Vulnerability Sucks

Being vulnerable sucks and I struggle with it on a daily basis. I have opened up and been vulnerable to people whom I trusted, and it backfired (badly). Instead of feeling brave and free, I felt shame. I believe that being vulnerable has the ability to be great, but it can also go inconceivably wrong in many ways. The disappointment can be brutal; the personal rejection of who you are, and what you stand for, is soul-crushing. Trust is broken, and that is difficult to overcome.

Brené Brown (2010) speaks (and writes) about the courage of being vulnerable: “Vulnerability is not weakness; it’s our greatest measure of courage”. But being vulnerable is painstakingly uncomfortable; it’s not “safe” to share your thoughts (good and bad), feelings, opinions, and especially one’s heart, when there is no guarantee that we won’t face rejection in some way or form, as a result. For those of you who know me well, you know that I put up a fierce wall around my heart years ago. It protected me from experiencing (yet another) ending that inevitably would disappoint, and hurt like hell. So I numbed myself to even the possibility of what could be. Brown (2010) affirms that when you numb vulnerability, you are basically trying to take the pain away from your emotions (i.e. grief, shame, disappointment). Unfortunately, by being numb, you also miss out on the potential to feel joy, and be hopeful about what the future may hold. But having hope can be just as scary as allowing yourself to be vulnerable… maybe even more so, because without hope, you have nothing.

Being vulnerable is scary; especially if you haven’t learned to fly.

Over-sharing?

When I “share” my life and (occassionally… well, maybe more than occassionally) my opinions on my blog or other forms of social media, I open myself up to critique and judgement. It happens all the time; there is always that angry text, or DM meme, that soon follows, insulting my opinion and telling me that I am “wrong”. When it comes to politics (especially lately), people don’t usually budge from their “I’m right and you’re wrong, so shut up” opinion. I just want to know one thing…when did it become acceptable to experience anger and rage because someone has a different viewpoint than you? The “facts” become skewed, and the uncertain, becomes certain, whether it is true or not. Blame is thrown around as if my opinion started a war. Anger erupts, and manners are thrown out the window.

How many of us have asked this same question?

We pretend that what we do, or say, doesn’t have an impact on others; but it does. For every “effect”, there is a “cause”. “If you didn’t do that, I wouldn’t have done this…”. It is all very predictable. Widely known are the words from Albert Einstein: “Insanity is doing the same thing over and over again and expecting different results”. It’s all about the choices we make; be it “safe and comfortable” (what we already know), or take another route, for better or worse, and make it an adventure. As for me, I haven’t always made the best choices, and I don’t have any words of wisdom to give you about sharing varying degrees of vulnerability with others in a less awkward, and more comfortable, manner… but if I figure it out, I will share it with you. I promise.

Reference:

Brown, B. (2010). The power of vulnerability; TED talks. Retrieved from https://www.ted.com/talks/brene_brown_the_power_of_vulnerability

The Calm After the Storm

We all experience challenges when it comes to working with, and managing, difficult people and situations. Our days are filled with stress and anxiety, and it can get to the best of us if we don’t learn how to self-regulate our response to things that we cannot control. It doesn’t help that we are in the middle of a global pandemic, and at a time of much needed reform to address the great racial divide in our country. 

You can’t calm the storm, so stop trying; what you can do is calm yourself,

the storm will pass. (Timber Hawkeye)

This has been a year of being tested on many levels… emotionally, physically, and mentally. We have all been under quarantine for several months during the Covid 19 pandemic, and most recently, the great racial divide has come to a blistering head, and we are faced with the harsh reality that even in 2020, all men and women are not being treated equally. There is a deep pain that has been centuries in the making, and countless events of injustice that have been normalized for far too long. 

How are we handling the stress and loss of control that surrounds us on a daily basis? I, for one, am struggling. I find myself feeling anxious from the minute I wake up and listen to the Morning News, to the minutes that I finally lie down in my bed, trying to shut my brain off from the noise that is somehow silent on the outside, but deafening, and relentlessly loud on the inside. But it is the time in between those hours, when we are at work, and trying to do the best that we can to carry on with our lives, that can be the most difficult. We struggle to block out the “noise” and strive to make a difference with our patients and their families during a 12+ hour shift. We also have our own families who need us to keep it together, and function in a somewhat “normal” capacity, during a time where nothing is “normal”, and hasn’t been for a while. 

