation. It was a calling, and I carried the task with a smile. This past week I noticed an unwelcome feeling coming over me. It was a feeling I hadn’t experienced in many years. It was dread. I was dreading the return to the critical care bedside. How could I dread something I loved so much? I cried out to God to bring back my joy for the field.

When I sat in bed praying to feel better I realized that all this was hitting me harder than I thought. I realized that even though I thought I was doing ok, I really wasn’t. Even though I thought I could handle stress well, I don’t guess I had ever experienced stress like this.

Typically, nursing is about healing. A patient comes in sick, and we make them better. That’s not COVID-19.

And yes, I had experienced lots of death and dying. It was part of the job. So it wasn’t the people dying that got me. It was the fact that most of them seemed to be dying. The ones that were in Critical Care, anyway. The prognosis of these people was horrible, and when you have to break that to a daughter who can’t talk to her mom, or even see her, it’s depressing.

I was used to elderly and debilitated patients dying, but this was different. I was seeing people my age, younger, or just a few years older, and they were not doing well at all.

Nursing had always been a career where I had to be careful with infectious disease. I frequently encountered illnesses I could pick up and take home if I didn’t use proper protection or hygiene, but this was different. It was so new, and I watched the information available change day by day. One minute it’s airborne, the next droplet. One day the CDC says one thing, the next day, something else. The suggested PPE (personal protective equipment) changed faster than I could keep up, and it became this constantly evolving situation. I sadly knew that each time I came to work things would be different than when I left.

Do I need to shower and change clothes at work? Is it in my hair? The questions I had to ask myself. Is a Level 1 mask good enough, or is a Level 3 safer? Wait, now you’re saying it’s aerosolized and I should definitely wear googles? Why didn’t anyone tell me that yesterday?

Am I bringing bad stuff home to my children? They’re so little still. The fact that our government and healthcare system was treating the response to this unlike anything I had ever encountered only added to my thoughts. I mean, your president says everyone needs to stay home. Except you. You need to run into it head on! Unless your patient’s heart stops. Then, don’t run; put on your PPE first. It was going against everything we had ever done as lifesavers!

Everyone was watching us. People whose sole job was to make sure we were protecting ourselves properly. And while I appreciated the effort, it also made you feel pretty odd. I mean, what kind of crazy crap makes hoards of upper management and administration watch your every move? What exactly were we dealing with? The answer to that seemed to change every day!

I never felt so helpless. Everything we tried seemed to be in vain. They typically weren’t getting better. One week this was the go-to drug of choice, the next week something else, and the next week the surprising news that none of it would improve outcomes. In fact, it might make it worse.

It didn’t matter that the mask or respirator hurt my face, left bruises and sores, or that it left me feeling drowsy and cloudy headed after so many hours on straight. It didn’t change the fact that I was paranoid about the seal, worried that the tiny virus could somehow get through.

The stress made me become the type of person I didn’t want to be, short tempered and easily frustrated. The high acuity of the severely critical patients forced me to become the kind of nurse I didn’t want to be, hurried, harried, just struggling to keep them alive, keep my head above the water. My shift would end and I’d be sure I had missed something, which drove me crazy, but at least they had lived through my shift. They would likely die after I left. The prognosis was always poor.

Seeing the fear in their eyes, or hearing the words, “am I going to die,” remembering those words after they were gone. Holding their hand, offering comforting, muffled words, but knowing you were no adequate substitute for their loved ones.

Speaking of loved ones. We had those too, and just this week my nine year old said sadly, “Mom, I don’t want you to go to work. I’m worried you’ll get sick.”

But then I also had loved ones who had no idea. As I was leaving work today it occurred to me that not many of my family members had called to check on me. It wasn’t their fault; they didn’t know. I had not told them the toll this pandemic was having on me, and that’s when I knew I needed to. I see Facebook posts of people who don’t even think the pandemic is real, or that it’s like the flu. They have the privilege of not knowing how hard this is hitting me and my coworkers. I don’t normally try to play a pity party or seek attention, but I realized that a lot of people just didn’t know. They didn’t know that we’re not ok.

I have spoken with my coworkers and peers, and all the ones I have questioned are feeling the same pressing weight as me. They’re tired, worn thin, worried, beyond the typical stress of saving lives on a daily basis. It’s beyond skipping lunch and bathroom breaks to keep someone from dying. That’s just a regular Thursday. This, this is different. This is harder.

I don’t know the answers, and I don’t know if things will ever be the same. I don’t know if there’s anything you can do to make it better for your nursing friends. You can pray. You can send us a message, drop off some toilet paper, or even just a long-distance hug. We need so many hugs right now, and social distancing is messing that all up. The typical outlets aren’t available to decompress, or the ways we deal with stress are not allowed. Nurses have the added weight of homeschooling, when that’s not something they are used to, or a spouse out of work. We’re dealing with all the same stress and aggravation as the rest of the population, but also the additional stress of facing this monster up close and personal.

We can’t pretend it’s not happening or busy ourselves with conspiracy theories. We’re too preoccupied with telling ourselves, “it’s not your fault. You did everything you could do.”

This is all I can write right now. There’s more, so much more, but I am exhausted after a day of the above. I need to lay down so I can wake up and do it again. See, that’s the great thing about nurses. We are not ok, but you’ll still find us when you need us. We’ll be in the clinics, ER’s, and units ready to do all we can do for those who need us. We’ll worry about us later.

How I Fell in Love With Nursing. Again.

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First love is easy, isn’t it? With stars in your eyes and a naive nature, you swing headfirst and heart-strong into the relationship. You have dreams for the future, the butterflies for excitement to spur you forward, and even a bit of healthy hesitancy to keep you honest. But somewhere between that first date (or shift in the case of nursing) and eventual broken expectations, you end up feeling betrayed. It’s nothing like you hoped it could be. You end up disappointed, likely broken-hearted, and sadly, if your experience was especially harsh, guarded and skeptical for any silver lining that might exist up ahead. Sound familiar?

