Today is the Day

Well, I finally made it to Hawaii. for those who don’t follow me on facebook or twitter, I am on the cusp of huge changes. I am getting married today.

It’s funny..as I wake up today I think about, what makes today different from any other day? We have been together almost 6 years. Why should doing this make any difference? Yet it does. There is something about getting married, an added layer of legitimacy to the relationship, a validation of sorts. Part of me is so excited for this, to have this moment in time where I can say beyond a doubt that this is the person I choose to be with, let no one come between us. And yet, there is part of me that is scared to death. I was married once before, for about 5 minutes it seems like. the divorce process took longer than the marriage lasted. I had no interest in ever getting married again. I was badly hurt, and it seemed to me to be the ultimate lie. I never thought I would ever meet someone that I wanted to do that with ever again. I realized 2 nights ago when we landed and I was feeling so anxious what that was. I have no doubt that I love this man, and he loves me. Yes we have had hard times, and ups and downs. Things are never perfect. But I am human, and I am scared of being hurt. I do not ever want to suffer like I once did, to feel your world crumble beneath you as the person you gave your heart to crushes it and throws it back in your face.

The avoidance of pain is one of the strongest instincts a human can have. But what happens when that instinct becomes the driving force in your life? What opportunities get missed because one is afraid of being hurt? Of making the wrong choice? Ultimately, I do not have any regrets. When I think back on my life, good and bad, it has made me who I am today and that is a pretty awesome person. I have the fortitude and determination to tackle anything in life that comes my way. I have a compassion born from having suffered, an ability to connect with humans by placing myself in their shoes. I have a passion for life that can only come from almost losing it. And I have a capacity to love that is infinite.

These experiences in my life have shaped me, have molded me, have given me so much. I do not have to let fear and anxiety rule me, but can instead choose the path of acceptance and hope. For me, that is the ultimate power of leading a life not run on fear but on love. Today is the ultimate manifestation of that trust in the universe, taking the next step on the amazing journey of mine. To all of those who have impacted my life, I thank you. And to those of you that I have not yet met, look out here I come!

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I Am A Work In Progress

Cultivating inner discipline is something that takes time; expecting rapid results is simply a sign of impatience. ~ The 14th Dalai Lama

This morning for a moment, I found myself repeating negative old behavior. I have recently embarked on a spiritual, emotional and physical transformation. It has been going remarkably well, however at times I do find myself slipping momentarily back into negative ways of thinking. While in the midst of pondering psycho behavior, I read the above tweet. It was exactly what I needed to hear. I have a choice, always, to engage in negative, self-destructive behavior, or I can stop. I know this, but become frustrated that I still feel my moments of craziness. Reading this reminded me that I am a work in progress. It is unrealistic of me to expect perfection, or to expect my mind/body/soul to be perfectly balanced and perfectly disciplined at all times. It is a transformation…which implies process, not achievement. I am in the process of changing my ways of being, reminding myself to approach life from a place of positivity. The very cool new thing though, is that I can see these choices, in a clear way. I can see examples on a moment by moment basis, options and opportunities for choice and growth. I can see the chance in front of me to become crazy psycho drama Sarah, or choose differently. It is becoming easier and easier to choose a different path, as opposed to the same crap as always. This to me is a gift, something that I had forgotten was possible. I am so happy and grateful that I have this chance to become different today. that I can be in touch with the real me, open to possibilities, open to love, open to peace and harmony in my life. That I can embrace that which used to scare me, and experience life to its fullest. This is what it means to truly be human, to live in the moment accepting the gift of life in its entirety. I can be free of craving, free of ownership and possession, free of jealousy and hate. I can let go of that which diminishes me, and embrace that which elevates me. Every day I can make this choice…and know that it is possible to achieve. in time, with practice. I am living in a moment of grace, and can choose to expand those moments to encompass those around me. I can let go of control, which is an illusion anyways, and just BE. I am so excited to see where this journey takes me, because I know it is about that…the journey and not the destination. For the first time in my life I can truly say that with certainty, and that is a wonderful feeling.

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The Freedom of Travel Nursing

I was dozing last night, when I had a random odd thought- travel nursing has freed me from the constraint of myself. How often do we get in a mode of being that caters to others expectations of who and what we should be? We get this idea of what nursing is, we go to school, we model ourselves after someone we admire, we get feedback from our managers that we are not meeting expectations but how often do we really get to be our most authentic selves?

