Thursday, December 31, 2009
For myself, it has been a year of momentous change, uprooting, letting go, and moving on. In 2009, I lost at least 15 or 20 pounds, continued to live with chronic pain and Multiple Chemical Sensitivity (MCS), quit my job as a Public Health Nurse, sold our house, sold or gave away most of our possessions, bought a mobile home, and left our beloved Western Massachusetts for parts unknown. What a ride!
As 2010 begins, Mary and I find ourselves in Americus, Georgia, making our way down the East Coast of the US, ready to turn West and continue along the Gulf of Mexico in search of a new life, community, improved health, and an opportunity to "reboot" our lives as we enter our third decade of marriage.
In terms of my health, I am not sure where to turn next. My chronic pain continues unabated, and my hope is that living in a warmer, sunnier climate will ease the pain that challenges my body most every day (but at least not every moment!).
In terms of MCS, we must make a concerted effort to avoid exposures to fragrances and chemicals that make us sick, and this is one of our greatest challenges from day to day. Nasty and toxic chemicals are everywhere---in homes, businesses, and even as we walk down the street. Laundry detergent, perfumes, scented candles, emissions, cleaners---we are surrounded and under siege.
When it comes to work and career, my identity as a nurse remains strong, but my resolve to work as a nurse in the future is wavering. I will most likely seek employment as a nurse again, but will also continue to explore other options---such as health and wellness coaching---as I take time to contemplate what I have already dubbed "my occupational navel".
The world itself is also in flux. Some form of health care reform is on the table here in the US, even though it has been watered down to some shadowy semblance of what many of us would like to see. War continues unabated, and injustice and violence run rampant in many countries as the world economy sputters and burps.
Still, people of good will can be found everywhere one turns. Service, compassion, volunteerism, community, sustainability and peace are common, and more and more people are dedicating their lives and livelihoods to causes in which they believe. Suffering can be found anywhere one looks for it, but responses to that suffering can also be seen, and it is in the response to suffering that we see hope for the future. In the mainstream media, bad news can dominate and overwhelm, but the alternative (and mainstream) media can also offer hope, with reports of amazing work being done to assuage the disparities and injustices of the world.
So, I ask myself how I can assuage the suffering of others in this New Year, how I can give back and improve the world in which I live. At the same time, I ask how I can continue to heal myself and improve my own well-being, since I can only help others if I come from a healed and healthy place. Sure, there are wounded activists out there who try to save the world while ignoring their own needs, but I am a true believer in the notion that one can only help others if one is willing to help---and heal---one's self.
With the New Year comes new opportunities for growth, self-reflection, self-improvement, service, positive change, community, and all good things. My desire is for 2010 to be the dawn of a new life for myself and my wife, and also a year in which every person moves closer towards their greatest desires and their own optimal well-being. Every day is a new chance to start again, and my hope is that many people will achieve their dreams, live in peace, live healthier and more prosperous lives, and take time to work towards a better world. Yes, it's a troubled world, but it's the only one we have, so may 2010 bring us closer to the vision of a world in balance and at peace.
Happy New Year to all, and may all brings be free from suffering.
Monday, December 28, 2009
Friday, December 25, 2009
On a personal level, this has been a year of great change, upheaval, letting go, and moving on. I plan to make 2010 a fantastic year of growth, improved health and unparalleled happiness, and I wish everyone the same as this year comes to a close and a new one begins.
May all beings be free from suffering, and may we all continue on the path of global and personal healing.
Thursday, December 24, 2009
Monday, December 21, 2009
My humble thanks for this wonderful honor, and Happy Holidays to the folks at Nursense.
Saturday, December 19, 2009
After almost fourteen years as a nurse, I am questioning what the next chapter will look like. Will I work with Latinos in New Mexico, Native Americans in Arizona, the rural poor, the affluent and sickly? Or will I find a way to make a living as a health and wellness coach, eschewing the world of nursing altogether? I have great desire to be an entrepreneur, but the world of self-employment is not always what it's cracked up to be. However, with my wife as my business manager, I may stand a chance at significant success!
This time of travel and self-reflection is helping me to disengage mentally from the world of work and employment, allowing me a golden opportunity to dig deeply and decide how I want to spend my time and earn a living. There are so many roads from which to choose, and nursing is, as a matter of course, one of the easiest paths to trod.
Of course, when push comes to shove and money needs to be made, a job as a nurse will certainly pay the bills, but only time will tell if there is indeed a nursing job out there that can truly feed my soul, for that is what I have decided work should really do.
Nursing can be a soulful occupation, and if I can work as a nurse and be fulfilled in that endeavor, then I'll be ready to sign on the dotted line. Til then, I will continue to examine my occupational navel and unravel the riddle of figuring out just what will make my vocation more than simply a means to a financial end.
