November, 2007 Archive

i got the fancy invitation/notice in the mail yesterday.

the annual awards night for our unit’s deserving and nominated/voted staff is three weeks away. i am supposed to respond if i can make it. not only do i get to go for free, i get to take a plus one. the fancy card didn’t mention the award i will get, i assume i will find out when i get there.

if i’ll go.

but i won’t.

the first logical reason is the fact that i am scheduled to work that night. the second reason is the fact that i am not so good at stuff like this, and i get really uncomfortable. yeah, you can blame it on insecurity issues.

the last reason is that i feel embarassed to show up. i realize now that what i stupidly thought to be irrelevant is actually a big deal to others. when the nomination form was given to all of us a few weeks ago, i did not nominate anybody because i arrogantly thought it was a waste of time to make such a big deal out of it. when people were filling up the form, i went around joking: “don’t nominate me in all categories, really, please, one is enough”. isn’t it funny, how some people take a certain joke so seriously?

anyway, kidding aside, it was not the lack of deserving people that stopped me from ignoring the nomination thing, but it was my i-couldn’t-care-less-about-awards attitude. i always express my appreciation to the people who are doing their jobs, and i honestly thought that was enough.

now, i realize that i am wrong. it will be so embarassing to accept that award and see people who are definitely more deserving than i am, sit there and feel robbed because i couldn’t be bothered. next year, i will be the very first to fill out that form. i promise.

i’m calling the nurse manager to express my regrets. i will tell her i am working that night, and also, that i don’t know what to wear.

monday night, she was smiling.

after i gave her enema, she smiled. after i gave her a heparin shot, she smiled. after i repositioned her, even in obvious pain, she smiled.

i think it was not because she was elated with the things i did to her. it was just because there was nothing else to do. she only spoke hindi, and i have no clue what she was talking about when she did talk.

so, she smiled.

i had to call her daughter in the middle of the night when she refused the second enema. after talking to her daughter for a few minutes, she passed the phone back to me, nodded and motioned me to go on. then, that smile.

granted that the sad result of her EGD came back that night, and the hateful tumor was labeled malignant, but still. she was not one of those patients who reeked of death. she was weak, yes. but dying? that did not even cross my mind when i left tuesday morning.

when i came back tuesday night, i was a little surprised that her name was not on my patient list, but i was not concerned. i thought they either moved her to a basic unit, or worse, to ICU.

then, they told me she died.

i wanted to cry. out of shock, out of empathy to her very enthusiastic daughter who filled me in with every little details of her mom’s life in the few minutes that we chatted. the sense of sadness that overtook me was the kind that daughters share when they lose their mom.

i wanted a moment. a minute or two maybe, just to be sad, because that was how it was, sad.

unfortunately, my job didn’t give me the luxury of that moment. to make matters worse, there was the annoying irony. a couple of my coworkers who sensed i did not take the news very well tried to dismiss the idea of grieving, even for a moment, by saying “come on May, she was better off going anyway.”

granted that was true, was it wrong to grieve anyway?

well, not that it was wrong. it was just that there was no time. literally. four patients waited for me, all needing my undivided attention. there was blood pressure to be stabilized, a confused patient to be kept safe, a psychotic patient to be watched, an unresponsive patient whose children were in the corner of the room, crying in frustration and fear had to be monitored. clearly, the last thing all these people needed was a teary eyed nurse, crying for a patient who was not even there anymore.

so i bit my lip, started my night with the same smile i usually start it with, and ended it physically tired and emotionally unfinished. i just didn’t find that moment to grieve. not until now. i know it sounds overly dramatic that i am taking that moment now, away and a long time after the fact, but i am. here, now, where i have the luxury of time.

it’s not that i do not welcome death. it is the uncertainty of when it is coming that i wrestle with. especially with people who seem to have so much more to live for.

it’s not that i do not understand others’ “death-doesn’t-get-to-me” attitude because i do, and have reacted that same way plenty of times. it’s just the fact that sometimes, we are left with no other choice but wear that i-couldn’t-care-less facade just because we don’t have time.

nursing is such a conflicting job sometimes.
we are expected to be human and sensitive so we can take better care of our patients by feeling what they are going through, for their sake.
and yet, we are also expected to detach ourselves from our emotions so we can take care of our patients and make intelligent decisions, also for their sake.

when i think of nurses who have done this for 20 years or more, i wonder how they cope with the conflicting expectations for so long. i wonder how they maintain balance and still be a good nurse. you know, the kind who is not immuned to human emotions but also the kind who does not get overwhelmed by human emotions.

it didn’t go well.

my application was not approved.

you can say that at the moment, i am in US citizenship application limbo. by that i mean my application is on file and the decision of INS is pending. i will be notified as soon as a decison is reached. when, i have no idea.