A profession you can truly love isn’t that different from a romantic relationship. It’s something that gives your life a new purpose, a reason to hope, excitement, and the ability to get better at it as you go along. It’s the chance to think of someone other than yourself, but like any relationship, the one with your career can become strained. I’ve been in the medical field for 20 years now, and I think I’ve experienced every stage of the process. I mean, if Nursing was Dante’s Inferno, I probably transversed through every circle. Y’all, I fell out of love with it, and it took purposeful determination to make my way back into my partner’s good graces. At one point, I think I hated it. Just being brutally honest here.

That first year was something, am I right? Fear, panic, but somehow an exciting adrenaline rush, a pride that I’ve discovered you can’t let slip away. I was proud to be a nurse. I was proud of my vocation, and I was proud of the hard work it took to get me there. I was proud of that R, and of that N, and for a while no one could take that from me. But then came the bad apples. Damn, if they don’t ruin the barrel.

Somewhere between holding an elderly woman’s hand and double charting for the billionth time, my heart started to harden. Do you know the difference between a good nurse and a great nurse? I was always a good nurse. I took care of my patients, and I got the job done. I was honest (for the most part), and I did no harm (that I’m aware of). I smiled at my patients’ faces, and I even meant about 80% of what I said. This will sound so harsh to the layman, but my fellow nurses will understand. It’s not easy giving all of yourself with little to nothing in return. I mean, yeah, you get the paycheck, but that even seems paltry in the face of preventing death or giving up Christmas with your family. So, it becomes a job. A thing you do, day in and day out. I can even recall telling my husband I felt stuck. Lord, help me, I did. I could think of no other “job” where I could work 24 hours, yet get paid for forty hours, while maintaining the best benefits offered in our little city.

I ask again, do you know the difference between a good nurse and a great nurse? A good nurse gets the job done, but a great nurse loves the job they get to do. I guess I had to move from one to get to the other.

All I know is, I entered the field like a young, star-crossed lover, but about a decade into it, I wanted to breakup. I had become disillusioned, and it wasn’t what I thought it could be. Maybe I entered the career thinking I could make so many differences, but I wasn’t open to what could change in me. I became a woman focused on the obstacles before me, and blinded to any blessings scattered throughout. I wasn’t heartless, mind you; I still felt contentment when a patient told me how much my care had meant to them. But those Hallmark moments couldn’t outweigh the injustices I felt. I focused on every single hardship in my field, and I took personally each offense. I allowed the Negative Nancy’s to feed the fire of bitterness inside me, and I assumed every demanding patient canceled out the kind ones. There’s certainly that need for self-care, but I think I came to a place where it was almost always about me.

“Why is this so hard,” I asked, never contemplating for very long how it must be on the other side of the bed.

“What do they expect of me,” I would question angrily, without asking myself what I might give.

I saw my field only as a difficult endeavor, and seldom as a privilege. I carried the weight of a thousand martyrs, except I had forgotten the cause for which I gave myself. I was a good nurse, who did my job, but not a great nurse who loved the opportunity to do it. And I suppose that’s many of us. It’s not that we don’t enjoy what we do; it’s just that sometimes we hate it just as much. That sounds so terrible, when I type it out like that, but if you’ve never held a position where you don’t cry while cleaning the dead body of someone you just hugged that morning, then you may not understand. If you haven’t been punched, kicked, or called the worst of all swear words by someone you’re trying to help, then you won’t get it. If you haven’t cringed over calling someone in a position above you, knowing they will scream at you merely for doing your job, then this may seem like harsh words. If you haven’t felt the anxiety of trying to do the work of two people, while not making a mistake that could cost someone else’s life and your career, then you just won’t have a clue. It’s not easy to carry the weight of so much on tired shoulders, and for many who do, they end up angry and perhaps even resentful for a profession they once loved so much.

Back to the relationship bit, it’s as if the marriage is falling apart, and you don’t want a divorce, but you can’t look at his socks balled up on the floor another day or you might snap. I guess sometimes, when you realize you don’t love them like you used to, you have to take it back to the beginning. You have to remember the first time you saw them, that first date, or first, tender kiss. The spark is still there. You just gotta know how to stoke it.

I recall sitting in a computer class taking a critical care course, and I was digging it. Us Critical Care folks, we love all that medical stuff! Sitting there, I knew I loved the knowledge. I loved the dynamics. I loved the process. I loved the people. I loved making a difference in people’s lives. I loved nursing. I did. It was time to act like it.

Back when my husband and I were just dating, I remember we had been off again, on again, at one point. I had found out some stuff, and each of us had been idiots. We loved each other, we knew that, but we were kinda just coasting along, existing as a couple. Like, maybe involved, but not committed entirely to the future of it. Well, anyway, I remember standing in the card aisle on Valentine’s and I had found the perfect, mushy card for him, when suddenly God smacked me upside the head.

It was like, God said, “Brie, if you’re going to give that to him, you need to mean it.”

And I was like, dang, you’re right. I love him. I really do. We can work through this.

And we did. Every day since our relationship got better, and even now, each day is better than the last. I guess, I had to come to a place in my nursing career that was similar. I loved it, but I had to start acting like it. I had to do more than just show up. I had to get invested. I couldn’t focus on my husband’s faults, any more than I could deny my own. And I couldn’t selfishly fixate on what nursing took out of me. I had to start giving of myself more. I had to see through clear eyes. If you focus on a stain, that’s all you see. What you should look at is the fact that the fabric is still good. It can be washed. Nursing was still good. I think my vision of it had just become tainted.

My career truly began to change when I focused on the opportunity to provide care, the privilege of meeting people at their darkest hour, and leading them back into the light. I threw off sympathy and instead embraced empathy. I put myself in my patient’s shoes. Heck, even the administrators’ shoes. I saw my occupation as the ministry it was, my chance to care for the hurting, and to help those in need. I didn’t face the relationship with what I could gain, but what I could give. I didn’t focus on what wrong was being done to me, but rather what good I could sow into it. Y’all, I fell in love all over again, and it wasn’t because the object of my affection was perfect, but because it gave me purpose, passion, and a sense of fulfillment. Was it still hard, at times? Yes! But beyond that it was good. In fact, it was great. And then I realized, I was great too.

