This story is from the Anamnesis episode called Breaking Point: Why We Become Activists at 3:44 in the podcast. It’s from Tammi Nander, RN, founder of her own nursing advocacy group, the Last Pizza Party, and @nursenander on social media.
Well, my name is Tammi. I go by the username @nursenander on various social medias and I primarily use TikTok as a platform to talk about the conditions of healthcare and health justice. I’ve been a nurse since 2015 and my main specialty is ICU.
I did decide to leave bedside about a year ago, after the COVID pandemic negatively affected my mental health and my physical health. As well as, you know, I was working the COVID ICUs during the entire pandemic and became pregnant. And so I was presented with this opportunity to work from home and try to make a difference in healthcare through my grassroots, the Last Pizza Party. And so that’s where my story kind of begins.
So the National Nurses March was on May 12, 2022, and we met in front of the White House, I want to say around 8 or 9 a.m., it was pretty early. I don’t remember the exact time that we got to Audi Field because as long as we walked, the time passed, it was an incredible experience.
I was very, very lucky to be able to work with the organizers and help them in whatever way we could to help organize that. So I had a pretty good rapport with Ashley and Najah and Veronica and Justin. And so let me first just say, I want to say they did a really good job for a group that has never organized something of this magnitude before. And so there were some hiccups. But they handled it great.
Marching From the White House
Arriving in front of the White House — that’s where we started the march — it was so empowering just to see, I’m getting goosebumps thinking of it, to see everybody’s signs and how many people this turned out. And when you walked and you would hear the chanting and the chanting would go back, like, I want to say a mile. I mean, it was 10,000 people, maybe more. Healthcare workers and their families came to raise their voices. And I can’t describe the feeling of having, just hearing this chant go all the way back about a mile. It was so empowering and it was almost like just this burst of energy that wouldn’t go, like your adrenaline.
So we walked, oh my God, must’ve been like 4 miles, I think, that day, but we never lost our energy. I was still … I had just had a baby, by the way, so I was not in great shape. But when I tell you just the power of coming together with so many people, screaming the same message, I could not stop. I don’t remember having that much energy in like a really long time.
It was incredible. And when we finally turned the corner — actually before we turned the corner, we went under a tunnel. And it kind of reminded me of my husband, he likes race cars and, you know, he’ll go really fast, so it echoes. And so we went under this tunnel and that chanting would echo. It was so loud and you could see people in the buildings and apartments looking down and waving and like cheering us on. And it was just really, it felt like we were seen, which is a big thing for us.
You know, a lot of healthcare workers, we don’t feel like anybody hears us. We feel like we’re just screaming at a brick wall. So just being out there and having the community rally and like cheer us on as we passed was incredible. And when we went under that bridge and it echoed even louder, it gave us that last push of energy that we needed to go the rest of the distance.
And shortly after that, we turned the corner and we saw Audi Stadium and we were just like cheering every, every person that turned the corner as soon as they saw Audi Stadium, they were cheering, they were cheering. And I love, I was at the very front. They had me with a megaphone helping lead. So I was ahead of even the people, you know, the, I forget what they’re called, kind of guards that hold the crowd back as we go. But you know, I got to lead 10,000 people. It was really, really amazing alongside that group.
And so it was just fun when you turn the corner, it was just this continuous cheer, like a wave of cheers as people saw, oh my God, we’re done. We get to sit down. There’s food, there’s bathrooms, there’s water. And so we got into Audi Stadium and immediately went to the bathroom, got some water, got some food. And then we had a little bit of a time delay because it got off to a late start because of something going on with the police department. So we were late, but we only had a set amount of time to be in Audi Stadium.
So, then, you know, after, all night, I had practiced the speech and I was nervous because I am actually not a great public speaker. And so they came to me and they said, we’re running short. You’re going to have to cut your speech short. And I’m like, what am I going to cut out? And to this day, I couldn’t tell you what I cut out. I don’t, I don’t really know. I just remember walking up to the podium and turning around and there was so many people and I was just like, man, this is — I was kind of shaky and if you saw the video, it was kind of like swaying back and forth, kind of like, not being able to sit still and that was kind of a self-soothing thing. It was nerve-wracking.
