A Nurse's Truth: In Healing You, I Healed Myself

I have had a life-long struggle with self-worth. I remember, even as a young child, feeling ever so different from those around me. It felt deeply lonely and it forced me to wonder if I had a place in this world.

This feeling of lack persisted into my adulthood. It became so strong in my teen years that I heavily contemplated suicide and wondered if I were even worthy enough for life itself. I felt empty, drifting through life with no reason at all.

As college approached, I mulled over many different careers: writing, teaching and nursing among the many choices. There were many things that attracted me to nursing, but the sticking point was that I wanted to make a difference. I desperately just wanted to be worthy of life, worthy of existence and helping others seemed the only way to find that.

I received my degree and my license as a Registered Nurse and set out to help others, wishing desperately to help others. In this past decade I believe that I have helped many, although I had been naive about how many there would be that I would not be able to help. What I did not expect is how serving others would help myself. That my helping others would go far beyond giving me a feeling of worth-- it would make me whole.

Nursing gave me a way to make a living by helping others and has allowed me to live beyond existing only for myself and my family. It has given me many things: confidence, knowledge, connection, purpose. 

However, my patients themselves have given me ever so much more. Getting to know and care for my patients, even the challenging ones, has been one of the greatest blessings in my life. Nurses and other health care professionals see patients on their very worst of days and it is astonishing how quickly you bond with people and the stories they tell you. My patients have honored me with their honesty, with their shortcomings, with their vulnerability, with their pain. Making a space within myself to carry their stories inside me has made me a better person. My heart and the depth of my compassion has grown each and every year of my practice.  

I still feel lonely often. My heart often feels broken open at the injustices of this world. Everyday I wonder if my work has been enough to truly help my patients.

The knowledge that I do have, the knowing that pushes me through each day, is that I am not alone in my suffering, in my loneliness. This is a lonely world full of imperfect people like myself. Separately we are imperfect, with jagged edges and voids of space looking to be filled. Together we fit together as puzzle pieces, our jagged edges fitting perfectly with the broken edges of another.

My dear patients: In embracing your imperfections, I have embraced my own. In honoring your stories, I have honored my own. In loving you, I have found a way to love myself.

There is a parable from the bible that is oft quoted in healthcare- “Physician, heal thyself.” I say, with complete honesty and gratitude, that in healing you, I have healed myself.

And, for that I will be forever grateful.

SaveSave

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. 

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.

Cold Hands, Warm Heart

My entire life I have been plagued with having cold hands and feet. Most of the women in my family seem to have the same trouble. As a child, it was something that I gave little thought to. However, after becoming a nurse-- a very hands-on profession, to say the least-- it became something that I thought about and worried about daily. After all, I care for my patients in times of distress and touching their bare skin with my ice cold hands didn't seem soothing at all.

I've learned some tricks since those early days, just out of nursing school. I take Niacin at my doctor's recommendation and this seems to boost my circulation and ease my Raynaud's Syndrome(a condition that causes my hands and feet to become blanched and painfully cold). I have hand warmers that I heat in the microwave and keep in my scrub pockets when my hand are painfully cold. I also have learned to rub my hands together before touching a patient(except in an emergency situation, of course). Still, even with the tricks to keep my hands warmer, it's not uncommon for my patient's to occasionally wince when I first touch them. It makes me feel terrible.

When I was a hospice nurse years ago, I found that the older generation seemed to love me more for my chilly hands. There is an old adage, "cold hands, warm heart", and many seemed to think my cold hands signaled a compassionate heart. There were several older women that even went as far to tell me that they don't trust nurses with warm hands. Now, I'm not one to shrug off anyone's beliefs(especially when they benefit me- ha!) but I don't truly believe that someone's poor circulation likely is connected to their compassion. However, I've learned over my nursing career not to disregard anyone's beliefs. Nursing is a calling that leads us into a world where we live with one foot in this world and the other foot in the next world. I've seen so many things that could never be explained by science. Nursing has opened my mind to so many things that my pre-nurse self would have shrugged off. I learned during those years as a hospice nurse to accept that sometimes, something like having cold hands, can turn out to be a strange blessing.

 Yes, I said that it is a blessing(although I admit to moaning and groaning in the midst of the cold, Iowa winter when my fingertips turn a nearly permanent white). It forces me to be conscious of how my touch can impact others, both good and bad. At the beginning of each of my patient visits, I take a moment to warm my hands and my stethoscope with speaking with my patient. It forces me to slow down and remember my patient is a person, not simply a body to be assessed. These extra moments of humanity have been such a gift, to both my patients and I. My patients are my heroes and hearing their life stories have been one of the greatest blessings of my career. Those moments of simply listening, not always allowed with today's overwhelming nurse/patient ratios, are crucial to our patient's health.

