"I Care About You"

Some reflections on this week's time at the hospital..

I cared for 2 patients - both of home were in their early seventies. That was about the only thing that had in common. Going down the list almost every other assessment and observation differed. One patient was malnourished, the other slightly overweight. One patient had a complex medical history prior to admission, the other did not. Female, Male. Depressed, Optimistic. Few visitors/support system, a room decked in flowers, cards, phone calls, and an attentive wife. You get the idea.

Clearly, the second patient was easier to be around. When I walked into the room, his face lit up, he would greet me by name, and put out his hand. I was thanked repeatedly for every task I performed. We chatted like old friends...about the Peace Corp, folk dancing, nursing school, faith in God. We laughed about an episode of urinary incontinence. And yet, in the midst of all that, I knew I was not necessarily needed. If I hadn't been there, someone else would have. Whether it be his wife, one of many friends who called in to send their get well wishes, or a staff member [as they all adored him], when I left his room today after saying my goodbyes, I left with a light heart, knowing that his faith, his optimism, and extensive support system would pull him through.

On the other hand, saying goodbye to my other patient was not as painless. Without going into too many details, this woman has led a hard life. Due to a number of psychiatric issues and a debilitating swallowing disorder, this woman looked like a small child curled up in her bed. There is not an ounce of fat tissue on her body. She does not receive anything by mouth and is hooked up to a feeding machine that goes into her jejunum. She is notorious on the floor for overuse of her call light, and before I had even chosen this patient at the beginning of the week, I had already heard about her. Most of her requests were for more of her anti-psychotic medications...but really any care need was fair game. She was often anxious and in distress, and I witnessed her tell a number of people to just leave. She was intent about particulars: no lights on in the room, ice water with no ice, stack of washcloths within reach, come as quickly as possible when the call light flashes, but do whatever you can to avoid entering otherwise, don't ask a lot of questions. And I totally get why almost every care giver on the floor was griping about her. I heard everything from "I'm so sorry that you have THAT patient" to "I think it should be a rule that no one has to take care of her for two days in a row." Let's just say I had to do A LOT of biting my tongue. Granted, I recognize being a student nurse and being a staff nurse or PCT or doctor is not exactly the same. However, I do not believe that is an excuse to speak or act this way about a human being.

Now, I admit there were moments in caring for her when it was not easy. Today, I was accused of stealing her keys. A few times she expressed wanting to be alone. And so many times I just didn't know what to say to her. But my heart just ached for this woman. Here she is all alone in this hospital room, anxious as hell, all she can think about are her medications, feels like everyone hates her and that no one is listening, and frankly, does not have much going on in her life to be hopeful about. She is a mother and grandmother, but I just sensed that she hasn't felt like a useful and productive human being in a long time. At one point, she looked at me as I was holding her hand and said in a very distraught and scared voice "I will never be normal." My heart just broke into pieces.

I saw myself in that woman. I realized that as much as our life circumstances differ, humanity jointly desires significance and reassurance. The neat thing about just patiently listening and promptly answering her call lights is that she really seemed to be calmed by my presence. She learned my name quickly and would watch for me as I passed in the hall and would call out. And although this was exactly the reason so many were at the end of their rope with her, I found myself delighted to see the light come on. Granted, it did make it difficult if I was in the middle of something and in some regards took away from the time I spent doing other tasks, but that light symbolized an invitation to love. I didn't care if she begged me for more medication or asked for an endless amount of cloths or was upset about something I had nothing to do with. In every moment, I just looked into her eyes and did my best to convey that I cared. Even if it took me a few times to understand what she was saying. Even if in that moment she abruptly decided she wanted me to leave. It was worth it. Today she called out saying she needed to be changed and that she wanted "Alyssa" to do it. And it just made me smile. I didn't try and preach too much to her about how everything was going to be okay or how she should be more cooperative with treatment or any of that. But today before I left, I took her frail hand and held it in mine and said, "You are going to have to hold on a bit longer. You are beautiful. And I care about you. I love you. And God loves you." She just looked at me for awhile and gently nodded. She squeaked out a "thank you" and that proceeded to say "thank you for helping me." I gave her a little squeeze and told her how nice it was for me to meet her. As I stood up to walk out of the door, she looked at me with a slight hint of a smile and said "Drive safe."

