Pregnancy Initiation: the ICU Nurse’s Experience

 

DSC_1340Since I work at a very large urban hospital here in Dallas, people often ask me if I know a friend or relative who is also employed there, like there is some kind of hospital-wide nurse coffee date program where I mingle with nurses from all floors and disciplines. I usually barely even consider the name, not out of insensitivity, but because most likely out of the thousands of people who work there I don’t know this person. If they work in trauma, it’s likely. If they work in surgery, it’s possible. But then someone asks me about a labor and delivery nurse and I jokingly reply, “oh no, they are from a completely different side of the world.”

In hospital terms, my trauma intensive care unit is as distant from the world of babies and breastfeeding as it could possibly be. We don’t see the same kinds of patients, we don’t have any nursing common interest except basic human pathophysiology (which we share even with the psych people) and we are in totally different towers of the hospital. And on those rare occasions when I do encounter someone from those mystical few upper floors, it is for some catastrophic patient who required a total hysterectomy and massive blood transfusions and resuscitation. Needless to say, we aren’t introducing ourselves and exchanging credentials in this scenario. In a few words, no, I do not know your friend, although thank you for asking.

But even though I have never stepped foot onto those floors, never cared for a laboring patient, and honestly still feel somewhat awkward holding my friend’s children, I have now found myself smack in the middle of the baby world by experience. Since the moment that plastic stick said “pregnant,” I’ve been suddenly inundated with the world of pregnancy and childbirth and found myself completely overwhelmed.

On one hand, I was completely (and unknowingly) ignorant. Whenever you tell someone you’re pregnant, whether that’s your physician or your mom or the check-out person at Trader Joe’s, everyone has a piece of invaluable advice, the diamond-in-the-rough of pregnancy that you cannot live without. Heed my words carefully and memorize them because this one thing will save you. This specific swing or this book or this food to avoid indigestion. It’s like the underground railroad of communication, like no one has figured it out the way they have and you’ll be desperately lost if you don’t register for these five life-saving products.

So I eat all this advice up, jotting down notes in my phone for a book to read, a blog to peruse or a tip to remember. And it quickly becomes a vast mountain of electronically stored information that seems random and disjointed because at ten weeks, I had not investigated my parenting strategies yet. And more than that, how much was I expected to know about the world of pregnancy before I got pregnant, especially being a nurse? What exactly are the expectations of my knowledge at different stages of my pregnancy? What should already be routine to me as a nurse, even though I have not seen a baby being delivered since nursing school? What the heck is the difference in all these strollers that look identical to me?? If you could see inside my mind, it’s somewhat of a comedy of errors that cycles back and forth between complete confusion and rabid internet consumer investigation. Because I am not going to gamble my crib mattress decision on the fifteen year-old Target employee’s advice.

On the other hand, I did have some experience working in labor and delivery as a nursing student: a whole month of shifts during my last semester of nursing school in fact, and that provided me with a deceiving amount of pride (that was immediately squashed by the influx of baby-related questions). In school I had seen a C-section, a vaginal delivery and even a STAT c-section. What more could there be to it? How hard could it be when women do it everyday across the world in a grass hut with nothing but a dirty towel and absolutely no hand sanitizer. What essential keys could I possibly be missing for an activity that is as vintage as Adam and Eve? HOW HARD COULD IT BE?

So I slacked on voracious reading in my first trimester, mostly due to the fact that I was physically asleep the majority of the twenty-four daily hours, and trusted that my innate nursing compass would lead me in the right direction towards the scenario where I have an effortless labor, a healthy baby, and butterflies floating around my perfectly sweat-less head. The OB would ask me what questions I had and I would simply shrug, not yet worried about making a decision about cord blood banking or epidurals. I simply wanted to know if we could still travel to Italy at the end of my first trimester and was it normal for me to cry because someone honked at me at a stoplight.

But as soon as I recovered from the foreign and uncomfortable world of nausea (those six letters cannot begin to contain the range of experiences listed under that title), I realized the epic and infinite amount of information at my fingertips and how much knowledge I lacked, even as a nurse. Just because everyone puts in an IV the same way did not mean that I knew what to expect for labor or how to care for an infant. Simply because I had seen a handful of labor experiences did not indicate that I knew a single thing about how the process will go depending on whatever situation I end up in for my delivery. I bow to you L&D nurse and repent of my pride. I admit there is more to it than verbal encouragement and listening to fetal heart tones.

Since then, I’ve started stalking my friends who have recently had kids and those who I distantly know are labor and delivery nurses. I want some kind of reassurance that I won’t be completely inept as a mother and I won’t freak out during labor causing them all to look at me like the crazy ICU nurse who knows just enough to be too much. Looks like there’s a lot more to it than pushing and cutting and swaddling.

Thankfully, I’m not alone. Every first time mother has told me of similar reactions and panic attacks and their children are alive and healthy. And I’m still banking on my internal, female mama-bear instincts to help me out when the time comes. Despite my initial pride, I’ve been humbled to a new level of ignorance that cannot be founded upon my nurse abilities to participate in a code without an ounce of anxiety or do six beside procedures in one shift. Yes, we’re going to go to the childbirth preparation class that I initially thought would be absolutely superfluous. Yes, I’ve started reading and asking my doctor in-depth questions about birthing scenarios. And yes, I’ve gained a whole new level of respect for those nurses who navigate the intricacies of the “baby side of the world” and I’m sure that will only vastly increase when I actually go through the whole labor experience. Looks like I’ll be a writing a “Part Two” to this post in four months.

