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Sunk Cost Fallacy in Nursing – Why are you a nurse?

I was just out of high school with no idea where to take my life. I knew what I enjoyed. I knew that there were creative passions within me but I didn’t know that any of those could be turned into a career. That’s too much pressure. The career path is not laid out for you. There are no steps 1, 2, 3 to get to where you want to go. With nursing however, there are steps.

  1. Study Hard.
  2. Work Hard.
  3. Get Paid
  4. Climb the Ladder as you study further.

The template is made for you. You can follow those rules. You’ll survive. So when my mother told me that I should do nursing because it would give me a decent pay check and other government worker subsidies, I listened. I followed the steps with blurry vision (from the tears filling my eyes as my life took a shape of its own that teen me hadn’t fathomed). I made it work.

I studied. I found the job. I worked and followed the protocols. The work wasn’t easy but there was not much thinking to do on “how to succeed” – I just had to play my role and do as I was told and do it well. I could do that…for years…and years is what I did.

Years of books and early commutes to get to work by 6:30 and clock in at 6:45 for shift change. Get briefed on the previous shifts work, pick up their slack, have the morning meeting, the quick coffee, the dusting of the work space and start the whole routine, meds, doctors rounds, observation charts, empty catheter bags, insert catheters, syringes, blood tests, IV rounds, admissions, discharges, ringing bells, funky smells, visitors with the imaginary nursing degrees telling you that you don’t know how to do your job, patients without any patience, supervisors with no vision, doctors that kill you. Deaths. Infections. Pre-Op and Post-Op care. The list goes on and on and on and on. It sucks but it’s your job and you’ve been doing it for years and it’s everything you know how to do. You’ve put your all into it. You’ve not honed any new skills. This is everything.

You’ll keep doing it because it will pay off one day when you’re in one of those supervisor positions where you can delegate and chill out with a big paycheck. It’s worth it. You’ll pay your house off. Send your kids to college. Get that dream vacation.

But there’s a voice in your head. It’s a little voice that you shut down constantly. It’s telling you that you’re not happy. Your legs don’t want to move when the alarm clock rings and you often groan and drop out of bed onto the floor, where you fall asleep again as your dog or your partner rolls you into the shower. What? Did I lose you? That’s just me? Okay. So you get up off the bed and walk to the shower. You don’t feel alive but you’re still at it! You’re still doing your 12 hour shifts because it’s worth it.

Or are you suffering with what’s called “the sunk cost fallacy”?

The Sunk Cost Fallacy

The Misconception: You make rational decisions based on the future value of objects, investments and experiences.

The Truth: Your decisions are tainted by the emotional investments you accumulate, and the more you invest in something the harder it becomes to abandon it.

The misconception is that you can only pay off your house and educate your kids and do major life stuff because of your job as a nurse. You are invested in your job. It’s going to help you reach your dreams.

The truth of the matter is – that unless it’s a fulfilling journey, that’s no kind of life. We shouldn’t live for that one moment in the future that’s not guaranteed. We should enjoy the journey too. My aunt was a nurse. I was a student and worked in her surgical ward for a couple months. She worked hard. Her ward was well organized, neat as a pin and it was one of the best run wards in the hospital. Nurses didn’t all like her because she was strict on them. As her niece I only truly began to understand her life when I myself became a nurse and learnt of the stresses. She told me constantly about her dream. She worked out how many years she had to continue in nursing in order to pay off her house and save up for a decent retirement with beach holidays lined up. She seemed to have her plan all laid out. She suffered a heart attack and died before she could see any of that come to fruition. I was distraught over her death but I still continued on with my nursing career never stopping for a moment to think that it’s not the right answer. It’s my job. I do my job regardless of how it makes me feel. Isn’t that just what adults do? One of those things that just is the way it is. Why do we breathe oxygen? Why do we even exist? Who knows. We just breathe oxygen and we exist. That’s just what we do.

It wasn’t until I accidentally made money out of a hobby that I realized that there was another way and then still, I dragged out the nursing gig for years beyond that. Letting go is DIFFICULT.

There are so many attachments psychologically, financially, socially that keep you tied to your job but you sacrifice your happiness for it, believing it’s your only option. When it first struck me that I could toss away all the investments I made: I could throw out my studies, my licence, my time, and all the things I learnt, I was still held back by the reputation and social expectations placed on me…everyone thinks it’s a mistake to leave the thing you worked hard for. They tell you to stick it out. It becomes a part of your identity. Who are you? I’m a nurse. Those 3 tiny words pack a bundle of stories that instantly makes you more interesting or more hated. Whatever it is, you’ve made it a part of your existence and identity. How do you chop off a part of yourself? Really think about what it is that’s holding you back from quitting. Weigh that out with your level of happiness and inner fulfillment.

