Friday, December 30, 2005

Drawing to a Close

We drank champagne at work today. The masses clamored for the office to shut down early and our boss relented, even though he was planning to let us all go early anyway, just like he did last Friday, the day before Christmas Eve. The corks popped, we drank a toast, and the lights were turned off, leaving the last twelve months of love and labor behind us.

The turning of the year often naturally predisposes one to reflection and review. More than eighty people have been under my care this year, several dying quite peaceful deaths while surrounded by loving family and friends. The year also saw relapses and remissions of addiction, domestic violence, divorce, recovery from alcoholism, resurgence of cancer, improved health, and continued chronic physical and psychiatric illnesses. With so many patients, I can't say that everyone is better or worse---there is a continuum of recovery and rehabilitation, and they all find a different place along its trajectory, that place often changing from day to day.

Professionally, it's been a year of proving my mettle (to no one other than myself) and holding my own, often putting in more hours than I might like in a given week. More and more, the management of information has become part and parcel of my job, something they never really mentioned in nursing school. Still, I feel good about what I've been able to accomplish, the care I've given, the lives I've been able to touch, the students I've guided and laughed with.

Reflecting further, I also recognize certain skills and areas of assessment that I would like to develop: neurological assessment; cardiac assessment; further improvement of my Spanish, especially in relation to psychosocial counseling

I could go on, but it's just too uninteresting.

On the other work-front, I now have a three-week break from teaching---also known as stuffing the minds of nascent nurses with too many facts and potential scenarios. One more semester, and I plan to retire from my stint as college professor, glad to have learned that I can do it, and glad (in some ways) to leave it behind me.

Anyway, life at work evolves and shifts, but also remains quite constant. The basic calculations are the same, the cast changes from time to time, but the underlying feeling is continuous, and these three-day weekends? They're priceless. What is one golden lesson learned? Self-care is paramount. A sick and depressed caregiver is no use to anyone in this world.

Here's to another year of satisfying work, and continued gratitude for the luxury and blessing of having such work to fulfill myself and my place in the scheme of human endeavor.

Wednesday, December 28, 2005

Friday, December 23, 2005


I use this quote by Mother Teresa as the "signature" on my email account...

"I have found the paradox that if I love until it hurts, there is no hurt, only more love."

What more can I say on the eve of Christmas Eve?

Monday, December 19, 2005

O! Merciful Monday!

The week begins, not with a roar, but with a relative hum. While some of the usual suspects surfaced as expected, the intensity of said surfacing was subdued. Is it the coming of the holiday season? I would think not---things usually heat up about now. Let's just say it was a day in which there was room to breathe and think clearly. Any day like that is worth exulting over.

That said, the usual holiday and winter-time mood shifts are also making themselves known. Financial stressors, winter's tightening grip, and the shortening days all take their toll, but the coming Solstice actually signals the beginning of the (slow but steady) return of the light, the sun going down 30-60 seconds later each day after December 21st, taking us all the way to the heady days of late June's summer cauldron. But I digress in thinking of the more verdant times ahead....

Today I did what any prudent Nurse Care Manager would do: a patient has difficulty waking up early enough to shuffle her school-age children off to school, so I bought her an alarm-clock in the guise of a Christmas present. It was accompanied by toys for the kids as well, and I explained that the clock is actually a gift for the kids, although they would much rather oversleep and miss as much school as possible. Hopefully, my gift will pay dividends in improved educational outcomes and life opportunities for these young ones. You just can't care for the parent if you don't notice (and try to improve) the plight of the kids. Nursing is so much more than blood pressures.....

I was able to give good holiday news to another patient today. She went off of her AIDS medications (unbeknownst to me) for various psychosocial reasons about six weeks ago, and I was afraid that her virus would bounce back and mutate with ferocity in the face of such an opportunity. Luckily for her, the bloodwork came back unscathed and we will restart meds right away. A lovely Christmas gift of continued good health.

The day was capped off by administering a 100-question final exam to my beleaguered students. From the looks of things, people did fairly well. I consciously made the exam only modestly difficult, a welcome reprieve for them at the end of a long semester.

