Tuesday, May 23, 2017

Are Funny Memes Damaging to the Profession of Nursing?

I'm incredibly proud to be a nurse. Being a nurse has been one of the greatest joys of my life.

Not long ago I was attending to a patient and she asked me if I liked my job. I answered her with a fervent 'yes!' and told her that my job challenges me every day and that I get to meet the most amazing people. I told her that I can't imagine doing any other job.

She very honestly opened up to me and told me that after seeing what nurses post on Facebook, it seemed like we hated our patients. I was a bit speechless but assured her that I love my patients and think of them often even while not at work. She further admitted that she has avoided going to the hospital in the past because she didn't want to be cared for by a nurse that didn't like her job or her patients. I was horrified that someone that may have seriously been in need of medical care did not seek it because of my fellow nurses' social media posts.

Her frank confession changed the way that I viewed my colleagues posting of humorous(and often rude)memes on social media. I know that nursing is a very stressful job and that those in medicine often compensate for the stress by coping with humor that can be very inappropriate. Break rooms at hospitals are full of jokes that would surely be deemed unacceptable on the floor where our patients can hear them.  Social media, however, is an entirely different beast. The jokes and memes put out by medical professionals do not only come before those inside medicine, they are seen by everyone on your friends list.

So, I'm asking with honesty-- are these jokes and memes harming the profession of nursing, a profession often regarded in the past as the most honest of all professions? I fear that it is.

I follow a blogger that happens to be a physician and he recently shared a meme from a nursing blog's social media feed. It was relatively harmless, but indirectly inferred that nurses may not care about their patients. The comments on the meme ranged from nurses mocking their patients to non-nurses commenting that it seemed like nurses no longer care.

I felt sick. I care every, single day. My co-workers care every, single day. I work for a non-profit and make a very low wage and bust my ass every hour of every shift and often work unpaid hours so that I can finish my charting and communicate with other agencies working with my patients. I think of my patients often in my non-working hours and am often brainstorming ways to help make their lives better. I know that I'm not alone. The vast majority of nurses care so very, very much for our patients even when we become jaded and are exhausted physically and emotionally.

I've shared some memes here that my nurse friends have shared on their public social media feeds. I admit that I shared the more mild memes because the more offensive messages made my stomach hurt. We're publicly implying with each of these memes and messages that our patient's pain isn't real, that our patients are stupid and that we don't really want to care for them. 

I know that I'm going to be lambasted by the jaded nurses who will accuse me of not having a sense of humor. That's fine. I can deal with that. I do understand how years on the job can jade you and how humor can get you through the toughest day. I actually happen to have a wicked sense of humor and a raging potty mouth. However, there is a time and place for everything. 

I can't help but think about the most vulnerable of patients out there. Those who already have a fear of hospitals. Those are are sick but are afraid of being shamed for their weight, or drug use, or lifestyle. Those who have already had a poor experience with medicine of whatever kind. 

Is there a chance that these posts may increase their fear so that they may not seek out help? 

Is there a chance that patients may not trust their nurses during their hospitalization? 

I believe there is a strong chance of that happening for some patients, even if the number is small. And, if that is so, isn't that enough reason for us to stop publicly posting memes that make our patients feel shamed, even in the smallest way? 

I promise you that I will do my best to think in the future before I make a public post, both about what the post may make others feel about my beloved profession and how it may impact the psyche of a future patient. My profession deserves such a pause of thought, as do my patients. 

Sunday, May 14, 2017

Birth and Mothering in America: Mothers Deserve More

Working as a public health nurse with low-income, high-risk families has opened my eyes to the world in so many ways. The person that I am today and the person that I was seven years ago(before embarking on this area of nursing) are so very different and for that I am so thankful.

