Happiness is...

Today I feel happy.  I am not sure exactly what it was about today, but it's one of those days where I have found a lot of joy in even the smallest of things.  I am not sure if it's a song or what, but something related to Charlie Brown has this series of statements that begin with "Happiness is..."  and that is what has inspired this post.

Happiness is....

• Seattle.  Tomorrow bright & early I will be en route to the city I have come to love.  Though I am very happy to be living & working in California, Seattle is like a second home.  The cityscape as you drive in from the airport, the waterfront views, the cool, crisp mornings, watching the rain come down from the warmth of one of many coffee shops, when the sun finally shows its face and all of Seattle comes out with it.  But all that is secondary to one thing: the people.  When I moved to go to college, I did not know anyone.  Four years later...I had to say goodbye to dozens of people who have shaped and changed my life forever.  Reconnecting with people you love has to be one of the best things in the world.  
• Mail.  Anyone who knows me knows how much I love mail.  When I have worked the night shift and am sleeping during the days, sometimes I will wake up around noon, momentarily, to go check and see if the mail has arrived.  I am also guilty of keeping the door open (with the screen door) so I can hear the truck when it turns on our street and being "upset" on holidays because the mail isn't delivered.  You would think with all the hype that I must get a substantial amount of exciting mail...though I do probably get more snail mail than most, there are many days when I get nothing of substance.  Still those days I get a card from a friend or a package covered in stickers - it makes my day.  Hence why I send a lot of mail.  That realization that someone took the time to write a message or assemble a package or pick out a postcard....find your address...track down a stamp or took a trip to the post office...it just makes you feel incredibly loved.  Though I know the world continues to move full speed ahead into the digital age, I am fighting it.  Even with Imani, I am convinced the 46 cents is truly a small price to pay to remind someone they are loved.
• Laughing for no good reason.  I can tend to be rather sarcastic, and truly do enjoy a little wit and a good laugh.  I worked last night and at one point in the middle of the night, I was looking at my status board that lists the patients I am taking care of and happened to see they were all listed as Fall Risk.  I couldn't help but share with the other nurse I was working with, "Hey, you know what I just realized?  None of my patients can walk."  And we burst into laughter.  I guess it was just the sudden realization that even though the 4 kids I was taking care of had completely different diagnoses and ranged in age from toddler to teenager, somehow they all had something going on that was affecting their ability to walk.  To most people, this is not the slightest bit funny and maybe even somewhat offensive, but the point is I am learning not to take myself too seriously and laughing with my coworkers definitely helps get through the stressful times.
• Everything fitting in your carry-on suitcase.  My mom has always been a huge advocate of rolling clothing and packing strategically.  After moving away from home for college, I learned the art of packing as I traveled and moved a number of times.  Although I could afford to pay the extra $25 to check a bag, I was determined to at least try to fit everything I needed into a carryon suitcase and a purse.  The moment you realize you packed everything AND have room for an extra shirt or two....a huge sense of relief and accomplishment (and the added bonus of not having to wait at baggage claim upon arrival).
• A good parking spot.  My sister always says: "A good parking spot equals a successful shopping trip."  [Of course if we lived in a city with real parking issues....a good parking spot would be more like winning the lottery!]  But there is something about arriving at your destination and spotting that open spot that gives you a little boost of endorphins...and today I was blessed with a lot of good parking spots.
• A home-cooked meal.  I was inspired to cook tonight.  Despite the fact I don't cook a whole lot since I started working night shift and moving home, I do genuinely enjoy cooking.  I decided to make feta and spinach turkey burgers...it's really quite simple but they taste like you put a lot more time into it :)
• Having true friends.  I have always been blessed with wonderful friends.  No, I was never the most popular, I didn't have the hot boyfriend...or even a boyfriend at all, I wasn't a star athlete, but I always have had friends who loved me for who I am, who have been there through thick and thin.  To have friends who care about you all over the country and even the world, it's a wonderful feeling.  Investing in my friendships is a top priority and taking a step back to see what a wide circle that has been cultivated over the years...it's a pretty cool thing.

Remembrance

I am writing today from my heart.  I have no political or social motives, nor do I have any claim to the solution to the brokenness of this world.

One cannot help but be moved by the Sandy Hook tragedy.  As I have watched media coverage along with the rest of the country, tears have come as I, too, am devastated by this loss, especially of so many small children.  I was touched by an interview I heard with one of the teachers describing how she heard the gunshots and ushered her kindergarten class into the corner for “story time” and preceded to read them a book.  Heroes are uncovered when tragedy strikes, and for every horrific act, it seems a multitude of individuals respond by doing something good.  Though it cannot bring back lives that were lost or take away the pain and grief so many are facing, it does offer a glimmer of hope.