How to Find Peace in Patient Care

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Not long ago I encountered a new nurse with multiple questions, and while I adored the fact she sought answers to the things she did not know, I also sensed a self doubt within her. I totally got it. I saw myself in her wide, startled eyes, and even fifteen years later I could easily recall the hesitancy prevalent in being a new nurse. I remembered well the fear, worry, and realistic concern that I might do something wrong. I mean, it’s true. Hastily made mistakes could kill people. But I also could remember the irrational fear I had held, the anxiety that I would mess up even the things I knew how to do. For years that irrational worry had made nursing far more difficult than it needed to be for me. And though a whopping, healthy dose of attention to detail and awareness could save your license, as well as a person’s life, one step over the line into performance anxiety and bedside-care doubt could tire you quickly. No one could survive the burnout of that particular feeling. I saw that fear in this new nurse’s eyes.

As a newer nurse you have a choice to learn from your mistakes and press on, or you can crumble under defeat. You have the choice to build on your knowledge and gain much-needed confidence. I’ve seen the other side of the spectrum, mind you, as I’m sure most of us have. It’s that overly confident, cocky new grad who thinks they know everything. They don’t ask questions, and it’s usually the patient who suffers. They teach their incorrect knowledge to the new hires that follow, and safe technique goes out the window. So, I’m all for the pursuit of knowledge, asking questions, and taking an extra pair of eyes along. Heck, after twenty years in healthcare I still ask questions and seek new answers daily. That’s not what I’m talking about. I’m talking about doubting the knowledge you do have or anxiety over skills you hold under your belt.

This problem of bedside anxiety won’t go for everyone, and if it doesn’t pertain to you then I say, that’s awesome. Truly. Because it sucks. I think it’s the introverted, overthinkers who encounter this problem the most, and it will surefire make you resent your career. I used to be that nervous nurse, but no longer. I found my peace in patient care.

So, here’s what I said to this new nurse when she spoke anxiously about the continued stress of making a mistake in nursing.

You have no control over out of control things.

And that’s the truth of it, my friends. I used to be one of those people who desired control over all the things! I think most critical care nurses have that desire within them. I wanted everything just so-so, my ducks in a row, and my plans laid out. Basically, I desired a Mary Poppins kinda day, everything practically perfect, and anyone who’s nursed for like five minutes knows that ain’t happening. But it wasn’t just that. I also put too much pressure on the control I had over a patient’s outcome. And, yeah, while my performance could positively or negatively affect my patient, my ability to do well couldn’t stop someone from checking out to the great beyond. Somewhere around my tenth code, where the patient didn’t make it, I realized this.

I don’t care if you knock out your compressions like an ACLS guru, if a patient’s heart is tired of pumping, they will probably die.

I don’t care if you give every medicine correctly, checking allergy lists and the five rights, if a patient is too far gone to respond to the treatment ordered, it won’t matter.

It doesn’t matter if you give the best Diabetic education and insulin administration teaching on the planet. If a patient wants to chug Mountain Dew like it’s the air they breathe, they’ll be back next month in DKA.

It doesn’t matter if you provide the most encouraging and uplifting advice to the addict, you may find out they’re dead next week. I’ve had this happen.

It doesn’t matter if you provide the best care in the whole hospital, certain families will still complain.

I don’t care if you do everything right, catch every mistake before it happens, and think three steps ahead for your patient’s best outcome. If it’s their time, then it’s their time.

It’s not you. It’s not me. You can’t control an uncontrollable situation.

For me, I had to realize that I can only do what I can only do. I can’t get everything done. I won’t check all the boxes administration wants me to check. I can’t place myself in two rooms at once, no matter how much my charge nurse may wish it was so. I can’t control what a patient’s family does when I leave the room, and I can’t change what a person does when they wheel off my unit. I can’t save everyone. Sometimes because they don’t want saving, but most of the time it’s because healthcare is bigger than me. Life and death is bigger than me. Destiny, God’s will, or whatever you personally call it, is bigger than us all. We can only do what we can only do.

We come in and do the best we can. We work with what we’re given, which often times is less than we need. We do the absolute best we can, and to quote my favorite work-husband of all time (love you, Terry), we try and “leave em better than we found em.” But then we just gotta let go; let go of this idea that we hold life and death in our hands. I mean, yeah, how I titrate those three vasopressor drips can mean the difference between life and death for my patient! And giving the correct med or wrong one will have good versus bad outcomes. It’s my keen eye that catches a potential problem before it becomes a real problem, and that makes me feel very good. Yet I can’t keep bad from happening if it’s gonna happen. I can do my best, but that’s all I can do.

In nursing we hold much responsibility. As we’ve seen in the news, our mistakes can be costly, to more than just ourselves. That’s why we keep learning, keep asking questions, and keep trying hard. What we don’t do is fear. Fear, worry, and anxiety have no place at the bedside. Fear and anxiety will tell you that something bad might happen. Realistic thought will tell you that something bad will happen. Maybe not today or tomorrow, but one day it will. You can do everything flawlessly and it still will. You have to let go and just do what you know to do, realize that you’ll make mistakes, but you’ll learn from them. Sixteen years ago I failed a clinical exam because I didn’t give my patient up in the chair his call light before I left the room. Do you think I’ve ever forgotten to give a patient their call light since? I haven’t.

You’ll mess up, miss something, and forget plenty. Personally, each day before I work I pray in the shower. I ask God to “help me hear His voice and do no harm.” It has worked well for me thus far, but I also know I had trouble hearing that small, steady voice in my heart until I let go of the fear that I wouldn’t. I had to become confident in where God had placed me as a career, and each day I go to whatever floor and whatever assignment with that same peace. I’m going where I need to be, with the patients I need to have.

I can’t control everything that happens at the bedside, but I can control my own thoughts. After all, it’s my thoughts that drive me.