In the end, I will be changed. I will be completely and utterly transformed because of this tiny human who will enter the world with my tears of joy and an entire waiting room busting with family members. I will be a better friend because I can relate to people in another gigantic and universal way. I will be a better daughter, daughter-in-law, granddaughter, sister, and wife because I can now step into another set of life shoes. And I will be a better nurse because not only will I have gained a valuable perspective of an area I had previously essentially ignored, but I will also have a deeper respect for those nurses who (literally) keep the patients alive and coming.

In the meantime, feel free to contribute your diamond-in-the-rough piece of advice and I promise to faithfully google until I have a sufficient answer. Third trimester here we come…

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Interview with NurseEyeRoll: Becoming Nursey

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Congratulations to Kati from the blog NurseEyeRoll on publishing her first book! It’s such an exciting accomplishment and I wanted to share the love by doing an interview with her about the book!

Kati and I have developed a relationship over the past year through some guest posts and internet communication and actually got to meet and hang out about a month ago. She’s just as fabulous in person (even more so) and I thoroughly enjoyed getting to spend time with her. She’s also a fantastic nurse blogger and if you aren’t already familiar with NurseEyeRoll, then jump on it. While her blog applies to nurses at all stages of their career, she hold a special place for new nurses and encourages them with her tips and antics. Enjoy this interview and purchase her ebook! 

You can currently get it as a PDF and download it to your e-reader. Print copies will be available for online orders later this week. Here is the link to her post explaining how to purchase the book.

How would you describe your new book?

It’s a look at my journey from nursing school to critical care nurse with some stories and advice along the way. It’s the book I wish I had when I started nursing school!

What inspired you to write this book?

I’ve written quite a few posts over the last year or so. The more you write, the more content there is to sift through for people that are just getting familiar with the site. Having the new nurse in mind, I wanted to have a book that someone could read that had all of the foundational information I’d created, with some bedside stories in the mix. It’s my attempt to help people try to put that big picture of what it means to be a nurse together as quickly as possible. I basically took the most important posts, revamped them, added more information and stories and put it in a book!

What was your favorite aspect of writing it?

I really enjoy writing out my experiences. I like to go over it again in my head and write it out in a very detailed way so you feel like you were in the room with me when it happened. It’s so fun to me to be able to do that.. with some yummy coffee and my dogs snoring at my feet. That’s a seriously perfect day if you ask me!

What is your goal/hope in writing it?

I just want people that are going through nursing school and having a tough time to feel a little better. I want new nurses to be able to be a step ahead and feel comfortable, confident, and autonomous at the bedside as quickly as possible. I want to be able to relate to seasoned nurses that have had similar experiences but just couldn’t put it into words, or give them something they can give to the newbies they’re precepting.

What was the hardest aspect of writing it?

The hardest part of writing it was writing one of the chapters that was tough to re-live. I also wanted to insure I protected the privacy and dignity of my former patients while also giving realistic and honest advice. That can be quite the challenge to walk that fine line.

Do you have a favorite story or chapter in the book?

My favorite story is actually the one that was the hardest to re-live. I learned a lot technically, emotionally, and spiritually with that patient and family and will never, ever forget them. It profoundly impacted me and it was an honor to care for them. I really hope my experience will help other nurses when they’re faced with similar situations.

What is your favorite thing about being a nurse?

I feel a lot of joy helping and caring for people when they need it. The look of pure gratitude you get from an elderly woman who can’t get up to the bathroom without your help any longer is priceless. Every single day you have capacity to profoundly impact someone just while doing your job. To me, that’s amazing and I love it. I never want to do anything else.

What do you consider the hardest thing about being a nurse?

The hardest thing about nursing is not putting yourself in your patient (or their loved ones) shoes every single hour of every shift. It’s really hard not to imagine what you’d do if your husband were the one sitting in that bed, dying from ARDS or who had a devastating stroke after an aneurysm ruptured. It’s really, really hard to disconnect the dots and that can be overwhelming at times. But in the end, it’s worth it.

What are your future plans for NurseEyeRoll?

I feel like they change every single day! I’m now a Nurseonality and contributor for Scrubs Magazine. I also write for NurseTogether frequently as well. I will continue to write weekly on my blog and stay active on all of my social media platforms. I hope to eventually write another book. My passion is to be there for new nurses – I would love to visit and speak at nursing schools about what it’s like to go from having no patient care experience to working in critical care.

Thank you Kati and we look forward to seeing your success!

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Pregnancy and Paleo: Second Trimester

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I’ll start off this post with some level of apology for my lack of blogging lately! Needless to say, a new house and an upcoming baby are enough to keep me busy, along with my relative lackluster approach to cooking compared to my pre-baby enthusiasm. If you’ve experienced pregnancy firsthand, you know intimately the whole new world of trials and joys unique to this period of time and you may full well empathize with my depleted motivation for most of my routine activities. All that to say, I have had a plethora of thoughts running through my head lately and they all converge on a rather cliche but nonetheless true feeling of overwhelming gratitude.

