Writer's Block

I just woke up from a dream about this blog. I dreamed that another blog writer was in an uproar about my fat baby post, and had done some sleuthing and tried to identify my wife and I by name—except they identified us as my distant cousins in another state. Bizarre. Anyway, I've had a bad case of writer's block about this blog for at least a year now.

Gratuitous Calvin & Hobbes illustration

Part of it is because of fears of being found out. Not that I think I'm doing anything bad, but blogs are not well understood. I don't think I'm overreacting when I say that I'm afraid of my company's "no tolerance" policy. They apply it mostly to social networks, e.g. talking about a patient on Facebook; but I doubt blogs get special treatment, even if they don't violate privacy. I'm just wary of having this blog "discovered" and subject to rash scrutiny. No tolerance is no tolerance, and I'm thinking there's not much room for subtlety or nuance. I don't think I violate anyone's privacy (patient, coworker, myself), the knee-jerk reaction to "blogging about your job" in the world of medicine is not a good one. I'd probably be assumed guilty before proven innocent, and I don't know I'd even get a venue to prove innocence. Of course, if I were some respectable attending physician, I'd probably be fine—heck, even picked up and featured by marketing! But I'm just a hospital employee.

Home life is busy too. The baby is starting to sit up, greedily grab everything within reach, and she has a tooth crowning. She's only six months old! We got a dog (are you crazy? I hear you scream) which has been a project in itself, although he's a very good dog. Settling into and fixing and modifying the home we purchased has taken its fair share of time. In fact, here's a handy flowchart to my writing process:

 There's also the fact that I'm getting comfortable at my job. Nursing school and being a new nurse provided me lots of material for blogging, since those are hectic worlds full of idealism, issues, and controversies. Now that I'm settling into being a good ICU nurse in the real, practical world, it seems harder to write. Many things are too technical and nuanced for writing. Or I realize that the system of modern medicine, while broken, still works pretty well. In some areas of inefficiency or less-than-ideal practice, I realize I can't think of a better solution, and that makes me shut up. But there are still things I could write about, I'm still learning, and besides I'm still unsure about myself when the proverbial C. difficile ridden human excrement hits the proverbial fan.

Just the other day, in fact, I had your "classic" ICU transfer: we're bringing you this young patient, obviously crumping and going to die, probably been dying all day but no one can figure out what's wrong, here's a really insufficient report because the night shift floor staff doesn't know this person from Adam, by the way there are no good ICU physicians on consult and the residents are all out of the hospital at a class, HERE YA GO! I needed the help of three or four nurses, poured in fluids, started pressors, hung drips, took them back down, scrawling drug calculations on paper towels at the bedside, started lines, enlisted doctors to the bedside who weren't even on consult, etc., and in the middle of all this I'm talking to and trying to reassure the young spouse who has to go home and take care of little kids. All this time the patient is laid out and not moving or responding to anything—in the back of my mind, I'm thinking probably nobody's home. Come to find out days later the patient is weakly nodding appropriately to questions, which is a huge, huge thing in our world. And all I could think was...they pay me for this? I mean, I really saved a life that night. If I found a guy down in the street and did CPR, I wouldn't expect someone to walk up and pay me $30 an hour for my efforts. Nursing is weird like that. See? There I go talking about patients again. How do you write about being a nurse and not bring up individual stories? Hence, writer's block.

 I've also been downshifting into what you might call lazy adulthood. I'm entering my thirties, and for the first time in my life I'm making decent money and don't have to go to school. Granted, my job would like me to get my bachelor's in nursing, my CCRN, eventually a master's...whatev. I mean, I endorse all these things, but you know what? My paychecks are still coming in, and they won't go up when they do these things. My focus right now is on enjoying life with my family, enjoying my house, building my finances...and walkin' my dog.