What do you think? Are you hostage to your investment? Or is nursing really something you actually love doing?

Copyright: Featured Image Posted with Permission from the Creator (Illustration By Tom Richmond)

Do I ever regret Quitting Nursing?

So this is a question that comes up from time to time in conversation – people ask me if I regret quitting nursing. I even find myself asking myself that. The short answer is no. There are however things I do miss about it – I definitely DO NOT miss the backache, headaches and stress. I feel better paid for the work I do now as an online entrepreneur and I do not want to go back to a position or career in which I’m literally breaking my back and getting mistreated by my employers. The stress is absolutely not worth it.  Read More

NursingHabits Free Book

Artwork by Jeff Conway: Buy his paintings.

Hi loyal readers.

I want to thank you for the ongoing support and love. I’ve been rather busy but I still get so many beautiful and touching letters and comments coming in daily. You have inspired me to give back to the nursing community. I’ve been working on a new book which I’ll be publishing for you all to download for free! The book is a more detailed account of how I turned my career around after suffering nursing burn out. It will also contain advice and tips designed to help you decide what’s the right move for you.

Read More

Disease is no match for the human spirit | Positive thinking

ConsciousnessIf there is one thing I’ve come to appreciate through nursing, it’s the complexity a single human being is made up of. The brain is one of the most complex things in the universe and it’s right behind the nose! Anatomy aside, the human spirit is quite a captivating thing. The one thing I’ve noticed repeatedly is that a person’s attitude and outlook toward life matters hugely and can effect the progression or regression of illness.

When I was still a pupil nurse, it was new to me to see so many ill people so when I saw a 36 year old female patient wheeling herself into the surgical ward, I was stunned silent for a minute before I could ask what she had come in for. She was battling cancer, had a gangrenous right leg, and was booked to have her leg amputated that morning. While I struggled to come to terms with the state of her body, she kept a smile on her face and said “Don’t worry dear, it’s just a body. I’m made up of much more than this flimsy thing.” I felt embarrassed that she caught me staring but amazed at how bright and happy she looked despite the painful ordeal she was going through. The operation a success, her smile never faded. She kept a great sense of humour, helped herself as much as humanly possible, rarely rang the bell and never spent a single moment in self-pity. If she caught me pitying her, she’d stop me in my tracks. She believed there was still much to be grateful for. I know that there must have been hard times during the diagnosing and treatment process and that she wasn’t overjoyed having to deal with cancer but even though the cancer was destroying her body, she laughed a pure laugh and she strengthened people around her with her spirit and you couldn’t see a sign of sadness in her eyes. What matters is that she could still feel happiness and kept doing whatever she needed to do to live life the best she could, given the cards she was dealt.

On the other hand in another ward, I had a diabetic patient who had gone blind. She couldn’t walk very far because her legs would ache under her weight. She’d cry all day and night, and she’d ask over and over again why God had punished her like this. Her body was full of aches and pains and while we’d do as much as we could to help her with pain relief, she would never be even mildly content. I’d try to comfort her and sympathized with her but she left me feeling a sense of hopelessness around her because she would remain unresponsive to any positive encouragement. Naturally her misery repelled people. Her family would rarely visit her which added to her misery. She wouldn’t smile for a single moment and she would not attempt to help herself or regain some independence. She looked terrible and she was miserable every day. Her ailments were far from a death sentence. With a diet change and a closely observed treatment plan, she could have returned to a relatively normal life but she saw the disease as punishment and so it became punishment and her blood sugar wouldn’t settle. She’d be continuously in and out of hospital, her family abandoned her and we had to hand over her case to social services. She no doubt, will continue to suffer and her condition will get worse if she keeps up that attitude.

Whatever you’re going through, don’t let it consume you. There is something inside of you that’s indestructible and if you keep in touch with it, you will make it through any battle just fine.

Edit: Coincidentally just as I finished writing this post, the song “Inside Us All” by rock band “Creed” came through my headphones! There really is a peace inside us all.

Spooky Moments on Night Shift

It was a wintery night shift in the post natal ward, when the midwives from the labour ward called in some of the post natal team to assist with a difficult delivery. The patient was a stage IV AIDS case and she was in no condition to be put under the knife, it was too risky. She was to have a normal vaginal delivery, despite being too ill to feed herself or go to the toilet, much less push a baby out.

