Not Just Math and Science

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I recently remembered something that I had pretty much forgotten: being a nurse requires creativity. Being a nurse means you are a creative person.

Let me back up. My husband and I have been talking a lot about creativity lately- what it is, what it means, what it looks like- because our definitions have grown very skewed, a veil over our eyes that has kept us from being able to identify it in ourselves. It’s not that we aren’t creative or full of ideas; we just have been labeling it as that. And that truly is a loss, as we have discovered.

For most of my life, I have equated creativity with artistic proclivity such as the ability to draw or paint or sing, usually materializing in the form of someone with brilliant tattoos who carries around an expensive camera at their side. Someone carefree and whimsical, someone with visions of grandeur and a disregard for menial things like budgets or timelines. And that is definitely not me. Before I started really delving into writing, which is very clearly a creative endeavor, and before my husband started calling out these qualities in me, I saw myself as linear, rationale, organized. I even had a nickname of being the “rationale” one, which I never really contested, although I always felt a bit hurt by the label. I didn’t want to be uncreative (aka boring) and I didn’t want to always be the reliable one. But in the midst of a strict nursing schedule, work out schedule, and stringent eating requirements, I figured everyone else was right. I wasn’t creative.

To make a long story short, my husband Seth has helped me over the years to realize that I am not only very creative but that even during that time- when I was working full time and seemed to be very organized- that I was operating in creativity because I was a nurse. And nursing requires a very unique type of creativity that many nurses don’t realize. And I’m writing this blog post because I wonder how many nurses feel the same way? That you are the sum of rules and time tapes, medication deadlines and charting restrictions, rather than dynamic problem-solver who manages one of the hardest jobs day in and day out. Admittedly, it is less fluid than being a freelance photographer but it’s no less artistic. I’ll show you what I’m getting at.

Say you have two ICU patients, one is sick and you’re titrating Levo and Vaso and running fluid boluses. You’re managing a vent, a feeding tube, an A line, a central line and you’re busting it to make sure the bags don’t run dry, the pressure doesn’t fall too low, the patient gets turned. Now in your other bed, you’ve got a walkie talkie who needs ice chips and to take a walk and some help in using the urinal (omg seriously, can you not do it yourself??) But you’ve found yourself in a tricky situation where you’re needed in both places and yet you can’t be there. You’ve got to find a way to elicit help from others, delegate, and prioritize in order to keep everyone safe. In that moment, you’re not worried about getting your charting done on time; you’ve realized that there are bigger things going on and that you’ve got to find a way to make it all work. And you do. If you’re a bedside nurse, you’ve got loads of creativity leaking out of you as you problem-solve every hour of the day, as you communicate with difficult family members or staff, as you form a picture in your mind that is so much more than tasks. As you impact people, who are so not linear.

When I was functioning as the family care nurse in the ICU, helping to coordinate donor patients, family meetings, and a whole host of other miscellaneous jobs, I had an encounter where I found myself completely in over my head. A grandmother was dying and the family was bent on blaming someone, so naturally, that became anyone in sight. The physicians, the hospital, even me. They were grieving an inevitable, natural death but they didn’t know how to process it and so the situation became riotous. With the entire family running back and forth from the hallway to the room, yelling and cursing, shouting into the air, it was my job to do something. They were scaring the other patients and it was quickly approaching a level where I would need to call the police to intervene. This kind of behavior wasn’t good for anyone and it couldn’t go on.

Then I did something that was risky and possibly even uncouth, based only on a gut feeling, a thick skin, and the kind of courage that only a nurse can have. But I did it because I was responsible for finding a solution to this problem and I would go down trying. At 26 years old, barely strong enough to pull a woman twice my size, I dragged the mother, the leader of this family riot, into the hallway and out of the ICU. Once out the door, I whipped her around to face me while she kept yelling, not even saying comprehensible words, and with my blue eyes blazing, I told her to shut her mouth, probably in about as many words. I will never forget the look on her face as her jaw dropped to the floor, stunned into silence. She immediately stopped talking, probably out of complete shock that this tiny white girl would command such a presence before her, and started to listen to me. We stood in the hallway and I explained, clarified, comforted, snapped her back to the reality of the situation and twenty minutes later she was hugging me and thanking me for bringing her back down to earth. Was that rational? Definitely not. Was it even the most logical solution to the problem? Probably not. But thank God it worked because I had to get creative to stop the mayhem and restore order. I had to find a way to make this better.

