Smiling through the Pain

Nurses are caretakers; it is our job and natural instinct to be the provider of care, and not be at the receiving end. I’ve been on the other side of the bed (as a patient) a few times… each experience was pure torture for me; I cringe when I think about the compromising positions that I have had to endure. I am a terrible patient. I have severe trust issues; when one has worked very hard to be fiercly independent, it is an uncomfortable feeling to be vulnerable. I have been living with back pain for years; after two spinal fusions, I have (almost) gotten used to it. I megadose on Ibuprofen and Acetaminophen two- three times a day, and I try to smile through it and not complain. I carry on with my day and know that others have it far worse than I do. I joke that it’s “tough to get old”, and I am fully aware that I am at the age where it is natural to feel aches and pains; but the reality is, pain can be exhausting. It affects everything that you do, or want to do; a simple trip to the Mall to go Christmas shopping becomes less fun and festive by the minute, and you eventually rationalize that gift cards will be a win-win this year, and head for the comfort of your car… and if you are being honest with yourself, you know that this is not normal.

The MRI showed arachnoiditis. I do not know what the future will bring, but I got through today, and tomorrow I will do the same.

Broken Branches (the sequel)

I’ve had a complicated relationship with my sister most of our lives; one could describe it as a roller-coaster of highs and lows. It has come very close to a verbal agreement to terminate the biological bond several times (in anger), and always as a direct threat from her ….“We are done”; “Never speak to me again”; “You are severed from the whole family” “Consider yourself uninvited to Christmas dinner”. I believe we are there now, and like all relationships, others have been affected from the broken branch off the family tree; and for that, I am heartbroken, because no matter what issues there are between us, it is not something that calls for others to jump on the bandwagon and take an official “side”. We are both “right” in our own minds… but we own it as individuals.

Perhaps I could have waited a day or so to consider the permanent damage that was caused by disclosing some of the personal texts that I received… perhaps I could have just remained silent, and allowed the storm to eventually pass like it always does. But that’s how life is sometimes…we act, or re-act, according to how we are feeling … pain, sorrow, anger, or joy… this is life, and life is sometimes messy. I am always honest about who I am, and what I stand for, and I will continue to do so, because if nothing else, I have earned the right to have an opinion, regardless of what others may think of it.

Anger is like a strong wind; it calms down after a while, but some of the branches are already broken”– Rumi

Pain and disappointment are heavy burdens, and can come from a very deep place in one’s heart, even if you have built strong walls to protect it. It is the feeling that no matter what you do, even if you tried your best, it is not enough…it can even make you feel that “you” are not enough. (Don’t believe it for a second!) Ironically, some of the people who are supposed to be the closest to us, and most trusted, can be the ones who can cause the deepest heartache; they can be one’s harshest, most unforgiving critic; they carry expectations that can become twisted in reality or perception… and sometimes, anger can make one deaf to reason, and blind to the truth.

As I sit here today I am thinking about how words matter, and how you treat others matters. Kindness matters, and so does forgiveness (with, or without, a proper apology). It’s not ok to use your words as a means to intentionally inflict pain or shame… I know this feeling well, and I don’t want to use my own words to cause harm to others. I will continue to stand up for what I believe in, and for what is right… even if I stand alone, as an army of one.

Our Unforgettable Patients

If you want to find out what motivates nurses to do what they do every single day, ask them about some of the patients who made a difference in their lives…the stories that they tell will move you; they will make you laugh and cry, and they just may help you to understand the power of purposeful service to others. Every now and then, completely out of the blue, I am given a gentle reminder of the unexpected gifts that this amazing profession has given to me. Yesterday, while I was cleaning out my glass cabinet looking for my red Christmas wine glass that reads “He sees you when you’re drinking”, I came across my rather impressive collection of shot glasses, and I found myself thinking about a patient whom I had the privilege of caring for several years ago. Let me explain…