To say that I am a little on edge, well, that may be the understatement of this really challenging year. Unfortunately, as a nurse, we have to try to remain calm when everyone around us is screaming. Yes, during an emergency we focus on the task at hand, and trust that our training will automatically kick in when it’s necessary; that’s the easy part. The hard part is when we are not in an emergency, and we “lose it” over something that may not have triggered us so easily before… maybe over an error with the schedule, or sitting in traffic, or scrolling through social media and reading a post that angers you to the core because you thought your friend was smarter (and better) than that…yeah, it is in those moments where you start to have your own personal “storm”, and it isn’t pretty, and it definitely doesn’t cast a beautiful rainbow in the aftermath. This kind of storm can get you into some hot water if you are unable to reel it in.

I think we all manage stress, fear, and anxiety differently, but for some of us, loss of control is one of the most difficult obstacles to overcome; at least it is for me. I’ve always told my daughter that you can’t control how other people act, but you can control how you respond, or react… that advice is on point, and easy to say, isn’t it? However, it is not always easy to do. Sometimes we don’t know how we will react until it happens to us… we can respond differently depending on the circumstances of the moment. For example, we may be able to remain calm and composed if we are in a great mood and slept for more than six hours… or if we are working with our favorite nursing team… but maybe the words (themselves) are not the issue, but the tone is what rubs you the wrong way? Maybe you just want people to care more, and be more accountable… like you… maybe that would make things different and more palatable? 

I’ve been doing some research and soul-searching to identify ways that I can try to improve my own ability to manage stress, and react in a calm(er) manner when faced with a situation that makes me want to scream a few expletives at an unsuspecting person. I sought advice from two of the smartest people that I know, and they gave me great insight into actions that I could do (immediately) to improve how I respond to either (a) prevent the “storm” from happening, or (b) how to de-escalate it if that ship has already sailed. One of them is a friend and colleague, Dr. Mark Stein, who shared with me some things that have worked for him and are based on conjecture, bitter experience, and frustration with other approaches; they are:

  • Identify what the current problem is, and determine what you want to happen to fix it
  • Find common ground in whatever the dispute is
  • Nobody likes being told they are wrong, even if you prove it with facts (especially if you prove it with facts, I may add)
  • Imagine being them, and try to determine what they are saying, and why they are acting that way; in most cases, they are afraid, and in over-their-head with the problem, and they want someone to help solve their difficulties
  • Offer to help figure out the problem with them
  • Provide a compliment, or kind word to them about something that they did that was good
  • Lastly, and he couldn’t stress this enough, bring in doughnuts from a good bakery, “not just Dunkin’”; sharing food breaks down barriers, and has always worked for him when interacting with a potentially difficult person or group

Dale Carnegie (1981) believed that the only way you could get someone to do anything was to (somehow) make the other person want to do it. Carnegie (1981) also quoted John Dewey, a great American philosopher, who believed that the deepest urge in human nature was the desire to be important. I believe that with this kind of thoughtful insight into human nature, if one can take a few minutes to process some of the issues that have led to a dispute, and strategize how best to address it, in a positive manner, the outcome would be far better than if you allowed yourself to show anger or frustration. 

In the end, no one really “wins” an argument; according to Carnegie (1981), the only way to get the best of an argument is to avoid it altogether, because even if you “win”, you still “lose”; making someone feel bad, or inferior, will cause resentment, and that is not a battle worth winning. 

My last thought on this subject is to try to be mindful of some of your own control issues and triggers; not everyone has the tools in their toolbox to manage extreme periods of stress and environmental obstacles that are out of their control.  We are in unchartered waters when it comes to coping with being bombarded by tragedies and heartbreak in the News and many social media outlets on a daily basis. We need to take time to embrace silence, and focus on being mindful of our own needs, while showing empathy to others. No one truly knows what others are going through in their personal lives. Please be safe out there, and may tomorrow bring us closer to peace, equality, and justice.

