The Double-Edged Sword

This is a re-post of a blog post I did years ago when I was working at the bedside in the ICU and I’ve had several requests to post it again on this site. It’s also related to another post I’ll be doing next week. Enjoy!

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Sometimes I wonder how to maintain a balance.

Just the other day I watched a man in his early forties, who had come to the hospital after an accident, bleed to death. With his leg wrenched off, a mess of shreds of flesh and coagulated blood, he had reached the end. The doctors took his wife to the bedside and calmly but firmly explained that there was nothing else they could do. The damage was too severe, the injury too great. The dripping blood collected in a pool underneath him like a morbid summary of the sad tale.

I watched for a few seconds like an unattached observer, noticing the inconsolable wife and other family members with a haze of self-protection between us. With only a ting of grief, I watched as the wife laid her body over her husband, begging and pleading into the air for him to live. Her desperate requests fell upon a silent room as she screamed and wept. Her tears wet his face but he didn’t move, already drifting in the middle place between alive and dead. Finally he passed away slowly and quietly and the family was left with some privacy to grieve. After such a commotion, the silence was deafening.

Functioning as the charge nurse that day, I was aware of the situation but because of the hectic pace of the unit at that time, I didn’t have the mental energy to soak it in fully. I cognitively understood but I held back my emotions for the sake of the job, for the sake of keeping the unit functioning at the highest level. Patients needed to be admitted from the  ER or OR, nurses required help with bedside procedures, and some of our other patients were declining at a rapid pace, requiring all hands on deck as we hung blood pressure medications and put in chest tubes. If you’ve ever been the charge nurse, you understand the feeling of the weight of the hospital world on your shoulders, the responsibility of life and death weighed around your neck. When you’re the charge for the trauma ICU, with everyone in the hospital calling you to fix a problem or make room for a patient, in many ways those are accurate assumptions.

There’s a fine line between entering into the emotions of the situation and preserving yourself for the sake of the job. A conundrum common to any area within the hospital realm. Nursing can be a diabolical and equivocal profession for this very reason: the maddening crux of self-protection and compassion. It’s a double-edged sword that boasts both danger and power.

On one hand, I consider myself to be an extremely sensitive person who relates to my patients and families on an emotional level. In my job working with families, I sit and listen as they vent about frustrations or griefs. I cry with them as we turn off the machines and let their family member drift into breathless silence. My heart aches inside of me as families have to make impossible decisions about the future of a loved one’s care. Few choices are straightforward and easy, and most require all they have left emotionally, mentally, and physically. Sleep, proper nutrition and self-care become obsolete as families focus whole-heartedly on the task at hand, the healing or demise of their loved one. I’ve gone home and cried helplessly because of a devastating patient situation, the grief and loss too much to bear. Seth has listened as I relate some of the horribly unfair circumstances that are inherent in a broken, fallen world. I function in deep compassion for my patients and families, empathizing with them over their heartbreaking situations.

Regardless of the specific area, nurses are not strangers to the unlucky, unfair circumstances that plague humanity. From oncology to NICU to outpatient clinics, we all encounter the unexpected test result, the unbelievable diagnosis, the unexpected and tragic turn of events. We experience on the ground level variations of pain and loss that many people can’t comprehend. We are exposed to some of the most triumphant and desperate situations, watching people defy the odds or succumb to the inevitable. Nursing is a highly emotional profession with the pendulum swinging between hope and loss, pain and victory, life and death.

On the other hand, I felt completely unattached to the man dying that day, knowing that if I let myself indulge, a deluge of tears would follow. I went to a party after work that night and as my  mother asked me, “how was your day?” I related the incidences in a matter-of-fact tone that seemed to shock her. I realized abruptly that it wasn’t normal for someone to say they watched a patient bleed to death while sipping iced tea at a wedding shower. In my callousness and self-preservation, I hadn’t even stopped to wonder at my own disillusionment with the situation.

But as nurses, we can’t always allow ourselves full depth of emotion at a certain time. It’s one of the disadvantages and hard boundaries that come with the job. If I imagined Seth lying in the bed as the patient and me, the desperate wife, weeping over him, I surely wouldn’t have been able to continue with the day. I would’ve been overwhelmed with inconsolable grief at simply the thought. I would’ve sat down dejectedly at the bedside and ignored the other duties required of me.

Nurses get very extensive training in assessment skills, safe medications practices, and the scope of our license. But treading the fine line between emotional indulgence and self-protection is something you have to learn on your own, in your own way, so that you can go back to work the next day and be satisfied with your profession. Everyone comes to that place, the place of peace with difficult circumstances, at their own pace and in their own fashion. And it changes as you move through various stages of life. You constantly have to reevaluate yourself, your calling, and your emotional reserve to adapt to the situations before you.

Sometimes I’m amazed at my ability to push my emotions aside and continue in the job of saving lives. Sometimes I’m surprised as I can’t seem to stop ruminating over a seemingly routine but difficult situation. I shock myself with how I react to some predicaments and not others, or the degree to which I react.