This young man was diagnosed with Acute Myelocytic Leukemia (AML) in his late teens; he had spent several years in and out of the hospital for chemotherapy treatments and subsequent admissions for fever/neutropenia, blood products, etc. He had been doing well; he was working hard and attending college on a full scholarship when he found out that his cancer had relapsed and he was going to need a bone marrow transplant (BMT). He stayed strong and optimistic; he had big goals and cancer wasn’t going to get in his way. He was turning 21 just before his scheduled BMT and he had plans to take a trip to Las Vegas with his friends because that was how he wanted to spend his birthday “sipping Patrón tequila and partying”. He knew that each birthday was a gift, but “21” was a milestone that he wanted to experience the most; he wanted to be like every other 21-year-old who got drunk on his birthday as a “right of passage”. This was amusing to all who knew him because this young man was the very last person you could imagine drinking tequila in Vegas! Unfortunately, due to an infection, he ended up having to spend his 21st  birthday in the hospital (in the very un-exciting state of NJ). Yes, he was disappointed, but he rolled with the punches that kept coming his way (as always).

I was working nights at the time, and at the stroke of midnight, on his 21st birthday, all available staff on duty that we could muster up for a few minutes, entered his room singing “Happy Birthday to you…”; we all had shot glasses (aka 30 ml clear plastic medicine cups) of apple juice in hand to toast the now “legal” birthday boy. I had a “real” shot glass from my one and only trip to Las Vegas and presented it to him for his “shot” of AJ, which he happily kept as a souvenir. As corny as this little make-shift party was, he loved it, and he talked about his plans for next year to (really) celebrate…I am certain that he never doubted for a minute that he would get to Vegas one day.

I would try to visit with him regularly to check-in and see how he was doing, and each time that I was there, he talked about his “Vegas” birthday party and smile. I didn’t fully comprehend until then how much this small gesture meant to him and that he would always carry that memory with him. Sadly, that would be his last birthday; he had fought so hard, and he never gave up. He taught me about courage and resilience, and accepting defeat gracefully. At his wake, his sister thanked me for taking the time to help him celebrate his last birthday. It meant the world to me that I could make a difference… showing someone just one small act of kindness could be that one thing that they need to get through a difficult time.

I cleaned out one of my glasses and drank a shot of apple juice in your memory today. Cheers my friend!

When you are a nurse, you know that everyday you will touch a life, or a life will touch yours.” – anonymous

enjoy the little things

A Time of Reflection

reflection experience

Christmas is a season not only of rejoicing, but of reflection.“- Winston Churchill

As we enter the holiday season, please remember to take a few moments to reflect on the people and things in your life for which you are grateful. While things haven’t always gone the way that I wanted, or hoped, I have been very fortunate, and I am thankful. I have a close relationship with my daughter, which I value above all else; I have two golden retrievers that are always happy to see me, and shake with pure joy every time I walk through the door; I have family that loves me (for the most part), and have always been there when I truly needed them; and I have an amazing army of friends who support and love me, even when I feel unlovable. I have had an extraordinary career in a profession that has given me far more than I could ever give in return; and I have been able to pour my heart out into words on this very personal blog, which has gotten me through an extremely difficult year, with the loss of my father.  So thank you for taking the time out of your busy day to read my posts; I am also grateful for you!

Life can only be understood backwards; but it must be lived forwards”– Kierkegaard

Reflection is the ability to “think things through” in order to gain insight into something that has occurred in the past; it allows us the opportunity to consider our actions and choices, and learn from them. It is in the quiet moments when I press the “pause” button and use thoughtful reflection to help process the good, the bad, and the ugly, and (hopefully) calm the mind and spirit.  I may not enter a church as often as I used to, but I pray every day and feel close to God whether I am in my house, or His. I appreciate each day and know firsthand that time passes quickly, and no one is promised tomorrow. I have “enough”, and I wish for you the same.

I wish you enough

I wish you enough sun to keep your attitude bright no matter how grey the day may appear.

I wish you enough rain to appreciate the sun even more.

I wish you enough happiness to keep your spirit alive and everlasting.

I wish you enough pain so that even the smallest of joys in life may appear bigger.

