dramatic-unicorn

[dramatic-unicorn]

I think the hardest thing about critical care nursing is the parents. Parents of the kid who overdosed on drugs or the kid who shot them selves when they could no longer take the pressure. Of the kids who where hit by drunk drivers and of the drunk driving kids, or the kids who are victims of freak accidents that changed the person they will be forever. The kids who are fighting for their lives from an infection that most people walk off or the kids who were beaten by someone they thought loved them... It doesn't matter what happened to their kids, or whether they are 18 or 60 years old, the pain from their parents grabs ahold of me at a visceral level and turns me inside out. The worse sound I have ever heard is the sound of a mother arriving to see their child for the first time after a significant trauma that is not recoverable. You can never unhear it, and it changes who you are.

You know what, though? I think the best part of critical care nursing is the parents. How they thank you with tears in their eyes as they say good bye to their babies or how they jump out of their skin when the monitor alarms, and you physically feel the tension bleed out of the room when you say "that's not real, they're fine." When their baby makes eye contact with someone for the first time since their brain injury and mom wraps you in a hug so tight you can't breath, but you just hug her back, because this is big and you're just as excited as she is. How you walk in to the room and get meds ready as slowly as possible, because Dad is telling is baby about his fishing trip, and your patient is responding to the sound of his voice for the first time, and you'd rather clean infected bed sores for a month than interrupt this moment. Of the look in their eyes when they find out their babies heart is salvageable and will save a life and beat on in another person even after they say goodbye to their truest love.

I love celebrating with them and grieving with them and worrying with them. It's terrible and wonderful and heartbreaking and amazing. It's everything I never wanted to experience and exactly what I needed nursing to be. It's brutal and it's painful and it's liberating and it's beautiful and it's raw and exactly where I'm meant to be.

[dramatic-unicorn]

DNR

I cried at the bedside of a patient for the first time in years the other day. For days, I’ve been asking myself why. We knew they were going to pass. Their injuries were not survivable. I have always been good at compartmentalizing until I'm in the appropriate company to break down, so why did this patient, this situation unravel my much practiced professional composure? 

Through a storm of tears and shattered hopes the decision to not resuscitate had been made. It was in the best interest of the patient, of this, I have no doubt. The relief I felt for my patient at that time was complete. However, I failed to realize they would be the first DNR to pass on my watch without withdrawing care. I didn’t realize until the heart went from stable to flat lined before I had the chance to dial the first three digits of the family’s phone number.  I didn’t realized until the fingernails of my balled fists had drawn blood from my palms in my attempt to control the visceral need to start chest compressions. I didn’t realize what it would be like to watch someone die while you try to think of anything you can do to stop it besides the things you're not allowed to do.  I didn't realize the gut wrenching feeling of failure the families wails would draw from me. I didn’t realize how much sadness I would feel over the fact that I spent those few minutes scrambling to stabilize them instead of just holding their hand so they weren't alone. 

My Mom said, “This is good. Its a reminder that you're not numb, and we all need that every now and then.” 

I guess this is true. Its easy to become jaded in the healthcare industry, Easy to forget the way loss of human life should make you feel, expected or not. I don’t ever want to wake up and find my self cold and emotionless, or just going through the motions of my job. I always want to wake up with the strength and drive to fight for the ones I can save, the compassion to mourn the ones I can’t and the objective logic to know the which side of that line we are standing on. I want to go to sleep feeling like I did everything I could and felt every thing I could for my patients, because sometimes I’m the only one standing at the bedside when its time for them to go , and no one should have to leave this world without someone feeling it.  Even as a DNR.

[dramatic-unicorn]

Nursing is a profession that no one understands, except for other nurses. Often, on my long drive home, I find my self pondering ways to explain it to other people, but there really is no way. Nursing is so many things at one time, that trying to explain it to an outsider makes you sound clinically insane. And in reality, maybe you are...

Because nursing is waking up and sneaking out of the house without waking your family, because the sun won't even be up for 2 more hours. It's drinking a strong cup of coffee on the way, because there is absolutely no way to tell what you are about to walk into. Nursing is breaking your back, both literally and figuratively, for big box companies that will replace you at a moment's notice if you crumble underneath the pressure. It's knowing deep down that they most likely need you more than you need them.

Nursing is walking around the unit for the last time with a patient who is about to lose their leg and its keeping the family from seeing tears running down your face that match their own as you wheel their son/husband/father/mother/wife/daughter to the OR for that procedure. It's spending the next two hours rounding up every available employee on the unit to write something encouraging on the window, because you want them to come back to a wall of happiness, and most importantly, it's the feeling in your chest when they hug you after seeing it.

