Friday, April 1, 2011


Waiting for a particular turn of events is a good way to head yourself into disappointment. Depending on anyone to make you happy, make you feel good or lift your spirit is a sure way to place yourself in isolation. When your joy is dependent on people and conditions, it is restricted. Joy must spring forth from you before it can surround you. Joy must be the way you walk and the way you speak to those who come into your realm. Joy is knowing you are doing what you can, the best you can, and you are feeling good about it. Joy is knowing time is on your side and wherever you are, you are the joy. Joy is taking a moment to say thank you, a day to do for self and an energy of sharing what you have. Joy is not what happens to you; it is what comes through you when you are conscious of the blessing you are.
 -Iyanla Vanzant-
 I read this quote on Yolanda Holder's blog this week. She is the "walking diva" and currently is the Guinness world record holder for "most marathons run by a woman in a calendar year." I believe she actually even tied with the male record and did 104 last year. One of which I did a 5 mile run during!
She is incredible and inspiring and I just love that she posted this Iyanla Vanzant quote on her blog. Iyanla Vanzant is one of my favorite authors as well... gotta love such women of strength, wisdom and grace!

This week I have been feeling strange. Oddly detached from everything and just kind of feeling a little emotionally lost or lack luster in a sort of way. Not particularly sad or upset or worn out.... just kind of floating through the motions. You know what I mean? 

This quote came at such a perfect time. I want to have joy. I want to be joy. In my line of work joy is a commodity. I have some co-workers who are those types of people... they exude joy in everything they do... even when they are completely livid or frustrated or exhausted.. they always have a smile to share or a hug to give. I want to be like that more often. 

Earlier this week I read an update on from one of my old nursing instructors who is battling cancer. She wrote a simple story that stuck with me...

A blind boy sat on the steps of a building with a hat by his feet. He held up a sign that said: "I am blind, please help." There were only a few coins in the hat.
A man was walking by. He took a few coins from his pocket and dropped them into the hat. He then took the sign, turned it around, and wrote some words. He put the sign back so that everyone who walked by would see the new words. 
Soon the hat began to fill up. A lot more people were giving money to the blind boy. That afternoon the man who had changed the sign came to see how things were. 
The boy recognized his footsteps and asked, "Were you the one who changed my sign this morning? What did you write?"
The man said, "I only wrote the truth. I said what you said but in a different way. I wrote: 'Today is a beautiful day; but I cannot see it.'"

 My assignment this week was a tough one... a patient with severe necrotizing fasciitis (trust me you don't want to know more... it's a bacterial infection that eats away at your skin, muscles and bones and causes painful, awful looking wounds.)
Another patient with a severe poly-substance and alcohol abuse history and 3-4 different mental health disorders to boot. Came from our blind rehab unit as a code blue from a narcotic overdose. Now I get him a week after he assaulted about five of our nurses, (including an attempt to kick me in the face while I held him down so that our charge nurse could give him ativan) sending one of our nurses down to the ER after he kicked her square in the chest.

Yeah... not fun. 
So, two days in a row I am buried in dressing changes and drip titrations, hoping to eventually wean this guy off sedation for possible extubation in the morning. The man is on enough sedation to knock an elephant out (7mg versed, 250mcg fentanyl and 0.4 of dexmedetomidine) and is still awake, restrained and agitated... attempting to talk around his ET tube and thrashing all over the place.
Magically, by the end of the first night he mellows out and we end up spending the morning rocking out to Journey and Pink Flloyd on the classic rock station. I am pretty shameless about singing while I work. I grew up in choir and I miss singing so I love it when I have a chance to sing with/for my patients and luckily it didn't bother him at all. The day was busy but it ended well.
The next night it was the same thing all over again.... dressing change.... drip titrations... argue with the interns about getting something other than fluid for my patient's bottoming blood pressure and begging for  basically every. single. thing. I needed to make my patient stable and comfortable.

He was still agitated and nervous... suffering from paranoia and anxiety most of the night.
But then again.... morning rolls around and he is starting to mellow out. I sat at his bedside, holding his hand in an attempt to offer some comfort and he motioned for me to sing for him.... pointing at me and then pointing at his ear... waving his hand in the air like a conductor. I had the song "Landslide" by Stevie Nicks stuck in my head that whole night and knowing he was a classic rock type of guy I figured I'd just sing that. So, I pulled up a chair and began to quietly sing...
"Well I've been afraid of changin' cause I've built my life around you... 
And if you see my reflection in the snow covered hills
Well maybe.... well maybe...
The landslide will bring you down"

It's almost 6:00am now and I can see the sun start to peer over the hills... I finish the song and he motions for me to sing it again. I look at the clock and despite being behind on charting I figure I can spend an extra few minutes here... hoping he'll fall asleep for a little while.

And suddenly something changes... his grip on my hand relaxes and he closes his eyes. Tears are falling down his cheeks and I can see he is in a bittersweet moment. Pain and peace and fear, all wrapped into the same space. 
6:20am now and I look out the window again... this time being greeted with one of the most stunning sunrises I have ever seen. I immediately stood up and snapped a picture with my iPhone... hoping I could show it to my patient since his bed was facing away from the window.
"You have to see this! The sunrise is absolutely gorgeous!" I hold my phone up to his face and instantly realized what I had done....
how could I forget? 

He cannot see it.
This man is blind.
He tries to smile around the ET tube and motions for me to hold the phone closer.... he has a tiny amount of residual sight in his right eye. My heart sank as he squinted and pulled the picture about an inch away from his face. 
"Can you see any of it? Can you at least make out the colors?"
He turns towards me and shrugs with a slight nod and a small smile.
In that moment... that story became so incredibly real to me.
'Today is a beautiful day; but I cannot see it.'
I wanted to cry... I wanted to crawl into a hole and hide from the world, I felt so awful for being so insensitive to my patient... but instead I decided to have joy... I decided to be joy. I described the sky in detail to him and then proceeded to sing to him once more. I sat next to my patient... his hand in mind and I soaked up that sunrise for every minute it had left. I silently prayed... thanking God for the ability to see such a beautiful day.
It is one I definitely will never forget.


  1. Wow, what a nice post. It brings tears to my eyes. What a life lesson. You are a wonderful nurse!

  2. that guy...he is really crazy, but at times a total sweetheart. i feel bad for him. you are amazing for working with him the way you do.

  3. thank you for this beautiful post that i started my doctoring day with. you are such an amazing rn, and person and soul- thank you for sharing your stories