A team of about 7 nurses took their positions around the patient; I grabbed her lower right leg, while another nurse grabbed her left leg. There were two nurses pinning down each of her arms, a nurse at the top of the bed, keeping her shoulders down as two midwives manually pushed the baby out by pumping on the patient’s abdomen. The patient was frantic and resisting our actions as much as her weak body would allow. Her screams were haunting and her eyes were wide with fear. The midwives pumped and pumped and pumped, pushing that baby down. If anyone were watching us from the outside, they’d have run screaming in the opposite direction, because I am sure it looked thoroughly evil to anyone who didn’t understand what was going on.

When the baby finally popped out, we were exhausted but happy that the baby was breathing well. The mother remained weak and didn’t even have the energy to look at the baby. We transferred them both to the post natal ward. It was going to be a long night watching over this patient. I shut the doors and windows and checked in on the mother every 15 to 30 minutes. She seemed as well as she could be, given the circumstances. I was ordered to check her vital signs every half hour. Everything was fine until about 3AM. I went to the patient’s room and stood at the door feeling incredibly uneasy. It took me a minute or two to work up the courage to open the patient’s room door and when I finally did, a bird came flying right at me from inside the room! I ducked and let out a little shriek. The bird flew around me and went straight back inside the room. It would circle the patient then sit on one of the bed posts, and then it would circle her again and move to the next bed post and did that until it had a chance to sit on each of the four bed posts, then it would fly toward the closed window, and back around the patient to restart the sequence in the same order as before. The feeling of unease grew increasingly intense. I found the birds behaviour really peculiar as I watched from the doorway for any signs of life from the patient. I wanted to believe she was just fast asleep but the sinking feeling in my stomach told me otherwise. I quickly ran to the window and pushed it open to let the bird out and it flew out almost immediately, disappearing into the dark misty sky.

I called out the patients name, then shook her shoulder slightly…no movement…no pulse…she was dead. Her eyes wide open and her face spelling terror, I was thoroughly creeped out. The doctor declared her dead while I searched the tiny room and the entire ward for any opening the bird could have come in from. All windows and doors were closed and there were no open vents that it could have sneaked in from. It was quite a large bird so surely I would have noticed it in the room before? Why did it appear in this particular room at the time of this woman’s death and where did it come from? Why was it up at this ungodly hour? These questions played on my mind as I sombrely thought of the now orphaned baby in the nursery who started crying uncontrollably. I held the baby with tears in my eyes and stared out the window, as the birds started to come out of their nests, and for the first time, instead of feeling at peace watching them, I felt an irrational sense of anger toward them…as the baby’s cries grew stronger…

Dealing with people who shame you for quitting nursing.

Have you ever complained about a certain aspect of nursing or contemplated quitting nursing only to find a bunch of people that would shake their heads at you and make you feel ashamed for feeling the way you do?

Some common complaints and the judgmental responses you may get:

nursing-habits-icon“I don’t get paid enough! I work overtime without pay. I often have to stay in on lunch breaks and after hours because there just isn’t enough staff and the patients struggle at the end but now I’m beat, broke and don’t have much time for my family or friends.”

 

person

“Nurses shouldn’t be looking for money, they should be doing nursing out of the goodness of their hearts and as a service to humanity.”

 

I’m sorry but times are tough and the “goodness of your heart” isn’t going to save you when they try to repossess your house and put your kids on the street. If that’s the case why do doctors get paid so much? Nurses have every right to be well compensated for the work they do. It doesn’t make them evil if they ask to be better paid. They still care about the patient at the end of the day but they have needs too!

nursing-habits-icon“I am stressed out, burnt out, losing my hair, my manager won’t help, we’re understaffed and overworked.”

 

person“You chose nursing, deal with it, you should be doing this out of the goodness of your heart. Stop bringing the nursing profession down.”

 

Now I know there are people who really are very thin skinned and complain because they want to complain, but allot of us don’t want to have anything to complain about! Pay us well, give us enough staff, treat us like we’re valued, assist us when we’re overwhelmed. It isn’t much to ask. I know I personally pushed myself to do everything I possibly could to keep things running smoothly and it did nothing but harm at the end. Too many nurses end up with damaged backs and health issues that cannot be helped or reversed and it’s usually because they aren’t given the resources they need to survive such a difficult and challenging career. I also often found that management would try to cut corners and save money by sidelining the needs of nurses and expecting them to make do under unbearable conditions. Like running a full ward of 32 critically ill patients with only 2 nurses. Again the goodness of your heart isn’t going to heal your broken back at the end of the day. No other career in the world is expected to run on love alone.

nursing-habits-icon“Doctor Who is being nasty again, he didn’t get his coffee because I answered the telephone at the nurses station and now he wants me fired”

 

person“Doctors are very important to us because they make us money, a nurse is replaceable, we don’t care much for the goodness of her heart, goodbye and good luck finding a new job.”