This is the Number One Thing Nurses Forget

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I’ve always been fond of saying that nurses wear many hats, and over the years I’ve worn some more than others. Some of those hats I’ve wanted to hang up, if you know what I mean. Some of the hats nurses wear feel like a dunce cap some days, and some feel like a crown on others. Maybe one more than the other. I’ve had days where I feel like I’m wearing a maid’s hat, and I’ve had others where I feel like I’m wearing one stamped “doormat.” It can be downright exhausting wearing all those hats! Especially the ones you didn’t plan on, like babysitter, drug dealer, or punching bag. It’s those hard-to-wear hats that bring us down, wear us thin, and push us away from the bedside.

It’s like one day you look up and you say, “this isn’t anything like I planned it to be. I didn’t sign up for this. Things have changed! I can’t do this anymore.”

Sound familiar?

Resigned to an unfair, rarely rewarding career, you trudge through each extremely long twelve hour shift with dread and dissatisfaction. You rack your brain for how to make a change. You may even feel trapped in a situation that no longer brings you joy. I mean, if Marie Kondo told you to hold up your job in one hand, you’d probably toss it. Am I right?

Perhaps you’ve just forgotten why you do what you do.

There’s a section of my blog analytics where I am shown Google searches that led to my posts, and I often find a reoccurring theme. Yesterday one read, “help me get away from bedside nursing,” and my heart broke a little bit. I had been there myself at one time, and my burn out almost pushed me away from nursing completely. I almost left something I love and something that I was called to become.

That’s the thing about hats. They’re like bad haircuts. You get a bad haircut or color and it transforms your whole look. You glance in the mirror and cringe. You get to where you don’t even want to look in the mirror until something is different. Nursing hats are like that.

If you have a shift where you wear a hat that makes you feel unappreciated, used, taken advantage of, or pushed beyond your limit, then you feel like a failure at what you do. It doesn’t bring happiness; it just brings frustration. Wear that hat enough days and you don’t even wanna look in the mirror. In fact, you forget what you ever looked like before. You forget the appeal and shine of your very best hat. You forget it even exists.

A few years ago my husband came home from work and told me something I’ll never forget. At the time my husband owned a small restaurant in our town. He had offered to feed for free the participants in a drug rehabilitation ministry. So naturally the minister overseeing the program wanted to meet this man who was offering pizza at no charge. Upon introductions the minister recognized my husband’s last name. He recognized it because of me.

As my husband retold the conversation to me, it seems that the minister had come across a past patient of mine in his work. The reformed addict had told him something that stuck with him. Something that made him remember my name.

The addict had said, “I went into the hospital tons of times with overdoses. And each time they treated me like a piece of garbage. They saw me as a lost cause! But then there was this one nurse. She made me feel like I was the CEO of the hospital. She made me feel like I was somebody special. She made me feel like I was worth something, like I could beat this thing. So I decided to do just that.”

Y’all. This story floored me. But it also reminded me of something that’s too easy to forget in nursing.

We make a difference in people’s lives.

Not always. Sometimes you don’t. But then sometimes you do. And those times? They’re special. They’re worth putting on a shelf and pulling out after a bad day. Cause you’re going to have bad days.

The thing you have to do with that is remember what hats are important, and forget what hats are not.

Some days you get treated like you’re a waitress. That’s okay. Because what really matters, I mean, what really, really counts is the truth of what you are. How you’re treated (sometimes) doesn’t define you. You are more than that.

Nurses have the opportunity to serve mankind at their worst! And yes, while it does feel that way sometimes, consider this. You have the chance to make a lasting impact. Nurses not only saves lives, but we also change lives. During a time when patients are their weakest, lowest, and most discouraged, we are allowed to enter their private moments and give them what they need the very most. We give oxygen to those that cannot breathe, but we also give laughter to the depressed. A song can brighten the day of a patient feeling down, and the right medication and therapeutic touch can lift them higher than you realize. A smile soothes the soul. As a nurse you have this power.

You’re not simply a pill pusher! You’re a hope dispenser!

You’re not “just a nurse.” You’re a life-changer.

You’re not just a servant! You get to be a servant. You are allowed the chance to serve mankind at its most difficult time, when ill, and your work makes them feel better. This isn’t just some little thing. It’s huge.

It’s easy to get so distracted by all the hats we wear (especially the hard hats) and forget that the most important hat we wear is Life Impactor. We impact lives, we change lives, we make lives better. We leave them better than we found them, and that’s worth celebrating. It’s a lofty calling. Is it always appreciated? Of course not. Little in life is. We ignore a beautiful sunset as easy as a buzzing fly. But many times you’re the light coming over the horizon, your patient notices, and they are better for it.

Now, it’s your job to be better for it. Realize the light you shine, understand the impact you make, and never forget that it’s the grandest hat you wear. And at the end of the day, it’s the only one that matters. It’s why we do what we do.

Finding Joy in Nursing

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Before I started my most recent travel nurse position in a Cardiac Critical Care Unit, I had to complete some online education and checklists to prove I was proficient in the knowledge and skills I claimed. As I went through the skills checklist marking “very experienced” on almost all of them I felt a surge of adrenal. Seeing the scenarios in print made me feel like I was almost doing them, and I realized I was excited at the thought.

I frigging love this stuff, I thought.

And it surprised me a bit. At the time I was back home on vacation, lounging in my pajamas, with hardly a care in the world other than the email from my compliance office of things I needed to complete for my next assignment. But rather than being perturbed over the intrusion of my off time, I was eager to get back at the bedside. I suppose that’s what really surprised me. I wasn’t dreading returning to work as an ICU RN. I was eagerly anticipating it.

It’s not that I didn’t love my time off. Of course I did! But I also loved taking care of my patients. The thing is, it had not always been this way.

Don’t get me wrong, now. It’s not that I hated my patients. I had always enjoyed caring for people, but somewhere in the frustration over increased charting requirements, low staffing, and bosses who forgot what it was like to be at the bedside, I didn’t enjoy it as much as I wanted to. In fact, some days I had right near hated it. Some days I drug myself home and wondered how much longer I could make myself stay at the bedside. It became an exhausting, exasperating exercise in what felt like futility. Between the noncompliant patients and family members you couldn’t please, I was burned out. This made me sad. Not only sad for myself, but also my patients. They deserved more from me.