When reflecting on loss of life, I cannot help but think about Kenya and the hundreds of people around the world who die each day from malnutrition, disease, and war.  The difference between these lives lost is that no one will see their story on television, their pictures rarely make the papers, and their families will not receive an outpouring of support and condolences from a heartbroken country.  On one hand, I am grateful these daily tragedies are not consistently covered by the media because I am not sure any of us could emotionally bear some of injustices that people around the world face.  But by keeping these realities out of sight, we have reduced human life to statistics.  We vaguely know the impact of HIV/AIDS, malaria, decades long civil wars, sex trafficking, female genital mutilation, famine & starvation….but we are hesitant to allow ourselves to get emotionally involved.  I include myself in this “we”….even though I do deeply care about those suffering around the world, there are times I just cannot bear to read or watch anything about another place or another issue, because I already feel so burdened by the slums of Kenya.  I think this is where we have to trust that as we seek the Lord, He will guide our hearts to the places and issues and the people we are called to care about.  No idea where this line originates from but I like its concise, powerful message…..you don’t have to do everything, but do something. 

Imani Care International is my response to what I experienced in Kenya.  As many of you know, starting a nonprofit organization was not what I had originally planned or hoped to do.  Yet that was the direction God was pulling me, and once I surrendered my own ideas, I caught a vision for Imani and things really just began to fall into place.  Though a huge part of how ICI will help to support health in the Nairobi slums is through financial resources….I am equally, if not more, passionate about giving a voice and an awareness to individuals…amazing people I met who have given me so much as I pay witness to their lives of determination, sacrifice, perseverance, and faith in the midst of some pretty horrific circumstances.  Probably the thing I most look forward to about returning this March is to be able to hear more stories and affirm the humanity that we all share.  Not everyone can, will, or even should go to Kenya, but it is my responsibility to share those stories and to give remembrance to lives that are lost.  

I was jokingly asked how much it would cost for someone to get the clinic to name something after them.  The truth is…it’s not about the money, it’s about the relationship.  They are not some people in Africa I send money to from time to time.  They are a second family, people I talk to on a regular basis and share the joys and sorrows of life with.  Peter, Francesca, Hadijah, David…they are my friends.  I cannot wait to be reunited with them and look forward to sharing their stories with those who have generously supporting Imani.

The Unspoken

Being a nurse is really hard.  Since I have started working, every time people ask me about my job or how I like being a nurse, I find myself internally debating how honest of an answer to give.  I usually respond something like "It's a lot to learn, but I like it" or "I really enjoy being able to see the same kids and families over a longer period of time."  Both of those are true.  But that is only a small portion of what I really want to say.

I never really knew what a nurse (in the 21st century) did until I went to nursing school, despite wanting to become a nurse years before.  And until I actually got a job and starting working on the floor, I did not know truly know what it was like to BE a nurse.  Yes, nursing is one of the most trusted professions...a profession where they make little pins and mugs and things that say "Nurses are Angels."  I knew I was entering a career that many before me have found to be rewarding and satisfying, and of course, the salary and benefits weren't too shabby either.  Aside from several school lectures about "burnout" and "compassion fatigue," I entered the world of nursing somewhat oblivious to the complexities of providing holistic care.

So what is all of this prologue leading up to?  I have been on my own for about a month now, and several nights ago I admitted my first patient coming in with a suspected cancer diagnosis.  When the charge nurse informed me of the patient I would be receiving in the middle of the night, my initial focus was on what type of care plan to prepare and which room they would be going into.  Yet when the patient and family arrived, it hit me that this was a pivotal moment in their life.  As I looked into mother's eyes, I saw the immense fear and the intense anxiety that accompanies the unknown.  I saw her trying so hard to be brave for her child, who had not been told anything.  I made it through my initial assessment, charting, and explaining general hospital things, and left them to settle in.  It wasn't long before my co-worker came by to inform me the mother was standing in the hall on the phone crying.  My heart sank.

My head told me....Alyssa, she is on the phone, let her be, you don't want to interrupt or eavesdrop or try to pretend like you have known this woman longer than an hour.  Plus what if she asks you a lot of questions?  What do you know about any of this?  What is she finds out how new and inexperienced you are?

My heart disagreed.  She needs to know she isn't in this alone.  She doesn't need a lot of words, she just needs someone present.  Go be the kind of nurse you have longed to be.