These chilly hands have also been a reminder to me that human touch can be a burden or a blessing. Now, as a sexual assault survivor myself, this should be ingrained in me. However, many of my jobs in my career have been in positions with unsafe nurse/patient ratios with shifts that were a blur of nursing assessments and treatments. There have been many times in my career that time was a gift that we were never given. The patients were a haze, the memory of one blending into the next, and there were few, if any, deep connections made. I often wonder if my rushed assessments, as necessary as they were, were toxic to the patients who could have used an ear to listen, some human touch not contingent on care  and care from a nurse who wasn't breathlessly ticking down an impossible to-do list for the shift and praying for no crisis as she simply didn't have the time. 

These wintry digits have also been a reminder to me that, in nursing and life, there will be many things that I will have no control over. I was born with these perpetually blanched hands and they will likely be chilly until my death(and, I suppose, after my death. Too morbid?). It's a small thing, really, these hands and there temperature. It may seem like a silly thing to spend so much of my time thinking about. But, these hands- they touch so many in my day and I want that touch to be therapeutic. So, I take that which I have little control over and do what I can to ensure that my touch, which comes out of a deep desire to heal others, reflects the warmth of my heart.

I've always tried to do the very best for my patients. I truly have. There have been many times that it did not feel like enough. Too many times.  I keep learning and growing and allowing my heart to continue to expand. The lessons of nursing are many and can be found most anywhere- even in the blessing of these perpetually cold hands. 

~Nurse Mandi

Love is the Bridge Between Us

 

As a public health nurse, I often work with refugees, dragging my nursing bag into their humble low-income housing. Years ago, I had a final visit with a family that I had worked with for many months and that experience was one that I will never forget. 

I remember shaking the snow off of my nursing clogs as I entered the very warm apartment. This family had come from a very warm country and had not yet acclimated to cold Iowa winters and they kept their apartment as a warm oasis from the winter’s cold bite. I felt the tension the moment that I walked in the door and noticed the sadness in the eyes of each of the family members who greeted the interpreter(there to bridge the communication divide) and I at the door. Emotions were high on this final visit, as the family had become very attached to me (and I to them). There is a bitter sweetness to final visits and we were all feeling that-- the joy of the family no longer needing a nurse and the sadness that our journey together had come to an end. We went through the familiar motions of our visit; weighing the baby and scheduling doctors’ visits and talking through any needed education so that the family can live their best life. And, too soon, the visit was over and our time together had come to an end.

As I stood to leave, the mother motioned for me to be silent. She said, through the interpreter, that she would like me to not say goodbye this time-- it was far too emotional for her and she would like to think that we would meet again. In fact, she was certain that we would be together again in the after life.

She motioned for me to come over and stand by her and then motioned for her children to encircle us. I could tell by the children’s immediate move into position and the confident smiles on their faces that this had been practiced before my visit. The children were so excited that they were teeming with energy, bounding on the balls of their feet as their mother chided them with a smile, asking them to stand still.

She took my hand in hers, her dark skin contrasting completely with my blindingly white skin, and told me that we were sisters now. She said that, in her former country, when someone helps your child that you are bonded to that person for life, that life could never separate you. At this point, she began to cry and, even though I was willing myself not to cry, I could feel the wetness on my cheeks that let me know that I was failing. She stepped away from me for a moment, attempting to wipe her cheeks surreptitiously, and came back with an intricate incense burner, which was reminiscent of the one that had been used in my childhood church.

Her children began to sing a song together-- the words in a language unknown to me, but somehow known to my heart. She smiled her gratitude to her children and brought her focus back to me. She began to swing the incense around me, enveloping me in a cloud of pungent sweetness. She began speaking quickly over me, the interpreter struggling to keep up with her words.

May you live a life of peace.

May your children and your children’s children live a life of peace.

May you live a healthy life.

May your children and your children’s children live a life of health.

May you live a life of abundance.

May your children and your children’s children live a life of abundance.

The words were spoken over and over again. Incense rising. Children’s voices singing sweetly. My client, the interpreter and I were wiping our leaking tears and smiling through them. I could feel the invisible strings that connected us all together in that precious moment. 

I felt the intention of each word spoken over me and felt the words fall around me, as heavy and comforting as a thick blanket on a cold night. I believed with every atom of my being that she wished so very much for these blessings to be true that they would be.  She had no way of making sure that these intentions which she spoke over me would come to fruition and, yet, the words were bursting with the power of dynamic, heartfelt yearning.