Monday, November 30, 2009
The water of the lake is absolutely still, the air is chilly, and the full moon itself seems to move quickly through the sky above me, even though I know that it's the low-flying clouds that are actually moving, not the moon.
I picture the clouds as representations of the thoughts that constantly swirl through my head, and the stillness of the surface of the lake represents the nature of my mind, or how I am told my mind should be. Those clouds are simply brief interruptions of the clarity of the sky above them, and the sky remains as vast and deep and unperturbed as always, no matter how many clouds pass over its wide-eyed screen.
As the clouds pass overhead, they are very clearly reflected on the surface of the dark lake, as in the placid face of the large white moon. The reflections of the clouds are no more real than my many disturbing thoughts, but I seem unable to distinguish between the real and the unreal.
I know the reflections in the water are simply reflections, just as I should know that my thoughts are only thoughts and nothing more. Why do my thoughts so easily disturb my peace of mind? Why do the clouds that pass across the surface of my inner lake so quickly cause ripples and waves that easily throw me off course?
My undisciplined mind yearns for clarity, its surface so frequently disturbed from within and without. That lake, so calmly reflecting the moon and clouds above it, knows nothing of worry, of anxiety, of rumination. Would that my mind could learn the lesson taught by the stillness of that clear, cold lake and the vast sky above it.
Thursday, November 26, 2009
On this day of Thanksgiving, I am sending my heartfelt wishes for a wonderful day, whether you are with friends, family, at work, at play, or on the road. This is indeed a day to reflect on our blessings, and I will certainly take the opportunity to reflect on the many things for which I am personally grateful.
We are currently in southern Maryland, making our way south on our round-the-country journey. I know that Digital Doorway has been somewhat quiet of late, and I hope to bring more life here as our journey continues on.
Thank you for stopping by, and many blessings on you and yours, now and always.
Tuesday, November 17, 2009
Having lost a friend to homicide (by police) in 2001 and now a friend to suicide in 2009, there is a continuum of grief and mourning along which I continue to travel. Ironically, it is only quite recently that I feel I've made significant progress in accepting and coming to terms with my friend's 2001 murder, so perhaps I have been handed this newest challenge in order to further sharpen my skills of recovery.
Suicide, that most self-centered of acts, removes a person's physical presence in a sudden, unexpected and brutal way. This self-inflicted disappearance sends ripples---or perhaps shockwaves---throughout multiple communities and layers of relationships, and each individual impacted by the news must grapple with their own messy constellation of feelings, be it guilt, remorse, anger, disbelief, shock, or any number of normal reactions in reaction to an abnormal circumstance.
For myself, I question what I said or didn't say, what I did or didn't do, the invitations not offered, the times I gave up or pulled back. I used the word "brutal" in the previous paragraph for a reason, in order to more fully illustrate the painful significance of a suicide in relation to those left behind. It is indeed a brutal reality when the phone rings and the news that a close friend has taken his own life is communicated across the ethers. It is gut-wrenching and maddeningly brutal, a harsh slap in the face, an iron fist to the solar plexus. It is exhausting.
For those of us left in the wake of suicide, it is a process of recovery and acceptance, and we do what we can to make it through the days in the wake of unwelcome news that painfully and irrevocably changes our lives.
Saturday, November 14, 2009
Eight years ago, another dear friend died unjustly at the hands of the police, followed by the death of my great-aunt, my beloved dog, and my step-father. Digesting this recent history, one of my personal themes for the majority of the last decade has been recovery from grief and traumatic loss.
Now with another friend suddenly gone, the list of losses suffered over this last decade has lengthened, and my personal resiliency vis-a-vis grief and loss is challenged once again. In one respect, I am at a loss for words, but on the other hand I have a deep need to reach out across the ethers and ask for support and prayers.
Death has visited our house, and we dance the dance of grief once again.
Wednesday, November 11, 2009
These days of living on the road with my wife and dog as peripatetic travelers is beginning to challenge even my own self-perception of who I really am. An enormous part of my identity has been wrapped up in being a nurse for more than a decade now, and as we embrace the open road and all it has to offer, that very identity is shaken to the core. Still, it's a comfort to have both a vocation and a calling that serve both my sense of identity and my ability to be economically stable.
For now, we travel the highways and byways of the United States, and I will eventually christen my work as a health and wellness coach, taking my work as a nurse to a new level of novelty and service. Til then, my "nurseness" is simply a state of mind!
Friday, November 06, 2009
Today, I was placidly sitting in my cousin's living room with my laptop. Knowing that there were several roofers crawling around above our heads, some modicum of loud sounds was not unexpected. However, when a series of crashes occurred in a space of several seconds, I looked up to witness a body falling rapidly through space towards the ground past the window opposite the couch where I was seated.
With my wife yelling for help and my cousin calling 911, we ran to the back yard to find a roofer who had fallen from the second floor level, bouncing off of the roof of the dining room and the deck before landing on the ground.
