No Such Thing as Too Smart to Be Just a Nurse


This post is for all the people who’ve ever told me (or other nurses) that I’m “too smart to be ‘just’ a nurse.”  There are a lot more of these people than you might think!  In some twisted way I guess some people think this is a compliment.  (Newsflash: it’s not!  It’s actually quite insulting.)  Obviously the people who say such things have no idea why it’s so incredibly important to have a very intelligent nurse.  So let me educate you as to why if you or your loved one are ever sick, you better hope against hope that your nurse is every bit as intelligent as your doctor:nurse pic

Because I’m the one who called the doctor to tell him that your sodium was rising rapidly & thus we needed to stop the hypertonic saline drip you were on & change it to regular saline.  And I did this because I have the smarts to know that no matter how critically low your sodium was initially we can’t replace it too quickly or we can cause serious brain damage.

Because I’m the one who noticed that your creatinine, an indicator of kidney function, was off the charts & realized that, with your history of diabetes combined with your current dehydrated state, this was a serious problem that needed to be addressed immediately.  So I’m the one who called the doctor & made sure you had IV fluids ordered & a nephrology consult to further explore your renal failure.  I don’t want to know how much worse your kidneys could have been damaged if I’d just assumed the admitting doctor was aware of the problem & waited till the next doctor happened to look at your chart the next day.

Yes, we nurses know what all of this means.

Yes, we nurses know what all of this means.

Because I’m the one who noticed you were lethargic & slow to respond to my questions, so I checked your blood sugar, found it was dangerously low, & corrected it so that you didn’t end up in a hypoglycemic-induced coma . . . or dead.

Because I’m the one who begged for a palliative care consult because it was obvious to me that your mother was dying & furthermore that she was READY to die, & I wanted her to have the peaceful death she deserved.palliative care

Because I’m the one who noticed you were on a boat-load of narcotics but didn’t have a stool softener or laxative ordered, so I called the doctor to remedy this situation because I didn’t want you to develop severe constipation or worse yet a post-op ileus due to such a “simple” oversight.

Because I’m the one who recognized your mother was having a massive heart attack & demanded the doctor come to see her, even though it was the middle of the night & he had to come in from home, so that I could ensure she was transferred to the ICU where she could receive all the care she so desperately needed.

We nurses know what this means too (bad heart attack!!).

We nurses know what this means too (bad heart attack!!).

Because I’m the one who reminded the doctor to discontinue your blood thinner the night before your heart cath so you wouldn’t bleed out during the procedure the next day.

Because I’m the one who reminded the doctor to order a physical therapy consult so your dad could improve his strength & mobility prior to being discharged home with you.physical therapy cartoon

Because I’m the one who noticed all of your morning lab results were a bit questionable, so I demanded that the lab re-draw them to ensure accuracy.  (And thankfully for your sake the first set was wrong.)

Because I’m the one who noticed your mother’s urine was cloudy & foul-smelling so I made sure she had a urine sample sent & antibiotics started to treat her UTI before she became even sicker than she already was.

Because I’m the one who reminded the doctor that certain medications like Ambien (a commonly prescribed sleeping pill) are really bad for elderly people, so I asked her to order something milder like Remeron instead.

This isn't totally a joke.  Ambien can be very bad for elderly people, but not all doctors realize or remember that, which is why it's important to have a smart nurse to remind them!

This isn’t totally a joke. Ambien can be very bad for elderly people, but not all doctors realize or remember that, which is why it’s important to have a smart nurse to remind them!

Because I’m the one who noticed that your blood sugar was low on your morning labs (but not so low that lab called it to me as a critical result), so I rechecked it & found it to be even lower, dangerously low in fact.  I corrected this by giving you D50, basically sugar water, in your IV.  But I shudder to think what might have happened if I’d overlooked that low blood sugar on your morning labs.

Because I’m the one who noticed that your dad was having trouble breathing & decreased urine output, so I called the doctor & ensured he had a STAT chest x-ray done & some Lasix given because I realized he was probably going into acute heart failure . . . & that couldn’t wait till the doctor rounded the next day.Congestive-Heart-Failure-e1351349118720

Because when the doctor tried to explain what was going on with your body & you didn’t understand a word of it, I’m the one who translated the words into plain English & helped you understand your condition so you would be less frightened.  This is because I have the intelligence to understand your medical condition but also the ability to translate that into simple terms that anyone can understand.

Because I’m the one who noticed that your blood pressure was low &, knowing this could affect your body’s ability to perfuse all of your vital organs, I made sure the doctor ordered a fluid bolus to help increase your blood pressure.  But I also closely monitored your urine output & your respiratory status to make sure we weren’t overloading you with fluid & risking sending you into heart failure.IV fluid

In case you’re wondering, these are all scenarios I have truly encountered as a nurse.  And these are just a small fraction of the things I & my fellow nurses do on a daily basis to help provide excellent care to our patients & their loved ones.