It’s an impossible double-edged sword, the blade of self-protection and compassion. It gleams at you, waiting for you as you walk into work everyday. You wield it as best you can, trying to make the wisest choices, but sometimes it cuts you when you least expect it. Then you remember it’s both your weapon and your downfall, and you grow in respect for it.

We pick it up before a shift and lay it down afterwards, but we all know it’s never far from us.

Then and Now.

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Once upon a time, my life was really hard.

When I was in nursing school eight years ago at TCU I had so many hurdles to overcome. I had to get up, walk to get my breakfast that I didn’t cook and didn’t pay for, and then go to class. I had to read during my hours when I wasn’t in class in the quiet library with no interruptions, studying for those long periods with no one asking me to get them milk or see what they made in the backyard with sand. I had to get up at 5am ONE day per week and go to a SIX hour clinical where I basically did nothing since real nurses barely even let nursing students play with the kids in pediatrics let alone actually take care of patients. I had to take summers off and rest my tired mind while going on vacations and dreaming about what kind of nurse I would become. Those days were full of trials and hardships consisting of endless time, few encumberments and FREEDOM.

Doing graduate school has been a slightly different story.

When I was still working, had a newborn and starting NP school I would get up at 5am everyday of the week to study on the days when I didn’t have to go to work. When Evy went down for a nap, I studied. When she went to bed at night, I studied. When I woke up in the morning, I studied. I lived and breathed patho and my poor husband somehow kept us afloat, cooking and cleaning and oh yeah, going to his own job. But she slept a lot and couldn’t really do anything and I had more time to envelope myself in textbooks and watch online lectures. Then I quit my job because, as you can imagine, such a pace is unsustainable, especially when you have the option to knock something off the list. And since that can’t be my child and I didn’t want it to be school, work had to go.

Now I have a toddler. A beautiful, vivacious toddler who refuses to take naps most days and wakes up at 6:15 in the morning. So when she does nap, I study. When she goes to Mother’s Day Out twice a week, I study and try to throw something in the crockpot and fold laundry while I listen to lectures. Thankfully, my school load isn’t as heavy as it was with those first few intensive classes because although I have less time, I also have less emotional energy to give. Because in case no one has every told you, toddlers are fascinating energy-depleters of the cutest sort.

Let me explain. I tell Evy it’s time to take a nap. I lure her into her room with the promise of reading her favorite bunny book six times. She takes the bait, wanders into her room and I gently close the door shut. Aha, made it this far. Then I change her diaper, put her pajama pants on and we sit and rock and read and rock and read. Then I close the blinds, turn off the light and tell her in my quietest voice that she’s going to take a nap now. She thinks its a suggestion and I most definitely do not. She wants to get in her crib but I make her sit in the chair with me and calm down because all she wants to do is play with her animals for the next two hours instead of sleep. But mommy is too smart for that. I know her tricks. So I make her sit and rock with me in the dark.

Evy, be quiet. Time to go night-night. E-I-E-I-O Donald had farm, woof woof here… Child continues to sing Old MacDonald in her sweetest toddler voice, missing approximately every other word. Evy, no more talking. Time to go to sleep. She’s quiet for a minute. I close my eyes, hoping she will follow my lead. Then I get a tiny finger up my nose. Mommy wake up! No baby, be still. Close your eyes. Close ya eyes mommy! Accidentally slaps me in the face. Go to sleep baby. Be still. We rock and there’s a lull in her singing. Mommy does actually fall asleep then I get woken up by a round of Twinkle Twinkle Little Star. Oh goodness gracious, please go to sleep. Not so that I can do something fun or relaxing or even productive around the house, but so I can finish my paper on prescriptive authority for NPs in Texas versus other states. I would rather take a nap here in this chair and you won’t even let me do that. I luv you mommy. And then suddenly I wish I could sit and hold her in this chair forever and not miss one moment of her amazing little life. Every frustrating moment is worth it because I’m not going to remember this paper, but I will remember listening to her breath while she snuggles next to me.

Eventually she does either fall asleep or play in her crib for an hour while I sneak away to my computer, cram Paleo chocolate chips in my face and try to figure out how to properly reference this obscure government document in APA. Needless to say, my life isn’t as easy as it used to be. I don’t have hours of uninterrupted time to study or a carefree existence with no real responsibilities. In contrast, I have a husband and a daughter and a house and mouths to feed and errands to run and that’s nothing compared to the hoards of nurses I know who work full time, do school and have like five kids. They are the true heroes and someone should write a blog about them.

But this isn’t a post about my frustration at putting my child down for naps or even the difficulties of being a mom in graduate school. Its a post about looking at that little face or feeling that tiny finger in my nose and thinking about the example that I want to set for my daughter. I want her to be a strong leader who loves God and follows her dreams. I want those things for her because I want them for myself as well. And I think that despite the monotony of unloading the dishwasher, it’s all time well spent. Those days in nursing school were important because they were setting me up for when I am today. And these days I’m in now are important because Evy will know the depth and length and height of her mother’s love for her. And hopefully, she will have an example to live up to in a mommy who loves Jesus and works hard to help people.