i passed the history test and everything, there was no problem with that. but the agency/lawyer that petitioned me will probably be investigated. the reason behind that is the fact that i didn’t work for the hospital that petitioned me. not even for a day.

i signed a one year contract to work with them, but i didn’t. before you raise your eyebrows to that, let me explain. when i got here and didn’t have my license yet, i was informed by my lawyer that i had the option to work as a nurse assistant while reviewing for the licensure exam, or wait till i pass the exam and start working only when i get my license. he gave me that option, so i decided not to work and just review full time.

a couple of weeks after that decision was made, i talked to my lawyer about my plans of getting married and eventually moving to where my husband was working, 65 miles away from the hospital i was supposed to work. 

we discussed my concerns. i asked him if it would be okay for me not to work with my petitioner so i can move in with my husband. keep in mind that i was just toying with this idea because i knew i signed a contract. the truth is, i would have worked there longer than i signed for if he told me i can’t go, but he didn’t stop me.

he said it was perfectly okay. he said a lot of his clients do it. in fact, a lot of his clients do not even report to the petitioner or to him when they arrived, and there is really no way for them to track all the nurses. he implied he was surprised i actually showed up in his office, because a lot of nurses do not even report. “besides, it is really no big deal as long as you just continue to work as a nurse wherever you go, because that is what you were petitioned for” he said.

i asked him if i needed a certificate of any kind to prove that it was okay for me to go and breach the signed contract. he said i didn’t need to have any. he further said he knew for a fact that there were hundreds of nurses out there who did not work for their petitioner and there was never a single problem about it because of the nursing shortage. he then reemphasized the fact that what mattered is that i work as a nurse, it didn’t matter where.

there was a logical explanation why i didn’t question this. i myself know for a fact that a LOT of petitioned nurses from the philippines did not work with their petiioners, but went to other places where they have families or firends. i also personally know people who did not report to their petitioner when they got here, despite the fact that they have signed contract of one, two or three years. and yes, i have NEVER heard any problem with that.

with my lawyer’s verbal approval, i went on my way. i passed the NCLEX and got my license, and started working where my husband and i moved. i have never heard from my lawyer or my petitioner in the past five years, and at the same time, i have met a lot of filipino nurses who did exactly the same thing i did, and they all got their citizenship. without any problem.

thanks to my unlucky stars, i got to be asked about my petitioner and just when i thought i couldn’t get any more stupid, i did.

interviewer who was not very friendly (iwwnvf): what is the name of the hospital that petitioned you?

may, THE stupid (mTs): i’m sorry but i don’t remember.

iwwnvf: what do you mean you don’t remember? that is not an acceptable answer. you HAVE to remember.

mTs: i’m sorry, but i really can’t remember.

iwwnvf: how can you say you don’t remember? you understand that you are applying for a US citizenship, and that hospital is the very reason why you were given a visa to come to the US, right? and you don’t even remember what the name of the hospital is?

mTs: i’m sorry.

iwwnvf: well then, we cannot continue this interview if you cannot answer that question. you’re a nurse right?

mTs: yeah

iwwnvf: yes or no.

mTs: yes.

iwwnvf: did you bring papers to prove that?

mTs: no. sorry. i only brought the required documents in the appointment letter.

(silence)

mTs: oh, i have my license in my wallet.

iwwnvf: okay, i am giving you a chance to try to recall the name of your petitioner. how can you not remember? you just worked there in 2002, when you came here. that was just recent.

mTs: well, i didn’t really work there. that’s why i don’t remember.

iwwnvf: what? do you realize that by law, you are required to work at least ONE day with your petiioner, and then you can go wherever you want. just one day, and you never worked even for a day? do you know that is against the law?

mTs: i was told by my lawyer it was okay for me not to work there.

iwwnvf: your lawyer has nothing to do with it.

mTs: but he was the one i communicated with and he was the one who recruited me from the philippines. he worked for the petitioner. i have never met my petitioner.

she then dialed the investigation department, left a message about the situation and instructed the person in charge to find anything they can find about the law office that processed my petition.

then, it was all downhill from there. i was asked all kinds of questions and was later instructed to write an affidavit about everything i told her, have it notarized, go back to INS that same day and wait for further instructions. i went back and waited for the interview officer for over an hour so i can give her the affidavit, only to be told that it will be placed on my file and i was then advised to wait for a decision letter in the mail.

that interview ordeal lasted for approximately 70 minutes. my poor husband who was waiting at the parking lot was already thinking morbid thoughts. and why not? his interview lasted less than 10 minutes. he was asked four history questions, and he was given his approval letter faster than he ever thought possible.

he later told me he was scared i had severe asthma attack and i dropped dead on the waiting area. and i thought i was crazily paranoid when i imagined the police escorting me to my tiny cell. what can i say, we are both loonies.

i learned a few of things from this experience:

1. there is no limit to my stupidity. why i didn’t even look up the name of my petitioner before i went for the interview is now beyond me. i have no one to blame but my moronic self for being so stupid. i mean, if i interview me, and i didn’t know the answer to that very simple question, i would deny my application too. the sad conclusion is: when it comes to my stupidity, the possibilities are indeed endless.