Many of you are already familiar with my health story of UC and if you aren’t, you can read the full post here. For years, I struggled against my unwilling body that sabotaged me with flare after flare and unexpected complications. Medications failed, side effects tripled, and my general response towards my disease was fear, anxiety and a lack of trust in God. Then I met my husband Seth and he initiated many of our dietary changes that led to my healing including several rounds of a very strict elimination diet and converting entirely to a Paleo way of eating (no grains, dairy or refined sugar of any kind). For the last two years, I’ve cooked most of our food at home, spent outrageous amounts of money on expensive but immaculate quality ingredients, and inoculated myself to a lifestyle that revolved around taking joy in a seemingly permanent change of pace. I had grown used to our new normal, the routines that consisted of planning out our meals extensively and alternating the cooking schedule between Seth and me. Prior to getting pregnant, we had developed a cadence to life that we found fulfilling and rewarding.

And then comes the baby. If I was honest, I knew full well that my life would change dramatically following the birth of the child, as every new mom in the world will tell you with bags under their eyes between tears of joy. But I did not expect my life to change almost instantly, completely altering our routine and throwing all my Paleo food in the limbo of nauseated disgust. Over the past several months, I’ve been able to eat all of my previous favorites like pizza, pasta, bread, cookies…you name it and I’ve probably been caught eating it out of the fridge at night.

At first I found myself feeling guilty for this newfound freedom brought on by the natural immunosuppression that occurs when you get pregnant. I had spent the past several years indoctrinating myself to the world of non-processed foods and here I was, essentially a hypocrite to my own preaching. Yet, I think there’s another way to view the situation and that’s with a heart of gratitude and amazement.

Currently we are eating about 50% strict Paleo and 50% whatever sounds good after a long 12-hour shift, and I’m satisfied with our change of lifestyle at this point. I fully intend to return to our strict Paleo diet after delivery but rather than bullying myself with guilt, I’ve decided to embrace my limitless dietary vacation with a glad and thankful heart. Did I ever think that I would eat pizza again? No. Did I ever expect to go to a Mexican food restaurant and not pout through the entire meal? Nope. And here I am, shoving chips down my throat with the rest of them. What an amazing gift!

Here’s the real key: I’ve come to a level of healing that I didn’t think would ever be possible again and I believe I’m a much more informed and well-rounded person after having spent those previous years learning about dietary strategies for disease.

After a check-up with my gastroenterologist the other day, she made a comment about how I deserved to have a break after everything I’ve been through with my disease. This doctor has seen me almost since the advent of my condition and has walked with me through the depths of tears and uncertainties over the years. Now, I don’t think I “deserve” anything, nonetheless complete and utter freedom from UC, although we have put in a lot of time and effort towards that cause. But more than deserving, I am thankful for the blessing of this nine months- even if I revert back to active UC later on and this healing doesn’t persist. For these precious months, I’ve gotten to experience a respite that brings such relief, and I haven’t even mentioned the heights of excitement at housing another human being. From my perspective as a Christian, God has given me two huge blessings wrapped in the same package and I want to see it as such, rather than berating myself for allowing processed sugars past my lips.

Life isn’t linear or predictable and I’m so thankful for the adventure of it. We never know when healing will begin or end, when new life will surprise us, or how our lives will change in an instant. With my type A personality, it often takes me a while to adjust to sudden changes that I can’t control and this past six months of pregnancy has been a very rewarding and stretching test of my trust and willingness to adapt to what God allows. Without a doubt, I am a better person because of it and I believe becoming a mom will only increase my flexibility and adaptability.

I needed to re-learn how to be gracious with myself. Certain trials wax and wain during your lifetime and physical ailments are a perfect example, so if you struggle with a disease or condition, take heart that not knowing the future isn’t always a bad thing.

Other than my limitless diet, I’ve had a flawless pregnancy so far and I hope that continues! I’m still working full time, planning out the holidays, and making baby shower lists. I am officially off the hook on taking care of any patient with a horribly contagious disease (nice pregnancy perk) and now I’m actually getting big enough that people ask me when I’m due rather than just staring at me and wondering why I’ve gained all this abdominal weight. I’ve graduated out of my bigger “prednisone phase” scrubs into some maternity ones and we’re headed into my third trimester with a rejuvenating burst of energy (to help me finish the nursery)! Baby Bridges is undoubtably on the way and I can’t wait to meet our little boy or girl here before we know it.

Since I have still been cooking some new Paleo favorites, I’ve included some photos and links to recipes as well as a few links to some fun projects I’ve done lately. Happy holidays everyone!

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Pumpkin Bread (pictured above) from the new Against All Grain cookbook Meals Made Simple! I also got a chance to meet Danielle when she came through Dallas on her recent book tour!

Granola from Meals Made Simple

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Paleo Pumpkin Pancakes from Mangia Paleo! Find any recipe with pumpkin and I’m in! I use organic canned pumpkin and one day my goal is to get brave enough to make pumpkin puree from scratch. We’ll see how that goes.