So I went over.  I pulled up a chair.  I took her hand in mine.  I don't remember who spoke first or really anything that I said.  I just know I held her hand and I was there.  As much as I wanted to break down and burst into tears, the drive to be fully present for her held back the floodgates.  And so the night progressed, and I was their nurse for the following two nights as well, walking alongside them as they went through the diagnostic procedures and eventually the confirmed case of cancer.  On one hand, I know this is only the beginning...that I will experience similar scenarios with other kids and their families.  But it will not ever become normal or routine.  The day it does...I will need to stop.  For that family, it was the worst day of their entire lives.  Everything changes....and there is hardly a moment to take it all in, as treatment starts almost immediately.

The juggling of the head and the heart, the balancing act of dividing your time between 4 patients while trying to be 100% present for each one, the long hours, the unpredictable schedule, the learning curve coming from school, the constant feelings of inadequacy and many fears....it is not easy and after some shifts, I never want to return.  But the thing thus far that keeps me pressing on is that brief moment when the mother introduces you to her relatives as "our great night nurse" and gives you a big hug.  Somehow those 10 seconds make up for the exhaustion, tears, and doubts.  I don't know how long I will work on this unit or even at a U.S. hospital...but I do know that wherever the road takes me, I want to be present and share the unspoken.

Flowing Streams

I am quite tired as I write this, but it is one of those times where I have this sense of urgency to blog.  Several thoughts...no carefully thought out theme or blog title.  Believe it or not sometimes I will just be going about my day and out of nowhere I will have the title of a blog come to me, or I will start to mentally write out a blog post in my head...  But none of that today...just some insights into my heart as I reflect on the past several weeks of life.

I realize this is the third time I am posting this picture...but I guess I just wanted the opportunity to write a little more than a Facebook caption.  Now, I had no idea this existed until a Canadian couple I am in contact with visited Imara in October.    I was very excited to see new pictures of the clinic, but this definitely was a shock.  On one hand, it's one of the most touching and incredible things I have experienced.  I mean, who wouldn't want to be honored in such a way?  Some people pay millions of dollars to get their name on a building. A lot of times people don't get their names put on anything until they are dead!

On the other hand, I feel very undeserving of such an honor.  I could not have done anything that I have done thus far in my life without the grace and faithfulness of God, and I want him to receive the honor & glory above all else.  Plus, I believe the people of Kenya, especially those at Imara, have given me more than I could have ever given to them.  I hope to cherish and honor them, just as they have done for me.

The underlying message this represents is what is most encouraging to me.  We have a friendship, a partnership...we are in this together.  I knew that if I really was going to move forward and start a non-profit that it must be on the foundation of supporting and partnering, and not going and doing.  The truth is...I am not really very equipped to provide healthcare to Kenyans, as much as my heart does desire to.  I do not speak Swahili.  I did not grow up in the African culture.  I know very little about tropical diseases.  But, the lovely part of it all is that God has used both my strengths and weaknesses to help support the wonderful, wonderful things that are already going on in Kenya.  And that is why it is so exciting for me to extend that opportunity to others through Imani Care International.

As I was driving to work this evening, I heard this guy on the radio say something that really struck me. When I was at the next red light, I found a piece of paper and quickly wrote it down, so I wouldn't forget.  He said in regards to how we use our money/possessions/resources/influence, we should want to be "flowing streams of blessing, and not stagnant pools of entitlement."  Think of that one for a moment.  I never fully understood the concept of generosity and the joy of giving until recently.  You would think that as I am trying to start a nonprofit I would be saving up my funds exclusively for Imani...and honestly, that was my original intention once I started receiving a "real" paycheck.  But from that first paycheck...God just began rewiring my heart.  And there just have consistently been situations and opportunities that have just plopped themselves right in front of me....and I know my heart has changed because I am just so eager to give and so excited to watch God redistribute what He has blessed me with.  I don't want to be stagnant....yes, I want to be wise and there is wisdom in saving, but there is just something so freeing about not being attached to money!  And not viewing it as exclusively mine, to benefit me only (or even my own organization).

I guess my challenge for myself, and maybe for you as well, is to give with absolutely no expectations.  Sounds easier than it really is.  That means when you are helping a friend out through a tough time, you don't do it because you want to ensure they will return the favor.  It means you don't always expect people to pay you back or make them feel indebted to you.  It means donating to things even if you cannot get a tax-write off.  That means if we want to be "flowing streams," our generosity really should never stop...it's not just a season or a time of the month or a stage of life.  That means giving even when you have already "tithed" for the month.  It means letting go of something...whether it be time, money, material things, control....and expecting nothing in return.  It's freeing.  And more likely than not, God will just entrust you with even more to give :)

Tears

The past 2 nights I have made several of my patients cry- that is to be expected as I am the bearer of the needles, the icky tasting medicine, and waking them up during the middle of the night.


