Wednesday, November 25, 2009

I can do all things through Christ which strengthens me. Philipians 4:13

As noted earlier I am a sensitive person and being in nursing school has brought that side out in me even more! I had the opportunity to be touched by something inspiring and heart warming in class again yesterdy. My teacher was talking about caregivers and their roles. She explained how taxing it could be and difficult it is since it is a 24 hr job expressed with constant love. It was pretty disheartening at first especially since we had to discuss elder abuse as well! Then she commented on how rewarding it could be in our lives to truly care and love another person. This is what she shared in her slide and the clip she showed:

A son asked his father, 'Dad, will you take part in a marathon with me?'  The father who, despite having a heart condition, says 'Yes'.  They went on to complete the marathon together.

  Father and son went on to join other marathons, the father always saying 'Yes' to his son's request of going through the race together.  One day, the son asked his father, 'Dad, let's join the Ironman together.‘
To which, his father said 'Yes.'
For those who didn't know, Ironman is the toughest triathlon ever.  The race encompasses three endurance events of a 2.4 mile (3.86 kilometer) ocean swim, followed by a 112 mile (180.2 kilometer) bike ride, and ending with a 26.2 mile (42.195 kilometer) marathon along the coast of the Big Island Father and son went on to complete the race together. 
This explains their story a little bit more, another great clip too:

The human touch...

Life is like a box of chocolates.

Today I had the opportunity to listen to an amazing woman speak about her time as a caregiver to both her husband and son. Her husband died eleven years ago of Alzheimer’s and her son after being a hemiplegic passed away five years ago. These tragedies have been seen as blessings in disguise as she described her experience as a caregiver. In reading her book I say the undeniable patience, compassion, and gratitude she has in her life. She always seemed to know exactly how to care for her husband although she compared herself to a duck who is really paddling like crazy underneath the surface of an unruffled appearance. She would not get offended by the things her husband would say to her because she was able to separate the person she once knew from his disease. She had such courage to face this crippling disease alone in her marriage and quite frequently people would not believe her that there was anything wrong with her husband. She had some much love for him that she was willing to care for him no matter what and would always put herself in his shoes, how she would want to be treated. She had courage to let him have some autonomy and to let others help her. She was giving of herself 24 hours a day at home but would still have loved to give for others in her service. She saw so many things as blessings in her life and frequently referred back to how they had a wonderful marriage for thirty-four years. She was always thankful for those small moments when he would come back to himself and tell her he loved her. How hard it must have been for her to continually be faced with this trial everyday and when they were still both so young.  It was in this critical time that she had to prepare him, her and everyone else for the day when he would “graduate” from this life having accomplished his mission, which she really had to rely on her beliefs. Not only rely on them but really believe in them and know that there was hope beyond this existence. There are so many wonderful things I could say about this woman and her experience but if you want to experience it for yourself go and read her book! It is much like a published blog where she wrote her feelings and experiences of living with “Big Al” It is inspiring in many ways and has lots of uplifting quotes.
What touched me most about her experience was not in what she was saying but how I felt when she was there. She truly has compassion for each person, even strangers and knows the value of each person as a child of God. She played two songs at the end of her speaking to us while she went around and rubbed lotion on our hands. It reminded me of the Savior and how he went around washing the disciple’s feet. It was not only a sign of humility but compassion to reach out and really comfort someone with a simple human touch. I was crying before she even got to me but as she rubbed lotion on my hands I wanted to tell her how thankful I was for her in creating and sharing a wonderful experience with us. I could not utter a word but I think she could tell how I felt as looked me in the eyes and smiled without needing to say anything I could feel her love for me.
I am reminded by this experience to treasure and value what is really important in life, humanity. It is something that connects us all even though we may seem as strangers. We are all really seeking the healer’s touch that is so often found in each other.  We can care and love for each other and we must!  We need one another. There is so much good to be found in serving and allowing others to help us as well. I challenge all of us to reach out to someone today and every day. Call someone you care about that you have not spoken to in a while. Make amends for life is too short to waste time holding a grudge to be right when there could be so much peace.

