On leaving

I sat down to blog about a day volunteering with students…but then, being the multi-tasker that I am, I checked my work email and discovered this from a student:

   I wanted to wait until my psych grade was finalized and everything so this wouldn’t sound like brown nosing! I want to tell you how grateful I am to have had you as an instructor. Although I am not specializing in psych nursing, the content you taught reaches into every aspect of nursing. Even working as a CNA, I hear your voice when I am with a patient telling me to give them a little of my time and telling me to use my ‘therapeutic communication’ :). I am now less judgemental and more patient with not only patients but just people in general. You have also inspired me to find something I love and specialize in it, like you have done with psych. So, I just wanted to thank you for all your hardwork in teaching and also with Project Homeless and Project Motlow. You have reminded us that nursing isn’t just skills and patho, but it is also caring and empathizing.

Thanks again:)

This is so poignant right now. I don’t think I have the words to express the emotions that I am experiencing at this moment. I feel a lot of joy to know that I have touched someone’s professional practice and personal life in this way. This is exactly why I am a teacher. My own psych instructors laughed at the patients as if they were some kind of freaks. There was this separation of “us” and “them”. My own practice and personal journey, luckily, has taught me how very very wrong this approach is, and how it doesn’t help the patient to get better and it also harms me because it is not living up to my potential as a caring human person and it separates me from wonderful people who walk this journey of life alongside me, not underneath me. My aim as a teacher is to impact the student perception of the people they encounter; to get them to be aware of judgments and not allow those judgments to affect our beautiful potential for meaningful human interaction. Very much of my philosophy comes from various nursing theories, predominantly Jean Watson’s Caring Science, and the rest comes from my personal experience with phenomenal human beings that society and even themselves have labeled as “bad”, “no good”, “worthless”.

I am also feeling a good bit of sadness…and maybe  not quite regret or doubt, but definitely some inner conflict. Yesterday I accepted a new job. As of April 27th I will no longer be a teacher. I am moving into a managerial/supervisiory type position – officially “Administrative Coordinator”. I have made this move almost 100% for financial reasons. The finances are a HUGE factor and the difference in salaries is remarkable. I have been focusing on my excitement about NOT having more days left at the end of the month than money in the bank and trying to ignore the fact that I am leaving something that I love doing. And apparently I am leaving something that I am good at.

I may have more words on that later. I definitely need to drudge up some words for this volunteer experience because I have to do a write up for, well publicity. And of course when I HAVE to write something, I start to feel stuck.

More words soon.

too much to say

My thoughts are like little bumper cars today….careening wildly around the enclosure of my mind and smashing into each other with reckless abandon. Unlike bumper cars, whom do not generate progeny with each collision, my thoughts crash against each other and form new little thoughtlets that quickly grow and yearn for new avenues of thought… “follow me here”, “no, no I am the one you want to follow”, “pick me me MEEE”. As soon as I mentally turn to follow one train of thought, there is another demanding equal attention. I want to write about my body and health, about running, about the clothes I wear when running (and wondering if there is a running line out there for overweight women’s bodies)…I want to write about my spirituality and this sense of being led and guided, but at the same time feeling so very blind and frightened as all these changes are happening in my life. I want to write about nursing and my thoughts on being a nurse, my personal philosophies about the practice of nursing and how I am forced to look harder at myself and my practice during this time of looking for new job possibilities (what do I really want to do? and why?)

Ah me, so many thoughtlets. I also want to start getting together thoughts for this book I want to write. I mentally write paragraphs and start new chapters just about every day…but the getting onto paper is a challenge. I actually think I want to “write” this book, or at least start that way until my thoughts are more cogent. So I bought a pretty little journal to get started on this process about two weeks ago. And there it sits on my coffee table, its pristine pages quite neglected.

