10 Microns Can Change Your Life

A single bacterium tends to range in size from a fraction of a micron, to 10 microns. In the body, harmful bacteria can double their population in less than ten minutes. Infections start out small, and can turn dramatic very, very quickly. It’s a miracle that any of us survive in this constant rain of harmful bacteria, especially in the winter months when we’re all driven into close quarters with one another. That miracle is the immune system, and it’s an amazing thing. Sometimes, though, even it’s no match for an aggressive infection.

As a student nurse, I witnessed a patient die from a bacterial infection as ICU staff and doctors struggled to stop it ravaging their system. As a practicing nurse, I tended to patients who had to have deeply invasive surgeries due to bacterial infections, and to patients who nearly died of bacterial illness. I remained vigilant to signs of infection, and supported my patients through recoveries both short and prolonged. My heart rejoiced as they mended and recovered, and eventually parted from our unit to resume their lives. Perhaps naively, I assumed that they would pick up close to where they left off.

Of course, I knew that hospitalization, especially if prolonged, would lead to recovery that would extend well past the point of discharge. People grow weak when they’re convalescing, and it takes some time to build up strength and a sense normalcy. We learn about the strain that this can cause on interpersonal relationships between patients and their families, especially their caregivers, when we’re in nursing school. We see it play out on the floor as professional nurses.

It wasn’t until I lost my job due to a bacterial infection that I realized just how impactful something the size of up to ten microns could be on the entire course of an individual’s life, and I wasn’t even hospitalized. Sure, I was racking up serious bills between all the doctors visits and trips to urgent care, but I figured I’d be alright. I may have been spiking vicious fevers and suffering repeated, excruciatingly painful ruptures of my tympanic membranes, but I was still able to mostly work! I might not have my health, but at least I had a job doing something I loved, and I just had to keep pushing through a little longer until I did have my health again.

My immune system started fighting this losing battle in October of 2018. At first, I thought it was just a cold, or maybe the flu. As I continued to get not quite better, and then ill to a more serious extent, I chalked it up to my new job. I’d been fortunate enough to get work as an RN on a surgical unit, and while the patient population wasn’t particularly ill, my coworkers were constantly coughing, sneezing, and rasping their way through their shifts. It had been a while since I was exposed to so much illness in one place, and I figured my immune system would catch up eventually. It is one of the miracles of the human body, after all!

By mid December, I’d called in sick to enough shifts that my manager requested that I bring in doctors’ notes for future illness. I explained my lack of insurance, and how I was already having to pay so much for the urgent care visits with my fevers spiking up to nearly 104 degrees, but agreed to go to the doctor if I had to miss again. Having never missed so much work before in my life, nor had any sort of disciplinary action taken against me at work, I didn’t realize that this was her way of telling me that my job was at risk. Granted, the fact that this subtext escaped me entirely wouldn’t have changed anything. I continued to push through and work when I could, and to pick up short-staffed PM & weekend shifts to try and make up for the day shifts that I missed during the week. I spent every day off resting in an attempt to recover.

On January 1, the new insurance I’d signed up for kicked in thanks to having been well employed since mid August! I was able to go to a doctor that wasn’t urgent care telling me that I had a cold, the flu, external ear infections, or rhinovirus. By this point, I had a raging sinus infection, pneumonia, and bilateral inner ear infections so bad that I was losing my balance just walking down the hall. I missed three more days of work due to high fever, and a fourth because, while the first round of antibiotics was starting to work, my eardrums had ruptured so badly that I couldn’t hear–and who can auscultate breath or bowel sounds when they can’t hear?

I took in the doctors’ notes. I signed up for short-staffed shifts that weekend to try to make up for my absences. My boss asked me to come in the next day after the first half of my scheduled double shift, and for the first time in my life, I was terminated from employment. I wasn’t gracious as idealistic me would hope to be. I wept. I pleaded. I ran from her when we got off of the elevators, and fled the building in horror and shame. At the time, even more horrible than the blow to my ego, was the fact that she said that my absences were destabilizing my unit. The fact that I had caused an unsafe environment for my patients and coworkers plunged me into a pit–no, a chasm–of guilt and despair.

So here I was, out of a job because of bacteria replicating at a pace with which my body couldn’t keep up, on day three of what would turn out to be two courses of aggressive antibiotics, and piled high with bills from repeated urgent care visits. I spent two days buried in tissues from tears of grief and guilt as much as snot from my sinus infection, one day trying to clean my house, because after having been sick for literally months it was its own little nightmare, and a fourth in bed hugging my dog because she always makes me feel better. On day five, I started looking for work. Little did I know what a strange limbo position in which I was to find myself.

You see, nursing positions in the Bay Area are highly competitive. I’ve heard tell that managers get hundreds of applications for each position they post. I can only imagine the kind of decision paralysis this must trigger. I have trouble picking mustard at the grocery store, and there’s maybe only a dozen of those to choose from!

This abundance of applicants leads naturally to experience requirements. Generally, RN I/new grad positions go to RNs with either no, or less than six months of experience in any nursing role, and RNII+ positions go to RNs with at least a year of experience in acute care. Technically, I had five months of experience. However, being employed from August-January, I had more than one HR person inform me that this meant that I had six months of experience, and therefore did not qualify for RNI/new grad positions. At the same time, with only five, or six, months of experience under my shiny new nursing belt, I did not have enough experience to qualify for RNII positions. I didn’t even have enough experience to qualify for my old job, despite my manager having encouraged me to reapply.

I’ve had my hands inside of people. I’ve touched living bone–admittedly while wearing gloves, but I’ve touched living bone! How cool is that?? I’ve cared for patients that went from miserable and bedbound for weeks, to walking out of the hospital smiling and ready to rejoin their lives. That’s even cooler! Admittedly, some patients did not make it, and I felt every loss. Those losses make me all the more grateful to be alive, and all the more determined to get back into an acute care position.

I need to help people. I yearn for it to the point of filling out dozens of job applications a day, to receiving hundreds of rejections based on my inexperience, and continuing to push myself at every possible opening, even when I’m quite clearly underqualified for the listing. You never know when luck will strike, after all. When I was sick, all I did was work and sleep. Now? All I do is work and fill out job application after job application.

A little more than a month later, as the bacterial infection that lasted a few months and didn’t hospitalize me continues to leave me teetering on the brink of bankruptcy, on the brink of losing my home and custody of my child in the process (the very reason I cannot simply move to get my required experience), I find myself wondering what was waiting at home for my patients, and wondering how I hadn’t wondered that sooner. Did they get to go home, finally recovered, grateful as I am, likely even moreso for how critically ill they were–only to learn that they stood in risk of losing so many of the things they held dear as well? Had they already lost them? Had they survived one kind of ruin, only to find themselves hurtling into another? All because of the staggering replication of something mere microns in size?

Oh, how I hope not. How deeply I hope that there is a happier corner to turn for all of us.

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