Sick and ye visited me...

This week I felt that I did not practice empathy as much as I did the previous week taking care of my patient. Last week my patient was suffering from C-diff, which meant constant diarrhea. I realized that it must have been embarrassing and frustrating to have this condition. I told him I was sorry that he had to go through this and that I was there to help him. We talked bout how having diarrhea was not a fun experience and how we could make it through it in the best way possible. I also had two other experiences of practicing empathy this week.

       In practicing empathy I realized that it was mostly recognizing how the person was feeling, listening to them and validating back to them how they were feeling. There were times when it was appropriate to interject my own feelings but mostly it was about listening. I definitely feel that this builds a trusting relationship. In working with my patient he was very cooperative and was not afraid to ask for help when he needed it. I think empathy truly shows the patient that you are there with them in this experience and not just merely on the sidelines just taking care of the objective parts of their diagnoses and not the whole person.
           I hope to take the time and see where people are coming from and how that affects their struggles with their diagnoses. Everyone is different and their experiences are varied, how one person reacts to treatment may be very different from another. It is important to recognize this because some patients may need more human interaction than anything else. I think it also helps put into perspective what you are doing for this patient. For me it was dealing with stinky diarrhea but it really did not bother me as I thought about how I would feel in the situation. I would not want to be going through this and I definitely would not want to be sitting in it either even for a minute! I was also reminded that morning of the Savior and how we should be looking for him in our patients. I feel that this is a different level of empathy in seeing how the Savior would see this person and how when we take care of these people we are really caring for the Savior, " Naked, and ye clothed me: I was sick, and ye visited me: I was in prison, and ye came unto me.Then shall the righteous answer him, saying, Lord, when saw we thee an hungered, and fed thee? or thirsty, and gave thee drink? When saw we thee a stranger, and took thee in? or naked, and clothed thee
Or when saw we thee sick, or in prison, and came unto thee? And the King shall answer and say unto them, Verily I say unto you, Inasmuch as ye have done it unto one of the least of these my brethern ye have done it unto me" (Matt 25 38-40).

What Stop Signs, X-rays, and achieving the impossible all really mean.

Well this week had some highlights that affected my way of thinking as a nurse. First of all one should always obey the rules and laws even when it seems inconvenient. I learned this as I was pulled over by a policeman on the way to clinical at 5:30AM for running a stop sign. I felt embarrassed and guilty when this happened and did not particular enjoy feeling that way. I applied this to nursing in the ways we follow all of the six rights. It is important to have follow through on these because you never know when you might mess up and get caught with unpleasant consequences for your patient and you. Thankfully the car full of girls I was carpooling with made this event a memorable one we can all laugh about together. The policeman also knew to chose his battles wisely when giving out tickets to nursing students and let me off with a warning. (Which still took me forever to resolve!) Secondly I learned what it felt like to learn some upsetting health news and dealing with the procedures that might follow. I tested positive for TB and had to have a chest X-ray, my first ever! I was frustrated that this was happening and felt uncomfortable as I donned a gown for the procedure. This helped me remember how a patient can feel uncomfortable lying there exposed to us during their care.

I thoroughly enjoyed Jay's presentation and was amazed by all of her accomplishments despite her disability. As she was talking I began to think about what really defines a disability because for Jay it almost seemed like her disability was only visible aspect of her while her will made up for any physical thing she lacked. I was just amazed at how she persevered through all of her trials. Here I was thinking how hard life was for me as I contemplated the tests, assignments, relationships, work, and other responsibilities I had, feeling completely inadequate. Jay however was up at the front of the room teaching us and telling us of her ability to accomplish a masters degree. I felt as if I really was the disabled one! I could not see the inner strength in myself as she did, nor realize my potential. I became to understand that the only really disability people have is lack of motivation, confidence, and belief in the impossible to be done. There may be physical limitations upon us but the only thing that really limits us is our will power to do something.
       This made me realize that I could do so much more with my life and witness the blessings of good health more. It made me see the potential in not only myself but in others around us. In nursing we tend to be helping others who cannot help themselves. This is a wonderful concept and should still be implemented but are we doing too much? I have come to realize that in clinicals I am often waiting on my patient hand and foot and not encouraging their independence. In future care I want to reasonably believe in people's capabilities and encourage a belief in themselves. I have come to realize that this is what nursing is to help people really heal. Just as we need the atonement to be forgiven we also need it to be healed. I should be helping people accomplish the highest quality of health possible in all aspects so that they too may get their master degrees and contribute to the world with their own capabilities. It should be a focus on what we can do not necessarily everything we cannot do. I feel that this was the message Jay was giving us that we can do things and people with disabilities are children of God also sent here with a purpose and can contribute to a meaningful life.