I think it is no coincidence that I am stirred into movement (both mentally and physically) today and the sun is shining. Well, most of the time anyway…there are quite a few puffy white clouds and some even have ominous dark linings…but they are scattered enough to let that marvelous sunshine through. As I type, I am sitting on my front steps and reveling in the feeloing of the sun on my face. I am like a bear coming out of hibernation , a long and cold and sickly hibernation at that (still dealing with the vestiges [i.e. mucus and snot that have taken up residence in my upper bronchioles and sinuses]) of that darned bronchitis …and I yearn for activity. Well at least I did make a “writing date” and I finally ran (still hacking) today. Its a start.

Much to say

I have much to say, which means one of two things…I will either say not much of anything at all because too many random things are bouncing off the walls of my cranium…OR…I will say much, and it may or may not make any sense whatsoever.

To begin: I am reading a lot of very exciting books right now. I think too much. I may need to cut back a bit. This reading can be a little on the addictive side. I finally finished Alice’s Adventures and Through the Looking glass…and I was underimpressed. Alice’s Adventures was pretty good. Some interesting parts that weren’t in the movie I remember. I really loved most of the nonsensical poetry – especially the Walrus and The Carpenter (always has been a fave), and some of the made-up words were fun – but some of it just went on and on and on… Through the looking glass made it ever so clear that the stories about Carroll’s drug use are absolutely true. Absolutely and without a doubt. Honestly I finished reading most of the book over a month ago…and then just let the book just sit forlornly on my nightstand with the last few pages unread….because it was getting quite torturous and I was not fond of either the Red or the White Queen and by the end I mostly just wanted them and Alice to shut their faces. The most enjoyable part of the stories for me, were the lovely illustrations…Alice and the Dodo, the Jabberwocky, The Lobster Quadrille, the Mad Hatter. All quite lovely and familiarly comforting.

Here is a snippet of my favoritist – the Walrus and the Carpenter as told by Tweedledee:

“the sun was shining on the sea, shining with all his might: he did his very best to make the billows smooth and bright – And this was odd, because it was The middle of the night…”

Now, I am also re-reading A Room of One’s Own by Virginia Woolf. I am absolutely in love with Virginia Woolf. Enraptured. Reading it now for bookclub and I can’t wait to talk about it with my favorite ladies. As I have said before, I literally devoured the book at lightening speed before, so I am looking forward to savoring it now.

Reading Nursing by Jean Watson. She is my nursing hero. I find it interesting that a great deal of what I teach is in this text. I have studied her theory and ideas at various times, but not to the depth I would like…but it is oh so obvious how much she has influenced my practice. I am about half-way through this one – which is pretty good considering that I have mostly been reading this one at the gym while on the elliptical machine. It is quite stimulating really. I want to talk about this one more in depth, to better serve my nursing readers…but I will have to cogitate that a bit further.  For now, I will just share a quote that says much:

“A humanistic-altruistic value system is a qualitative philosophy that guides one’s mature life. It is the commitment to and satisfaction of receiving through giving. It involves the capacity to view humanity with love and to appreciate diversity and individuality. Such a value system helps one to tolerate differences and to view others through their own perceptual systems rather than through one’s own”.

I am also reading…rather working through The Artist’s Way. I don’t know how artistic I am becoming but it is so very therapeutic right now during a time when I really need it. This is a recovery workbook, whether you are recovering from being a blocked artist or from grief and loss or Whatever. Cameron’s gentleness and fierceness are beautifully inspiring.

Last but not least, 1984 by George Orwell. It is fascinating, depressing, scary,…well that is all I have to say for now. That and that it is giving me freaky dreams. But I guess that is what I get for reading it before sleep.

Last student is finishing up…so I am too.