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Maple Glazed Donuts (and some with crushed almonds) from the Against All Grain blog (pictured below). You can buy a simple donut pan for only a few dollars and it’s a fun treat. I tried to make Seth promise that he would never feed our children regular donuts from the donut store. He replied, “I can’t promise that. There might come a time when the kids need to go get some donuts with their dad.” True. Can’t argue with that.

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DSC_1397Check out my Lululemon maternity photo shoot with my friend Andrea from the blog Loubiesandlulu.com!

Also take a look at my tips for nurses with health concerns on Scrubs mag!

 

 

The Most Selfish Profession

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In the onslaught of recent events, nurses have endured a wide variety of reactions. While nurses have been getting a lot of criticism in the media and press, we’ve also experienced an overwhelming amount of support from others inside and outside the profession. Enjoy this bit of satire to lighten the mood and thank all those nurses who take the selfless route every time and make us proud. It’s not easy, although some might say it is. #nursesfornina

Ask anyone and they would identify nursing as the most selfish and lazy profession. As nurses, we often neglect our duties for hours, play on the Internet, and essentially waste as much time on the clock as possible. We linger around the water cooler, making up gossip about various coworkers and management, lacking any kind of impetus to do real work. We glance back at our patients from time to time but there’s really no rush, right? They can manage on their own in a prone bed on an oscillator ventilator in a sedation coma. We take bathroom breaks with regular frequency, go out to eat for lunch (and stretch out the hour into two), and leave early on Fridays if we want. In reality, we don’t take our job too seriously.

There’s no sense of urgency or immediacy. It’s essentially the most-stress free job you could have. You don’t need to pay close attention as you complete an assessment or titrate a pressor. The arterial line probably isn’t reading correctly anyway. Just recycle that manual BP of 55/32. That acute change in mental status? Most likely he just didn’t get enough sleep last night. You say you’re allergic to this type of antibiotic? I’m sure you’ll be fine, take some deep breaths. You can rationalize almost any finding. The alarms are so considerate and only go off when there’s a true emergency, not every two seconds, waking my finally-sleeping patient. In fact, if you silence the alarm quickly, it’s like that short run of V-Tach never even happened.

You’ll never get caught up in a frustrating debacle for a simple miscalculation on a narcotic flowsheet that happened three shifts before you got to the patient. It was an honest mistake and I’m sure they will eventually figure out who didn’t do their math correctly or how the computer malfunctioned. It’s not like your career is at stake or anything. It’s almost impossible to get fired from a nursing job.

We lack true responsibilities and act accordingly. We sleep in past the alarm, roll out of bed and into work whenever we feel like it, definitely never at the crack of dawn or for an entire night shift.  We take the words “on call” very nonchalantly and drink away the night at a bar, shrugging off the possibility that we might have to go into work. It’s really not that important that I stay clear-headed for my job. We would never sacrifice a day off to come in to help the unit when we’re short staffed. We don’t stay late or come in early for a fellow coworker who wants to see her daughter off to her first prom. In short, it’s my time and I’ll keep it that way.

I flippantly observe my agitated, helpless patients and shrug at them with an unconcerned look that simply says, “good luck.” I passively carry out physician orders, ignoring words like “stat” or “asap” or “critical.” I never move at more than a snail’s pace. I blindly follow the orders I receive rather than questioning the first year resident’s decisions. I don’t ask questions or advocate for my patient but follow the relaxed approach, letting fate take its course. I’ve never reminded a physician to put my restraints back on my agitated vented patient. That would be too much effort.

We absolutely never take risks. We avoid the places that no one wants to go. We would never sacrifice our own health and wellbeing for someone we don’t even know, especially with the possibility of contracting a life-threatening illness. If someone coughs on me, I’m out the door, never to return. You’re on your own. We’re always treated by others with respect and are the last to be blamed in a controversial incident. I’ve never heard a nasty nurse joke or a colorless pun about my job. I sleep well at night knowing all of this.

I’ve never wanted to shout profanity at the person from the lab. Pause. I’ve never wanted to shout profanity at the person from the lab.

I have never met an unkind family member. Even those who are feverishly scribbling down my every move are gracious and appreciative. They would never threaten me or shout at me or tell me I’m incompetent as I run myself ragged trying to save their family member’s life. They always understand the reasons why I do the things I do and hardly ever bring up some ridiculous google article and force me to read it at the bedside. In fact, I absolutely love the fact that WebMD lists cancer and stroke as a symptom for every common ailment. It makes my life so much easier. Each family brings me cookies and flowers and commends me to the CEO of the hospital as the best nurse who has ever worked at the bedside.

I’m affirmed daily, well-rested, and carry an extremely low amount of stress. I’m essentially getting paid to be awesome at watching a monitor. Don’t be fooled, this job is cush and I get paid WAY beyond what I deserve. I don’t understand anyone who says this job is hard.

Now to anyone who has ever been a nurse, known a nurse, worked with a nurse, been related to a nurse, etc- you know all of this is a satirical spin on nursing life that is mostly untrue, (while I still encourage nurses to take excellent care of their patients and not make narcotic errors). And that’s why it’s funny. If you’re a nurse, you understand many of these misconceptions and can relate to the frequent frustrations with a sense of humor.