Hugs and kisses

In clinical this past week I may not have expressed feelings of warmth but I know they were shown unto me. As I entered my patient's room to check in on her she greeted me warmly and opened her arms to a hug and a kiss on the cheek. I was hesitant at first having known that her breathe was anything but pleasant first thing in the morning but I let go of my inhibitions and embraced her as well. This was a positive way to start the day and I remembered how important a simple human touch can be. In interacting with one of the nurses this week I received warmth and respect from her. When I came fully prepared to address an issue with her I had confidence in myself and discernment. In return she responded to me with respect and understanding. I noticed that she valued my input by looking me in the eye, taking the time to talk to me and giving me directions as what to do next. I felt that she trusted me with the action given me to do for my patient. I also had to receive some criticism this past week on some of my actions which was disheartening because I really was trying to do the right thing. I had to learn to accept the criticism gracefully and respect the person who gave it to me because I know it benefits me in the long run.
It is important to let go of our inhibitions we hold sometimes in ourselves. We can be a germ-phobic and should wear gloves at appropriate times but sometimes we have to let down the nursing barrier and just be there for our patients. They need to know that we can laugh with them and spend time getting to know them, not just what their chart says. They need to know that even though we feel a sense of urgency our tone does not reflect it. I found this to be a challenge in trying to get everything done but in remaining calm and mostly confident in my skills I was able to create a sense of warmth.

In future practice it is important to take the time and be with your patient. You may feel rushed or tired but be there when you are there. Your encounters with your patient will be brief and you only get that once chance in aiding them to heal. You have to let your guard down and not hide behind barriers especially if you are feeling insecure. You must be confident or else they will see right through you and not trust you in your care for them. It is important to remember that everyone is on the same team in trying to help the patients and each other. Criticism should be accepted in a non-offensive manner, learn from your mistakes. It is often through criticism that the most important lessons learned will forever be remembered.

Wit from Whit

Our class had to watch this amazing film called "Wit". It is amazing, inspiring, and gives an inside look into what a patient often goes through while dealing with a certain illness in the hospital. I highly suggest you watch it but make sure to watch it with a box of tissues. I swear I have been brought to tears in more of my nursing classes than I ever have before in school! Here is what I learned from watching it:

As I watched the movie wit I was unprepared to say the least as to what the film was truly about and how it would affect me. It truly has affected me and the way I hope to act within my capacity of health care.  In the first interaction in the film with Dr. Kelekian and Vivian I learned that it is important to really inform the patient of all possible treatments not just the one you want them to have. This is also important because sometimes a patient may not even know what questions they should be asking, giving all the information necessary can help them think it over and evaluate it for themselves.  One should also not assume that because the exterior seems tough that they are, they really may not be especially if they are going at it alone as she was.  That is what made me think more about the title of the film and what it meant. Usually wit is used in unsuspecting ways and it is a type of intellectual humor. Meaning that one has to dig deep beneath the disguise of words to what is really being said. I felt that in this film her wit is what kept it light at times despite her situation but underneath it all was really her screaming out for help. 
The young Doctor in this film drove me insane and I wished at times that I could jump in to stop him! Unfortunately there were characteristics in him that I saw in myself as well. He did not seem confident or calm in his assessments, and he did not really listen to the patient. He was only seeking for answers he wanted to hear and that could be useful to his research. I learned from watching him that I need to be aware of the tendency to just treat the body and not the patient as a whole entity.  I learned that is important to be confident in your practice, remember you are treating a patient not just a disease, and make them your number one priority. I have also learned that even though we have not experienced what our patient might be going through and taking care of them is our job, to remember that this is their life they are living everyday even when we are not there.
I was so grateful for the nurse Suzie and her compassionate nature in contrast with the pride of the others in the film. She really was the patient’s advocate and made sure she was well informed. I enjoyed how she was able to laugh at her mistakes and be a true caregiver to Vivian mostly by listening.  This laughter, human touch, and listening ear were vital to her care because she was not only undergoing chemotherapy but also life therapy. Vivian had a lot of time to think and come to the realization that under it all it was humanity that matter and kindness that made the difference or meaning in life.  I know that from watching this film I learned the importance of that fact and how precious life is, each should be treated with the utmost care.