In all(or nearly all) nursing jobs, nurses are privileged to work with people of all colors, cultures, languages and personalities. The uniqueness of my current job is that I work with my families in their own homes and, thus, am immersed in their cultures while we work. The majority of my clients are refugees or immigrants and it is not unusual for me in one work day to visit a myriad of homes-- all of which may speak a different language and have a completely different culture(many thanks to the amazing interpreters who help me in my work). I believe that I have grown more as a person in these past years than at any other time in my life.

As I learn from these new Americans about the cultures that they have come from, I've been shocked many times over to find the disservice of our U. S. culture, medicine and politics on mothers and families.

One of my first expecting clients was a woman from a small African village(I know that Africa is a continent and am being intentionally vague in order to protect my client's identity) and she, a brand new refugee in America, was ready to have her baby any day. I remember during our education about what to expect from a birth in an American hospital, looking at her and realizing that she looked terrified. When I asked her what she was feeling, she said that she was scared and asked me where all of the other mothers would be? She said that in her former home, all of the mothers in the village would come and support her during both the labor and the weeks after. Every need would be met and she was treated like a queen during labor. After the baby was born, the baby would be cared for while the mother rested. The entire village would celebrate the birth and the mother. New motherhood had previously been such a joyous time and now she feared that it would simply be lonely and exhausting. 

Here, she said, she'd never felt more alone. Pregnancy seemed to be treated like a contagious illness and the birth like a surgery to correct it. Everything seemed so clinical and cold. She wished that she were back in the refugee camp, she said.  I remember freezing in place at those words from a woman that was so proud to be a new American and had otherwise completely embraced our culture and traditions.

Another client of mine, who had birthed another child in another small village and now had a newborn in America was suffering from Postpartum Depression. She was struggling each day to simply keep her head above water. I asked her if she had experience Postpartum Depression with her last pregnancy. She looked at me,eyes heavy with sorrow, and replied, "There was no such thing as postpartum depression in my country." I assured her that there must have been, that mental illness permeates everywhere, but she was adamant. She said to me, "I was supported by my entire village every moment of my pregnancy and the baby's first months. I was never alone. Here I am always alone. No one asks to help me. My neighbors don't even reply to my hellos in the hallway and seem to not even have noticed that I now have a new child. This is the loneliest place that I have ever known. It surprises me that all women here don't suffer from depression."

Yet another beautiful client took me aback at her response when I asked her how her first American birth experience was.  She responded that the birth that she had in the refugee camp was a far better experience. She hoped to never experience an American hospital again in her life. Her response held the theme that many clients before her had shared-- the birthing experience here was cold, clinical and lonely. 

I can't help but wonder-- as a mother, a nurse and a human being-- if we are doing a grave disservice to our mothers here. For all of our focus on a medical-based, clinical birth, studies show that the U.S. has the worst rate of maternal deaths in the developed world and that 60% of the maternal deaths each year are preventable(Source here). The U. S. is one of only two countries that don't mandate any paid maternity leave(source here).

We are giving mothers a cold, clinical birth that may not even save them from death in preventable situations, providing little to no support after the birth and forcing many mothers back to work before healing their bodies or bonding well with their children.  Our communities don't rally around new mothers to offer assistance. Other mothers often offer only criticism of the new mother, even strangers in the grocery store feeling compelled to offer unneeded advice without compassion or real assistance. New motherhood is terribly lonely and exhausting here. I cannot help but know, with a sickening pit in my stomach, that we could do so much better here in America.

This Mother's Day I wish for a better future for the mothers in America and around the world. We celebrate our moms one day per year, but the truth is that babies are being born into the world by mothers each day and they deserve so much better than the current American experience of new motherhood.

Wednesday, May 10, 2017

An Open Letter To the Teacher Who Taught me How to Live

 I have always loved school. As a child, I greeted every summer with a bit of sadness to have to leave the classroom for three months. I have many beloved former teachers. However, I only have one favorite teacher-- a woman that reached into her soul to teach me far more than the Language Arts lessons that she was paid to teach every day.

