I work on a per-diem basis, which is basically like being a temp. I get my jobs through an agency, like a temp agency for nurses. I'm registered with several different ones. I studied all the regular nursing specialties in school--pediatrics, maternity, child health, psychiatry--so when I want a position, I just call up my agencies and say like, "I want to work the night shift at a hospital. I'll work pediatrics or psych or whatever." Or I'll say, "I want to work private duty somewhere in the suburbs."

My agencies can usually get me an assignment like what I want. I may have to be a little flexible sometimes--maybe the position will only be for a week when I want it to be for a month--but generally they can get me what I want. So I've never worked at one particular place on a permanent basis. I'm a generalist and I move around. I've worked in hospitals and private homes. I've worked in drug and alcohol detox, and with mentally retarded and developmentally delayed patients, group homes for adults and for teenagers. Lots of things. My longest assignment was six months, I think, and that was too long.

I like being self-employed, but nowadays, there's basically nothing else I like about this job. [Laughs.] I'm just tired of it. It's changed so much. You no longer really have time to devote to your patients because of the cutbacks and whatnot. Where they would have had three nurses doing something at one time, now they have one. It's very difficult. Your work load is extremely heavy and this is really a thankless profession. People are more concerned about tipping a cabdriver who did basically nothing for you than trying to give a decent salary to a nurse who's saving your life--someone who makes it possible for you to live another day.

You may have read in the newspapers that there's a big demand for nurses, but that's a lie. Nurses are being fired left and right. The new buzzword is "downsized." I can get all the work I want because I am experienced and I am willing to be a self-insured, temporary employee. I'm not looking to get on staff, get benefits and all that. So I've got plenty of work, but there's no support any more. Staffs have gotten so small that it's just overwhelming.

For instance, I was working at a nursing home recently and this doctor was coming the next day to do physicals. So, the supervisor wanted me to prepare the charts for him. Used to be, this was a job for more than one nurse; now it's just me. And there were forty patients per floor in this nursing home--which is typical--and everybody is having different tests and things and all of it is generating different papers. Each patient has five or six different test reports, each a couple of pages long, and all those papers have to go into their charts. Multiply that by forty. So I have to go through all of this, the names and numbers and all this paper and put it all together into the chart. Then they want me to pull out the form that the doctor actually writes the physical on, so he can just come in and write whatever he wants to write. Then they want me to do his job: take the patient's temperature, the pulse, the respiration, weigh the patient--all so he doesn't have to do it.

So I'm not legally responsible for any of this, but I'm supposed to take my time to do it when I have dressings to do and I have to pull out their medications and all the other things that I was hired to do. It was a terrible position. Just impossible. Things like this are what I don't like, and these days they are the norm.

At a lot of my nursing home jobs, I don't stop moving except during two fifteen-minute breaks and my hour meal, especially if I work the night shift. One director of nurses said to me, "At night, you have a lot more down time." And I asked her, where is this down time, because I need roller skates. [Laughs.] Of course she didn't answer. These nursing homes are just very tough and the hospitals aren't much better. And I'm sad to say that private duty is getting harder and harder to come by for someone like myself because the people who hire a private nurse to come into their homes usually have money, which means they are usually white. And generally these people don't want a black minority taking care of them. If they can get a Filipino or any other minority, they'd prefer that.

We have too many foreigners in the country, foreign nurses. A lot came here during the quote-unquote "time" when we were supposedly having a "nursing shortage." The early 1990s, this was, if it ever was. But my thing is, if that was true, it is no longer true. So they should rescind their licenses and send them back to their countries. But they are not doing that; they passed all kinds of rules and laws, and they are allowing people to stay here, get their working papers or whatever they are doing. And it's really not fair, and it is really, really sad, because what it does, especially in New York, is help encourage racism, as far I'm concerned.

Another big problem is that people have become so litigious. Most nurses I know, if somebody dropped dead or fell down, they would run in the opposite direction. So would a doctor. And it's not even just getting sued anymore; now you can be brought up on charges. You can be held legally liable.

Let's say you made a mistake. You gave someone aspirin when they should have got codeine or something simple and harmless like that. Well, if you report that you gave so and so the wrong medication--even if it did no harm--you could be fired. They can report you to your agency and they will fire you. They can also report you to the state that gives you your license or your registration board so that you can't practice anymore. Or they can bring you up in front of their board and they can say, "Why did you made a mistake like that?" And maybe you say, "Oh, I was upset that day. My kid. My boyfriend." And they say, "Oh, so you were upset? Okay, you must be under psychiatric care for a year. We're going to suspend your license and you're gonna have to pay to take a medication course." It's really rough.

They are also trying to make us have a lot more accountability, even for things we have no control over. For instance, in a nursing home, you have your nurse's aides and your nurses. The nurse's aides are basically there to assist and to clean, they are more like maids than nurses and they are not responsible for caring for patients. Well, these days, if the nurse's aide makes a mistake, then the nurse--the person with the license--will be blamed. The nurse will be held legally accountable. I had a girlfriend in one nursing home who got fired because of her nurse's aide. A patient laid in his own urine all night. When you opened up the door you could smell the urine. It hit you in the face. My girlfriend had nothing to do with it; it was her aide's job to change the sheets. But because she signed on the accountability sheet--which everyone just signs at the end of their shift because they have to--because she signed that and thereby said that patient had been taken care of, she was ultimately responsible. And she had worked at that home for years.

Nothing like this has ever happened to me, thank god. But only because I'm very careful [laughs]. I am very, very careful and I make sure that when the supervisors try to get me to do things that I know I shouldn't do, then I don't do them. I do what I'm legally bound to do and I watch my behind.

One time a supervisor gave me an accountability sheet to sign and I refused, so she asked me what I hadn't done. I said, "I've done everything that I was supposed to do. It's all done. All the medication is done. The forms are done. The this-and-that are all done." And she said, "But you didn't sign the sheet." Well, let me tell you what else is on this sheet--things like: "Are there any spills on the floor?" How am I suppose to know? Somebody could have vomited on the floor back in the back room. I wouldn't know.

There were all these questions on this form that didn't have anything to do with my job. "Are there any spills on the floor? Are all the wheelchairs put away? Are any of the exits blocked? Is the pantry cleaned? Is the utility room cleaned?" These are questions for the janitors and I didn't know the answers, and I refused to sign because if I'd put my John Hancock down there and then maybe something happens like there's a fire and one of the exits was blocked--well, I could have ended up in court. I could've been charged with something because I signed that form. It's really pathetic. But hospitals and nursing homes and everybody is trying to protect themselves and nurses are getting the blame.

You don't make friends acting like this. When you refuse to do certain things, they don't like you and they may not want you to come back and work there anymore. So it's very difficult, but at least I'm still working steadily, although I really would just like to quit and do something else. If there was any other way for me to make decent money, I would. Unfortunately, for the time being, I am stuck.

Originally, when I started out doing this I was just a kid in high school and I really did believe that nursing was a good thing and I thought I was helping people and I enjoyed it. Now I feel like there's no room to do what I like to do. There's no time to give personalized attention. No time to actually sit down and listen to what the patient's fears are, or maybe even give them a nice back rub, or lotion them, or something just to make them feel better. Walk them around the hallway. Things like that to make them feel better and to help them help themselves. With so much suing and everyone so short-staffed, you can't do that any more. And then you look at other nurses and they are like: "I'm just here to get a paycheck." And they truly, truly don't care. And being a person that cares, and you try to do what's right, it's just not worth it. But I understand the other point of view: nursing simply is not what it is cracked up to be.

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