If it isn’t apparent to you yet, let me just explain that, especially at night, there is no guarantee when a doctor will next see you or even look at your medical record.  Not to mention if you’re lucky doctors spend maybe 30 minutes a day with you, whereas nurses are with you for hours & hours each day, so inevitably we know you much better.  This is why it’s so incredibly important to have a very intelligent nurse because we’re the ones who are meticulously following your vital signs & lab results & keeping the doctors up to date on your condition so that nothing important is missed.  We’re the ones double-checking all your orders & making sure they make sense & that nothing has been overlooked.  I say none of this to make doctors look bad or appear incapable; I just realize that patient safety is every bit as dependent on intelligent nurses as it is on intelligent doctors.  Once you realize this too, I sincerely hope you will never again tell me (or anyone else) that I am “too smart to be ‘just’ a nurse.”

Despite the challenges & frustrations of my career, I'm still glad I chose nursing over med school.

Despite the challenges & frustrations of my career, I’m still glad I chose nursing over med school.

Murphy’s Law of Nursing


This post is meant to be entirely humorous & should not be taken to mean I hate my job.  Anyone who has been a nurse for more than a few weeks or months will smile & nod because you know these are all so true.

1. If you run out of alcohol swabs, saline flushes, tape, or any such thing it will always be while fully garbed in an isolation room.

2. If you bring more than one IV start kit, you will get it on the first try.  If you bring only one IV start kit, you’ll miss it & have to go back for more supplies.

nurse-cartoons-relevant-experience

3. Insulin drips, PD (peritoneal dialysis), & other such patients who require a reduced nurse to patient ratio will always come in 2’s & 3’s which will invariably screw with staffing.

4. Management’s idea of fully staffed will always mean no one ever takes vacation, gets sick or injured, requires surgery, has a family emergency, has a baby, or calls out due to fatigue & exhaustion.

5. The patients who are the sickest &/or in the most pain are often the least vocal about it, sometimes because they are truly too sick to waste energy complaining & sometimes because they “just don’t want to bother you.”  On the other hand, the least sick patients are often the ones with the longest list of demands, many of which are far from reasonable.

disatisffied patient

6. The most popular time to admit or transfer a patient will always be at the very beginning or end of the shift.  And they will always come in 2’s & 3’s & 4’s.

7. The doctors who are the most difficult to get up with in the middle of the night will always be the ones who never order any prn meds or anything that would help save you from having to wake them up at 0300.

8. The patients whose family members are really close to them & truly take good care of them are often the most reasonable & even downright helpful to the nurses.  On the other hand, the patients whose family has ignored them or cared for them poorly will often be the most rude, demanding, & generally impossible to deal with.  A lot of this probably stems from guilt & embarrassment of course, but it’s nonetheless a frustrating paradox to observe someone who has clearly ignored their sick mother for a decade suddenly  watch you like a hawk & quite literally TRY to find a problem with every single thing you do.

demanding patient

9. If you need to perform a STAT glucose check, that will be the exact moment that the glucometer needs to be QC’d.

10. The patient who needs 3 different IV antibiotics, blood transfusions, IVF, & Dilaudid/Phenergan on a regular basis will be an impossible IV stick.

iv cartoon

If you’re a nurse or anything medical, feel free to comment & share your own Murphy’s Law stories.  I’m sure there are tons more.  We really do have the best job in the world, but we have to be able to laugh at the absurdity of it all or we won’t survive.

 

 

 

10 Reasons Why Night Shift Rocks


Today is a special day for me because it marks three years that I’ve been working as an RN.  It is simply amazing to think of all of the things I’ve learned & experienced in just three years.  It feels like just yesterday I was that super-anxious new grad nurse, so excited to learn but so afraid to try so many new things.  Now I’m a charge nurse & preceptor; my, how things have changed!!

Three years ago I was also absolutely PETRIFIED to start night shift.  I was sure I’d never sleep again & that my whole life was basically ending.  I didn’t fall in love with night shift immediately, though I never hated it as much as I thought I would.  After six months or so at my first nursing job, I started rotating shifts so I could experience day shift as well & eventually went to straight day shifts.  However, when we moved to NC two summers ago, night shift was all that was available so I took it.  At first I told my manager I wanted to switch to day shift ASAP but after a while I changed my mind.  I found that the night shift routine had grown on me & for right now I’m not even thinking about going “back” to day shift any time soon.  With all of the negative things associated with night shift, I thought it would be fun to compile a list of all the reasons why night shift is actually AWESOME.

1. This is a generalization for sure, but I have found that IN GENERAL night shift nurses are the most fun to work with because they tend to be more laid-back & relaxed.  For someone like me who has her fair share of anxiety issues, it’s great to work with people who are more relaxed because that helps combat my own anxious tendencies.  I think part of the reason night shift nurses tend to be more relaxed is because the doctors are not quite as available to us, so we have learned to handle situations on our own.  This isn’t to say we don’t keep the doctors informed about what’s going on with our patients.  It’s just that we realize that every time our patient has a BP of 180/90 it isn’t the end of the world & if the doctor is busy & doesn’t call us back for an hour or more, it’s ok.  If you work day shift, please don’t be offended by what I’m saying here.  As I said, this is a GENERALIZATION & it probably has more to do with the way the shift itself flows than the actual people who are working it.

