July 2016 – thatnursewrites

Bittersweet Endings and New Beginnings

November 2015:My son stepped onto the field to perform his final half time show with his high school marching band. He was a senior and he was getting ready to graduate. The theme of last year’s marching band field show was, “Completing the Circle”. Prior to the performance the seniors and their parents were called to the field for recognition. I realized my son had completed the circle when I recognized the voice of the person calling out names to be my son’s fifth grade band teacher, the man who taught him how to play his trombone.

My son joined the high school marching band as a freshman. He was still weeks away from his 14th birthday, wide eyed and serious but managed to crack a smile from behind his mouthpiece when we’d call his name from the stands to embarrass him.
His existence in marching band had me at hello the minute I saw him march into the stadium in uniform for the first time as a freshman. It continued through every parade, football game and competition until the moment I saw him march out of the stadium at the final football game as a senior. The ending was bittersweet.

New Year’s Eve 2016: My husband and I were with friends. Our son was at a party and our daughter was staying at her friend’s house. The ball had just fallen and the four of us were wishing each other New Year’s greetings in our family group text message.

My daughter’s text message read, “He’s going to college and I’m going to march”. My daughter has also been a band child since fifth grade. She plays trumpet. As she has stood on the sidelines watching our son, my husband and I have watched her become one with her trumpet, practice her heart out and achieve her own music success. She will begin high this fall and follow in our son’s footsteps of music excellence but she will not walk in his shadow.

The final football game last fall was not only my son’s bittersweet ending, it was my daughter’s new beginning. The middle school 8th graders were invited to play pep band songs with the marching band that night. My daughter jumped at the opportunity and immediately bonded with the trumpet section.
My house is clean, my laundry is done and my refrigerator is full. Tomorrow begins a new season of marching band. It’s four and a half months of eating on the run, extremely busy weekends, evening rehearsals, extreme heat, wind, cold, rain, fundraisers out the wazoo and a disastrous house. We as band parents have no idea what the season will bring, we just make sure our lives march in sync with the band. I’m ready.
Tomorrow morning my son will drive to high school band camp once again. This time it’s to watch his little sister take the field with her trumpet for the first time as a member of the high school marching band. It’s her turn to shine and I look forward to seeing this through her eyes.
One thing is certain. In six weeks my daughter will march into the stadium for the first time. Her navy blue uniform with gold trim and a white sash will illuminate her ice blue eyes. She too will have me at hello.

Binge Watching

Last week, July 9-16 I was on vacation in a mountain lake, surrounded by trees, water and nature. I returned home rested, refreshed and craving an episode of my favorite History Channel series Mountain Men only to find that it’s on a small hiatus and a new episode would not return until July 28. I had to find another vehicle for my head to enter the woods after work when I literally don’t have the time to step foot into them myself. This week, just moments ago I finished binge watching Season 2 of Alone.

If you aren’t familiar with the series Alone below is the premise:

These people are skilled survivalists. Ten people are left in the Vancouver Island Wilderness carrying a backpack filled with 10 approved items of survival gear and some cloths. They are alone with no other human contact left to hunt, fish, build shelter and fire and survive the elements and complete isolation. The prize is 500,000.

For the record I’m not a huge reality show fan. Yes I watched survivor 15 years ago and turned my back on the ridiculousness of it and Jeff Probst within a few seasons. The only other reality show I’ve followed is Top Chef. Top Chef came into our lives when our children were young and our dinner menu was limited and mundane. From Top Chef, my husband and I cultivated a greater appreciation of food and cooking. Since then, we’ve enjoyed cooking together and trying new recipes.

In previous posts to this blog I’ve talked about my new found interest in nature and the outdoors. As my mid forties progresses and my children need me less, it is doubtful this is just a passing phase. Each time I enter the woods I gain knowledge, mental clarity or a visual I didn’t have before I went in. So what I have I gained by watching Season 2 of Alone? Ironically I paid close attention to the survivalists when they talked about and demonstrated basic survival skills I didn’t know before; fire starting, shelter building, fishing, gutting fish, edible plants. Some of the contestants were spiritual, earthy and enjoyable to watch because their strong connection to nature was obvious and calming in a way. Through their knowledge, skill set and demeanor they became part of the ecosystem of their environment and they knew they belonged there.

I know that I can’t continue to watch reality wilderness shows and expect to find peace. I have to get out there and do. I am a hands on person. I look forward to doing. I just haven’t had the opportunity. So what do I do when I want to learn something? I buy the book, I read, I do. Right after I finished watching the final episode I purchased a book Wilderness Survival For Dummies and a book about trees and wildflowers in the Maryland and DC Area. I look forward to what awaits me inside these books, learning and doing.

When Social Media is too much

Recently, one of my former coworkers made the decision to be placed in home hospice after treatment complications from a long illness. Through the course of her illness, she followed all the rules, took care of herself during treatment, kept a positive attitude and fought a very brave battle. Unfortunately she was told all treatment options have been exhausted. Instead of seeking additional medical opinions and miracle cures, she of sound mind, with her family’s support, made the decision to die.