 

Nurses are constantly made to feel undervalued and doctors can be such bullies about it. How can anyone be happy in a job that doesn’t let them feel valued or wanted? There has to be a sense of accomplishment and a sense of being valued.

Here’s an interesting talk about how people really want to feel valued in their profession not just do the job and get paid for it.

So the next time someone makes you feel like you’re the scum of the earth for raising complaint about your job, tell them you appreciate their input, (it is important to hear them out, they may actually have a point at times), then evaluate whether you’re being unreasonable in your complaint, more often than not, you’ll find you had a good reason to feel the way you feel and you should do something about it. Nothing improves by laying low and staying silent!

What are a nurses pet peeves?

Nurses put up with a lot of sh*t. Both literally and figuratively. Here’s a list of sh*t I hated dealing with in my nursing career:

1. Doctors with huge egos. 

images-150x150A doctor I know once had a nurse fired simply for answering the ward telephone in his presence. In a hospital there are all kinds of emergencies and answering the telephone may well save a life! Of course nothing could be more important than Doctor Bruised Ego over there!

 

 

2. Managers with their nose high up in the air.

Some managers develop a similar sort of bloated ego as doctors do. This can cause a lot of issues for everyone. Of course I wouldn’t class all matrons (or doctors for that matter) the same way…just a few.

3. Patients that think they own you.

crazy-nurse-150x150Technically they do sort of own you. They can get away with murder and there’s almost nothing you can do to those obnoxious patients…almost.

Nurses I worked with at least found ways to warn each other about these patients by using code words in the patients diagnosis. “This is Mrs Smeegle and she has HPT, DVT, Chronic PIA (pain in the ass)”. Or for a particularly dimwitted patient we’d say “we have a case of low apgar”A scoring system used on newborn babies to assess their physical condition. A low apgar score, would usually indicate a lack of oxygen to the brain and the possibility of retardation.. It was little ways of not only warning other nurses that this patient may be a danger to herself and others, but also a tiny bit of vengeance for her terrible attitude (having a little inside joke/laugh at her expense). Yeah, some might find this horrendously offensive but I think it’s harmless compared to the immense amount of stress these types of patients inflict on nurses daily.

4. People that think of you as a walking pharmacy because you work at a hospital.

How many times have people come up to you and asked if you could get them meds? Like you have the ability to just walk into the hospital take whatever you please and hand it out to everyone. Well, yeah you can get away with that sometimes in tiny quantities and there are people who you really don’t mind helping out, but then there are those that keep coming back for more, or worse, they tell their aunts, uncles, cousins and cousins cousins cousin that you can supply them with free meds for a lifetime. nursing-habits-icon

5. People who think all you do is clean poop and sleep all day! 

This should have been higher up on the list. This makes me go CRAZY INSANE! I just can’t stand it when ignorant people undermine the job as though they’d survive even one hour doing what nurses do! It’s an insult above all insults. Say that to a nurse and you’re not gonna have a good time next time you need to get your shots buddy!

Let me know in the comments below what you find unbearably maddening from your experiences as a nurse. How do you deal with the issues that you experience? Also, if you’ve got a story to tell from a patients/doctors/managers perspective, I’d love to hear it.

Nurses! Backache isn’t necessarily just a symptom of being a nurse!

I recently discovered some shocking news that a RN I used to work with died of Cancer. She complained about back and body pain for ages but dismissed it as part of the package when you’re a nurse. Every nurse experiences backache…nothing to panic about right? She was oblivious to that fact that she had cancer until 2 months prior to her death. She continued serving others until the day she died.

Yes nursing is the noble profession and you do have a tendency to put others first when you’re a nurse…but there are times when you’ve got to use your skills and intuition to take care of yourself and that’s probably the most important thing you could do for the world and yes, for your patients too. We need more nurses…not less…so do everyone a favour and go get yourself regular check ups. You know better than to ignore persistent pain! Think about what you would tell your patient to do…

Afterthought: I find it really aggravating to know that in South Africa, the hospitals don’t provide regular mandatory checkups for health care workers. We’re surrounded by doctors and medical equipment everyday. It wouldn’t take much to have free health checks for staff at least 6 monthly, if not every month. Does your hospital provide you with regular check ups? Are there gyms freely available? Do they provide counselling if you’ve been through emotionally taxing experiences? Nurses are human beings not machines…with the kind of work we do, our employers owe us a lot more than a pay check.