As nurses, we work tirelessly day after day enduring long shifts, little to no time for breaks, and thankless patients. I’ve had to go to the bathroom for hours but held it as we went to STAT CT or did one bedside procedure after another. I’ve had patients spit, slap, push, curse, vomit on and berate me. I’ve had to call the police on several family members for getting too aggressive in the ICU. I work weekends and holidays despite the fact that I would love to be with my own family. I endure the monotony of first year residents with a smile on my face, trying to help them not kill anyone. There are many, many frustrating aspects of nursing but if all the bad outweighed the good, then why would we do it?

Because of supportive coworkers. Because of kind families who really do bring cookies. Because of the satisfaction of seeing the patient who was on his death bed walk back in the door months later. Because, despite the satire, it is a great job to have if you want a family and flexibility. Because we have a unique opportunity to permanently impact someone else’s life. Because we signed up for a level of selflessness that proves to be extremely rewarding. Because of a million more reasons that make the job worth it.

Our commitment and fortitude has been put to the test lately and we’ve come out stronger than before, sticking up for each other and advocating for ourselves. It makes me proud of this profession, and it should make you proud too. #supportthescrubs

Why do you love being a nurse? Why do you continue to sacrifice for the patients and families? Why should we be proud of our profession?

A Nurse’s Thoughts on the Ebola Crisis

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I don’t think anyone will dispute the fact that the Ebola epidemic has become a global crisis. With throngs of people dying in West Africa everyday with horrific symptoms, the virus spreading across borders and oceans, and a widespread underlying feeling of panic, this nightmare of a disease has come to life in the daylight.

With many recent, widely-popular films and TV shows like World War Z and The Walking Dead, we imagined the thought of a worldwide plague simply as a thrilling, and generally unrealistic, fantasy (excluding the true fact that zombies don’t exist, despite what some fans might say). We indulged in escapist entertainment without concern because those people on the screen are only actors and, in our minds, a worldwide pandemic isn’t possible to such a degree in our modern world. While entertainment isn’t inherently bad, we’ve insulated ourselves in this instance from believing that our media mimics reality.

With our digestion in recent years of media disillusionment, we’ve finally had a wake-up call and the Ebola virus epidemic has provoked a variety of reactions from general unease to sheer panic and terror. In our house, we’ve responded with humor, not out of a calloused lack of sympathy, but as a way to diffuse my own fears. We watched the entire first episode of this season of Homeland trying to identify all the times someone could’ve contracted Ebola from Carrie, the main character. We had soup the other night and I got several versions of “Ebola what?” (a bowl of what?) from my husband. Yet despite the lightening effect of humor, I’ve found myself struggling over my opinions and emotions because I see the virus from several various perspectives.

As a human, or global citizen if you want to use that term, I grieve for the people of the affected areas of Africa with my whole heart. Having watched a substantial amount of media coverage from the West African infected locations, it pains me immensely to see such suffering and death. No matter who you are, seeing such a deplorable disease ravage innocent people and result in such catastrophic demise is not only unnerving but appalling. It strikes our innate human core of compassion and invokes a feeling of solidarity with those who share our species, despite their location in the world. Those people, those children, didn’t ask for Ebola. They didn’t sign up to die this way, yet disease is a part of a broken world and tragedy befalls all of us at some point, in some way. This same feeling of human congruency is why people donate money to the Red Cross or volunteer to help during disasters or pray for people they will never meet. It sparks a basic human concern and people respond in a variety of degrees. And I don’t think we should ignore those tinges of compassion but give money, provide support, and pray for those countries and people. Because is my life any more valuable than those who have died in Africa? Absolutely not. We have to stick together globally on this.

As a human, I’m so proud of the healthcare and aid workers who journeyed into those countries, fully aware of the high likelihood of contracting the disease. They took that innate sense of compassion and translated it into action and some of them nearly lost their lives for it. I’m not saying that everyone needs to buy hazmat suits and jump on a plane to the infected countries (actually unless you work for the CDC, please don’t do that!). But I want to point out the fact that those workers who chose that route did so for the betterment of humanity, along with various other personal reasons. How often in our modern day and age do people do things for the betterment of humanity at large? While selflessness has not gone completely dormant in our modern day, my opinion is that this type of sacrifice is truly rare. For one person to sacrifice their life for another, especially a person they’ve never met and who cannot offer them anything in return, is truly marvelous. It is a testament to the reality that glimpses of redemption still exist in a dying world.

As a nurse, I’m also so proud of the healthcare professionals here in the US who have volunteered to care for the infected patients. With the same sacrificial and altruistic motivations, they willingly put on a gown, booties, gloves, hat, mask, and goggles in the proper order countless times a day in order to help save the life of a person they’ve never met, with the acknowledged risks being high. While we have more control over the hospital environment, better equipment and medications, and less of a threat of contracting the disease, the same questions would cross your mind if someone asked you to walk into that room and clean up that patient’s vomit. Even if everyone in the world told me that I had NO chance of contracting Ebola using proper precautions, it would cause me to think twice. Yet those doctors, nurses, and other hospital workers set aside their own concern for self and are giving those patients the best care they can because that’s what healthcare professionals do: care for the needy. I’m proud to be a part of such a group of people with empathy that expands beyond professional obligation to true humanitarian concern along with a unique brand of courage and bravery.