But my patients have made me cry too. Of course, when I say cry, I really mean a tear or two is shed and then I must hold it together...knowing that in some sense I have to be strong and save my emotional moments for a setting off of the floor.  No, none of the kids hurt my feelings nor did any of them crash. In fact, all things considered the shifts have been smooth....busy enough to stay awake, but not so busy that I can't sit down for a few minutes every now and then.


The tears come when I hear (from report) or read (from the chart) parts of their stories and realize I, as their nurse, have become a part of their story...even if just one or two 12 hour shifts in the months, even years of intermittent hospital stays, rounds of chemo, weeks of monitoring. It's not just about their diagnoses. With my limited knowledge about the complexities of the floor I work on, knowing the cancer subtype carries little meaning to me. It's when I come to find out a patient who has yet to reach their 2nd birthday is being placed on palliative care. It's the patient who has been at the hospital, not for medical reasons, but because there was no foster home to discharge them to. This was also the patient who told me that I did not look like a nurse-in-training because I had the name badge and the right outfit on. This 7 year old assured me I looked "ready to take care of patients all by myself."


It is not all sad; in fact, remission rates for many childhood cancers are quite high. But these kids are not statistics. Each of their experiences here changes who they are and who they will become. I pray the experiences only make them stronger, believing they can make it through all of life's challenges and knowing what it means to show compassion.


So we revisit the question Do you love your job?   My current answer (and hopefully my lifelong answer) is I love these kids. No, it is not like being a nanny because you typically aren't thought of as the "fun" person. There are not fun outings, gift-giving, game-playing, craft-making....but there is a definite sense that you are playing a part of walking that child and their family through this detour, a change in course that can be quite lengthy. You hope and pray that eventually they will be back on track, but a part of you knows that some of their journeys will end before then. I have always considered it a privilege to be there for people in their most vulnerable times, when they need it most, and it is an honor to be able to come to work to do just that.

The Jasmine Doll

Typically I don't post twice in the same week, but this story deserves its own blog.

As I was at the local Christian bookstore in the greeting card aisle, I overhead a conversation between a young girl and her mother.  The girl, about 5 or 6, stated to her mother, "I want to give away Jasmine."  This statement caused her mother to pause for a moment, before replying, "Your NEW Jasmine doll??  The one you JUST got for your birthday??"  The child seemed puzzled as to why her mother was asking these questions, but replied with assurance, "Yes!"  At this point, I was eager to hear the mother's reply.

"But you just got that doll.  Your aunt gave that to you.  I was thinking you could give away some of your old toys...your baby toys, not your new toys.  You love Jasmine."

As I begin to share my thoughts on this, please know I do not condemn this mother, because I could have easily been in her shoes.  In fact, I think the mother's response was the human response, the way all of us naturally want to respond.

The mother and daughter walked out of my ear's range, so I did not hear or see how the daughter responded.  However, this conversation really had an impact on me, and even a week later, I continue to think about it.  It reminded me immediately of the woman who poured her perfume over Jesus' feet (a story shared in 3 of the 4 gospels).  The disciples were frustrated, even angry, by this woman's actions.  Why did she waste such money on such expensive perfume?  She could have helped the poor!  Besides, who did this woman think she was, coming up to Jesus like that!  In the same way, this mother could not accept that her daughter selflessly wanted to give away her Jasmine doll.  It wasn't because she didn't love this new doll she was given; in fact, I believe it was because she loved this doll so much that she wanted to give it away.  Yet her mother was resistant.  It could be because she was worried the aunt might find out the doll was given away.  Or she was worried her daughter might change her mind, and did not want to risk having to buy a new doll.  Or maybe it was a bit deeper than that.  Could it be she was uncomfortable that her daughter was willing to sacrifice something as dear to her as Jasmine??  What would the mother's equivalent be?  Her new outfit?  Her jewelry?  Her car?  Maybe she couldn't bear to donate the almost new Jasmine doll along with her out-dated, thoroughly used clothes. All of this is speculation, of course, but it really got me to thinking.

What is my Jasmine doll?  And would I give it away??  As Christians, we can be the worst hypocrites.  We love to take about sacrifice and being generous, yet most of us have made it into an equation, a line-item in our budget, a tax deduction.  When is the last time we gave away something we actually liked?  Or something we actually needed?  When is the last time we "gave until it hurt"?  Isn't that what sacrifice is?