night shift humor

2. For someone like me who is mildly claustrophobic & despises crowds, day shift can be a little challenging because it is a CONSTANT CROWD.  A lot of the people who make up this crowd are tremendously helpful & often at nights we wish we had those folks around.  If your patient needs to leave the floor for a test any later than say 9:00 p.m., guess whose job it is to take them to the test (& possibly stay there to monitor them, depending on the test): yours!  There is no transport at night.  No PT/OT to help get the heavy or difficult-to-move patients out of bed.  No case manager to call when your patient’s wife is refusing the oxygen that is absolutely vital for him to go home.  No wound care nurse to assist with the crazy complicated dressing that you suddenly have to change at midnight when it gets soiled for various & sundry reasons.  No IV team to help with the impossible-stick patient who needs two different IV antibiotics, IV fluids, & K/MG replacement.  Basically there are a ton of great resources that simply aren’t available at night.  This isn’t to say we can’t provide the same level of care.  It’s just that as a night shift nurse you’re required to be extremely resourceful & figure out a lot of things yourself.  The upside though is that for someone like me who gets anxious in crowds, it’s really nice to feel like we “own the hospital” at night.  We definitely interact with other depts & certainly with patients’ families, but night shift is just not the same constant crowd, & for a socially anxious person like me, that is wonderful.

3. As I discussed above, night shift has a lot fewer ancillary depts to help the nursing staff which can definitely be challenging at times.  However, another upside to this is that night shift nurses of necessity build really great teamwork.  It’s not that day shift nurses can’t or don’t help each other.  They definitely do.  But on nights it’s just the bedside nurses running the show, for the most part.  Because we are less distracted by the various other depts constantly coming in & out of the rooms, we are better able to sense who’s struggling & step up to help each other, often without even being asked.  Nursing is definitely a team effort & on nights that is especially true.  Additionally, having great teamwork I believe builds greater job satisfaction which for me is definitely an added bonus.

4. Financially night shift is clearly the better option.  Night shift is hard on the body & mind without a doubt so there’s a reason we get paid more.  Of course the trouble is once you get used to that extra money, you don’t want to leave it.

5. You will definitely sacrifice sleep at times, but if you can learn not to sleep all day on your days off (which has never been a problem for me because I am not a night owl by nature), you can have a lot more “free time” to catch up on housework, doctor’s appointments, grocery shopping, & just life in general.  When I worked day shift I realized that I was almost as tired as when I worked nights & I felt like I had a lot less time to get things done outside of work.  And I was making less money!

6. Because there are fewer ancillary depts going in & out of the rooms & less chance of patients leaving the unit for tests & procedures, it is considerably more likely that you will have time to actually TALK TO YOUR PATIENTS with fewer interruptions on night shift.  Trust me, my phone still rings way more than I wish it did & inevitably that seems to happen when I’m starting an IV or having a crucial conversation with a patient, but in general I do feel that I have more time to get to know my patients on night shift.   Sometimes this happens at 0200 when they can’t sleep & just need someone to listen to them.  I do think night shift nurses are less likely to be remembered by patients (at least our names) because hopefully they do sleep for at least part of our shift, but I also know that being there for a patient in the middle of the night when they are tired, lonely, & afraid can be a truly rewarding experience.

nurse pic

7. It is true that it is very easy to gain weight on night shift.  (There have even been research studies showing all of the health dangers of night shift.  They’re very depressing so I try not to read them!)  I’ll confess that I gained about ten lbs my first year as a nurse, but at last half that time I was working day shift so maybe it wasn’t totally night shift’s fault.  Anyway, I managed to lose all the weight & more, & I’ve kept it off for almost two years now, all of which has been while working night shift.  The upside to this is that when you do learn to manage your weight on night shift, you will feel like an absolute rock star for proving all the statistics wrong!

8. There is a certain level of constant fatigue that accompanies working night shift.  Actually I think it might just accompany being a nurse in general.  (Or maybe just being an ADULT!)  Anyway, for me that background level of fatigue is actually a good thing because believe it or not, it calms my brain a little bit.  I’ve spoken to my therapist about this & she says it’s actually quite logical.  For someone like me whose mind is constantly GOING, GOING, GOING like the Energizer Bunny, having a certain level of background fatigue can slow the “wheels” down just enough so that I can actually focus better & function optimally.  It sounds totally backwards I know.  But I swear it is true for me.

9. As I’ve mentioned previously, there are a lot less people around on nights.  One of the positives to this is that night shift nurses can (& do) talk about anything & everything.  This leads to some seriously hilarious conversations that are probably not fit to post here.  😉  But trust me when I say we have a lot of fun.  Of course nurses of necessity have a very twisted sense of humor so our idea of what is funny is often a bit “off” anyway.

sense of humor nursing

10. As I mentioned at the beginning, I DREADED night shift.  I had serious anxiety about it for MONTHS before I even graduated because I knew as a new grad nurse it was inevitable.  However, realizing that I can not only handle working nights but actually ENJOY it has brought me a tremendous sense of accomplishment.  Furthermore, it has reinforced to me that often the things we dread in life can actually be blessings in disguise.  I guess what I’m trying to say is, never say never.  I never thought I’d be happy working as a night shift nurse but here I am doing it & loving it.  🙂

