Saturday, July 22, 2006

Gender in the Bonner-Wasko Household

Cassie mused about an issue she was trying to understand: "I think that womans have short hair and ladies have long hair."

Although she's started to hang out a lot more with two female friends, Cassie's best friend of long-standing at school is Paul. Paul is a peanut of a little boy, a week older than Cassie but only up to her shoulder (she's also semi-gargantuan for her age). They both report that he "protects" her on the playground. He loves to play fireman and pretend that he's shooting things. And both Cassie and Paul's favorite color is pink, although there is the important distinction that Cassie favors "medium pink," while Paul likes pale pink.

In the bath, Cassie draped two washcloths over her lap and said "I'm an embarrassed girl. I have a penis."

Meanwhile, Emerson loves to watch sports on television. It's of necessity mostly baseball (Pete's obsession), but a girls' basketball game on last night's Monk had him similarly entranced.

Thursday, July 13, 2006

Squeamish Need Not Apply

If nothing else, I should definitely learn wound care in this job. My last week has included:

- Almost more leg and foot ulcers (pressure sores and stasis ulcers) than I can count. They look, and apparently are, incredibly painful. One particularly Eeyore-esque patient really was strenuously fishing for us to tell her that yes, her pain was worse than anyone else's. We pretended not to notice the heavy hints, but agreed in the elevator as we were leaving that although it's impossible to compare any person's pain to any other's, we could assure her that she won the prize for amount of complaining. By the way, the secret to a tolerable dressing change seems to be a dab of lidocaine gel on a square of gauze, stuck to the wound for about 10 minutes before you start to irrigate it or otherwise mess with it.

- A very mild-mannered and unexceptional-looking silver-haired gentleman with a 4 x 4 square of gauze taped to his face under the left side of his glasses. When the gauze is removed, it reveals a dramatically gaping socket that almost looks like a Halloween-ish exaggeration. The job of the nurse is to take a flashlight and look carefully at the tissue to make sure there's no infection, then clean it out by squirting in sterile saline, whereupon the mild-mannered gentleman sloshes his head side to side several times to get it in all the nooks and crannies, and then expels the fluid out of his nose and into a basin.

- A nice older lady with an incredibly doting and supportive family and a nasty-ass surgical belly wound that's having some healing issues. Wounds that don't heal sometimes get "tunneling" or "undermining," which is where the tissue under the skin kind of gets eroded, and you can get pretty extensive cave-like areas beyond the edges of the original wound. Her daughter Nancy is particularly loving, and also notably earthy and irreverent. When she first saw the extent of her mother's wound, she told her, "jeez, Mom, you could keep your cell phone in there!"

Thursday, July 06, 2006

The Stars Say Don't Do It

Today was my second day on the job (other than a couple days two weeks ago in a little darkened conference room receiving orientation from a nice lady and her LCD projector) as a visiting nurse. I spent it shadowing another nurse as he made visits, many of them actually in the same territory I'll be working.

When I got home, I happened to notice my daily horoscope while I was reading the comics. The first sentence:

"Travel is probably a bad idea today, as is getting involved in other people's problems."

Oh dear. What ever would Nancy Reagan say?

Tuesday, July 04, 2006

Gainful Employment

Tomorrow I start work. I'm going to be a visiting nurse, working (as it turns out) for the same home care agency where I temped for a couple months (answering phones, entering data...) while I was doing my RN refresher course. Starting work again is good in a lot of ways, not least of which is the return of regular paychecks. I find myself feeling kind of dazed and vague and maybe apprehensive, though.

This is, other than temping, the first time in ten years that I'm truthfully just taking a job in order to have a job. I never aspired to be a visiting nurse, and it seems almost haphazard for me to have ended up here. In my last few jobs, I've had the feeling of working toward something. My career goals are still not terrifically well defined, but my intent has been ultimately to work on making hospital care better, safer, and more humane. Being a ward nurse, at least I was in a setting that might contribute to my future credibility as well as my understanding of systems issues within hospitals. Of course, being a visiting nurse might provide me with insights I would never have had otherwise, and could lead me to a productive career path I can't yet envision. But in the ways I've been thinking about my future until now, time spent as a visiting nurse seems not to get me anywhere, seems to keep me treading water.

Even less rationally, there is a sense that it's not... I don't know... home care is not where the action is. There's no drama or glamour. I recognize that it's ridiculous, but somehow it affords a person even less of an illusion that one is saving the world. The practical, the down-to-earth, the nitty-gritty daily needs are what the whole thing is about. It's probably at least as useful, truth be told, as hospital nursing, and there are aspects of the job that require skills that hospital nurses don't have to have. It isn't easy work. But still, one doesn't feel fancy doing it.

Still and all, it is good to be going back to work. Before getting the position, my maternity leave (/unemployment) felt uncomfortably open-ended. And a job hunt is not really what one is in the mood for postpartum. Well, postpartum plus having been sort-of fired from one's last two jobs. One feels, to be perfectly honest, like an unkempt, flabby-bellied, urine-leaking, bleary-eyed, damaged-goods screw-up. Not a position of strength, exactly.

I had been dreaming almost nightly that it was finals week, or that I had papers I hadn't even started and would be lucky to get done if I pulled an all-nighter. By day, I was going round and round in my head about whether I should try to get another clinical job right away (i.e., get back on the horse) or look for something in administration or research (i.e., try to get my confidence back first). For two hours, I'd be sure that one was the right way to go, and then the wind in my head would shift, and I'd be certain that I should do the other.

