Reverence

The longer I work and experience life in critical care, the more I realize how incredibly little I know. The body is a phenomenal and fascinating organism. Chemical, hormonal, mechanical, electrical functions all working in concert to orchestrate the moment by moment intricate functioning of homeostasis.

Intervening requires understanding. Diagnosis requires understanding. Treatment requires understanding.

I had a conversation with a former student recently. A student who is in the beginning stages of her nursing career, about to come off orientation. She said she was afraid to go off orientation, afraid she’d miss something.

I told her she would. She would miss things. I told her that I do. I miss things.

I’m good at my job, but I’m not perfect. I know a lot, but there is more that I don’t know than I do know. I try not to miss things, but I do. I miss things.

I told her to do her best, to take peace in that.

Most days, I walk away taking peace in the truth that I did my best.

But, intervening, diagnosing, defining treatment is a life or death matter. Missing things can result in death. The responsibility of that truth can at times leave little room for peace.

In place of peace, I am left with a consistent feeling of reverence for the body and the phenomenal and fascinating organism it is. But I am also left with worry and fear (stress), with wonder and a desire to grow (eustress).

The desire to grow, the desire to know more, the desire to not miss things interestingly intertwines within the chemical, hormonal, mechanical, and electrical functions of my own homeostasis.  

It is in maintaining a healthy reverence that I find the most peace. Reverence for the body, the one I care for and the one I dwell within.

Politics

Driving today. Freely around town. Pups in the back. Food in hand. Passing manicured medians, blooming crepe myrtles. Radio streaming.

DNC this week. RNC last week. Politics roaring. Voiced thoughts, yelled opinions, slandered character, free speech.

A million miles away, 7 women sit at home, grieving the loss of a man, worrying about the one taken and tortured by the Taliban, unable to work, unable to move, unable to speak.

Tomorrow, a most amazing event in the 240 year history of our great nation, a woman will be nominated as the primary party candidate for president. A woman. It doesn’t matter if you like her, if you vote for her, if you appreciate her. It doesn’t matter how you feel, the truth is, a woman is being nominated for president.

His shift was over. He looked defeated, weary. I inquired of his downcast look. He told me of his family, his life a million miles away. He told me of his family here, helpless. I heard his words. I heard his living story. But it felt the million miles away that it is. It felt foreign. It felt unreal.

I deny that I live a life of privilege. I do not have exceptional wealth, I do not drive an expensive car, wear name brand clothes, or go on exotic vacations. But the truth is, my ruler is off. I have measured privilege with the wrong metric. I have measured privilege against excess and not against essentials. I have never gone hungry. I have always had a bed to sleep in. I have never had to worry about clean water or even warm water. I have never had to worry about how being a woman effects me politically or socially or financially. I have never feared the Taliban.

I sit at home. Weary from work and lack of sleep. Content in life. Privileged. Mindful of my Muslim friend, of his family, of those 7 women so far away, of the one taken and tortured, of the ones sitting here helpless.

He told me his life, his story. My heart was affected. He walked over to me, gave me a hug, comforted me.

And as he prays to Allah, I will pray to God.

Value

There have been so many as of late. So many who hurt so much that they don’t value. They don’t value to the point that they find themselves laying in beds, with or without tubes in their mouths, with counteractive drugs running through their veins, with restraints on their wrists, writhing wildly in bed or lying so incredibly still.

Heroine.

The families come and sit and watch and wait and grieve and their mere existence displays the value that is, that they do not feel.

Tylenol.

And there are too many times when there is no family at all, and the value they don’t feel is loudly reinforced by their aloneness.

Cheese.

I’m not sure what it is. I’m not sure if it was the stepping away for a time. I’m not sure if it was the teaching. I’m not sure if it has just been time and aging and maturity. But I feel the jaded cloak that has so long enshrouded my heart cracking and the reality of the work that I do weighing heavier than in previous times.

Unknown.

