Thursday, November 12, 2015

Deal or No Deal

Hey there!
So I'm starting this post without really knowing where I'm going with it. I feel like writing something down often helps me to think it out, and I'm much faster at typing than writing so here I am. If this post doesn't make sense, it's because I don't have a plan. I may not even publish it, but I have found that blogging is cathartic for me.

So. I'm wondering about the best way to deal with grief. Since I'm in grad school, I know I should be all scientific and give definitions of actual ways of dealing with grief, but I ain't gonna. I'm going to talk about it in the ways that I've experienced it and seen others experience it as well. I don't have any evidence for this, and I don't want to offend anyone. This is just me working things out.

For a lot of people, there is a period of acute grief- meaning something happened and your sadness is sudden and strong.  In most cases, there is a period of grieving or mourning, and then while the sadness still affects you, life has to move on. In the hospital, I see people go through periods of acute grieving frequently. Not everyone is the same. Some people cry a lot. Some want to cry, but they can't. Some people are in shock and feel like the whole experience is surreal. Some want people close and others want to be alone. Sometimes, it's shocking and horrifying and other times, it's expected and peaceful. While some people are realistic, some people are in complete denial of the reality that's in front of them. Some people are emotional and others are stoic. Some fluctuate between all of these reactions. There is no time-frame for acute grief. If I am confronted with a patient or family member who is experiencing something tragic, I feel like my role is to determine whether they want someone present or to give them space. I can offer them a hand to hold, a shoulder to cry on, a drink of water, kleenex, or a prayer. I can't fix the problem, but there are little things I can do to show that there is someone who cares.
Here's my theory about acute grief. To a point, you can control how you react, but letting your feelings of grief take over is acceptable and part of the process. Dealing with the feelings will help you continue on with your life even though part of you has changed. The biggest mistake you can make is refusing to deal with the reality of the situation and pretending it doesn't exist. Otherwise, there is no formula for successfully handling acute grief.

My current question is how to deal with chronic grief. I work on an oncology unit, and the reality is that a lot of the patients that I get to know and love will pass away because of cancer. We have a lot of patients who come to the floor time and time again with complications and new problems. Some stay for a long time. If a patient is beating cancer, they usually don't get admitted to my unit. I've been on my unit for just over 4 months and already I recognize many names of the patients who get admitted. Already, there have been patients that I've gotten to know who have passed away and sad situations happen routinely. It's very different from acute grief. What is the best way of effectively dealing with this?

 I want you all to understand that I'm not complaining. I truly love my job, but this was just a really sad week, so that's why I'm asking these questions. I am not assuming that healthcare workers are the only ones who deal with chronic grief, but that's what I know so that's what I'm talking about.

 I think that some nurses are too affected by sad  things that happen and they don't choose jobs that will expose them as much.

Some healthcare workers- doctors in particular get to help make these decisions- choose to fight until the very end so that they can say that they gave it their best shot. This bothers me because sometimes fighting is much worse than the alternative. I read a book that compared end of life decisions to General Custer and General Lee. Do you want to fight into oblivion? Or surrender with your dignity and army intact? Everybody gets to make their own decisions, and this is just my own opinion. I understand why people deal with grief in this way, but it's not going to work for me.

Some nurses have developed a wall between their work and their emotions. The grief is not getting through to them. They don't talk about it. They can still be very caring and wonderful, but they are not affected. These nurses are still incredible nurses. I totally get this, but I don't think this is a possible solution for me.

The opposite of building a wall is allowing all the emotions and grief overtake you. If I allow this to happen, I will be burnt out within 5 years. And that's not going to happen.

So far, if I were to sum up the options, they would be: avoiding grief, fighting grief, denying grief, and giving in to grief. None of those are what I want. What's the other option?

Here's what I've worked out so far. 1. Faith in Jesus, His sovereignty, and in a better life beyond what's here on earth is the only thing that will always give hope and a way of dealing with tough things. 2. Take situations one at a time, find a time to deal with them (the car on the way home?), talk it out with yourself (or the steering wheel?), then choose to move on. 3. If a situation is bigger than a steering wheel conversation, make sure you have a human support system that allows you to vent, binge on ice cream with, and gives good hugs. 4. Remember to appreciate everything that you've been given. 

