Out of the Mouths of.... Patients

This will be a short and sweet post.  It doesn't need to be long.  Sometimes patients are pretty smart.  And sometimes patients are tired of getting woken up repeatedly, especially when the necessity of it is beyond their understanding.
One patient recently kept asking me to leave him alone so he could sleep (in a tired, whiny, but sweet way -- you know, the way that makes you feel sorry for him
).  It gets exhausting when labs must be drawn every hour, not long after drifting off to sleep.  In this patient's effort to convince me to just let him sleep, he imparted this piece of wisdom...

"But sleep is the most important thing for getting better!"

Ah yes, little buddy.  Preach it.  You might just be sermonizing right in the face of the [night shift] choir, but PREACH IT.

A Word on Worry-Screens [or, Permission to Be Parents]

Lately it seems I've been taking care of patients with very vigilant families.  This is a good thing.  I am always happier as a nurse to have families that care about their children and are involved in their health care.  The flip side of that is usually cause for heartache and sadness.
Yep.  Involved families are a good thing.  Loving, involved families are even better!  I have learned in a few years of caring for other people's kids that, no matter how smart I may be, parents know their kids better than I do.  I always try to make sure that parents understand that I know this - that I believe this - and that I will believe them when they tell me something doesn't seem right.
This beast called the Pediatric Intensive Care Unit takes involved families and drives them batty.  Yep, batty.  I don't blame them in the least.  We do it to them.  We hook their kids up to a big, shiny monitor with flashy colors, blinking lights, and some noisy alarms thrown in to wake them from a dead sleep in a panic just for good measure.  We even go so far as to explain the basics of "normal" values that we look for - all in the name of "family-centered care" and with the thought in our minds that maybe we will set their hearts at ease by making them more familiar with the surroundings.  The trouble comes when folks get focused on numbers and forget to look at their kid.  Usually our monitors are quite necessary, but, parents of hospitalized children, let me set your jumpy hearts at ease for a minute...

[monitors are a means of gathering information for doctors and nurses].

Yep.  That's it.  They're not meant to be worry-inducing screens designed to suck you in to their never-ending play-by-play and draw you away from your child's bedside.  Please, just watch your child.  It's my job to keep my eye closely on that worry-screen so you don't have to.  We use monitors to gather information.  We also use YOU to gather information about your child -- but when you are focused on the monitor and reporting the numbers to me that I am already spending my hours watching, you simply give me the same data twice.  I know the ins and outs of those worry-screens better than you do, as I should.  I know why they alarm, and I know when those alarms are serious and require immediate attention.  But you know the ins and outs of your child better than I do, as you should.  And if you are watching the numbers on the monitor more closely than you are watching your child, you cannot offer me the intimate knowledge of your own child that I can only get from you. And while I promise to listen to your intuition about your child, I ask you to listen to my intuition as a nurse.  All nurses have it.  We have those moments, quite often before the numbers on the monitor start looking funny, that we simply know things aren't right.
[And, hear this, we have many more moments where the numbers on the monitor start looking a little funny, but we know everything is alright, because nursing involves such a much bigger picture than just numbers on a monitor.]
Those numbers are just one piece in a puzzle that often fits together a little differently with each passing hour.  Every time I come in to assess your child, I am piecing the puzzle together all over again, seeing where those pesky numbers and beeping alarms fit in with your child's "bigger picture".  Sometimes they're significant, sometimes they're not.  I'm not placating you when I disregard an alarm and tell you that it's ok.  I promise.  I like to be honest.  If things do take a turn for the worse, honesty prior to that moment sets us all up to deal with it together.

I can never love your child the way you do, parents of hospitalized kids.  I won't say something like, "Trust me, I care about your kid too."  That just sounds trite.  I understand that sometimes the very rise and fall of your breath depends on what is happening to your child with each passing second.  I do not have that level of emotion when it comes to your child.  If I did, I would be rendered quite ineffective in an emergency.  What I do have is a deep love of caring for kids and their families.  I have a conviction to be honest with you.  I am vigilant as a nurse, so that you can be released to be vigilant as a parent.  I will keep my brain engaged for your child.  I will strive for comfort, for healing.  I will fight for your child all night long.  I will even fight for the things you wouldn't know to fight for.  I often fight for your children, parents of hospitalized kids, and you never know it.  Sometimes you even sleep right through it, which I count as a victory, because you have often been up for even more hours than me.  I count that as yet another way that I have cared for your child - parents that have been able to sleep just a little bit are much better equipped to be involved in important decisions, to comprehend complicated explanations, and are more able to be a calming presence in stressful moments.