A bit of backstory before I tell you about the teacher that changed my life-- when I was in seventh grade my best friend, Jacki, died in a car accident.  I was brought to my knees with crushing grief and sadness. As a junior high student that had never experienced the death of someone my own age, I was frozen in my grief and unable to cry or work through her death. When thoughts of Jacki would come bubbling up, I would push them immediately back down. No one had taught me how to mourn and so I simply moved on with my life with all of my feelings bottled up inside me, the pressure rising with each passing week. That year passed in a blur and I went on to my eighth grade year still frozen in grief and with a torrent of unshed tears inside.

Language Arts was always my favorite class as I was (and am) a voracious reader and persistent writer. Mrs. Wood was my teacher that year and we bonded immediately over a shared love of the written word. I did not know in those first days that we would end up sharing so much more.

On the first day of class, Mrs. Wood handed us each a journal that we would write in and she would periodically read. Some days we would write about simple, everyday topics and other days we were allowed to write about whatever we wanted. I loved journaling and felt a sense of freedom with every word that passed from my pen onto the page. As the months passed, my trust with her grew, as I felt connected with her through her kind written responses to me in the margins, scribbled in red pen. I began to look forward to the days that we would pass our journals back to her in her wire basket, knowing that I was passing what was in my soul over to a teacher that would treat my words with respect.

After a few months I began, finally, to write about Jacki—how much I missed her, my memories of her and my sadness at the great loss.  There was a rush of emotions that began to flow out of me onto the page. I was voicing for the very fist time the pain of losing my friend, a pain that I had not yet begin to work through. I struggled not to cry in the classroom as I allowed the pain to flow onto the page. 

Days after I submitted my journal with my writing about Jacki inside,  I arrived to find the other students being shuffled out of the classroom for an assembly. Mrs. Wood kindly asked me to stay behind with her. I was flummoxed and was a bit worried that I was in trouble. I was a good student and had never been in trouble before and my mind swum with all the imagined things that I could have done.

She sat down facing me, our knees nearly touching as we sat on the tiny student chairs. She shared with me her own deep pain from when she had lost her young and beloved son Jonathan years ago. She did not hide the depths of her pain and cried -- tears soaking her clothing until she was left damp and disheveled.  I was humbled and in shock as she shared the story of her great loss, speechless to be in the presence of such pain. I was honored that an adult would trust me, a child, with such powerful emotions. 

Then, her story complete, she asked me to share the story of my own loss. I know now that if she hadn't shared her own story first, I would never have been brave enough to tell her the depths of my own pain.  I told her of my sweet friend and my memories of her, of how much I missed her. For the very first time since her death, I found the tears shake loose inside of me. I broke down and I wept while Mrs. Wood held me and assured me that it was okay to cry. I do not know how long we sat there, intertwined as my tears fell on her shoulder and hers fell on mine—it seemed, at once, like only a second and many years had passed.

After we cried together, we sat quietly and she talked softly of the things that I could do to help manage my grief. She asked me if I would promise to come to her if I was ever struggling in any way. I promised her and knew that I could trust her with anything, for she had shared with me the deepest pain of her soul with me.

That fall day(and all of the days after in that school year), I was taught how to mourn, a skill that should be innate in a human soul but somehow is not. She taught me how to manage uncomfortable emotions and the coping skills that I found that day are still used today. I still journal, allow myself to cry, scream into my pillows, run at breakneck speed until the anger is spent and seek help when I need it. Life is full of suffering and the mourning of loss and those lessons, the knowledge of how to simply survive great heartache, have served me again and again in my life. I know today that I would not have been able to undertake a career in pediatric nursing if I had not been given the tools to cope with my own suffering and the suffering of those around me.  I had been given a firm foundation to set my life upon.

I left that day feeling lighter than I had for a year, on a path of healing. What I had realized that day is that many teachers can teach knowledge, but the true teachers are those who use their lives to teach us how to live. I am thankful everyday that I was given Mrs. Wood to teach me how to share my life with others and live a life of meaning. I will never forget her and remain forever changed by the depth and courage of her teachings.