When rounding, I find myself at times standing alone in the room with the patient, in the dark of night, the patient sleeping, the lights of the monitor illuminating the room, the beeps of the pumps occasionally serenading the overwhelming stillness. When I find myself here, I always think about the day they were born, I think about the purity they embodied, I think about the mother who held them at her breast, and I wonder what transpired from that day to this day.

Black Freeze.

Life has transformed and changed their body and their mind and their heart, but they are still that embodiment of purity.

Meth.

Sometimes, when I close my eyes, I see the blood stained stripes on the bilateral upper extremities.

Alcohol.

The patients remain, pulling at the cloak, unable to be released from my HIPPA locked reality.

Value.

Unforgotten

In truth, since the events of that time, not a month has gone by that I don’t think on that patient. Days will pass, and sometimes weeks, but not a month.

In time I forget their names and their faces and their stories, but not this one. It stays ever close to me. There are a myriad of them that stay close to me, but I believe that she has stayed the closest.

The way that it ended was horrific. I had really never witnessed anything so horrific. It wasn’t horrific because of blood or guts or fluid, but because of life and time and circumstance. It was horrific because of love.

We cried. The staff. The normally untouchable ICU crew who soldiers in and out every day. We cried. Despite watching death on a weekly or daily basis, we were not prepared for this one. And truthfully, if it happened again, I still wouldn’t be.

There was a desperate sadness in it that I have not quite seen since.

When it was all over, all that was left was a forgotten vase of flowers. I watched it for days. I would eventually take it home. I still occasionally put fresh flowers in it.

The first time we met, we laughed and joked and it was a pleasant time. It was a time full of hope and promise of healing.  I often find myself remembering that part too. I’m thankful for that.

I am always reminded this time of year.

I always wonder what happened next, when they went home.

I wonder how they remember the events of that time. 

Doing it Right.

It’s been nearly 4 months since I left Searcy, Arkansas and moved to Dallas, Texas.

It has definitely been a change.

I miss Searcy. I miss how settled I was beginning to feel after so long of not feeling settled. I miss having a “normal” schedule. I miss being able to go to church every Sunday. I miss so many dear friends I had made there. I miss teaching. I miss College church. I miss the cookies. I miss having great places to run with my running buddy. I miss my house. I miss my yard. I miss sitting on my back porch. I miss my coworkers. I miss the traffic. I miss a lot.

But I feel used again. I feel invested in something that is so much greater than myself. I feel my brain churning and turning. I feel my critical thinking being used in full force.

I love what I do.

I feel like me again.

But I wanted to do it different this time, do it right. I didn’t want to put myself in another situation to quickly get burned out and get turned off of the work that I truly love to do.

The problem has always been that when I’m in the ICU I love my job but over time I begin to hate my life due to the schedule and various demands of the job. Out of the ICU, I love my life but don’t truly feel used and fulfilled in my job.

So the question, the quandary, has been, how do I do it right?

I work for a company now that appreciates this struggle. They acknowledge the work life balance problems of working nights on a rotating schedule in a job that is 24/7/365 with no respecter of weekends or holidays. They get it.

And because they get it, I’m working for a company that works to provide a work life balance. So 3 nights on, 6 nights off.

I have time to feel “normal”. That is incredibly, indescribably invaluable. I have time to let the stress fall away so I can go back in.

Life isn’t perfect, no job in no place will ever be perfect. But things are good. Things are right.

So, it’s time to get settled again. It’ll come in time.

NP Notified.

NP notified.

It’s a short note written by nurses to legally cover themselves from negligence. It’s a note that means that the nurse noticed something that wasn’t right or “normal” and the Nurse Practitioner was notified of this information, this change. It’s a note that means the Nurse Practitioner now has additional information they need to act on. It’s a note that means if nothing was done and the patient experiences harm that the Nurse Practitioner was liable, was negligent.

NP notified.

Critical lab values, vital sign changes, urinary output, ST changes, med reactions, etc. etc. etc.

NP notified.

As a nurse I had given the drug lasix tons of times. I never thought much about it. As a nurse practitioner, it was the first drug I ever ordered. I debated: Should I give it? Should I just give more fluid? If I give it will I hurt their kidneys? If I don’t give it will I hurt their heart? their lungs? How much should I give? How much is too much?

