Working on Holidays

I was at the receiving end of a comment recently, which was clearly intended to belittle, from an unlikely source… a parent of a sick child in the hospital… the remark was this “Who are you… you’re not important, you’re here working on a holiday”. In my nearly 30-year career, I can honestly say, that was a first. The world of healthcare is not a 9a-5p, Monday-Friday job… hospitals do not close down for summer vacation, snow storms, weekends, or holidays… they are always “open for business”. Nursing is a 24/7/365 job. In fact, during any type of disaster, emergency, or significant weather condition, nurses are considered “essential personnel” and are (strongly) advised to report for duty. While most others are warned to “stay off the roads” during a State of Emergency, we pack overnight bags in anticipation… and when the time comes, we search for an open stretcher in a quiet corner and (try to) sleep so we can work the next day in case others cannot make it in for their shift.

Nursing is a profession of dedicated service to the community in which it serves, just like police officers, EMTs, and firemen/women; and it’s not just nurses that keep a hospital running smoothly… it’s also the Doctors and Advanced Practice Nurses, Patient Care Techs, Respiratory Therapists, Security, Housekeeping, Food & Nutrition, etc. We all know the expectations going into our roles. I have worked many, many holidays in my long career…and yes, I still do. I worked on Christmas Day last year, and I will most likely need to do it again this year. I accept it, and I am grateful that I have a job that I love, with people that I have grown to love. We all have families that we would like to celebrate the holidays with… but if we can’t, we make the best of it; we post a sign in the staff lounge for a pot luck feast, and we all contribute to the festivities… we find ways to laugh through it, and we reschedule the time that we can spend with our own family so that we can take care of yours. Working on a holiday is not a measure of importance or title… it is just something that we know we must do to care for those who need us.

I wish that I was able to say what I was thinking to this parent, but I bit my tongue; I am in a position that requires me to de-escalate situations, rather than speak my mind. But I do wish that I would have pointed out that those he attempted to minimize (it was not just me), were there (on a holiday) taking care of his child… and that is not unimportant to us, and it shouldn’t be to him either.

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Death from Despair

We have all felt sad, disappointed, and lonely at one time or another in our lives. Those of us who have struggled with loss, pain, isolation, low self-esteem, failure, rejection, and financial/ personal/professional stress, have experienced varying degrees of darkness and despair; it’s not a fun place to be, and not everyone makes it out alive. Some have been in such a low place that they feel their only solution to overcome this immense pain and suffering is through one final extreme act of choosing death over an unbearable life. Depression is an illness that often can be mistakenly viewed as a character flaw; a sign of weakness, or inability to cope with everyday life. The American Psychiatric Association (2018) defines depression as a medical illness that affects how one feels, thinks, and acts. It is, however, treatable; but one must be able to ask for help.

Suicide is death from despair. According to the Center for Disease Control (2018), suicide rates in the U.S. have increased 25% in the past two decades and are increasing among adults aged 45-64. Among those aged 15-34, suicide is the second-leading cause of death (CDC, 2018).

When we hear about someone we know (or know of), who has committed suicide, we are often shocked. We question why/how someone would feel so hopeless as to choose to end one’s life, while others fight so hard to press on through their own struggles to live another day, grateful to be alive. No one truly knows what others are going through; we all have our own inner demons.

Those of us in healthcare have seen the outcomes of an attempted suicide. My first experience as a young PICU nurse caring for a teenage girl who attempted suicide by hanging, was extremely difficult and heartbreaking; there was no happy ending or miraculous recovery for this young, troubled girl. This story was tragic, and yet it happens everyday. She had gone through a bad break-up with her boyfriend, and the pain and rejection led her to self-mutilation, which didn’t dull the pain deep inside of her, so she hung herself; her sister found her, and called 911. She was brought back to a life of vegetation. She wore a haunted look of pure rage, which seemed to be her only facial expression when “awake”. She had just enough brain activity to continue medical interventions. I still think about her from time-to-time when I hear of another suicide in the news, and I wonder if she ever found the peace that she was looking for so long ago. I truly hope so.

What can we do to prevent our loved ones from choosing this ultimate act of despair? First, we need to be able to recognize signs and symptoms of depression and not be afraid to ask our friend/family/co-worker if they need help, or want to talk….or even if they have ever thought about hurting/killing themselves. We need to support better medical coverage for mental health and pre-existing conditions. We need to prevent those who have mental health conditions from being able to legally purchase a firearm. And last, we need to open our eyes and recognize when someone that we love needs help; we need to support them and not judge them. “There but for the grace of God, go I”.