This thought process was inspired by a talk I had with someone recently. I have been blessed to have met so many interesting awesome amazing people on my journeys. From random foursquare postings that have brought great friendships into my life, to coworkers whom I can honestly call friends. I have been exposed to all these truly wonderful characters, full of quirks and complexities.  But what has been the most astounding is the discoveries I have made about myself. I have discovered that I am, in truth, a social person. I truly like people, and I enjoy talking with them. I am in fact, a happy person. I don’t have to be weighed down by my past, or my notions about myself. Which most of the time are based on old judgements and suppositions garnered from negative experiences. It is possible to let go, and step outside of yourself when you are not constrained by “what everyone thinks” or “how it has always been”. By being a new person in a new place, it allows the freedom and space to try out different aspects of myself, that maybe I would have been too afraid to try before. I am not worried about judgment or opinions when I am traveling. I can be the real authentic me in a way that is not possible when surrounded by people who have expectations based on how I have always been. I do not need to feel self conscious, because I can approach each experience new, without fear of reprisals or condemnation. What is the worst that can happen? Someone will spank me and take my birthday away? They don’t like me? They decide I am annoying beyond all reason? The reality is nobody can make me feel badly about me, except for me.  It is truly liberating to be able to approach each new interaction without fear of rejection or results. to just be in the moment, full of possibilities, aware of my power to shape my experiences for the better. Maybe its a mid-life crisis thing, maybe because I am turning 40- I don’t know. but I am going to go with it. This is fun!

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New Things

Well exciting…I have new hair and a new contract! I interviewed for the position in Edinburg. No problems. I have been forwarded an 8 week contract, I am approved for my 2 weeks off that I need for Hawaii, squee!! Everything seems to be falling into place. They want to start with 8 weeks to make sure I like it, and then extend if I want. works for me.  It has been interesting, because I realize that I am quite unusual. Travel nursing is all about flexibility. you have to be flexible and be willing to try different things- different shifts, different places, just be different.

I am not sure how I will navigate it- its an hour drive time according to my map on my phone. of course I am sure traffic could affect this too. I will have to figure out if I am going to go and stay when I am there and work my days or drive back and forth. I guess I will see what happens once I have my schedule. The first week is going to be a challenge, as I am still finishing up my contract at VRMC. I will end up having 3 days orientation at the new hospital in the daytime and 3-4 nights working VRMC that week. but it will all work out. I think this is going to  be great- I will be able to get the money together for my trip, have 2 weeks off in beautiful Hawaii- do overtime in a more constructive way and have some new experiences. I think some of my frustration level is working so many hours in the same location. its easier to do more hours per week with different jobs. it breaks up the frustration and issues because you are not having to deal with the same crap for days on end. I am hopeful I can get on a good groove at the new place- I really want to try 6 on 8 off. if I work Thurs- Tuesday, that will allow me a whole 8 days off to recover, and to work extra somewhere else if I want. its like having a mini vacation every other week. and I can pick up Friday and Sat. nights at VRMC if I want every other week too. that will be premium pay and make it very doable.

Now I just need to get my ducks in a row, update my TB test, get my drivers license and nursing license renewed soon. my eating has been very good- I have been consistently eating between 12-1500 calories per day for almost 2 weeks. I just need to get my exercise going more consistently. its really hard when I am working so much. I managed to stay away from the chocolate brought into work last night, which was a miracle in and of itself lol. I think I am going to take advantage of my time on call tonight, go for a walk, take a shower and clean the house a little, go to the grocery store. this will put me in good stead for tomorrow- I have a date with a friend to go see the avengers and go out for Japanese food yay! So lets see what happens. I feel so good about all the new possibilities in my life. 🙂

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Changes In The Air

Well, I had another day at work. I ended up working again with the nurse described in my last post. The day was ok. Crazy as usual. The only different thing was I tried again to discuss these issues and find resolution. I spoke with my managers, and we all had a meeting together. it was an exercise in futility. The interesting thing is, it doesn’t really matter. At this point, I do not care if he changes or not. That is on him. It did clearly illustrate some core values that I have in conflict with my managers. I do not care for their style of management, or lack thereof. The take home point was that I made the decision to move on. I will hopefully continue in a PRN capacity at this hospital, but it is time for a new assignment.

So I spoke with my agency and there is something opening up in Edinburg exactly when I need it to. Everything seems to be falling into place. I will be interviewing hopefully today for that. Orientation week will be challenging as I am working the last week of my contract here and need to start there, but I am confident I will work it out. I may not sleep, but I will work it out.

