Daddy Issues Part III: Steve Jobs

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Steve Jobs was not a very popular movie. My son did not particularly like it. I loved it. This is probably due to my persistent romanticizing of any father figure who attempts, however awkward and clumsy, to connect with their daughter. Steve Jobs was not a good parent to his first child. I am left with the impression that he worked to rectify the relationship in his own way, and I loved it. Jobs certainly had issues. I am not sure I would have liked him, okay that’s a lie, I am completely drawn to people like him. He was portrayed both as brutally demanding and fiercely protective of his people. I relate to this. I am often passionate about my beliefs to the point I get a little excitable. It is a bit of a flaw of mine. I am admittedly a little jealous of those people who manage to stay cool and collected all the time. How do they do that??? Secretly, I bet they have skeletons in the closet. Maybe even real ones. People should get worked up about stuff sometimes. It is what makes us human. Dispassionate people scare me. Seriously. However, they seem to be more productive than the erratic ones. That topic is too big for Daddy Issues. 

I was also interested by the way Sorkin and Boyle handled the relationship with John Scully. John Scully addressed his relationship with Jobs in 2013 at the Forbes Global CEO Conference. You can watch the video here. I was struck by the amount of regret he still carries in regards to the relationship with his former friend. More importantly, I was impressed by his dedication to being a mentor. There were several times the movie alluded to Scully and Jobs having a father- son relationship. So, essentially John Scully was Steve Job’s Work Daddy. I tend to think most of us need one. At least I do.

My relationships with my former work parents remain strong. I still turn to them for professional advice and guidance. I still rely on their opinion and expertise to help me make good decisions about my future. I am sure they find this exhausting at times, especially since there have been so many potential jobs. I hope I adequately convey my appreciation. I really do understand it is an investment in their time and energy. 

I have been extraordinarily lucky to have the relationships I do with some of the most intelligent people I know. They have constantly supported me through my professional career, and it has been a bumpy ride at times. My work parents have taken the time to teach me lessons and to help me grow as a professional, they have counseled me and offered advice, and they have used lessons they have learned to illustrate how they understand my struggles. They never left me hollow and inadequate, they taught me. Just like good parents teach their children. Hence, work parents. (I know, TG says grown ups just have mentors. I have both!) 

So, as I continue on this interesting quest for adventure, professional fulfillment, and possibly even enlightenment, I must remember to keep an eye out for people who have something to teach. I continue to be amazed when I meet someone new who likes to impart information and experience.  It is even better when they take the time to help me learn how to apply it to my personal and professional growth. People come into our lives, and if we pay attention we just might get lucky enough to benefit from their experiences.

These relationships require a level of vulnerability that can be intimidating for some people. It is hard to allow someone to see your insecurities and faults. It takes humility to allow someone to judge your actions. You cannot allow someone offering you guidance to hurt your feelings. You have to leave your pride out of the equation. This is hard at times. I found myself wanting to defend my actions. Sometimes, it was not even the point I was necessarily wrong, it was just there was a better way to handle situations in the future. It is all about growth and progress. Growing pains hurt.

I still miss my old job. I miss having people I knew and trusted available at a moment’s notice. I am having to learn to operate in foreign environments and I do not always have all the information I would have readily available. I know much more about the EMR there. I know my nurses there. I know all the other physicians. It does make a difference. However, I keep telling myself this is a great opportunity to learn. I am learning so many new things. I can’t wait to see what I learn next. So, while this job is in some ways infinitely more difficult, I get to become a better Nurse Practitioner. This is only going to improve the care I am able to provide. So, I will struggle on and deal with the stress. It will be worth it. I hope. steve-jobs-movie-poster-800px-800x1259

Subserviently Yours

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We have all had the good fortune to meet the smartest man in the room. You know the one. The guy who feels the need to educate you and correct you on every thing you do. He may have good intentions, and perhaps he does not mean it condescendingly at all (me? yes, I have been guilty of this from time to time.) I am talking about the other guy. The one who has to be the brightest light in any room, however instead of shining brighter, he just walks around trying to dampen everyone else’s light. That guy is an asshat, officially.  

Collaborative Teamwork.