15 Reasons Why Nursing is the Best Career Ever


Those of you who know me in real life may be aware that I spent a great deal of time pondering whether I should attend nursing school or medical school.  For a number of reasons I chose nursing, not the least of which was my scholarship to attend nursing school.  Even after graduation & moving on to “the real world” for a while I still had a lot of days (or nights) when I wondered if I’d made the right choice.  To further complicate matters I’ve even been told by well-meaning but clueless folks “You’re too smart to be just a nurse” or some variation on that theme.  Those comments used to really bother me & I couldn’t help but wonder for a while if maybe there was some truth in them.  But the longer I’ve been a nurse the more I’ve realized that being “smart” has little to do with whether one should be a doctor vs a nurse (or anything else for that matter).  Both fields require a great amount of intelligence along with many other important skills.  For right now I’m very content that nursing was the right path for me.  Someday I will probably “move on” to nursing education, Nurse Practitioner, or maybe even med school.  I’m not ruling out anything at this point.  But for right now nursing seems to be a perfect fit for me & I’m so glad I chose this path.

nursing humor

To be honest when I decided to attend nursing school I intended to be a bedside nurse for only a few years, maybe 5 years at most.  My sole intention was to advance to being an NP.  However, it didn’t take long for me to realize that I actually love bedside nursing, a lot more than I honestly thought I would, & I’m in no hurry to leave it.  Yes, I have stressful shifts in which I wonder why the heck I chose this profession, but thankfully those are few & far between, & even on those shifts I know that I’ve made a positive difference in someone’s life in some way, no matter how small.  I’ve been blessed to work with some AMAZING people at both of my nursing jobs, from fellow nurses & nursing assistants to doctors & respiratory therapists.  What I’ve realized is that in healthcare (as everywhere) no man (or woman) is an island.  None of us can do our jobs alone.  I am not one of those nurses who feels the need to “cut down” doctors or compete with anyone for attention or glory.  The truth is every single healthcare team member is irreplaceable.  From housekeepers to nursing assistants, from doctors to pharmacists, from physical therapists to nurses, we are all invaluable.  And our patients receive the best care when we treat each other with the respect & dignity we all deserve.

With this being nurses’ week I’d like to send out a salute to all my fellow nurses for the excellent care you provide in whatever function you serve.  I’d also like to share what I believe are some of the best things about the nursing profession & why I can’t imagine a better career.

1. OPTIONS.  I for one cannot think of any other career in which you have as many options as nursing.  In the hospital alone, nurses can work everything from ortho & med-surg to ICU & ER to OR & endoscopy.  Or we can select a specialty like wound care, case management, or infection control.  If we tire of working with adults, we can switch over to babies or children or vice versa.  Outside of the hospital nurses can work with hospice, home health, or in nursing homes or other long-term care facilities, schools, & clinics.  With additional training we can move on to nursing education, Nurse Practitioner, Nurse Anesthetist, management & administration, informatics, & many other roles.  The possibilities are truly endless.

2. Working 3 days (or nights, if you’re a night shifter like me) a week is awesome!!  I truly do not think I could ever return to the 9-5 grind.  Such a pain in the butt!  I love working my 3 12-hr shifts & then being done for the week.  Yes, I have NO LIFE outside of the hospital for those few nights but when it’s over, it’s over & I have more time left over for just LIVING.

3. Working with sick people is a constant reminder that life is short & good health & long life are never guaranteed, even for the young & seemingly invincible.  Since becoming a nurse I know I live my life with greater purpose & intention.  I hold those I love closer.  I don’t take tomorrow for granted as much.  I appreciate my good health & work harder to maintain it.

stethoscope

4. It’s often been said that nurses “eat their young,” & lateral violence is a well-documented phenomenon in the nursing world as well as in the healthcare field in general.  However, I must say I am blessed to have never really encountered this kind of behavior.  On the contrary, the nurses and nursing assistants I have worked with have been some of the kindest, most intelligent & hard-working people I’ve ever known.  From relatively new nurses in their 20’s like me to experienced nurses in their 50’s & 60’s, we all have so much to offer, & I’ve learned so much from my coworkers, not just about nursing but about life.  Some of my best friends are other nurses & I love you all.

5. Nurses can talk about ANYTHING.  And I really do mean anything.  If you’ve ever had a gross question about the human body, as a nurse you can ask it in front of your coworkers with no fear of embarrassment or scorn.  No topics are off the table with us.  It’s so much fun, trust me!

6. Nursing is never boring, at least any field I’ve worked in thus far has never been boring.  Whenever I have free time at work, there is always something to be done, from organizing supplies to helping out my coworkers with their patients.  Though I certainly have a routine, no two shifts are ever the same.  I never know what I’m going to see or encounter at work & that is part of what makes it so exciting.

7. On a similar token, the learning never ends.  I’m constantly taking classes to further my nursing knowledge or to learn about a new technology, piece of equipment, or computer system.  The continual learning curve, I believe, keeps my mind stimulated & interested & hopefully young as well.

8. Hearing a patient say thank you is one of the greatest feelings in the world.  Sometimes they don’t even say it but you can see it in their eyes & their smile.

9. Watching a patient who you thought would never recover start to improve is so inspiring.  I’ve seen patients I thought would never leave the hospital alive, much less walking & talking, recover & prove me wrong in so many ways.  Of course I’ve also seen lots of horribly sad things, but in order to survive in nursing you have to focus on the good stories.

10. As I emphasized previously, healthcare is always a team approach.  No one saves a life on his or her own.  But I know without a doubt that there have been times in my nursing career when my own critical thinking & quick actions, along with the help of others, have quite literally saved a life.  I can’t describe to you how great it feels to know you’ve helped save a life but those of you who’ve been there know what I mean.