I also went and chopped more of my hair off. It is a little shorter than I wanted, but it looks cute. My hair though is almost a metaphor for my life right now- I needed to get rid of the dead ends, and it will grow back. It had become damaged and hard to manage, but I was afraid to let it go. No more. I absolutely will not live in any kind of fear. I am the one who has to live with my hair, and myself. I cannot have it to please others. It is mine and belongs to me, just as my life and profession does. My new path of eating is also going well. It has been hard to find anytime to exercise, as my work schedule has been completely insane, but at least the food is on the right track. my daily calorie count has been between 1200-1500 calories pretty consistently. I need to watch and keep up with my water intake. when we get super busy at work that tends to drop off and I notice a difference. I also need a new scale, mine is possessed or something and give me a different reading every time.

I guess though ultimately I am feeling like things are changing for the better. I feel like I have found the “secret” so to speak, at least for me. I must stay in the moment, positive, embracing all things, and loving myself. Taking that care that I give to others and applying it to myself. I deserve to be treated with respect and care, I deserve to be happy healthy and whole. Because I am awesome, and the only person who can deny me that is myself.

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Don’t Break My Zen

What an interesting week this has been. While I continue to be a nexus of possibilities, having all kinds of amazing experiences, it is fascinating to see what kind of response this elicits in people. The majority have been fabulous and supportive. Some have been inspired to start their own journey of self discovery. While yet others seem to make it their personal mission in life to pluck my very last nerve. Yesterday at work I had a uniquely challenging day. I was charge nurse, working with a very “special” nurse. While I am able to get along with him on a personal level, professionally he could infuriate Mother Theresa. This nurse always has issues with me when I am charge and he is not. It is silly really, as I am not one of those charge nurses that subscribes to the belief that somehow I am really in charge of anything. The truth is, we all hold licenses, we all are accountable, we are all employed, and we all had to pass a drug test to be there. As far as I am concerned, manage your own crap. It is not my job to chase you, or be a hall monitor. It simply means I give bed assignments, and fill out the charge report sheet. I am always a resource and a team player, so nothing in that changes by me being “in charge”. I don’t particularly care how people do things, just get your job done and let’s have a good day.

This gentleman does not subscribe to my philosophy on anything. not on nursing, not on being charge, not on a thing. He started out the day cranky because he was not charge nurse, I was. It went downhill from there. no matter what I did, how I tried, he was impossible. and to make things worse, he wouldn’t even allow me to try to fix things, or resolve any issues we were having. he would just throw my words back in my face, literally. The truly funny thing, is all of the things he complains about in others, he manifests in himself to a tee. And he was not content until he pushed me to the point of tears. He literally broke my zen. It was as though he took upon himself a personal challenge to burst my happy bubble. The more I tried to breathe deep and seek peace, the more he pushed. Takes some talent, really. One could admire his determination to piss me off, if it wasn’t so annoying. By the end of the day, I was frazzled, frustrated, exhausted beyond all reason, and so DONE. If I could have packed my stuff and walked out never to return again, I would have. I have zero tolerance for unprofessional dramatics. it is an unbelievable waste of time and energy.

The odd thing was, this persons antics really have helped me. It has further cemented my belief that there is a path for me, and that path does not include being like him. I had become complacent to a certain extent- content in the job location, settled so to speak. it was easier to just keep renewing my contract, even if I am not being stimulated and challenged. This is not the person I wish to be. I never want to be complacent in my job or any aspect of my life. I needed a stick to remind me that there is more for me out there, new experiences and new people to meet. I never need to live in a state of fear or anxiety. I do not need to choose to remain in an intolerable work environment. While I genuinely and truly like and respect the majority of people I work with, I have some fundamental issues with my work place. Unfortunately the biggest one of them all, is the fact that status quo is maintained. I think Clara Barton, the founder of the American Red Cross said it best-  “I have an almost complete disregard of precedent, and a faith in the possibility of something better. It irritates me to be told how things have always been done. I defy the tyranny of precedent. I go for anything new that might improve the past.”

I will have to work with this person tomorrow again. But I think I shall thank him. I will thank him for the gift of shaking things up for me, reminding me that I have a higher purpose in life, and motivating me that much more to achieve it. I am the captain of my own destiny, and no person shall deny me that right. As I said to him yesterday, and will say again tomorrow- you’re not the boss of me. I also think I will take some earphones and soothing music along..just to be on the safe side.

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Respect in Nursing

• No man, not even a doctor, ever gives any other definition of what a nurse should be than this — ‘devoted and obedient.’ This definition would do just as well for a porter. It might even do for a horse. It would not do for a policeman.  Florence Nightengale, [1859]

I just read an article entitled “How to get the credit you deserve during Nurses Week”. Once again, I am angered and feel that nurses are being taken advantage of. The article quotes a person (with multiple letters and credentials after her name of course) “A nurse is valued for her ability to coordinate care among the team, when working with other disciplines, what does it say to the group that the nurse is the least educated among them?” The article went on to conclude that the only way for nurses to attain more respect from administration, patients, their co workers and the almighty physician, was to advance her education. Anyone surprised that this article was promoted by an online education program? that within the body of the article itself was a commercial for a school?

