Change of Shift at RehabRN

The newest edition of Change of Shift is up at RehabRN. Please pay her a visit to read the freshest blog entries by some of the best nurse bloggers around.

The Fresh Air Fund...

Here's a great video for the Fresh Air Fund, an organization that I periodically promote via this blog. Please consider supporting them.....

Making a Difference in Haiti

Nurses and other health professionals from around the world have descended on Haiti to assist in the recovery effort following the recent earthquake. According to National Nurses United, a national nursing union based in California, more than 7,000 nurses have already volunteered to travel to Haiti, and more are signing up each day. These are impressive numbers, and there's no doubt that nurses are playing a major role in the Haitian effort. The California Nurses Association seems to be at the forefront of this undertaking, and it is incredibly heartening to see my chosen profession so well represented at such a crucial time of need.

For myself personally, I am deeply sorry to not be in a position in my life to travel to Haiti and pitch in as so many others are doing. Timing and personal circumstances are important, and I regret not being able to go. Taking part could be a life-changing experience, and I hope the best for the nurses who are going to Haiti.

When Katrina hit Mississippi and Louisiana several years ago, I was also not able to go to the Gulf personally, and instead took part in fundraisers and other events back in Massachusetts. Similarly for Haiti, I am raising funds for Partners in Health, and readers are encouraged to click here if you would like to donate to this excellent organization's work in Haiti.

Living with chronic pain and Multiple Chemical Sensitivity make participating in such work seem somewhat untenable for me at this time in my life, and I regret that my current physical health prevents me from taking part. Still, my heart goes out to the people of Haiti and those who are volunteering their time in this massive recovery effort.

May we all---myself included---realize how our own petty grievances and wants are so small in light of the suffering endured by so many, and may the people of Haiti be uplifted by the outpouring of support and love flowing their way from around the world.

50 Best Blogs for New Nurses

Digital Doorway has been named as one of the 50 best blogs for new nurses on the Nurse Practitioner Schools website. It's an honor to be on this list of excellent and interesting nurse bloggers, and I hope that Digital Doorway can continue to live up to such attention.

Digital Doorway Turns Five

On January 18th, Digital Doorway quietly turned five years old, and this important anniversary passed me by without notice.

Over these last five years, this blog has been the repository of a great deal of my musings about nursing, health care, medicine, spirituality, life with chronic pain and chronic illness, Multiple Chemical Sensitivity, and many other notions and experiences along the way. While some nurse bloggers focus keenly on nursing, Digital Doorway's life has been an itinerant one, wandering from subject to subject, meandering through many doors along life's innumerable corridors.

Blogs have a life of their own, and this blog has lived through any number of permutations. Along the way, there have been awards and recognition, and my writings here have actually led to paid work as a writer both in print and online, with some projects still underway.

I'm grateful for the opportunities that writing this blog have afforded me for the last five years, and although I may have lost some readers by not staying more clear and focused in my choice of subject matter, it has been a consistently gratifying ride.

Since my wife and I are still on the road and blogging about our experience, my blogging attention has admittedly been drawn elsewhere, but Digital Doorway will continue to be a place where I document my life, my thoughts, and my future work as a nurse when our traveling days are over.

Please stay tuned as I continue to retool and reevaluate what Digital Doorway is truly about, and thanks for being here.

Change of Shift, and Digital Doorway Makes the Cut!

Well, folks, I finally made the cut and submitted two pieces to the most recent edition of Change of Shift, the ever wonderful nursing blog carnival that consistently pleases and enlightens readers around the globe every two weeks! Please click here to read what's on offer this time around!

Fundraising for Haitian Relief

Dear Readers,

On this Martin Luther King Day, I am taking action by creating a personal fund-raising page on the website of Partners in Health, a non-profit organization dedicated to serving the poor of the world.

Founded by Dr. Paul Farmer on a shoestring budget decades ago, PIH now works in a number of countries around the world, but has worked specifically in Haiti for more 20 years. With boots on the ground in Haiti for so many years, PIH was able to be one of the first organizations to respond to the recent disaster, and I am honored to actively raise money on their behalf. My goal is to raise $1000 in the next week, and I ask that you consider donating today in memory of Dr. King and his historic legacy.

Please click here to visit my personal donation page on the Partners in Health website.

Thank you!

Quick Links to Haiti Updates on the Ground

To navigate quickly to several organizations' Haiti-related updates, please follow these links:

Partners in Health (PIH)

Doctors Without Borders

Yele.org

Google's Haiti relief web page

Haiti Relief Fund

Fonkoze

Mercy Corps

Responding to Haiti

With news of the devastation in Haiti coming to light, we all pray for the survivors, relief workers, and those searching for missing loved ones. With the death toll rising in the poorest country in the Western Hemisphere, it is hard to fathom how much more the people of Haiti can take. President Obama pledged $100 million in aid today, and there is no telling how much it will take to rebuild the country, bury the dead, and tend to the wounded and traumatized.