One RN to heal them all! “The Yoga Nurse” – Be Inspired!

coverMNmedium.com_-217x300I quit nursing in January and even though we’re now in August and the business is a whole 8 months old, it’s felt like no more than 3-4 months. Time flies when you’re having fun. I don’t like it but yeah, it’s true. We could try subscribing to the Dunbar theory of longevity. (Dunbar is a character in the brilliant book “Catch 22”, and he believes that in order to live a long life, you should spend as much time as possible being bored or experiencing unpleasant conditions.)

“A half minute before that you were stepping into high school, and an unhooked brassiere was as close as you ever hoped to get to Paradise. Only a fifth of a second before that you were a small kid with a ten-week summer vacation, that lasted a hundred thousand years and still ended too soon. Zip! They go rocketing by so fast. How the hell else are you ever going to slow down?” – Dunbar.

Though Clevinger (from Catch 22), does make a stronger point: “Maybe a long life does have to be filled with many unpleasant conditions if it’s to seem long. But in that event, who wants one?”

Anyway, the bottom line is, you have two choices.

You can have an incredibly miserable but long life or a blazingly fast and fulfilling one. I chose the latter. With the internet being what it is today, none of you have any excuse to be trapped in a job you’re no longer feeling and a burnt-out nurse is probably every patients worst nightmare. You owe it to yourself and the nursing profession to be happy. If you’ve tried it all and still find it difficult to get through to 6:45 then, try something different!

I’ve had the honor and privilege to work with a wonderful RN in the US, Annette Tersigni, better known as the YogaNurse.

She is a nurse entrepreneur or  yogapreneur and she has created a transformational new movement in health care called Yoga Nursing®. She helps nurses, yoga therapists and other care givers to learn her accredited programs so that they can relieve chronic stress, anxiety, pain and suffering for themselves, their clients and their communities worldwide. She runs her own blog, hosts retreats, learnt all the tricks and trends of the internet by herself and never lets age be a factor in determining what she can or cannot learn. Check out her website www.yoganurseacademy.com and you can be on your way to a fulfilling yoganursing career or just find a way to relieve your nursing burnout.

Theme Hospital for every hospital manager

didithemehospital2_2I’m extremely stoked to find that they’ve released an HD mod for an old game that I used to play, called “Theme hospital” by “Bullfrog”. Surprisingly it still works perfectly despite being more than ten years old and it still looks great. I used to play for hours in my teen days, before I had any idea that I was actually going to become a nurse someday, and practically live inside the walls of a hospital for a good few years! An unintentional manifestation I call it. I think I was enjoying the game a little too much!

I used to enjoy managing the staff, hospital budget, equipment and patients in the game. It felt really satisfying when you got through a challenging level and started building a good reputation, so that you could earn more money to improve upon your hospital. Of course the games’ difficulty level could never match up to the real thing but I often found myself thinking that the management at my hospital could do with a good game of Theme Hospital because they don’t seem to have any management skills at all. Perhaps the game could reinforce some basic principles.

It teaches you that staff should be kept happy, with a relaxing staff room, a nice salary and as little overtime as possible. If you failed to budget, and couldn’t hire more staff to assist overworked staff, your hospital literally collapsed. Patient happiness depended on the quality of care and you had to keep your staff happy, to keep your patients happy. If you didn’t do proper queue management (prioritize patients), your patients died in the hallway and you’d suffer the consequence. Control of infectious disease, cleanliness, comfort, maintenance of equipment and staff education mattered hugely in the game and were the deciding factors on whether you passed or failed the level.

These were the types of things that didn’t get enough attention at the hospital that I worked for. They’re so lax on training staff you could be an LPN (staff nurse) for years before they’d allow you to train again (depending on your skin colour of course!). Staff were continuously unhappy and overworked, the patients were always complaining because they weren’t getting the attention they deserved (not enough staff). If this happened in the game, the hospital manager would have her name plastered to the hall of shame and she’d be fired. But in South Africa, criminals become presidents, so why not hire total idiots to run our hospitals?

On the lighter side, I do wish we had patients with funny illnesses like ‘Bloaty Head Syndrome’, ‘Slack Tongue disease’ and ‘Elvis Syndrome’ – at least staff would have a fun day at work.  I love this game. Try it out sometime. 🙂