Now that I am making a sizable income, I really fight between wanting to give away every penny and trying to be "financially responsible."  It can be a fine line sometimes...God gave us wisdom and knowledge for a reason, but I also believe he wants us to "give until it hurts."  And giving is so much broader than the box we put it in!  It's not just donating to charities once a month or participating in a food drive at the holidays.  It's giving of our time...it's calling that friend who always has drama in their life and just listening.  It's giving of our money...not just picking and choosing what we feel like giving to, but asking God to lead us to opportunities.  It's giving of our resources....no it is not bad to give away our old clothes, but sometimes I think there is so much more we could do with our homes and our possessions...maybe having more people over or letting people borrow things...knowing they may mess them up or forget to give them back.

As I just started a nonprofit, I am both excited and reluctant about the aspect of fundraising.  I have never been afraid to talk about causes I am passionate about and asking people to consider being involved.  However, now that the cause is one that I specifically started, I do feel a bigger sense of insecurity.  I am a firm believer that God will move people's hearts to be generous.  It is not my place to tell people that they need to give money to a specific organization or that they can afford to give more.  I was not called to raise money; I was called to share stories about Kenya and provide a way for people to be involved, should they so chose.  One thing that I have realized this week is that I don't want my giving to be exclusive to Imani Care International.  I still want to be involved in other people's passions and ministries.  And I am so excited and so blessed to have the resources at this point in my life to do so.

Night Shifts, Naps, & Nonprofits

And so it begins....


I had my first three night shifts on the floor this past week.  I am exhausted, despite almost two whole "recovery days."  It is not just the fact that I am physically tired....I am mentally and emotionally drained.  I don't know how it is with other jobs and transitioning from school to the "real world" but in my case, none of my clinical experiences adequately prepared me for the complex conditions that the kids on my floor have.  I keep telling people that the unit I am working on basically requires me to do all the things I wasn't allowed to do in nursing school....central lines, blood transfusions, narcotics, lab draws, chemotherapy....  Needless to say, I am learning A LOT.  I will be learning a lot for a long, long time.  The hardest part is you know you aren't supposed to know everything and that you will make mistakes, but you just pray that the mistakes you make will not harm a child....its not like making someone the wrong drink at Starbucks....

Everyone wants to know "Do you love your job?"  Well, I don't see that as an easy question to answer, especially after such a short time.  The best answer I can give is...I think eventually I will.  The truth of the matter is at this point everything is just overwhelming.  Not necessarily in a bad way, but everything is new, you are desperately trying to cram in all this new information while still using your basic clinical judgment, and converting all of your adult clinical experience to pediatrics, and trying to ask the right questions and do things safely....there just isn't enough time or energy to really fully embrace the moment.  I mean, of the 13 hours shift, I probably had maybe 15 minutes where I felt I could really be present with my patient and not be thinking about 58556 other things....  I know it will take time...and I have to be patient with myself, but at the same time, you don't really want to ever let your guard down so much that you aren't double checking all the things you really need to.  I just pray that every shift I will have at least one moment that reminds me, okay this is why you are doing this, and so far that has been the case.  One patient shared about how hard it has been for her to have her disease and in those few minutes, I felt like my presence actually was making a difference.  And I think that is really what nursing is.  A lot of busyness and chaos and running around like crazy...but also those tender moments of making a difference in your patients' lives.

What keeps me going through all of this....the nonprofit....Imani Care International.  Hopefully in the next month or two, I will have a website to direct you to, in order to give you a more comprehensive picture of what Imani Care is all about.  God has been so faithful in bringing things together to make my dream a reality.  I am still in the process of wading through some of the legal paperwork, but all things considered, everything thus far has moved faster than I could have hoped for.  A number of people have really gotten on board to help...a graphic artist is working on a logo, a college student is helping with the website, my attorneys have been wonderful, the board of directors has been extremely flexible and encouraging...  I continue to be in contact with those at the clinic in Kenya and they continue to encourage me and remind me why I am doing all of this.  I am hoping to be able to make a trip to Kenya sometime in the January/February time frame....I am still trying to figure out exactly how to approach this topic with my supervisor...but I do have peace that God wants me to continue to invest in Kenya, even while I am working here in the States.

I am reminded that following God's call is not necessarily suppose to be easy or always enjoyable.  It's hard to put yourself in a position of truly having to trust in God's strength and faithfulness to bring you through each moment.  And it's kind of ironic...but starting this nonprofit I had no previous experience or education, and am essentially doing it all by faith....and I have found a lot of joy in it.  And of course, nursing I have been working towards that for years and had plenty of education and preparation, and it is the hardest, scariest thing I have ever done!  Ha Ha!  So there you go :)  But I will press on and continue to take in all that I am supposed to learn through it all, and live for those moments of joy....