That single quote above, made me angrier than I have been in a long time. Do we work in a place where we walk around with bar codes on our chests, that if you scan them tells us our content including our educational status and expiration date? Because I do not hold advanced degrees that somehow makes me less credible and less worthy? really? The best nurse I know, the nurse I respect and admire beyond everyone, is a diploma nurse from Scotland. She has been doing this since she is 16 years old. And god bless her, she is of an age that you do not ask her age. I adore this woman, I respect her tremendously, and I use her as a resource. She has retained compassion and care as the core of her health care delivery method. She is an amazing nurse, and the best asset to our unit that we have. Everyone is thrilled she has returned to the ICU from cath lab.

The supposition that critical thinking skills can only be achieved via an institute of higher learning pontificating at me to the tune of 40K is ludicrous. I have respect in my work environment because I create an atmosphere of competency, compassion, knowledge, and approachability. I have respect from my coworkers because I treat others with respect. I have respect from the members of the health care delivery team because I demonstrate the ability to participate in the system. I educate myself on the disease processes of my patients, I become in tune with what is needed to help them along the path and assist them in their recovery. I act as a resource and help those around me. they are ALL our patients.

The role of the nurse in the health care team as I see it, is to interpret the physician’s orders, implement them, observe and evaluate, report back to the physician the results, and make recommendations based on those observations. It is the ultimate scientist. The physician sets up the theory, we observe for results.  You need to be able to ask questions, both of your patients and the doctor, in order to uncover the information needed to help the patient progress. The amazing bonus to this job, is we get to do this with people, not in some cold sterile lab. We are working with humans, full of all their complexities and emotions. We get to hug people and love them. This is why I became a nurse, because it is a profession that demands the combined usage of my brain and heart. The human component cannot be denied.

I am respected in my profession today, because I conduct myself in such a way that it cannot be denied. I do not hold any advanced degrees. I have an Associates of Science in Nursing. I have worked across many aspects of nursing, from direct patient care to administration. The reason I am respected for what I do, is I manifest competent compassionate care. I am able to discern what needs to be done in order to accomplish the goals for the patient. Whether that is discovering that the patient has nightmares from a bad childhood, thus she does not sleep well and has anxiety problems interfering with her recovery, or anticipating what information the physician will need during rounds and having that readily available for them. Have I had times where I am disrespected? Of course. We all have encountered that doctor who is “special”. However the majority of the time, I have discovered that it is because the doctor does not know me, therefore lacks trust in me. If I continue to demonstrate a primary focus of care and concern for the patient, combined with the ability to observe and report, respect comes. It is really that simple. And I do not need an advanced practice degree for that.

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Transformations

I have been experiencing some amazing things lately. I do not know if this is a midlife crisis, or what. I am approaching a big birthday though I am choosing to ignore that. I cannot help but feel that I am on the verge of some big changes. I have been reinvigorated in many aspects of my life. I have had some amazing aha moments- from listening to music to watching films- things that have reaffirmed my belief that we create our own reality. When I sit in negativity, whether that be in my personal or professional life, it affects me. It affects those around me. Yes, it seems terribly cliché – but it is true. I am practicing a new yet old philosophy. to be centered, here and now, in my present, full of all possibilities. I can choose which possibilities I wish to manifest in my life. I am the author of my existence, and can choose to experience myself in a new way. Do people change? Maybe no. But you can discover a new aspect of yourself, that you can be a different you. So far this week, since practicing this, I have been able to seek out new things that reaffirm that I am on the right path. I have lost 15 pounds according to my scale. I feel transcendent. not because of the weight loss, but because I FEEL different. I feel happy. from inside. content and free of obsession and addiction. I do not need to look to outside things to validate my existence. I am here, I am now, I am love. I do not need to worry about other’s perceptions of me. I can be free to let go of fear and anxiety and that which does not enrich my life. it is time to let go, and to just BE. I feel like I am the Jewel in the Lotus. I finally get it…its about loving and seeing that which is possible. those possibilities create reality, by my observation of it. I then will make choices that create that reality.

and no…I’m not high I swear 😛 I am just…utterly happy.

