Surviving Your Hospital’s Transition Periods

“Hello, Mrs. Jones,…bam…bam…bam…what brings you to the emergency department…bam…today?” I asked my first patient of the evening.  Our conversation is punctuated by the sounds of jackhammers and a wall being ripped apart at the seams from across the hall.  “Well, Erin…bam bam….bam….I am having chest pain…bang bang…bam…and am worried I could be having a heart…bam bam…attack” Mrs. Jones replies, yelling over the construction clamor.  If my patient isn’t having an MI, I probably will be by the end of my shift based on how this night is going, I think to myself.

Our emergency department is expanding and with it naturally come growing pains.  Of course I don’t know when or how to expect them because it seems expansion plans are kept secret among administrators.

A few of my fellow ER nurse practitioners are leaving their jobs as transition periods often prompt the unhappy to move on.  This makes periods of growth even more difficult as their remaining shifts are then dispersed among the remaining NPs and PAs.  Most notably, the two nurse practitioners who actually prefer working weekends are leaving their posts meaning more Saturday hours for yours truly.

Last night around 2am I strolled into the break room to microwave my much needed midnight snack only to find the place torn to shreds and the nasty, splatter-ridden communal microwave nowhere to be seen.  Oh well, perhaps the hospital expansion will cause my waistline to shrink.

I’m a status quo kind of person, I don’t like change.  At least, not change that’s out of my control.  E-mails announcing the opening of six new patient rooms that I’m expected to staff but have never seen stress me out.  The addition of new shifts and hiring of unfamiliar faces leave too many unknowns for my taste.  Just when I think I have arrived at a place of stability in my day to day life as an NP, something always changes no matter where I’m currently employed.

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While times of transition can be difficult, I am learning to look beyond the temporary growing pains toward future benefits.  I have arrived at a place of comfort in my career, I’m confident in the patient care I provide, so perhaps these periods of forced challenges are a positive.  Despite the minor inconveniences of shaking up my work schedule and suffering through a chorus of construction sounds, with change comes opportunity.

Our hospital is becoming a certified trauma center attracting high acuity patients.  As a nurse practitioner, this will once again force me to brush up on old skills and perfect new ones.  I’m excited for more complex suturing, fractures and learning new tricks of the trade.  Having met our hospital’s newly hired trauma surgeons, I’m excited for the opportunity of working side by side with these skilled physicians.  I learn more each time we interact.

Even more specialists have been hired to care for our increasing volume of patients with specific needs.  These doctors are very nurse practitioner-friendly as opposed to their predecessors.  They treat me as a professional and respect my medical opinions.  Based on our limited interactions so far, I expect a spirit of true collaboration among the NPs and MD’s now staffing our emergency department and hospital as a whole.

While times of transition and growth present plenty of problems (I’m not bringing a hot meal to work for dinner tonight) my personal pledge is to see these as they are, small, minor and unimportant, instead taking responsibility for embracing change.  Rather than endure this transitional period until I once again reach a comfortable norm, I will maximize learning opportunities allowing it to make me a better provider.


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