It was quite a scene, and it was indeed gratifying to be able to quickly assess his injuries and level of consciousness, cajole him not to move a muscle, and determine that he could safely wait for the ambulance to arrive.
Luckily, he sustained no major injuries and was treated and released from the emergency room within several hours. Every time I respond to an event of this kind (like car accidents), I realize that I should really undergo a refresher course in First Aid and emergency medical response. However, my nursing assessment skills did indeed come in handy, and I was happy to be of service, however limited my abilities.
Photo by Mary Rives
Tuesday, November 03, 2009
Perfumes, scented candles, deodorants, laundry products, household cleaning products, the list goes on and on.
My wife and I are working hard to heal ourselves from chemical sensitivity, but when one of the best ways to heal is avoidance of the offending substances, we are challenged to find a way to truly save ourselves from the ill effects of exposure.
Still, we do not sequester ourselves, and we strike out into the world with hopes of healing, connection and community. There are many ways in which chemical sensitivity has limited our lives and negatively impacted our social connections, but now that we are traveling and living on the road, we simply put our best foot forward, hope for the best, protect ourselves as best we can, and consider ourselves lucky to have such freedom of movement and direction, sensitivities be damned!
Sunday, November 01, 2009
My wife and I are now on the road, making our way down the East Coast towards the warmer weather. Our travel blog, Mary's and Keith's Excellent Adventure, is becoming increasingly robust with photos, videos and tales from the road.
Our new lifestyle poses many exciting challenges and novel experiences, one of which is health care. While we still have health insurance from my old job until November 30th, the next step will be securing (at least) minimal catastrophic coverage from that date forward, and then making sure we take very good care of ourselves while we travel. Good nutrition, exercise, high quality supplements and a plethora of fresh air are undoubtedly part of our personal health prescription.
I will be reporting on our health challenges and successes along the way, and hope to talk to other full-time RV'ers to see how they handle health on the road (although many full-timers are retired and relatively secure with Medicare coverage).
Stay tuned, and please visit our travel blog for further updates!
Friday, October 30, 2009
Thursday, October 22, 2009
A Puerto Rican woman about the same age as my mother, she likes to joke that she is my "Hispanic Mother", and for all intents and purposes, it's true. Obese and disabled, she keeps more than a dozen birds in various cages in her small apartment, and several of them are regularly perched on her shoulder (or on top of her head), eating sunflower seeds right from her lips. Her apartment is filled with knick-knacks (some of which I am guilty of giving her, I must admit), and our visit was punctuated with screams and applause as "The Price is Right" played loudly on the TV.
Although maintaining long-term relationships with former patients can be tricky in terms of personal boundaries, this friendship has been consistently special and it has only been occasionally burdensome to maintain. Our connection is intimate and sweet, and there was just no way I could leave the area without a proper "adios".
After an hour visit, we realized that it was time to say goodbye, and we hugged and kissed each other on the cheek repeatedly. After our second hug, both of our faces were wet with tears, and she held both my hands in hers as she gave me her abundant blessings for a long life, a joyful and wonderful journey with my wife and my dog, and she thanked me from the bottom of her heart for my friendship over the years.
I left the stuffy apartment and emerged into the bright October day, stopping under a resplendent tree bedecked in autumnal yellow. My heart was filled with love, tears streaming down my face, and I gave thanks for the heartfelt and soulful connections that being a nurse has provided me over the years.
As we prepare to leave this area where we've lived for seventeen years, there will be more tearful goodbyes. My "Hispanic Mother" is one who evoked very deep and bittersweet tears, and I have no doubt there will be more to come as we draw nearer to our very imminent departure.
Wednesday, October 21, 2009
As my wife and I embark on our cross-country sojourn and North American Laughter Yoga Tour in search of community, adventure, right livelihood and peace of mind, we will be writing about our process on our travel blog and writing about our Laughter Yoga experiences on our Laughter Yoga blog.
Taking all of these changes and peregrinations into consideration, Digital Doorway, therefore, will be the place where I will process my experience from yet another perspective---that of a nurse on sabbatical from nursing who is in the throes of launching a new business as a Health and Wellness Coach, offering Laughter Yoga as a Laughter Yoga Leader, and pursuing continuing work as a writer.
For those readers who are looking for pure nurse blogging here on Digital Doorway, you may be somewhat disappointed in the months to come. There are plenty of excellent nursing blogs bookmarked on the right-hand column here on DD, and I encourage you to read them regularly with great interest and enthusiasm. Meanwhile, I am interested to see how my writing unfolds as we launch our trip across the country and our worlds expand with life on the open American road.