Then one rainy Tuesday morning in May, I came downstairs to the living room with Emerson in my arms and discovered that Pete had left me a little pile of mail on the corner of the couch, and on top was a card advertising a job fair at my old temp work site (let's call it Big Network Home Care). I picked it up, looked at it, and the date was that very day. For a moment I thought "oh, well." But then I realized that there really was no reason I couldn't go. Well, no reason besides having to figure out something to wear that would be roughly presentable and appropriate for a grown-up to wear out in public. This was challenging but not an insurmountable hurdle, and I thought it might actually be kind of nice to start my job hunt with something low-pressure like this. You know, a job I didn't necessarily really want, with people I already knew. It would just get me out in the world, talking to other adults in a professional capacity, and nothing big lost if I came off like a total space case--it would still be good practice, and get me thinking about what I should be saying or not saying. I could work up a patter of sorts and figure out what worked and what didn't.

I put Emerson in his car seat and my resume in a folder, and off I went in the downpour. When I got to the office building, there were signs for the job fair pointing to a makeshift set-up in an empty office area on the first floor, not up to the BNHC offices on the second floor. There were a couple of balloons, a table with some platters of snacks, and another table of various brochures and cards. I helped myself to some juice and a couple of pineapple wedges and walked around jiggling Emerson in the Baby Bjorn on my front while the HR lady finished talking to the one other potential applicant there.

When it was my turn, I was honest about my recent history, including a fairly detailed description of my leaving Other Famous Hospital at the behest of the nurse manager. I said I wasn't at all sure that I would be ready for home care, but I just figured I'd come by and chat anyway. The HR person agreed that my not having two years of med-surg experience (more like four months) could be a problem, but I might as well talk with a nursing supervisor. She then called upstairs, and I heard her mention the name Tammy. Oh, right, Tammy. I remembered her, actually, but I never would have been able to summon her name if I hadn't overheard it. So then in a couple minutes, Tammy came down, and I was able to say, "Tammy! Hey!" and compliment her new hairdo (actually very nice--all sharp and stylish whereas before it had been kind of mousy, fat-girl, don't-look-at-me). I told her the same thing I'd told the HR lady, but we also talked about Tammy's recent divorce (oh, so that's why the hair change...) and her daughter, and my kids, and Emerson smiled at her, and blah blah blah. Finally she said, "Well, I have the same concerns you have about your clinical skills, but why don't we try it. If it's not working out in a couple months, we'll just have that conversation then." Um, okay, I said.

So then all of a sudden I had a job. I hadn't even really said I'd take it, which briefly gave me a "wait a minute" sort of feeling, but I figured I'd sit with it a while, and if I had to, I could always call and back out. But the more I thought about it, the more it seemed okay. Tammy had said they could do what they had done with somebody else recently who had limited clinical experience, which was to pair her up with a particular nurse who had both years of home care experience and a background in teaching, to provide a particularly rich preceptorship experience, advancing the new nurse's independence as warranted by her growing skills. So it seemed like, well, what more could I ask, really? Here was someone who knew and liked me, offering me a chance to learn clinical skills with a one-to-one mentor. I didn't have to lie or exaggerate my confidence or my experience or my skills. I could be hired as-is, even if I was the nursing equivalent of a dented can of peaches.

There's another idea that's been kicking around in my head over the last couple months, too, which comes into play. I have two small children. Maybe for the next couple years, it might even be okay to have a job that's to some degree just a job. Maybe even though I'll be working full-time, there's a sense in which family can come first. It's possible I don't have to be pushing my career forward for a couple years. I could take a brief break from even thinking about it. It seems a little silly that this is a revolutionary idea to me, that it took this long just to think of it. I guess it's proof I'm not very post-feminist, which is reassuring. And it doesn't mean that the career won't come back to its ascendant position in a few years. But for now, maybe I'll just be a plain old working mom. That doesn't sound so bad.

Tomorrow, the World

I finally managed to trick myself into blogging again.

I've accumulated an awful lot of things to write about, accompanied by a paralyzing combination of resentment (that I get so little time to myself) and guilt (that I haven't been making time for this somehow--you know I really could have if I set my jaw and made it happen). Layered over all of this is a kind of fuzzy, bemused detachment and wordlessness that comes of not writing for so long that I don't actually trust that I have anything to say.

This has been a pretty potent mixture, it turns out, and very effective at keeping my fingers from the keys. But I found the way to make myself post something. I instigated a negotiation with Pete in which I was granted a couple of chunks of hours without childcare duties. This was, of course, not sufficient, since there are a thousand things I'm behind on, a hundred things that urgently need doing (so much so, in fact, that it is a tiny bit tempting to curl up in a motionless ball and do nothing at all, just stare straight ahead and divert my cowardly brain by reading whatever kleenex box or piece of junk mail lies directly in my line of vision). So what I did was this: I made a to-do list, and on it I prioritized cleaning the cat box directly before blogging.

So here I am. I am cheating on my own to-do list. I really, really, really don't feel like cleaning the cat box, so I'm skipping an item and writing a blog entry instead.

This is what passes in my life for being an evil genius.