11. Nursing is hard.  There are times when you will want to quit.  There are times when none of the stress seems worth it.  But the bad days make the good days sweeter.  And the challenges remind you that this really is a worth-while career.  As so many wise folks have said before, nothing good ever comes easy.  All jobs are hard at times & everyone has bad days.  But at least when I have a bad day as a nurse, I still know I’ve helped someone, & that makes the bad days easier to tolerate, at least for me.

12. Helping someone die peacefully & helping their family process this loss is one of life’s greatest challenges but also one of life’s greatest rewards.  There are some patients you will see more often than your own family members & losing them will be very difficult.  But knowing you made their last few days, weeks, or months at least a little more comfortable is an incredible blessing.

13. I don’t do OB nursing & never plan to, but I did get to witness both a C-section & a vaginal birth in nursing school & both were amazing experiences.  Though it’s not something I ever plan to pursue as a career, watching a baby enter the world is pretty miraculous.

nurse comic

14. I know it may seem unlikely that a profession that centers on caring for the sick & dying could possibly be humorous, but trust me when I say I’ve laughed more at work than almost anywhere in the past few years.  From crazy things that patients say (both confused & not confused) to crazy discussions with coworkers & everything in between, I’ve laughed a lot as a nurse the past few years.  And also trust me when I say that having a “wicked” or “twisted” sense of humor is a serious requirement to survive in the healthcare field.

15. Nursing will change you.  If you work in a healthy atmosphere & can maintain a positive (but realistic) attitude, nursing can & will make you a better person.  I know nursing has made me more confident, more resilient, more assertive, & so many other important things.  When I think about all the times I’ve stayed up 24 hrs straight or worked on just a few hours of sleep & still balanced the needs of 3-5 challenging patients, I think “Motherhood might be doable after all!”  In all seriousness, this profession does change you.  It will expose you to a lot of dark, scary, & tragic things.  You will see the “underbelly” of humanity so to speak.  But you will also see wonderful, life-affirming things that will renew & restore your faith in humanity.

If you’re a nurse, I hope this post has helped to remind you why our profession really is so amazing.  If you’re not a nurse, say thank you to those nurses who’ve helped you during times of illness or injury.  Trust me when I say you will make their day by doing so.

 

10 Life Lessons Nursing Has Taught Me


It’s probably been said a million times before but it’s worth repeating: nursing isn’t just a career; it’s a profession.  Some would even say it’s a calling.  In any case I can’t believe that in just under two months I will have been a nurse for three years.  It’s absolutely mind-blowing to think of all the things I’ve learned & experienced in just three years.  But it’s not just “nursing knowledge” that I’ve gained.  The things I’ve learned as a nurse are just as often lessons about life itself.  These lessons are actually very universal but I feel blessed to have chosen a profession that really does MATTER, a profession in which no matter how stressful or busy my shift may be, I still know I did at least a few things to make someone’s day a little better.  And I feel blessed to be in a profession that because of all these things brings continual growth to me as a human being. 

Today I would like to share the ten most important life lessons I have learned in my first three years as a nurse.  In ten or twenty years I’m sure I’ll have plenty more to add to this list & then it will be even more interesting to look back on these.????????????????????????????????????????????????????????????????????????????????????

1.  Life is way too short to do anything but have as much fun as you can.  I’m not trying to say we should just party it up all the time & neglect our responsibilities in life.  But what I am saying is that NONE of us, no matter how young or old, is guaranteed tomorrow, so no matter our current circumstances we need to truly make the most of every single day we’re alive.  Whatever goals or dreams you have in life, chase them NOW because you never know when you might not have the opportunity again.  If your current circumstances in life are making you miserable, find a way to change them, & if that’s impossible then change your attitude.  Life is far too short to be miserable all the time.

2.  On a similar token, life is often cruelly unfair.  Bad things happen to good people ALL the time.  It’s horrible & it can & will make you question everything you’ve ever believed, especially when you’re still young & vulnerable & trying to figure out life.  But that’s ok.  Question away.  Just don’t let bitterness take over or you will be of no use to anyone, including yourself.  At the end of the day if there is a purpose to life, it’s very simple: the purpose of life is to live it, to soak up as many experiences as you can, to have as much fun as you can, & to give & receive love as much as is possible. 

3.  Life is what we make it.  As mentioned above, circumstances are often unfair & not entirely within our control.  But our attitude about them can make a world of difference.  It’s perfectly normal & acceptable to experience sadness & anger when bad things happen, whether in relation to our health or otherwise.  But if we never move past this stage, we will be miserable forever.  We have to learn to process our emotions & move forward in life no matter what hardships we’re facing.  As Pema Chodron so wisely stated “Nothing ever goes away until it has taught us what we need to know.  If we run a hundred miles an hour to the other end of the continent in order to get away from the obstacle, we find the very same problem waiting for us when we arrive.  It just keeps returning with new names, forms, manifestations until we learn whatever it has to teach us…”  For example, I’ve seen diabetics on dialysis in their 20’s & 30’s because they have refused to deal with their disease in a responsible manner & have continually not taken care of themselves at all.  These people are often obviously in denial of how sick they are but this “protective mechanism” of denial does not protect them from the physical consequences of their disease.  I’ve also seen diabetics who are in better shape & better health than most non-diabetics because they have a good attitude & take care of themselves, even though it is not easy.  Please don’t think I’m saying those who suffer negative outcomes, especially at a young age, DESERVE those things.  Of course not.  I’m just saying we cannot always control the cards we’re handed in life, but we can control how we play them.end of life

