Women Interviews-Rachael: Nurse in the ICU Dealing with Life and Death on a Nightly Basis

Starting her workday at 8pm as a nurse in the ICU, Rachael discusses how she prepares herself for a rush that involves life or death decisions. In this interview, we find out how a person’s life is impacted when your work schedule runs contrary to that of everyone else and involves people dying in front of you.

Age? 26

Places you have lived? Cleveland, Columbus, New York

Places you want to live? New York and I have to say somewhere in New Jersey but I don’t know where yet.

Where do you work? Nurse in the cardiothoracic unit at Lenox Hill Hospital

There are so many stereotypical ideas out there of what a nurse is supposed to be and do, can you tell us what it is really to be a nurse?

Well, I work twelve-hour shifts and my day starts at 8 o’clock at night. I usually get a patient who is fresh out of open- heart surgery, relatively unstable, with an IV drip and on a lot of medication. As a nurse, I have to trouble shoot all the problems such as if the patient is bleeding internally or if his or her heart is not effectively pumping. It’s not just passing them a pill and telling them they will feel better, it is like you are treating a machine that is the body; it is all business, all the time. It is a lot different than you would think and if you could be a fly on the wall, I would love it because no one can really see what we do.

Do you feel respected by doctors and surgeons or do they often behave as if they are the big shots and you are only there to assist them?

It depends on the surgeon. There are some that are very good and will come ask you what you think because you are the one who has seen the patient for the past twelve hours. They have that holistic view and nine times out of ten they will listen to your clinical assessment on what the patient needs. I only work with surgeons and a lot of times I encounter very egotistical “I am God” personalities, surgeons that come in, take a one-minute look at the patient and think they know better. It is hard sometimes because you have to take what they say and do it even if you think it is wrong. But you kind of have to respect the place they are coming from because I have found situations when a surgeon who doesn’t want to listen to you is right.

Can you remember a time in the ICU that was particularly hard for you to get through?

Well, I have been there for two years now and so far, no one has ever passed away during one of my shifts.  However this past week, I had a patient who wanted the hospital to withdraw care; that was also the wish of the patient’s family. It was very hard because we could have given him certain kinds of care and gotten him to a point where he would have been ok and could have even gone home but this was not the person’s wish. I had to step back and over the twelve hours I was there I had to watch him go from a stable condition to the point where he passed. As nurses we are trained to do the opposite, and try whatever we can to keep the patient stable.  I didn’t want to be the one who let this happen, but seeing the family at peace and understanding that this is what that patient wanted helped me get through it.

What are your thoughts when patients in a dire situation prefer to be at home regardless of the risk rather than stay in the hospital and get the care they need?

I don’t think that is an easy question to answer and it depends on the person. I think if I can give an advice, it would be to have a living will in which you specify what you want before anything happens to you; because otherwise it is a legal issue for us. I do have to say this discussion is so weird for me because I never talk about my work. I hate talking about my job because either nobody wants to hear it because it is too uncomfortable or I don’t want to talk about it because it is too much.

Despite the obvious, what is something personally difficult for you in your career?

It is really stressful and there is never a moment where you are not making a decision that will affect someone’s life. Especially in the ICU where I work, it can be very emotional at times. You have a lot of family members, some with strong personalities and they can come down on you very hard so you have to control your emotions and not let them get the best of you. The hours are another con because they are horrible.

Speaking of the horrible hours, what does working the nightshift do to you and how does it affect your social life, which you ranked as the least important part of your life?

If affects it a lot because if for most people, simple things like happy hour or going out to dinner are no big deal, for me, I get so excited when I get to do those things because I go to work at 8pm, which is the time when most people come home from work. Even with my boyfriend, I see him maybe two nights a week and that was even when we lived together. If I work a Friday night then Saturday night when we go out I am always tired so I feel like I have become a little bit more boring. My social life is forced to be last and it makes it hard to find time for my friends and boyfriend.  Remember when you would pull all nighters to study in school? Well imagine pulling all nighters every week for two years, it’s crazy.