Linkin Park wrote a beautiful song about suicide, called One More Light (2017). The irony that one of the writers, Chester Bennington, committed suicide a year later, speaks to his state of mind and intimate understanding of the effects of suicide for the ones who are left behind to try to heal from this great loss.

Video:

One More Light (lyrics)

Should’ve stayed, were there signs, I ignored?

Can I help you, not to hurt, anymore?

We saw brilliance, when the world, was asleep

There are things that we can have, but can’t keep

If they say

Who cares if one more light goes out?

In a sky of a million stars

It flickers, flickers

Who cares when someone’s time runs out?

If a moment is all we are

We’re quicker, quicker

Who cares if one more light goes out?

Well I do

The reminders pull the floor from your feet

In the kitchen, one more chair than you need oh

And you’re angry, and you should be, it’s not fair

Just ’cause you can’t see it, doesn’t mean it, isn’t there

If they say

Who cares if one more light goes out?

In a sky of a million stars

It flickers, flickers

Who cares when someone’s time runs out?

If a moment is all we are

We’re quicker, quicker

Who cares if one more light goes out?

Well I do

Who cares if one more light goes out?

In a sky of a million stars

It flickers, flickers

Who cares when someone’s time runs out?

If a moment is all we are

We’re quicker, quicker

Who cares if one more light goes out?

Well I do

Well I do

Linkin Park (2017)

Songwriters: Brad Delson / Chester Charles Bennington / Dave Farrell / Francis White / Joseph Hahn / Mike Shinoda / Robert G. Bourdon

One More Light lyrics © Universal Music Publishing Group

If you, or someone that you know, are having thoughts of suicide, please seek professional help; call a friend or family member, or call the

Suicide Hotline: 1-800-273-8255

 

References:

American Psychiatric Association. (2018). What is depression? Retrieved from https://psychiatry.org/depression

CDC. (2018). Suicide rates rise sharply across the US, new report shows. Retrieved from https://washingtonpost.com

Linkin Park. (2017). One more light. Retrieved from https://youtu.be/Tm8LGxTLtQk

(un)happy father’s day

This is my first Father’s Day without my Dad. I can’t escape the barage of commercials and advertisements suggesting the “perfect gift for Dad”; my heart breaks and I change the channel quickly. This year, as I visit my Dad at the cemetery, I am painfully reminded that everything is different this year. There will be no family BBQ, or “Whale of a Dad” Carvel ice-cream cake, which my Dad loved so much (those chocolate crunchies were his favorite!); no sentimental card with a boat/fishing theme (because that was his favorite thing to do when he was healthy), and no brightly covered gift of pajamas/shirts/shorts/slippers, or whatever Mom thought he could “use” that year.

This Father’s Day I am working, so today Shea and I, and our dogs Riley and Gracie, visited my Dad and planted flowers at his grave. He always enjoyed it when we would bring the dogs to visit, and he loved Riley so much; she never left his side during his final days. He didn’t get the chance to meet Gracie, but I’m sure that they would have quickly bonded, playing fetch with tennis balls, and some belly rubs too of course!

I brought my Dad a stepping stone and solar-powered cross to decorate his grave, and I thanked him (again) for being such a great Father and Pop-Pop.

My Father and I didn’t always see eye-to-eye, especially when I was a teenager growing up in Jersey City. He was tough; very (very) strict. When Mom got angry and said “wait until your father comes home!”, we knew that we were in big trouble. Times were very different back then, and for better or worse, we were literally afraid to misbehave. He did the best that he could, and I don’t think I fully appreciated or understood that until I became a parent myself. He looked out for us from the day that we were born, and protected us until his dying breath.

After my Dad became a grandfather, or “Pop-Pop”, as he was called, I saw a completely different side to him, which was pretty awesome. He adored his granddaughters, and he learned to be comfortable saying the words “I love you” out loud (which was not common as I grew up)… and those words later evolved to “I love you more”, which we knew, deep down, that he sincerely did. I am so grateful that I had the opportunity to grow close to my Dad and have him in my life for as long as I did. I was able to witness seeing him open up his heart to the life of being a beloved, generous, supportive, loyal, dependable, (and really funny!) Father and Pop-Pop.

Happy Father’s Day in Heaven Dad!

I love you and I miss you everyday, but today even more.

me and dad

The Giving Key

Keys open things that are kept locked in order to give us a feeling of security and comfort that our most cherished things are safe and protected, such as our deeply vulnerable and honest words in a diary, our fragile heart, which has been broken too many times…and also, the door to where we live; our sanctuary; our home.