Doesn’t that sound like a dream come true? I love working with a team of people who are committed to a common purpose. Each person has their own perspective and part of the problem to solve. Respect and time is given to each member of the team. Everyone has a voice. More importantly, everyone shares common goals.

I want to find a place where this is actually the culture. I find myself trying to engage nurses in conversation about their patients. I tell them what I have in mind, and start asking them for feedback. They have seen the situation from a completely different angle than I have. I trust and respect their insight. However, I am often greeted with a blank stare.

When I do not understand why something is being done, there is a high probability that I do not know part of the problem. Perhaps I just do not have a firm grasp on the situation at hand. Nothing is better than when I am close enough to the physician I am working with that I can ask them about it without them assuming I am challenging them. I have learned to choose my words carefully and to explain my intentions, but these conversations have taught me so much over the years.

I have had so many physicians, nurses, NPs, and pharmacists who have been willing to explain and teach me. There are so many disciplines working together, each one bringing their own level of expertise to the table, it would be ridiculous to not utilize their experience. I love learning about things from a different perspective. It gives me a more dynamic understanding of the situation.

Now, what about the asshat leader who is running amok and telling people inaccurate things? It is perfectly acceptable to be wrong from time to time, however I continue to be astounded by the number of people in the world who cannot admit to this. These same people love to walk around with their chests puffed out and head tilted at a slightly posterior angle, while looking down at you incredulously. They appear to be amused by your attempts to use your intelligence to learn about something new. They have to make inconsequential changes to your plans, just so they can say they did something.

Then, imagine their voice as they come over to talk to you. It all seems so earnest. They pull you aside and the whole conversation becomes very serious. They are imparting secret, magical information that cannot be gleaned from Uptodate. You listen expectantly, holding your breath in anticipation, pride welling up in your soul. Oh, he must have seen I was struggling! Perhaps I should let out a little giggle. I am so lucky to have this big, strong, virile man of medicine to keep me on the straight path. I could never have figured this out if he had not come to save me from my own ignorance. 

Then you hear it. He is telling you how he is concerned for your well-being, and how he is so glad he can offer you his expertise. After all, he is a very busy and important man. Oh, swoon. I can’t believe he would take the time to tell me to use two 20 mg vials instead of one 40 mg vial. (Or something else equally ridiculous.) He will explain to you that the current evidence-based guidelines cannot be accurate, he has never seen that side effect the black box is warning against. No, it is not a well-known use of that extremely expensive drug. It is off label. Apparently, all the best cures are secrets. Only the best doctors get access to that information. The elite medical schools train them to pick up signals via a beacon in their neck. That is why they hold their head like that. I swear. I read it in a medical journal. You know, the ones nurses can’t read. 

Ugh. All I want is to be able to have a conversation with the people I am working with. I love it when they have time to explain a concept I had never actually seen in real life, or just one I did not know a lot about. Seriously. I love to learn. I love to see the things I am learning about used in real life. For the love all that is good and intelligent in the world, do not expect me to follow archaic guidelines that are not in sync with current evidence based practice. There is a reason we have standards of care. I have found a lot of comfort in having mentors who taught me how to find these guidelines, and how to use them.

Of course, there are situations that may not fit the usual mold. There is most certainly an art to the practice and science of medical care. Sometimes there is more than one way to skin the proverbial cat. Please don’t try to teach me the wrong way to do things. Don’t use the phrase “that is how we have always done it.” I will want to know why. I always want to understand the rationale behind things. I want to know why we are choosing that particular option. Do not try to convince me to use antiquated methods when I have current peer-reviewed evidence at my fingertips. (Yes, I know the research and evidence is always changing… that is a topic I am woefully not able to discuss with anything resembling intelligence.)

Here is the point. Don’t talk down to me. Don’t pat my head like I am a wayward child. I am a professional, and despite my struggles to always portray myself in a dignified light, I am reasonably intelligent. I actually think there are some topics I can discuss with a pretty good level of mastery. I have been taught by the best! I do things to the best of my ability. If I come across a situation I am unsure about, I assure you I will seek your guidance. If you notice something I did not, or you just want to tell me about it, that is great! I love learning from experts. I may even take notes. I can promise you, I will be looking it up as soon as you walk away so I can remember it for next time.

