A jar with a heavy lid

About this time last year, I was anticipating the loss of a friend. Not just a friend, my North Star Nurse. I was given the grace of finding out she was in hospice, and was given the gift of time to spend with her and her family last winter. I was also privileged to serve my friend in her time of need, and I’m grateful for that gift as it has helped my healing tremendously.

When I found out she was dying, I contacted the Employee Assistance Program through my work. They provide a few free sessions with a counselor and help team members get access to resources through their insurance. It only took one EAP session for the person I spoke with to refer me to a therapist, as she expected this was going to take more than 4 sessions to work through. I appreciated the brevity, as it got me connected with a therapist before I really even needed one. I thought the grief would be too much to bear, and the nurse in me wanted to prepare for the worst.

I have written pages and pages about the experience surrounding the life and death of my North Star Nurse. I’ve written chapters, vignettes, verses… I’ve drawn, painted, and burned through my grief and it has been tremendously cathartic. Ironically, I witnessed the best death I’ve seen in my life, and ended up not needing therapy for that aspect of my mental wellbeing. (I think this is irony, you can tell me when we get to the end).

“They sang, ‘don’t waste your hate’…” (Nahko & Medicine for the People)

In the early parts of the pandemic, when everyone was fearfully hiding in their homes, I was working as a Home Health nurse visiting patients in the field. I then covered my manager’s role while she took on another team with a management vacancy closer to her home. I was quite a novice leader, but I had a ton of support from my own manager, director, and other leaders and teams around me. I knew how to be a nurse, I understood the foundation of modern Healthcare, and I more or less knew how to keep myself and my family safe. My nurse skills activated, and I was in fight mode. I was surviving and thriving.

“WE’VE GOT THIS” — Me, 2020.

I remember New Years going into 2021, and everyone saying “thank god, a new year, a fresh start and goodbye to COVID” — and thinking to myself “nah, 2021’s going to be another shit show. 2022 is our year!!!”. I had it in my head that 2021 was going to be difficult (which it was), but feeling prepared in that way made it much easier to cope.

The end of 2021 was when I lost my friend. And that, though it broke my heart in so many ways, was not why 2022 has been — one of the worst years of my adult life. It has certainly been woven with sadness and grief. That part I had the tools to deal with, and have continued to do so. The year wasn’t filled with a bunch of terrible tragedies in my personal life. No major illnesses or losses to pile onto the loss of a dear friend (and the world’s best nurse). I’m figuring this out as I’m writing, but I had it in my head that this year was going to be the sweet breath of solace from the pandemic… and it wasn’t.

Instead of a great inhale, and a sigh of relief — it has felt like a plateau of more of the same, and a little bit worse. (Gross, get over yourself, Jessie).

Let me explain —

The pandemic was hard. REALLY hard. For the whole world. Some areas were worse than others. It was a bright light shining on all the cracks in Healthcare in the United States. It brought awareness to the problems that we’ve all known about, but haven’t been able to articulate very well. Or we have, but nobody was listening. Or they listened, but were disinclined to help. Or they tried to help, but were silenced… It’s nuanced.

The cracks have continued to grow.

And grow.

And grow.

Now there are staffing shortages at all levels of Healthcare. Not just nurses. But Healthcare Workers like Certified Nursing Assistants (CNAs) — the ones responsible for cleaning and wiping the butts and bodies of anyone seeking formal healthcare services at any level (from the home to the hospital and everywhere in between). The remaining Healthcare workers are being run ragged (too many patients, not enough staff to care for them, and nobody pumping the breaks on referrals or admissions — because, you know, they’ve got bills to pay, too). There is a shortage of rehab therapists, social workers, mental health workers, managers, and so on… We have people. Our planet has humans. Our country has humans. Adult ones. There are people all over the planet with the ability and desire to work — but what I believe is at the root of this shortage is healthcare workers are finally realizing their worth. They understand the value of their experience, their expertise, and their time. It seems like Healthcare Workers are no longer accepting overwork or under-compensation for the services they provide. Huh. (I could be wrong, and I’d be happy to discuss and learn from someone who sees it differently).

Dig a little deeper, and notice the privatization of American Healthcare (think about private insurance, pharmaceutical and medical device companies, and healthcare corporations) causing a Healthcare Root Rot like we couldn’t imagine.

What I’m getting at is this — instead of spending the last year talking to a therapist about the grief surrounding the loss of my friend, I’ve exhausted myself trying to talk my way out of worrying about the crumbling walls around me. (I’m not referring to my employer, I’m talking about Healthcare-capital-H across the country). My employer is doing their best to recruit and retain excellent clinicians. I get to spend my days providing onboarding education to new folks, and figuring out new ways to make home health easier to learn and resources more accessible. It’s my literal dream job — in a nightmare Healthcare climate.

And though some metrics seem to improve, the overall sense I have is that we still have a lot of work to do.

Caregivers and CNAs are undervalued and undercompensated. CNAs can be covered by insurance. Caregiver services are not billable. Can we change it?

Nursing and rehab services are covered by insurance, but we’re not allowed to bill for the time spent documenting (and a LOT of our time is spent staring at a screen, figuring out if we captured every bit of our assessment in our notes). Can we fix it?

All Healthcare professionals require some sort of college education or advanced training (certification courses, associates/bachelors/master’s/doctoral degrees, etc.). All of that training costs money, and our student loans are still not forgiven. Can we have it?

Some days I believe we can make Healthcare better. It’s a big beast of a machine that seems to be cycling out of control. I may not be able to change HEALTHCARE. But I do believe I can take action locally to improve the lives of the people in my community. I have ideas that won’t go away at the turn of the year. And I have hope that 2023 will, in fact, be our year. It has to be… because if it’s not, I don’t see myself continuing to ride this crazy train for much longer.

What would I do?

Who knows.

Become an End-Of-Life Doula? Teach something at a college? Manage a bookstore? Work on a farm? Manage the grounds at some facility or for my village? Sleep?

Is this burnout? Probably. Is it also anxiety, depression, ADHD, PTSD, and whatever label you want to put on the box of a human’s experience? Perchance. Does it hurt? Meh. It ain’t great, but it’s not the worst.

“I know you can be overwhelmed, and you can be underwhelmed… but can you ever just be… whelmed?”

“I think you can in Europe…”

10 Things I Hate Bout You

Gather and Create

They sang don't waste your hate
Rather gather and create
Be of service
Be a sensible person
Use your words and don't be nervous
You can do this, you've got purpose
Find your medicine and use it

— “Manifesto” — Nahko & Medicine for the People

Love,

Jessie