That's all folks. Thanks for sticking with me. :)

-C-

Ecclesiastes 3:2-8 Italics added by me
   "there is a time to be born and a time to die,                    
    a time to plant and a time to uproot, a time to kill and a time to heal,
    a time to tear down and a time to build,     a time to weep and a time to laugh,    a time to mourn and a time to dance,     a time to scatter stones and a time to gather them,    a time to embrace and a time to refrain from embracing,     a time to search and a time to give up,    a time to keep and a time to throw away,     a time to tear and a time to mend,    a time to be silent and a time to speak,     a time to love and a time to hate,    a time for war and a time for peace.


Thursday, October 29, 2015

FYI

   Hey peeps, here's the deal. For the past year, I have tried to post as close to weekly as possible. I know that when I go to blogs, I like it when there is something new. If you've noticed recently, I've been really bad at being consistent.
   Here's my theory: 1. I am back home, and 85% of the people who read this blog are people that I now get to see and talk to on a regular basis. 2. A lot of what I write comes from an issue or a frustration, and right now I am at peace with nearly everything in my life- thus I don't need to write in order to vent. 3. Most of the big changes in my life have settled in.

   I still love blogging and sharing stories. However, most of my patients these days are not crazy (for which I will be forever thankful), but the crazy stories aren't as good. I mean, how many stories about bodily fluids can I share before I lose all of my friends? Also, some of my stories are very sad, and I don't always want to share those moments. Finally, the stories that I would really like to share are all about people saying nice things to me, but that would not make me very popular.
   All that being said, I am a people pleaser. But this is me giving myself permission to not be a consistent blogger. I will when I have something to say, but it will be more infrequent. Thanks for reading and sticking with me.

-C-
 

Monday, October 12, 2015

Balance

In my short (or long depending on how you look at it) 23 years of life, I've come to the conclusion that my life and the world is all balanced. I've pictured it as a teeter-totter. Sometimes, it takes a while for the weight to distribute itself evenly, but it will eventually. Sometimes, things are pretty even for a while, and sometimes there is a lot of back and forth. Lately, I've seen a lot of back and forth, ups and downs and I'd like to share some of them.  To be fair, I'm going to share some sad stories. Just a warning.

A patient beat cancer years ago, but didn't follow up and when they finally did a scan, they found the cancer everywhere. The patient decided to get chemo as a last resort, but it was too much on their body and the patient passed away only days after.

But... I got to hold a newborn baby for a good half hour the other day.

A patient comes into the hospital frequently because their condition is slowly deteriorating. When I take care of them, the patient is in agonizing pain, but we're pushing the limit on the pain medications that we can give. There is nothing else I can do except hold their hand and spend time with them.

But... A patient that I have taken care of on multiple occasions introduced me to a family member who I had heard about. The family member said, "So this must be Caroline- I've heard a lot about you." And the patient touched my arm and said, "Yeah.... This is my Caroline."

A patient has been in and out of the hospital for months because they keep experiencing complications. I walk into the room to find them crying because they haven't been able to go back to their home state for months and are missing their family.

But... A patient who had been in the hospital for nearly two months was finally well enough to go home.

One of my favorite patients with no history of cancer had a CT scan done that showed a new mass that was most likely cancer. I saw it and knew, but the doctor hadn't come to tell the patient yet.

But... I've hugged more patients and family members in the last month than I did in my entire time at my last hospital. Especially patient's mothers. I've hugged a lot of concerned moms who are willing to sacrifice their everything for their (adult) kid and need someone to tell them to take care of themselves too.

One day at work, I took care of four women under the age of fifty who were all very sick. Some of them had young kids, but none of them would ever be able to have completely normal lives. It was a tough day.

But.... I got to watch the supermoon lunar eclipse thing with a patient from his room. The moon would go behind a cloud and I'd get some work done, but if the moon came out, he'd put on the call light so that I could go and watch it with him for a few minutes.

A patient thought she could go home in time for a special event, but then experienced a serious complication that made us wonder if she would be able to leave the hospital. She was so disappointed, but handled the news with as much dignity as I could imagine.

But.... Her family and hospital staff worked hard to make the day as special as they could and include her. It was similar to something you'd see on facebook to make you cry. It was really special.


These all revolve around me and the balance that I can see and experience. When a patient is in pain, I take care of them for 8 hours and then go home. They don't get to just leave like I do. Sometimes, I feel a little insensitive because I can get in the car and move on with my life. However, if I don't balance out the sad things, I think I'll get dragged down. It's a tricky balance (see what I did there?). 

Tuesday, October 6, 2015

My apologies

Hey y'all,

I think that this has been the longest break between posts since I started as a nurse over a year ago. So very sorry. I am not even close to being out of things to talk about, but life keeps moving and prioritizing can push blogging back for a while.

