Monday, December 27, 2010

The World of an Introvert

A few years ago when I went to Colorado for my best friend's wedding, it was the first time I was able to actually sit and talk to her husband Andrew. I quickly realized that he and I were two peas in a pod... both of us deeply intellectual people and reflective by nature, creatively oriented and severely introverted. I was so happy to know that I was able to connect so well with Ami's husband because I knew the friendship I had formed with her was going to be a life long one... and knowing I could get along with Andrew so well meant the world to me... and her also, I think.

During one of our long discussions on that trip we began talking about the popular Myers-Briggs personality test. I had never heard of it before but once Andrew and Ami began explaining it to me I was enthralled and wanted to immediately know what "type" I would be... the test is broken up by eight different type indicators and each person has four out of the eight.

You are characterized by being either:
Extroverted or Introverted
Sensing or Intuitive
Feeling or Thinking
Judging or Perceiving
I turned out to be an INFP on my original test but was also very borderline on the Perceiving vs. Judging line and these days I tend to lean more towards INFJ. (INFJ's make up only 1% of the population btw, the rarest type of all the Myers Briggs combinations.)
Now I know a lot of people think that these personality tests tend to be silly or limiting and I've often heard... usually from men that I know... that they think it's kind of dumb to put yourself in a box by labeling yourself as one of these types. I on the other hand love Myers-Briggs... and I'll tell you why. I tend to have a very strong sense of my identity defined by the fact that I am an extreme introvert and I think if you read the description of what an INFJ is... you would have me dead on.

"Consequently, most INFJs are protective of their inner selves, sharing only what they choose to share when they choose to share it. They are deep, complex individuals, who are quite private and typically difficult to understand. INFJs hold back part of themselves, and can be secretive. " Source

Bingo... me in a nutshell. I think for so much of my life I felt like I was living in a world that did not understand me... a world full of people that didn't really see me or value the things that I valued... and you know what I've realized over the past few years? I was... and I still am living in a world of people who don't understand me! When I first discovered the Myers-Briggs Type Indicator... and after talking to Andrew and discovering how similar we are... it was as if a huge weight was lifted off of my chest. For the first time in my life I felt deeply understood by someone... finally there were words that explained who I was and I realized that the reason why I often times felt uncomfortable in my own skin is because I was forcing myself to be something I am not.

See... I live in a world that is often driven by extroverts and people who love and value everything opposite of what I love and value. I am a person who so deeply values alone time... it is a necessity for my psychological well-being and physiological health. I enjoy silence and I gather energy from the calm, quiet moments I am able to withdraw from the crowds and reflect on what I'm feeling... what I am processing internally. Although I am articulate, I often times have difficulty verbalizing what I am feeling... but give me pen and paper and you will see my heart. I hate being in large groups of people where I have to small talk for hours and engage on an active level.... for me it is incredibly draining. I love having small groups of like-minded people that I can share my heart with. I love it even more when I can sit one on one with someone and share my thoughts, feelings and experiences with them and I absolutely love to be a recipient of the same on their end.... but more than anything I just long to be known .
The more I share... the more you listen and the more you are able to share your heart with me.... that is the ultimate prize in any relationship of mine.

The problem with being me is that often times people misunderstand my reclusive tendency as snobbery or they assume that because I want to be alone so much that I am lonely or shy. Both of which I am not. If I am in a group or with someone who is louder and more talkative than I am... I tend to shutdown internally and it is very easy for me to remain on a surface level with them... sharing pleasantries and laughing at their jokes but you never really see the real me in those situations and I very quickly become exhausted when around those types of people. Consequently, I have chosen to surround myself with people who are all similar types to mine. Out of my group of best friends (there are more than 10 of us who are extremely close to each other) I can safely say that only 1-2 of them are genuinely extroverted.... and even then they tend to lean towards the introverted spectrum. All of us for the most part are quiet, reserved people who value more than anything the ability to be known by one another... the ability to rely on the fact that our friendships are deep and based on being able to share and trust that our friends will actively listen and we will be heard and understood by one another. I consider myself incredibly lucky to have so many friends who I know understand me... the real me... and value the things that I value.
Now if only the rest of the world could be the same.

I am curious... have any of you ever taken the Myers-Briggs test? If not you can take it here. If so... what type are you? 
For those of you out there who are introverted like me... in what ways do you think that has affected your relationships with others, especially those around you who are extremely extroverted? 

Friday, December 24, 2010

Merry Christmas!