When she was done, I looked around the tiny, shabby apartment filled to the brim with children. It was so full of love that I wondered how it could be contained by these cracked walls. I knew in my heart that I had done many things for this family in the past year, much more than was in my job description. I knew solidly that they were in a much better place than when I met them. I also knew that they had taught me much more than I could have ever reciprocated.

I gathered my nursing bag and headed for the door, quietly putting my shoes on while continuing to wipe away tears. I would not say goodbye. I was certain that she was right and our paths would cross again, even if it was just in the memories passing through are minds. Goodbye was not a word that would suffice the end of the visit.

Instead I gathered every bit of intention within me and I said, as I was crossing the doorway echoed by the interpreter behind me-

May you live a life of peace.

May your children and your children’s children live a life of peace.

May you live a healthy life.

May your children and your children’s children live a life of health.

May you live a life of abundance.

May your children and your children’s children live a life of abundance.

A Letter To My Muslim Patients From a Nurse

I do not work in a traditional nursing role. I am a public health nurse who goes into low-income areas and serves those in need. Many of my patients are refugees and immigrants but I also serve many who were born in this country. In a single day I may meet with five different families, each with a different language, skin color, culture and faith. I can say without reservation that this job is both the hardest nursing job that I've ever had and the most rewarding.

The most eye-opening part of this job has been getting to know so many different cultures, traditions and faiths. It has been such a great blessing in my life. Getting to know my Muslim patients has most certainly been one of those wonderful blessings.

I know that in post-election America, there is much uncertainty right now. I know that many groups of people, including those of the Muslim faith, are scared. I know. My refugee patients are scared. My immigrant patients are scared. My LGBT patients are scared. So many of us are frightened. And, yet- so much of the hate has been focused directly on you-- my Muslim patients.

You have told me during my patient visits that you are anxious for your children and if they will be harmed, panicked at the possibility of a Muslim registry and what that may mean for you, terrified to wear your hijabs in public and are sometimes simply too full of fear to leave your home at all. I am so terribly sorry for your sorrow and fear. In the past two weeks I have left our visits with a sinking pit of shame in my stomach for what the hate that is pervasive in this post-election country is doing to people that I care so much about.

If you are my patient, I have already told you that I care for you and that will you will always receive the same quality of care as that given to my other patients. I have hugged you and assured you that the election results will not impact our visits when you voiced concern. But, there is so much more that I want you to know.

I know that your faith is not one of violence and that the actions of a few do not represent the whole. According to the Pew Research Center, the population of Muslims around the world in 2010 was 1.6 billion. Yes, I said billion. If the growth of the Muslim population continues at the projected rate, by 2030 they will encompass a full quarter of the world's population. And yet, the violent actions of those in the name of the Islamic religion are few and far between. I know that as a Christian, I am not discriminated against each time that someone of the Christian faith commits a violent crime(which happens frequently) and, yet- you as a Muslim are discriminated against for each and every infraction of those who share your faith. It saddens me deeply that so many can judge you, my beloved patients who have shown me so much love and hospitality, for something that you had no control over and are as horrified by as we are.

You have the right to health care, education and all basic human rights and deserve that such things are provided by those whose judgment is unclouded by political judgment or discrimination of any kind.  I will provide that for you and so will the vast majority of other public servants. If you at any time feel that you are provided sub-par health care, education, safety services provided by police officers or fire fighters, etcetera; I hope that you will find the courage to speak out. I hope even more that you will never need to speak out as it is my firm belief that those serving the public should have the hearts of servants of ALL people.

I know that mental health impacts every facet of your life and that living within fear means that your mental health and physical health will be impacted each and every day while we persist in this volatile and discriminatory post-election world. I know that you may need more support through this time and I am determined to give that to you. You do not deserve these burdens placed on your already weary shoulders and I will do my best to stand beside you and help you in any way to shoulder that burden with you. I implore you to ask for help if you need it.

I know that we cannot lump any section of humanity together and imagine that they are all the same. As human beings, we are all originals and are unique. However, my time working with the Muslim population has led me to believe that those of the Islam faith as a whole are extraordinary people. I have never seen such hospitality before as I have seen going into the homes of my Muslim clients.  You may have very little and yet you will offer me the last food in your fridge, the only chair in your home and likely would offer me the very shirt off of your back if you felt that I needed it. I have never felt anything but love in the homes of my Muslim patients that I have been welcomed into. I am a kinder and gentler person because of you.

