Lessons from a phone....

My husband and I walked into a phone store, that shall remain nameless~  the store was brightly lite, the employees were well dressed in shirts and ties and the layout of the store was neat, clean and well organized…One would have thought that what would accompany such a store would be good customer service, joyful employees and that we would walk out of the store with new upgraded phones and a smile.  NOPE…the experience was less than stellar. The employee was well versed in his sales pitch but was not willing to go outside of that pitch to make a sale… and the irritation level that it left us with was a bit high! 

We decided to try one other phone store/electronic store just a hop skip and jump away~ What met us this time was very different. The store was dimly lit, overstocked and a bit disheveled in appearance, the employees were dressed in jeans and matching t-shirts… The difference, however, was the employees met us with a smile and a helpful hand, some laughter and we left them with a big sale…

What made the most difference?  The first impression of the employees…not the interior of the building or the way the employees were dressed…when it came down to it those outside appearance things didn’t mean squat…Now I have been the first to say that appearance means everything…that cleanliness wins out and nicely dressed employees is a must~ now I still think this, BUT none of that matters if the employee isn’t personable or if they don’t  give a rats ass that your there!! The difference in the appearance of the stores and the way the employees were dressed was huge…BUT so were the attitudes that they each carried. 

I guess there really is a lesson in even the smallest of things…For whatever reason, as I drove home with my new phone, I was thinking how the 2 stores and their employee’s approach really did make a difference to me and my husband. We will not go back to that first store…but we will go back to the second.  The guys that helped us out with the phones even got a courtesy photo and upload to my Facebook page (with their permission of course J).

I’ve read in many a report that nursing is the most trusted profession…why is that?  I’ve often thought that it was because of our origin…Nurse Nightingale and all that…the white uniforms, the cap, and the role of caregiver…

While I am not 100% sure why nursing is perceived by patients to be the most trust worthy profession, it is my honor to be in that profession.  I want my patients to trust me and I want them to respect me.  I want to take care of my patient in a way that leaves them feeling cared about and listened to…as well as taken care of with expert hands.  I want them to feel my heart when I care for them.  I used to think that it was about a clean room, a clean pressed and stain free uniform, nice hair, clean nails, and of course good care! …… but after my experience I KNOW it is more than that… while all of the above is nice and adds to the comfort of the patient and their family~ without caring and comfort from the nurse, the patient and their families could give a bleep what their room or their nurse looked like!!

The ER Beast

I usually write an inspiration to nurses on my blog and who knows maybe that is what this will end up being, but I feel the need to write about my experience yesterday and the decision that is solidified for me.  I work in the ER, in case you hadn’t gathered that from my blog already, and have done so for the last 11 years.  The ER can be a roaring beast that devours all in its path…or at times can be a gentle beast that lets those working there stay alive to come back another day. 

Yesterday was one of those days that just makes you want to find a corner to cry in…we had 2 nurses call out~ so we were short staffed from 7am -7pm and the patients just kept coming…our supervisory staff were all off to conferences so there was no physical help available from them…the rest of the hospital was dealing with their own issues and had no nurses to spare….(which makes me think of the Seinfeld episode where Elaine is in the public bathroom and asks the women next to her if she could spare a square….and sure enough the women says NO!) any way…

Our amazing team that worked yesterday pulled together and we got the job done and we did it very well!!!!  BUT for 12 hours we didn’t get a break…we ate sandwiches, sent to us from our cafeteria, on the run… we had full rooms and a full waiting room all day long so there was no break  to be had when a patient was discharged…just another patient put in the bed…we had a serious trauma come in, in the midst of the day…so that takes 2 nurses, a tech and a doc out of the mix for an hour… and again the nursing team, techs, docs and secretary all did an amazing job keeping up with all the patients, the orders and the chaos!! 

I have stayed in the ER for several reasons, the energy of it, the staff, the schedule isn’t bad, I am really good at ER nursing, most other types of nursing seem boring in comparison, and complacency. For me, this type of nursing seems to be losing its appeal. What I don’t love anymore is the chaos…controlled chaos is one thing but the chaos of yesterday, and the all too frequency of those days, is another…and for this 45 year old nurse I’ve about reached my limit.

The self-care routine that I have been doing has allowed me to stay sane while working and has allowed me to feel less burned out with nursing all together…but what if yesterday is the wave of our future in the ER…Our hospital is building a new hospital in another town, merging another hospital… and this ER is going to remain open but with no beds to admit them to…so the ER will be full at all times with critical patients that need to be transferred to the new hospital for admission(and we all know how long that takes!!!!)…call outs are ongoing as is not being able to find anyone to come in… and on and on it goes…

For now I will be increasing my self-care in order to remain where I am until another plan unfolds…and I do have a plan~~ Praise God!!

