Change

Change can be hard; we become comfortable with habit and familiarity. The longer you stay in one place, the harder it is to leave. I feel strongly that in order to grow, one must be open to, and adapt to, the challenges of change. I (especially) advocate for trying new things in one’s career, such as earning professional certifications, or going back to school to pursue a higher degree. I have written many letters of recommendation endorsing fellow nurse friends and colleagues whom I truly believed had the potential for great things in the field of nursing for other positions, promotions, or awards… even if that meant that they would be leaving my own unit/organization for bigger and better opportunities. I applaud them for being brave to try something new. As a nurse leader, it is my responsibility to raise others “up”, and I am proud to do so, just as it was done for me by my mentor, Nicole; she taught me many things about leadership and change, and led by example. Nicole also re-introduced me to the rare genius and leadership lessons from Abraham Lincoln in Lincoln on Leadership (Phillips, 1992).

“I have simply tried to do what seemed best each day, as each day came.” –Lincoln

Some of Lincoln’s greatest quotes have held the test of time and have proven to be especially true and powerful in our current political climate.

A house divided cannot stand“- Lincoln

Yes, change can be difficult, but believe in yourself and your ability to overcome obstacles and take control of your future. Confidence comes from stepping out of your comfort zone and expanding one’s experience, expertise, and perspective in other areas. In my 30-year nursing career I have worked in many sub-specialty areas in the world of Pediatrics. I was never afraid of change; it actually sustained my love of nursing. I was challenged with each and every opportunity. These different experiences have proven to be invaluable to a nursing career well-lived and loved; I wish the same for you!


Reference:

Phillips, D.T. (1992). Lincoln on leadership: executive strategies for tough times. New York: Warner Books

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

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Suicide

We have all felt sad, disappointed, and alone at one time or another in our lives. Those of us who have struggled with depression, loss, pain, isolation, low self-esteem, failure, rejection, or financial/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 an 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 the 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

My truth

I read an article from a recent Oprah magazine featuring an interview with late night talk show host, Jimmy Kimmel. Oprah asked Jimmy “On which truths would you stake your life?” (Winfrey, 2018). Predictably, he responded with a joke… something about never putting ketchup on hotdogs… but then he answered seriously “do unto others...”. The golden rule. Good one. But the question resonated with me more than the response because I feel so strongly about my convictions and truths that I have often gone toe-to-toe with people who, in my opinion, are just plain wrong. The answer to this huge question is uniquely personal to all of us, but I believe that it tells a lot about who we are, and why we do what we do, every single day. I also think that it is important to consider what we stand for, and what we don’t, from time-to-time to check-in with our own moral compass.

enemies winston churchill

The truths that I would stake my own life on are simple. I believe that you should always try to do the right thing, even if it’s hard and people get mad at you. I believe in honesty, fairness, equality, human rights, and animal rights, and I will do my best to advocate for those in need when I feel that there is an infringement on those rights. I believe that everyone deserves a second chance (after that, it’s a crap shoot), and even though it can be difficult, it is both necessary and important, to forgive others who have hurt you. You have to do it for yourself, not for them.

I’ve definitely made mistakes that I wish I could change. Looking back, I thought that I did the best that I could at the time, but regrettably I could have done better. If I did, I think my life would be completely different than it is now. I could have been braver, trusted more, fought harder, or let go faster. Live and learn. I think that it is extremely important to forgive ourselves for past mistakes, and try to not live life with regret/guilt/shame…these things can haunt you forever if you allow them to; trust me, I know.

So I ask you…on which truths would you stake your life?

stand up

Reference

Winfrey, O. (2018, April). A stand-up guy. Oprah Magazine, 19(4), pp 120-121.

Starting over

Starting over in a new job is not easy. With each job comes new staff and colleagues (or what I like to call future friends!), new policies & procedures, and new rules and responsibilities. Earning trust and respect from those in a new organization is critical to your success in your role, and ultimate job satisfaction. You have to “prove yourself” to those who don’t know you and wonder about your level of competence and skills. Merely saying that you have been a nurse for close to 30 years is not enough; you have to show them you are worthy and that you know your stuff. You look at yourself in the mirror of the restroom to make sure that you don’t have dog hair on your black pants or food in your teeth, and you silently give yourself a pep talk, “you got this!” before you walk into the crowded auditorium.