And although my life is pretty amazing right now, sometimes I wish certain circumstances were easier. Even as I write this post, I’m sitting in a reclining chair getting my Remicade infusion at the hospital. It’s not ideal, but it’s my reality. But I know, even though I can’t explain how, that each second has a purpose and every moment has a reason. And I know that every nap time and every paper and every clinical shift will be be composed into a beautiful story that isn’t finished yet.

My life isn’t as easy as it used to be, but I wouldn’t change it for anything.

 

 

 

 

 

The Blog is Back.

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Blogging is a tenuous task.

As you may well know, I’ve had several blogs in the past and have enjoyed the art of putting together words and phrases, of telling stories that are unique to me. Those desires haven’t changed but this time I’m blogging on my own terms without worrying about stats or ads or timelines. I plan to blog when I feel led and say whatever is on my mind. That means that one day I might talk about being a nurse practitioner student while another I might be discussing the things that God is teaching me. I don’t want to be confined to a genre or a niche. Life is full of niches but life isn’t defined by them. Plus I don’t have the physical time or emotional energy to keep up with running a real blog.

I will say it again, blogging is a tenuous task.

In starting another blog I’m voluntarily putting myself in a position to reveal my deepest thoughts, my hurts and concerns, my views on my life and God’s purpose in it. And while most people would do anything to keep these things hidden away, I’m sharing them with the world. And in the most humble of attitudes, I believe that is a courageous task in today’s society of criticism and comment, of soap boxes and narcissism, of judgment for being truly honest. But I really think that honesty is what changes people and so I’m willing to take the chance.

This is what writers cannot help but do: share their words with the world. The older I get (the closer to 30 I get!) the more I’m discovering that writing is not only a pastime but a calling, a part of who I am. An integral part of my soul. I function better when I’m writing and I thrive off of the thrill of finding new ways to say something. I realize that all sounds dramatic (or nerdy) and it quite possibly is, but that doesn’t make it any less true. Whether or not I ever publish anything, I cannot help but be a writer and see the world through narrative. I feel like I’m finally coming into myself, so to say, and embracing these gifts that the Lord has given me and trying to use them for his glory. Oh, I love to write so much and I haven’t stopped over the past two years. I’ve got a few tricks up my sleeve.

But enough about that. Here’s what we’ve been up to lately…

General life: I’ve been a SAHM for the past fourteen months (you get more cool mom points if you use the acronym) and have enjoyed it immensely, although it has been hard for me at times. I don’t do well sitting still and so, by divine appointment, I’ve been given a daughter who refuses to sit still either. We’re a perfect match. Seth and I are enjoying co-leading a home group (sadly soon to be solely leading) from our church and these people have become some of our closest friends in a relatively short amount of time. Being able to bare your soul to a kind ear is truly a blessing. We do homeowner things like yard work and get really excited when we don’t have anything planned for Friday night except watch This is Us. That’s the basics.

Family: Seth still works for the same company here in Dallas as a muscle activation technique practitioner and he loves it. Five years of marriage lingers on the horizon and we’re having more fun than ever (albeit sometimes fun equals doing dishes and having “healthy conflict”).  Evy turns two this weekend, which completely blows my mind, and I can honestly say she’s the most amazing human on the planet. I never knew I could enjoy having a conversation with a two year-old so much. I also never knew that kids started trying to drop their afternoon nap before two. I also never knew how much trying to put an obstinate child down for a nap zaps all your remaining patience and sanity. And so it goes. Yet, she’s still amazing.

Career: I have retired from ICU life and am looking forward to some colds and flu and routine vaccinations in primary care. I have 15 months left of my FNP program, which seems like a long time or maybe a short time but either way I feel like I’m nearing the finish line after making it over the hurdles of advanced patho and pharm. I’m gearing up for clinical and looking forward to the day when I will actually be a NP.

Health: ugh. Do we really have to talk about this one? The past six months have been particularly challenging as I’ve been in a massive UC flare that has consisted of scopes and steroids and eating absolutely  nothing on Christmas day. There are a few positives, like I’ve become very proficient at making bone broth and my doctor probably has me on speed-dial. But other than, it’s been hard, especially hard when I now have a tiny person who literally depends on me to live. So we’ve had days full of Daniel Tiger when I hope and pray that I’m not destroying my child’s brain by allowing her to imbibe pictures of colorful animals and catchy songs (songs that get stuck in your head, I mean). I’m fairly confident she’ll be fine considering she already knows how to say her full name and the she lives is “‘merica!” BUT thanks to Prednisone, my husband and my family, it looks like we’re through the worst of it. I’m still going to have to be on a biologic med, which wasn’t my preference, but I didn’t choose this disease and sometimes I don’t really get my choice in my treatments either. I have to be functional and this is what it’s going to take.

That’s about it for now. If there’s anything else you’d like to know, please feel free to ask. Since I have about two years worth of blogging ideas bottled up, I’m sure you’ll be hearing from me again soon.