When you’re a person who is practiced at practicing humility, it eventually becomes easy to get prideful about how humble you are. Weird right? Thus is the plight of the human condition--anytime you begin to think you have mastered anything hard, it creates a blind spot in your self-awareness about this very thing.
I have been working towards a career in Wound Care for three years now. I have purchased online curriculums, attended various medical conferences, and interviewed with several different companies in that timespan. Vohra has been on my radar the entire time. I even did a stint with them launching urgent care services in a few local nursing homes that wound up being unsustainable. And so, when they swooped in and made me an offer at the 11th hour of contract negotiations with another company, it seemed the stars had finally aligned in my favor.
With all of my experience as a SNFist and nursing home medical director, I was ahead of the game. I knew how hard it was to work with them—the lack of urgency, the frank disarray, the constant cutting of corners. Not only that, but Vohra equipped me 25 hours of online training and more than 80 hours of on-the-job training with experienced physician trainers. I have never once gone into a new job feeling prepared and supported. This was going to be a cinch! By the end of last week, I was chomping at the bit to get started.
It started with IT trouble. I needed a password reset right off the bat. Then I was handed three new patients the moment I walked through the door on top of seven existing ones. Then I found out that the nurse I had been speaking with was training a new nurse to take over her place as wound nurse and it was also her first day on the job. We found ourselves frequently unattended, the blind leading the blind from patient to patient.
Neither of us knew where to find anything. We couldn’t establish a good workflow. She couldn’t anticipate any of my needs and I found out about needs I didn’t know I had in the most inconvenient ways possible. There were no aides to help us turn and position the patients. We were writing down wound measurements on a notepad and trying to keep them organized. Some of these patients had several wounds all needing debridement. It was taking forever to get through rounds.
Most of the wounds didn’t have the dressings on them that were ordered. Most of the patients were incontinent and not wearing diapers. There was poop everywhere. Massive amounts of stool were caked into the crevices of 4-inch-deep wounds. One patient had profuse, watery diarrhea the entire time I debrided his four sacral and buttock wounds. I thought the smell would bother me, but it was the sheer quantity of it and how challenging it was to clean up.
Many of these patients were young, in their twenties and thirties, and completely immobilized. Their facial expressions were vacant despite being cognitively intact. I imagined the powerful coping mechanism one would need to perfect in order to exist in a place like this as a twenty-five-year-old. Rather than lose your mind about the fact that you are stewing in your own filth for hours while your skin breaks down, you escape to a warm, serene place somewhere deep inside yourself. You can’t make the call bell ring any louder. You can’t make your aide take a shorter lunch break. You can’t even reposition your own leg when it hurts. So, what’s the point of being mentally checked into your body at all?
It wasn’t that I ever expected this job to be easy. But I expected to be at ease with it right away. I took for granted that my trainers have spent several years honing the soft skills needed to thrive in this environment. They had invested countless hours training their wound care teams at each facility, reiterating their needs, adjusting their expectations, and building those relationships. It was hard in ways I didn’t expect and that made me feel like I was failing.
Today, I drove through Hurricane Helene’s tropical storm winds and down pour to get to my facility. It was supposed to take an hour but due to a major accident, a roadblock, and a tree down in the middle of the road a few miles later, it took me one hour and forty-five minutes. I arrived flustered with my bladder ready to burst. However, I had a nurse’s aide and a wound care nurse who were a well-oiled operation. For all of three patients, I only had to lift a finger to do my actual job. Everything ran smoothly and I was able to exhale for the first time all week. Imagine what I could have done with a team like that my first day on the job!
Not so ironically, I’m co-leading a prayer workshop at my church tonight with my husband. I worked through the prayer exercise video included below on my way home.
When I let myself grieve my broken expectations, I realized that I wasn’t just mad at myself; I was mad at GOD. This was supposed to be the one time He made things easy on me. If this is where He has been leading me for the past three years, why was it still so hard? I’m still not sure I know the answer to that question. My best guess is that everything comes with a cost. If it’s a noble but hard thing, that cost tends to be even higher. And so, my years of experience in the long-term care setting might be helpful eventually, but right now aren’t worth a darn. This is a hard job. Period.
But I have never run away from hard things that I know I can become good at. I called attention to some important needs for patients who cannot advocate for themselves. I never had to raise my voice or chastise anyone. I showed my team that I am not above doing dirty work to get my patients the care and attention that they need. The aides connected their role in helping me to do my job better and that they also have the responsibility of keeping their patient’s wounds clean.
I trained side by side with the best in the Wound Care field. They made it look deceptively easy. Maybe one day I can make it look half as easy as they do. In the meantime, I just need to keep showing up with my ego buried carefully under the necrotic wound bed of my toughest patients.
Selah.
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