Merry Christmas Eve Friends!
This holiday season I am working 7 shifts out of the 9 days over the holiday week... I'm not even halfway through the stretch and I am already feeling completely overwhelmed and physically exhausted. Being a certified insomniac doesn't help the matter and I've been going on virtually no sleep for the past few days. As a matter of fact I've been up since 3am and I have to head back to work tonight for another 3 day stretch of 12 hour shifts.... Merry Christmas to me huh? :(

On a happier note, I did manage to put my tree up though! Being the Starbucks fanatic that I am... I have Starbucks Christmas ornaments all over. This one is one of my favorites :) I also was able to take part in a gift exchange with Chris' family yesterday and I got a gift card to Cinnabon (heaven) and a Disney ornament! I also got in some good call of duty playing with the boys which is always fun!

We also have the wonderful Charlie Brown tree set up with its single ornament.
Charlie Brown is probably my all time favorite holiday movie because I think there is so much to learn from that one cartoon. Such a good message and in many ways I feel like most of my life I have been a Charlie Brown tree myself.
I put the Charlie Brown tree next to one of my favorite prints by Vol. 25. She has a great shop on Etsy that you should all go checkout. For me it is a great reminder to stay thankful and this holiday season that is no exception. There is so much to be thankful for... I am truly blessed in so many ways. So today I wish for each of you to have a wonderful holiday season filled with laughter, family, friends, love and a gratefulness for each day we are able to wake up and live life to its fullest. 
I am so thankful for each of you!
Merry Christmas Everyone :)

Tuesday, December 21, 2010

Thank you goes a long way

For those who know me, I think most would describe me as being a pretty feisty character. I make up for my vertically challenged 5'1" self by having a large personality and a seriously scrappy side. Now granted... I have my moments where confrontation is difficult and there are times when I think I could use a little more gusto in speaking up for myself... but on the whole... sharing my opinion is not usually an issue of mine.

In a lot of ways I think its a very necessary trait to have as an ICU nurse... especially an ICU nurse working in a teaching hospital. I know I've mentioned it before but I will say it again... working in an environment where sometimes the physicians you are working with have such little clinical experience can be tough because often times we are all learning together.

In my unit the residents and interns cycle through their ICU rotation on a monthly basis. When I first started working here it was completely discombobulating because every month... just as the old ICU team settled into their routine and figured out how we worked here ( and usually just as I was remembering their names)... they were headed off to their next rotation and we were left to adapt to a whole new set of residents and interns. It's tough also because with each new set of folks you have to figure out which ones have more experience and which ones work well with the nurses.... which ones are good about putting in orders when you ask them to and which ones will actually work with you and not above you... if you know what I mean. To put it plainly... the rotation process of working in a teaching hospital sucks.

But... now that I'm starting to head well into my second year in the ICU there are some things that I am starting to really appreciate about the teaching hospital environment. One thing I have really been loving recently is the fact that I'm starting to see some of the physicians come back for their second rotation here. Those scared, unsure interns that we worked with last year are now coming back as confident, more experienced residents... and not only that but most of the time I know them well and have built a rapport with them which is so cool. I love seeing the growth in them and I love feeling invested in their growth as burgeoning, competent doctors.
What's even better about it, is that in many ways I think we as nurses can be a strong resource of clinical experience and encouragement for them (or a serious pain in the you know what... if you so choose). I have to admit that I have been known to have my bad days with interns... especially when they decide to do basically everything in the book to irritate you. 
See: How to Make Your Life Miserable in the Hospital--Guar-OWN-teed: A Ten Step Guide  by my favorite blogging doctor for a great example of what I mean.
But now that I'm starting to see these people come back through their second ICU rotations... I understand the value in actually investing into each one of them...
A few weeks ago we had an intern in our unit who managed to do basically everything on the "How to piss off your nurse" list and  it ended up being a very rough night. Poor thing was trying so hard to be nice and I don't think she had any clue what she was doing but I wasn't reciprocating the friendliness. When the morning came around and she thanked me for doing such a good job and acknowledged how busy the night was... my response was less than friendly, "Just part of the job I guess... but I appreciate that." My tone was not enthusiastic.
Then a few nights ago I walk into our breakroom and this same intern left one of the most thoughtful notes on our bulletin board. She thanked us all for being the "best and most intelligent nurses" she has ever worked with... "Thank you for teaching me, guiding me, feeding me and making me a better doctor!" 
Instantly I felt like a terrible person because I knew that the one on call night I had with her was completely horrendous. I guess the good news is that I definitely learned a good lesson here... no matter what the situation... there is always room for more humility and grace on my part... and also...a genuine thank you seriously goes a long way.  

Friday, December 17, 2010

7 Quick Takes Friday

It's been 7 days since I last posted and since I have a ton of things to write about and absolutely no time to write them... I've decided to join in on Conversion Diary's 7 Quick Takes Friday!