A couple more small pieces of insight...
1) Please, stay off of Google.  It's just scary, and reality is often scary enough.  Most doctors and nurses are happy to talk.  Ask questions! :)
2) Don't let awful news stories about medical professionals screwing up or being mean cloud your view of all of us.  Remember that for every news story about a bad nurse or doctor, there are many more of us who truly care, are honest, and are as safe as a human can be.  Just as the few nasty criminals [hopefully] don't cloud your view of every person you meet, don't let those news stories set you up for a distrusting, uncomfortable relationship with those of us who care and are working with you to care for your child.

All this to say, don't try to be your child's parent AND nurse.  You'll implode.  I offer my vigilance to you as a gift.  Please accept it, and go back to hugging your kid.  That darn monitor is going to beep either way, and I promise to stay up and worry about it for you.

See With GiGi Eyes

Today we all went to my grandma's to visit.  We call her "GiGi" now since she has graduated to great-grandmotherhood.  I tend to stumble over that title, since I had my own GiGi for the first half of my life.  It's a little weird to have my grandma bumped up a generation in the line-up.  I guess it's the same kind of "weird" as those moments when I realize all over again that I'm a parent.  Anyway, back to our visit...
My grandma's house isn't particularly child-proofed.  My oldest just turned two precisely 2 weeks ago.  Bad combination.  He's a good kid, but seriously, how much can I ask of a barely 2-year-old?  There are little kitty figurines that elicit a constant squeaky "yeow? yeow?" from him.  There's a real kitty who spends much of our visits running away and hiding (I wonder why?).  There's the super-cool step stool in the kitchen that's (handily) just small enough for him to pull around behind him and (not-so-handily) just big enough for him to crash it into walls and cupboards (and the occasional shin).  GiGi's cane is hanging from the kitchen counter and ends up in his hand, flailing at counter-level.  And GiGi keeps a tablecloth and placemats on her table.  Oh my.
Need I explain to you how much of the visit we seem to be piping up,
"Don't touch that!"
"Please leave that alone!"
"We don't chase the kitty!"
"STOP! You're getting peanut butter all over the tablecloth!"
"CAREFUL!"
Yeah.  It's ridiculous.  And my grandma... sweet thing that she is, she just smiles a little and says, "Oh, it's okay. Really. He can't hurt it.  It's washable."  Etc, etc, etc...
Here's where I sometimes wish I could see with GiGi eyes.  Sometimes things aren't important.  When your little person is simply acting like a little person and exploring his world, sometimes an inanimate casualty or two is just not that big of a deal.
There are so many reasons God designed families.  One tiny little reason is so we can share eyeballs.  My grandma might be really short, but she can see farther than me pretty much all the time. :)

My Little Monkey-Footer

I love photos.  I love how they can capture a tiny moment forever.  My life has been full of tiny moments for the last few months.  I am thankful to still be on maternity leave, spending every day with my munchkins.  I have a bit more time to capture those tiny moments with my ever-handy phone.  Today it was J in his monkey-foot jammies.  They're my favorite. One glance and R starts up his funny little monkey noises that come out as "Eeee-eeee-ee!" instead of the proper "Oooh-oooh-oo!" that his dad taught him.

                                              Relish your tiny things. :)

