I lean back and rub my eyes. It is 2am and while the rest of the world sleeps, I am monitoring the ICU beds at four different hospitals. This time of night I am always fighting back drowsiness. My post cancer body does not like it when routines are disturbed or sleep is lost. At least my light blue scrubs are as comfy as pajamas. This is one of my last night shifts at this assignment. I am facing job insecurity after cancer.
I take a moment to stretch and then resume my “rounds”. With a simple click I am able to remotely connect to each room via camera. As my camera connects my image pops up on the television. I am able to talk with both nurses and patients, adjust ventilators, and give orders.
Tonight there have been many emergencies. I function as the first line of defense in hospitals with no in-person night time critical care doctors. I am, in a sense, a canary in a mineshaft. I am the first to identify a patient’s worsening condition and first to start needed treatments. The majority of issues I can manage remotely. On occasion, twice tonight in fact, I need to call in the bedside team.
My shift is busy. Many times I am fielding multiple calls at once. It is not uncommon to have two or more nurses in line waiting for me to camera in to the rooms for help. Usually though, in the early morning hours after the midnight medication distribution and before the 4am lab draw, there is a lull in calls. It is during this lull that my tired mind has time to think.
I have done my fair share of night coverage. Emergencies happen 24 hours a day and night shifts are an unpleasant but necessary part of critical care. Still, after the extraordinarily brutal two and a half years of the COVID pandemic and fighting and beating cancer, my body is tired. I now constantly struggle with fatigue. Twelve hour shifts have become quite a challenge to my worn out body.
Though this night shift is busy and tiring it is still easier than bedside work. The stress is far less and I am able to do things like go to the bathroom, eat, and stay hydrated during my shift. These simple acts of self care are often not possible at the bedside. Though only part time, this job has allowed me to maintain at least some income through cancer treatment, fatigue, and even broken bones.
But with COVID numbers easing and a recession looming, the hospital system is looking to cut costs. I was notified this week that in three months there will be downsizing. In six months the program may shut down entirely. As a part time contractor my shifts will be the first to be cut. It looks like I will soon be out of a job.
This is not the first time a contract has ended. In fact it is not even the fifth. This is the nature of critical care contracts. What you gain in freedom you lose in stability. You must be prepared for a rainy day. But my rainy day turned into a rainy year and there is no end in sight. Losing the small amount of stability this job provided is a devastating blow. I now have difficult choices to make.
Cancer changed everything. Not only has my body changed but my mind has changed as well. My heart yearns for peace not emergencies. My body yearns for rest not stressful action. Sometimes I wonder if I have “gone soft”. Still, there is no shame in admitting things in my life have changed and the physically strenuous and extremely stressful critical care lifestyle does not serve me anymore.
But what else can I do? This is all I’ve known. It is the only way I know how to support myself. I wonder how many other cancer patients are struggling with these same realities.
In a perfect world I could put work aside and focus on healing. I would have the financial stability to step back, take time for myself, vacation, write, read, create art, and figure out where my life goes from here. But this not a perfect world. Like it or not my malpractice insurance premiums, medical licensure fees, and maintenance of certification requirements just keep coming. Bills have to be paid. I simply have to make money somehow.
These are difficult choices. Do I focus on my health or do I focus on maintaining income? Do I continue to work in a career that brings me stress and physical difficulty or do I take a financial hit and find something that actually makes me happy? I grapple with these questions regularly.
My tired mind snaps back into the present as a “ding” notifies me a nurse is requesting my assistance. With a sigh I put on my headset and click the camera to send my picture to the bedside. The nurse tells me the patient’s blood pressure is dropping and they are starting to crash. My own problems will not be solved tonight, but I can save a life and that will have to be enough.