Nursing Theory in Practice

Maybe I am just quirky. I love nursing theory. I mean, I enjoy other theories as well, but nursing theories in particular give me warm fuzzy feelings. (I can hear some nurses making gagging noises as I speak). Someone said to me recently that nursing theories aren’t truly applicable to reality of practice. I have to disagree. They are applicable – they provide a framework to build practice upon. They provide different ways of thinking and experiencing the nurse-client relationship. Now I will admit, some theories I do find interesting but I don’t feel inspired to build my practice on their foundations. But usually I am able to dig out some kernals of goodness that I can bring into my practice. The more theories I learn, the more adaptable I am to the individual client experience in the ways that I am able to think, feel, experience and provide care. Now there are some theories that make my blood sing…and I think “Now that is how I want to provide care, that is the lens which I want to filter my practice through!” Some of those theories have links in my sidebar.

Perhaps this love of theory comes from my particular personality.Perhaps it is because I am a psychiatric nurse and these theories are perfect for my practice (really I think I could apply some nursing theory to any practice, so that is not it)  I love philosophy and anthropology and all things (well most things) spiritual. I love a good theory that ties those three things together in the context of thinking feeling and doing. I love a theory that makes me look at instances in my practice and think “if I had approached that problem from this perspective, or if I had acted in this way – then that situation would have been better. Not only for the client, but also improvement in the kind of care that I am capable of providing. Because I do want to continually improve.

So I digress from my intended purpose for these ramblings (which if you have read this blog at all, you will discover that to be typical). 

A nursing theory that I have been learning to practice of late is Peplau’s Interpersonal theory. Now this is not one of those that initially made my blood sing. Truly it seemed rather rudimentary and simple. This is the one theory that curriculum lead by the accrediting agency wants me to teach.  Since I do want my students to pass the NCLEX, I will teach it, but first I have to feel some passion about it (I am afraid that was a little lacking last semester when I taught it for the first time). I do hope that as I get more comfortable in this teaching role that I will add in some Watson or Parse…but I digress again. Peplau.

So her theory is all about the interpersonal. That applies of course. What I am discovering is that in its very simplicity is where its beauty lies. I love that it outlines phases of the nurse-client relationship and does so in such a way that allows for a building of trust and a clear direction for movement towards health. When that first report is received the nurse has time to reflect on her/his own values, beliefs, judgments about the client’s situation. If the nurse indeed goes through this process, she will be able to deal with any emotional flux and remove them from the professional relationship before it ever begings. This will hopefully avoid the damaging effects of countertransference that often occurs when the nurse is unaware and the emotions bleed into the nurse-client relationship. Peplau also acknowledges that the nurse and client come together as strangers, and must very quickly advance from strangers to a deeper place of trust and sharing that will allow for identification and then resolution of problems. In the medical world of bustle, flurry and the dictates of  insurance, there is little time for this to be accomplished and if that trust is not developed, information vital to the problem resolution can be overlooked or withheld and opportunities for healing lost.

Another important piece of Peplau’s theory is the identification of different nursing roles in the nurse-client relationship and how these roles can help the client achieve resolution or rather movement through unfulfilled stages of development. These roles include the common sense ones – that every nurse knows to be a part of her/his  job description: teacher, technical expert and resource person. ALso included are other roles that may be more challenging: arbitrator, change agent, counselor, surrogate. Last semester when I mentioned the role of surrogate I saw the face of several students twist in obvious disapproval. “I don’t want to pretend to be anyone’s mommy”, one said, “that doesn’t seem healthy”. Yet we can model healthy behaviors and be a source of support that is motherly, sisterly etc., that perhaps that person never had. It does not mean that we become like a mother to that person and that we continue in that role. No, that would not be healthy for either of us. I am reminded of a female patient who shared with me her self-hatred and her confusing feelings toward her own mother who had not helped her, who had closed her eyes when the client as a teen told her mother that she was being molested by her step-father. In my role as a nurse, there was no way for me to go back in time and make that situation any better for her. What I could and did do is what Peplau’s theory lays out for me. I became a surrogate mother for a few moments in time. I heard the clients pain and anger and mirrored it to her. I offered her positive affirmation of her worth and that she did not deserve what happened to her, that what happened to her was not okay. I created a safe container for the client to express her feelings, and offered her comfort, acceptance and love.  Then we moved on. In my next encounter with her, I was likely (I don’t recall exactly) in another role – that of teacher, or technical expert.  Peplau’s theory not only tells us it is okay and appropriate to move from role to role, but also how determine the appropriate role depending on the client’s needs. 