It got to where every little thing made me furious. Another “mandatory” meeting? Oh please. The double charting of restraints made me fume. New policies caused me to roll my eyes, and I got on the bus that no one cared about the bedside nurse. No one! I was a body, a number, a workhorse to be used and abused by surgeons with a god-complex. Whatever.

I dreaded going to work, and I didn’t want to be a nurse anymore. It broke my heart. I had always wanted to be a nurse, like my mother, but I told myself the field of nursing had simply changed. It wasn’t the same, and because of that I’d lost my spark.

I ended up taking a step back. I cut down my hours, and thankfully financially I could. I focused on raising my babies, and that was where my joy was. It worked for me. But I was still sad about the time I did work. Something wonderful would happen. A patient would tell me how I had changed their life. A family member of someone who almost died would spot me in the store and suffocate me in a grateful hug. A former patient would bring a gift by my husband’s work for me, and brag about the care I had provided in their worst time. I felt overflowing with pride at theses situations, but I also felt like a fraud. If these people could see how frustrated I had become at the field, they probably wouldn’t feel the same about me. No matter how kind and cheerful I remained at the bedside, I wasn’t blind to the bitterness that had crept unwanted into my heart.

And then came the time for me to return. Seasons changed, circumstances altered, and I found that a full-time return to the bedside was required.

I can do this, I thought.

I wanted to do it. But I also wanted to not hate it. One day I stood in the hot shower, extremely exhausted from my prior shifts, and I began to pray.

“Give me a joy for it, Lord,” I prayed.

That’s what I wanted. I didn’t want to just get by. I didn’t want to just be able to endure. I didn’t want to do like so many other of my fellow Americans and just countdown the days until I could retire. I wanted to love my job again. We weren’t made to trudge through life miserable. I mean, life is not easy. That’s the reality of it. But it does make a difference how you view what’s before you.

The fact was nursing had changed. I had seen it change drastically just in the past decade. There were frustrating things about the field. But there were frustrating aspects of anything. My kids could ruin a fun day with fighting and complaining, but I didn’t stop taking them places. I focused on their happy smiles, not their tired whines. I focused on their “thank you’s” and “this is the best day ever’s” rather than the pulled hair and dirty tears. That’s how I had found joy in the difficulty that’s parenting. It’s how I could find joy in Nursing too.

I began to see things differently. Instead of focusing on frustration solely, I focused on the parts that gave me happiness. I counted it all as joy. I saw myself as a servant, not a slave. I saw myself as a helper, not a doormat. I saw myself as a lifter of spirits, not one crushed by my own bad mood. I recognized the gift of what I did. I had the privilege to care for people when they needed it the most. I had the lofty task of saving lives, of changing lives. I had the opportunity to positively impact people at a time when they were at their lowest and most vulnerable. I had a chance to shine.

Did some days still suck? Of course! But underneath it all was joy. Joy that I got to be a part of something pretty darn amazing. I could make a scary situation a lot less frightening for someone. I could pull someone from the brink of death and watch them walk out of the hospital a week later. I was a ringside witness to amazing technology that could give a goner twenty more years. I got to be a part of some pretty spectacular stuff, and I got to smile and be loving to people along the way. It was a choice. And I chose joy. By God, I chose joy.

That was just the beginning, though. It was like, the more I walked in joy, the more I felt joyful. The more I focused on the good stuff, the less I saw the bad. When people griped, I walked away. I sang a happy song to myself, I had a conversation with a lonely old lady, I taught someone something new about their health, I lent a hand to a drowning, new nurse. I smiled. It wasn’t that I was blind to the problems inherent in my field. I wasn’t sticking my head in the sand. But I was seeing more than the suck. The joy was there all along. I had just forgotten how to see it. I had been blinded by my own indignation, side swiped by injustice, defeated by the doomsday talk, the wind sucked right out of my sails. But then I found it again. I found my love for nursing again.

Again, it had always been there. I hadn’t changed. The field had changed, but I didn’t change along with it. I didn’t adapt. I stood rigid. And yeah, some things I needed to stand firm on. Nurses did have rights. But we also had responsibilities. It wasn’t the dying man’s fault the budget had been cut. It wasn’t the lady with a STEMI’s fault that Medicare had changed. They still needed my best. They needed a woman who wanted to be there; not just a woman who wanted a paycheck. To be that woman, the one they needed, I had to put my focus on the people who needed me. I still saw the things that needed fixing in healthcare, but I didn’t let those overshadow the joy that came with making someone feel better.

Making someone feel better! That was the best of it. That’s where the joy was, and that’s where I found it. I reckon you can find joy in almost any circumstance. You just have to be willing to look.

What’s a Bad Day in Nursing Like?

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I walked quickly along the crosswalk, the little, illuminated, man-figure on the street sign guiding my way. My hands in my pocket, head slightly down against the smattering of cold rain, and body and mind weary from a long day at work, I made the short walk to the parking lot where I could make the much anticipated journey home. It had been a bad day.

When suddenly, out of nowhere, a car jaunted through the dark, directly at my person. Startled and shocked I froze, much like a deer in headlights, stuck to the pavement I stood awaiting my impending death. I stared in terror at the driver who had turned quickly into my path across the street, and I saw them staring back just as surprised.

I kept walking.

My heart hammered. They almost killed me! I thought.

A moment later, that is the perfect representation of my day.

It almost killed me.

As I got into my truck and drove home I felt certain I would cry. I mean, all day I had wanted to. Many moments throughout the horrendous day I had desired to duck into a supply closet and release a torrent of tears. For surely that would let loose the stress that mounted within me.

On a bad day in Nursing you may want to cry, but you don’t. I think it’s because you’re afraid you won’t be able to stop.

Yes, I had felt certain I would cry on my way home, but once alone and away from my bad day I realized I could not. There was nothing left. I felt so spent, so dry, so expended, that not even a single tear could fall. I wanted to cry. I felt like I needed to cry. Surely it would make me feel better!