Reference:

Carnegie, D. (1981). How to Win Friends & Influence People: The Only Book You Need to Lead 

            You to Success. New York, NY:Simon & Shuster. (originally published in 1936).

This article was published on Allnurses.com

https://allnurses.com/the-calm-after-storm-t721220/

American Skin

I read somewhere that ultimate evil is knowing what is wrong, seeing what is wrong, and looking away.

I feel like I am on the outside, looking in, at two different Americas; each with separate rules of law that shine a blinding light on the hypocrisy that is so tragically astounding, it’s actually a crime. I am outraged every single time that I hear about another violent killing of an unarmed African American man/woman/child, by a white civilian, or even worse, by an officer of the law, who chooses to end the life of someone because of the color of their skin….as if it is their right to do so… as if they could get away with murder (and some do). And if you are not outraged too, then you’re not paying attention.

I am a blonde, middle-aged, educated, white woman living in New Jersey, who, by sheer will, and a determined character, does not back down from a fight. It does not escape me that I am probably the last person one expects to write about racism in America in a blog about nursing, but this is far too important to me to stay silent.

It boggles my mind that some people are quite seriously offended by a silent protest during the National Anthem at a sports event… they do not, or cannot, understand that their symbol of American patriotism and unity, in a one-minute-and-forty-second song, doesn’t apply to ALL Americans. There is no UNITY. There are Americans being killed as the words “land of the free, home of the brave” are being sung. The silent taking of a knee speaks volumes. Many are outraged by it… but what they should be outraged by, is that this is what it has come to… this plea for attention to a crisis in our country, on a public platform. Yes, it HAS come to this. Sadly.

Who Are You?

Too many people judging others’ skin, when they barely feel comfortable in their own. (ASB)

Please stop looking away. Something needs to be done. We can no longer look away while lives are lost. How do we stand up for what is right, and put racism away in the history books for good? This can’t go away on its own; we must all commit to having only ONE AMERICA, with laws that protect and apply to everyone.

One of my favorite songs by Bruce Springsteen is called 41 Shots (American Skin). Bruce has performed this song in only a select few of the many concerts that I have attended, and often in response to racial injustice. Please take a few minutes to (really) listen to the lyrics. If you haven’t been afraid to wear a hoodie, or take a jog, or drive a car… well, then count yourself as lucky, but don’t ignore the truth.

American skin (41 shots) 41 shots (8 times)

41 shots, and we’ll take that ride 
Across this bloody river to the other side 
41 shots, they cut through the night 
You’re kneeling over his body in the vestibule 
Praying for his life 

Is it a gun? Is it a knife? Is it a wallet? 
This is your life 
It ain’t no secret (it ain’t no secret) 
It ain’t no secret (it ain’t no secret) 
Ain’t no secret my friend 
You can get killed just for living in your American skin 

41 shots (4 times)

41 shots, Lena gets her son ready for school 
She says now on these streets Charles 
You got to understand the rules 
Promise me if an officer stops you’ll always be polite 
Never ever run away and promise mama you’ll keep your hands in sight 

Cause is it a gun? Is it a knife? Is it a wallet? 
This is your life 
It ain’t no secret (it ain’t no secret) 
It ain’t no secret (it ain’t no secret) 
No secret my friend 
You can get killed just for living in your American skin 

41 shots (4 times)

Is it a gun? Is it a knife? Is it a wallet? 
This is your life 
It ain’t no secret (it ain’t no secret) 
It ain’t no secret (it ain’t no secret) 
It ain’t no secret (it ain’t no secret) 

41 shots and we’ll take that ride 
Across this bloody river to the other side 
41 shots my boots caked in mud 
We’re baptized in these waters and in each other’s blood 

Is it a gun? Is it a knife? Is it a wallet? 
This is your life 
It ain’t no secret (it ain’t no secret) 
It ain’t no secret (it ain’t no secret) 
No secret my friend 
You can get killed just for living in 
You can get killed just for living in 
You can get killed just for living in 
Your American skin 

41 shots …..

