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....

Three is a Magic Number

Yesterday was a big day.  For whatever reason, I had a feeling that I would find out about the status of my nursing license and nonprofit organization on the same day.  It has been a couple of weeks chalked filled with good news and reason to celebrate...1) I have a job, a wonderful position that I have dreamed about since I was 12 years old, 2) I passed by board exam and now am officially a registered nurse, and 3) Imani Care International now exists as a public benefit corporation.  [Is this real life??]  


Last night I was so excited to blog because I had been waiting for the "big three" to actually happen.  I began drafting the contents of the blog post in my head (which I often do), but kept coming up short in terms of the title.  The title....I always put this unnecessary pressure upon myself about the title of things.  I know the impact of first impressions and when it comes to the written word...the title is like a magnet...and you hold it is positioning to the side that draws people in (and not repels them!).  Yes it is just my personal blog and at the end of the day, I could title the post "Thursday" and it wouldn't matter.  One day I would like to write a book, and I anticipate the most difficult aspect to be deciding on a title and design for the cover.  It seems like one of those things where you only really get one chance....to knock it out of the park...or strike out.  In watching the Olympics, specifically gymnastics, I cannot imagine what it must feel like to spend years working towards something, and in a couple of moments having that dream, that aspiration fade away.  And with Olympic gymnastics...it's rare that you get another shot at it.  {This is all headed SOMEWHERE...I promise!!!}


On the radio the other day, they were sharing this little story about a lady in the scrapbook store commenting that she was "saving all of her good stickers."  Apparently the store clerk overhead her and essentially scolded the woman for hoarding and not living in the moment.  When I heard it, I immediately thought...oh no....I save my "good" scrapbook stuff too!  Of course, the story really isn't about scrapbooking supplies...though it made me question what project I am saving the "good" stuff for....  It's about the way we approach life and our willingness to put ourselves on the line, take a chance knowing we may come short, but resting assured we did not leave a stone unturned.  Use the nice dishes!  Go on that vacation!  Stop making a bucket list and start doing it!


When I think about the events that have taken place in the couple of months, it is hard to believe that I am only 22 years old.  But God always reminds me that our days on this Earth are numbered and there is no time like the present to move forward on what you are called to do.  Since junior high, I wanted to be a pediatric oncology nurse.  Sometimes I would mention this to my peers and they would look at me confused...not knowing what I was talking about.  This dream stemmed from a combination of my love of children, my encounters with people who had battled cancer, and my deep desire to help people.  I held this dream close...imagining a life of me moving to TN and working at St. Judes and maybe even making it on one of their commercials someday..haha  As I volunteered at the children's hospital in high school (the one I now am employed by), I loved every moment of it and knew it was what I wanted to do.  This dream stayed strong through the first 2 years of college.  Everything was on track.


And then God asked me to give it up.  Stab in the heart.  He started asking me to think about serving internationally.  I remember saying...God I will give you a couple weeks a year....I will go on missions trips...I will volunteer, but don't ask me to move there.  Don't ask me to give up everything.  Oh we wrestled...it probably took at least 6 months before I would even consider the idea of moving overseas.  At that moment, I was in the planning stages of my much anticipated Kenya volunteering time.  See I did want to go to Kenya.  I love travelling and I knew I wanted to go spend time there.  But I wanted to do it on my terms and I still didn't think it was going to be something I would be invested in for life.  And then I got there...and my heart was forever changed.  All of the sudden, I couldn't imagine doing anything else with my life but loving those people in Kenya and providing healthcare.  Now I was thinking Okay wow God, now I understand why you are sovereign and your plans are perfect.  I will give everything to stay here and be with these people.  