When it comes to blogging, my "nurseness" is certainly a given, and that nursely lens does indeed inform how I see the world. However, as my wife and I begin to live full-time on the road for the foreseeable future, it remains to be seen how my non-nursely voices begin to make themselves known more strongly. I certainly hope that you, dear Reader, come along for the ride, and I welcome your comments and suggestions!
Monday, October 19, 2009
Wednesday, October 14, 2009
I am so impressed with my public health colleagues, the local school department, and all of the people with whom I have been so lucky to collaborate. H1N1 has been a rallying cry for many disparate entities in towns, schools, and cities across the country and around the world, and the collaborative nature of many of these relationships underscores how professionals from very different areas of expertise and education can work together for a common cause.
I am excited and nervous about how this next stage of life will develop as my wife and I take our Laughter Yoga business on the road and I launch a new professional pursuit as a health and wellness coach. Please stay tuned for updates as I build my new website and officially begin work as a coach, while Digital Doorway continues to be a place where I share my ideas, adventures and thoughts along the way.
Tuesday, October 13, 2009
When the teachings “click” for you somewhere deep in your heart and mind, then you really have the View. Whatever difficulties you face, you will find you have some kind of serenity, stability, and understanding, and an internal mechanism—you could call it an “inner transformer”—that works for you, to protect you from falling prey to wrong views. In that View, you will have discovered a “wisdom guide” of your own, always on hand to advise you, support you, and remind you of the truth. Confusion will still arise, that’s only normal, but with a crucial difference: No longer will you focus on it in a blinded and obsessive way, but you will look on it with humor, perspective, and compassion.
Thursday, October 08, 2009
For those of you not yet aware, my wife and I are in the midst of radical change in our lives. In six days, we will quit our jobs, leave our New England home of seventeen years, and begin traveling the country via RV in search of adventure and a new home.
This journey will take us down the East Coast via Connecticut, New York, Pennsylvania, New Jersey, the DC are, Virginia, the Carolinas, Georgia, Tennessee and Florida, and then across the Gulf Coast through Mississippi, Louisiana and Texas. We will then proceed through the southwest US and up the West Coast and beyond.
Along the way, we will be visiting friends, family and intentional communities, always with an eye for a place that feels like home. If you have a suggestion for a place to visit, please let me know!
We will be posting about our experiences on our new travel blog, Mary and Keith's Excellent Adventure, so please consider visiting and becoming a follower of our blog (as well as this one, of course!).
On the road, we will be looking for opportunities to offer Laughter Yoga to workplaces, hospitals, senior centers, cancer centers---and group of people who would like to learn how to laugh for no reason! Our website, Laughter Incorporated, explains Laughter Yoga in detail, and also outlines the services that we offer. Your profesional referrals are welcome, and if we are coming to your town, we just might offer a Laughter Yoga session to you and your friends for a modest fee!
In addition, I will soon be launching a new business as a Health and Wellness Coach, so please stay tuned for an announcement about this exciting development in my professional life.
Thanks for tuning in, and please stay connected with us via Digital Doorway, Keith and Mary's Excellent Adventure, Laughter Incorporated, and last but not least, The Adventures of Bob the Nurse.
Be well and happy!
Tuesday, October 06, 2009
One technique for arousing compassion for a person who is suffering is to imagine one of your dearest friends, or someone you really love, in that person’s place.
Imagine your brother or daughter or parent or best friend in the same kind of painful situation. Quite naturally your heart will open, and compassion will awaken in you: What more would you want than to free your loved one from his or her torment? Now take this compassion released in your heart and transfer it to the person who needs your help: You will find that your help is inspired more naturally and that you can direct it more easily.
Monday, October 05, 2009
Reflecting on what it means to be successful, talented, and fulfilled, my friend remarked that, for him, at forty-five, it's all about being present. He's a successful artist and cartoonist, a very gifted person, and his statement about being present for life, about noticing and witnessing life, really hit home for me.
How much time do we spend not even being aware of our surroundings? How often do we engage in conversations while simultaneously thinking about the next thing that we need to do or accomplish, the next thing to cross off of our list? We careen through life without even noticing what's in front of our noses.
I'm guilty. I'm the worst. So many moments just pass me by. But as I prepare to jettison my current lifestyle and leap into the void of travel and embracing the unknown, I feel an opening within me, an opening of spontaneity and the embracing of being present, of really savoring the moments that so often slip by.
I am so thankful to my friend for framing this notion of presence so keenly and succinctly. And being present is going to become my modus operandi for the next iteration of my life on the road.
Friday, October 02, 2009
In the public health arena, many of us are wondering just how the public will react to these reports and the growing numbers of children who are ill or dead. While it's true that an average of 36,000 Americans die every year from the flu, the majority of these individuals are usually elderly or otherwise compromised, and if the number of children who die continues to climb, anxiety and fear will rise proportionately.