As I prepare to start NP clinicals, I find myself training for similar scenarios, ones that require a depth of understanding and communication that goes far beyond training in a classroom. Skills that only come from experience and freeform thinking, skills that are born out of creativity. How do I get someone who has been smoking for thirty years to consider quitting? Do you think telling them that smoking is bad for them and that they should quit is going to work? No, it won’t. They’ve heard it before. But if I can get them to think about what they might lose or how far they would have to get before considering stopping, then maybe I’m getting them somewhere. Closer to where I believe they should be. And this is only one of so many scenarios that I will encounter in primary care that require finesse in order to solve.

Everyone has heard from a nursing instructor or a textbook that nursing is an art, not just a science. But I wonder how many of us have lost that realization, who don’t acknowledge that what we do everyday requires intense problem-solving, creative solutions, and out-of-the-box communication? It’s more than giving meds on time, keeping people from dying, clocking in and out, and administering health advice as a provider. Being a good nurse or NP requires accessing that core creativity that each of us possesses and using that to excel at our jobs.

Some people probably doubt that creativity inside of them and that’s a shame. It’s part of what makes us human, relatable, and worthy of confiding in. But it’s true. Nursing is so much more than math and science. In fact, I would venture to say that nurses are some of the most creative people in the world.

60 Minutes for my Sanity

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On a typical day I only get 45 minutes, or 30. Or none. So honestly most of the time 60 seems near impossible, especially with a little one at home. But 60 minutes for what? To keep my brain, my heart, my soul alive. 60 minutes, taken in three chunks, to keep my sanity. I had gotten out of the practice of stepping back, away from my responsibilities and school work, to enjoy something that gave me life, something that would lend some perspective. But I’ve taken some steps towards balance over the past few months and I’ll explain why and how. And before you completely discount this post, like I would’ve, because I’ve already used the words “balance my life” and “perspective,” keep reading.

For the past year and a half now I have essentially been a stay-at-home mom with the caveat that I’m getting my masters online to be a nurse practitioner. In a few short weeks I’ll go skipping off to clinical three days a week and I’m sure I will miss my daughter terribly. I’m trying to soak up every minute that I have left with her this summer, knowing that this could very well be the end of my time as a SAHM, which is bittersweet for me. I’m looking forward to having a career and being a mom. A BOTH/AND situation.

But despite encountering the trials and joys of caring for a tiny person 100% of the time, I’ve always kind of laughed at the modern convention of “take time for yourself” as if this was akin to meditating for hours or using your “stressful” life as an excuse to splurge on pedicures and spray tans or go on golfing weekends. What mom has time for that? What working dad with a family finds this feasible? The terminology seemed frivolous to me; the ideas self-centered. I would gladly take the time to watch a show or read a book or, let’s be honest, simply take a shower, when my husband would offer but I couldn’t condone “putting myself first” on my own initiative if that meant neglecting some other duty (dishes, school work, laundry, phone calls).

But then something happened a few months ago that shook me up. It forced me to examine my patterns of behavior and thinking. And after some contemplation, I realized that while some of those patterns were productive, others were very destructive. Because of all of my denial of self, my masochist productivity, the giving up my free time for the betterment of those around me, I realized that I might actually lose my mind if I didn’t reorient myself within my day. I had lost the ability to get outside of the walls of my home and see the bigger picture. I had to change something. (As an aside, I think it may actually be MORE important for parents that stay at home all day with their children to do this as you never get a moment of your own. And, of course, the laundry will always be there so it can wait a few minutes, as much as that empty box on your daily checklist will haunt you.)