1200-353415-new-beginning-quotes

During the excruciatingly long week of hospital orientation, I sit in a room full of young nurses, most of whom are just beginning their careers, and I feel so old. I don’t have much in common with them, but eventually we begin to talk about what brought us “here”. We all feel grateful for the opportunity to work in such a wonderful children’s hospital, so that is the common denominator, and where the glimmer of hope and excitement begin. We are all on our own individual journeys and yet we ended up together in this room…starting over, again.

grateful

I recently received a beautiful book, The Wisdom of Sundays (Winfrey, 2017), from my friend Sandra, that I haven’t been able to put down. The book has brought comfort to me during what has been a very difficult year of loss. In one of the chapters Oprah talks about grace and gratitude, and she points out that gratitude opens up a new channel within oneself where blessings can be more clearly recognized. Winfrey (2017) quotes Eckhart Tolle, “If the only prayer you say in your entire life is thank you, that will be enough”. I’ve experienced many changes in my personal life and career; for better, and for worse. With every choice I have made, I have learned something from it; sometimes that lesson is filled with sadness or regret, but mostly it is filled with gratitude and thanks.

Change can be difficult and scary, but it is inevitable; one cannot evolve or grow without it. Making changes and starting over in our professional lives can be even more precarious…especially as I am inching closer to my retirement. Fortunately, I am not afraid of change, it gives me hope that the best is yet to come.

Reference

Winfrey, O. (2017). The wisdom of sundays. New York, NY: Flatiron Books

Last Time for Everything

When I heard the song “Last Time for Everything” by Brad Paisley on the radio, it brought me to tears because I clearly remember the last time that I spoke to my Dad on the morning that he passed away; I told him that I loved him, and he responded as he always did, “I love you more”. At the time, I had a strong feeling that it was the “last time” because he was so ill, but just two days before, when he was having a good day, we sat in the living room together and talked about the usual “stuff” and ate dinner together…I had no idea that it would be the “last time” we did those simple, everyday things. “Things” that later end up becoming cherished memories. The regret is that you wish you said more, stayed longer, and listened closer. The moment when I remember that I can’t pick up the phone to call my Dad to share some news, or talk to him about my day, ask his advice, or laugh about something funny… makes me miss him terribly. Those “last times” become exponentially important when they are no longer a possibility. That’s when it all becomes very sad…and very final.

last time


Nurses are acutely aware of how, in the blink of an eye, a life can be taken, often without any warning. Terrible, tragic things happen all the time… being involved in a car accident on the way to work, enjoying an evening out at a Jason Aldean concert, dancing in a nightclub, even just walking around town… the world can be an unpredictable, unsafe place. Our country is experiencing trying times, and anyone who watches the evening news knows that no one is safe from the potential of harm. Life is cut short for those who are lost, but it is the survivors who have to learn to cope with a new reality and resulting pain. While it is difficult to overcome, it is also a sad fact of life. “No one gets out alive” has been quoted often. The meaning is that we all (eventually) die, and the advice shared is to “not sweat the small stuff”, or not to take things too seriously… which is really hard to do. There are those who are lucky (or maybe more enlightened people of faith?), who are able to not waste time or energy on the draining, exhausting act of worrying; I’m sure they are (much) less burdened with stress, negativity, and insomnia!

Nurses, in particular, are faced with the difficult task of providing comfort to those who have lost someone. They become the survivors…the obituary reads “he is survived by his wife of 55 years, his children, and grandchildren”. Nurses are at the front lines; they know the words to comfort and console. And sometimes there are just no words to be said, and a hug or a kind gesture are the only thing we are able to give to those whose lives are forever changed. What words can ease the pain of a parent who loses a child? There are none that exist. It is unspeakable; unimaginable. Nurses stay strong in times of pain and grief because they must; it is a part of the job. Our patients and families look to us for support and guidance to help them through the worst day of their lives.