One more thing I have noticed. Don’t listen to every man in the room and make it a point to not listen to me. Am I the only one that notices a difference when some men talk to women as opposed to how they speak to other men? Why am I hushed when men are invited to offer insight? Why am I a bitch when I am just being matter of fact? I hate to break it to you guys, your penis does not make you smarter. I have to be honest though, men are not the only asshats. I have had these strange interactions with women as well. I am not kidding when I say it bothers me when people are so transparently attempting to exert their dominance over everyone in the room.

So, come on. Give a girl a break. Feel free to educate, correct, and guide me. Just don’t be a jerk about it. I promise to continue working on the same thing. Perhaps there is a way to foster collaboration and open discussion without all the egos and BS. Maybe I should google that.

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Well, cat videos are educational too.

Daddy Issues Part II

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It’s the middle of January *2006. I have been a nurse on the night shift for about six months. My patient load tonight is insane. Part of it is my fault. I ask to keep the patient at the end of the hall even though the rest of my group is at the other end. The thing is, I am worried about him. He is in room *417. *details and names are changed for privacy.*

Mr. 417 has been in the hospital for several weeks. When I first meet him, he is a cantankerous grouch. He does not like being stuck in bed with the tube snaking out of his nostril and connected to suction. He is unable to eat, so we continuously drip nutrients like lipids, glucose, and vitamins into his veins.

I am still inexperienced, and completely naive about the seriousness of his condition. Yes, he is quite old, but has always been healthy up to this point.

I dote on my little cranky man, pick up extra shifts, and ensure that he is well cared for. Mr. 417 is excessively difficult to please. Everything has to be just so, and I have our routine down pat.

It is three in the morning. I have been running from room to room all night. I am doing a bowel prep for a colonoscopy in room 405 and the patients in 402 and 407 are call light happy. I am in Mr. 417’s room about every 20 minutes to check on him, and to try to find some relief for his discomfort- all to no avail.

I am busy giving a bed bath in room 405, and unable to check on him from 0235 until 0300. When I finish my tasks I hurry to check on him. What I find is a new nurse’s worst nightmare. I run to get my charge nurse, and we get an ABG and a CXR. Obviously in shock. I have to call a doctor and get some help for my patient.

I pick up the phone and dial the number. I ask the answering service who is on call that night. When she answers, I promptly hang up and burst into tears. I am one of those annoying people who cry at the first sign of stress.

Oh, the call light is going off. My patient in room 405 has tried to get up and navigate her way to the bathroom without assistance. The Golytely effects hit her rapidly. There is a very large problem all over her room. We do not have a nurse’s aide tonight.

I have to call the doctor. Let’s call him Dr. Snape. Everyone knows that is not his real name. In my hospital, he is infamous. This is a man who does not like to be woken up. Nurses dread calling him, and almost everyone has a Dr. Snape story. His reputation is legendary. He is also known as one of the best doctors.

I beg my charge nurse to call him for me. She refuses, however we do have an impromptu practice conversation. I take notes. I gather his chart, and make sure I have current vital signs, I&Os, and lab work available.

I take a deep breath, and with shaking hands call the answering service back. I sit there and silently rehearse what I am going to say. The phone rings, and the call is transferred to me.

I ramble my rehearsed speech, my words hurried and breathless. The patient’s name, room number, admitting diagnosis, admitting physician, and why I am calling. I do not stop speaking until I get all of that out, then my voice trails off uncertainly because I do not know what to do next and I have yet to take a breath for fear that he will interrupt me.

Dr. Snape is silent on the other end for a few seconds and I am shaking with anxiety. He starts asking questions. He wants details. Not only about tonight, but about the events that have led up to tonight. Who was his surgeon? What did they find? What medications is he on? How long as he been on them? Is he fluid overloaded? Did he smoke? What did he do for a living? When was his last set of cultures drawn? What is the plan from oncology? Where is his family? What does the patient want? Does he know how sick he is? Does he have children? I am fairly certain he asked me who the man took to senior prom. (looking back, it seems that after a minute, he was testing me.)

Then, this exchange:

“What was his respiratory rate before?” I nervously double-check my notes.

2000: 22

2100: 24

2200: 22

2300: 22

0100: 24

0300: 39

I respond “Between 22 and 24.” Without skipping a beat Dr. Snape asks “Wouldn’t that be 23?”