The government claims that the H1N1 vaccine is safe, and they are urging every pregnant woman and individual between the ages of 6 months and 24 years to be immunized, among others. I have heard projections that only 20% of eligible Americans may actually elect to receive the new vaccine, but I am not certain how accurate that estimate is. When the vaccine begins rolling out to local health departments, schools, medical providers and municipalities next week, it remains to be seen how the public will respond to well-publicized offers of mass vaccination against a novel disease.
Of course, at times like these, the public can react in many ways. A small percentage feel that the government has overreacted, blowing the risks of H1N1 out of proportion. While this could potentially be the case when the book is finally closed on H1N1, there would be even greater consternation if the government underreacted and millions needlessly died. Hurricane Katrina taught a mean lesson when it comes to government negligence, and it appears that the Obama Administration does not want to repeat such a disastrous mistake at a time when the stakes are so high.
Meanwhile, other segments of the population worry and fret over every sneeze and cough, while others simply wait to be told what to do. Most, I feel, are simply watching the headlines, testing the winds with a tentative finger, and biding their time as the situation develops and changes.
So, the reports of deaths continue to roll in, cases are diagnosed daily, and the entire infrastructure of the global community itself is potentially at risk. You can wager any amount of money that massive contingency plans have been made by most every government on earth, contingency plans that focus on how crucial infrastructures can continue to function in the face of widespread illness.
Plans for continuity of operations are now being drafted by hospitals, newspapers, factories, schools, and many companies and organizations that realize the potential for massive disruption if widespread illness should visit their particular organization. Just imagine if you run a high school. What would you do if 50% of your teachers were ill, or 75% of food workers, custodians or bus drivers called in sick? Woe to those who leave their plans undrafted.
The wave of H1N1 is indeed beginning to swell, and just how powerful and far-reaching that swell will become remains to be seen. To be sure, it will be a historic flu season in many ways. Whole economies may be impacted greatly by the disease, schools may be closed, factories may lay idle, and governmental and non-governmental organizations may be crippled by absenteeism and illness. And when it comes to the children, we can only hope that the number of deaths is kept to a bare minimum in the larger scheme of things.
Thursday, October 01, 2009
Wednesday, September 30, 2009
Meanwhile, H1N1 challenges the public health infrastructure, and the availability and distribution of the vaccine poses questions that still cannot be fully answered. And as the manufacturing of that new vaccine is ramped up, seasonal flu vaccine distribution has been slowed to a veritable trickle, confounding the plans of even the most earnest local health department.
Speaking of H1N1, studies now show that many pregnant women and others eligible for the H1N1 vaccine will refuse to receive it, leaving public health officials wondering just who will want it, anyway? In our local circles, many of us are asking the following question: "If we throw an H1N1 party, will anyone come?"
Wednesday, September 23, 2009
In prior blog posts (see "Stirrings of Nursely Guilt"), I have discussed the feeling of being indispensable as a nurse, carrying my nursing positions like crosses that I alone can bear. That's complete hogwash, of course, and I continue to process the emotions that lay beneath the nursely guilt complex.
Leaving my current position---at a time when the public health infrastructure is facing its greatest challenge in a generation---is truly a test of my personal resolve, and the guilt underscores for me the fact that I truly want to leave my position in qualified and well-prepared hands.
Today, it seems that the capable and qualified hands for which I have been waiting may well be ready to relieve me of my occupational burden (and guilt!), and I am only now beginning to see glimmers of light at the end of the tunnel.
Personally, these are exciting times as my wife and I ready ourselves for the cross-country trip of a lifetime. Wresting ourselves from our occupational shackles is one of the final acts that we must mindfully commit prior to stepping off of the precipice into the Great Unknown. And knowing that we may very well have found the person to whom I can pass the public health torch is a feeling of relief beyond measure. Now, as I wait to hear that the offer of employment has been accepted, I dare not to hold my breath........
Monday, September 21, 2009
Here is a link to a very interesting and informative post on the 25 most famous nurses in history, including a separate section on famous fictional nurses. Of course, they have not yet included Bob the Nurse on such lists, but I intend to make sure that Bob does indeed go down in nursing history!
Sunday, September 20, 2009
In preparation for my departure, I will continue to write the training manual, purge and organize files, order supplies, and administer as many flu shots as I can before my successor takes over. Now, the problem is that production and distribution of the seasonal flu vaccine is now slowing to a trickle as manufacturers try to cope with the ramped up need for H1N1 vaccine. So, plan as we may, how can we hold successful and far-reaching flu clinics if the flu vaccine is in short supply? Woe to the public health nurse who wants to be ahead of the 8-ball for a change.
So, we prepare, we strategize, and we hope---with multiple fingers crossed---that one of the interviewees is indeed intrepid, ready, willing, and able to pick up the torch and run with it into the crashing waves of flu season.
