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You are Not Replaceable at Home

My first childbirth experience was really tough and a lot went wrong. My daughter was in the NICU on a ventilator for quite some time. I tried #breastfeeding but had no support and I couldn't navigate my challenges. With the birth of my second child, I wanted so much to succeed in all the ways I felt I failed my daughter. Again, I had a fairly eventful birth and he too ended up in the NICU for a short period of time. I was darn determined though and committed fully to overcoming any obstacle that presented, and many did.


At five weeks, post-yet-another-cesarean-section and bladder surgery due to complications in surgery, I had to return to work because we were financially strapped. I was starting a new job as well, in Labor & Delivery, more than an hour drive from our home. I had just gotten rid of my bladder drainage bag and was armed with my turbo breast-pump, but fourteen hour days seemed super intimidating so I reached out to nurses in an online group for tips and encouragement. How was I going to get enough time during the day, as a new hire, to pump enough for my son? How could I best maintain sufficient milk supply for him? He was already more than 10 pounds!


A plethora of tips were provided, many that I shared with new mothers I cared for as a nurse, but one in particular piece of advice I printed and kept in my journal as a reminder for many years... my duty was not to make comfortable my co-workers, but rather, my loyalties were to my son's health and happiness.


My son turns 25 next week, so maybe you remember that breastfeeding was not the norm when he was a child. It was already a bit weird that I was pumping for him, and it became more weird the longer I did it so garnishing support wasn't easy. It seems sad when you realize these were maternity nurses, the exact people who should offer the greatest support to new mommas, but leaving a laboring woman to go pump requires another nurse who is likely already strapped herself to manage your client. Accommodating my need to pump was really hard to navigate most days. The guilt I felt every time I walked away, to the closet offered nursing mothers so we could pump, was significant. I was burdening my new colleagues, and these were important relationships that I was just starting to cultivate. Even worse though, I was abandoning laboring women who I really cared about and who were depending on me for support. Every single time, I had to remind myself that my greatest loyalty is to my son.


We had a long and joyful nursing relationship. I can still remember his sweet little face looking up at me with each feeding, his big toothy grin while he was nursing into his toddler years, his acrobats as he got older, and how nursing him kept him from being hospitalized while he had Rotavirus. The boobie fixed everything. Today especially, as he seems so far away from me, I could not be more grateful for these years and I am grateful that we were both blessed with the health benefits of that commitment. I am not even in contact with any of the nurses I had previously inconvenienced, at least beyond facebook. I could not be more grateful for the nurse who gave me the courage to commit to my greatest priority.


My point is that you are replaceable as a nurse, but you are not replaceable at home.


We learned this well during the pandemic. We learned this well during the healthcare restructuring, at least in Indiana when our governor denied federal funds because he refused Obamacare, thinking he had a better strategy which only led to 4,000 nurses being laid off in our largest hospital infrastructure. (That man is now running for presidency, just saying.)


As I look back over my #midwifery years, as much as I had somewhat control over my clinic schedule and could accommodate so much for my kids, I was an entrepreneur so I was working all the time. I was at home most days, but I was at my computer or on the phone with a client. Even when I was really present with them, I wasn't emotionally available because my mind was wrapped up in the business, in the needs of my clients, in serving a large community of women. We strive to be compassionate, to be patient-centered, and to truly create change for women and babies and as midwives, we really bring a unique knowledge base and background to our work. This is true too as a nurse practitioner, and maybe I am a bit biased, but I felt the work I was doing was critical to protecting women and creating change long into the future. I was saving lives.


Having said that, now that my midwifery practice has been closed a few years, it is clear that we are all replaceable at work. I really didn't feel there were other safe options and I always felt the clock was ticking faster than I could work to create positive and very necessary change within my profession, but the reality I see today is that someone took my place in midwifery, many midwives in fact, but I was NOT replaceable at home.


Being a nurse gives us a sense of job security but even in a pandemic, many nurses lost their jobs as primary care clinics, specialty clinics, and surgery centers closed their doors. Budget cuts close midwifery clients regularly. Market saturation is also causing many positions to be offered for less and less pay, even less than nurse practitioners were earning as bedside nurses, or fewer positions are available at all. No matter your number of certifications, degrees, letters behind your name, trust me, you are replaceable.


As I work with students in graduate nursing programs, I get to know the back stories of so many nurses and many of the trials they endure as they work through graduate school. Many have children, a number of children even. Several have more than one job and yet still maintain at least a B average in their studies. Some even suffer cancer, the death of a child, and navigate toxic relationships or divorce while remaining active in their classes. We give more time and energy to our professions, as nurses, than most. We give more to our patients. We give to our coworkers and we give to our bosses. We give more to our jobs than we often give to our children, to our families, and certainly to ourselves. We think this is honorable and that martyring ourselves is a worthy life endeavor.


We all think we can balance better, that we would never put anyone or anything in front of our precious children. Then we stay late to catch up at work. We bring charts home. We give up self-care because there is more work to be done. We talk about work, we consume ourselves in advocacy work or extra projects, and our minds are full, leaving little time or patience for "Mom, I have a question to tell you." We are stressing about work when we should be relaxing with our family.


The status quo in our profession is exploitation. I was checking out at Target the other day, and there was a long line of college kids waiting to pay for their back-to-school items, and when I asked the cashier how she was doing, she responded quite angry that she was very frustrated because she hadn't gotten a break and had been there for two-and-a-half-HOURS!! As she scanned the mass of people for her manager, I thought to myself, thank goodness this woman didn't choose to become a nurse. Team players pinch off that need to urinate and we eat granola bars from our scrub pockets to get through the day. We have to see more patients, do more procedures, make more money for the corporation or be deemed not up to par.


What we don't often recognize, is that healthcare is a business. I struggled with this even as a new business woman, managing my own private practice like it was a ministry. I was trying to do good for everyone else, completely at my own expense and failing to properly manage my business. It seems a conflict of interest to be both the compassionate clinician and the clever business administrator. In larger corporations, it's no secret that hospital administrators are earning millions while those putting their own lives on the line, wrecking their mental, physical, and emotional wellbeing in effort to provide quality care are truly suffering. Burn out is epidemic; suicide is nearing this level among healthcare workers, especially nurses.


We are replaceable at work. We are not replaceable at home. Don't fall into the trap of wrapping your identity around your role at work. This is not who you are at the core; it is only part of who you are and it is a part that can be pruned. Being a father or mother is not replaceable. This time can't be made up. Our spouses need us to invest in them too. We need to invest in friendships and connection, even more so we need to invest in ourselves. Do you have a hobby? Do you read for fun? What do you do for pleasure, just for the mere fun it the experience?


I urge you to challenge the status quo and get your life back. If you feel overwhelmed, even a little resentful at work or at home, it's time to renegotiate your role. Your greater loyalty is to your family, your own happiness, and your health. Unapologetically.

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