4.  Tragedy will prove the mettle of a family.  Families who are close are better able to handle tragedies because they have made plenty of good memories together & have actually had those difficult conversations about end of life issues.  Families who aren’t close will be completely ravaged by tragedy & are often unable to let go because they realize, far too late, what they’ve neglected.  It can be gut-wrenching to watch families break down during tragic experiences, but what we as nurses learn from this is that we need to have those difficult conversations with our own families.  No matter how awkward it may be, we have to talk to our loved ones about what they would want done if they had a massive stroke, car accident, or some other tragic injury in which they become incapacitated & unable to speak for themselves.  Whether you’re in the medical field or not, please think about these issues.  I don’t care if you’re 20 or 50 or 80.  You NEED to think about these situations & make your wishes known.  And you need to know the wishes of your loved ones.  God forbid you should face such a horrible scenario but if it should happen, it is better to be prepared & have some kind of plan than to have to bear the responsibility of making those decisions without knowing what your loved one would want done.

5.  Nursing has taught me that I can handle WAY more than I thought I could.  I can be up all day & work all night with no problem (not every night of course but sometimes).  I can take care of between 3-5 sick patients & still get my charting done & leave on time at the end of my shift (most of the time).  I can start IVs on people who have almost no veins to offer (not always of course, but more often than I ever dreamed possible).  I can help families process the impending death of a loved one.  I can hug & cry with family members when that death occurs.  I can clean up any & all body fluids without feeling nauseous (at least 99% of the time).  I can call a doctor at 3:00 a.m. & know exactly how to sum up the situation & what orders I need in two minutes or less.  I can leave my lunch to go collect a stool sample, wash my hands, & go right back to eating like that is completely normal.  I can be hit, kicked, & scratched by confused patients without losing my temper.  I can be yelled at by angry patients or family members without wanting to run out of the room crying (ok, sometimes I still want to but I don’t).  I can call a family member in the middle of the night to tell them their loved one might not make it till morning without breaking out in a cold sweat.  I can make patient assignments for the next shift even though I know that no matter what I do there will always be someone upset with their assignment.  I can listen to all kinds of crazy stories from patients, some confused, some not, without batting an eye.  Basically I can do so many things that I never thought I could do & this gives me the confidence to know that I can accomplish just about anything, at work or at home, if I work at it hard enough.  Some things will be incredibly difficult at first but practice really does make perfect, or at least close to it.

6.  Sometimes people can be incredibly stupid.  If you’re not in the medical field, you would not believe some of the crazy things we see & hear in the hospital.  Sometimes it’s enough to really make you question humanity.  But as nurses we have to learn to let it go, to remember the patients who make it all worth it, & to understand that the stupidity we see is often rooted in ignorance & lack of education.  Some of this is willful ignorance for sure, but some of it is not.  If I ever become so jaded & cold that I cannot see the good in others, I pray someone will tell me STAT so I can leave nursing because that is the point at which I would be useless & no longer worthy of this profession.  But I hope that day never comes.

7.  If you don’t take care of yourself, you cannot take care of anyone else.  Yes, as nurses we all have shifts when we go 8 hours or more without using the bathroom, eating, or drinking a sip of water.  But we can’t let this become the norm or we will burn out completely.  This concept is why I only work OT once a month at most (occasionally more if there are special circumstances but those are rare).  I know that no matter how good the money is, working OT every week is just not worth it.  I know I need my days off to relax & recharge in order to be mentally & physically capable of being the best nurse possible, not to mention the best wife, friend, daughter, etc.  Nursing may be a calling but it isn’t our only calling in life.  If we let it overwhelm us & take over our whole lives, we will soon find that the joy of it has been lost anyway.burnout

8.  There are a lot of people who love to complain but don’t want to actually do anything to effect change.  This is applicable to coworkers as much as it is to patients.  We all have to vent sometimes, especially in a profession as busy & stressful as nursing.  But we need to be conscious of how much we’re just complaining without actually accomplishing anything.  Trust me, I see things that anger or frustrate me all the time.  But I try to come up with practical solutions to as many of these problems as I can.  Otherwise I know I’m just spreading negativity & bringing everyone down, including myself.