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Decisions

ok, well oddly enough I have found myself in the same place for almost a year. this means I am approaching the need to make some decisions. I like where I am, but I also need to consider everything. The main issue, is that I have opted for the tax advantage program of pay- this allows me to work for less of an hourly rate, but receive a large stipend tax free in my check each week. this helps me when I do overtime, because I do get an overtime bonus- but I don’t get knocked into the next tax bracket. when I work for straight hourly pay, a large portion goes to uncle sam.
so that being said, you can only do this for 12 consecutive months in the same location, or you have to change to the straight hourly as “non traveler”.
now, there are pluses and minuses to both. I am comfortable where I am, its close to where we are living, I like the area and I like the people I work with. the down side is the financial. the hospital corporation has its own agency it uses, and their pay rate is significantly higher, but they only offer a 401K plan, no insurance of any kind. I don’t have insurance currently, but I was going to enroll with my agency this month for that. If I convert to hourly with my agency, I will end up with a significant pay cut, at least 400 per week. that is not a good thing at all. plus any overtime will be taxed at the higher rate, which frustrates me beyond all reason.
so…basically I can either take something with my agency for 13 weeks and add an hour+ commute everyday, go out of state for 13 weeks, or change to the hospital staffing agency. the other option is to take something for 3 days a week in McAllen, and go with the local agency for 1 day a week where I am. that at least should get me 4 days per week consistently. I don’t know though. lots of things to consider.

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Nursing is a Gift

“Compassion is a mental quality that can bring us true lasting inner peace and inner strength”.- the 14th Dalai Lama.

Nursing is a gift. it is a gift you give your patients, your patient’s families, your coworkers and yourself. No other profession allows for the level of compassion and human contact that nursing does. We see people at their most vulnerable. We help people when they are most desperate. We often are the link that keeps them hanging on, or the one that gives them the permission to let go. We are the soul of medicine. I believe that with all my heart.
I recently had two radically different experiences with a patient’s death. In the first, we had a patient who was all alone. His family wouldn’t stay with him. They would come, visit, and leave. This poor man had been through countless surgeries. He had wounds and machines and had suffered. His family had elected to make him no code status- to allow nature to take its course. We knew his time was limited, and we tried to encourage his family to stay with him. They decided not to. The night he died, he was all alone. Except for nurses. I looked up at the monitor, and saw that his heart and breathing was slowing. I went into his room, pulled up a chair and sat down. I held his hand and told him it was ok. I wasn’t his nurse, just a nurse working that night. His nurse was frantically busy trying to reach the family, but they wouldn’t answer the phone. I held his hand as he died, and saw his soul leave his body. I cried for him. It tore at my heart, but he did not die alone. I do not care what your religious beliefs are, but I maintain that you can tell when that “spark” is gone. Even when someone is not responsive anymore, when they are no longer conscious, you can still tell when they have passed away, machines or not. As a nurse, and as a human being, I cannot bear the thought of someone passing their last moments on this earth alone. Not if it is remotely in my power to prevent that. Eventually we were able to reach the family, they came and signed papers and left. It was hard on all of us to see that.

The next day that I worked, I had a vastly different experience. A patient that I had taken care of for many weeks was gravely ill. Multi system organ failure, no hope for recovery. No evident brain activity. I had become close to the family over the preceding weeks. His daughters came back to town in order to assist their mom and to say goodbye. I was not his nurse that day. but the family asked for me. My time was spent hugging the family, being a shoulder to cry on, and giving them permission to grieve. They were in limbo- not able to move forward because he had not yet passed away, but he was for all intents and purposes gone. They elected to withdraw care and let him pass. It was difficult and hard, and I cried with them. The funny thing was, my “nursing” was for the family. We had already done everything we could for the patient. We were there to ease any residual suffering- but he had family to be with him as he passed from this world. What the family needed was our support to tell them it was ok. That was the gift that I could give them that day. To acknowledge their pain, to validate their feelings, to support their decision and to tell them it was ok to feel exactly how they were feeling.

As I see the flurry over advanced education for nurses, I am struck by how little people seem to know. I realize that what people are struggling for is a way to quantify what nurses do. I don’t think that can be done by a piece of paper. There is no degree in compassion. There is no certificate for empathy. You can have the technical skills of a god, but if you lack the ability to connect with another human, you cannot be an effective nurse. You can memorize charts and drugs and machines and abnormal values. But if you cannot put yourself in the shoes of your patients and their families, you are doing everyone a disservice. Whether it is holding the hand of a nervous patient and telling her its ok, or bringing a sandwich to a worried husband, all of it is part of nursing. It is a gift, the gift of loving someone, even if only for that moment. And I am always enriched by that experience, no matter what form it takes.

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