Friday, May 27, 2011

a moment

today every part of my soul feels weary. i have been walking in a sort of daze. a mix of exhaustion and sorrow and gratitude. there are moments in your life that change you. moments that give you such a clear view of your existence that you can never be the same. i made the choice to become a nurse because i knew that if i did my life would never be the same. 
it has been a long month. a busy one in our unit and it has taken a visible toll on everyone. lots of sick calls. lots of complaining. lots of very sick people who need a lot of care and not enough people to give it. emotionally we have all been drained. i am drained too. 
in the past month i have taken care of multiple patients with debilitating, chronic, fatal diseases. they teach you in nursing school how to have boundaries. how to let go and care at the same time. how to set limits with chronic patients without seeming harsh. i have never been good with that. i oscillate between the lines.
yesterday was my last night of a long stretch at work. i was tired and in pain. i had a very stable assignment. not a busy one by any ICU standard. just difficult. one patient on his 7th round of chemotherapy, suffering from a vicious cancer and a mild infection. i was thankful he slept for almost the entire 12 hour shift. thankful for the chance he got to rest and restore but thankful for myself too. thankful for the minimal interaction needed. 
my other patient, a man in his prime, suffering from the end stages of ALS (lou gehrig's disease). the only muscles left with any sort of function in his body were above his neck. he could not move, could not eat, could not speak. he couldn't even breathe without the help of a ventilator and tracheostomy that was placed. he could barely mouth enough words to ask for what he needed. his wife was there at the beginning of my shift. she wanted to make sure the night shift nurse was a "good one." that is always a bit of an anxious thing for me. the ICU is stressful and often times families of ICU patients are burdened with fear and sadness and an acute awareness of their loss of control. then here comes this 26 year old girl who will be taking care of your husband, father, brother... your son, who is on a ventilator and a plethora of medications that need titrating and managing. for them it is terrifying. which i understand. i do. but it is still hard.
it is hard to tell what they expect. what they want. do they want you to be happy and positive and cheerful? do they want you to be serious and somber and just down to business? or do they want you to be friendly with them and treat them like you have known them for years? i see some of my co-workers who are warm and friendly and smiley. hugging their patient's family members and chatting like they are bff's. i have never been good with that. i am not good at being smiley. i am genuine and hard-working and compassionate but i am not smiley. when i am at work i am serious and professional. i think some people see it as being cold and that is difficult for me. i want them to know that i am giving 100% of my attention to their loved one but it is hard when you don't know how that person receives that message. everyone is different. 
often times i am the one who relates to the few that everyone else has a hard time with. the quirky, walled up, introverted ones. the ones that take a little more time to get to know. i get that because i am that way too. maybe it is a trust thing. or maybe its just time. i find though that the ones with the hardest shells have the softest hearts. a lesson my mother taught me years ago and one that i never forgot. 
i knew this could be a difficult night. i was right. it was difficult. it was long. it took every ounce of energy left in my being to give the care i gave. it took a lot of venting sessions in the break room and hugs from my co-workers too. i am so incredibly thankful for them. they keep what little sanity i have left intact. 
i spent 90% of my evening trying to understand my patient's pleas for help. imagine what it would be like to have your mind fully functioning and completely aware of your existence but to have no way to connect that to your physical body. imagine having no way to move into a comfortable position. no way to wipe the tears from your eyes when you are sad. no way to scratch your head when it itches. or move the covers off of your body when you get hot. no way to eat or no way to communicate clearly that you've gone to the bathroom in your bed and need to be cleaned up. no way to tell someone you love them. or to say that you are in pain.
every time we had to do anything to my patient it required a 30 minute session after of discussing ways to reposition him. he would nod and attempt to mouth words but it ended up looking like the mouth of a puppet on strings. everything jumbled together and nothing was comprehensible. i resorted to head nods and one word phrases. 
Is it your head? no
Is it your arm? no
Is it your shoulder? no
Is it your hand? yes
Is it too low? no
Is it too high? no
Is it your fingers? yes
Do you want me to spread your fingers apart? he smiles.
I fix his hands and he begins to nod his head towards his left and looks down at his hand.
Do you want me to fix your other hand too? no
Huh... try to mouth it to me.
Up? no
are you saying head? no
Im sorry but I can't understand. Try again.
I turn on the lights and walk around to the other side of the bed and begin again.
Is it your arm? no
Is it your leg? no...
I take a deep breathe in and proceed to look around for anything that looks uncomfortable.
30 minutes and 10 pillows later we have him propped up in a position that is comfortable.
an hour later the process repeats itself again.
by the end of the 12 hour shift i was translating to people what he was trying to say and dictating exactly where he wanted every limb of his body to be. down to every toe and finger... everything had its place. by the end of the 12 hour shift i had nothing left. i thought about his wife at that moment... and how she looked on the verge of tears when she left the night before. and how i thought that it was because she was sad that her husband was dying. and now i was wondering if it was also because a part of her was dying too. the life she once knew and the love she once had would never be the same. the dreams she had. the children they had. nothing would be the same. ever. and how she must feel so incredibly exhausted and drained after a year and a half long of this.
i wanted to weep for her. i wanted to tell her how sorry i was and how unfair it was and how i wished it were different. for both of them. i wished i could do more. make it easier some how.
i prayed at that moment that God would give her rest then. peace. that she would sleep well and heal too while her husband was being taken care of here. 
when i went into the room to say goodbye that morning he looked over at me and mouthed the words, "thank you. you're the best" and smiled so wide i could see the deep wrinkles form around his eyes.
i could feel the tears reach my eyelashes.
"no my friend, thank you" i squeezed his hand and smiled back.
there are moments in your life when you know that you will never be the same. and in that moment i knew that as i walked down the stairs to my car that morning, i would feel every step and inhale deeply every breath. that i would go home and tell the people in my life that i love them because i can. i also knew that this was one of those precious moments... a moment where i would surely never be the same.