I wish you enough gain to satisfy your wanting.

I wish you enough loss to appreciate all that you possess.

I wish you enough hellos to get you through the final good-bye.

(The copyright for this poem belongs to the author: Bob Perks)

Building a Better Boat

I am a work in progress. I want to be strong(er). I am trying to “build a better boat”… one that doesn’t sink in rough waters, or crack under pressure; one that can withstand the dark and scary storms that life brings, sometimes without warning. I am not perfect and I have made mistakes that I wish I could change… but here’s what I know… I can’t change the past, and tomorrow is never promised. God willing, I wake up each day with a fresh start and another chance to get it “right”.

We (all) have absolutely no control over how others feel, or what they say, or do. We are only responsible for our own actions. Being accountable to what we “put out” into this world is very important. A flower cannot grow in darkness. Owning our thoughts, feelings, successes, and failures are things that can never be taken away from us; they are a part of who we are, like it or not…and no one can truly know how it feels, unless they are “us”. No one has the right to judge or take away that which makes us who we are, and what we believe; “do not judge, or you too, will be judged” (Matthew 7:1-6).

We each have a path that we must take in life; sometimes we are surrounded by family and friends, and sometimes we must take that path alone. I am not afraid.

Better Boat (lyrics)

I ain’t lonely, but I spend a lot of time alone

More than I’d like to, but I’m ok with stayin’ home

My how the last few months have changed

I’m smilin’ more despite the pain

(Chorus)

I breathe in, I breathe out

Got friends to call who let me talk about

What ain’t workin’, what’s still hurtin’

All the things I feel like cussin’ out

Now and then I let it go, I ride the waves I can’t control

I’m learning how to build a better boat

Written by: Travis Meadows, Liz Rose

Performed by Kenny Chesney (2018)


			

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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The importance of “best” and “worst” shifts

Close your eyes and think about the worst shift that you ever survived; I use the word “survive”, because after such a shift, one can feel like they have been through Hell and back in what seems like a never-ending 12.5 hours… who am I kidding, we are nurses, it’s more like 13-14 hours! My worst shifts weren’t the “busy” ones that happened because we were short-staffed, didn’t get a break, or got swamped with admissions… those happen all the time and we (just) get through them. No, the worst shifts stay with you; you remember how they made you feel… sadness, self-doubt, anger, or frustration… or all of those things piled into one really crappy day.

We remember the painful things; it’s not by choice. As nurses, we often bear witness to horrific events that occur every day, in every city or town. We see car accidents, victims of violence, drownings, child abuse/neglect, etc. We try to help in any way that we can, and when we can’t, our heart breaks because of our limitations. My worst shifts will never be forgotten… I remember the bruised, emaciated body of a little boy who was kept in a cage in his adoptive parent’s basement as we tirelessly worked to resuscitate him; we did everything that we could, but it was too late. I remember caring for a teenage girl who attempted suicide by hanging, and was brought back to a life of complete debilitation. I remember providing end-of-life care to a young girl who fought a courageous, but impossible, battle with cancer, and once she peacefully passed from this life, with her parents and siblings at her side, her mother’s heart (literally) stopped beating, and we had to immediately go into life-saving mode, call a “code blue” and start CPR on mom, right outside of her deceased daughter’s room. We brought her broken heart back, whether it wanted to continue to beat or not. I still think about that family many years later. I will never forget that day and the lesson it taught me that one can truly die from a broken heart.

Now… take a breath, close your eyes, and think about your best shift at work…did it inspire you to be a better nurse, or a better colleague…or a better person? The best shifts are not the ones that are uneventful, or dare I say, “quiet”.  No, the best shifts are often unexpectedly extraordinary. A “best” shift is created when you are working with a great team and all the stars are aligned in your favor for a positive outcome. I remember one of my best days… I was an active responder during a Rapid Response that quickly escalated into a full code. We did everything in our power to re-start a life, but we soon became painfully aware of the high probability that we may lose our (very) young patient. It seemed inevitable, but during the final pulse check, as we all looked up at the monitor in complete silence… a rhythm suddenly appeared, and pulses returned. We coudn’t believe it, but we gratefully accepted this gift from above. The best shift becomes that “crazy, unbelievable” story that you share with one another, forever bonded as witnesses of a true miracle.