As I write this, a National Public Radio reporter is crying as he reports on the plethora of injured children and adults laying on cots in a hotel driveway in downtown Port au Prince.

Money is pouring in from all corners of the globe, and you can make a difference by donating to organizations such as Partners in Health and Doctors Without Borders. The online organization Care2 offers a useful selection of information on the crisis, and National Public Radio also has a list of resources available on their website.

When making donations, please be cautious that you are giving money through a secure and reliable website, and be aware that some scams have already been detected as people scramble to donate money quickly.

There have been some rumors circulating that American Airlines is offering to fly nurses and doctors to Haiti for free, but I have not been able to independently confirm that information.

We keep the people of Haiti in our prayers and thoughts, and join with others in the sense of helplessness that many of us can feel when devastation strikes. May we all do what we can, give what we are able, and hold the people of Haiti in our hearts and prayers.

Happy New Year From Change of Shift

The first edition for 2010 of Change of Shift, everyone's favorite nursing blog carnival, is up and running. I thought that I had submitted a post for this edition which is inaugurating the new year and new decade, but alas, I didn't make it this time. Still, there's plenty to read over there, so enjoy!

The Demise of the Public Health Nurse

Back when H1N1 was on the rise, the city of Worcester, Massachusetts laid off all but one of its public health nurses, much to the consternation of the public health community. Public health has rarely been understood by Americans in general, and perhaps the H1N1 pandemic has brought the benefits of the public health infrastructure into the spotlight for both the public and politicians.

Back in October when I left my position as a public health nurse for a small college town in Western Massachusetts, I felt guilty that I was leaving at a time when I was needed the most. Luckily, I was quickly replaced by a skilled and capable nurse who was able to pick up the gauntlet and lead the town through the maze of H1N1 prevention and immunization clinics.

Now I have learned that the public health nurse position in that particular town has been eliminated, and the new director---a former public health nurse for the town---will fulfill the responsibilities of both nurse and department head, a monumental task that seems altogether untenable, no matter how capable and earnest this individual can be. From the surveillance of infectious disease to the management of tuberculosis, public health nurses need time and resources to fulfill their duties, and more and more nurses are being asked to decrease their hours and the scope of their practice, significantly limiting their overall effectiveness.

Public health is often seen as an expendable expense by politicians and bureaucrats, and the signs all point to the fact that public health---and public health nurses---are still not appreciated for the ways in which they safeguard the health of the population and work to prevent the spread of infectious disease.

The gutting of public health programs around the United States is a travesty, and when the ability of a local public health department to fulfill its responsibilities is emasculated in the interest of saving money, everyone loses.

Digital Doorway Nominated as Top Nursing Blog

Digital Doorway has been nominated as a "Top Nursing Blog" by Nursing Programs Online. I am honored and pleased at the nomination, and invite readers to visit their website for more information about other outstanding nursing blogs. Thanks to the committee at Nursing Programs Online!

Learning From Pain

Living with chronic pain is like living with a psychic hitchhiker who never pays for gas or food. Pain comes along on vacation, but never picks up the tab after an evening at the night club. Pain robs one of ambition and drains the energy out of the day.

Pain is also a teacher, and we can learn to use our pain as a focus point for learning and growth. Yes, the pain can dog us throughout the day, but we can rise above it, ignore its desperate calls for attention, and even experience moments---perhaps even minutes or hours---without being conscious of its determination to be heard.

My pain is a nagging sensation along the right side of my spine, sometimes coiled there like a viper, at other times stretched out, enjoying its ability to take up space, coercing other nearby muscles to join the party. It doesn't move around much, but it has some contacts in other areas of my personal geography, and sometimes they chat and collude together. When the pain is more dispersed, my discomfort and unhappiness can grow exponentially, and the pain seems to thrive on my misery.

Sometimes, I realize that I haven't been conscious of any pain for minutes on end, and at other times I'll notice that it's been hours since I felt any pain. These are moments for celebration, and my deepest wish is to string together periods like this so that, eventually, I have entire pain-free days.

This morning, it's like a metal rod has been surgically implanted along the right side of my spine, and even if I stretch and pop a few vertebrae, the pain does not relent. Still, I expect that there will be moments and minutes today when I won't even notice it, when I am so enraptured with what's in front of me, leaving no space in my consciousness for something as measly and undeserving of attention as pain.

My pain gives me pause, makes me focus on my body, bringing me into the moment even when that moment is not a pleasurable one. Pain sharpens my awareness, reminding me of my corporeal reality, and can sometimes be a window into the suffering of others.