That day my teacher lit a lamp for me, a lamp lit with the fire of her own suffering, so that she could light the way for me to find my way out of the darkness. I am forever grateful. 

Wednesday, May 3, 2017

These Hands

These Hands

My grandmother once told me that I had the hands of a man.
Short, stubby fingers with swollen knuckles and cracked skin.
Chronically anxious, I have often bitten my nails until they bled.

As a nurse, they have comforted the dying.
Were the first hands to touch a newborn baby.
Stroked the hair of a frightened, sick child.

They are often cracked and bleeding. 
Nails short and without color.
Some will take their hands away instead of shaking my weathered hands.

As a mother, they have registered a temperature without a thermometer.
They have placed bandages on scrapes and wounds, sealing them with a kiss.
Stroked my children’s backs until they feel into a blissful sleep.

They often have patches of eczema, red and raw.
Shiny from the coconut oil slathered on for protection from frequent hand washing.
I have taken to hiding them when my picture is taken.

They have written words that poured from my soul, hot and acidic.
Written replies to thank you cards from souls who now felt less alone.
They have wiped the tears from my own face as I wrote my painful truths.

They are hands that tell a story.
A story of a life well lived.
They are beauty, redefined.

Friday, March 24, 2017

A Lesson in Joy

I was at The Salvation Army recently to pick up something for a client. As I was walking in the doors, there was a young man walking out with his grocery box. in his small box of groceries, they had placed a single, small bottle of soda in the box(which I've never seen before). 

This man, who appeared to have intellectual disabilities, was as happy as anyone that I've ever seen in my life. He showed me his bottle of soda and delightedly told me that he hadn't had a soda in years and that he was going to drink this one today. He was grinning ear-to-ear, his glee contagious to all around him. 

After a moment, he paused in his giddy dance of joy and noticed my empty hands. He asked, somewhat somberly, if I was getting a box of food, as well. I explained to this sweet young man that I was a nurse getting a car seat for a client and was not picking up food for myself. 

He looked confused and asked me if that meant I wouldn't get a bottle of soda. I replied that no, I wouldn't. His face, moments before filled with absolute joy, fell and he began waving back on forth on his feet as if in absolute misery. I tried to explain to him that I didn't need any soda and was not upset in the least. 

His face then lit up again with an idea. He asked me with excitement if I wanted to share his Coke. He told me that we could sit in the sun and share his soda and was so excited at the prospect that he was shaking with joy. 

I didn't, of course, share this young man's soda. He deserved to enjoy every bit himself. His soda didn't fill my stomach but his kindness fed my soul.

That afternoon, on a day in which I'd been incredibly stressed before, I sat on park bench in the sunshine and had shared some conversation with a kind, young man. This complete stranger sipped on his small bottle of soda and grinned as we talked. He was drawing every ounce of happiness out of that simple moment that he could.

After he drank the last drop of the carmel colored soda, we parted ways. I have never again had the privilege of meeting that young man again but this memory will forever be a reminder to me: that gratitude and joy are both choices that we make on a moment-to-moment basis. 

I will never be the same. 

Sunday, March 19, 2017

Journey Back to Baker Street

"In memory everything seems to happen to music."

It's amazing the power of a song to strip the years away in a single moment. A song from my childhood came on the radio this morning and the world folded in on itself and thirty years disappeared in a breath.

I was driving my daughter to school  and, just as I put my car into park at the elementary entrance, the song Baker Street by Gerry Rafferty came on the radio. I hugged my daughter goodbye and then sat in my car and let the waves of memory wash over me as I listened to the distinctive notes of the saxophone playing around me.

When I was little, maybe 6 or 7, I was given a tiny portable 45 record player. It was my treasured possession, even though the pink pleather box was cracked and weathered. It came with a single record, Raindrops Keep Falling on My Head by BJ Thomas and I played that solitary song over and over and over again until my parents begged for relief. I tucked the record player back into the bottom of my closet and forgot about it for some months.