As a nurse, I will admit a fear of being exposed to an infected patient, especially since the disease popped up in my own backyard of Dallas, Texas. But the reality is that people walk in the door everyday and we have no idea what deleterious organisms they are harboring, what active TB they are coughing on us, or what set of symptoms will quickly prove to be the flu. We take that chance everyday, recognizing that the nature of our profession puts us at a higher risk for contracting a communicable disease. But does that stop me from coming to work? No. Does it cause me to use proper hand hygiene often? Most definitely yes. I can’t fret over those risks a millions of times a day because it would prevent me from being able to do my job.

As an expectant mom, I find myself experiencing a whole other layer of complicated emotions in this conundrum and I won’t deny an elevated level of fear. If it was just me, I wouldn’t be as concerned for myself, realizing that my adult body or my husband’s body has the ability to fight off infection should I contract the disease. However, with this tiny baby in my belly, moving and kicking and taking all my calories, I’ve found myself starkly more protective. It’s not just me anymore. There’s a dependent little person relying on me to care for it- and I will at all costs. Even though I’ve never met this baby, have no idea what it’s face will look like, and haven’t picked out it’s name yet, I will adamantly and even desperately do everything I can to keep this baby healthy and alive. And it makes me more hesitant than I would normally be about this type of threat.

But the bottom line of all these emotions, opinions, and arguments is that we can’t ultimately control the outcomes. Hear me out. We can use proper precautions; we can quarantine those exposed to infected victims; we can send every capable healthcare worker to West Africa armed with hazmat suits but at the end of the day, life is unpredictable. It just takes one person to slip through the cracks and the epidemic starts all over again. I don’t say this to discourage you but actually to provide a perspective that has proved helpful to me. If we assume we have complete control of every aspect, we are foolish and arrogant. Ask anyone who has ever been in an unexpected car wreck and they will tell you they didn’t intend to get in an accident that day. Life is unpredictable and many times that proves exciting for us. Anything is possible; tomorrow is a new day; Life is a box of chocolate and you never know what you’re going to get. If life was strictly an algorithm with reliable outcomes, we would be insanely bored. We weren’t wired to function that way. On the other hand, sometimes life is unpredictable in a harmful way with tragedy and loss inherent to human existence. We happen to find ourselves on the scary side of the coin in this particular predicament.

As much as I fear for the life of my unborn child or my husband’s life or my own life, I can’t become paralyzed by overwhelming fear of the unknown. That’s a debilitating thought that would prevent me from being able to go about the routines of daily life. I can acknowledge that wisdom demands that I wash my hands frequently and stay alert for any suspicious symptoms. But I can also rest in the fact that I’m not in control of the world but God (in my Christian worldview) controls the fate of all people.

As a human, I can grieve and pray and donate funds to help get care to those in need. I can take pride in those who have sacrificed for others and try to live my own life more sacrificially in my daily routines. As a nurse I can wash my hands a million times a day and then rest in the fact that the outcome is ultimately outside my control. As a soon-to-be-mom I can pray for the health of this baby and then surrender my fears.

And I encourage you to do the same. Don’t succumb to overwhelming fear but recognize the frailty of your life and live sacrificially today. This moment is the only thing we are guaranteed.

And please, don’t forget to wash your hands.

Italian Adventures

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We’re finally back from Italy and I couldn’t help but share a few photos from the trip! In the true spirit of “when in Rome,” we ate a whole spectrum of tasty fare including some Paleo-approved and some not Paleo-approved dishes. (We can all agree that delicious dairy and sugar infused gelato is a necessary pregnancy exception). Fortunately, I’ve continued to have entirely no symptoms besides routine pregnancy ailments like fatigue, nasal congestion, and a generic lack of cooking enthusiasm. Enjoy this tiny snapshot of our baby moon vacation to Venice, Florence, and Rome!

 

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Pregnancy and Paleo- First Trimester

DSC_1339You might’ve noticed I haven’t been blogging, instagramming or cooking much for the past three months. Normally, I would consider this a personal failure, a deviation from many of our routines and my personal goals. But something changed over this summer, something that has completed altered everything, and I consider it the biggest blessing of our lives.

Months of nausea, extreme fatigue, sensitivity to smells, irrational emotions, and a whole host of other completely strange changes to my body would not normally be something to celebrate. My inability to cook entirely, and some days even open the fridge, has severely hindered our daily routines and left us eating out for, let’s be honest, at least two months straight now. I’ve deviated from Paleo in such drastic ways that I would’ve totally judged myself looking in from the outside as a complete hypocrite. I’ve devoured bread, ice cream, macaroni and cheese, pizza, and dirty dirty Mexican food. I went six weeks without working out completely. For several weeks, I took two naps a day on my days home from work. I’ve succumbed to a level of laziness I never before thought possible, returned halfway to a diet I never thought I would embrace again, and haven’t regretted one minute of it.

All for the sake of this little life growing inside me.

The secret is out. We’re having a baby Bridges coming in March!

