A Day In The Life

Some days you question everything : should I have seen this coming? Did I respond quickly enough? Would another nurse have caught this sooner? Did I do enough?  Does my patient’s family blame me for this situation which was indeed possible but not plausible? And those questions keep coming even though you know if another nurse asked those exact questions about themselves in the same exact situation you’d answer them with honesty and certainty that absolutely nobody would have done a single thing differently than they just did. 

Then the patient’s daughter and caregiver looks to you in the crowd of RNs, MDs, NPs, Xray techs, cardiac diagnostics folks and says “thank you for jumping into action so quickly.  I’m so thankful you were here” and all of those questions fade into the background and they are replaced with a new resolve. Critical care is like that; full of questions and unforeseen situations that you may not be expecting but are always ready for in the back of your mind. It helps when you have an amazing team with you. There are perfect storms and it is my belief that God places the right people alongside you in the eye of those storms. For me it was Rachel, Richard, Steven, and Helen as my fellow nurses coming in and out of the room assisting and bringing supplies and support. Missy as the nurse holding the rest of the unit together as we were short staffed and I was also the charge nurse that day and supposed to be the one holding it down. It was Dr. Leacock and Hilary (one of the greatest NPs on earth) leading the charge and getting us all through that seemingly endless shift of complications and varied treatments. It was our strong team of PSTs answering call lights and assisting our other patients which allowed the above team to focus where we really needed to focus. 

Some days you need to decompress with someone who was there and witnessed and understands the day you’ve just had because they experienced it with you. I thank God for my “work wife” who is so often that person for me.  I also thank God that my actual husband, while he may not fully understand the reason, accepts my need to do so and never gets angry with my “going out for dinner after work” texts even though I’ve already spent the day with my work family instead of my home family. 

Some days keep you up well into the night and wake you up restless in the morning and you just need to get it out and analyze the day and feelings involved. That is what this is, so if you’re reading, thank you for supporting this tired but thankful nurse. 

I Try to Say Goodbye

Sometimes it hits you when you least expect it. Sometimes you don't even realize when you are experiencing it that it's affecting you like it is. Sometimes it takes a young girl singing her heart out on a television show for her dying father to really bring it out and up to the surface and I can do nothing but sit and cry. It's hard, it's sad, and in the end, it's my honor. 
I believe that it truly is an honor to sit with a family as they make the choice to give up the fight for their loved one that can no longer fight on their own. You stand witness to the most gut wrenching time in the lives of people you didn't know existed  before their loved one came to the ICU.  You watch as the doctor talks and you can actually feel the hope fade as the reality of what they already knew sinks in. When the family looks to me, their nurse, and asks "do you see a chance for recovery?" they already know in their hearts what my answer will be but I can see them physically yet almost imperceptibly brace for the sound of the words they dread. 
It is these times that my job becomes sacred. I am not just a body coming in and out of a room titrating IV medications, drawing labs, emptying drains, monitoring vitals and intracranial pressure, and even turning loved ones from side to side.  In those moments I am still those things but I become more. I become a part of their history that can never be erased. When they think about the final days they had on earth with their precious loved ones - fathers, mothers, brothers, sisters, sons, or daughters- my presence will be there. My actions will be felt and remembered by those families long after their loved ones have left my care and I've had many patients in their place. I take that role very seriously and it tears at my very being as I know it does to my fellow nurses as well.  Yet I know there is no other place on this earth I would want to be.  To have the opportunity to provide comfort to the sick and the dying is an occasion that I don't take lightly. To witness a life leave this place for what I believe is a better place is truly a gift that I am lucky to receive. Not because I enjoy death but because that is the closest to true humanity I will ever see.  It is my job but it is so much more. 
I hope that I bring some measure of comfort and peace to families during this difficult time. I pray I can be a calm in the middle of their worst storm.  I can't take the pain of losing a loved one away from my patient's families. What I can do is offer them my heart and my hands and my physical acts of titrating IV medications, drawing labs, emptying drains, monitoring vitals and intracranial pressure, and even turning loved ones from side to side. And when the time comes I can give them my time and oftentimes my tears. It may sound strange but I embrace those moments just as I embrace the very mourners left behind. As nurses we don't only care for our patients but for their families as well. It is with them that the memory of our actions and words will always remain.

Born This Way OR The Problem with My Kids

I have two of the most wonderful children.  My daughter is 7 and my son will be 6 in a few weeks.  My daughter is a sweet, loving, and smart child.  I don't mean smart in a "she can answer all of my questions and have adult type conversations" kind of way even though that is entirely true.  No, she is smart in an incredibly emotional way.  She really gets that people have feelings and that those feelings should be protected.  She strives to include other children, including her younger brother, in all of her activities.  She wants to be sure that nobody feels left out.  As I said, she is only 7 years old but she has already figured out that Momma doesn't know everything.  I thought I had a few more years before she realized that I don't have life all figured out.  She is just so darn smart and already displays leadership qualities that tell me that she is destined to do big and admirable things in her life that far surpass my capabilities.