I have been on the phone, shaking, and speaking in rapid, unsure answers for what feels like an eternity. I miss the joke. “Ummm. Yes, sir. That would indeed be 23.” The nurses are gathered in a curious and supportive circle around me. There is a titter which feeds my anxiety. I wish I were anywhere else in the world at that moment.

When Dr. Snape asks who the respiratory therapist and charge nurse are- I am so relieved. I hurriedly respond “*Nurse Ratchet, would like to speak to her?” and without waiting for an answer, I abruptly put him on hold, transfer the call, and burst into tears. I am convinced I am an utter failure. I contemplate switching careers. Then, I rush off to take care of Mr. 417. I have to transfer him to ICU. I see Dr. Snape in the unit when I am dropping off the rest of the patient’s belongings, and I avert my eyes and scurry away.

The rest of my night is a mess. I worry about my patient, and I have a ton of things to do since my routine was interrupted. I go home that morning feeling like a terrible nurse, and wondering if I am even capable of this job.

The next day, I walk into the break room at the beginning of my shift, and find this in my mailbox. *It has been edited to leave out identifying information. *IMG_7835Well, that is weird. What does this mean? Isn’t that my job? Oh, well I am flattered. Obviously. I still have it after all these years. It lives in a metal box. Along with a copy of the recommendation letter he wrote for me when I was applying for a fellowship after grad school.

This night is one of the defining moments of my career. It is the beginning of my relationship with one of my mentors. It took me years to get over being too intimidated to speak to him, but once I did, I was pleasantly surprised.

Night shift nursing brings about a completely different relationship with physicians than day shift. You typically only see physicians when there is a crisis. For many of them, they have been awake all day working, and this is the time they should be at home asleep. It makes it difficult to foster overly friendly relationships.

However, given enough time and exposure, you eventually do. Over time I learned how to be prepared for my encounters with them, and that made their job easier, which helped reduce some of the stress. I learned how to see them as people instead of doctors. I like them a lot more as people. Totally less scary.

One day, after I had been working closely with him as part of my clinical training for nurse practitioner school, I mentioned that night. He immediately remembered. He did not know it was me though.

He was an awesome teacher while I was learning how to be a mid-level. He sought out chances to challenge me, and he was quick to correct and to give me feedback on the job I was doing. Now, to be honest, I hit the jackpot when I chose preceptors. I picked them for their willingness to teach, and they all gave their time and expertise generously. I am so grateful for these physicians and nurse practitioners.

But, this is about Daddy Issues. How on earth does that apply to this nursing story. Well, duh… because it is my story. Remember me? The girl with daddy issues?

I started noticing a trend to my relationships with a few of my mentors. Especially with ******* (you know, Work Mommy) and the one who became Work Daddy. The two of them were the ones that I sought out for advice. I respected their opinions, and felt that they understood my goals and aspirations. The joke became that they were Work Mommy and Work Daddy. (Don’t worry- Work Mommy has a story too!)

Now, while it was initially a joke, I see how it is applicable. As I mentioned in Daddy Issues Part I, parents are our first mentors (or they should be, anyway) and when your mentor is also somewhat responsible for you as an employee, it is easy to see how mentorship could be similar to a parental role. These are the people I come to when I need help. They are the ones who offer guidance and recommendations for my future.

It is their opinions I trust. I feel like they have my best interests at heart when they offer me advice. I am never afraid to tell them when I do not know something, and I am not afraid to take chances and risk looking foolish for asking questions.

Mentors are so important in life. They are coaches who develop skills. They are people who are interested in how your career affects you personally. In some instances if you are lucky, they become friends.  — although, that may change if Work Daddy finds out I called him Dr. Snape.

***I would like to point out that Alan Rickman is a very commanding presence. Also, Professor Snape did kinda turn out to be a hero in the end- He always looked out for Harry, and tried to protect him. This is where the pseudonym came from.

One last thing, I am so grateful for the experiences I have had with my mentors, and I would not trade any of it for anything. Quite basically, I am a lucky girl.

 *** update. Work Daddy is no longer my employer, however he remains a treasured friend and mentor. ~10/29/2015 ♥️LQ

Daddy Issues. It’s not about sex.