I don’t even remember that patient. I don’t remember who they were, why I gave lasix, or if they peed. I do remember that debate, though.  The first time I felt the burden on my shoulders.

NP notified.

Throughout my time as a nurse practitioner, I’ve had an average of 15 patients per shift. Let’s say that only 1/3 of those nurses charted that I was notified of something during those shifts. That means for every shift I’ve ever worked, there are at least 5 legal documents that say I was made aware of information and was legally responsible to act.

NP notified.

When I get to work I like to round. I like to see and examine ever patient. Look at their face, touch their body, see their wounds, observe their breathing, listen to their heart, see their monitor. I like to have a clinical idea of their body, of who they are.

Rounding takes time. Depending on the night it can take me anywhere from 1-4 hours. The other night  when I finished it had taken 3 hours. I finally had time to respond to all the calls, all the notifications that I had received during that time and I entered orders on all the patients.

NP notified.

Despite all the notifications, the calls, the exams, I miss things. Despite the legal responsibility and the expectations, I miss things. We all miss things. Sometimes they are small things, sometimes they are not. Some things are easily forgotten and we move on. Other things are not forgotten but can become a haunting of sorts. One that will visit us for a time, a long time. These haunting teach us and change us. They notify us that we didn’t act as we should have. The burden shifting its weight on my shoulders.

NP notified.

Welcome to Your New Home!

Welcome to your new house!!

This was my first real house and I worked hard to make it feel like home. I loved living here. I loved this home. I was able to find much peace and beauty here and in Searcy. I pray these things for you too.

I wanted to share some things with you about this house. I suppose I feel like it is my child and I just want to tell you about it as I walk away.

Yard

I will admit that this yard can be a lot of work, but I have loved working in it. When I moved in there was little to no landscaping. Though there is still much to be desired, I have built and planted most everything.

The back yard has two dark pink crape myrtle bushes. I planted them to grow and provide a bit of privacy from the neighbors. I thought about planting a tree in the back northwest corner, but I didn’t want to block the view of that beautiful field. Along the west fence I planted gladiolas (I am hoping to have a beautiful vase full waiting for you on the cabinet, but they may not have bloomed yet). I originally planted them in the front yard in the brick bed I built, but I had no idea they’d be as tall as they are and frankly they looked silly. So, this spring, I transplanted them to the backyard. I think this shocked them a bit, but they are resilient. If you choose to keep them, I anticipate they will be even more beautiful next summer.

The back yard also had a blue bird house. I have spent hours sitting on the back porch watching Mr. and Mrs. Bluebird. There are currently 5 eggs in the house (unless they’ve hatched) and I am anxiously awaiting the chirpings of the baby birds. I anticipate that they will not hatch before I leave. This is their second set of eggs for this season. Blue birds apparently usually have two “litters” (I don’t know what you call it for birds) every season. After they are born you will see Mr. and Mrs. Bluebird feeding them all day long and the birdies will be silent until one of their parents arrives at the house and then you will hear a chorus of glories baby bird chirps. The house is falling apart. But I have deeply enjoyed watching them. I anticipate that they will also be back next spring.

The front yard has a brick bed that I built. I originally planted 7 tulips and they were beautiful. Despite being perennials though, I only had one bulb come back this year – I was disappointed. I also planted 3 mums which have grown beautifully. I planted them in the fall last year after the tulips and gladiolas were done for the summer and they did okay, but they seem to be thriving now that they’ve really had time to root. The two outer ones are purple and the middle one is white. On the end I have a white crape myrtle bush. It has really taken off this year. It needs to be pruned and cut back to keep it under control. I also planted begonias this year. They are annuals and will die, but hey were pretty and white for the time.

On the other side of the house there are a few plants as well: three white azaleas next to the house and a suffering pink azalea at the front of the house (I’m not sure how it will fair). That front area was originally mulched, but I laid sod down and I like it better.