Wednesday, May 25, 2011

Life and such...

First things first... can someone please explain to me how it is already the end of May?
Seriously, where has the time gone?
I feel like my days are just melting into one long sleepless night.
I don't fully understand it but life feels like it has been busy lately. Or... more correctly, I feel like I haven't been able to keep up with my life and all of the things I wish I could be doing....
I don't think I've picked up my camera in months.
I have way too many photos that need editing and not enough hours to do them.
I'm also really tired these days.
I should be running more.
Especially since I will be running my first marathon race in less than TWO weeks.
Eating better would be nice too but that requires actually going grocery shopping and cooking.
Seeing my friends feels like a luxury because I hardly see them at all it seems these days .
I should probably start studying for the CCRN exam that I stupidly signed up to take mid-August. yuck.
 (CCRN = certification for critical care nursing.)
Work has been seriously crazy lately.
Did I say that I miss my friends already? Cause I really, really do.
Especially the ones who are in other countries right now.
I should also probably make a point of cleaning my kitchen at some point.
Our sink has been full of dishes since the weekend...
I went on a mini cleaning strike because my roommate and our mutual friend who was visiting this weekend decided to become sloppy boys and make a mess of the house.
I was annoyed and decided not to do the dishes... hoping they would magically disappear at some point.
They haven't.
Bummer for me.
I don't know how people who have kids manage to have a life... or keep their house clean.
It seems like there has been a lot of talk about kids and babies around me lately and to be honest I'm a little overwhelmed about it.
Chris wants to have three children.
Up until very recently I wanted to have no children.
I'm coming around to the idea of  having children.
Really the "ren" part of that should be in parentheses but we shall see.
Thankfully the kids issue won't need to be really dealt with for a while but its crazy/busy times like this where I think, "How in the world could I manage kids and my life and my sanity?"
Seriously, how do y'all do it?
Yes, I just said "y'all"
And on that completely unrelated note I think I need to go get some coffee.
It's only 2:00am and I'm already starting to count down the minutes until my shift ends.

Such is life.

Monday, May 23, 2011

Friday, May 20, 2011

7 Quick Takes Friday

1. I am a master at getting sick this year. Earlier this week I came down with food poisoning and proceeded to puke my guts up for the last hour and a half of work. I had to have Chris come pick me up from work and the poor guy had to hold my hair back as I proceeded to hurl up everything I had eaten in the past 12 hours. It was disgusting and awful on many levels. Thankfully I am better now but that was really crappy. At least I have a wonderful boyfriend who can take over the nurse role when the nurse in the house is sick.

2. I did Bay to Breakers for the first time last Sunday! B2B is a very famous race ran in San Fran. every year. Full of runners and non-runners who all come together and throw tortillas (totally random) and dress up in costume and run a 12k across the city. There is also a tradition of people running it in their birthday suits... can we say awkward? It was fun to see everyone come out and party in my favorite city. I also got a small taste of what the SF marathon is going to be like. HILLS :(
 Definitely one of my favorite costumes. A family ran together with shark fins on their heads and whenever they saw a group of people standing together they would run around them and circle them like sharks haha.