But there was nothing left. I had used it all.

A bad day in Nursing can be like that.

You give all you have, you hit a wall. You think to yourself, I can do no more, I can go no further!

But then you do. Why? Because you haven’t a choice. Your patients need you.

As I drove home I thought about my day. I wondered how I could have done things better. I wondered if I had given my patients the best of me that they deserved. My guilt over human limitation weighed on me, and I knew I had to push it off.

“Lord,” I prayed, “help me to let it go, to leave work at work.”

A bad day in Nursing can follow you home. Your family can suffer, your marriage take the brunt. My children already had to deal with a tired mother after twelve hours bedside, a mother who wished to cuddle and hold her children, but often was so exhausted from a day of caring for others, had little left but to sit on the sofa like a stump. I couldn’t take home thoughts of work stress too. They didn’t deserve that.

So I tried to leave the bad day behind me. I imagined it floating from my body and being left in the air behind my vehicle as I sped away, turning up the radio and smiling at the Tracy Chapman song, my bad day like dust that I shook off, exhaust from my tailpipe.

I still thought of it a little. It was as if I had to slowly let go and let it drip away, rather than the dramatic leave behind scenario I imagined.

A bad day in Nursing can’t really be quantified. You can try and say, “well, this wasn’t the worst day I’ve ever had.”

The worst day was when that baby died.

Or, it wasn’t as bad as the day I had chest pain. That day I fought for twelve hours straight to keep that man alive. Something about the stress of knowing your actions mean the difference between life and death for someone you don’t even know personally.

A bad day in Nursing isn’t something that can be walked away from. You can’t just go take a break. Sometimes a coworker can help, but usually they are just as busy as you. So you hold your urine. You count on invisible fingers that it’s been 19 hours since you last had something to eat. You try and figure out how you can make the anxious patient calm, the angry family member happy, or the condescending physician a decent human being. You hold one portable phone to your ear while the unit secretary announces another call for you on hold.

Just a minute.

Be right there.

I’ll take care of it.

A bad day in Nursing isn’t something you can check out of mentally. When you’re fed up, finished with the day (emotionally, that is), and certain your nerves can take no more, you still keep going. You can’t decide to do it halfway or to give less of yourself. You can’t go somewhere else in your head or give a mediocre, halfhearted performance of your duties. When life is on the line you always have to be vigilant and present, 100%, no matter if you feel you have nothing left to give.

That. Is. Nursing.

It is giving your all, even when you think you can’t. It’s hitting a wall, and then walking around it. It’s reaching the end of your rope, then miraculously finding there’s more. It’s being empty, yet still pouring out your tank. It’s running, even though you feel as if your legs have been cut off. It’s reaching the end of yourself, and then starting again. Sometimes it’s a time clock perseverance, where you ache for the end of your shift, because only then will it be over. The bad day, that is.

After a bad day I always question myself for a moment.

Did I do the best I could do?

How could I have done better?

And of course…

Can I keep doing this?

This morning I saw a friend on Facebook. It was someone the field of Nursing had brought me. It was someone who had happened upon my hospital bed (if you believe things just happen), and it was someone whose life had changed. They had told me it changed because of the things I had said. This person had come to my ICU bed as an overdose, another one in a string of so many before. Broken in so many ways. Some people saw a pointless case, repeat offender, hopeless addict. I saw a hurting heart in need of love. For some reason my kind words, encouragement, and love showed this person that they were capable of change and worthy of a better life. Just an ordinary day at work, nothing spectacular, yet a life had been saved and changed. This friend was still clean six years later. An event that almost ended in death had instead turned into a new life. And I had something to do with that.

That thought (the one that what I did mattered) brought me peace and joy. I was reminded that while there will be bad days, there are also good days, and what I do has an impact. I am where I need to be, with purpose, and I can meet each day with the expectation of doing something wonderful. Sure, some days will be hard ones, ones where I feel like I barely got by, or that I did horribly, but then they won’t be.

Bad days in Nursing are like nothing else you know, but the good days can have a positive impact you never imagined possible.

The Most Unpopular Nursing Post Ever

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Recently an older, male patient said something to me that made me pause.

“I want to thank you for serving me today, and doing it with a smile.”

Service with a smile. Sounded like some slogan for one of those restaurants that makes you wear lots of gaudy buttons and that hangs sports memorabilia all over the wall. I bet they sang some original yet ridiculous birthday song complete with clapping and out of tune voices.

“Thank you,” I replied. “Are you done with your tray?”

Then I hefted his heavy lunch tray into my arms, and it rested slightly on my shoulder as I exited his room.

“Please turn out the light,” he instructed. “And close the door.”

As I pulled the door to, making certain it didn’t slam loudly, a fellow nurse walked quickly through the hall.

She noted the tray on my shoulder, and she commented, “you look like a server in a restaurant.”

I always had drawn many connections between waiting tables and being a nurse, but as I carried his used tray down the hall I considered my role as a nurse and a servant. I supposed I was fine with it.

It’s a common complaint among the nursing community. Being a servant, that is. Being treated like a waitress, a maid, or I’ve even heard it described, “I’m not your momma!” Nursing is a profession, not simply a job anyone could do. You can’t, after all, walk in off the street and suddenly start titrating IV Levophed to maintain a blood pressure compatible with life. Nurses go through years of school, followed by years of on the job training to reach the level of knowledge and competence the job requires. They’re expected to monitor for minute changes in condition that could signal a life-threatening decline, they’re required to understand a myriad of medication doses and side effects, and the level of skillful performance of bedside procedures is of invaluable importance to the medical field. As such a well-trained, highly educated, and much needed provider in healthcare, nurses shouldn’t be expected to perform such menial tasks as fluffing a pillow or retrieving numerous popsicles and jello cups. How about a mint for your pillow?!

This idea we get in our heads, that being a servant is annoying or beneath us, I believe it only aids in breaking down the high respect for our profession. We feel sometimes as if we aren’t being highly regarded by the population for which we care, but I’ve discovered it’s the little tokens of servanthood that help close the circle of healing and wellness for patients.