Around the yard are a few oak seedlings. I had originally planted 8, but the ones remaining are the ones that endured last summer’s heat and the hard winter we had. I got them at the Arkansas forestry department; I wanted to get native seedlings that would thrive in Arkansas. The one on the East side of the house is too close to the road and looks a little silly now – sorry. I had thought of planting dogwoods on the east side of the house or crape myrtle bushes, but time and money.

I had the picnic table built. My original intent was to stain or paint it and seal it. The builder told me to wait a year as the wood needed to sit. I don’t know why I listened to that boy. The table needs to be scrubbed with bleach and sealed. I’ve been meaning to do it, but I haven’t.

I meant to get gutters hung. I’m sure once you do the yard will easily reshape itself. It will need a few bags of dirt and time will allow the grass to replace what has been washed away.

I’ve had a contract the last two summers with Fairway Lawns (501) 588-2696) and they have been excellent to spray weeds and nurture the sod that is still young. They have really helped the yard to be healthy and have been a great company to work with. If you wanted to use them you could ask to pick up with the treatment where they left off of the address.

I sat for hours in the back yard. It is quite cool under the patio. Sometimes you can hear the cows in the nearby field. The sun sets beautifully in the west and it is easy to watch. Sometimes I would sit and watch the rain. It has been a place of great joy for me.

As I said, it’s not much but I have truly loved working in this yard. I wanted to lay some roots, and I did. It has been very healing and encouraging to me.

Guest Bathroom

I took the door off of the guest bathroom because the two met in such a way that is felt crowded. It is in the garage and a baggie with the hardware is taped to it. It should go back up quite easily if you wish.

Master Bathroom

I left a squeegee hanging in the shower for you. Feel free to throw it away if you don’t want it. I leave it hanging in the shower and use it after every shower and it has kept the glass quite clear. I recently had some house guests who didn’t use it and I could tell a big difference.

Air Vents

The air vents are funny. They are in the ceiling and frequently spit out white flat chunks of paint (like annoying snowflakes). I assumed after living here a few months it would stop, but nearly two years later they are still spitting it out. So, if you see white stuff on the floor, just look up and you’ll see an air vent and know that it is just part of having a new house.

Garage

I’ve only been in the attic once and it does have floor boards over the garage area if you want to use it. I am leaving for you the water hose covers (they will be on top of the water heater). They go over the faucets on the outside of the house so your pipes don’t freeze.

The garage door code has been set as ****. I am leaving the booklet that will tell you how to change it if you want, but honestly, no one even knows the code.

ADT

I travel a lot and will frequently be gone for up to two weeks at a time. Because of that I had the ADT security system installed. As a single woman though, it brought me significant peace of mind. It cost around $50 to activate. It will be deactivated on July 1. I’m leaving the yard sign though.

Neighbors

I have met a great many of the neighbors. I met them while walking my dog. There are many single women in the neighborhood who are very dear. I hope that you will meet them. Many of them walk at night and it should be easy to meet them if you wish.

The neighbors directly across the street are a sweet young couple. They have two little boys. The youngest is a 4 year old red head who is a talker and will love to run over and talk to you once he meets you.

Up the road is another sweet couple and you will see them riding around the neighborhood in a golf cart. 

Mail/Trash

The mail comes between 2:30 – 5. It is almost always between 4:30-5, but I think there is a new girl and not it is closer to 2:30.

Trash pick-up is on Monday and Thursday. They come anywhere between 10-2:30.

Recycling is every Monday. They come before 9. I don’t know if you are a recycler, but I left you the bins so you don’t have to go downtown and pick them up. Sorry they are so nasty; they gave them to me like that. They do not collect glass.

I suppose that is really all I have to say. I’m sure I will remember something else later. I do truly hope you get settled here and feel at home. I’m not sure what your church affiliation is, but I found a real home at the College church of Christ. I know that you are experiencing much transition in your life, but know that as I am experiencing transition too, that I will be praying for you.

Flourished

She’s going to make an offer today. And then, within a matter of weeks, it won’t be mine.