Telling My Story in Front of 10,000 People
But once I started telling my story, it became very clear to me that I wasn’t alone because people were cheering and they were encouraged and I could tell that they had experienced some of the same things that I had. And it was this incredible feeling of camaraderie and being united and just this fierceness and it gave me so much energy.
And so once I got going, it was much easier for me to tell my story and they were cheering and that encouraged me and I felt like we were just, it was great, this feeling, you know, the audience was encouraging me to tell my story and ramping me up and kind of being my hype, you know. And so then I heard myself yelling at one point. I was like, I didn’t plan on yelling, but here I am because they know what’s up.
[From her speech:] We won’t take this any longer. We’re sick of being stretched thin. We’re sick of moral fatigue. We’re sick of empathy manipulation. We’re sick of being called heroes.
So when I was giving this speech, the first part of that speech was my experience as a new grad nurse, and you learn so much in your first 6 months. The first 6 months of nursing is absolutely your hardest. I can attest to that. You do not learn everything in nursing school. You just don’t. And so you rely on your co-workers and those seasoned nurses and your charge nurses to pretty much mentor you. You know, you go through this precepting period, sometimes it’s, you know, a few months, sometimes longer. And a lot of times the hospitals will let you off of your precepting period early because they’re short-staffed, and that’s not safe.
But that was the story of me being a new grad and trying to figure out things that I didn’t know. And this patient had a CBI, which is a continuous bladder irrigation. He had just had surgery on his bladder. And so if you’re not familiar with that, basically there’s a giant 3-L bag — should be two of them — and they’re running continuously into the bladder. It’s kind of like a three-way Foley. So the Foley will go, it’ll irrigate the water in and then it’ll irrigate it out. And so the problem with that is you can get blood clots a lot. I did not know … I don’t remember ever learning about this in nursing school. Not every nursing school is going to teach that. That’s why you have these preceptorships and you rely on your fellow nurses.
And so I didn’t know what was going on, but I had this patient days prior and I knew him very well. He was a stoic kind of Southern man, didn’t want to say he was in pain. He didn’t want anything. He did not bother me for days prior to this. He was fine. I would offer him pain medicine. He didn’t want it.
I Just Felt So Alone
So I knew for a fact that something was very wrong with this man when he came back from surgery and he was screaming. It wasn’t like him. He was screaming. He was wailing. He was arching his back. And I felt so bad because I built a relationship with this patient. He reminded me a lot of my father, how gruff and abrasive he was. And so I really bonded with him and I felt terrible because I didn’t know what to do and I’d given him all the ordered medications, the Percocets, the morphine, the Dilaudid, anything, nothing would work. I had put pages out to the doctor. The doctor’s in surgery. He can’t get back to me. I told the HUC, please call every 15 minutes until I get a call back from this doctor. And I just felt so alone.
I went to my chargers and I said, this patient’s in pain. I can’t figure out why. I don’t know what’s going on with this thing that they sent him down from surgery with. And she just was so, she was kind of annoyed. And I’m gonna say this, she has always been very nice to me. She’s not a bad person, but this is what happens when you are stretched so thin, sometimes you’re gonna lose your temper. And so she was like, I don’t have time for this. I don’t have time for this. And she brushed me off and I didn’t know what to do. And that was what I was met with because everybody was so stressed out.
And I went to my nurse manager and I remember her clacking [keyboard clacking]. That’s what it sounds like. Clacking on her keyboard, writing her emails that she would embellish with these emojis and it’s like, you have time for emojis, but you don’t have time to help anybody on the floor. She would never help. And she told me that she couldn’t help. She was busy and to find someone else.