I’ve been there myself. Run ragged, understaffed, and pulled in multiple directions. When you are literally fighting tooth and nail to keep one patient from dying, and then another asks for a box of Kleenex, it’s a flustering moment. To try and be everything everyone needs is impossible. In such a high-stress and extremely demanding (both physically and emotionally) environment it’s difficult to keep a calm head, much less be Betty Crocker or Mary Poppins. And certainly not Florence Nightingale. We’re too busy double charting patient care for reimbursement purposes! And no food at the nurse’s station! But I digress.

The point I’m trying to make is that while, yes, it’s difficult to be a servant, that doesn’t mean it’s a bad thing. It’s actually ok to be a servant to mankind. It’s actually our calling. If you hate people then serving them through the field of nursing might not be something you need to do. After all, people come to us typically in their most desperate and vulnerable state, and service with a smile might be that one simple thing that makes being sick a little bit easier.

I can remember once taking care of a patient when it really hit me how my attitude affects those around me. This particular lady was a walkie-talkie. She didn’t need to be in the ICU. I had a patient in the next room on a billion drips, tubes everywhere, knocking on Heaven’s door, and here was this lady asking to get up to pee. Again. I sighed and said something or other, to her request. My words didn’t matter as much as my face. Because while my words said “yes, I’ll help you,” my attitude said, “I don’t have time for this.” And perhaps I truly didn’t. There never is enough time in the field of nursing. But what struck me at that moment was how I must have made her feel. As a women myself who uses the bathroom frequently, I wondered how I would feel in her shoes. I would likely feel like I was a nuisance, like I was bugging the staff, like my needs weren’t important. No one should ever feel that way. We have to remember that.

I’ve discovered that patients won’t remember when I did chest compressions and helped bring them back to life. They won’t notice the dangerous med error I caught. They probably will never realize how I advocated for them on the phone with their difficult to deal with physician. They won’t even know if my patient in the other room is far sicker than they may be. What they will remember is how I treat them. And contrary to popular belief, we don’t treat people well for better patient satisfaction scores. We treat them well because it’s the decent thing to do. We treat them well because being sick sucks. We treat them well because that’s what we’d want if it was us or our family in that bed. We treat them well because that’s our job. And treating someone well means having a servant heart, a heart that gives of itself for the betterment of someone else.

It’s easy to forget that.

Nursing is a difficult, frustrating, and often times an overwhelming vocation. Yet it is also a privilege. People come to us at their worst and they say, “help me. Will you please help me?!” They place their life and future health in our hands. Sometimes they place their garbage or their bedpan in our hands, but that’s just a small part of the whole picture of making people better.

So sometimes I’ll carry trays, and other times I’ll start an IV to give much needed hydration and pain meds. Sometimes I’ll spoon feed someone who can’t use their hands anymore, and then I’ll also assist the physician in inserting a tube in their side to drain fluid so they can breathe. Sometimes I’ll give a bath to someone, because being clean just makes you feel good. I’ll hold the hand of a patient who is scared of dying, or I’ll educate family on how to use a feeding tube. Regardless of what I do, it will be a service, and it will be one I provide with a smile. Somedays it’s hard to smile. It’s hard for nurses, and it’s hard for the patient who doesn’t feel well. Maybe it’s even hard for that surgeon who’s always grumpy. Yet I’ll still serve with a giving and forgiving heart, a heart that steps into the shoes of someone else, and a heart that remembers an integral part of my job is serving others, in all capacities. That is why I’m here.

A Generation That Hates Mondays

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We’re a generation that hates Mondays. Have you noticed that? Monday Memes abound, and when Sunday evening draws to a close the majority of America falls into a state of silent dread, downtrodden for the walk into whatever workplace that awaits them the following morning. I wonder to my self sometimes, was it always this way?

What are we working for, or who are we working for? When did we become so discontent with our station in life that the thing we spend the majority of our time doing (work) becomes the thing we dread the most? Worse than death and taxes, it seems work has taken first place as the most certain thing we absolutely must face. And we face it with a deep-set frown.

I mean, you gotta work, right? Someone has to pay the bills, pay the second mortgage, finance the Disney trip next summer, and keep the kiddos in designer duds. We live to work, we work to live, never imagining there could be a different way.

We’re afraid to do the things we really love, the things dreams are made of. I went into the nursing field over packing up and heading to Hollywood because my dad insisted the medical field was the smart choice, the reliable choice, the vocation that would bring in a steady income. Because that’s the world we live in.

We don’t chase dreams; we chase paychecks. We don’t create a debt-free life. Instead we create the life we’ve always dreamed of, complete with price tags we can’t really afford. We pack our lives and over-sized homes with things we don’t really need, but things that might fill the emptiness we have over doing a job we don’t really enjoy.

Or perhaps we forget who we’re working for. Generations before us had a pride for their jobs, whatever they were, because they knew they were working (in essence) for their families. Today we’re usually working for a newer car, a bigger lawn, or to payoff our caviar dreams. We work for vacation, not for the satisfaction of a job well done. We work overtime for those coveted vacations that photograph well, the ones to even make the Joneses green with envy. We work day in and day out for those paltry two weeks that are so jam-packed with all the things we’ve been missing that we’re exhausted from our time off. Is there any Monday worse than the Monday after vacation?

Is there a way we could hate Mondays less? I mean, Monday isn’t really any different than Tuesday, or Friday for that matter. As a nurse I can be off on a Monday as easy as work a Sunday. So it’s not so much Monday that we hate, but rather what Monday represents. And typically Monday represents the return to something we’d rather not return to. It’s a return to a job we hate, a job we gripe about endlessly, yet are afraid to leave. We’re afraid to make a change, as if we truly believe that the evil we know is far better than the one we do not.

So, we’ll keep robotically returning to something we dread, living life like a replay reel. Just like the movie Groundhog Day, we’re forced to repeat each and every day just like the one before it. Yet even in that movie, didn’t Bill Murray discover he could change the outcome of each and every day?