I believe that my job as your nurse does not end when our visit is completed. As a nurse, it is my job to advocate for my patients, especially those who may not be in a position to advocate for themselves.  I believe that all oppressive structures, such as the talk of a Muslim registry and  of the disallowing of Muslims into our country, should be decimated. I believe that you have every right to the same rights as every other human being in this country. I am not Muslim but I am committed to standing up beside you in every way that I can to ensure your safety.  When I casted my non-Trump vote on election day, I was not only voting for myself and my families, but I was voting for you, my patients, as well. I did not take that vote likely. I have been spending my days calling my elected officials on my lunch breaks to protest Bannon's appointment and any talk of a Muslim registry. I know that this is not enough. I promise to not stop my work until we all have equal rights. I know that as a straight white Christian woman that I can never understand what it like to be discriminated against for who I am but I will keep trying to eradicate the hate.

This letter will not solve your problems by any stretch of the imagination. It will not solve anything at all. I only wish to be a tiny light of love in your life in a time of great divisiveness and hate. I only wish to bring you a small amount of the love and joy that you, by being my patients and thus a part of my life, have brought me. I wish that I could also bring you peace. I promise to do all that I can to make that peace happen for you someday.

I stand beside you, my Muslim friends and patients, with love.

Nurse Mandi

Refugees and The Lessons They Teach Us

I have always been a book fanatic and buy books, both new and used, and have a house in which every shelf is swimming with novels and tomes of non-fiction. Having a home full of books that I can pluck from a shelf at will has always made me feel measurably abundant. That is, it did until the day that I met a new refugee family.

In my job as a public health nurse I work with many refugee families, helping to ease the transition from years of life in a refugee camp into the startlingly different life as a resident of the United States. Working with these families and hearing their stories of their former lives has been one of the greatest blessings of my life.

This day I walked into the tiny apartment of a new refugee family with an interpreter at my side to bridge the communication gap. I was no longer startled by the stark emptiness of the apartment, as I had been when I was new to working with those in poverty. As a direct contrast to the consumer society of America, refugees come here with nothing and are grateful for every simple pleasure- the roof over their head, food on their plate, the lack of gunshots outside their window- and often live in tiny, low-income apartments without a single piece of furniture. This apartment held only a single chair and a shelf proudly nailed into the opposite wall.

The solitary chair was immediately proffered to me, with reverence. I never fail to be humbled by the grace and kindness offered to me in these homes. I declined to sit on the chair and instead sat on the worn carpeting, the family and my interpreter and I forming a circle in which their preschool-aged daughter, born amidst gunfire in the middle of a military uprising in their home country, spun within as though we had made the circle for her joy alone.

They did not stop their daughter from her joyful dance as many American parents would have- cautioning their daughter to sit quietly and let the adults speak. Instead they grinned and laughed and we all watched her spin and giggle. The conversation came in stops and starts as it often does while communicating with an interpreter, as we discussed their health, doctor referrals, food supply and community resources. The daughter continued to spin and giggle and we smiled at her with each pause in conversation. The family seemed to light up at my apparent joy in watching their daughter and this shared joy created a kinship beyond the fragile bonds of a nurse on her first visit to their home. There was a moment of pause and the father met my eyes and gestured to his daughter, “There is nothing so beautiful as a child who has no fear, no?” he said as the interpreter scrambled to interpret into English. The world stood still for a moment as I measured the words in my heart and nodded yes, at a loss for words, imagining the life that she had lived in her first few years.

He stood on shaky legs from sitting cross-legged for so long and walked over to the solitary shelf tacked to the wall. On it sat a single book, one of the books made for toddlers learning to speak with one picture and its accompanying word on each page. He handled the book with a reverence that I had never seen someone hold a book, even though I surround myself with bibliophiles that love books with fervor.

He sat, again completing our circle, and opened the first page. On that page was a photo of a perfect apple and he pointed at the picture, saying in clumsy English, “apple”, and nodding for his daughter to do the same. She stopped her spinning for the moment and carefully annunciated the same word in beautiful English.  They completed each page of the short board book in the same way. When they were done, he replaced the lone book on the shelf and bowed to it as he walked away. I thought back to my shelves stacked with books and suddenly did not feel abundant, I felt gluttonous.

He somberly said, though the voice of the emotional interpreter, “My daughter will learn English and go to school and live the American dream. “ I watched her dancing with such joy, no longer encumbered by the violence in her homeland or the constriction of the refugee camp, and I knew that he was right, she would find her own version of the American dream.

I was humbled and inspired and reminded of the importance of literacy and vowed to stop hoarding books and share them with those who have few and to treat each and every book with the reverence that I saw that day. Even more importantly, I was reminded of the American dream and how it still lives today in the heart of every citizen, whether born on this sacred soil or across an ocean.

SaveSave