This entry is simply "a day in the life". Nothing profound, nothing earth-shattering. Just the fatigued chattering of a tired Monday-night nurse.

Buenas noches.

Saturday, December 17, 2005

Ghost in a Machine

Previous post details system error.

Progress report:

Nurse 9.0 reboot relatively successful.

No hardware malfunction found, except for chronic low-back pain and sundry medical problems (ie: gastroesophageal reflux disease, hyperlipidemia, and enlarged prostate).

Software occasionally malfunctions secondary to pharmaceutically-corrected clinical depression.

Nurse's "better half" is source of continued solace and joy, as is offspring.

Canine companions: ditto, although ageing rapidly.

If nurse is really a "ghost in a machine", care of said machine is paramount.

Off to bed.

Tuesday, December 13, 2005

System Error

+Warning: healthcare provider system error/
+Nurse 9.0 program malfunction.
+Available memory at 98% capacity.
+Hard drive malfunction.
+Input overload.
+Processor speed at full capacity.
+Suggest re-boot system, replace hardware, or call manufacturer.

Friday, December 09, 2005

Thanks, I Needed That

Sometimes positive feedback can lift one's spirits and renew one's commitment. While pondering what to write about today, I considered several comments which came my way in the last few days and went straight to my heart.

At my workplace recently, there was a "consumer meeting" in which some of our patients voluntarily came to a group meeting to give their honest feedback about our program and what it means to them. My supervisor described how one of my patients---a gentleman with paraplegia from a gun-shot wound to the spine---emotionally exclaimed how this is the first time that he feels like a human being in terms of his healthcare. He said how amazing and strange it is to have a nurse who actually calls him on the phone from time to time to offer assistance and make periodic home visits. He said, "You have no idea how that feels." My supervisor admitted that, listening to this testimonial, tears came to his eyes.

Just today, I struggled to make it to work in a snowstorm only to receive a cell-phone call just before arriving that I was welcome to work from home and not risk coming out in the storm. Somewhat disappointed that I had missed an opportunity for a snow-day, I was rewarded in my efforts by being able to assist a patient in obtaining an urgent ultrasound and an urgent visit with one of our doctors. While she may have been able to make it to one of those appointments today without my help, she certainly would not have achieved both. Leaving work early, I was even able to drive her home, stopping at her pharmacy along the way to pick up her medications which she admitted would not have happened due to her disability, the snowstorm, and not having a car. Her gratitude was overwhelming, especially when she said, "No one cares like you do."

A student in my class to whom I have given some extra support and compassion said some embarrassingly laudatory things (thankfully privately) about me last night as she packed up her things at the end of class, and I found myself truly grateful for being "seen" by her, even though the support I have offered did not seem worthy of such unbridled praise.

While I may sometimes forget how the little things that I do for others can be very meaningful for the recipients---even when what I do seems so relatively minor---I also remind myself how the feedback which I receive from those whom I serve can only strengthen my resolve that my work is worthwhile and tangibly effective. For every patient who is unable or unwilling to show appreciation for what they are receiving, there are ten whose gratitude is like a balm, a reinforcement that helps me to continually recommit to my work. Feeling that how one earns one's living has value for others is priceless in its abililty to sustain one in moments of stress and overwork.

We were reminded by my boss just yesterday that our agency---and the specialized care which it provides---is being watched by many in the healthcare delivery industry around the country. The results of our work has been published in professional healthcare management journals,
studied by The Robert Wood Johnson Foundation and by the Boston University School of Public Health. My commitment stems from the fact that what we are doing may eventually serve as a blueprint for delivering compassionate and quality care to disabled and underserved communities of patients around the country. An opportunity to possibly be part of healthcare history is a driving force behind our collective passion for our work.

On this snowy evening, I can feel good about the energy I put out into the world, despite the headaches, frustration, and overwhelmed feelings which abound. These small doses of positive feedback will go a long way toward refreshing me in my continued pursuit of finding meaning in daily life.

I really did need that.