The Giving Key is a “pay it forward” movement that helps support and create jobs for people transitioning out of homelessness (TGK, 2018). The concept of The Giving Key was created by Caitlin Crosby, who was a singer and living out of a NYC hotel room; she wore her hotel key as a necklace, and realized that like old keys, we are all unique, flawed, and sometimes discarded or replaced. She wanted to repurpose old, used keys and make them meaningful, so she got the idea to engrave them with inspirational words (such as Dream, Love, Hope, Strength, Faith, and Believe), and give back to the community to open doors to those who are in need of a place to call home (TGK, 2018).

Each key has a word of your choosing that represents something that one may “need”; the meaning can be different for everyone. The gift of the key may be yours in the beginning, but ultimately, the true gift is in the giving to others. When you find someone who needs “it” more than you do, you pay it forward and give them your key, and hope that it helps them, as it has you.

I have purchased several keys over the last few years. My first was “love”; it was an old silver key that had been weathered and worn. I identified with it. I wanted the gift of love to open up my heart to the world around me as it had been closed for a long time. It is a scary thing to be able to learn to love and trust again; I haven’t quite figured that out yet. Once a heart is broken, it is never truly the same. But one day I found someone who needed the key, and the word, more than I did…she was going through a really tough time after a difficult divorce. I recognized her pain and brokenness, and I knew that she needed to find love again…self love.

love

After awhile, I came across the keys again and I chose another word, “strength”. When both of my parents were diagnosed with cancer, and I was struggling with working full time and commuting to NYC, and taking courses for my Master’s degree, I prayed for strength to get through each day, and be present for everyone who needed me. A few months ago I reconnected with an old friend…the kind of friend that you don’t see often, but when you do, it’s like no time has passed at all. That day God put me where I needed to be; she needed to be lifted up. She needed a friend, a cheerleader, and someone who understood her struggle. Once again, I saw something in her that I knew all too well. I gave her my strength key because I wanted her to have a constant reminder that she was strong and brave, and that this, too, shall pass.

strength

My new key is “hope”, which I chose because it is something that I need to remember to never lose, so I don’t give up on myself or others. As long as there is hope, there is a chance that things will get better.

hope

I just purchased a key for my daughter. I won’t share with you the word that I chose for her, but it is something that I hope for her every single day. I only wish that she could see herself the way that I see her. It is probably my most important key.

 

The Giving Keys. (2018). About us. Retrieved from https://www.thegivingkeys.com

 

 

Celebrating Nurses

Every year around this time I receive a “Happy Nurse’s Day” card from my parents…today, my card came from my Mom; she always remembers. She reminded me how proud she is, and how proud my Dad was, of me being a nurse. The loss of my Dad always sneaks up on me. It is that constant flow of support and love that has been the driving force throughout my career, and completion of my Master’s degree. The journey that I have been on has not always been smooth sailing; there have been more than a few bumps and sharp turns (and U-turns) along the way, which have led me to where I am today…which is mostly a good place.

Nursing has been the one constant in my life. This amazing profession has helped me to grow in my career and overcome many challenges. It allowed me to support my daughter as a single parent, buy a home, and basically make “ends meet”. We are not paid nearly enough for the work that we do, but we get by.

I have worked with amazing nurses in my long career and they will always be my forever friends; the “job” connects and bonds you in a way that most other professions do not. We share similar stories, frustrations, heartbreaks, and challenges. Nursing is hard work and often we do not get recognized for having sharp instincts, endless patience, strength, and resilience…all with the sole purpose of keeping our patients alive!

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Nursing Supervisors    

nurse supervisor

As a nurse leader, it can be challenging to perform your role while walking the line between Nursing and Administration; the rules change. We are held accountable to strictly adhere to staffing guidelines, ensure patient and staff safety, consider patient acuity with staffing that is balanced with expert, competent, and novice nurses so that those with more experience can teach and develop new grads. In most hosptials, there is an abundance of upper management/leadership support and resources for patients and staff during the weekdays; on the off-shifts (eves and nights), weekends, and holidays, the responsibility of “steering the boat” changes from “many” to “one”; this singular, fearless leader is the Nursing Supervisor, who has to make difficult decisions and know when, and who, to call for help. They are called to respond to patient/family complaints/concerns, patient and non-patient emergencies, and occasionally discipline/coach staff… all while knowing that some of the choices you have to make may not be popular or well-received. I try to make the best decisions that I can, with the information that I have at the time. I am imperfect. I have made mistakes. I have miscommunicated via email, and I may have been too busy to remember to count to 10, and think before I speak during a particularly stressful moment. I am acutely aware that during every shift, I have a ton of responsibility to many: patients, families, staff, colleagues, and administration. Not everyone can appreciate that perspective…some can only see what is happening in their own area, and not the other things that may be going on in the rest of the hospital that can sometimes take precedence. We only know what we know.