Enough for today…the house will not clean itself!

The Teacher is settling in.

I have had so much to talk about (and still do) that I have nothing to say. I get that way sometimes, so much going through my head that I can’t sort it out into anything specific to blog about. But oh well, here is my best effort. Perhaps it won’t be so intellectually engaging, but it is at least an update on me.

I have been working ALOT! 60-70 hours per week for the last 3 weeks. Hubby thinks more, as I have been working at home too. Whew. But my hope is that is going to change next week and in the weeks to come, that I will begin to work some normal hours!

But it has been good preparation. This past week I lectured every day, and I enjoyed it! I talked until my little voice was hoarse. I mean seriously, considering that I talked for 2-3 hours every day. But the good news is that because of the way the nursing program works, and shared lecturing, my lecturing is over for the semester. Yay! Now I can prepare for the clinical setting which is where the bulk of my time will be spent teaching for the rest of the semester.

I am rather proud of myself. I could not have imagine a few years ago that I would be able to stand in front of 75 people and speak intelligiently for hours without experiencing intense anxiety. The biggest challenge was the iTV system over which I am broadcasting. I have 25 students in front of me and then the remainder are spread between 2 other campuses. It is a really neat system, very interactive – they can see and hear me and I can see and hear them just as if they were really in front of me. But it takes some practice attending to the screens, the camera, my content and the students in front of me. But I survived! Woohoo!

Now this week I will be taking students to orient at the psychiatric hospital in Nashville where I will be with them in the upcoming months for their clinical experience. I think I am a little more nervous about this than lecturing. It is a new environment for me as well as for them, and i have a lot of coordinating to do among a lot of different units and I have to figure my way around. But, everyone keeps telling me that clinical is the most enjoyable part. Just getting the hang of things.

One good week of student contact under my belt! I have successfully completed lecture and even survived my first student complaint (also successfully resolved), and I think successfully imparted information to students in a way that was interesting and engaging.

No wonder I have been practically comatose this weekend…..

Back in the Work Force and Biting off More Than One Can Chew

I have been MIA, its true. Just so much to do during the final days of my time being unemployed. I make it sound sooo dramatic don’t I? That’s me!

SO, I am officially 3 days back into the workforce. I feel glad – but mostly because I now desparately need money to pay bills. Bah humbug! I went back to a previous job of 6 years – but will be working prn until I find my true calling…..okay that would be a little more drama. However I am looking into options that will allow me to use my masters, that will broaden my horizons, and that I will like. Maybe a big order, but hopefully not. I have my fingers crossed for a nursing faculty position at a local community college.  The interview was a BIG DEAL for me, as i have never done anything quite like that before – but I enjoyed the challenge, and actually enjoyed the interview. So I am hopeful.

But it felt kinda funny – funny and good – to go back to the old job. There were so many faces that were glad to see me and welcomed me back with genuine enthusiam. It made me feel good. There may be downsides too, but for now I will focus on the present and what is good about having the job – like some degree of financial security!, and the ease of stepping into an old position and not having the stress of learning a new job. So I have some gratitude.

Now, as for biting off more than one can chew…..I decided to do quite a few projects during my time off – which didn’t really completely come to fruition, but I am getting there. Hubby says the lawn project might be finished by 2019. haha, bah humbug once again. You see, I decided to till up my front lawn and cover it with mulch. I also have grand visions of a water fountain, arbor covered in clemetis, stone walkways and a stoned seating area. But for now I have mulch. Thank goodness for hubby! I had no idea how much work it would be to till, cover with newspaper and then cover with mulch my sizeable front lawn. I think I tend to have a grander view of the end product and a not always so realistic view of the work entailed. Which is probably all for the best, as otherwise I probably wouldn’t have started the project. Okay, so to give me some credit, I did downscale my original grandiose landscaping ideas, which included similar visions (but with a berry garden) for the side yard.