Last Saturday I ran my first trail race! It was a 10k which was perfect because for my long run that weekend I was supposed to do 6 miles... why not throw in an extra 0.2 miles right?! Well, unless you are dumb like me and you decide to follow people off trail and make it 7 miles instead of 6.2... not so fun then. It was by far the hardest run I have ever done... possibly harder than my half marathon because it was UPHILL the entire first half. I survived though and I even got a cool medal for it!

The following two days after my first trail race I could barely walk because every muscle from my waist down was screaming at me and punishing me for being so cruel. It was so bad I had to call in sick to work the day after.  Don't think I will be doing that race again next year... 
I was lucky enough to meet a good portion of Chris' family last week (he has 8 brothers and sisters... 6 boys and 3 girls in the family!) I was expecting to feel incredibly overwhelmed because I'm so introverted and I come from such a small and not-so-close family but it was actually really, really great and I absolutely love them all already. They were all so welcoming and I was so thankful for that. I've always wished I had a bigger family that I was close to and I'm excited to get to know them all more. 

Despite the fact that I feel like I have no time to catch up on anything... blog writing, cleaning, sleeping, running, seeing friends... I have been able to keep up with my marathon training... I think signing up for regular races has helped with this and it has paid off! I officially made a record for my mile time this morning on the treadmill. When I started running 7 months ago I ran a 13 minute mile and today I ran an 8:45 minute mile! Woohoo!!
This week at work was absolutely INSANE. I got to see a man's chest opened up at the bedside by our CT fellow because he went into cardiac tamponade. The only way to fix it was to crack open his chest right then and there. Literally I stood a foot away from a man's open chest and beating heart. By far one of the most amazing things I have EVER seen in my entire life.
I was able to take care of this same patient the day after they opened his chest up and it was incredibly terrifying for the first four hours because he had an intra-aortic balloon pump. It was my first time working with one of these and within minutes of me getting report on him he crashed his blood pressure and went into a heart arrhythmia called SVT (supraventricular tachycardia) = not good.
It has been a very long time since I  have been scared at work and let me tell you.... I was TERRIFIED. It all ended up being okay though and it actually gave me a great shot of life in terms of being excited about work again.... I mean how many times do you get to see a person's heart beating in their chest?!
 I have yet to do any Christmas decorating... yes... it is the 17th of December and I just started my Christmas shopping last night and I have not hung a single Christmas decoration and my fake tree is still sitting in it's box... hopefully I will fix this problem today and hopefully I can take some pictures and post them soon... haha might be an ambitious goal.... wish me luck.
On that note  I think I am going to get started.... time to be productive. :)

Yay for the weekend being near! Happy Friday Friends!

Friday, December 10, 2010

"Please Lord... don't let me cry"

"What Sarah Said" by Death Cab for Cutie

And it came to me then that every plan is a tiny prayer to father time
As I stared at my shoes in the ICU that reeked of piss and 409
And I rationed my breaths as I said to myself that I'd already taken too much today
As each descending peak on the LCD took you a little farther away from me
Away from me

'Cause there's no comfort in the waiting room
Just nervous pacers bracing for bad news
And then the nurse comes round and everyone will lift their heads
But I'm thinking of what Sarah said that "Love is watching someone die"

I know that death comes with the territory of being an ICU nurse. It's simply a part of the job and in many ways it can be a wonderful part of the job. My view on death since I have become a nurse has changed drastically. It is not something I fear anymore... nor is it a negative thing by any means. 
Death in many ways is beautiful and peaceful and incredibly full of grace. 
To be present and actively involved in such a deeply personal moment with someone is truly a gift. 

This week I had a patient die (seems like its been happening to me a lot lately) and it was the most painful death I have ever witnessed. It was expected because the patient had lung cancer with mets to the brain, and bone but still... I don't think there is ever a way to be fully prepared for the death of a loved one. Just a week prior to his death the patient was playing golf with his friend when he suddenly couldn't breathe and was admitted to our ER with a pulmonary embolism. He ended up intubated, sedated, chemically paralyzed and on every medication in the book to maintain his blood pressure, prevent heart arrhythmias, prevent blood clots.... the list goes on.

When I received report from the PM shift nurse... he began desaturating to the low 70's (normal is ideally above 95%). His blood pH was 7.11.... extremely acidotic... not a survivable level by any means. He was on 100% oxygen on the ventilator with peep and pressure support settings maxed out as high as we felt comfortably going. The ICU fellow, intern and resident all crowded into my room and we began thinking of everything we could do to try and fix this.

"I can increase his tromethamine to 20gm? Maybe that will help with the acidosis?"