Notes: Written during the reunion tour, after the police killing (with 41 shots) of an unarmed person, it was a regular inclusion until the end of that tour.


Lyrics retrieved from Bruce Springsteen Lyrics database: brucespringsteen.it

Nurse’s Week, and why it’s different this year

I’ve always felt pride when I said the words “I am a nurse”… but this year, amid the health crisis that our world is facing, those words mean so much more than they ever have before. This year, pardon my language, but the “shit” is real. This year, the world has changed; we are living in a time where we must be six-feet apart, and wear masks just to shop for groceries. Hand sanitizer, Lysol, and toilet paper are being sold on the black market, and meat is being limited per person; we are not used to such (dare I say), “hardship”.

Nursing, in the year 2020, has changed. No one ventured into the Nursing profession thinking that we would be risking our lives, or the lives of our families, just by showing up and doing our job, caring for those in need…and yet, here we are. We are experiencing a new reality that brings even the most healthy among us, to our knees.

I have friends who have tested positive for Covid 19 and have recovered (or, who are in the process of recovering), and I knew people who were not as fortunate; who died alone, having no closure at all. I just pray that they had a kind nurse, or other healthcare provider, staying with them, holding their hand, and telling them that they were loved.

While most of us are staying at home, practicing social distancing, almost all (active) nurses and healthcare providers are going to work every day fighting the good fight. The timing of Nurse’s Week this year actually makes it quite ironic, because while most Nurse’s Day/Week celebrations are cancelled (and that’s ok, we have bigger fish to fry), we all agree that the cause is too great to risk any progress that’s been made to flatten the curve. We’ve also been blessed to receive so much love and kindness from the community, shown to us with generous donations of food, treats, and supportive messages to show their gratitude for our work. This year, we are being called HEROES… and that is pretty special indeed!

I wish all of my Nurse friends and family a very Happy Nurse’s Week… I love you, I support you, and I thank you for showing up, even when it’s hard… please be safe.

Be Safe

“Be safe”. We are saying this to one another at the end of almost every conversation lately to let others know that we care about them and their well-being. We are all afraid of the invisible virus that we cannot see, but one that is consuming our days and nights. The biggest fear most of us have is from the unknown; who has “it”, are we “safe”, and if we are, for how long? We lock ourselves behind closed doors and hope that it won’t find us, but you can’t turn on the TV or login to social media without reading about it… without hearing the latest statistics and body count… without seeing the damage that it is causing, near and far, but it’s the “nearness” that is the most scary.

Hospitals are running out of masks and protective supplies. We don’t know if we will have enough hospital beds or ventilators. We don’t even know if we will have enough healthcare professionals to get us through this nightmare of a virus, especially if it doesn’t go away soon. It’s not like other serious illnesses are taking a step back and not requiring treatment or hospital beds… no, they still exist and deserve our full attention as well.

Those who are fortunate are able to work from home, but the bravest people I know are showing up to work every day, even though it’s hard; even though they are afraid and don’t know how or when this will end… while the cowards are out buying up the last rolls of toilet paper and hoarding them because they don’t care about anyone else… as if that will save them.

So if I haven’t already said it to you… please be safe. Please take care of yourself and know that I care about you.

Carrying our Grief

I came across the story of an orca whale whose calf had died; she was photographed carrying her baby’s body across the sea, holding it with her nose as if it would miraculously, in time, come back to life. She carried that baby for seventeen days and 1,000 miles on a “tour of grief”, until finally, the mother whale let it go. It was heartbreaking to watch or think about, and yet many of us can relate to this feeling of loss and deep desperation.

You never know how strong you are, until being strong is your only choice (Bob Marley)

Losing someone that you love is hard; devastating really. I thought about this mama whale because a dear friend recently lost her child; he was a very bright and successful young man, and he fell into a dark place that he could not escape. He took his own life and I doubt that he knew, or even imagined, the ripple effect that his act of despair would have on the world around him… how could he know… he was in unspeakable pain that he hid from everyone, and he felt alone. While we all pray that he has found eternal peace, his family and friends are in mourning; their world has forever changed, and there is a hole that cannot be filled; it remains empty with the ghost of a lifetime of memories; the only thing they can hold onto. 