Beware of the moment you think you have everything figured out.  It should caution you.  So I came back...wanted to do nothing with the U.S. and had my sights on going back...to be a Mother Teresa figure in Kenya.  And then God asked me to give that up.  What???!!!  I thought this is what YOU wanted God.  I finally have seen these people through your eyes and now you are going to just rip that away from me???    I was devastated.  I couldn't believe this.  As I write this, I am reminded that anything we hold too closely can become an idol, can become something that keeps our eyes off of the Lord.  So I let it go.  I didn't let my passion, emotions, and love go, but I let go of the plans and ideas I had in terms of what the next chapter of life would look like.  And it gives me chills to write this...not long after I let it go....I got it back.  Yes, I was handed it back and told okay now start a nonprofit!  Oh my my my...God you are FUNNY!  I can't do that.  Me??  Start a nonprofit??  I never took a business class in my life!  Find someone else to do that...I just want to love people and be a nurse!   


Well fast forward...and I got everything my heart desired and MORE.  Both of my dreams came true, though they are constantly evolving, changing, morphing, and I try my best not to hold them too closely.  I am blessed.  And because of that, I want to be a blessing to others.  Both here and abroad.  And so the adventure continues....and what an adventure it has been.

Standing In Awe

Though it has only been several weeks since I last blogged, each day has been packed full of answered prayers, leaps of faith, and doors swinging wide open.  In the midst of the whirlwind, I now take a moment to stand back in utter amazement.  Where to begin..


Well, let's start with the picture to the left.  Peter sent it to me this week- it is the newly renovated clinic, complete with a reception desk!  You may remember that a van crashed into the front of the clinic back in the winter, about the same time I was seeking birthday funds for the clinic.  The renovation you are looking at is a direct result of the generosity of many family and friends.  So thank you, from both me and many grateful individuals in Nairobi.


Next on the list....do I have a job?  When am I taking my board exam?  Am I a real nurse yet?  The answers are not yet, in several weeks, and no.  Until yesterday evening, I had not yet received my authorization to test from the state of California.  Every day that passed without that anticipated email increased my stress level, especially as the board of nursing's recorded message stated they are no longer accepting phone calls.  As anxious as I was to be cleared to take my exam, I definitely was enjoying the true summer vacation and used the "down time" to pour myself into nonprofit things.  So I will take my board exam on July 23 (meaning I better start actually studying) and then hopefully apply for and receive a nursing position at the children's hospital.


Alright enough about that...on to the exciting stuff!  I had the opportunity to meet with several attorneys a couple weeks ago, and by God's grace found a firm that got my vote.  I have been attending two community education classes: Grantwriting and Developing & Managing a Nonprofit.  I enjoy them both, and have met some interesting people.  The timing of taking the classes and not having a job yet so I can attend the classes is no coincidence.  This week I took on the project of going through my room at home and turning our spare room into my office, or what I like to jokingly call "headquarters."  I guess all those office supplies I have been hoarding may actually come in handy...


So what is next?  Well, I am begininng to recruit a board of directors, will file the articles of incorporation soon, and will continue to seek advice in order to develop a thorough organizational plan.  I have a newfound appreciation for a variety of specialities including web design and accounting.  There are many skills which I can teach myself enough to get by.  I do not think creating the webpage is one of them. 


I know this is getting long and my sister has probably stopped reading paragraphs ago.  I must acknowledge the faithfulness and provision of God in all of this.  There are many examples I could share but most recently I was just praying for God to show me if I was supposed to move forward with the nonprofit, and if so, to make it clear.  That same day I received a check I had forgotten about in the mail and a good friend asked me to come and share with a group of people that weekend.  Then today I received an email about Seattle Pacific's global health exhibit at Seattle Center that I had been interviewed for about a month ago, but had not thought of much since.  When I saw the picture of me with Blessings, I just thought this is why I am doing all this.  This is why I am walking in faith into a world totally foreign to me.  This is why even though I have no homework or tests that I gladly stay up late into the night working on various tasks.  This is why I still can look at pictures from my trip and cry.  It reminds me of this quote a friend shared with me....God doesn't call the qualified, he qualifies the called.  Be encouraged, my friends.