Yes, it is my pleasure to recommend you for this job!

Never underestimate the importance of experiencing the best and worst days in your nursing career with friends and colleagues who have walked those long hospital hallways right beside you. I always knew the reason behind my success, and decision to keep showing up when things got hard, was because of the special bond that we all shared with one another. Yes, it is always about our patients, but it is also about not dropping the ball when our team needs us.

I think this is what I miss the most. I miss the camaraderie and the connections. I miss feeling like I am a small part of a much bigger picture. I miss laughing when the only other emotional choice would be to cry. I yearn for the days where I wouldn’t have to look more than a few feet away for a friendly face who was willing to share a not-so-fun task with me, if for nothing else than moral support or a witness! I miss those days, but I will never forget them for as long as I live.

I often get asked to provide professional recommendations for many of the nurses that I have worked with in past roles as either a peer or manager. I see it as an honor that I am entrusted with this important step in creating new and exciting career opportunities for the people who continue to challenge themselves to learn and grow, for only change can provide new perspectives and ideas to help us to think and practice in a different way from what we already know. Today, as I completed one of those professional references for an old friend, I thoughtfully considered the last question, “What are the top 3 strengths of this candidate?”. All I could think of is “where do I begin…”. As a nurse who showed up to care for the sickest of the sick in 2020, in NYC, during the earliest, scariest, and deadliest time of Covid, the “strengths of a nurse” have new definitions, like courage and bravery, selflessness, and unparallelled dedication to her (or his) patients. In a time when the future was not certain, and science became so unpredictable, even deadly, showing up day after day, is really all that needs to be said. That’s the nurse who I want working beside me, whether we are in a pandemic or not!

Remembering my purpose

I was just honored with an award for my blog. I never expected it, and it was a joyful surprise, and I haven’t had many of those lately. It’s never been a competition for me. It’s just been me, sitting at my laptop, and writing what is in my heart. Less of an ambition, than it was a form of self-expression. I prefer my words in the written format, because I am less astute at the speaking part of interactive communication. This recognition was a gift I think that I needed right now, with feeling somewhat uninspired as of late. So I am grateful for the kind words. It made me very happy and proud.

Being a nurse has been the one thing that I have been really good at; it’s how I define myself, even now. But I was having lunch with friends recently (all nurses) and we started talking about our most memorable experiences and patients… and we had some serious belly laughs… and some painful memories came up as well. It made me remember something that I heard that goes a little like this… “you pay for good days by having bad days, you pay for joy with pain”. And it was then that I realized that I almost forgot “her” name. I remember everything about her, from the day of her cancer diagnosis, to her last day on this earth in the PICU many years ago. As fate would have it, I was there for both. But I never want to forget her name. She was important and she was memorable… and she made a difference to all whom she met in her too-short life. She has always been one of my “reasons” for being proud of what I do for a living.

I have the heart of an empath; I can feel sadness and pain, and it makes me feel the same. I can feel joy and lightness, and it makes me feel alive. I am the happiest when I feel like I am doing something to help others, so when I feel like I am in a rut, I feel useless. And that is not a great feeling.

I currently work as a nurse for an insurance company; it’s a good job and I get to mostly work from home, which is a huge part of why I made this career choice. But as a nurse, it’s never been about insurance…never. Insurance is boring, let’s face it. Being a nurse is far from that. I can tell you that we never even considered it in our practice. That’s not to say that it wasn’t an “issue” in the medical management of our patients, just not “our” issue. I believe that we all deserve the same level of great care. Period. Hard stop.

That’s why it’s so hard for me to understand when my “members” (my pediatric patients) don’t get approved for important procedures/testing/consults with specialists that are out-of-network, etc., that could help with diagnosing, or managing, complicated medical and behavioral problems. I come from a place that always wants to help; to fix what is broken, but I can’t do that now. It’s not the way that this job works. But they try, and I try. And that’s important too. I guess I just need to remember my purpose in all that I do, whether I can see the outcome of that, or not.

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.