We all experience grief differently; some fall into a deep sadness, and want to push through the pain alone, while others prefer to tell their story… over and over…sharing memories to keep their lost person alive in some way. While there is not much that we can do or say to lighten this burden of grief, we can try to just “be” with them…be there, be gentle, be kind, and be a good listener.

Going GOLD

September is Pediatric Cancer Awareness month; we encourage everyone to “Go Gold” with the goal to shed some light, and increase awareness, for those affected by this terrible disease. Here are some facts about pediatric cancer: according to the American Childhood Cancer Organization (2019), each year there is an estimated 15,780 children aged 0-19 diagnosed with cancer in the U.S; approximately 1:285 children will be diagnosed before their 20thbirthday… that’s a pretty scary statistic. It becomes even scarier when you receive that diagnosis for your own child.

I’ve worked as a staff nurse and nurse leader in Pediatric Oncology, and although kids are surprisingly (and extraordinarily) resilient, sadly some do not survive, even with the best doctors, and most up-to-date protocols… but we never stop fighting, and we never, ever give up! And the kids and their parents…well, they become superheroes and fight like champions against this heartless, evil “villain” living inside them. 

Taylor Swift performed her song Ronan on the Stand Up For Cancer fundraiser event several years ago; she wrote the song in memory of a 4 year-old boy (Ronan) who passed away from cancer after reading a blog written by the boy’s mother, Maya Thompson. The following is a link to her performance:

References:

American Childhood Cancer Organization. (2019). About ACCO. Retrieved from https://acco.org

Swift, T. (2012). Ronan. Retrieved from https://youtu.be/tvN7BOAQn9I

Bullying from above: Working in a hostile environment as a nurse leader

Many organizations are focusing on implementing a zero-tolerance policy for bullying behavior that has historically been done at the staff nurse level. New nurses enter the workforce, eager to begin their professional journey, and then are faced with the harsh reality that “nurses eat their young”. They are met with criticism and intolerance; sometimes even cruelty. We have all gone through it at varying degrees; most of us developed a “thicker skin” until we proved ourselves to be competent, and were gradually accepted into the team. It is not an easy process and some nurses don’t even last a year; they decide that this was not what they signed-up for, and opt to transfer to another unit, another organization, or even decide to leave nursing altogether. 

When bullying or incivility is tolerated in the work environment, job satisfaction and retention are affected (Lachman, 2014). Smart organizations are proactively focusing on retention, and are inviting staff nurses to become part of the solution through peer mentoring and retention committees. But what if the bullying is being done from above, at the administrative level? Nurse leaders are not all created equal. There are many levels to leadership roles, from a Manager or Supervisor, to Chief Nursing Officer, or Vice President of an organization. To presume that hospital administrators and nurse leaders are above bullying behavior is a great falsehood; it happens all the time in competitive organizations. I’ve witnessed it firsthand, and it left quite an impression; it makes one question the integrity of the entire organization. While some leaders “talk the talk” about transformational leadership and anti-bullying initiatives, they do not always “walk the walk” when it comes to their own behavior to other managers and leaders. The environment can become hostile, and many mid-manager level leaders are unable to speak-up for themselves out of fear of making a mistake, and concern over job security. While nurse leaders must try to follow the vision and goals of the organization to implement changes that ensure patient safety and improve outcomes, they still face obstacles on a day-to-day basis that can be challenging to overcome. The most justifiable and well-intentioned suggestions can fall on deaf ears from the powers that be when one is working in an environment that doesn’t foster collaborative change. Even very experienced leaders can feel pressured by upper administration to perform tasks that are above and beyond realistic expectations, often without help or support.

When someone from administration decides that the organization wants to “go in a different direction”, no one’s job is safe. The Union does not protect managers, and leadership jobs can be filled quickly, with enthusiastic candidates looking for a new opportunity and career advancement. In fact, other leaders from within the organization can often begin to sense when a colleague is being left out from the “inner circle” and start to distance themselves from you in fear of being connected to the outcast. You begin to wonder when and how you will be “let go”, or asked to resign with reputation intact, so it is easier to find another job, as if it was your idea to leave instead of being fired. Sometimes, a small severance package may be offered to make the dismissal somehow less offensive.