And finally, there was a travel nurse named Rosemary, who I will never forget. And she finally heard the call bell and the guy screaming and she walked and she’s like, what’s going on? And I said, I was like on the brink of tears. I was like, I don’t know what to do. I’m failing this patient. He’s in so much pain. I’ve given him this, this, this. And she’s like, stop, just take a second. Cause I was frantic. I was not able, everybody’s like, why don’t you, critical thinking skills. Look at this. I was a baby nurse and I felt alone. And so she took me by the shoulders and she said, take a look, take a breath. Do you see, let’s do an assessment. Do you see the CBI? Why is there blood in the CBI? There shouldn’t be. And I’m like, oh my God, the blood is backing up. What’s going on? And she’s like, we have to aspirate. And I was like, cool, what does that mean?
And so she brought me to the supply room, we got the supplies, we came back and she taught me how to aspirate, which is a very messy, messy process, but these clots came out. These giant clots, they look like jelly. It was really gross. But all of a sudden, the irrigation was going through, it was not blocked anymore. But the issue is, when you have a blood clot blocking it, the weight of that 3-L bag is just sitting on his bladder, which had just been cut open. So that pressure could have ruptured his bladder inside of him.
He could have died if Rosemary had not come and helped me. So thank God that she did. And she walked me through, she told me all about Belladonna opium suppositories. Those are the best way to control this type of pain. Because pain management is so nuanced. And anyone, I encourage you to take a really good class on pain management, it’s so valuable.
But after that, I went to my manager’s office and I said, I came to you. I came to the charge nurses. I went to every nurse. No one could help me. You sat here typing on your computer. I was fuming. And I, at the time, was a very mousy person, but this is the first time I think I ever found my nursing voice because I laid it out on her. I was like, you refuse to staff this unit. You refuse to staff us safely. I could have killed that patient.
And she said to me, “This is a hospital, patients die. People die here.”
And I just, I remember the color just, I knew it was draining from my face. And I was like, this is unacceptable. I can’t, I can’t work here anymore. And so I thought if I left that I would find something new. And so I went on to a higher acuity of care and PCU, which I loved. But, unfortunately, this is how hospitals are run. They’re just run like that. So you continuously get into these situations where everybody’s too busy to help you and the patients will suffer for it.
[From her speech:] I stood frozen, shocked, but thinking clearly. And in that moment I knew what I needed to do. So I found a new job. But that didn’t help anything; in fact, every manager that I had from that day forth was complacent in risking our patients’ lives and our licenses.
And after that, I went back and I don’t think I had cut my speech short enough because we were really, really cutting it close on time.
But I do know that after that, a lot of people had come up and wanted to like take pictures or just tell me their story, and say, you know, how much it meant to them. And it was really incredible. And I’m a little socially awkward. So when I meet people for the first time, I kind of like clam up a little bit. So having that many people come up to me and tell me how much it meant to them was kind of like, I was a little like shell-shocked. But I met so many fun people and it was just really great. It’s sad to hear people come up and share sad stories with me. But it’s also, I’m not alone, and that just meant a lot.
As a travel nurse, I’ve worked and had management approach me and say, “Hey, we saw a social media post and we don’t think this is going to be a right fit.” It wasn’t me sharing patient information. It wasn’t about that hospital, but it makes them uncomfortable knowing that I will share everything with people and I will be honest. And so sometimes I’ve worked contracts and have no issue. And sometimes I’ve had contracts end early because they are concerned that I’m going to spill the tea about how their facility is run. And so getting up in front of 10,000 people on a recorded YouTube link and sharing my story and calling them out. No, no, I’ve let go of that a long time ago. I’m all in. I’m going to be honest with people.
[From her speech:] If we stand together, we can hold hospitals to a standard. We can pass the Nurse Staffing Standards for Hospital Patient Safety and Quality of Care Act. We can federally mandate safe nurse-to-patient ratios nationwide. We can tell Congress our stories and Congress will hear us say, “Congress, don’t call me hero. Give me work conditions that a human can thrive in.”
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