Nursing is taking a bite of your lunch and chewing while you run to the bathroom. It's taking another bite of your lunch and helping someone else to the bathroom. Nursing is throwing your lunch away, because it's been sitting in the breakroom for 4 hours and who knows what is growing on it at this point. Plus, there is a bite missing that you're pretty sure you didn't take and nursing is absolutely AWFUL.

Nursing is not seeing your husband or children for basically 3 days straight. It's catching a potentially fatal complication at shift change, and having to clock out without knowing the outcome. It's living in a constant state of doubt: should I have, could I have, why didn't I? It's filling a water bottle at 0515 and drinking it at 2115 while sitting in your car trying to cultivate the energy to get out and walk to the front door.

Nursing is spending the whole day trying to get your surgery patient's pain under control, and it's the huge smile on your face when the rate it 2/10 at shift change. It's the smile on their faces after completing their 45 minute bed bath, and it's the sweat rolling down your back, because its 100 degrees in their room. Nursing is breaking off tiny pieces of your heart, and passing them out to complete strangers. Its giving everything you have to people who may not show you any appreciation, or even respect. Nursing is the sad goodbye after day three knowing you may never see that person again, as well as the happy goodbyes, for the same reason.

Nursing is seeing the beginning of life and the end of it, the close calls and the ridiculous admissions. Its the tears and the smiles and the cuss words and the feelings of giving up and it's the hope and the pain and the waiting and the schedules that never work out. It's the people you can't save, and the ones you could, if they would only fucking let you. It's discharging the patient that you spent days thinking they weren't going to make it and it's the hug before they get in the car and the "I hope I don't see you later" comment, and it's the uncertainty, and it's the uncertainty, and it's the UNCERTAINTY and nursing is absolutely AMAZING...

Who would do this to themselves on purpose? Who, but the clinically insane, would put themselves through this on a regular basis? Why would anyone want to do anything thing else?

Nursing is a profession that no one understands, except for other nurses, and surviving in this climate is not for the faint of heart.

#WereAllMadHere

[dramatic-unicorn]

Imagine you had a grenade. At random times, under certain conditions, the bomb explodes, blowing your hands to pieces. Some times it happens back to back decimating pieces of you, other times there's a bit of a break; often long enough so that you almost heal, significantly scarred, but functional. This goes on for years. Finally, you get rid of the toxic bomb. Your fragmented being slowly returns to a somewhat flawed version of its natural state. Although, the unstable bomb is theoretically no longer an issue, there are other bombs scattered here and there throughout your life. It's been a long long time since any kind of explosion tore you apart, but it doesn't matter. When you get to close to one, your heart rate increases. You feel like you can't quite catch your breath. You notice a tight sensation across your back from the muscles preparing to defend or run. This is fight or flight, and no matter how faded your scars become you may always have this reaction to the object or the circumstances that worked so hard to destroy you.

Intoxicated people make me nervous. I often think how fun it would be to be one of those people who can go out for drinks and enjoy my self, but being in a bar feels like being in a room full of bombs. I very rarely drink to a "tipsy" state of mind, because I'm terrified to give up any control over myself while someone near me is drinking. How will I protect my self? And on the rare occasions I do find my self in a place where I feel safe enough to let that guard down I wake up wondering why in the hell I thought that was a good idea.

You're probably wondering who cares, and why I'm telling you all this. I have a huge interest in behavior, Nature vs. Nurture, Physiological responses to psychological trauma, especially in regards to myself. I'm interested in the science behind why my resting heart rate goes from 54 to 75 when I'm in the company of someone who has been drinking. Why it shoots to the low 100s if they touch me or ask me a question. Analyzing my own behavior tends to redirect my anxiety in times of stress. So does writing. Sometimes those two coping mechanisms blend and you find your self missing 5 minutes of your life you lost reading the ramblings of a Dramatic Unicorn.

[dramatic-unicorn]

Walking into the hospital is basically walking in to a new adventure every day. A new challenge.  A new learning experience.  I scan my badge to unlock the door of my comfort zone, and then I step through it. My natural state is to avoid change at all costs; To dwell in an environment I can navigate through muscle memory alone. I've learned over the last couple years, however, that this place of comfort and repetition is where burnout lives. While the introverted and severely empathetic part of my mind loves to be wrapped in the comfort of knowing what to expect and how to deal with it, what's left of my personality longs for challenge and new experiences. I have a visceral need to grow, even while every part of my psyche fights it. Critical care can be a difficult environment for an empath. It's a world of strong emotion and high stakes. Life altering decisions, and constant noise. I find my self coming home depleted, and requiring an empty quiet space to recover. I'm so blessed to have a family who so willingly shares me with my career, because I do not pretend to deny that some days my patients get the best of me and my family gets what's left. At the end of the day when I swipe my badge to clock out and open the stairwell door,  I do it stronger.  Smarter.  More resilient. 