Strength for the Day

Sometimes it just takes everything within me to crawl out of bed in the morning. This primarily has to do with exhaustion and my body begging for another hour, even another few minutes of sleep. Yet there is also an element of getting out of bed that signifies taking on all the burdens, responsibilities, unfinished to-do lists, etc. that carry over from the day before. I find it can be rather overwhelming. Nursing school and perhaps the profession of nursing as well, presents such a double standard: we are suppose to be all things for all people, while simultaneously taking good care of ourselves and not let ourselves get burned out. Well that may work on paper or in words, but how do you realistically do that?

I had a moment, rather several moments this past week, where I legitimately could say "I don't think I want to be a nurse." This somewhat charged statement stemmed from a variety of circumstances, but in retrospect, I think I really was trying to say "I don't want to only be a nurse" and "I am more than a nursing student" and "I can't do this on my own." There is so much pressure to invest all your energy into this process of becoming a nurse, which is great except that suggests that our identity lies in our up and coming careers in nursing. Now I think this has become an acceptable model of education because nursing is such a respected career and to some extent is more holistic in nature than other careers. But I refuse to believe nursing is who I am. I have strengths and weaknesses and hopes and dreams and fears and triumphs and abilities- all of which I believe shape how I view and engage in nursing, and not the other way around. I am loved by God simply because I am His creation and his child- not because I am becoming a nurse or because I want to help people. Yes, nursing provides the opportunity to be the hands and feet of Jesus, but I refuse to believe that nurses are held to any separate standard in the Lord's eyes. [stepping down from my soap box]

Strength for the day: that often is my prayer and my request each morning. Some days it is more like strength for the hour or for a class or presentation or test I have to endure. I often receive the comment "I don't know how you do all that you do" and the honest answer to that is "I don't, God does." It's the times when I do try to lean on my own strength and understanding that I fall flat on my face. And here is the perfect segue back to Kenya. From the beginning, the desire and the inspiration behind this awareness and fundraising adventure has been from the Lord. I mean I really just caught a vision and ran full speed ahead with it. I hate speaking in front of a lot of people- yet I knew that's what I needed to do. I really don't enjoy asking people for money- yet I have and still feel complete peace that encouraging people to share their resources is okay. I thought maybe I could raise a couple hundred dollars- to date, over $1,300 has been collected. I am simply an instrument, the microphone through which God is speaking.

All this to say, I feel much more at peace when I think about God continuing to lead and guide my every step through the seasons of life. I look forward to the people I meet, the conversations we have, the laughs we share, and the tears we shed. I continue to ask God to show me the fullness of His love for me, and soften my heart to be able to embrace it. And I don't have to be a nurse to do so. I don't have to perfect grades. I don't have to prove myself. I am loved. I am wanted. And I will be used.

A Thankful Heart

This week was arguably one of the most crazy weeks in my entire life. To get a small taste of what I mean, over the first 4 nights of this week, I got a total of 10 hours of sleep. (Sorry mom!) But as I have said before, God is so faithful and there were so many moments that I look back on and am so grateful for.

I gave 3 presentations about Kenya this week to Microbiology, Junior, and Senior Nursing classes. They were all so wonderful- attentive and supportive. Microbiology alone donated $247 on the spot! Probably the most rewarding part of it all is having conversations with people afterwards, and hearing about what other people are passionate about. That was one of the reasons why I really wanted to do these presentations- there is just something about hearing someone talk about something that their heart is passionate about that makes the person watching think about what it is that they love and care about. Even though I only have one more presentation scheduled, I just don't really want to stop! So we will see where God leads next.

I have run into a roadblock, but as far as roadblocks go, it is a GREAT one to run into. Basically, this whole campaign/supply drive thing has gone way beyond the scope I initially had anticipated. I have already raised more than enough money to stock up the Mukuru clinic's supply room. So now I am considering finding another clinic or two to provide supplies too. I also realize that there is no way I can take all the supplies with me, so I am exploring options of purchasing supplies locally. It really would be the best option- it would help to support the local economy, I wouldn't have to try and transport a ton of supplies, and it would allow for things to be purchased more on an as-needed basis. I would have the opportunity to actually assess the needs and then purchase supplies accordingly, which would be ideal. At this point, I am trusting that God will continue to direct me, and pray that all the people who have donated will rest assured that I will ensure their money goes to the purchasing of medical supplies.