Sometimes Death Gets Personal

I work in the field of pediatric intensive care.  No, not neonatal intensive care where they take care of preemies.  Pediatric intensive care, where kids fall into the category of "pediatric" from the day they are born until they are 18 (and sometimes even older).  This means that I care for a widely diverse population with problems ranging from minor to life-threatening.  We do trauma, we do illness, we do surgery, we do those horrible child abuse cases where out-of-control grown-ups shake tiny babies until they die. Yes.  Die.  We see kids die far more often than I care to admit.  I've had my share of joining parents and families at those very intimate moments at the end of a life.  We really do see the best and the worst of people in our profession.  And even though it may sounds callous, I've somehow come to a place of accepting the frequent presence of death around me.  Not to say that the tears and emotions don't well up when I hear a mother cry for her child.  I hope I never get used to that.  I want my heart to stay soft somehow - I want to let Jesus work through my heart because He is strong enough to comfort others and walk them through grief when my own heart would have to form a thick, hard shell to be able to do it myself time after time.  And in my struggle to find this balance, suddenly death reached right into my life.  From the vantage point of almost a year later, I can see that this is one BIG tool the Lord has used to keep my heart soft.  When you have walked the same walk and you really KNOW what "it" feels like, you are much better equipped to care for others.  I am thankful for that.
So, the story.  Last year, death got more personal and reared its ugly head in my own living room.  My own mother had been re-diagnosed with breast cancer after having kicked it a few years back.  This time it had spread and her doctor had run out of treatment options.  When he finally suggested calling hospice, she asked to move into our home to live out her days.  We said yes, of course, and began shuffling around our home to make room for her and my teenage sister.  Our toddler's crib ended up in our closet, and a hospital bed soon moved into our living room. I even took a leave of absence from work to pick up the extra burden (read: privilege) of caring for my mom, who quickly deteriorated physically to a very dependent state.
I can't even begin to relate the gratitude I have for the many family and friends who supported us during that time.  We had financial support, errand-runners, shoulders to cry on, a motor home parked in our driveway to offer extra sleeping and living space, and more food brought over than we knew what to do with. We even had dear friends who came over repeatedly to join us around the piano singing hymns just for fun.  My mom sure loved that.  Even after she could no longer offer her own requests verbally, we did it anyway, because she loved it.  It reminds me how important presence can be in the emotionally unbelievable, surreal moments of life.  It's hard to step into those super-intimate moments in a person's life where they really need someone, but you don't necessarily have to talk.  Sometimes (most times) presence is more than enough to soothe a tired, weary, burned-out, saddened heart.
Anyway, yesterday was Mother's Day.  It was the first Mother's Day since my own mom went home to Jesus.  I now have two boys of my own.  This is J's first Mother's Day.  He has no idea what's going on and just grins at me with that adorable chubby, toothless face when the tears start to roll.  Only a couple people during the day had even mentioned my mom.  I know people don't know what to say, and I can't blame them.  It's a tough subject.  Lots of people probably think that by bringing it up they're going to make me sad.  Here's the thing: I am thinking of her whether anyone else mentions her or not.  It reaches into my own grief and touches my soul when someone joins me in remembering her.  It reminds me that she is not forgotten by the rest of the world. There is comfort in that, even if talking about her leads to a few tears. These are the moments when presence + words = a little comfort.  Anyway, here's what I wrote in therapeutic fervor last night, after managing to make it through Mother's Day without breaking down, in my sudden need to do a lot of remembering all at once.

"Today, I miss my mom. Not many have thought or dared to mention her today. But the thoughts of her absence are a near-constant ache and a barely held-back tear today (now considerably less held-back). I think of our sweet little Jack, who she knew of but never met. I think of how she would have soaked up all his little smiles and coos like so many shining rays of sun! I think about how many words Roy is saying now and how cute each one sounds coming out of his mouth - intelligible now, but just not quite right in that adorable not-quite-rightness that only a toddler can manage. I think about those less-than-stellar moments when I lose it and how she would have just stayed quiet and let me lose it, all the while working to make it better by cleaning up my clutter or entertaining a baby or joining me at Starbucks to sit for a while. I miss having "Once Upon a Time" parties in our living room, eating ice cream and kettle corn. I miss her kettle corn that she made in her Whirly-Pop on my stove because she knew I loved it. I miss her knack for burning things and then saying that she liked them burned. I miss pump-wumps with too many chocolate chips, because that's how many you're supposed to put in.  I miss her weird addiction to Taco Bell hot sauce.  I miss the sound of her voice. I miss how she'd always sign cards and notes with "YMLY" followed by a couple hearts for good measure. I really miss watching her enjoy my own child. Man, how she loved that kid! I miss watching her enjoy my husband and hearing her say, yet again, how long she prayed for my husband long before any of us knew who he was. I miss watching her enjoy my goofy, giant dog - squishing her jowls and letting her sniff her face. I miss playing hymns for her by request. I miss rolling my eyes at her the way only an oldest child can roll their eyes at a parent. And as weird as it sounds, even to me, I miss that stupid hospital bed that sat next to my couch last year. Now in that space there sits a bassinet. Its contents are certainly cuter, I suppose, but no less beautiful, than my mother so close to her home-going. 
Don't get me wrong. I don't want her back. I would never wish a return to this earth on anyone who has tasted the glory of Heaven and the presence of our Father. And I really can't wait until we all get to join her. That's gonna be one big, stinkin' party! I don't miss my mom without Hope for the future. I know I'll see her again, thanks to a Savior who loves us ABSOLUTELY beyond measure. But for today, sitting here still on this earth, I miss my mom."

Anyway, here it is for some sort of safekeeping, I guess. I don't really care if anyone else reads this stuff.  It's my own way of working through life and work - death, life, and everything in between.  Why does writing help with processing?  I don't know.  Another one of those gifts that God gives us.  He is always good.  I wish more people knew that.  I wish more people had eyes to see that.  The thing is, it's the "bad" things that have the potential to open our eyes if we'll let them.  Bad things happen to everyone.  God is good.  You just have to open your eyes.