Saying Good-bye

I have been a nurse for many years, and in that time I have made amazing friends and memories. You tend to form close bonds with those that share common experiences… good or bad. We remember our favorite and least favorite nurses to work with, the best and worst docs, and the patients who remind us why we continue to do what we do. We mostly remember the best and worst shifts, and share stories that make us laugh, cry, or just shake our head in disbelief that that just happened. But eventually many of us move on, and decide to leave jobs that are no longer fulfilling, or the organizational leadership changes into something that you can’t support, or you decide to be brave and try something else…or a combination of the above… and we are faced with saying good-bye.

When we are no longer able to change a situation, we are challenged to change ourselves“- Viktor E. Frankl

Saying good-bye is hard. I’m terrible at it. It is so final, and the thought of losing one more person in my life that has become important to me, especially after losing my father recently, makes it even harder. Sure, we say we will stay in touch, and see each other soon, and stay connected on social media… but it’s just not the same. It is a loss, and loss is painful.

I have made lifelong friends in all of my jobs… they are the best of the best… but yesterday I had to say good-bye to some amazing people that I have grown to love in only 3 short years. I was leaving for all the right reasons, and I was prepared to say good-bye; I had been gradually talking about my need to leave my job for a few weeks; saying it out loud to reinforce to myself that it was for the best… but that last day was the worst. I cried. A lot. It was embarrassing. No one died, and yet today, I am in mourning. I don’t feel sad about leaving the place, or the job itself (it was a very stressful environment and a helluva commute to be honest); I am sad about leaving the amazing people that I worked with and got to know on a deeply personal level. They are some of the hardest working people I know. It is not easy to work in a huge Children’s Hospital in NYC. It’s a tough place that is indisputable proof of Darwin’s “survival of the fittest” theory; only those who are able to adapt to an environment, and struggle for existence, can survive and succeed. If only I could transport these amazing people to my new job, close to home, I would do so in an instant. But it’s not possible, and it’s not about me.

I will always have this piece of my heart that smiles whenever I think about you.

GWB

Nursing at end-of-life

Nurses are both blessed and cursed with witnessing life, death, and everything in between in our professional roles. We see pain and tragedy all too often… sometimes every day if you work in a busy Emergency Department or Intensive Care Unit. It can be very difficult to experience the feeling of helplessness when caring for a patient who is not going to “make it”. Our goal is to save lives. “Not today”, we tell ourselves as our patient crashes; we call for help and start resuscitation…sometimes it works, and sometimes it doesn’t. Highly skilled and experienced nurses are able to adapt to the stress of life-saving emergencies, but it is still a very difficult process; we focus on tasks and try not to think about the patient being so young. We try to block out the cries and looks of fear from family members as they pray for their loved one to survive. We get through them because we must; we have other patients who need us, and this is what we signed up for when we chose our profession… or it chose us.

We take the laughs when we can because humor really does help us get through those horrible shifts. We create “inside” jokes with our friends and colleagues to stay sane. I believe this is why nurses develop such strong bonds; we understand each other.

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And then there comes a time in every nurse’s life when we are faced with the challenges of caring for a loved one as they near the end of their life. I am here now. Both of my parents have cancer; my mother has malignant pleural mesothelioma, and my father has stage IV bladder-lung-bone cancer. Fortunately, my mother has outlived her predicted life-expectancy of less than a year by an additional year, and has responded to chemotherapy, Alimta. My father, on the other hand, has not responded to chemo (IV or instillation directly into the bladder), cyber knife, radiation, or immunotherapy. We have had those difficult conversations with the oncologist, who is as kind and compassionate, as he is honest. As a family we have practiced patient-centered care by placing his preferences and needs at the center of his treatment plan; he is now in hospice and we are focusing on comfort and quality of life. To say that I am deeply grateful to their expertise and care is an understatement; they are truly amazing.  They manage pain with all the available tools in their “comfort care” toolbox; what they don’t have, they get. Quickly.

Talking openly about funeral arrangements, and what to expect as death becomes imminent, can be impossible to imagine when you are face-to-face with your dying parent. I suddenly forget that I am a nurse, and am back to being a daughter that can’t form a sentence without crying. You are torn between wanting (much) more time, and wanting the pain to end for your loved one. I am much better at holding things in and not saying what needs to be said, which has led to a mountain of regret in my lifetime… but that’s another post, for another time. Trying to manage my feelings and emotions about being a nurse, and caring for my father, who is nearing the end of his life, is what inspired me to start this blog. I hope that it can help me to find the words that I need to say in the end.

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