How am I Supposed to Feel?

Our Father, who art in heaven, hallowed by Thy name. Thy kingdom come, Thy will be done, on earth as it is in heaven. Give us this day our daily bread...

This was the prayer my coworker whispered into my ear as she embraced me in my tears. I thought I had it together. I thought it didn't bother me. I thought I could just swallow it and move on. As I exited the room after time of death was called, all I could hear was the loud sobs of the family members present. I thought that patient wasn't supposed to die...the tears began to fall and I was overcome by the emotion I thought for sure I wasn't burying deep inside. 

I felt emotionally numb. There was nothing more than could have been done, yet I wanted nothing more than to see that patient breathe or cry out. The team was excellent, the interventions on point, and yet we still couldn't change the outcome. We still couldn't mend the grief of the family. What more can you do than be present, and ask if they need anything, or say, I'm so sorry...? 

After some chocolate, a long run and bike ride, venting to my best friend, and some writing, I developed some perspective on the event. I know some days will hurt and I know my job is emotionally, physically, and spiritually challenging. I know there are days when I'll feel like I want to cry and days I can't save people. There will be days I fail, and days I exceed expectations. Every day is different. I wake up and come to work every day because I have the privilege to be the hands and feet of Christ and touch people in a way many cannot. I have the ability to help save someone's life. I have the ability to educate those in the community about how to care for themselves. I have the ability to intervene, assess, and make a difference. 

In the ER we fight over the big cases, we live for the traumas and the high acuity patients, and we rejoice when we help them pull through and stabilize to continue their care as an inpatient...and then we are struck hard by the ones that don't make it. Those cases we try not to think about because they hit home and rock us to the core. Those cases humble us, are difficult to process, and leave us asking how am I supposed to feel? I have come to the conclusion that no matter what I do feel, it is important to feel it. Am I allowed to smile and move on? It is disrespectful to not mourn the loss I just witnessed? 

The charge nurse commended the teamwork and commented on how lucky the family was to have me as their nurse. I shook my head thinking, I don't know how to help them. I feel like I didn't do much for them. She smiled back reassuringly and said but they know that you did your very best and their family member had the absolute best care.

I honor that patient by feeling whatever feelings are aroused within me. I honor that patient by leaving everything I have in that room and knowing I gave my whole heart and soul. I honor that patient by saying a prayer for them and their family and processing the event the night after it happened. I honor that patient by putting my scrubs back on the next day, showing up with a smile, and once again giving 100% to every patient that walks through my ER doors. 

To my patient, 

I pray for you and I pray for those you left behind. I pray for all involved in your care and I pray your presence lives on in my heart as a reminder to always give my best. In your honor I will hold my head high, smile, and I will remember you. I pray that God is holding you tight tonight in a place better than the imagination can fathom. Thank you for letting me care for you today. 

Practice What You Preach

When you teach something it helps reinforce it in your brain. I tell my students this all the time:

Dictate your care to process what you're doing.
Talk about medications and side effects as you give them to educate your patient and help reinforce medication knowledge for yourself.
Sit down and discuss a patient's diagnosis with them. Print off guides and learn together about how they can better understand concepts and take control of their own care.

If you've never tried it, try it! I find when I study something and break it down to teach, I know the concepts 50% better than before, and I tend to retain that information.

Practice what you preach.

In educating about nursing practice and how to be a nurse I like to help students look beyond the diagnosis and at the whole person. Not the patient, but the person. This involves what my Jesuit schooling would define as cura personalis, or, care for the whole person: mind body and soul.

I was reflecting this week on how much I enforce quality time and connection with patients- Really getting to know them and understand something about who they are and where they come from. 5 minutes sitting and listening is all it takes. In addition, ask the patient what one thing you could realistically accomplish to make their day better and so they feel their needs were met. Integrating this in to a plan of care can be difficult with a large patient load, but intentionality and true care and compassion are recognized by a patient.

I love to see this put into action and was amazed by the kindness and creative ways each student helped their patients feel acknowledged and cared for. It's the little things. It's prune juice with butter, it's lotion to the feet, a shower, teeth brushed, a visit from the therapy dog, a warm dry shampoo cap...
What's beautiful, in addition to seeing and hearing appreciation and joy from these patients, is hearing how their joy invigorates these students and encourages them to make intentional care a core part of their practice. They acknowledge nursing is not tasks to be completed, but entering in to a person's health  journey and inspiring their healing through individualized care.

After days of enforcing intentional time and self care I found myself tired and working on my normal shift in the ER.

It's the little things...my lesson came ringing through my ears. This is something I strive to incorporate always in my practice, but I made it a goal to practice this more intentionally this day. I made it a goal to pay close attention to the little things. A chocolate chip cookie for the sweet patient waiting for a ride, warm blankets and water for family members. Extra timely and thorough updates while talking to patients. Finding one thing in common with them to recognize their humanity- (person, not just patient). These little things felt good, but even more they made the patients and their families extra responsive and grateful, which in turn made my day enjoyable with smiles all around. It reminded me why I love what I do.

Even the little things need reminders from day to day or they get lost in the hustle and bustle.

Practicing is an art and skills are lost when they are not practiced. As an educator I strive to continually learn so as to be a better resource to my students, but it is often the students themselves who teach me in addition to reminding me why I do what I do.