We’re overjoyed at our growing family! Although the past several months have come with some new challenges, we’ve gotten to soak in the promise of a new baby and celebrate with our families as we all prepare for this little nugget’s arrival. Now it’s time to announce it to all of you and hope you’ll forgive me for my relative silence.

If you’ve never been pregnant as you read this post you might judge me for my dietary relapses. And I will let you. You can sit there with that smug, self-righteous grin on your face wallowing in your dietary superiority for as long as you would like. But know that one day you or your spouse will be pregnant and you will take it all back. That disgusted look will morph into one of empathy and understanding. You will finally relate to the primary modality of the first trimester of pregnancy: Survival.

Compared to many women, my symptoms have been moderate. Thankfully, I haven’t vomited and I don’t take that for granted considering how horrible that portion of pregnancy can be for many women. I have, however, had major food aversions (including most meats and vegetables) and many days simply hated food altogether. I was scrolling through my past Instagram feed a month ago and thought to myself, “I used to enjoy this,” with a mystified expression on my face. On top of not desiring any of my previous Paleo foods, even the idea of cooking churned my stomach.

I have craved many non-Paleo foods and at first I indulged hesitantly. I had a bite of bread or a few pretzels or a small dose of frozen yogurt and as I remained symptom-free and experienced relief from my nausea with those foods, I got more daring. Since the immune system essentially shuts down during pregnancy to allow for the growth of a foreign being in your body, many women with autoimmune disease experience little to no symptoms during pregnancy and even manage to eat previously off-limit foods without any of the usual ramifications. Fortunately for me, that is the case.

I’ve visited restaurants I never thought I would patronize ever again and commented to Seth one night as we walked into the dirty Mexican joint that I felt like we were about to rob a bank. Talk about concurrent food guilt and exhilaration. Mostly I’ve tried to stay within the realm of “healthy” when going out but the cravings were sometimes overwhelming and surprisingly intense. For example, I’ve gone to La Madeleine at least once a week and gotten tomato basil soup with a Caesar salad (a restaurant I was never particularly obsessed with before). On several occasions I have been so ravenously hungry that I ate my meal in the car in the parking lot of the restaurant, not even making it home with my to-go container. Survival.

Now don’t get me wrong: I fully intend to return to my strict Paleo diet after the baby comes. Even now at the beginning of my second trimester I’m trying to return to mostly Paleo fare. It’s been an interesting mental battle over my eating choices because ideologically, I’m still very much against refined sugar and grains. I hold fast to my conviction they are deleterious for you, especially if you have autoimmune disease. But in the midst of this tumultuous new journey I’ve gotten so desperate at times that I would pick anything that I thought I could choke down. Again, survival mode kicks in as you’re trying to focus on anything besides the fact that you want to vomit.

This summer has been full of fun changes and our life looks almost completely different from several months ago. We suffered through the arduous house buying process and finally reaped the reward by purchasing our first home! Then we completely remodeled the kitchen, giving me the most beautiful kitchen in the world (I’ll do a full blog post on that soon) that I have yet to really use with all the cooking aversion. Then in the midst of all those changes, we found out that I was pregnant! Thankfully, we have a place to house this child and a kitchen to cook all kinds of yummy organic fare for this belly nugget.

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Sneak peek photo of the new kitchen!

Despite being overwhelmed at times, feeling unprepared, and wondering how we will measure up as parents, I feel genuinely thankful. God has given us a healthy baby so far and met all of our needs. Plus, I truly believe it’s God’s grace to allow me to eat whatever I’m craving during this crazy time period. It just goes to show that you never really know what’s ahead of you. And that’s what makes life so very fun.

Now that I’m back on the cooking bandwagon, you’ll hear more of me from a blogging standpoint. Keep on the lookout for some amazing Italy photos as we leave for Europe in a few days with our little stowaway! Also, check out these two newly-released cookbooks that have already blown my mind: The Paleo Mom’s The Paleo Approach Cookbook and Danielle Walker’s Meals Made Simple. I can’t wait to get back in the kitchen!

Please, Ignore the Rules

Dear family member,

I hope you show up high today! From the moment I see your glazed face, I’m instantly trying to dissect your personal cocktail, whatever combination of goodies you ingested this morning to construct your altered demeanor. Alcohol and meth? Cocaine and opiates? Every last Xanax you had in the medicine cabinet? Did you just take four more pills while I was trying to talk to you? Go ahead.

I hope you come drunk at nine in the morning and try to swing at someone. I’m just anxiously awaiting calling the cops on you and escorting you out of the hospital. Maybe you’ll just make a huge scene yelling at your brother in the hallway or perhaps you’ll threaten to murder your sister-in-law, or maybe you’ll threaten the bedside nurse, my favorite outburst of all. I’ll just turn around and walk away as you call each other crack head prostitutes in front of all the other people in the hallway. It’s no problem for me to call the police to look through the other visitor’s purse to make sure she doesn’t really have a gun like you say. Thanks for putting me through all that trouble.