9.  Change is hard.  Whether it’s a new computer system, a new policy, or a new piece of equipment, there is a learning curve for everything in nursing.  As human beings none of us really LIKES change.  It’s hard for everyone.  But if we want to survive as nurses we have to learn to adapt constantly & the same can be said of life in general.  In nursing, as in life, there is always something new to learn & that is part of what makes this such an exciting & interesting profession.  Not a night goes by that I don’t learn something new & I love that.  It’s what keeps me engaged when I’m exhausted & wondering why the heck I chose this path anyway.walk two moons quote

10.  Going back to the first point, life is way too short to stress about things that really don’t matter.  As one of my favorite books (Walk Two Moons by Sharon Creech) put it, “In the course of a lifetime, what will it matter?”  I try to ask myself this question when I find myself stressing about something that I know probably isn’t worth the anxiety it’s causing me, whether at work or at home.  This is exactly why our house is usually a wreck & I’m chronically behind on housework.  I realize that at the end of my life, whenever that may be, I’d rather have spent my free time cuddling with my husband & my puppy or making memories with my family & friends than obsessing over having a spotless house.  Trust me, I’m not living in a pig-sty, but our house is far from super organized & I could not care less.  Our house will never be featured on some kind of interior decorating blog or be filled with Pinterest-inspired crafts.  But it is full of love & affection & that is what matters in the end.  By all means, if having a spotless house brings you joy, feel free to keep it up.  I’m just saying we shouldn’t waste our precious time on things that really don’t matter if they aren’t also bringing us joy.  When I’ve cared for patients at the end of their lives I’ve never once heard someone say they wished they’d spent more time cleaning or organizing their house or working or doing any of the mundane things that so often stress us on a day-to-day basis.  Instead what I’ve heard is “I’d wish I’d spent more time with my friends & family.”  Or “I wish I’d learned to play the piano like I always wanted.”  Again it comes back to what I said at the beginning: life is far too short to do anything but have as much fun as we can. 

If you’re a nurse (or anything medical) & you’re reading this, what life lessons do you think our profession has taught you?  I’d love to hear your thoughts.

The Hardest Person to Forgive


Today’s blog post explores an idea that is certainly not original by any stretch of the imagination but it’s something I believe is very much worth exploring nonetheless.  Regardless of what, if any, religious affiliation you associate with (or associated with in the past), we hear a lot of talk about the importance of forgiving others & not holding grudges or allowing ourselves to become bitter toward those who have hurt us.  These ideas are of course very important because we cannot have peace in our own minds when we are not at peace with others, at least as much as is possible.  As hard as it can be to forgive others, when given some thought I believe most people would agree that oftentimes the hardest person in life to forgive is yourself.  Today I would like to explore why that might be and why it’s so important to learn to forgive ourselves no matter how difficult it can be at times.

forgiveness

If you have ever taken any kind of basic psychology course you probably discussed the well-recognized phenomenon in which victims of child, physical, or other types of abuse very often blame themselves for the abuse which they have suffered.  At first glance this may seem extraordinary & impossible to believe.  But delve a little deeper & one can reason that perhaps it is easier to believe that you made a mistake or somehow provoked the abuser to hurt you than to believe that someone, particularly a family member, romantic partner, or friend (indeed someone who should have been protecting you, not hurting you) actually CHOSE to hurt you & is thus truly a very screwed up individual.  Rape victims often are also perfect examples of this phenomenon.  Indeed society does a great deal of blaming the victim as well because frankly it is easier to believe that a woman (or man) provoked such a horrible thing to happen than to believe that there are such evil, disgusting people in this world.  This of course only serves to perpetuate the cycle of victims blaming themselves & being unable to forgive themselves for something which in reality is not even their fault.

However, we certainly don’t have to be abuse or rape victims (actually, I don’t like that term; let’s say survivors) to struggle with self-forgiveness.  How many times a day do most of us berate ourselves for not eating healthily enough, weighing too much, not saving enough money, or countless other things?  I’m not saying these aren’t worthy goals, they surely are, but sometimes I think in our haste to berate ourselves for our poor decisions we actually hinder our own progress.  Sometimes in our quest for perfection we miss the beauty of life that is right before our very eyes.  Indeed, we focus so much on our mistakes that we have no energy left over for actual self-improvement.

One of the greatest lessons I think we all have to learn in life is that there are going to be days when we just don’t like ourselves because we simply aren’t as “perfect” we want to be.  For example, as a nurse I know I have had to come to terms with the fact that I am not going to feel 100% compassion for every patient every time.  Naturally I want to, but sometimes it just doesn’t happen because I am just as human as everyone else.  And I have had to learn to forgive myself for this & to know that as long as it doesn’t prevent me from providing excellent care it’s ok.  Learning to forgive myself for not being the perfect “angel of compassion” at all times actually helps me to more quickly recognize my own prejudices & then set them aside & provide the best care possible at all times.  For example, when I have a particularly trying patient who is rude & dissatisfied with her care no matter how many times I bend over backwards to try to meet her needs, I have to remind myself that it’s ok to be annoyed with her.  It’s ok to mentally roll my eyes at these things.  I just have to possess the self-control to not allow these feelings to come across to the patient & to not allow those feelings to so overwhelm me that I become bitter & angry toward that patient or anyone else.  I have to see beyond the annoying behaviors to the hurting person inside.  Having come to these realizations has actually helped me to have greater satisfaction in my nursing career &, though I have no scientific way of validating it, I truly believe it has made me overall a more effective nurse.

I believe this idea is also very important for parents.  Though I am not a parent yet I hope to be one someday, & I know when that day comes there will be times when I look at my children & wonder “What the hell was I thinking?!”  And I will have to learn to forgive myself for those thoughts, to remember that every parent feels that way at times.  AND IT’S OK.  Similarly, in marriage or any serious relationship there are times when you look at your partner & wonder what you are doing with this person.  AND THAT’S OK TOO.  Being frustrated or upset with your partner or your child doesn’t make you a bad person.  It just makes you a PERSON.  The important thing is to be able to recognize these thoughts when they occur, handle them as objectively as possible (by that I mean not beating yourself up over them, just recognizing them for what they are: a sign of your own beautiful humanity), & moving on in the knowledge that as long as these thoughts don’t become the overall theme of your life, they’re not a big deal.