If bullying is being tolerated at the administrative level, what options do we have? Casale (2017) states that if incivility is not being addressed in the workplace at the highest level, it projects a general acceptance of bad behavior that provides the bully with a degree of power and control. For change to occur, administrators need to model, and commit to, a culture of respect and civility to ensure a healthy work environment (Casale, 2017). 

References

Casale, K.R. (2017). Exploring nurse faculty incivility and resonant leadership. Nursing  EducationPerspective,38(4), 177-181. 

Lachman, V.D. (2014). Ethical issues in the disruptive behaviors of incivility, bullying, and horizontal/lateral violence. MedSurg Nursing, 23(1), 56-60.

*This article was published on Allnurses.com

Sacred Ground

When I was young, I remember that my Dad used to joke every time we passed a cemetery, “ya know, people are dyin’ to get in there” … he thought it was so funny, and we would give him a courtesy half-laugh over the predictable double entendre. I realize that cemeteries may seem like a morbid subject to some, but I find them so interesting. I’m drawn to the history and the peaceful solemnness of the permanent resting place of so many; it is sacred ground. Every grave holds a story, and I think about the people who have walked this Earth, lived a life, and are now memorialized six feet underground by a tombstone, marking the ultimate ending to their story; the inevitable great escape to the unknown. Who were they; what did they do with the time that they were given; did they have a life well-lived; how did they die; how will they be remembered? I think about these things. That “dash” between your years from birth to death represents a lifetime; “only those who loved them know what that little line is worth” (Ellis, 1996).

Gravestones are an everlasting memorial to a life lost, but they tell very little about the person… some show a long life, and tragically, some are quite short. The picture below shows actual gravestones in the cemetery where my Dad, grandparents, and other family members, rest:

These lost souls are only to be remembered as Father, Mother, and Annie; no last name; no dates; seemingly anonymous to all who come across them.

One can only guess that these modest memorials are due to the immodest cost of a burial and gravestone… or, perhaps, those who buried them cared little about a name, or some dates… they chose to remember them simply. We will never know, and perhaps that is the way it was intended.

Do you believe in ghosts? As nurses we often witness the passing of a life; ask any nurse who works in an ICU or Oncology unit whether they have seen, or felt, something unusual, like a “presence” on their unit, and I would guess that many will say that they have. When I worked in pediatric oncology, one nurse told me that after a young boy passed away, his young cousin told his mom not to worry, she saw her cousin walking away, holding his father’s hand (his father had passed away a few years prior). Some may find it hard to comprehend such stories, but I find it comforting to think that we will be reunited with loved ones when we pass.

Reference

Ellis, L. (1996) The Dash Poem. Retrieved from https://thedashpoem.com

Being brave

I reconnected with an old friend recently, and as we were catching-up on this crazy thing called life, he gently reminded me that we all have stories. While some stories are harder to tell than others, most of us are fortunate enough to have a surplus of great memories that we carry as a reminder of who we are, and where we’ve been.

Owning our story can be hard, but not nearly as difficult as spending our lives running from it. Embracing our vulnerabilities is risky, but not nearly as dangerous as giving up on love and belonging and joy—the experiences that make us the most vulnerable. Only when we are brave enough to explore the darkness will we discover the infinite power of our light.” (Brené Brown)

Being brave can mean different things to each of us… it all depends on your ability to face your fears. Overcoming such an intense emotion isn’t easy; in fact, it can make us extremely uncomfortable, and is often the result of an act of love or necessity. My challenges with trying to be brave have changed as I have gotten older. As a child, being brave meant getting a “shot” from the doctor; as a teenager, it meant trying to overcome self-esteem issues; as an adult, it has been more about being honest when the truth was hard to hear; it was letting go after losing trust; it was starting over as a single mom. Being brave is stepping-up to a new challenge and trying again (and again) after failure. It is saying “yes” when every fiber of your being is feeling afraid and anxious and wants to (safely and comfortably) say “no”. Being brave is facing your fears and fighting a battle that you know you may not win, but will never give up trying.