In January 2022, it will be five years since I became licensed as a registered nurse and February 2022 since I put that license to use and began working labor and delivery at the same hospital that I’d delivered Tristan. Years before I graduated nursing school, I’d snagged a job as a patient care tech on the postpartum unit at the same hospital. If I’m not mistaken, I worked as a tech for about three years, which brings my time in the healthcare system to nearly 8 years. Compared to many of my colleagues, that’s nothing. Compared to my newly licensed counterparts – that seems like such a long time.

I’ve experienced so much and so little in that time. Leaving myself open to learning new things, I’ve picked up so many new skills, tricks, and methods, and haven’t stopped learning new things. I’ve made the move to a new hospital system; been a part of numerous birth stories, delivered multiple babies myself, and hoped I brought comfort to those experiencing loss. I’ve felt my heart race during obstetrical emergencies; found my voice to advocate for my patients, and felt defeated when my voice wasn’t heard.

My point is, I have grown an insane amount in both my practice and in my personal life since becoming a nurse. My life has been both enriched and stressed in that time and I’m sure it will continue to be so no matter what I do with my career – and those plans change often.

---

I’ve now been a nurse through a pandemic and refugee crisis.

I remember the new grad nurses flooding into our labor and delivery unit as the pandemic ramped up and threw the world on its head. There was one sweet nurse that I pulled to the side to check on – I don’t remember the specifics of the conversation – it really could have been about anything – but what I do remember was when she said through tears, “…and it’s so hard being a new nurse in the middle of a pandemic!”

My heart ached because, learning your craft – especially labor and delivery where anything and everything can go upside down fast – is so, so hard in those first two years. You feel wholly unprepared – like an imposter infiltrating a prestigious craft. School doesn’t prepare you for all the things you can’t learn unless you put your own two hands on them. Your instructors can’t teach you that feeling you get in the pit of your stomach when you know something just isn’t right. You learn those things with experience. And to learn those things when you cannot see facial expressions; when you cannot hear over the whirring off the PAPR machine or the vent that creates negative pressure in the room; with the constant change in policies and hospital regulations (do this! no, nevermind, do that!)… what that overwhelming feeling of defeat must have felt like, I can only fathom.

Experienced nurses were (and are!) feeling the pressure of the hospital caving in with patients, policies, masks and sickness. The nurse/patient ratio continues to increase as both the acuity and burn out rise. Everywhere is short staffed (often dangerously), while patient acuity demands attention. We don’t get paid more. We get push back when we stay late, refusing to abandon our comrades, because they don’t want to pay the overtime. But continue to power on! Here’s your pizza! We’ll pay pretty for some traveler nurses for you! Just don’t forget to clock out on time.

We are tired.

---

December 2020, I was nearly 4 years into the nursing game. I felt adventure in my bones – the need to fly far away. So I moved to Germany. COVID still raged. Patients still had babies, got sick, hemorrhaged, ended up in the OR. I’m still learning and growing and finding my way within my practice as I work among new physicians, midwives, and nurses. I’m discovering that the grass isn’t always greener in policy and staffing, but I am learning that there are always people that will have your back wherever you go. And there are people that drop everything they are doing to come to the assistance of those so much in need of our help that your life truly is placed into perspective.

Though I wasn’t placed at the flight line while our nurses were still staffing it (nurses from the states have been deployed to us to help with the influx of possible patients), I have seen the fear in the eyes of these women as the roll through the door on a stretcher, clutching their swollen bellies. They’ve been wearing the same clothes for days. Some of them don’t have shoes. One family brought every single item of their belongings shoved into a couple of bags, toddlers in tow. One family included 8 children. When I would bring in their meals, we’d all give each other a thumbs up and giggle at the absurdity of not knowing any other way to communicate with each other. I felt loss when they were all neatly lined up at the unit door by their father, and each of them thumb printed with my thumb. I told them to be safe and happy through the interpreter. And I hope they are.

Making a safe and comforting environment is important to my patient care practice. I will tell my patients that I am going to be honest with them – I refuse to sugar coat the pain and fear the will feel. But I also tell my patients that they are in a safe place – I tell them that they are my family when they are directly under my care. Never have I felt so much the importance to create a pocket of safety for my patients. That fear in their eyes cuts deep in my heart. Whether there is an interpreter there or not, I tell them, “I’m so happy that you are here and safe. You are in a safe place.” I squeeze their hand in mine and hope that I am conveying the power behind my words.

I’ve seen these strong women latch their newborns to their breast with such confidence; but scream in fear when their labor has turned for the worse and then need an emergency cesarean. I’ve been honored to assist in the delivery of an Afghani midwife; seen the father crouching in the corner of the room not knowing what is happening as his wife screams her baby into the world. Learning new customs during and after birth has been one of the greatest delights of my career.

---

Nursing has been and is one of the most demanding, exhausting, and fulfilling things I’ve ever done. I can’t imagine myself doing anything different.

But, I am tired.