Can we be the change?

What if we stepped out in courage to conquer something new?

What if we listened to the still, small voice in our head that told us of a different way?

What if we stopped working to have more stuff we didn’t really need?

Or we stopped losing sight of the joy that existed in every single day?

Maybe we could open our eyes to the little things that blessed us, instead of trudging in a trance to the beat of the same glum drum.

Maybe we could pay off debt instead of creating more. Maybe we could create time off instead. Maybe we could create the opportunity to chase a dream.

Because I’m still over here trying to figure out when in the world The Great American Dream stopped being about living your dreams?! And instead it became about striving in stress to create for yourself what someone else said is “your” American Dream.

We forgot how to step outside the box. We forgot how to focus on what’s important. We started one day working for all the stuff that will rust and ruin, instead of cultivating and creating a legacy to leave behind.

And you see, a legacy doesn’t have to be what the world says is “great.” Sometimes most times the greatest legacy you can leave behind is family and friends who have learned from you to cherish life as the gift it is. They know you don’t just cherish Saturday and Sunday, dragging themselves through the rest of the week in a disillusioned fog. No! They cherish every day. They work for the things they cherish in all of those cumulative days, and if it’s not worth cherishing then they don’t waste their time working over for it. They won’t work tirelessly for another man’s dream. They’ll create their own.

So why do we hate Mondays? Perhaps it’s because we’re uncomfortable. We’re uncomfortable living a life that fights for dreams we didn’t dream. Instead we’re working for dreams that society created for us. They’re dreams of paper and sand that will collapse before we ever obtain them. And even if we do grab a little handful, won’t the wind eventually just blow it away?

Perhaps if we were working for our own dreams, working for relationships with those we love, and working less because we let go of the paper dreams, maybe then we wouldn’t hate Mondays quite so much.

I mean, it’s worth a try, right?

Ask yourself, what are you working for? If you died tomorrow and it wouldn’t follow you to Heaven, then perhaps it’s not worth working so laboriously to obtain.

I don’t know, but maybe Monday can just be another day.

3 Ways to Know if You’re the Grumpy Coworker

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Have you ever worked with someone who so obviously hates their job that they literally reek with the stench of dissatisfaction? I can recall starting out as a new nurse many, many years ago and working alongside a chronic complainer who hated our unit. I didn’t even realize it was that bad until she continuously brought it to my attention, and I’ll always remember something my charge nurse stated after the disgruntled nurse trudged away.

She said, “you know, one bad apple can totally ruin the barrel.”

And to this day I realize she was so right. A grumpy coworker can ruin your entire day, or even ruin your workplace in general. As I’ve recently been almost infected by the rants and rages of another unhappy peer I’ve started to wonder if these disgruntled people even know how bad they’ve gotten. I mean, do they realize that they’re the bad apple ruining the barrel? Probably not. I think when you’re unhappy with your job it can creep up on you, pile up day after day, and finally just turn into a trash pile of discontent.

So being that gal who doesn’t desire to be around Negative Nancy any longer than necessary here’s a friendly checklist to let you (or someone working alongside you) know if you’ve become that grumpy coworker. After all, in the end only you can change your circumstances.

1. Constant complaining. If every single time you open your mouth nothing but complaints pour out, then you might just be disgruntled. No one is asking you to take on more than is fair, or to persevere silently through cruel and unusual treatment. In fact, if you’ve been unjustly assigned more work than you can handle then please speak up. Be the change! Take it straight to management! But here’s what not to do. Don’t grumble and gripe incessantly to anyone who stops long enough to hear you. We all work hard. That’s why it’s called a job rather than vacation.

Here’s the hard truth. If you truly have something to complain about that speaking loudly the injustice will solve then by all means put it in writing. Do something about it. And if taking your concerns up the ladder does not induce change then move on. Otherwise, if your consistent moaning is just to make yourself feel better, please stop. I mean, I’m all for venting. It’s good for us all, but in moderation. When every spoken word is a whining complaint it only serves the purpose of bringing the entire crew down. If you’re griping about duties that are part of a job description you agreed to then you don’t have a right to protest.

It’s pretty simple. If the job no longer meets your satisfaction then find a new one. No reason to persist in something you obviously hate, and no point in poking holes in the ship the rest of us are sailing in.

2. No respect for the job. When you can no longer treat the position you hold with the high regard it deserves then it’s time to try something new. Especially in a job like the medical field, we are professionals. When you accept the mantle of responsibility to care for other human beings you must walk in the manner that entails. There’s a pride that most any profession has. Most job positions involve serving others. So whether you’re a nurse, waitress, or sanitation worker you accepted the responsibility to do a job to the best of your ability for the betterment of someone else. Your service to your fellow man is something you should be proud of, but if you’re having trouble finding that sense of accomplishment then perhaps it’s time to take a step back and reevaluate what you want to do in life.

If your behavior reflects poorly on your title or position in general then you’re doing a disservice to the entire profession by continuing in your job. These may be harsh words to hear, but sometimes you have to be selfless. In your discontent you may be only thinking about how the job is negatively affecting you, but have you considered how you might be negatively affecting the job?

Which brings us to…

3. It affects how you treat others. If you are working in a job where you take care of people in one way or another, and you’re finding that you hate the people you serve, then it’s time to change your vocation. No one deserves maltreatment. No one deserves disrespect. If your customer, client, patient (or whatever you want to call it) is coming to you for help and you’re bitter and angry, then change jobs now! No one, and I repeat no one, wants or deserves a disgruntled employee. To inject your bitterness on someone else is unfair and downright rude. Am I right?

Here’s the thing. Only you can change your circumstances. I’ve been in jobs I didn’t enjoy, and the worst thing I did was hang around. If you’re unhappy then find something new, go somewhere else. Don’t be afraid, and don’t feel stuck. I’d rather take a pay cut than persist in an unhappy situation for years to come. If you’re the grumpy employee, quit! Find another job. And if it’s your coworker who’s displaying these characteristics then you might want to print this out and put it in their locker. Believe me, they’ll thank you for it in the long run. We all will.