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Okay. Before you read any further… if you are expecting a post about sexual exploits with older men, you are going to be so very disappointed. I am quite cognizant of the fact that my grandfather reads this blog. (Wait, you are insinuating that there may be exploits to write about!) But, that is absolutely not the point. This is a blog about the weird daddy fantasies I have had for as long as I can remember.

Hehehe. See what I did there?

So, to put some context to this I should probably explain that I do not have a relationship with my father. It’s okay. I don’t mind all that much. I have had lots of therapy, and I realize it has nothing to do with me yadayadayada. Frankly, it is his loss. I am awesome. However, I would be completely disingenuous if I pretended that I did not wish I had a relationship with him. So, for most of my life I have been moderately obsessed with the fathers of pop culture. (Oh, one important thing, I have not been lacking in the male influence in my life- I have lots of people who have selflessly stood up and assumed that role. I have a wonderful loving family, and it’s not like I have been deprived of male attention.)

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See? He is such a good dad! Who doesn’t love dad hugs?

I am obsessed with TV shows and movies that have a man who is excessively paternal. Rick Castle (Nathan Fillion) is the best dad. He has a teenage daughter (well, I think she is in college now) and they have a really cool relationship. I have always wanted that kind of relationship with my father. You know, the guy who frets over me, and is seriously protective and proud of me. So, it’s quite entertaining to imagine that this fictional character is actually my dad! This is common for young women (ok, almost middle-aged women who did not realize the teenagers were no longer their peers.)

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This must be a dude thing. My son kisses us on the forehead. It’s kinda sweet and condescending at the same time. I am leaning more towards sweet.

More about this style of dad. He is fun. He loves to play games and keeps up with what the cool kids are doing. He is not afraid to take his daughter to see a boy band. He has a relationship with his daughter on her level. Why? He likes her as a person! She is not a piece of property that he owns. He plays laser tag IN THE HOUSE! Decorates and dresses up for Halloween. This is a cool dad. My inner kid loves this guy.

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Well, if dad is a big kid- its probably best that granny is there. Even if she has a green goo face.

Now, what about the girl who is closer to my age? Maybe even a little closer to my own experiences?

Elizabeth Keen and Red Reddington on The Blacklist. There is some controversy as to whether or not he is actually her father, however he is so paternal and I am convinced that he is her dad. Which is probably the goal of the show’s writers anyway. (Side note: I just learned that paternal and paternalistic are not at all the same thing. Paternal is fatherly, while paternalistic is bad. Like dictator bad. hmmm.)

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I don’t really understand why she spends so much time in a hospital bed. Maybe she should be a little more careful. No wonder she needs a dad.

This show does a phenomenal job of demonstrating that even strong women are drawn to father figures in their lives. I mean, this chick carries a gun, and has all these smart FBI agents following her around, yet she still seeks the approval of the one guy who seems to actually be protecting her. Although, I would think that he could have done a better job protecting her by leaving her alone. Until you factor in the fact that her career went from zero to hero in about one day due to his interference. This is my greatest downfall, I can see way to many sides to situations. I never should have been a debater in high school. It has destroyed my decision-making abilities.

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I am pretty sure my fantasy father and I would share a bench in NYC- and somehow be this comfortable with each other.

So, the point is not whether or not Red is her father. The point is that their relationship reminds me of the relationship that I imagine my father could have had with me. Your father should be your first mentor. The first man who offers you guidance and advice with your best interests in mind. With this imaginary father, I know that he would never encourage me to do anything that was not good for me. A dad has no ulterior motive, he only wants to see his daughter thrive and to reach her fullest potential. This is the fantasy that I have. This understanding of the fictitious nature of my fantasy is what allows me to know that it is okay that I do not have a relationship with my father. He is not that kind of man. I am better off with my imagination, and borrowing characters from cheesy crime shows.

Now, in the real world the relationship I have with my mentor at work (whom I fondly refer to as Work Daddy- although rarely to his face) has been instrumental in my success professionally. When I was a baby nurse, I had to call him in the middle of the night. I was terrified. I had heard horror stories about the perils nurses face when they wake him up…

*So… I have Daddy Issues. I figure there are lots of women who do. It has nothing at all to do with sex or romantic relationships. I think that people are drawn to the ones who have their best interests at heart.