Partnership in the journey of health

As the music starts pumping through the MP-3 player speakers, the whole gym full of women take their positions and ready for the Zumba class to take off.  My friend and I give each other a grin and laugh…this is our first class and the gym is full of women of varying ages and shapes, but we are feeling a bit on display.  As soon as the instructor starts moving her body and giving instructions, intimidation melted away and the music took over.  An hour later we were drenched in sweat with big smiles on our faces!  I will not say that we knew many of the moves or that we looked cute doing them but the class was soooo fun!!  Wed. night we are going back for more. J

One week ago today, my friend and I made a commitment to one another to hold each other accountable as we once again pledged to live a life of health and fitness… We both had slipped into some unhealthy patterns over time and needed a good nudging and a hand hold to make a plan and stick to it.  So this past week we went to the gym, ate a more healthy diet, drank more water and attended our first Zumba class.  During this week we called each other and checked in…all of this helped us to stay focused and motivated. 

My husband and I do this partnership as well~ In order for our marriage to be healthy and to continue to succeed we depend on one another to stay focused on what is important, to partner up on the household responsibilities and errands…we partner up with the family (grown children that they are now.) and with any problems that arise. We also both make time to attend to the other’s needs and to make the other feel special and cared for. We are best friends, lovers and partners in this thing called life.

I also watch my amazing team of nurses do this partnership thing quite well on a daily basis in the ER…One of the amazing things about working in the ER is the bond that you develop with your fellow nurses…you must become a team in order for the work to get done and for the heartache of the job to not be so painful.  The bonds that I have developed with these nurses in the ER are strong and meaningful.  I call many of them friends and I mean it.

Of course in order to develop strong bonds with others we have to want the bond…we have to be present and be ready to stay in the moment for a little while…we have to be open to another person and that may mean experiencing pain, but it also means experiencing great joy. I have been blessed in this life with an amazing family that I cannot imagine my life without, wonderful friendships, much love and joy…and many people that I partner with on this ride of life…

Just a reminder to my-self and to all of you fabulous nurses out there…Our patients need a partner in their health care journey as well…and most often that partner is their nurse. We spent more time at the bedside, in their homes, in the office or on the phone with the patient than the doctor usually does so we are the obvious choice.  I went into nursing because I wanted to help people…at that time it really was a blanket thought, one that I really had no idea what it meant.  Now I know that when I say I want to help my patient, I mean I want to be present; to hear their story and to care about why they are there…I want to deliver sensitive and appropriate, evidence based care that is timely and accurate. I am ready and willing to be their advocate. I want to hold their hand and pray with them if they want that…I want to show them strong confidence and knowledge as I do my nursing interventions to aid in their recovery…I want to help them; to be their partner that day.

For me, I have another partner in life that aids me in succeeding and staying focused on what is important and that is Jesus…On this Easter holiday eve I am especially thankful to my heavenly Father for the gift of salvation and for the constant presence and forgiveness that he offers. 

I pray that for all of you reading this posting that you are someone’s partner in something meaningful and that you are able to offer your partnership to someone else as well.  For all of us nurses reading this…I pray that you would see your role in your patient’s lives as a partner in their journey to health, safety, life or death.

The woman at the well

There is an old Celtic tale about 5 sons of the Irish King Eochaid.  The sons were out hunting and got lost. They became tired and thirsty~ they set out in search of water. Each went a different way but all ended up, at different times, to the site of the woman beside the well. 

The tale tells that the woman guarding this well was hideous.  Blacker than coal was every inch of her. Her hair was a grey, wiry mass of substance that compared to a wild horse’s tail.   This hair appeared only attached at the top surface of her scalp.  Her nose was awry and held wide nostrils. Her eyes were red and smoke blurred.  Her center was a wrinkled and freckled belly that overtook warped, crooked shins, garnished with massive ankles and a pair of capacious shovels for feet and knotted knees.  Long livid nails escaped her hands. 

The oldest son of the King found the well first.  Standing before the hideous woman he asked for some water.  She told him the only way to get some water was to kiss her.  He refused, vowing he would rather die than kiss her and he turned away.  One after the other, three more brothers followed the path that led them to the woman at the well.  Each refused in repulsion to kiss the women and each of them turned away. 

Finally the fifth brother, the one called Niall, took up the quest and found the woman at the well.  Upon hearing the terms of the bargain, he agreed without hesitation not only to kiss her but also to embrace her.  When he had willingly done so, right before his eyes, the guardian of the well transformed from the distorted, hideous figure to a beautiful woman.  The woman introduced herself as “the King of Tara, Royal Rule.” 

She gave him the water and before he left the well she bestowed on him a blessing for himself and his children, that they should be graced with the Kingdom and highest of power. 

You see, Niall also saw the woman as the hideous figure that his brothers had seen but unlike his brothers he was guided by his deep and gentle heart, offering her loving-kindness rather than revulsion.  Take note from this tale, the other brothers were not cursed for turning away from the woman…instead they just remained parched, hard and dry. 