"ok let's do it..." next blood gas was even more acidotic at 7.10.
"Or what if we increase the peep to 20 and then add vasopressin to increase his pressure and counteract the decrease in cardiac output?"

"We are already on vasopressin... it's maxed out at 0.04... we could try dopamine?"

"No, he has a history of Atrial fib.... it's why he is on amiodarone."
"yikes, ok scratch that idea."

My alarms started beeping... he was now dropping his systolic blood pressure to the 70'sand his oxygen saturation was dipping into the low 60's.
I turned to the resident and reluctantly said "I think we need to bring the family in..."

"I've already sent the intern to call them"

You could hear everyone take a deep breath in and the feeling of defeat in the room instantly filled the air. This was not a battle we were going to win. By the time the family arrived we knew we had only a matter of minutes to have a plan of care discussion. The resident began explaining the situation and the decision was made to withdraw life sustaining measures and to provide comfort care only.

I encouraged the family to take a moment to say goodbye... warning them that it only would be a matter of minutes to possibly hours after I remove all of the medications.
They said they were ready and so I began...

One by one I removed 4 IV poles worth of medication.
I started by increasing the sedation and pain medication and I began with removing the paralytic.
As I wrapped up each IV bag and threw it in the waste bin all I could do was pray... the lump in my throat was growing larger by the moment and all I could think was, "Oh Lord, please be with this family."
"Lord, please give this family grace.... and Lord please.... please don't let me cry."

After all the medication was off I sat in the room with the family and just talked them through what was going to happen. We sat in silence.... the son, daughter-in-law and the patient's wife... all four of us sat in the room and watched my patient's heart rate drop down from 60... to 50... 40.... then at 36 it maintained for a little while.... he was holding on. His daughter and his grandson finally arrived and within seconds the last few beats of his heart mapped out along the monitor and faded away.... he was gone. I stood up and listened to his heart, checked his pupils and looked up at the son and nodded.

Instantly the room was filled with tears. 
"I'm so sorry for your loss. I will give you a few minutes and I'll go get the physician to confirm the time of death." The son nodded back at me and I left the room.

Luckily, my friend Dirk was my neighbor that night and I went straight over to him.... he must have seen the look on my face because he instantly gave me a hug....
"You ok?"

I nodded with a big sigh, "Yeah I'll be fine... this just sucks."

"I know." he replied.

The next few hours were filled with the logistics of dealing with a deceased patient. Setting up the family with the resources they will need. Calling the police to have them escort us to the morgue. Preparing the body, and wrapping him in that dreaded body bag. I held it together for the rest of my shift and when I made it out to my car I tried not to think about the night I had just endured.

Then... I turn on my car and the song by Death Cab for Cutie comes on....
I was instantly frozen... and sooner than I could say "Please, Lord... don't let me cry..." I hear the words
"Love is watching someone die"

Like a ton of bricks on my chest, the reality of what I had just witnessed hit me... and I felt those walls I put up crashing around me... 
and I cried ... I cried that horrible, ugly cry, the entire way home.

Sunday, December 5, 2010

Funny how life works...

If you would have asked me a few weeks ago to describe the perfect guy... I probably would have used words like confident, quiet, introverted, serious, strong, charming, determined and disciplined.
In the past my "type" of guy has always been the kind of guy you'd see in the military... I've always had a tendency to go for the real "macho... smooth talker" types.... you know the kind? The guy that all the girls are in love with and the one who just knows how to make you fall in love with him instantly. I've learned that most of the time if the guy is a smooth talker it's because he's had a lot of practice in telling a lot of women just what they want to hear. I almost always go for the guys that I have a ton of chemistry with.... a ton of chemistry and absolutely no trust. And what usually ends up happening is I'm blinded by those initial butterflies and that passionate draw towards someone and I fail to see the signs that this might not be the kind of guy I want to get into a relationship with.
To put it bluntly... I'm good at falling in love with jerks.

When I first met Chris he was not on my radar at all... there wasn't that typical "spark" of chemistry I'm so used to having with the guys I end up having feelings for. A long time friend of my roommate, Sam he would come over occasionally and all I thought was, "This guy is crazy!"
He is the opposite of anyone I've ever dated and the opposite of the typical guy I usually go for.
He's extremely extroverted and loud... especially when he is in groups. He's very social and goofy and funny. He's easy to be around and not pretentious by any means. He's incredibly genuine, honest and intense in his own way. When it comes to Chris... what you see is what you get. 
A few weeks ago, during an online conversation we were talking about the new  Call of Duty: Black Ops
 Call of Duty: Black Ops
(Awesome game btw)
When I got really excited about the new crossbow they had in the zombie level... he asked me to marry him. 
Literally... his response was...
"omg, Andi, you're the coolest chick ever. will you marry me?"