3. San Francisco is gorgeous! I love living in California... specifically norcal because it is so darn pretty. After B2B, Chris and I went out to lunch with Chris' little brother and his friend who just moved to the area. We had lunch practically on the water and it was an awesome day for it. That's Alcatraz over in the distance. :) I <3 SF.

4. In a little over two weeks I will be running my first marathon race! I am super excited too because one of my work BFF's Bethany will be coming with me.
She recently ran the Santa Cruz half marathon with me and we had a blast so I feel incredibly lucky to have her as a road trip buddy and cheerleader as I embark on one of the most crazy/exciting things I've ever done. :)

5.  A few months ago one of my very closest friends and co-workers was deployed to Iraq with the Army National Guard. I have been keeping in pretty good contact with her and I've been keeping watch over her house while she's been gone. It's been scary hearing her stories of the bombings that happen sometimes daily at the base there. Ever since Osama was killed she said it's been much worse. She dealt with her first trauma and death the other day too. Seriously, hearing her stories from a standpoint of someone so close to me.... its harrowing to say the least. I have a whole new respect for our soldiers and veterans. Especially those who have served in war zones. If you know one yourself... give them a big hug or an honest thank you. I'm sure they'd appreciate it.

6. I've really really really been wanting a puppy lately. Sadly I am allergic to dogs and cats so it probably won't ever happen... but seriously.... if this isn't one of the cutest things you've ever seen.. you have no soul.

7. I realized today that I never finished posting pictures of Lebanon and I never posted any of Ireland. Okay maybe a few but Ireland deserves a few of it's own posts. I will start working on that. Marathon training and life in general has really taken away time for picture editing and when you have 3,000+ photos to go through..... it's a little daunting. I'm not gonna lie I haven't even really started on the Ireland photos but I do have Lebanon pics to post and they will be coming soon :)
For now a sneak peek...

 Happy Friday Friends!

Sunday, May 15, 2011

I ran 26.2 miles!

I did it!
A week ago I actually ran the full marathon distance... 26.2 grueling miles. It was my last long training run before my first marathon race down in San Diego June 5th. Usually runners don't actually run the full distance before running a marathon race. Typically you run multiple 20 milers or a 22 miler. Because I am doing the Jeff Galloway run-walk method though, he recommends doing the full 26 mile distance so you can mentally prepare and know you can go that far. 

I was incredibly nervous and in my mind I kept thinking... there is no way I'll be able to do this by myself. Who in their right mind gets up on a Sunday morning and just runs a marathon
Apparently, I do :)

When I hit the 26.2 mile distance on my garmin I was right at the edge of the cul-de-sac near my house and I instantly broke into tears. 
I had officially run the full marathon distance and I managed to do it under 6 hours! I clocked the marathon at 5 hours 53 minutes. I am truly amazed that just a year ago I had only begun my running journey... just look at me now. :) I can't wait to run San Diego and get my first marathon medal! I will undoubtedly cry tears of joy again. 

Saturday, May 7, 2011

Happy (Belated) Nurse Appreciation Day!

Did you know that May 6th is Nurse Appreciation Day?

From May 6th- May 12th it is National Nurses Week!
A picture of some of my favorite ICU nurses and I at dinner earlier this week. :)

A little history for you: In 1974, President Nixon proclaimed a "National Nurse Week." In 1981, a resolution was initiated by nurses in New Mexico to have May 6th declared "National Recognition Day for Nurses." This proposal was promoted by the ANA Board of Directors and in 1982, with a joint resolution, the United States Congress designated May 6th to be "National Recognition Day for Nurses." The proposal was signed by President Reagan, making May 6 the official "National Recognition Day for Nurses." It was later expanded by the ANA Board of Directors in 1990 to a week-long celebration (May 6-12) known as "National Nurses Week."

In honor of the nurses nation and world wide who tirelessly care for, advocate for, love on and save the lives of their patients daily. Thank you for being you and thank you for all that you do. I am so proud to be apart of such an amazing, giving, challenging and fulfilling profession filled with wonderful people like you!
Happy National Nurse Week!
Now if you know a nurse or have one in your family it is officially your job to go spread some love and some thank you's this week. I'm sure it will be much appreciated. :)
Happy Weekend Friends!