Friday, September 18, 2009
Monday, September 14, 2009
Seniors feel slighted because they're lowest on the priority list for the new H1N1 vaccine. Middle-aged people who are otherwise healthy who would like the vaccine notice that they do not meet the criteria for being in the first wave of recipients, if at all. There are the many health care workers who usually don't receive a flu vaccine and are reluctant to get the H1N1 vaccine, even if it means protecting their patients from illness. Meanwhile, pregnant women are afraid to receive this newly formulated vaccine, even though they are top priority for receiving it in order to protect their gestating children, and parents of school age children are also afraid. And then there's the conspiracy theorists who feel it's all a government ploy to poison, sicken, and subjugate us.
What's an earnest Public Health Nurse to do, anyway?
The concerns, the worries, the misgivings, the fears, the suspicions---they are all rising to the surface as the flu season kicks into gear. There is certainly confusing information out there, and some of it even seems contradictory. We can rest assured that many media outlets will undoubtedly get it wrong along the way, further adding to the confusion that so many people feel.
So I answer calls, assuage fears, refer people to the most reliable websites about H1N1, and I cross my fingers that we find a qualified replacement for me before I leave my position on October 15th. It's a wild influenza world out there, and something tells me the weather's about to get rougher.
Friday, September 11, 2009
Now, I am not meaning to say that my work as a nurse is thankless, pointless and unrewarding. Far from it. But the Sisyphean aspect of nursing resides in the notion that whatever we do, however we do it, it never seems to be enough. Nursing of all kinds demands attention to detail, amazing amounts of paperwork, vast stores of patience (and some patients, as well, of course), and a willingness to consistently give more than you may have been ready or able to give. In my view, nursing is often the work of the willingly codependent, those of us willing, able and ready to go above and beyond again and again, even when it is against our better judgment, compromises our health, and subjects us to the vicissitudes of stress-induced illness.
As a nurse, I have consistently found myself in positions wherein I felt indispensable, the repository of information or knowledge that is, a) difficult to pass on and, b) incredibly important. Whether it be patient care or public health management, taking my leave of a nursing position is so often fraught with anxiety, hard work, and the knowledge that not everything that I know can be clearly communicated to my successor.
Winding up my work as a public health nurse, I am hard pressed to write down the endless details that constitute my position and my work from day to day. When I took this position, I was given five sheets of paper with cryptic instructions, three hours of rushed training, and an office and files that were in dire need of organization. I inherited a multifaceted position that was poorly explained and passed on in a manner that created the steepest possible learning curve as I dipped my toes in the waters of local public health.
Now, preparing for my successor (who has yet to be identified despite my having given a very generous three months' notice some two months ago), I am writing a training manual, organizing files, streamlining processes, and preparing for what I hope will be two full weeks of training for a position that is simultaneously fascinating and maddening.
As my wife and I prepare to step into the unknown in our personal lives, I am hoping to create as few unknowns as possible for the intrepid soul who picks up where I leave off at the health department. And with H1N1 breathing down our necks, that will not be a small undertaking for myself or the next in line.
So, I struggle to create a seamless transition, knowing full well that some "t" will be left uncrossed, some "i" undotted, and some loose end will inevitable be left untied. Did I say that this undertaking was Sisyphean? It may very well seem that way, but on October 15th when I leave that office behind, my shoulder will no longer bear the burden of the boulder being pushed up that hill, and I, for one, will rejoice at the freedom that the loss of that burden will engender.
Wednesday, September 09, 2009
Not having examined the speech closely, my hope is tinged with a hint of cynicism at the ways of Washington, but with the post-humous words of Ted Kennedy spurring us on, I feel that perhaps the reform we have all been waiting for may actually come to pass.
Even as the debate rages on, millions of American children still live without health insurance, the unemployed and underemployed seek primary care in emergency rooms, and the self-employed struggle to find coverage that doesn't break the bank.
Cries of socialism abound, but the President reminds us that Medicare itself was derided as being tantamount to socialism back in the day, and that "sacred trust" is now a promise that no American would ever wish to see broken.
I hold out hope that we will see comprehensive health care reform in this decade, and that my grandchildren will grow up in a country where they will never need to choose between medicine and groceries.
Health care reform? Socialism? If every American can obtain affordable coverage and no one has to go without, then I don't care what we call it. Can Obama do it? Only time will tell.
Monday, September 07, 2009
So, what does it mean to eschew the trappings of the workaday world and leave the workforce, at least temporarily? What does it say about someone who works in public health and chooses to step out of that role just as H1N1 begins to rear its wintry head in our very direction? How selfish am I?
As I prepare to quit my job, leave the workaday world, pack up our cares and woes, gear up the RV and launch ourselves onto the highways and byways of America, I feel stirrings of nursely guilt that I am abandoning ship just as my country needs me the most.