Another situation in which I believe we struggle with self-forgiveness is with regret.  I feel fortunate to say I truly do not have a lot of regrets in my life, but I do struggle with forgiving myself for those few I do have.  However, what I am slowly learning is that self-forgiveness is an absolutely vital step in preventing myself from repeating the same old mistakes.

I guess my point with this post is that I truly believe that we cannot move forward in life without self-forgiveness.  As long as we wallow in guilt & self-hate we are stuck in a self-perpetuating negative cycle.  Life would be a lot easier if we could just magically forgive ourselves (& others), but that’s just not the way life works.  As with almost everything in life, self-forgiveness is a process.  It’s an everyday event that requires conscious awareness & effort.  I hope that as you’re reading this you don’t think I’m making excuses for bad behavior or encouraging you to not feel guilty for things that you know in your heart are wrong.  Of course not.  What I am saying is that we cannot truly improve ourselves without self-forgiveness.  We hear so much in society about the importance of showing compassion to others & there’s no doubt that this is indeed most vital.  But just as vital is showing compassion to yourself.  There’s a fine line for sure between being compassionate toward yourself & making excuses for yourself.  But the line is there & it’s our job as human beings to stay on the former side of it.

To be perfectly honest this post feels quite like word vomit to me at this point.  There’s so much I want to say & the words just aren’t coming to me tonight.  Though I have fumbled through the words, I hope the passion I feel for this matter has somehow come through & that at least one person who reads this will be encouraged to begin the process of self-forgiveness & moving toward a brighter tomorrow.

I’d love to hear what you think on this matter.  Am I speaking to the wind or does any of this make sense?

Inexplicable Anxiety


Chaucer on his first ever beach trip back in July at Jockey's Ridge St Park in Nagshead

Chaucer on his first ever beach trip back in July at Jockey’s Ridge St Park in Nagshead

I don’t really know why I’m posting this.  I’m not sure that it will be interesting to anyone else.  But writing is one of the best ways to temper my anxiety & I figure there are probably other people out there who can relate to my struggles.  So here goes . . .

Today started out with me getting up early with Jared & feeling really content with life. We went to the farmers’ market & got breakfast at the restaurant there which we had never been to before. It was a fun way to start the day & I was in a great mood for no particular reason. And then, for no particular reason, that mood crashed & burned like a rocket falling out of the sky. Some days my anxiety just comes around a corner & chokes me before I even realize it’s happening. It’s maddening to say the least. My therapist has been helping me to slowly identify some of the triggers for my anxiety which has been very therapeutic for me. After all, if you don’t know the cause of a problem, how can you hope to cure or treat it? But I still have days like today when I am just inexplicably anxious for no apparent reason at all.

I have often said that I am the best version of myself when I’m at work because as a nurse I get to focus all of my obsessive tendencies onto caring for other people, including my patients & their families as well as my coworkers. I love helping out my fellow nurses as much as I love caring for patients. I’ve always known that I feel a very urgent need to have a job that is important & meaningful, which is one reason why nursing is such a great career choice for me. So even if I have a bad shift, which is inevitable from time to time, I can always leave the hospital knowing I in some way made someone’s day a little better.

It’s when I’m at home on my days off that my anxiety is often the worst. As I’m typing this I realize how ridiculous that must sound to anyone who doesn’t know what it’s like to suffer from some form of anxiety. But it’s true nonetheless. I don’t know how to explain this without sounding like some miserable frump who doesn’t know how to have fun & enjoy her life. I promise I’m not like that at all. I love music, books, & spending time with my friends & family. I love the feeling of a crisp fall breeze, the smell of sweet potatoes baking in the oven with cinnamon, the thrill of hiking in the Blue Ridge & marveling at the majestic mountains, the heart-melting experience of cuddling with an adorable puppy, & so many other little things in life that truly are the very essence of our existence. Yet may I just say that there are days like today when I feel like the world benefits from my overly driven but caring personality while I sit here wondering what the heck I’m getting out of this deal? And may I just say that I already feel incredibly guilty for even thinking such a thing much less actually writing it? But it is what it is nonetheless. As I’ve said many times before, emotions aren’t sins in my book. Emotions are what make us alive. As long as we’re feeling, we know we’re living. It’s what we do with our emotions that matters.

So for now I’m going to play with my puppy (Chaucer) who follows me around the house constantly & insists on sitting in my lap just about every waking moment & thus clearly thinks I’m the world’s best puppy mommy. And I’m going to listen to music that inspires me & reminds me that though I may be struggling with my anxiety more today than yesterday or the day before, I’ve walked this road a thousand times before. And, as it has a thousand times before, it will end. I will always have my “bad” days like this, but I will always have my good days too. And even on the bad days I can see the proverbial light at the end of the tunnel. And I know that my anxiety doesn’t own me. It doesn’t define me. It’s just a part of me. Just one small part. After all, if Chaucer thinks I’m awesome I must be.   🙂