Updates:

Life is good! Like.....really good. My job is really incredible. I am off orientation/training and am on my own again. I can't deny that I appreciate someone being there to have my back, but I am ready and excited. I am loving it. Because I work on an oncology floor, there are patients who come back again and again for chemo treatments or with complications or to manage their pain. I can look on the unit census list everyday and recognize some names from patients I had a week ago or a couple of months ago. The other day, a patient's mom stopped me in the hall and gave me a big hug. When I have a few minutes, I usually go and visit the patients that I know. It's like visiting old friends and I've only been there 3 months. A nurse/patient relationship is a real, deep, and amazing concept. I get to know these people when they are at their lowest points and develop trust and love nearly immediately. When I see them, it's like seeing a friend after a long time, and I can see how they are doing and either be encouraged or saddened by their progress. When they see me, I always hope that they feel safe and loved no matter what. It's great. And heartbreaking. But this is what I wanted from my job. I wanted the relationships. Believe me, I still have to use critical thinking skills and know how to perform a lot of tasks, but for me it has always been about the relationships.

Grad school is really, really busy. If I solely concentrated on work and school, I'd be fine. However, I am a little overly ambitious and want to maintain my social life. Thus, I am very busy. I'm really enjoying my theory class (which is surprising if you know me well) and have learned a lot. I actually like the work I'm doing, I just don't like doing it on their timetable.

I collect hobbies. I get bored and pick up something new. Yesterday, I decided I would learn how to code on the computer. There are free websites and so far, I've designed a website although I had absolutely no idea what I was doing. We'll see if this hobby lasts. And I'm still trying to learn bass.

I am officially moved out of my apartment and back with my parents. During this time, I will be saving money, paying off loans, and spending time with the people I love the most. It's great to come home from work and be excited to see who is there. It also makes working the evening shift easier cause I can see people every day even though I'm gone most evenings. Plus, if I'm saving money, maybe the next step for me is buying a house. Who knows?

Lately, I've been going through a book called "The Green Letters" with a friend. It's a book about spiritual principles, and it's been really good for me. One thing that I learned this last week was that God is working from and to eternity. He isn't working on my timetable. My spiritual growth will take place over the course of my life, and He is still working even when I don't 'feel' it. All I can do it seek after God in my daily life and let Him do the rest. This was really good for me to read because sometimes I feel like I'm not doing enough and I get stuck. This chapter helped me realize that my spiritual growth isn't up to me and that's alright.

Ok. I promise I'll blog again soon.

See ya!

-C-




Thursday, September 17, 2015

Bad Blood, Miss Colorado, 10,000

Hello Friends, Family, and Faithful readers!

Unless all of you unanimously decide to stop reading my blog, after this post, I will have just over 10,000 views on this blog. Quite honestly, that's not a lot considering I've posted pretty frequently, but it seems like a significant number so I've decided to celebrate with this ridiculous post. 

I am an oncology nurse, and one day I realized that my favorite singer- Miss Taylor Swift - wrote a song you might have heard of called Bad Blood (complete with an awesome music video). I happen to work with people who have bad blood. Literally. I love my job, and I love working with cancer patients. Cancer is a terrifying diagnosis, and I get to be there for people in a scary time. So I decided to change the lyrics of this song to fit my kind of bad blood or leukemia (blood cancer). Then I recorded myself.

Here are about 10,000 disclaimers:
I wrote this and then realized that without the music, you can't appreciate the brilliance of my lyrics. I am a little proud of it so I felt the need to put the words to music. Unfortunately, Taylor herself will probably not sing these particular words, so it's up to me.

I am showing all of you how much I love and trust you because I am recording my own singing. I do not have a good voice. At all. But I will not apologize for the pathetic, weak, and thready voice with those horrible highish notes because I am totally going out of my comfort zone here and that totally makes up for the pain it might cause you. Yes I am embarrassing myself. 

I attached the lyrics because 1. You might not understand me and 2. I'm going for a 10,000 character (letters and punctuation) count for this post. I messed up in this video but recording and listening to myself over and over again was too painful so you can deal with the mistakes. 

This is in no way scientific. You should not base your treatment on this song. Not every leukemia is curable. I am not trying to give anyone false hope or false information. This is me feebly trying to come up with words that kind of rhyme. THIS SONG IS NOT FACT. THIS IS GOOFY.