Growth is uncomfortable.  It's hard. It's down right painful at times, but there is no greater feeling than crashing through a barrier you've felt hovering over you and meeting the next barrier head on with your fear tucked tightly away. Present enough to keep you cautious, but boxed up and out of your way. Thousands of times through nursing school, I wondered if I chose the right carreer. I wondered how in the world I was going to survive in a climate of constant change and instability. Looking back on the last 4 years through an objective perspective, I see that I've survived by taking it one day, one hour, one life saving decision at a time. I can't look too far ahead, I have to look at right now. Today I looked up through the dust and debris, through the cracked hands and bruised hearts and notice I've been surviving, even thriving in this world I was sure I couldn't navigate, and not only that, but I've loved every torturous minute of it.

[dramatic-unicorn]

Nursing is like having a front row seat for the raw uncut version of life with no protective glass between you and the body fluid or other projectiles. It's being 3 knuckles deep in someone's butt trying to relieve some pressure from a 7 week (7 freaking weeks) impaction. It's driving home so fast you forget to pay your babysitter because all you can think of is that shower you're about to take. It's stepping out of the shower red as a stop sign from the heat feeling like you'll never be clean again.

Nursing is coming in on day 1/4 and listening to multiple doctors tell the wife that her husband won't be coming off the ventilator. Its standing by for support while she chooses comfort care, and continuing to support her when she changes her mind... Its extubating (taking off the ventilator) her husband on day 3/4, and, instead of calling her to let her know, making her a sign that says "SUPRISE!!!" so she will see it when she walks in and finds him doing well. Its feeling the excitement on the unit when everyone sees her coming. Its the goosebumps that don't go away when she bursts into the happiest tears you've ever seen when she finds him alive and well. It's that feeling in your chest when she hugs you and tells you she's keeping your silly sign forever.

It's taking care of the prostitute or drug dealer or drug addict or homeless person and breaking your back to take the best care of them even though society doesn't care if they die, but you do, and you want them to LIVE. Its the every 2 hour turns and oral care and the bazillion meds and orders for the guy that shot himself in front of his kids. Its the balancing of his family, because due to covid not everyone gets to say good bye. It's being so freaking mad at him for hurting his family and babies, but still being gentle because everyone deserves to die with dignity, and maybe, if you do your job just right, you may be able to save some other lives with his terrible decision.

Nursing is sitting with a teenager while they try to decide whether or not to withdraw care from their Mom who is slowly (but surely) dying from the complications of CoViD. Its doing everything you can to keep her alive while her soul is trying to sneak out everytime you turn your back.

Its the car wrecks on the icy drive to Grandma's house to help her with her medicine, its the unsuccessful suicides when the pressure was just too much. Its the trip over your favorite pet and hitting your head on blood thinners making it unsafe for you to live alone, its finding your spouse of 32 years in bed without a pulse, starting CPR, and walking out of the hospital with them alive and well 1 week later. Its the pain, the happiness, the hard conversations. The hope, the devastation, the uncertainty. Its terrible and wonderful and painful and amazing. There isn't anything to adequately describe it. A coworker today said "that's why we have friendships that no one understands as nurses", and that hit me in a real way. I could write all night and still not do it justice. One thing I do know: Nursing was the best decision I ever made.

#NurseTiredNurseStrong

[dramatic-unicorn]

     Starting a journal feels comparable to jumping off a cliff. You hear all the time how writing can help you mentally,  how it can relieve stress and hinder anxiety. You hear how writing your thoughts out can release pressure on your mind, but when you're staring at a blank piece of paper its harder than you thought to take that step off the cliff and take those private thoughts out of your head and lay them on the canvas. Yes, those thoughts may be troubling to you, but they're yours.  Why do we often connect so deeply with our demons? We fight them, we struggle, we turn away, yet making moves to free our selves from them seems infinitely harder than continuing the dance. So we keep them. Compacted as neatly as we can keep them, shoved in to any available spaces in our hearts and minds and we choreograph our lives around them,  stepping over them and living in their clutter. 

     Today I'm going to start trying to learn to declutter my mind and heart. To empty my personal space each day of the thoughts that seem to build up and make navigation in this world so much heavier than it should be. We'll see how it goes.