This episode of contemplation was essentially brought on by anxiety, by a culmination of stressors that poked me enough times in the side until I was forced to acknowledge it. It wasn’t even one big thing, just a compilation of small jabs that eventually festered into a wound that spread, infecting me with anxious thoughts and a depressed mood. I had to make some changes and that meant portioning out my time in small increments throughout the day to do activities that weren’t related to responsibility. 20 minutes in the morning, 20 minutes midday and 20 minutes at night. Hence, the total 60 mins.

I make my best effort to get up before my daughter wakes up. I attempt to sit on the couch, drink my decaf coffee that my husband made before he went to work, and spend some time remembering who I truly am. Sometimes this means reading the Bible, other times praying or journaling. Even a few times where I did nothing at all except keep silent. You can call it a quiet time or whatever else you want but it’s more than reading, more than learning. If I don’t remind myself of my true self- that I am a daughter of the King, that this world is at war, that God has called me for a purpose outside of solely being comfortable, happy and healthy- then I have already lost for the day. I will surrender to materialism and vanity, to productivity and anxiety. Although these shifts happen gradually and insidiously, they are vitally more dangerous and I have realized that without that 20 minutes in the morning, even ten, even five, then I am already running uphill and I will miss what God has for me.

My next twenty minute increment comes after I put my daughter down for a nap in the afternoon (or leave her in her crib for a few minutes if she refuses to nap). This is when I try to exercise and honestly I’ve been terrible at “making time for myself” in this area ever since my daughter was born. Some of it was health issues, some an insatiable need to do school work, but I realized that I didn’t need 20 more minutes of studying. I needed to take a break. So now I work out in my living room while I watch my stupid TV show and I try to let my body breathe, to exhale some of that anxiety that builds throughout the morning. Of course as a future primary care provider I highly suggest that everyone exercises at least a few times per week. There are endless health benefits as most people know, but they go beyond the physical. I had heard people talk about the benefits for mental health but I had never understood how vital that was until now- serving literally as my jolt back into the greater reality outside of what catastrophe will surely occur if she misses her nap today. I don’t have time to explain the physiologic ins and outs but exercise clears the head, suppresses anxiety, and energizes for the rest of the day. I have noticed that on days I don’t exercise, I feel apathetic, lethargic and irritable. Now, I can’t seem to go without those twenty minutes no matter what, like an addiction to something so good for me.

The last twenty minutes ends up somewhat fluid because this depends on our schedule and how tired I am but I try to reserve that time at night so do some reading or writing that’s not perfunctory. Fun reading. Fun writing. Stretching my creative mind, utilizing talents that threaten to go dormant, filling my soul back up for the next day. God without a doubt speaks to me through both reading and writing and it’s another way for me to communicate with Him during the day, just like exercise, just like my morning quiet time, giving the day a nice “full circle” feel. But really and truly, these things are essential to who I am. I can see my life more clearly; I feel like these are the moments when I really come alive amidst the daily chores and hassles. I look forward to it. I yearn for it. So I make time for it, even if that means taking a slightly later bedtime.

That’s it. It’s really not complicated and I don’t think there has been one day in the past few months where I have gotten the full hour spread out during my day. Life isn’t predictable and that’s part of the lesson- implementing structures that will be life-giving to you but also holding them open to whatever else God has for the day. Sticking rigidly to the routines will only worsen that anxiety that wants checked boxes and a clean house and this will spill over to your family, who ends up as the sad recipient of your dysfunction.

Call it “taking me time” or “a mental vacation” or whatever ridiculous terminology you want to use but it’s worked for me and I plan to continue it for as long as I can. And yes, sometimes that means getting a pedicure once in a while.

And just to nail home the importance of exercise, even twenty or thirty minutes of it, check out this amazing video on exercise. I think you’ll be impressed!