If only there was a way of “knowing”. I think that there should be a text message notification from God giving us a heads-up to pay close attention and take it all in, because that’s all we will have left… memories. White Light Alert:This will be your last day with your father; make it meaningful“. Most times we aren’t aware of the timing and significance of a moment that could be/is “the last time” for something….last time speaking to your loved one, last photo, last Christmas, last birthday, last time saying “I love you”… fill in the blank. There are so many “firsts” and “lasts” that we rarely recognize it until it’s too late. There are many “things” that Nursing has given me, but the most profound has been the gift of perspective. Whenever I have had a rough day, or feeling bad about something that hasn’t worked out the way that I wanted, I walk into my job on the Pediatric Hematology-Oncology/ Bone Marrow Transplant unit and I am suddenly reminded that my life really isn’t that bad afterall… my child (who is now an adult) is happy and healthy, I am physically and mentally able to care for those in need, I get to leave the hospital at the end of my shift, and I have a great job that constantly challenges and inspires me to come back for more the next day.

Reference

Paisley, B. (2017). “Last Time for Everything”. Retrieved from Youtube.com

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Becoming a Nurse

I remember the exact moment I knew that I wanted to be a nurse. It was Career Day at my High School. Junior year, 1983. I walked into the building not knowing where to start, feeling completely overwhelmed with rows and rows of tables with feathered-out brochures displaying a variety of options and fields of study. There were smiling college recruiters promising success, and colorful poster displays showing happy, culturally diverse students hanging out at the Student Center, engaged in thoughtful discussion, books in hand. It was during a mad rush of well-meaning parents, teenagers in tow, proceeding with focused determination to interrogate a recruiter from a nearby Ivy league university, that I was literally shoved into the corner of one table that was repeatedly being passed by, without even a second glance. (It is important to point out that back in the day, and by “day”, I mean, the 1980’s, there was a nursing shortage; it was not as popular of a career choice as it is now.) This table that I “found” had a sign that simply said: Be a Nurse. I remember thinking “OK, sign me up!” After all, I spent so much time in the school nurse’s office, she was on a first name basis with my parents; she always came through in the clutch when I needed a break from my classes and/or wanted to go home early. Call it fate, luck, or literally being pushed into a career; it was, as Oprah would say, my “Aha! moment“. I made the decision right then and there, and never looked back.

To this day it has been one of the best decisions of my life. It has been a job that has professionally sustained me for 29 years (and counting). But to be clear, it hasn’t always been smooth sailing. Yes, making the decision was easy; nursing school, not so much. The harsh reality of nursing was even harder. That first year after graduation was downright painful at times. As a new graduate nurse, you literally leave nursing school/college feeling on top of the world, thinking “I’ve got this!” (insert the laughing-out-loud with tears flying out of your eyes emoji here).

Then, you are “lucky” enough to get a job right out of college, working on the night shift, and your entire body, mind, and spirit are mercilessly handed to you on a silver platter (or bedpan, in this instance). You think that you are prepared to share your “gift” with those in need; heal the sick, save lives, cure cancer, maybe even meet a nice, handsome doctor (bring back that laughing emoji)…but soon, you realize that you are working with people who easily make Regina George from Mean Girls look like a Disney princess. Oh, and that handsome doctor is the one yelling, and hanging up on your for asking a “stupid” question. “Excuse me Dr. McDreamy, did you mean to order 500 mg of acetaminophen for a child that weighs 10 kgs”?

Yes, there have indeed been a few times (maybe more than a few) when I questioned “Why am I doing this”? But here’s the thing, nursing is one of the best jobs in the world in my humble opinion. I can’t imagine doing anything else. Every time that I am asked what I “do” for a living, I am filled with complete pride when I say “I am a nurse“. For every challenging and painful shift, I have received tenfold in amazing moments. I have patients and families that will forever be engrained in my mind as my “favorite”. I have learned about compassion, courage, strength, empathy, hope, faith, and love almost every single day in the patients that I care for, and in the nurses who care for them. They are my colleagues. My friends. My brothers and sisters in healthcare. Yes, there are bullies, but they are small in comparison to the amazing nurse heroes that I have come to know and love. We share similar stories, and it connects us in the same way that brings sports teams to championships, and war heroes, solidarity.

So when you consider leaving your job as a nurse, and you will, it’s ok. We have all been “there”. To paraphrase Teddy Roosevelt, “nothing worth having comes easy”.  Just don’t give up on nursing as a profession. Nursing is the gift that keeps on giving, there are so many different career paths that you can take; try them all if you so desire! Please don’t focus on the bad shifts; each shift is a lesson learned and presents you with opportunities for greatness, I promise you

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