I love this house, this yard. I’ve laid roots here: crape myrtles, gladiolas, azaleas, begonias, geraniums, oak trees; friends, community, life.

My time in Searcy has been beautiful. I have loved it. It has been a respite, a revival, a rejuvenator of my soul. I feel centered, refocused.

She wants to close much earlier than I  imagined. Forcing my denial to surface to reality.

I have missed the incessant beeps, the quiet hours, the midnight coffees, the smells, the fury that can come, the fixing. I have missed being able to walk out when the clock permits and know that for that moment I am done and not responsible. I have missed the hard conversations. I have missed helping them to pass. I have missed the good days of healing, of revival, of discharging them to the floor. I have missed the procedures. It has called me back.

I will miss the students. I will miss teaching. I will miss talking. I will miss forming those relationships and watching them grow. I will miss my colleagues who have taught me so much about a variety of things. I will miss chapel. I will miss the singing.

I will not miss grading.

I will miss this house, my home. My yard that I have relished working in. I will miss the bluebirds. I will miss the stillness of the patio and the beautiful view it implores.

I will miss College Church. I am so deeply thankful for the restoration of community, the reengagement, the realization of hope. I am thankful for dear friends who are heaven to me, who have showed me love, vulnerability, faith, acceptance, grace. I am so very thankful to have had a place, but even more, that a place was made for me.

As always, I do not know what Dallas holds. I do know, however, that God knows. He knows the plans He has for me.

Every opportunity has allowed me to grow. But I feel that I have not just grown, but flourished here. I leave with deeply mixed emotions. But I definitely leave with more than I came with. 

It calls to me

Our pinning ceremony was this past Friday. Graduation was Saturday. Another semester has concluded. Students have come and are now gone.

It is amazing how fast life goes by and how quickly things change and people move on.

I’ve enjoyed teaching. I’ve loved being at Harding. I have become so very settled in Searcy. I love living here. I’m able to be involved in church again.

Things are good.

But, I miss my work.

I miss the ICU.

Every time I step away it calls to me. Calls me back.

And before I know it, I find myself in my blue skin again with a mask on my face and a bonnet on my head.

I find a severely ill pt lying in front of me. Fighting. Letting go. Lying somewhere in between.

I find myself having intently difficult conversations with families.  

I find myself exhausted.

I find myself being used. I feel myself being used.

I feel God with me.

And so, this summer, I will transition from academia back to full time clinical practice in Dallas, Texas.

Where my story began.

“Where are you from? “

That question always eludes me. I have lived in multiple states, in all types of towns, been back and forth across the Mississippi river, never north of the Mason Dixon line. But people want a place, a town, a specific site.

“Where are you from?”

We left Senatobia, Mississippi 30 years ago. I was 5 years old. We packed a big truck and the family station wagon and drove across the country. Late in the night we pulled into a new driveway. Little did I know that my nomadic life had begun.

Mississippi to Oklahoma to Texas to Tennessee to Missouri to Tennessee to Oklahoma to North Carolina to Texas to Tennessee to Arkansas to…

It’s hard for me to comprehend that people are born in a place and stay in a place and live in a place and 20, 30, 40, 50 years pass and there they are. It’s hard for me to comprehend that I can drive 2.5 hours and rewind my life 30 years.

 “Where are you from?”

It was odd to see the people of my infancy. To see faces that remained in my memory but didn’t always have a name to go with them. To feel arms that had held me as a child to hug me as an adult. To hear a southern drawl that had once captivated my earliest of words.

 “Where are you from?”

But it really isn’t that odd. Time has no effect on love on people on truths. These people loved me before I was and love me still that I am.

“Where are you  from?”

My home has found itself in many places in many times. I am not from a single place. I do not know that. What I do know, is that one day, all those people from all those places and all those times will be with me and will love me because I am. One day, I will find myself with people who have gone before and will go after, who lived here or there, who knew me when. One day I will go home and learn where I am from. Until then I’m a pilgrim, a sojourner, a nomad.

“Where am I from?”

I’m from heaven. And I truly can’t wait to go home.