My darling girl is also extraordinarily kind.  If I'm having a bad day or if she happens to see a tear fall from my eye she has an uncanny ability to know exactly what to say to make me smile.  Often times it is simply to remind me that she loves me or that she thinks I'm the greatest Momma in the world - something I think all mommas would like to hear from their babies.  She is beautiful inside and out.

My girl is also a little weird.  Weird is not usually a word I think people use to describe their own children but there it is.  She is weird, but wonderfully weird.  She loves to use silly voices and make up songs that make absolutely no sense to anyone but herself.  The best part of her weirdness is that she truly enjoys it.  She can make herself laugh over a silly joke or song she has made up.  And what a laugh it is!  Her laugh is infectious and comes from the absolute center of her being.  She has an amazing imagination and it often surprises me when she tells me about the newest story she is creating in her head.  That little girl can have the most magnificent conversations with her stuffed animals and if I happen to catch a bit of their chats I honestly yearn to be a part of that inner circle.

My son.  My challenging, energetic, and warm-hearted son with his big blue eyes and his beautiful long blonde hair.  He forces me to be a better, more attentive mother.  He has the will of a lion and the determination of a grizzly bear looking for the next meal.  He lives life fully out loud.  He is strong and independent in a way that reminds me he won't always be my little boy.  That knowledge is simultaneously gratifying and soul-wrenching.

He is competitive.  With me for a mother that trait was bound to pop up in one of my children.  We love to play games together and whether it's board games on the carpet or basketball in the cul-de-sac he knows that if he ever beats me (which he sometimes does) it's that he truly has beaten me.  I don't let my kids win and while I'd like to say that is only for truly altruistic reasons about life lessons it's partly my own competitive spirit that drives my desire to make him work to beat me.  My hope is that his competitive spirit will eventually become the ambition he needs to become successful as an adult.  I want him to believe that he can achieve any goal he sets his mind to and works hard for.  

He too is sensitive.  He loves to climb in my lap and just be.  Some of the best times we have together are spent doing simply that.  Just taking the time to talk to one another about our days or something silly like who our favorite superhero is and why.  I find it impossible to fathom a better way to spend my time.  

So what is the problem?  First, there is my daughter.  She lives with her heart on the outside of her body.  She is easily broken and I have even found myself guilty of being the one who has hurt her which crushes my own heart.  A harsh word or admonition can stomp out the beautiful light that she emits.  Sometimes as a parent we have no choice but to discipline or correct our children's behavior but that doesn't make it any easier.  I'm not perfect but I make sure she knows that I love her beyond all measure. The problem is that the outside world doesn't feel the same way about her.  How do I teach her to be strong in the face of people who decide she isn't what they want her to be yet maintain that tender heart that welcomes all people to be a part of her little universe?  I tell her all of the time that she is special and that she is beautiful because that is truly what she is but I can already tell she doesn't fully believe me.  She is already doubting that she is good or smart or pretty enough and that destroys me.   

As for my boy, all of that strength and determination doesn't fully protect him either.  Take his hair for example.  It is long for a boy and yes he has been mistaken for a girl by someone who has only glanced at him.  But you know what?  He loves his long hair.  It makes him happy which in turn makes this Momma very happy.  I will admit that when I decided to let his hair grow long it was more for myself but he has decided he very much would like to keep it long.  We talk about cutting it, especially now that he is playing coach pitch baseball this season but we never quite bring ourselves to go through with it.  There are challenges with his hair and how to keep it out of his face.  We tried a ponytail for soccer last year and that worked great!  He looked so handsome and was so proud - right up until he wore it that way to school.  There were some older girls in the cafeteria and they laughed at his hair.  That was the last time he would wear it that way outside of our house.  It breaks my heart that he would let the opinions of some mean little girls change the way he chooses to look.  I have an internal struggle because I have a part of me that wants to force him to understand that it doesn't matter what other people think and that he is perfect in his way but I also comprehend that is not the way the world works.  What really amazes me is that it is not just a couple of mean girls that have affected him.  There are adults in his world that believe I should cut his hair to fit what they believe he should look like.  Trusted adults whom have made it no secret through their actions or comments that they don't approve.  In fact, when I was told of the girls in the cafeteria I was made to feel like it was my decision to let him have long hair that was the problem, not the actions of those mean spirited children.  How am I supposed to teach him that it is okay to be who he is and to ignore those that would disagree without hardening his heart against those detractors?  When did individuality become a liability?  

The real problem is that I want to teach my children to be, look, or create in any positive way that makes them feel fulfilled.  I also want to teach them to be strong in the face of opposition to the things that bring them that joy.  Please don't mistake me.  I agree that to be productive members of our society that some conformity must be maintained.  I am fully convinced it's not the job of the world to change to harbor the safety of my children's individual needs or dreams.  I don't believe in "safe spaces" for the protection of every little feeling or that society has a duty to protect the sensibilities of my children (although a little more thoughtfulness in the world would be great).  What I believe in is the ability to take a stand and say "this is who I am and it is enough."  My babies are already under so much pressure to fit in and to mold themselves to match what other people think they should be.  One of my biggest challenges in this life is to convince them not to do just that.