Sure, we could have changed our plans. We could have chosen to spend yet another frosty winter in New England, slogging through the snow to save humanity. But my wife and I are making another choice. We are choosing to catapult our lives forward in a radical way, and doing something this radical has its price, and one price that I am currently paying is the feeling that I am breaking ranks when my services are most urgently needed.
Now, I am not one to think that no one else can do my job. There are plenty of capable nurses out there, and two of them are interviewing for my position in a week or so. Still, taking leave of my job at this historical time does indeed put extra stress on our local public health infrastructure, and I am concerned that my replacement will completely miss the frying pan as she or he falls directly into the fire of H1N1 and flu season. (Oh, the guilt.)
Still, I am thankful and appreciative that my boss is so evolved and has given me her (understandably reluctant) blessings to go on my merry way. And perhaps my worries are for nothing. Will H1N1 fall flat on its face? Will the massive vaccination campaign never materialize? Will this public health juggernaut never leave the launchpad? I actually feel that the H1N1 horse has already left the gate and we are rushing headlong into what will be a pretty intense flu season, made infinitely more complicated by twin vaccination campaigns (for seasonal flu and H1N1).
May my successor accept this challenge with grace and equanimity, and may I take leave of my position without guilt or remorse. The helper and healer within me cringes at ever shirking my nursely responsibilities, and leaving this job at this time in history is one of the hardest professional decisions I have ever made.
Saturday, August 29, 2009
Friday, August 28, 2009
First, as we await the first shipments of seasonal flu vaccine (which should begin arriving soon), we are faced with questions from the public about whether they are eligible for the seasonal flu vaccine, whether or not they will be able to receive the H1N1 vaccine, and how they might protect themselves against these strains of flu that threaten to sicken and perhaps kill thousands of people. We are also faced with the public relations nightmare of explaining the different criteria for the two vaccines, based on the fact that younger people are more susceptible to H1N1 infection, whereas the elderly more often succumb to seasonal flu. While there is some overlap between groups susceptible to both illnesses, a great deal of education will need to be done in order to allay fears and identify who will receive vaccinations.
Next, there are fears that schools, municipal offices, police and fire departments, hospitals and other critical services may be seriously curtailed or shut down if large numbers of employees become sickened with a virulent form of the flu. Just the other day, I attended a meeting with a number of local school officials, and weighty issues of great import were discussed at length as the group wrestled with contingency plans that may or may not come to fruition.
It is the fear of the unknown that drives the anxiety surrounding H1N1, and the potential for widespread illness and death does indeed stoke the fires of the media machine and the conspiracy theorists alike. For me, on the front lines of local public health, my job is to allay citizens' fears, prepare for a double-pronged mass vaccination campaign (for seasonal flu and H1N1), and meet with local officials and others in order to answer questions and suggest ways for citizens to be healthy and maintain a calm but alert vigilance.
This will be an interesting flu season, without a doubt, and it will only be hindsight that will inform us whether our preparations were thoughtful, wasteful, alarmist, or simply prudent.
Monday, August 24, 2009
While I in no way wish nurses to only be portrayed as angels of mercy, the premier of Nurse Jackie did indeed leave a bad taste in my mouth.
Suzanne Gordon, a brilliant and insightful author for whom I have the highest esteem, has written a post about the end of the first season of the show. Ms. Gordon takes this opportunity to react to nurses like myself who have shunned Nurse Jackie out of self-righteous indignance, and she offers her own evaluation of the show, it's portrayal of 21st-century nurses, and how we as nurses may or may not be seen by the public.
I thank Ms. Gordon for her writing and her opinion, and when I do indeed watch Nurse Jackie on DVD some day, I will take her position into consideration and perhaps reevaluate the feelings that were stirred up when I first watched the premier.
Saturday, August 22, 2009
Saturday, August 15, 2009
Tuesday, August 11, 2009
This process of detaching ourselves from our home of eleven years, our hometown of 17 years, and all that is familiar and normal, is a process fraught with pain, pleasure, anticipation, anxiety, excitement, and plenty----plenty---of stress.
Now, don't get me wrong. I blame no one for this situation in which we find ourselves. We created this situation. We asked for it. We designed it. We will reap the rewards, cry the tears, and feel the highs and lows as we open a life chapter filled with uncertainty and adventure.
As we move through the process, stress settles in my body, curls along my spine, throbs in my neck, and disturbs my sleep. I toss and turn, I eat haphazardly, too much at one sitting---or not at all.
At work, I'm distracted, restless, frequently inefficient. I feel guilty for leaving my public health job just as flu season and H1N1 begin to heat up. Then again, I'm relieved that I'm skipping town before the infectious feces hits the proverbial fan.