Several years ago I worked with a really strong and brilliant Nursing Supervisor, Jackie; she did not mess around….she knew everything that was happening in the entire (very large) hospital, even if she wasn’t covering those areas. She could work the staffing numbers like a mathematician, and quickly move people where they needed to be to balance the numbers. In a crisis, she was calm, cool, and collected. She taught me a lot and never gave up on me, even when I made the decision to return to staffing and not stay in that role; I just wasn’t ready at the time.

We all have our own leadership styles, but the most important thing is that we lead with authenticity; we do the best that we can, practice the values of the organization, develop trust, and show compassion for others.

Happy Nurse’s Week! Enjoy the recognition from your family, friends, colleagues, and the organizations in which you work. You have earned it! It is the best job in the world!

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All Dogs go to Heaven

Please allow me to tell you about my sweet, beautiful collie, Steffi… I adopted Stef when she was 5 years old after being a breeder and show dog in Connecticut. I found out about her from a friend at the Children’s Hospital where I used to work because one of the therapy dogs who frequently visited the pediatric patients was a beautiful collie named “Jump”. Jump’s owner knew of my love for collies (I had one as a child, Timmy) and she knew that Steffi was being retired from breeding after having 3 litters, and she needed a forever home. I could not refuse this beautiful girl. Her picture and “story” below is still proudly displayed on the website today:

Steph2

CH. RIVERRUN DREAMIN’ OUT LOUD

“Stephanie”

(CH.Fleur de Lis Secret Weapon ROM x
CH. Long Acre Riverrun Rampage)

2009 Collie Club of America Winners Bitch

Judge Loralee Runnels-Bergmann critique at the 2009 Collie Club of America:
“Riverrun Dreamin’ Out Loud is another “Great One”
“Beautiful head, lovely stop, eye and expression.”
“What a beautiful girl – she has it all!”
Stephanie finished her Championship with 4 specialty majors
and her exciting win at the National Specialty.
Thank you to Judges Loralee Runnels, Mike Esch, Patti Merrill and Mary Benedict.

Stephanie is enjoying her retirement with Debbie Aston of East Brunswick,  New Jersey.

 My Stef

A dog is the only thing on earth that loves you more than he loves himself”– Josh Billings
Stef was gentle and sweet; she was graceful and elegant. She couldn’t care less about a tennis ball or stuffed toy…she was far too refined. She enjoyed being the center of attention, being petted and brushed, and she was a big fan of cheese and pizza. She got along easily with every dog and person who ever crossed her path and I was so proud to share the story of how we came to find each other.
Sadly, she seemed to develop severe anxiety and dementia the past two years; after many visits to the vet and extensive testing to rule out a medical issue, she was placed on medications to reduce anxiety; first, we tried Valium, which only made her sleepy, and then, Prozac, which helped a little…until it didn’t. We changed her diet to help manage her incontinence, which was hit or miss. Eventually we just kept her calm, happy, and comfortable, and helped her manage her difficulties with vision and hearing. Many times I had to help her navigate out of a corner because she couldn’t find her way out. I waited for her to let me know when it was “time”. Her “good” days of being perky, playful, eating/drinking, and wanting to be petted and loved, were being measured against her “bad” days, when all she did was pace and sleep, pace and sleep, and not eat or drink. I could no longer ignore what was happening. And yet I was afraid to make that very final decision. What if she was going to have more “good” days? It was now three days since she had eaten anything. My beautiful pup, who could no longer walk without tripping, or stay awake for any extended amount of time, and who could barely see or hear, needed me to love her enough to make the right and hard decision to let her go. Still… I waited one more day… I just had to know for sure. Today, she paced and she was anxious; she was breathing heavy and she broke my heart. Today, I held her and told her I loved her as she crossed over the Rainbow Bridge… until we meet again my beautiful girl.
“Such short little lives our pets have to spend with us, and they spend most of it waiting for us to come home each day” – John Grogan
Steffi
“Grief is the price we pay for love”- Queen Elizabeth II