Mounds of confidence or atleast muffins

This post is of a past Journal entry from one of my nursing classes documenting my time at the nursing home. This one in particular is about introducing oneself to staff and patients. (Just for clarity these will be in the What? So what? Now what? format we have to do for class).

As I prepared for my first day of clinical feelings of excitement and anxiety surged through me. I needed an outlet to calm myself down and also somehow start memorizing the “I have confidence” song sung in “The Sound of Music” in a needed time for courage. In failing to find a copy of the film I opted for a more service oriented option, making muffins for the girls I would pick up in the morning for clinical. As I mixed in the required amounts of ingredients I mulled over some of the things I needed to remember for the next day, putting the stethoscope in the right way, check; ironed scrubs that hopefully no one will pull on because I am too short to find ones that actually fit, check; hand sanitizer because when all else fails I still know how to preform proper hand hygiene, check! How was I going to tackle my biggest fear of really interacting with the patients and staff? Remembering what I learned in communications lab, one check for priceless! I knew that just like the muffins I was making blending together just the right amount of politeness, professionalism, humor, and the skills I learned was going to either create a masterpiece of delicious blueberry muffins, I mean a positive experience in communicating with others, or a flat affect of meaningless words( or bland muffins). I reviewed in my head how to introduce myself to those I was reporting to versus those I would be taking care of the next day.
My first introduction of the day was to my CNA C. It did not quite go as planned, my name was called out as to whom I would be working with and I followed her with my buddy to the first patient's room. It was through out the rest of the day that we got to know each other but I felt from the get go she was just ready to get things done and move on with her day. She often went ahead with her normal routine without introducing us, which was good because then at least I could practice my skills with the patients I interacted with during care. I found that talking to the patient's about normal things helped them feel at ease and comfortable with the care we were giving them. I saw how C interacted with her patients and how she really knew them. She would joke around with them and know what to say to help them understand and cooperate. I was able to introduce myself to lots of patients some were very welcoming while others made little or no response. Most of the time the only thing I could get out was my name and that we would be helping them that day. Beyond that there usually was either no understanding of what I was doing there or they would start in to how their granddaughter's name was Whittles! During lunch I was able to help a woman eat her food who all the while I was talking to her said nothing but would laugh every once in a while. I found that in my particular environment people were friendly and carefree about how they interacted with each other. It really felt like a home, in the sense that everyone felt welcome and had their place of contribution. It was difficult to tell who were the nurses and the CNAs because everyone treated each other as equals.
I learned that regardless of educational status each person's expertise should be respected and treated as a valuable addition to the overall team. Just like each ingredient despite its quantity is needed for the overall product of making muffins. It is important to make yourself known regardless of circumstance. You are not there just to provide skilled hands but comfort and assurance to those whom you care for in the clinical setting. I hope in my own practice I will remember to introduce those students or aides which might be working with me to the patients. It was good practice for me to speak to the woman the whole time who would not respond because I feel that it helped remind me that regardless of the patient's circumstance they should always be informed. Just like no matter how many times I have made a Betty Crocker's muffin mix I still need the information of correct ingredients to make the desired product.

In the end the muffins were delicious and clinical was a success. I hope I will become more familiar with the facility, patients, and staff as I continue to introduce myself.