“Best” and “worst” shifts are equally important because they define our actions, attitudes, and our experiences as nurses; we learn from them; they make us (more) human, and better nurses. They also create stronger and more unified teams, because best and worst shifts connect us forever. I wish you all best and worst days that will give you the strength and empathy that you need to be compassionate, grateful, and kind to one another.

nursing inspirational quotes Best of 50 Nursing Quotes to Inspire and Brighten Your Day NurseBuff

My article was published on Allnurses.com:

https://allnurses.com/general-nursing-discussion/the-importance-of-1169317.html#.W1eJt0Etm0E.link

Depression. Despair. Suicide.

I originally wrote this post about suicide two years ago after several incidents of “jumpers” from a nearby parking garage occurred within a short time frame, and I couldn’t get past the sadness and horror as I walked past it everyday. It touched me deeply, and I didn’t even know them… but I knew of them, and seemed connected to them in some way. Each time it happened, it seemed like a dark secret no one would talk about. There was minimal information in the newspaper, and I had so many unanswered questions. There is a stigma that comes with mental illness that many do not feel comfortable talking about. So we don’t.

Now, I’m going to open up and get very honest and personal. My cousin committed suicide when I was young… it was something that wasn’t talked about in my family, and I am still not certain of the specifics and I wish I knew more. A dear friend’s son committed suicide last year… it has been absolutely devastating for her, her family, and Alex’s friends (my daughter was one of his friends). They will always mourn his loss… he was gifted, and kind, and successful, yet he couldn’t ask for help to get out of the darkness.

Something happened recently that shook me to my core; my daughter attempted suicide. She became so overwhelmed with her work in the news industry, with this relentless cycle of negativity and civil injustice, that she quite literally “broke”. Her compassionate heart could not continue to write (and re-write, and re-re-write) about the horrific acts of violence and sadness in the world…. that, and the tragic loss of life with the global pandemic, and the isolation of being in quarantine, was too much for her to bear, and she lost something that keeps most of us moving forward… hope. My own beautiful daughter became so depressed that she didn’t want to live another day. That shocking realization is something that I was not prepared for… not my sassy, funny, bright, strong, successful daughter…. that can’t be… under my own eyes, in my own house. How did I miss this? I felt like I had failed her. In hindsight I did see some subtle changes, but she was good at pretending she was ok… she stopped working-out with her virtual trainer because it was so hot outside. She stayed in her pajamas all day because didn’t everyone who worked from home do that? She wasn’t sleeping because she was working so hard writing for the news show that she produced. And me…. I am a Nurse, so I went to work like I always did, even under the stress of Covid… I came home late, sore, and tired… and I missed it. But thank God, I was able to stop her in time… and I got her help. Yes, we have guardian angels among us.

We have all felt sad, disappointed, and alone at one time or another in our lives. Those of us who have struggled with depression, or other high risk factors such as loss, low self-esteem, rejection, or 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. We all have our own inner demons that come out when we are at our most vulnerable.

Depression is an illness that often can be mistakenly viewed as a sign of weakness, or an inability to cope with everyday life. This is just not true. The American Psychiatric Association (2018) defines depression as a medical illness that affects how one feels, thinks, and acts; it can lead to thoughts of suicide if left untreated with the right mix of therapy and medication.

Suicide has been described as 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. These are scary statistics…especially when they hit so close to home. 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; 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 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 the signs and symptoms of depression and not be afraid to ask 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, and most important, we need to support them and not judge them. “There but for the grace of God, go I”. Timing is everything, and if the pain and despair are recognized early enough, perhaps a life can be saved.

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. 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

The Giving Key is a “pay it forward” movement that helps support and create jobs for people transitioning out of homelessness (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