We're getting rid of the bad blood
We call it leukemia
There's lots of work to be done
We're getting rid of the bad blood (hey!)

Now we're fixing the problems
I believe we can solve them
It's gonna be tough but
We''re getting rid of the bad blood (hey!)

With this diagnosis
Some cells in your blood are called malignant
They are growing too fast
The healthy cells aren't going to last
Some signs of cancer might be 
You feel weak maybe you start to bleed
You feel like you're in so deep
All at once it can be overwhelming
Oh I'm so glad we found it in time
Both you and I

(Chorus)

If you catch it in time
Stem cell transplants can save your life
Chemo will kill the bad cells
But you might not feel very well
Medications will help you get through
When all of it catches up to you
You might want to give up hope
But treatments' come a long way, so Don't!
Oh, I'm so glad we live in modern times
You and I

(Chorus)

But band-aids don't fix bullet holes
I'm so sorry, I hope you know
We've got your back, you're not alone
But band-aids don't fix bullet holes
I'm so sorry, I hope you know
We've got your back, you're not alone
And with love like that
Cancer, WATCH YOUR BACK!

Tada!!!!!!!!!!!!!!! (Still going for the 10,000 character count)

Yup. Now you all have blackmail for the rest of my life. You're welcome.  

Anywhoo...... On to the next topic. I don't know what any of you have heard about Miss Colorado in the Miss America pageant or anything that followed. I am friends with a disproportionate amount of nurses on social media, so for me it has been EVERYWHERE, but it's possible that you missed it. Here's a quick update. 
In the talent portion of the Miss America pageant, Miss Colorado walked up to the stage wearing scrubs and a stethoscope. She gave a short monologue about being a nurse and a story of one of her patients that changed her life. It was short and sweet, but very good. All of my nursey friends were talking (in person and online) about how cool it was that she presented nursing as her talent. They admired and appreciated her.
Soon after, a TV show was talking about the pageant and made some derogatory remarks about nursing. I'm not going to go into details because that's not my point. In response, nurses got all fired up and defensive about our incredible profession. The main point is that the TV hostess didn't understand what nursing is all about.  It's the hot topic of conversation amongst nurses- who can come up with the best comeback or meme. 

(Just counted and 10,000 characters is a lot. I apologize for this long post.)

Here's my point. I think that a lot of people really don't have any clue what nurses do. For most of my life, I viewed nurses as the people in a doctor's office who took my height and weight and told me to wait for the doctor. That wasn't what I wanted to do... Even in nursing school while I was in the hospitals, I thought that all we did was pass medications and hope that people needed new IVs or dressings changed so we could practice our skills. That's not it at all. I think that instead of being angry and aggressive, we should try to educate people and help them understand. 

I realize that I am still a new nurse, and I can't speak for all nurses, hospitals, or situations. However, it is possible that I can still help teach you. So, in one disjointed paragraph, here's what I think nursing is: 
Nursing is taking in megawatts of information and picking out what's important. Developing a trusting relationship in the 20 minutes you have before you need to see the person in the next room. Looking at the big picture but still paying attention to the details. Performing accurate, thorough, informative assessments. Coordinating 6 doctors, social work, case managers, respiratory, physical therapy, xray techs, and your own work to make a reasonable plan- then doing that for multiple patients. Looking at a patient's medication list and being able to know the person's history. Knowing when to use your heart and when to use your head. Teaching at every opportunity. Continuously learning new machines, new policies, new research, and new team members and being able to use them effectively. Putting your own stress aside so you can hold someone's hand for 10 minutes. Prioritizing when it might seem like everything is a priority. Making quick decisions with wisdom and confidence. Taking more phone calls than is reasonable. Caring for family and patients as they deal with some of life's toughest moments. Learning to transition from crying to smiling in the time it takes to walk across the hall. 

So yeah. Be a nurse :)

I'm still a ways from reaching 10,000 characters. 
And I'm exhausted.
I need to waste some space.  

I'm going to type Oncology Nurse with my elbows.
OLOCDOKLIOFYJNuierse

Now with my feet.
Ojnc jnmoiklgy NMuerasdrfe

Now with my chin
ionjcikkolokgyh njhuhtrdfdsdrrte
(That's really hard to do without looking at the keyboard)

And I'm still not to 10,000. Well. A picture is word a thousand words, so that video can count for the rest of them. There you go. 

In this post I have given you my most embarrassing moment, 10,000ish characters, a rant, and so much love. 