Sooo, I hope to have pictures soon. Well, at least I hope before the year 2019.

So This is It

My last few moments in Raton, NM. The final bags are waiting to go downstairs, and as soon as I pack this laptop I will close the door on this chapter of my life. I am eager to go home: to be with my husband, reconnect with friends, see family and my kitties! Yet there is a certain poignancy as I look around at this apartment that once again looks as it did when I first entered – not quite mine. I look out my window to this amazing vista – and that is actually what I will miss the most. I have met some wonderful people and had fantastic experiences while I was here. And I think that I have experienced some inner growth myself – a kind of confidence that can only come from putting knowledge and skills to the test – not only my knowledge as a nurse, but also inner knowing of ‘okay-ness’ as I faced challenges that presented themselves to me while I was here.

No Raton is not the place for me long term, but it has been a good stay and I, for one, took the “road less traveled by, and that has made all the difference”.

I am where I am…hmmm where am I?

One week left in Raton, NM to go! And then it is back to Nashville and my dear hubby. Sigh. So many exciting possibilities ahead, and not sure what I am going to do with them, or for that matter what they all are. This job has been a stopgap for me after completing my MSN in December. It feels like the waiting to grow up (so I know what I want to do  you know) period is coming to a close, and yet I am still not really sure. Teaching is a possibility, and one that I feel mildly enthusiastic about. I have applied to two universities and one community college. And I think that I would find that interesting and stimulating, and perhaps I would really love it. It would give me the opportunity to delve more into theory, which is an aspect of nursing that I love learning more about.

But it isn’t my dream. I want to really use the skills I have obtained – and to continue to develop more! To put the theories and applications into practice – to truly help people realize their potential through potentiating healing of the body mind and spirit. Ah, but the question is, how do I go about doing that?! And no, I am not finding any job postings that meet that job description. Ideally I want to work independently, say in a holistic health clinic of some nature – where I can counsel and use the wonderful Reiki that I have had so little opportunity to put into practice (well, at least broadscale). And again there is the question…..how do I do that? This past weekend, I received some very sage advice to “act as if” (now where have I heard that before :)) I know how to do what I want, and just do it. Hmmm. I was told to reach for my dreams, to act in the present instead of waiting for the ‘right’ circumstances, to create opportunity…..

SO, I took a leap of faith and extended my desires to a friend holistic practitioner. I anxiously await his response. I feel excited about the possibilities, whatever they may be.

Tiny life

This has been an interesting, eventful and educational week at work so far. I am on a really long stretch and beginning to feel it. Luckily I have been able to stay in OB instead of floating to the floor or to ER.  On Friday, I was observing a young woman who was 7 weeks early when she suddenly went into full labor and delivered this teeny and tenacious little bundle. Talk about adrenaline, and not the fun kind. She delivered withing 20min of me discovering that she was indeed laboring. So the last two nights have been baby watch, as the infant is too fragile to be out of the nursery and is having a bit of a hard time. Life is so amazing. It takes all his energy to just get a little formula in, and yet he is hanging on. The saddest part for me is that he doesn’t get all the hugs and love (especially from his mom) that he needs because he has to stay under the radiant warmer to keep his temperature up. I have been trying to touch him as much as possible, because I think it helps. It certainly seems to calm him. This is my first experience of this sort, and it is definitely a learning one. I have delivered babies this early and earlier before, but I am used to having a nursery to whisk them off too. But here, I am it.