One day, some months later,  I was commissioned to help a friend of my mom's pack up her apartment to move. While there, I noticed her tossing some records into the trash. I asked if I could have them and she responded that many were scratched but I could have them if I wanted. I remember her shrugging and frowning as though perplexed at my elation over scratched 45s.  The only one of the handful of records that I recognized was Uptown Girl by Billy Joel as it was still being widely played on the radio. I grabbed all of them, recognizable or not, and finished the day of cleaning and packing with a spring in my step.

When I made it home, I pulled out my pink turntable, scooted up onto the bed that I shared with my sister and put record after record on. The woman who had gifted them to me had been right-- many were so scratched that they were unplayable. Two of them, the aforementioned Uptown Girl and Harvest Moon by Neil Young would play all of the way through. Most, however, ended up in my trash can.

I remember sitting there on that bed with my back up against the cold wall of the rickety trailer that we lived in in rural Iowa and placing the last record on the turntable. It too, was very scratched but I was persistently moving the needle around trying to find a spot that would still play. I'm not sure why I was so persistent with this final record, but I was. After a few minutes, I found the sweet spot and the sound of a saxophone solo burst into that tiny, dark bedroom. That sax solo was the only playable part of the record and, only a few seconds of it at that. But, there was something about the energy of those notes that stole my breath away.

I had always been an odd kid-- prone to crying jags, feeling the weight of the world perpetually on my shoulders, struggling with depression as early as kindergarten and with my nose perpetually in a book. It seemed that no one else on earth was like me. I felt lonely every, single day. However, those few notes that played out of my cheap, cracked pink pleather turntable were a revolation  for me. 

Those notes seemed to call out to me and tell me that I wasn't alone, that someone else out there felt the world as deeply as I did. I felt immediately less alone in the world. For the next weeks, until the record would become completely unusable, I would place the needle onto the record's single, sacred, unscratched section and cry with relief as the sounds of melancholy saxophone whispered into my lonely life and filled a hole that had never before been filled.

That broken record began a love affair with music that has since rivaled my voracious need for books. I had found the escapism and human connection of art. A tiny piece of my heart was healed that day and, if judging by my emotional reaction at hearing those same notes again today, the healing continues to this day. I am thankful for that single, broken record that was gifted to me at the time that I most needed it. I am grateful for the magic of music.

Monday, March 6, 2017

Cartography for Moms: Making a Map to Leave Behind

In the still, small moments of the dark of the night, I often catch myself wondering and worrying what would happen to my children if I were to die?

I'm not a stay-at-home mother but you might guess that I were by the amount of work that I do around my home. I am married but am the sole person responsible for cooking, cleaning, laundry, shopping, bill-paying and nearly every other chore around our home. I also meet 90% of the needs of our three children. I carry the weight of this family on my back every single day, like many mothers do. I'm not saying that my husbands contributions are not worthy-- he is the primary breadwinner and a good father. However, the scales for the entirety of our marriage have been tipped, no matter how I fight it, so that I do the vast majority of the household work and childcare, even when we've both worked all day.  While this is something that causes me stress on a daily basis, this article isn't about the unfairness of the situation. No, the stress of the work is minor compared to the constant worry that I carry about what would happen to my family in the instance that I would die.

Now, I'm not planning to leave this Earth anytime soon. There is nothing more that I want in the world than to care for my children until they are grown and to see what they become as adults. I am a nurse by trade, however, and I am painfully aware everyday that we are never promised tomorrow. This fact, the fact of my very impermanence, leads me to wake suddenly in the night, heart pounding in worry about how this house will run if I were leave my Earthly body.

There is nothing in my life that I love more than being a mother. It is the greatest honor of my life. It is also, particularly as a working mother in a high-stress career, the hardest thing that I have ever done in my life. My mind is a running to-do list that is never complete. I juggle so many damn balls every day that I have forgotten what it is like to have a peaceful mind. The chores, the worry, the duties-- they are never-ending. I feel, many days, that no matter how hard I try, I am failing. This is not an easy life but I never stop learning and have become somewhat of a juggle master- able to juggle it all and only rarely letting a ball drop. I often wonder if I were to pass on, if my husband could step in and juggle the same life so that my children would continue to thrive. I worry about it every, single day.