Til next time. 
-C-

Wednesday, September 9, 2015

A delayed thank you

   The other day, there was a brand new nurse who was orienting on my unit. It was her very first day. I was doing a procedure and asked her if she would like to come and watch me so she could get some experience. I had done it quite a few times, so I explained it to her.
    A while later, I was cleaning up some of my old junk out of my apartment, and I came across all of my old care maps and papers I did in nursing school. There was quite a pile. It represented a lot of agonizing, lack of sleep, hand cramps, and sweat.
   This made me think back to nursing school, and I would like to reflect a little bit on people who helped me out when I was brand new and scared out of my mind. There are a few specific examples that represent a much broader spectrum of people who gave me their time, compassion, and knowledge. Here's to you.

Thank you to the nursing assistant who took me to the side when a horribly mean patient made me cry in nursing school. She told me that it wasn't me, and that I was going to be a good nurse.

Thank you to the professor who marked me down on my papers because she knew that I was capable of more. She challenged me to think critically and try harder.

Thank you to my preceptors at Mayo and Northwestern who spent so much of their time teaching me when I was brand new, had no confidence, and had a million questions. Thanks for bringing extra books for me to read and showing me how to look things up so that I could continue learning.

Thank you to the doctors who would quiz me on my shadowing days and would try to teach me everything they knew in a couple of hours.

Thank you to the professors who wouldn't let me give up if I didn't get it right the first time. You helped me build my confidence and believe in myself.

Thank you mom for patiently listening to me cry or vent when I was stressed, sad, or got a bad test result back.

Thank you to all the nurses who would pull me into a room to show me a procedure or a strange wound or an interesting disease.

Thank you to all of the nurses who I graduated with for going through nursing school with me. We are all much more comfortable with each other than is normal.

Thank you to all the hospitals and patients that allowed a bunch of scaredy cat nursing students work with actual people. Thanks for entrusting us with your lives.

Thank you to my roommates, family, and friends who let me listen to your lungs and test out your reflexes. Thanks for listening to my gross stories and for getting excited for me.

Thanks for reading this blog :)

Love you all. See ya 'round.

-C-






Wednesday, September 2, 2015

Aspirations

   So originally I had another idea for this post, but I'm still working on it. Last night, I was bemoaning the fact that I didn't have any prepared blog ideas, but I've got one for you today. :)

  Today I didn't work on the floor. During training/orientation, they (don't ask me who 'they' are) have every nurse follow around different people to get a glimpse of other departments that mostly relate to where you're working. At my last job, I went to the cath lab and the pacemaker nurse and EKG techs etc.... For my new job I get a few different experiences as well (radiation oncology, outpatient oncology, wound care, etc.) Today, I was really inspired by the nurse that I worked with. I'm inspired and influenced by a lot of people, but I don't always feel the need to share it. Today was an exception.

   I followed this guy all around the hospital for about 5 hours. He greeted nearly every person by name- from the transporter to the nurses to the secretaries to the doctors to the CNAs. Each time he introduced me to someone, he would lift the person up. He would tell me that this person was a great worker and give me an example. Or that they've been friends for years and tell me a funny story. Not only that, but the guy I knew less than a day would talk me up as well. He'd introduce me and say something nice like, "she's working with me today and is really bright" (whether or not that's true is up in the air, but I sure liked hearing it)
    This kindness didn't just extend to the hospital staff. Each time he walked into a patient's room, he'd compliment the patient right off the bat. He'd start a conversation and include me in a very kind way. We needed to work with a patient who was giving the nurses a lot of problems. He waltzed right in that room and charmed the patient so much that he hardly noticed me working on him. Didn't give me one problem.
   Throughout the day, he was encouraging to me and pointed out some of my strengths that he noticed. He had a lot of knowledge about his job and taught me an incredible amount in 5 hours.

   In general, I think that I'm a pretty friendly person. There are good days and bad days, but for the most part I smile and try to make small talk. Compared to this guy, I am cold. I'm not posting this to degrade myself by the way- just to make an impression on you.
  Anywho... I learned a few things from this. One. I am now aspiring to be more like this nurse. Two. Can you imagine how incredible the world would be if every person was lifted up every time they were introduced or greeted? I want to speak about people in such a way that they feel better about themselves when they walk away. In my humble opinion, I think some of that is a choice, and part of it is a mindset. If I work on viewing people the way God views them, it will be a lot easier to see their strengths and not their shortcomings.

    I think I learned a lot more than what was intended :)
    That's all. I have a plan for next week's blog, but I actually have to work on it. Hang in there.

-C-