I read this tale in the book, Heal thy self by Saki Santorelli.  This simple tale spoke to me.  When I am at work I have a choice to see my patients in this very manner.  They come to me in many states of disarray…from physically repulsive to pristine…from angry to kind…from delusional to intact…and so it goes.  I wish I could say I always acted like the fifth brother and embraced each patient with my loving and gentle spirit…but I can say that when I do embrace them this way, my heart is forever changed…and when I don’t it is also changed…

When I choose to see beyond the physical imperfections, mental imperfections and bad behavior of certain patients and go to them with a kind and gentle spirit of caring I can see the change in them almost immediately~  Once we establish a kind exchange my heart is changed and I see them differently.  We are a culture of what we see… I pray that I will honor each patient as they are inside and that I will then be forever blessed. 

If you were to be completely honest with yourself…is there a certain patient population that causes you angst? Disgust? Fear? … without really knowing why?...

I had some reflection exercises recently in my Senior Seminar class that have caused me to look inside of my thoughts and my reactions to those very situations.

The exercise that recently got my attention was that of boundaries.  While reading the section many different thoughts were running through my mind…the boundaries I have set with my mother in order for us to have a relationship, actually ended our relationship all together because she was unable to NOT cross those boundaries over and over again without regard, and I at that point in my life was unwilling to loosen the lines of the boundaries I had made out of stubborn pride and need… maybe now…

Boundaries come into use for many different reasons…safety, security, independence…there are physical boundaries like fences and doors to keep people in or out....Rules of conduct and behavior are boundaries in civil codes of behaving. The boundaries I set with myself in my own behavior have been helpful but I didn’t ever think of boundaries as being a place of meeting and coming together~ like the shore line and the ocean…both needing each other to make the perfect picture of dependence and co-dependence in a good way.

The words that made me stop and think the most in my reading of, heal thy self, …that our roles as patients and practitioners are similar…that we are not just in a role…we are in a larger field of human connectedness~ of shared humanness.  Shared humanness…interesting. 

I tried to keep this concept in the forefront of my mind at work this week and it helped.  When one of our beloved female ER docs, who is scattered and slow but such a wonderful practitioner and patient advocate was driving me crazy because she was sooooo behind and patients were stacking up…I thought, we are in shared humanness right now and I will not get upset~  I instead re-organized her charts and kept her on task…she realized what I was doing and smiled at me with a nod and said, thank you…prior to this I would have re-organized her charts and made sure she realized I had done it and done it with some tude….

Yesterday I had another opportunity to realize my misunderstanding and my need for and about boundaries.  We have a population of alcoholics that frequent our ER. There is one man that can drive my emotions to a red hot steam in 5 seconds flat…I know this and I try to not take that gentleman and typically swap another nurses patient (one she is having a time with…) As I saw the name of the patient coming in via ambulance~ the immediate reaction that typically rises from me occurred…disgust.  I have thought about this over time and realized that this one man reminds me of my childhood and feelings of anger, repulsion and fear surface with those feelings…it took me a while to recognize this…

Just as quickly as the feelings surfaced the thought about shared humanness surfaced.  As I recognize that for the patient’s best interests and mine, letting another nurse take him is usually the right thing to do…yesterday I chose another option.  I took the chart and went to prepare the room for him.  I prayed.  I asked God to show me how to care about this person as His child…in our shared humanness…I asked God to show me what boundaries to place on his behavior and mine in our ER today without any of my own emotion behind them…typically and shamefully I would do the bare minimum with him and give nothing of myself while doing it…I asked to see the boundaries as shifting and moving as needed.

When the patient arrived in his usual state and with his usual rude, foul mouthed demands I watched him…I listened to my thoughts and let them pass without judgment…I felt my breathing quicken with my heart rate, I felt my face start to show disgust but I said to myself…shared humanness… I continued to let the paramedics get him off their stretcher and onto mine and I for the first time noticed something in me… fear…I could be him…my disgust came from the PTSD type recall of seeing my father drunk and acting in this way over and over again while growing up…my fear was no longer that I could be harmed because I was in control here, I had the power to make strict boundaries on this man’s behavior!  The fear that I recognized now was that I could have ended up like this man…it was in me, the compulsion to drink….he could be me…shared humanness….

I prayed continually as I assisted him to change, offered him a washcloth and soap to clean up…and tended to the carrying out of MD orders.  I prayed while he flung insults and threats at me and I continued to pray while I set boundaries that were fair and not out of my need…but both our needs…shared humanness…

I noticed that during my interactions with him I felt nauseous at times, SOB and irritated.  I felt my pulse race and my stomach clench.  I prayed for strength….so much of this patient and my guttural reactions were related not to him at all but to my cellular memory of home… BUT what did occur yesterday was the being present and being able to focus on the care of the patient despite my need to flee…I noticed my thoughts, and reflected on them.  I noticed the reactions physically and applied lavender oil to my wrists and neck…I breathed deeply and continued.   I will most likely continue to swap patients when he returns again…but I am thankful for the exercises in this book I am reading for class that are allowing me to slowly chip away at the protective layer that I have built over time and to understand why it is there…and flirt with the possibility of thinning it out!!