I'll often sit in bed and wonder if my husband can remember how to balance a checkbook and form a budget. He probably doesn't even know our bank password. Shall I leave it to him in a hidden document in the computer just in case? Should I write a cheat sheet for how I create our monthly budgets? I have a running mental list of where I can find our common household items and food for the best price so that I can feed our family and provide toiletries on a tight budget. Shall I make a list- won't the prices continually change? Would a list matter? Can I teach him about coupons and planning meals around grocery sales?

I'll be sitting in traffic and wonder what my children would eat every night if I were to pass on. Would my husband remember that he has to check each and every label for our youngest daughter's allergen? Could he learn to cook more than chicken nuggets and frozen pizza? What about cleaning up after dinner? I don't think he's loaded or unloaded the dishwasher more than a handful of times in our 16 years of marriage. Will he just leave the dirty dishes out on the table like he does now? Who will clean them? Will my children eat junk food and live in filth?

In the witching hour of early evening, when I am simultaneously and frantically cooking dinner, helping the kids with homework, making sure dance/tumbling/scout costumes are cleaned for their activities and cleaning the house...I wonder if he would be able to transition from an existence in which he gets to walk in from work and go straight to the couch into an existence of having nearly every minute of every day be in service to other humans.

When I am comforting my children after they had a hard day, I wonder about writing a document about all of the tiny nuances that I know about each of them so that my knowledge of them would never leave with me. Each of my three children could have their own, massive book. I know them better than anyone else in the world. Of course, as soon as I finished the books, they would need to be rewritten. My amazing children are growing and changing each day. I make sure to sit and listen to them each and every day because, somehow, each new day they are different than the last. I am willing to forgo time with my friends, a perfectly clean house and 10,000 other things to be sure that I get this time with my kids each day. I carry these moments with me in my heart. I cannot imagine how I transfer this knowledge of the metamorphosis of my children onto paper.

There are so many daily duties, large and small, that encompass my day as a working mother. How do I transmit this information to someone else so that they can care for my children in the best way if I was to leave?

And, so I wonder- is there such a thing as cartography for Moms?  Is there a way for me to make a map to show others the way of my family's life?  How can I leave a map behind in the case that I am no longer able to lead the way for my family?

Some items on the map seem much easier to navigate. I can much more easily leave a detailed budget than I teach the subtle nuances in our teenage son's voice that let me know that he had a bad day and might need to talk. I can leave recipes for healthy dinners and lists of what each child likes to eat but how do I explain how to navigate our middle daughter's mood swings when puberty rears its ugly head? I can teach him how to manage a calendar that is carefully color-coded so that he never misses an important activity for one of the kids but how do I explain the way our youngest daughter's eyes change ever so slightly before she has a flare up of her medical condition?

I do not know how to create this magical map, one which keeps my family afloat and moving forward even if their mother, the captain of the boat for the entirety of my children's lives, had moved on.

I think that maybe the maps that we, as mothers, so carefully craft to keep our children's life journeys running smoothly always have roads that lead our children back their mothers so that we can love and care for them at every step in the journey. I fear that if the mother is removed, that this magical map would not work at all. All of this worry has led me no closer to the cartography of the mythical mother map, and maybe the reason is that if you remove the mother, the map becomes useless.

I simply must trust that, should I leave this world, even as hard as I try to tether myself to it, everything will be okay. The map would not stay the same, their lives would not remain the same but my family would carry on their journey without me. Instead of spending my hours worrying about what my children would do without me, I must focus my time on making the most of the hours that we have today. Tomorrow isn't promised but this moment is and I must use it in a better way. I cannot leave my husband or my children a map that will magically light their paths but I can leave them a legacy of love.