She’s had an outpouring of support from family, friends and coworkers on social media. There’s pictures, memories, social functions and good times mentioned. While some choose to publicly support her, others choose to hold a silent vigil everyday for her in their hearts. I am in disagreement with some of these social media posts because some refer to her “fighting the disease” when she has clearly made a decision to die. It is even more disturbing that a few of these people who are encouraging her to “fight” are health care providers who know the reality of her disease and should know better than telling a dying woman to fight when there is no hope.

One of the most valuable things I’ve learned as a registered nurse didn’t come out of a textbook or in a nursing skills lab. It happened in real life at the bedside and more than once. When a someone tells you they want to die, as painful and difficult as it is, we must accept their wishes and let them go. Denial, anger, bargaining, depression and acceptance are all part of the grieving process but sometimes we as healthcare providers don’t have time for all parts of the grieving process until later. Sometimes out of respect for the dying we have to jump right on to acceptance and deal with the other stages on our own time.

Where have people’s morals and integrity gone? Where do we draw the line with our egos on what is appropriate to post on social media? What do we hope to gain by telling a dying woman to fight when she’s decided to throw in the towel because there’s no hope for her? Why do these people think they have to be “the one” for this woman? I am one of those who have held a quiet vigil for her everyday in my heart and I’m ok with that. I have happy memories of good times at work with her and lunch dates with good food. I will hold them dear. I accept her wish.

In the Wake

I am sitting in a boat on a mountain lake. The sun is shining bright on the water illuminating the green trees and the beauty of the mountainside. My skin is golden tanned and my hair is wavy and windblown. I have spent all week on this boat, allowing the lake to seep into my soul.
The boat is moving. I sit with my back against the driver so I can see the wake. As the boat moves through the water, the outboard motor creates an arrow shape in the water, the wake. Sometimes the boat turns and the water splashes me. It is in the wake of the boat that I realize I’ve found my center. I feel rested and back on track. During these days on the lake I’ve established a new rhythm of life. My lake life.
Each day I wake up early and drink coffee in bed. I meditate. I read while I eat breakfast, then I shower and write. By late morning we as a family choose our lunch plans and afternoon activities. There is always a boat ride involved. During these afternoon boat rides, I am a quiet observer, shifting my attention between the wake, the cabins and the trees. We stop for icecream and ride the boat until we feel the heat of the sun grow less intense and the air grow cooler. We head to the cabin for supper and a campfire to watch the sun set and the day end.
Tomorrow we will return to our city life. Monday I will rise again at 0430, shower, put on my scrubs and return to work. In the up coming weeks our freshman in high school will begin her marching band season. Our freshman in college will move into his college dorm and begin his marching band season. School starts for both kids at the end of August. We are headed for a busy fall.
I fear that the first time shit hits the fan at work and I become angry and burned out, or when the marching band bomb goes off in our house that I am going to be thrown off my center that lake life has given me.
I know my husband agrees with this next statement. We belong on the lake. It is our dream to own a place of our own for our family and friends to enjoy in years to come.
We practice The Secret and have asked the Universe to grant us this. Jim Carey once spoke of his use of The Secret when he was trying to establish his acting career. He said “I’ve already achieved this. I just haven’t accessed it yet”. Our cabin on the lake is out there waiting for us to make our home. We just haven’t accessed it yet.

Back in the Woods

This morning I entered the woods for a hike. Today’s trail is in a different location than the usual state park I hike. Today’s state park isn’t as big and the trail of wasn’t as strenuousbut I still left the woods with the same sense of calm I always do.
I gain something new every time I enter the woods. Sometimes it’s mental. Sometimes it’s physical. Sometimes it’s about nature. Sometimes it’s a cleansing. With each hike I go on my interest and appreciation for nature and the outdoors grows stronger and deeper. I wasn’t raised in a family that enjoyed being outdoors and I accept that. I can only be grateful that finally in my mid 40’s a synchronicity of events has led me into the woods and I can now focus on creating a lifestyle that is conducive to this. Rome wasn’t built in a day and I know that my new found interest only requires nurturing and my spare time. The woods are always there waiting for me.
I enjoy the physical challenge of hiking up an incline and feeling the sweat roll in, my heart beating faster, my gluteus muscles burning and my stiff knees cooperating with each step. Hiking is just as mental as it is physical. When I’m in the woods I often gain clarity on current situations of my life. One of my favorite things while hiking is to imagine pitching a tent, building a fire, cooking on that fire and spending the night in the woods. I’d read, I’d write, I’d reflect and as Depoche Mode says I’d, “Enjoy the Silence”. I’ve never been camping before. I’ve always enjoyed listening to my husband tell me stories of his childhood camping trips with his parents and sister. It’s something we never got around to when our kids were younger. I worked outrageous hours and even though camping was always in the back of my mind it wasn’t on my must do radar yet. It is now.
The trail this morning displayed a bounty of pine, birch, maple, oak, and hemlock trees. It’s a circular trail that leads hikers to three different waterfalls. I inhaled the smell of the falling water and observed the beauty of each waterfall I encountered. I also had a strong urge to strip off my clothes and enter the waterfall as naked as I was the day I was born to just sit there and let the water fall on me. I couldn’t do that though. It was mid morning and there were other hikers on the trail, including my two teenagers. My teenagers would end up traumatized for life and I’d get arrested for public nudity.
What I did do was take off my hiking boots and socks to dip my feet into the cool water. A few years ago I watched some Carol Tuttle videos on clearing chakras and learned how to clear each one. I remembered that one way to clear the root chakra was to rub your bare feet on the earth. I did that. I’m grounded now.