Several months ago, a dear friend of mine took his own life, partly due to unrelenting back pain that no doctor or healer could explain or assuage. My pain is similar, in that it cannot be identified or quantified by x-ray or MRI, and only one healer has had even a modicum of success in temporarily relieving it.

I understand my friend's motivation to end his own suffering and finally be without pain, but I am determined to beat the pain at its own game, turn it on it's head, show it who's boss, and leave this life naturally when my time comes, having lived a full life, undeterred by something as selfish and decrepit as pain.

Pain will not control me. It may limit my activities and make me think twice when there's wood to chop or water to carry, but it will not lead me deeply down those darkest roads of self-pity and fear. Yes, I have walked those roads and they are not pretty, but those are temporary visits, and I return to the light once more.

Pain is indeed a good teacher, and it is teaching me that life is for the living, and pain simply will not stand in the way of a life well lived.

2010: Cultivating a New Garden

It's a new year and a new decade, and with 2009 behind me, I am thinking about what qualities I would like to cultivate in this new year. Here is a list of what comes to mind on this blustery January 1st in rural southwestern Georgia:

Patience
Optimal health
Tolerance
Kindness
Eloquence
Service
Clarity
Perseverance
Trust
Faith
Abundance
Compassion
Understanding
Love

This list could go on forever, but the true rebirth of the New Year is in knowing deep within me that all will be well. So often, I walk in fear, worried for the future and fretting about the past, all the while missing out on the glorious present. I want to reject regret, forget about worry, forgive myself for fretting, and simply allow myself to live in the moment and embrace the present for the gift that it truly is. This is one of my greatest growing edges in this life, and my hope is that 2010 will be the year when I finally embrace the challenge and truly "get it". This is my hope, and I am sharing it here in this public venue in order to make it more real, and also to be held accountable as the year progresses.

Happy New Year to all, and may the newness of the year bring myriad blessings upon you and yours.

Saying Goodbye to 2009

It's been quite a year for many people, and 2009 is now in it's waning hours. As the year ends, so many people seem poised on the brink of change and flux, ready for new adventures, letting go of the old and welcoming the new. It's a time for reflection, self-evaluation, congratulations, repentance, and embracing of change. I've always loved the New Year and the opportunity to start again.

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.

Inspiring Blogs for People with Chronic Illness

I am humbled and happy to report that Digital Doorway has been included in a list of 100 inspiring blogs for people affected by chronic illness. My gratitude to the generous people at MedicalFuture.

Christmas Thoughts

On this day that's so important to so many, I pause to give thanks for family, friends, my health, my wife, my son and his new wife, our elderly but healthy dog, and the opportunity that I currently have to take a break from working in order to reevaluate and reboot my life.

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.

A Merry Christmas Change of Shift

Here's a link to the newest edition of Change of Shift, the nurse blog carnival that's a gift that keeps on giving every month of the year. I haven't contributed for months, and I plan to change that in 2010. Thanks to Kim and everyone at CoS who contributes so consistently! Happy Holidays to all!

Digital Doorway On List of Top 50 Nursing Blogs

I am pleased to report that Digital Doorway has been included on the Nursense list of the top 50 nursing blogs on the internet.

My humble thanks for this wonderful honor, and Happy Holidays to the folks at Nursense.

Of Nursing and Soulful Employment

At this point in mid-life, as my wife and I take a break from working and travel the country, I am giving a great deal of thought to my career, or what I think my career should be. Nursing is certainly the career track upon which I have been treading since 1996, and it is indeed a viable, flexible and (sometimes) attractive way to earn a living. While I have never worked in a hospital (which some nurses deem an irresponsible act of professional suicide), I have enjoyed many positions in the outpatient world, namely hospice, community health centers, home care, case management, and public health.

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.

The Moon and The Lake

Deep in the hills of southern Virginia, I stand on a small dock that rests on the still waters of a small lake adjacent to the campground where we are currently staying during this phase of our journey around the country.

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.

Thanksgiving

Dear Readers,

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.

Recovering From the Shock Of Suicide

Losing a close friend to suicide is like having the fabric of one's life torn open without warning. It is a shocking loss, a bitter and horrific loss. What could be more disruptive to the normal trajectory of life?

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.

The Dance of Sudden Loss and Grief

Today I am reeling from devastating news of the sudden and tragic death of a very dear friend. Death frequently seems to visit when least expected, and this lack of ability to prepare for loss is one of the factors that can make it so difficult to cope when death pays a call.

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.

What Next?

Being on the road, not working and simply traveling, I wonder what will become of my identity as a nurse and a health care provider. While I still introduce myself as a nurse, I begin to wonder to myself just what that means exactly. Am I a nurse because I think like one? Is it the tattered license in my wallet? Or is it the fourteen years of experience that simply make it so? Is my "nurseness" still intact when on sabbatical, or does it take a back seat to my basic humanity?

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!