in other news, this experience of travel nursing is creating life contrast for me – so that I am learning more about what I like and dislike. I like living in the city. I like being this close to the mountains. I dislike small town gossip. I dislike drama. I think that there is generally alot of drama when working in nursing in general (and maybe this is true for all areas) And I am not talking about drama with patients, but rather with and between staff – but it seems to be worse here and is hospital-wide. I am attributing that to the small size of the hospital and of the area. It is really tiring, and hard not to get caught up in it. It seems counter-intuitive to our very nature as nurses. But then, it seems that I see a lot that is counterintuitive to the profession of nursing. Working independently in home health for the past year, I forgot about that. It is hard  as a nurse to be caring, understanding, empathetic etc all the time, but it is part of the job, and I think it is a very vital part of the healing process. However, we forget, I think, to respect the patient’s lived experience and to attempt to understand their lived experience from their perspective instead of putting our own perspectives, judgments and attitudes on it – ah but I am digressing. I will stop before I get all into nursing theory (which I think needs to be a more integral part of nursing). Perhaps that is fodder for another day’s post.

Soliloquy on Feminism

A recent discussion has led me to ponder on feminism and what it means to me. So, in attempting to better understand my own position, I thought a discourse here would me most useful.

 I am a feminist. I have long thought of myself thus, but I guess I part of me has felt like I was largely a perimeter feminist – meaning that I am not engaging in rallys or active in feminist organizations. The other part of me is wholly feminist and it shows in everything that I do. and knows that I don’t have to be on the ‘front lines’ in order to be a feminist. Some might say, how are You a feminist, you who are in a traditionally female role as a nurse., when feminists have been fighting for decades to move women beyond roles that have been strictly delegated as “women’s work”. And I say that it is in this role, as well as in the other roles of my life, that I feel most feminist. It is here that I get to be a humanist – to treat all others with the respect and dignity that they deserve, and that is really (for me) what feminism is all about.  I also seek to expand the nursing profession and to broaden and dispel many of the myths of the “handmaiden” nurse through my educational process and through my daily interactions with patients and fellow nurses.

It is feminism that allows me to do this, to not accept the traditional role of the ‘handmaiden’ to the (male) physician, to seek to understand and to better the human condition through theory and research and evidence-based nursing (as opposed to medicine).  Beyond the work setting, it is feminism that gives me such a great relationship with my husband (who would not define himself as feminist I think merely because of the inaccurate societal connotations of the word but who I definitely think is humanist which almost amounts to the same thing) – a relationship of mutual respect and love where we can encourage and support each other in seeking personal and professional excellence and not limit ourselves by historical gender-based roles and expectations. Not to say that these expectations don’t arise – in the society in which we live, I don’t think we would be ‘normal’ (whatever that is) if they didn’t – but we are able to work through them and not allow them to burden us for long with their weight.

Feminism for me also means more than that. It means not accepting violence into my life just because I am a woman. This includes violence against other women – in the media and otherwise. It means not accepting less personally or professionally just because I am a woman. It means embracing and loving my womanhood and the nurturing, loving, and empathy that that entails for me. It means learning to value myself and to make choices about my life because I want to, and not because society expects me to, whether or not those choices are ‘traditionally’ female or not. It means spiritual freedom. It means accepting my body and its feminine processes without shame. It means not accepting the myth of original sin. It means questioning the patriarchy. It means making decisions for myself and forming my own opinions instead of just accepting the opinions of others. And yes, it means getting a little ticked off by religion, literature and media, especially the literature that much of our society is based on that excludes women. It means this and so much more for me.

And lastly, to speak on feminists as man-haters. I think that this is one of the biggests misconceptions about feminism. The way I understand and apply feminism to my life, this ideal is inc0nceivable – because feminism for me is not really about men at all. It IS however about acceptance and equality. I will say that I did go through a man-hating phase in my life -but that came from a place of woundedness, not feminism. I also think that it was a necessary process for me to arise from that place of woundedness to a place of loving acceptance. I love the men in my life, and know that life is about balance – yin and yang, male and female.

And yes, I do think that women are great! Yay Women!