Daily Prompt Burn

This is a response to Daily Prompt- Burn.

When I think of the word burn, I think of my childhood in Buffalo, NY in the 1970’s. We didn’t have all these music groups my kids listen to today that make wonder who in the world they are listening to and why this is music. We had Saturday Night Fever, The Bee Gees, and Disco. We didn’t sit in the house all summer long watching Netflix on our smart phones and playing XBOX either. We were outside where we belonged. We got dirty, played kick ball and rode our bikes. We ate homemade popsicles made from juice frozen in tupperware popsicle holders. If we didn’t like the babysitter we’d stage a water balloon fight minutes before my parents got home so they would be annoyed at the babysitter and all the deflated balloons on the lawn and not ask her back. We also had the game Burn.

Burn was a game my brothers, our friends on the street and I made up. Each player had to stand with their backs and arms flat up against the garage door. The object of the game was to dodge the ball being thrown at you without removing your back and arms from the garage door. If you removed your back and arms from the garage door you were disqualified. The person throwing the ball hurled it and if the ball hit you, well it burned. It was a good game of Burn if you had welts all over you where the ball hit you. At some point someone would break out in song, the song by the Tramps “Burn baby burn, Disco Inferno”.

We’ve long since outgrown the game of Burn and moved out of that house. We are all now in our 40’s and can’t move as fast as we used to. I am sure if we had a rematch today one of us would end up with welts. Probably me. In my mind I can still see that garage door and feel the welts on my skin. I always think of the game Burn when I hear “Burn Baby Burn, Disco Inferno”. A memory burned in my brain and frozen in time.

The Truth Behind July 1.

Becoming a nurse was by far the hardest thing I’ve ever done in my life. The memorizing and understanding of material and the hours of study and preparing for clinical were grueling. Not to mention the social lives of all student nurses fly right out the window the minute the first course begins. No, I can’t go to your party. I can’t be hungover because I have clinical at 0700. I have to be on top of my game. I’m taking care of someone’s loved one.

My nursing instructors were scary and mean and did not except sub par performance in the classroom or clinical area. I remember two of them in particular. One of them was a retired navy nurse. Tough as nails. The other one reminds me of the female version of Professor Snape from Harry Potter. They were relentless but they had to be that way. They were teaching us to save lives.

One very important thing they taught us is how to provide safe and effective nursing care which ultimately keeps us out of a courtroom. If the nurse receives a physician order that the nurse feels is written incorrectly, wrong or unsafe, the nurse must question the order immediately. Do not pass go. Do not carry the order out. Question the order. Clarify. Call the attending physician. Do whatever you have to do. Just don’t do that order.

Translation: IF the order is wrong and the nurse carries the order out and the patient is injured or has an adverse reaction, the nurse’s ass will fry. I repeat, in a court of law, the nurse’s ass will fry.

As a student nurse, I worked as a Unit Secretary on an acute medicine/telemetry floor throughout school. The things I learned were priceless. Part of my job was to put physician orders in the computer so the nurses could carry them out. I learned how to interpret a physician’s messy handwriting quickly and I was never afraid to use the hospital computer system and I’m still not afraid to. I learned how to navigate my way through a chart and use the telephone to collaborate with other units. I learned about roles of other health care providers; respiratory therapists, physical therapists, occupational therapists, nurse techs, dieticians and how the unit flows throughout the shift.

I listened too. I listened to what the nurses on the floor said about just about anything. I could never figure out why this one nurse in particular was always on vacation for the first three weeks of July every year. So I finally asked her. Her answer was simple and her message rang loud and clear. “Because July 1 is the day the new interns fresh out of medical school start. It’s chaotic and I don’t want to be around the first few weeks of it”.

July 1 is the day the new interns begin. They’ve graduated medical school and earned the title of MD. They’ve been matched with the hospital that they will do the residency of their specialty at. They are green as could be and now they are being let out into the world of healthcare. Now mind you, interns and residents have to discuss their treatment plan with an attending physician before implementing it but that still puts nurses on high alert during those first few weeks especially on the inpatient units, ICU and Emergency.

Listen to the voice in your head especially on July 1. The one that says there’s something wrong with this order. If the voice in your head says don’t carry the order out and get that intern over here, listen. Don’t carry out that order. You will fry. Also, try not to scare the intern too badly. Not on the first day at least. They are just starting out on their journey of savings lives just like you did.