So when he asked me out a few weeks ago... I wasn't surprised and even though I wasn't interested at the time, I was oddly able to have a very open and honest discussion as to why I didn't think we would work.
Unusual for someone like me who HATES confrontation and awkwardness in any form whatsoever.  
I explained to him that I thought he was great but that we are just way to different. I am almost always serious and extremely introverted..... and to top it off I am in many ways a "single at heart."
I loved my single life... a lot... and truthfully the thought of marriage, a relationship or even dating sounded incredibly overwhelming to me.... especially with someone who was basically the exact opposite of me in every way.
So... we left it at that and we continued to talk as friends... 
and I stored that conversation in the back of my mind... just in case.

Then, the day before Thanksgiving I had one of those no good, horrible, awful days where everything went wrong and I didn't get sleep and was basically in a really crappy mood.

When I talked to Chris that evening and was complaining about my awful day and the sleep I didn't get and the cooking that had to be done before Thanksgiving dinner... he offered to come over and help. He brought peppermint hot chocolate and sat and listened to me vent about my no good, horrible, awful day.... He didn't joke the entire time and he showed a serious side that I had not seen from him before. He even stayed and helped me cook all of the dishes I had to make for Thanksgiving the next day. That evening after he left, I told my two girlfriends Helena and Kelly that I was reconsidering dating him and that I had invited him to BFF thanksgiving.
I wanted to see more of the serious Chris I had discovered that night... I wanted to give the "nice guy" a chance. And for the first time in my life I decided that maybe chemistry wasn't such a good thing to base a relationship on... maybe... just maybe some fires start small, right?

On Thanksgiving night he came over, brought the newspaper and we proceeded to sift through the ads and plan out our insane black friday shopping plans (all of which included a 3am start at kohl's and a failed, yet desperate attempt at getting a 40" TV at target). That night he asked me out again and I said yes. We spent the entire weekend together that week and the rest is pretty much history. 

I mean really now... any guy who is willing to stay up all night with you and then proceed to go shopping with you and your girlfriend at 3am on black friday on no sleep... now that's a keeper.

The amazing thing about this whole process is that we still are very different from each other and that probably won't change. I still have moments where I think... "How in the world is this gonna work?!"
But the funny thing is that I'm not afraid at all. I don't think I've ever been so comfortable with someone in my entire life. I have a trust with him that is so foreign to me.... and yet so refreshing at the same time. I'm still getting used to the idea of being in a serious relationship but I think this is a big first step for me in figuring out whether I am truly meant to be single or married.
 I can't guess what the future will bring for Chris and I, but I can promise that this journey will be quite a ride at the very least. :)

Thursday, December 2, 2010

Life Lately

First off... to all my American readers... Happy (Late) Thanksgiving! I was all excited to do a Thanksgiving post... full of lovely photos of the dinner I had at my house (including the 25lb turkey I cooked!) but I failed miserably and forgot to take any pictures at all! Every year my group of friends and I have this tradition of doing what we call BFF Thanksgiving... usually the weeekend after and it is probably one of my favorite parts of the holiday season. I've said it before but the holidays with my family are usually pretty stressful and BFF Thanksgiving is the opposite of that which is why I love it so much. Although this year my family decided to split things up and it worked out well. Dinner with my grandparents in the afternoon and dessert with my mom and her friends in the evening... made for a lot less fighting this year which was much happier for everyone I think. :)
Thanksgiving morning I ran my first 5K race... in 38 degree weather, might I add (that is freezing for us Cali folk)! The race supported an organization called KidsStrong. A charity that supports families of child cancer victims and survivors. I was happy to make a personal record also! 28:50 minutes for 3.1 miles... not bad for someone who ran 13 minute miles just 7 months ago! :)
Another fun thing that has been a great addition to my marathon training... trail running! One of the things I love most about where I live is that we have the most amazing hiking trails just minutes from my house. Full of lush green trees and redwood forests. How could you not want to run all the time when the scenery looks like this?! One of these days I'll take my SLR out there and get some better pictures of the place. Unfortunately my iphone takes pretty crappy pictures but I think you guys get the gist :)
In a few weeks I will be running my first 10K trail race too which should be fun... especially because there will be finisher medals for that one. I'm a total sucker for those racing medals!
On a more personal note... this girl... the one who has been infamously single and has (for the most part) loved it and thought she would remain that way forever... is now in a relationship... *gasp* I know... there will be updates on that to come soon but for now I must get back to work :)

How was everyone else's holiday?