After thirteen years as a nurse, I need to step away from the desk, put down the syringe, close the file cabinet, and look towards a new way of being, both professionally and personally. The stress of work has taken its toll, and it's ironic that the stress of detaching ourselves from our lives here in New England is taking its own toll on my body and mind. That said, the day will come when we weigh anchor, pull up stakes, and listen giddily as the miles roll beneath our RV's eight wheels.
I look forward to sharing the journey with you, dear Readers, here on Digital Doorway and on our new shared travel blog. It will no doubt be a wild ride, and along the way I'll be exploring and
reporting on American health care seen through the eyes of a nurse traveling the highways and the byways of America with his trusty dog and loving life partner at his side.
I hope you'll come along for the ride!
Monday, August 03, 2009
Monday, July 27, 2009
Sunday, July 26, 2009
Saturday, July 25, 2009
Sunday, July 19, 2009
Saturday, July 18, 2009
Friday, July 17, 2009
Thursday, July 16, 2009
Monday, July 13, 2009
Essays must be vivid and dramatic; they should combine a strong and compelling narrative with a significant element of research or information. We’re looking for well-written prose, rich with detail and a distinctive voice.
Creative Nonfiction editors will award one $1500 prize for Best Essay, and two $500 prizes for runners-up.
Guidelines: Essays must be: unpublished, 5,000 words or less, postmarked by December 31, 2009, and clearly marked “End of Life” on both the essay and the outside of the envelope. There is a $20 reading fee (or send a reading fee of $25 to include a 4-issue CNF subscription); multiple entries are welcome ($20/essay) as are entries from outside the U.S.(though subscription shipping costs do apply).
Please send manuscript, accompanied by a cover letter with complete contact information, SASE and payment to: Creative Nonfiction, Attn: End of Life Stories, 5501 Walnut Street, Suite 202, Pittsburgh, PA 15232.
Please share this announcement with anyone who might be interested in submitting work. Please email any questions email@example.com.
Sunday, July 12, 2009
Friday, July 10, 2009
The Anchor House is "a multi-service agency for runaway, homeless, abused, and at-risk youth and their families" that has "committed its efforts to providing comprehensive, life-saving assistance to our most vulnerable population" for the past 30 years.
As a bicycle-pedestrian activist and avid cyclist, my brother, Ken Carlson, has achieved monumental results in his volunteer work on behalf of his Central New Jersey community of West Windsor, and his support of Anchor House is yet another manifestation of his generosity and kindness. Please feel free to donate to the Anchor House Ride for Runaways as Ken's sponsor, or simply leave a supportive comment here to thank him and his compatriots for their selfless work and dedication.
From the Fund's website: "Since 1877, The Fresh Air Fund, a not-for-profit agency, has provided free summer experiences in the country to more than 1.7 million New York City children from disadvantaged communities. Each year, thousands of children visit volunteer host families in 13 states and Canada through the Friendly Town Program or attend one of five Fresh Air Fund camps."
As a native New Yorker, my father benefited from a Fresh Air Fund scholarship in the 1930s and spent a summer in the countryside, working on a farm in New York State, so it seems natural to post about the Fund after receiving an email from their staff.
May every child have the opportunity to experience fresh air, good health, and the benefits of charitable programs dedicated to their well-being!
Thursday, July 09, 2009
Thursday, July 02, 2009
Digital Doorway will be on a brief hiatus until the end of the Fourth of July weekend. Mary and I are on a brief vacation in celebration of our 20th wedding anniversary. Please stay tuned, and visit again next week!
Wednesday, July 01, 2009
Friday, June 26, 2009
Nurses are trained to examine patients/clients in a holistic manner, taking into consideration myriad aspects of an individual's "biopsychosocial" self. From the beginning, nurses are trained to look for areas of both strength and weakness, and nurses are then taught to assist patients in learning new skills which will allow them the maximum amount of independence and quality of life possible.
Coaching and nursing seem to be a match made in Heaven. Coaching is all about helping people to maximize their health and well-being, create a wellness plan, be held accountable for their actions, and produce concrete results in their lives.
As a case manager and a visiting nurse, I have worked with the sickest of the sick, those with multiple life-altering illnesses, and underserved inner-city populations struggling with cycles of poverty, poor health, chronic illness, substance abuse, and institutionalized racism. On a personal level, having removed myself from that front-line world for more than year, I am now ready to work with the well, with those who are motivated and anxious to improve their health, those strongly desiring to take their level of wellness and personal well-being to the next level. Coaching seems to be one of the ways to do such work, and it feels like the right fit at the right time.
Nurses are coaches, for all intents and purposes, and grafting professional coach training onto a nurse's education seems to be a fail-proof avenue to create a new way to make a meaningful living in the world while serving others. If there are any readers out there who have had a positive (or negative) experience with a health and wellness coach, I would love to hear about it. And if there is anyone who would like to experience coaching with me for a very low introductory rate, I am very willing to work with any person committed to their health and open to engaging my services as I power up a new and exciting vocation.