Going back to the issue of stereotypes in your line of work, are there more female nurses and male surgeons or is the gender distribution in the two fields more equal?

We have a good number of male nurses working in the ICU and what I tend to see personally is that there are a lot more males in high acuity nursing. I don’t know if it is because the male persona has a preference for high intensity situations, though that can be just a stereotype. I don’t work with any female surgeons but there are a lot of female physician assistants and they do a lot of the work.

What do you like to do when you have down time?

I love to read which I know is so nerdy but it is the perfect way to keep your mind busy when you are not busy. Currently I am reading “A Book” by Desi Arnaz, it is about his life and relationship with Lucille Ball. It is not the type of book that I usually read, but I got it at work and I found it so interesting that I kept reading.

Are you happy wearing a uniform every day or is the uniform something you have to live with at work, even when you’d rather dress up a little or enjoy wearing your own particular style?

Wearing a uniform everyday means I don’t have to think about what to wear, but I feel completely lost in the fashion world. I don’t have any outrageous style that is my own; I just wear what makes me comfortable. Sometimes when you feel like everyone is dressed to the nines and everything is beautiful and expensive, you feel like “ugh I should really get into that” since it is a part of growing up but that will come with time.

Do you have any personal hang-ups?

I don’t have a lot of girlfriends so I have this hang up that I am just not likable. I grew up around guys and I feel like I don’t get along with girls as well. When I go meet my boyfriend’s friends and their girlfriends, I am always worried that they won’t like me.

How would you describe your relationship to your body?

I feel like I grew to accept my body because no matter what I tried, I always had big hips and big thighs. I grew to have a healthy relationship with my body and accept my hips and my thighs because they were what was different about me. However, when I started working the nightshift I wasn’t sleeping a lot, it threw my metabolism and forced me to be less active. I feel like I have gained weight and I feel like I do have hang ups because I am not at my best.  I am still comfortable but I just know I could be better.

How did your family’s circumstances affect whom you grew up to be?

My parents divorced when I was six and although we were comfortable, I always felt like my mom struggled a little more than she should have. I saw the struggles she went through as a single mom and even when she remarried; I think it took away from the spunk she had when she was younger. Sometimes you can get stuck in something if you are not able to walk away on your own. To me it has always been important that if anything were to happen to the people around me, that I would be able to stand on my own. My mother is kind of stuck and if the world came crashing down on her she would not have any options.

How does that affect your relationship? Is everything 50/50 with your boyfriend or are you not as strict about that?

My boyfriend and I are moving in together, but I don’t want my name on anything so that if I need to walk away, I can. I need to know that I can have a way out if I need one, even if that sounds bad. I will depend on him for things but I just have to know that I am independent and still work for me and for things that we want together. However, as independent and 50/50 as I want to be, I love to cook and will probably always cook dinner and since he comes from an architecture background so he will be the one fixing things. I just feel like whatever I am bad at he is good at.

What is the scariest thing about moving in together?

The scariest thing is that there is no scheduled you time anymore. I have always been someone who enjoys doing things by herself like reading. I also love to go to the movies by myself and have those nights alone because it is therapeutic and allows you to spend time on yourself. Moving in with someone makes it hard to find time do these things and I still need that time. It is also scary because it is make it or break it and if this doesn’t work then we are not working out as a couple and that is terrifying. I am not ready to break up with him but what if we hate living together?

Then you can be like Lucy and Desi on the Lucille Ball Show and have separate beds!

No, now that is not going to work [laughs].

What do you envy about others?

I envy people who are able to going beyond their comfort zone and try new things. In terms of ambition or going after something you really want even if that may be out of reach. Like I envy what you are doing [with the site], something new and different and I don’t know if I would have the confidence to put something out there that has never been done. I like that and wish I did things like that if I really wanted to.

What is one thing that comes to mind that makes you happy?

Everything is going in a good direction with my life, with my family, possibly a new job with no night shift, and moving in with my boyfriend; those things come to mind when I think about why I am happy.

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