2. it is not wise to rely on other people’s experiences and expect you will have EXACTLY the same experience. i was so preoccupied with getting all the history facts right that i neglected the most basic information i was supposed to know. i know somebody who was only asked who the president was and was then given the approval. i have never heard somebody saying they were asked about their petitioner, but unlike me, they probably knew anyway. i, however, take stupidity to the highest level. not only did i expect the same experience, but i also didn’t think.

3. just because everybody’s doing it doesn’t mean it is okay. it’s too late now, but if i can turn back time, i will not even think of breaching the contract. it would have been impossible for me not to remember that hospital’s name if i actually worked there for a year. or even a day.

anyway, my husband and i have exhausted our minds thinking the worst case scenarios. if am not granted the citizenship, i will just keep renewing my green card every ten years. if, they end up revoking even my green card because i violated the law, and they decide to send me home, i will go home. we will  figure it out from there.

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THANKS to all who wished me well. your good thoughts surely helped me. if not, i would have cried the second time she asked me that question about being involved in prostitution. or that second time she said “yes or no.” when i answered “yeah”. or the time she asked me “you mean your FATHER?” when i answered “my dad” to the question who supported me while i was still unemployed.

it is amazing how i allowed an authority figure to intimidate me. i am not saying the interviewer was mean, i’m just saying she made me feel like i was a heartless terrorist. don’t get me wrong, i am not denying the fact that i breached my employment contract with the verbal consent of my lawyer, i’m just saying i hate it that i allowed her, and her words, and her actions to make me feel like i was this worthless liar who does not deserve anything good in life.

and i hate myself for that. for allowing other people to have that kind of control over me. it is annoying that i do that to myself.

yet another proof that the grass is not always greener on the other side.

my coworker who was beaming with happiness when she told us she was resigning, is back. she was the one who was going to a hospital which she so ideally described as nice, easy and perfect, it might as well be called the “hospital paradise”.

she has not even resigned yet, and she is back. “so, what is this i heard? you are back? how did that happen? i didn’t even see you leave”, i joked. she laughed and told me that she will not risk starting a job in a shaky place. by shaky, she meant she found out on her first day of orientation that the so called hospital paradise was THIS close to closing due to bankruptcy.

i guess that explains why. healthcare is  business after all, and it is always wise to stay in the middle for balance. i mean, an adminsitrator can hire beyond what they can pay just to please the staff, but what good will that do in the long run? on the other hand, an adminsitrator can implement budget cuts here and there just to increase profit and please the higher ups, but what good will that do in the long run? if you ask me, both are wrong and will not work for long. what works is balance, balance, balance.

let’s all cross our fingers and hope she has learned from this experience and stop whining. sometimes, it gets more difficult to focus on doing your best when every hour, you hear a whiny nurse complaining about every single thing seen and unseen. it gets on your nerves.

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on friday, my husband and i are scheduled for an interview. the kind of interview that will eventually make us both US citizens. i have VERY mixed emotions about this whole thing so i will spare you the details. all i can say is that after reviewing the booklet that they gave us for possible interview questions, i have this weird idea that i actually know more about the USA’s basic history than the philippines’. it’s just weird. and it’s crazy that i have this feeling because really, the first time they asked me who the first president was, i answered Benjamin Franklin like i was so sure i knew i was right. i tell you, nobody and nothing can teach me to love and enjoy history. i know, that makes me stupid, but i’m just not into it.

i guess one thing i can brag about is that i actually know the colors of the flag. i would have been really messed up not to get that right. the only thing is, if they ask me to sing the national anthem, i might just have to kiss the citizenship goodbye.

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i’m working tonight and i need a load of good luck. yesterday was the first day that eMAR (electronic medication adminstration record) went live in our hospital. i need luck because i’m old. i have nothing against change and i am well aware that the first phase of change is always the most difficult.

the thing that makes me uncomfortable is the fact that when there are changes that involve technology and patients at the same time, the patients always sort of suffer the issues with glitches. when a new thing like this is started, time that should be spent with patients is spent figuring out new stuff in the computer. don’t get me wrong, it’s not that meds will not be given, it is that we will have less time interacting with patients because we need time to document the act of giving the meds.

i’m sure things will settle down after we get familiar with the new application. i just have to convince myself that i am not that old of a dog to learn new tricks. it was bill cosby who said: “it is not that old dogs can’t learn new tricks, because they can. it’s just painful to watch them”.

i so agree.