When I think about how many people have come together to support this cause, I just have to say "Thank You Lord" because it really is unbelievable. I mean we are still in economically challenging times, many donations have come from college students attending a very expensive school, and this is just one of many, many good causes to support all around the world. I can only say thank you, and all glory be to the Lord.

Power of Touch

"Let us touch the dying, the poor, the lonely and the unwanted according to the graces we have received and let us not be ashamed or slow to do the humble work." Mother Teresa

Today I started my first IV today. In a real person. In an actual patient. I mention this first because it really was a feat, something I will look back on and always remember. It was [and totally still is] a scary and nerve-wracking task to perform, but I can no longer say "I can't do it." Because I did. But what I really learned from my clinical experience today was about touch.

The majority of the day I spent shadowing an IV nurse. Essentially, we would get a page or an order via the computer, go up or down to the patient room, start a new IV or change a dressing or assess a PICC line- and then move on to the next assignment. Now first I must say this nurse was really good at what she did. No doubt about that. However, from the beginning of the day, I just kept thinking how can you just walk into a room, stick a needle in a patient and just leave? It was hard for me to do so- I wanted to assess how the patient was doing, whether they were in pain, know why they were in the hospital, offer some sort of comforting words...essentially just find out something more than what kind of veins they had. So I didn't have very high hopes for having a great day of connecting with patients.

But God is so good, so faithful, and has such a way of showing up in exactly the ways I need Him most, but don't expect Him to. Sometime mid-morning we went in to start a new IV in an older woman. She was apprehensive about being poked again, but otherwise was quite pleasant. I could tell she was in a lot of pain, so I instinctively just put my hand on her shoulder. She looked over at me, a bit surprised, but smiled slightly and sighed in a sense of relief. And in that moment, I knew that was all she needed from me right then. Just my hand touching her shoulder spoke volumes more than any words I could have come up with in that moment. I was communicating that I recognized she was a person, and in that moment, I wanted to care solely for her. It is always a challenge for me to disengage from such touching moments like that, but I also had peace that even that momentary connection was powerful.

I continued to experience this power of touch throughout the day. Every time I sensed a patient was struggling a bit- maybe in pain or lonely or discouraged or just in need of a little love- I would grab their hand, or stroke their arm. And every time the response was just so telling. People need love. People need to know they aren't alone in this world. And I can only imagine that for many of these patients...lying in bed alone with a list of diagnoses, a sterile looking-room, constantly being monitored, poked, assessed, administered to....even though they may be getting adequate, even exceptional, medical & nursing care- sometimes I think we forgot that maybe they just need us to let them know we care about them. And care enough to touch them. For the simple purpose of saying "I'm here."

One of the last patients of the day was a woman who had just arrived at the hospital. I don't know much about her medical condition or prognosis aside from severe pain related to a huge tumor on her ovaries. While the nurse initiated an IV, I was just chatting with her- making small talk and kind of getting a feel for the situation. She was describing her pain and what events led her to be in the hospital right now, and I nodded slightly to indicate I really did feel for her. I said something along the lines of "I hope better days are in your future" and just lightly touched her on the leg. And she just started crying. A lot. So much so that the nurse was a bit uncomfortable and was looking around for tissue. I volunteered to get some, instinctively. When I came back she was still crying, and I set down the tissue, and just went up to her, grabbed her hand. I looked into her eyes, and gave her a little squeeze. And I reiterated that I sincerely hoped that she would be relieved of her pain and suffering soon, and that she would be in my prayers. And she looked at me, and I just knew that she knew it was going to be okay. Maybe not right at that moment, maybe not without some more pain. But she wasn't going to give up.

Although nursing technical skills are important and a necessary part of being a nurse, I just cannot help but think that it just has to be more than that. For me at least, it has to be more. I want to love my patients. I want to know them in a way that makes them feel like they are the only person in the world in the moments I am interacting with them. I want to bless them. I want to encourage them. I want them to be able to cry. I want them to know they are loved. I want them to know that I am going to be there. I may not be able to take away pain. I may not be able to lead them into a full recovery. I may not even perform all of my skills to perfection. But I want all my patients to know they mean something and were fearfully and wonderfully made by our Father. And for me, that is the heart of nursing.