Thursday, May 5, 2011

The Bigger Picture

I still remember the first time I encountered the "ugly cry" in nursing. 
I was just starting my clinical rotation during my first quarter in the program and we were working at the nursing assistant level in a local nursing home. I remember the first patient I had and I remember the day that she died. It was incredibly sad but that wasn't the first time I experienced the ugly cry. No, the first time I was overtaken by those debilitating tears was the day I met my first patient's roommate at the nursing home. She had been gone the first few days we were there because she was getting a procedure done and needed to be admitted to the nearest hospital. I had been taking care of my first patient for almost a week when she arrived and I remember being startled as I walked through the door that day.
"I didn't realize there were two people staying in this room." I thought to myself as I backpeddled out the door to check the name on the plate near the entryway. 
I read the name and smiled to myself "That's the same name as my youth pastor from highschool. How funny!" I thought.  It was a common name with a unique spelling and as I walked through the door I instantly realized who I was walking towards. 
It was my youth pastor's mom. I knew he lived in the area and I remember the stories he would tell about her during sermons at youth group or on mission trips to mexico. She had a degenerative disease called MS or Multiple Sclerosis. It's a chronic, incurable, autoimmune disease that affects the central nervous system and causes the person to eventually lose almost all control of bodily functions. Walking, talking, sensation etc. It is a devastating disease and is heartbreaking to watch unfold. 
I remember my youth pastor, Steve telling us about the time his mom wasn't able to make it to the bathroom during one of her most severe MS attacks. She had soiled herself and was trapped on the bedroom floor until Steve came home to find her. Steve had to pick his mom up off the floor and proceed to carry her into the bathroom to clean her up. He described how incredibly humbling it was for them both and despite the awkwardness of the situation, they both chose to laugh about it and make the best of what were awful circumstances. But that was the day they both decided that she would need to be put into a home. I believe she was in her early forties at the time. 

Now here I am, years later, a college student walking into this woman's room, knowing the history of her disease and the affect it had on her family. I felt the air in my lungs starting to escape.
I introduced myself as I walked in and her face completely lit up. She threw her limp arms into the air and reached out to hug me. We proceeded to talk about her son Steve and how much he had impacted my life. I told her about my journey getting into nursing school and my dreams to become a missionary someday... partially inspired by the mission trips I had taken with her son in youth group. 
She was such a beam of light in that room that day. Here I was, this terrified nursing student, dressed in this hideous blue vest that was big enough to fit two of me in the waist but was so tightly wrapped around my hips the bottom buttons were about to pop off. The pockets stretching as they were stuffed with medication guides, notepads and a blood pressure cuff. I was awkward and tired and yet so thankful to finally be in the program after a two year wait. Nursing school was horrendous though and I felt very alone most of the time and was in survival mode all of the time.
I was broken then and on that day, Steve's mom was a ray of hope. 
She was so positive and kind and encouraging. She congratulated me and said I was doing a wonderful job. She even started giving me tips about my patient. Her roommate was a much, much older woman with severe Alzheimer's who would repeatedly whisper, "Where are we?" and "Where are we going?" throughout the whole day. As our conversation carried on I began to take in my surroundings. This was her life. Every day she would wake up to this woman next to her asking, "Where are we?" and she would kindly respond, "We are in our room, my dear." Occasionally she would tack on a chipper, "And in a couple of minutes we are about to watch Jeopardy!"
But that was her every day and it had been her every day for years and will continue to be until the day that MS completely takes over her body and runs its course. 
I finished up my conversation with her and said that I needed to go check in with my instructor.... finding any excuse I could to leave the room before those debilitating tears made their way to the surface for all to see. 

I made my way out to the gardens of the nursing home and managed to make it to the edge of the property where I was invisible before the flood gates hit. I sat there and sobbed uncontrollably for what felt like an eternity. I don't think I can even tell you to this day what it was that triggered that ugly cry. I think it was a combination of things really... the knowledge of Steve and the struggles he went through in putting his mom in the nursing home. Remembering the tears he shed while explaining the difficulties of that decision. The relief I had of finding someone I knew in such an unfamiliar and terrifying place. The release of fear and stress I had been carrying... doubting whether I was really cut out to be a nurse at all. 
Or maybe it was the realization that the world I was in wasn't nearly as bad as I thought. I had my health. I had people who loved me a lot. I had a job and was on my way to becoming a person that could make a difference in the lives of people like her. I was incredibly lucky. 
And yet somehow she managed to be my light that day. She managed to give me hope and encouragement. She made my day infinitely better. She made that clinical rotation infinitely better. In the midst of incredible pain and devastation... she managed to show me the bigger picture that day. 
That no matter what the circumstances... you can choose to have joy... you can choose to be joy.
And really... in the grand scheme of things... life is just too short not to have joy. 

*All pictures taken on the coastal highway in Northern Ireland