I spent eight years at the bedside before I graduated with my NP degree. I was so excited to get started and felt like “something” was about to happen. I had been a nurse in the Neuro ICU for many years in a couple different hospitals and I was tired of being “just a nurse”.
I naturally gravitated towards the NP opening in my department. Neurosurgery has a steep learning curve, and it took me a couple of years to get comfortable with it.
At first, it was great having the residents around. I grew up with them, which is a long time in a 7-year program! I’ve known some of them since medical school. But the group you grow up with is exceptional. They teach you everything they know, and then they become attendings.
By my 5th year into being a neurosurgery NP, something changed dramatically for me. Even though I knew the service inside out and I knew the attendings when they used to hide in the equipment room as residents, I never really belonged.
As the residents got more experience, they went on their way, and new opportunities opened up for them. But I was stuck in the same role. There was no other new and better opportunities that seemed to be open to me. I tried getting involved in various committees, I even worked on a neurosurgery NP fellowship program, but no one but me seemed to care about. I was getting increasingly frustrated. And the more frustrated I got, the angrier I got.
At first, it was just general irritation. Every one started irritating me. Then the way things were done started irritating me. I was still expected to sign in and out with the neurosurgery intern even though my knowledge base was 10x that of the stupid intern.
I was still hierarchically beneath him on the totem pole, irrespective of how many years I had worked for the service.
The orders trickled down from the attendings through the resident to the intern to me. I had less and less contact with my attending friends, so I was out of the loop.
Then it started to irritate me when I would report back to the intern about my day. He would say something stupid like “that’s not how we do it here.” Oh really? You’ve been here for a hot 5 minutes, and you are going to tell me how it’s always been done around here?
I found myself cursing out the intern, which is not too unusual, they tend to get used to that pretty quickly, but it was unlike me. The anger was mounting, and I didn’t understand it, and I didn’t know what to do about it.
I found myself in a toxic environment where anger filled me the moment I stepped into the hospital system. It all culminated when I mouthed off to an attending and told him to shut the fuck up.
You can say this an unlimited number of times to an intern, but when you say it to an attending (even one you used to be friends with), you get suspended for a couple of days and then to anger management classes.
What was the hell happening? Why was I so angry?
Fortunately for me, a new opportunity opened up at a nearby hospital with one of my old attendings that temporarily helped diffuse my anger but only for a couple more years. Once I got a handle on my new situation, I felt the excitement mounting again. And this time I knew I needed to address it head-on.
The problem was, I was completely over-educated for what I was doing, I have an alphabet soup of letters after my name, and yet I still feel like I was pigeon-holed into a role that was nothing more than being a glorified intern.
I had no control, I had a little flexibility, but ultimately, everything I did was to make the attending look great. I spent years of my life running from one crisis to another and had absolutely nothing to show for my efforts. I am essentially running on a proverbial hamster wheel.
Residents came and went, and each year, I had to prove myself to the dodgy intern who I wanted to punch instead of schmooze. I felt like I had already put my time in “growing up” with the intern.
But the fact was, as a nurse practitioner, I had hit a ceiling that I couldn’t get through. The surgeons didn’t want a nurse practitioner who was evolving in her role; they wanted me to do the same thing over and over again and play by their rules. It came to feel like I was doing scut work into perpetuity.
This need to do something meaningful and be respected was in direct conflict with what I was being paid to do. No one appreciated my efforts to do more because they detracted from the role I was given. At the time, I didn’t understand this. I just felt occupationally oppressed.
When I looked around, I saw a lot of other angry nurses and wondered if they have similar resentments. Did they feel like they had something to offer, but the healthcare system wasn’t interested whatsoever in what it was?
As nurses, we are commodities in the system, and our role is very specifically delineated. Deviation from the role creates a sort of chaos that makes everyone [except us] uneasy and unhappy.
So how do you manage this internal angst – the need to do something meaningful versus your reality?
Well, for me, none of my many degrees put me in a position where I could achieve what I wanted – which was control, flexibility, respect, and authority. Ironically, I have met so many nurses who also had an alphabet soup of credentials behind their names who were still working as staff nurses.
I have also found these nurses tend to be the angriest, and maybe rightfully so. But at the same time, I wonder why they don’t move on?
Why didn’t I move on? I spent years in a state of anger at everyone and everything. Was there nothing else that highly educated nurses could do? Were we afraid? Did we think that we’d lose all our fantastic nursing skills if we left the bedside?
It wasn’t until I started my own business that I indeed found what I was looking for. I was able to define my growth, decide what was next, and meet fascinating people and gurus. I started to grow intellectually again. I found purpose and meaning in creating value and meaning for others. Kind of like what I was originally looking for in the healthcare system . . . Go figure.
But starting a business wasn’t easy, and there was much more to the story.
I learned A LOT about myself when I started my first business. And I forced to delve into a world of personal development that I would have scorned earlier in my career. Stuff like EFT (emotional freedom tapping – it even sounds ridiculous, but it works!), manifesting, mindfulness, understanding psychology, and mental barriers.
The funny thing is when I started learning about this stuff in the business world. Isn’t that somewhat odd? It wasn’t until I started a business that I finally realized I needed a therapist, though my angry outbursts should have been a clue.
After being immersed in the hostile system for so long, I guess I thought being angry was normal. I wasn’t much different from anyone else.
What was interesting is what motivated me to accept a more holistic approach was a lack of business success.
It came up over and over that I had some intense limiting scripts, also known as invisible scripts. These scripts are beliefs that a person has about him or herself.
It is well known in business that your success is linked to your belief in yourself. It is NOT well known in nursing (or healthcare in general) that your success is linked to how you perceive yourself.
I realize the healthcare system triggered my anger. It was easy to attribute my lack of professional success on the “Healthcare System,” but ultimately, I am the one who determines what I do with my career and life.
Now that I’ve been immersed in business for a few years, I can see the writing on the wall much more clearly. I can see my angry self, and I wish I could tell her what I know now. Though I have to admit, I still cringe when I enter the hospital as it brings back such strong memories of being miserable. But for the most part, I have let it go.
My current business is helping other nurses find their true potential, create meaningful enterprises in using their nursing knowledge, and create value for our patients that the healthcare system is incapable of producing.
My advice for other angry nurses? Picking up more shifts isn’t the answer; the money isn’t worth it. Find something outside of the healthcare system that you love doing and find a way to make that work for you. Better yet, start a coaching or consulting business on the side.
You only need three customers to make it work!