I realize you hate your entire family. I realize you must surely be the only sane one. I believe you when you say they’re all out to get your money or the patient’s money or the crack money. I totally understand when you make a ridiculous scene over the twenty six dollars that the patient came in with in their wallet. Naturally, someone stole all of your money right before you arrived and you haven’t got a dollar to your name. You’re the distant cousin-in-law but of course it’s your right to have it because you’ve got things to take care of.

I absolutely condone you laying all over the ICU patient in the bed like this is a hotel room that you can inhabit in an inappropriate manner. Enough said.

It’s just a hospital for goodness sake! It’s no different from your local convenience store. There’s no need for decorum or rule-following or respect. Spit on the floor or ask me if you can use the patient’s bedside cup as a dip cup. Try to convince me that it’s sanitary for you to live at the hospital for a week and sleep on the floor in the waiting area. Let your one-year old baby crawl around licking the dirty floor in the hallway. Better yet, try to smuggle in your small child several times after I’ve told you not to.

Let me just say, I believe you when you say you are the Medical Power of Attorney. Yeah, you can’t find the paperwork right now, but let’s just forget about that little formality and let you make an end-of-life decision for your estranged brother’s aunt. It’s not like the whole affair is a legal process that I have to follow. The document must’ve just gotten lost and consequently you’ll be the one to get her cash when she dies. Makes perfect sense to me.

Sure I’ll call your parole officer and tell him where you’ve been for the past three days, even though you haven’t been here.

You’re right! Yelling at me will only help me find your husband’s lost dentures more quickly!

We can totally overlook the fact that your current wife, your ex-wife, your girlfriend and your baby mama are all taking punches at each other in the hallway. I realize that’s not your problem and I understand how you can be ignorant to how that all happened in the first place. Legal matters like being married are hard to remember.

Of course you realize this is a satirical representation of some of the crazy things that happen between patients and family members (although I’ve personally witnessed all of these outbursts). Obviously, all of the above scenarios burden and sadden me and I wish such drama didn’t exist, both for my sanity and for the people in those situations. And since this is the Internet and people don’t quite understand the fullness of satire and might think me merely rude and unsympathetic, let me explain.

No one’s family is perfect. Even your neighbor who seems to have it all together has a drug addiction problem or a psychotic parent or an estranged relationship with a sibling. There’s no perfect family and while some people believe in (or desperately hope for) the mythical Normal Rockwall experience, it’s an elusive dream that will inevitably escape them. Don’t feel bad when your family has these issues. Don’t be embarrassed when you have a skeleton that causes you pain or you’re the one who can’t seem to get along with the rest of them. Hopefully it makes you feel better that you’re not the only one. Or you might be the crazy one.

Drug and alcohol addiction is also an all-too real dividing force no matter your race, socioeconomic status, where you live, or the type of environment you grew up in. A boatload of Xanax seems to show up in people’s pockets far too often regardless of which college they attended. Addiction gets messy and causes problems and damages relationships.

The satire here is that people often ignore hospital decorum, which is a loosely relative but understandable set of rules. I would say “intuitive” to some points because, “Please don’t arrive under the influence of alcohol or illegal drugs” isn’t on my list of welcome rules when a family member first arrives (yet maybe it should be). Sometimes, I can easily understand their preoccupation as their teenage son was just brought in from a severe car accident and they can’t contain their emotions. I’ve seen people yell, threaten, cajole and manipulate during those ultimately stressful moments and we’re all willing to overlook those due to the situation. The human mind and emotions can only handle so much stress before limitations start to seep through the cracks.

On those other occasions, when people are simply misbehaving, I ask them to leave their drama at home, or in the hallway, or in the parking lot. We’re busy trying to take care of your family member and don’t have time to referee your quarrels. I ask them nicely to come back sober another day or beg them on the phone to come see their dying mother. I politely explain the rules and expect them to abide by them. The patients need the respect of a proper ICU stay and the families sometimes need boundaries and appropriate limitations. Everyone deserves a unique level of sympathy during such a time and we do our best to make that happen.

So as much as I joke about all the ridiculous encounters I’ve had with family members, most are kind and appropriate and helpful. They are thankful and appreciative of what we’re doing to sustain their family member’s life. And regardless of their background, amount of hospital experience or financial status, love and boundaries are often synonymous. Let us help you, just like we’re helping them.

Natalie-8

Cookbook Review: The Dairy-Free Ice Cream Cookbook

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Congratulations summer, you’ve met your delicious counterpart.

Kelly Brozyna, aka The Spunky Coconut, has been inventing delicious dairy-free, grain-free, and Paleo recipes for years now and I believe her most recent cookbook is the ultimate culmination of all her efforts! Kelly started delving into the alternate nutrition realm after her family fell prey to several diagnoses, including ADD, celiac, and autism. Isn’t it amazing how many of the health revolutions started with desperate mothers trying to find a way to heal their family members? By figuring out ways to make healthier versions of popular recipes devoid of refined sugars and flours, Kelly uses a plethora of alternative ingredients and creative mechanisms to provide her fans with tasty treats. She recently came out with her fourth cookbook, The Dairy-Free Ice Cream Cookbook and it’s exploded in popularity. While Kelly’s talents are definitely not limited to the frozen treat category, I believe she has some of the best ice cream recipes out there for three reasons: simplicity, creativity, and of course, flavor.

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Simplicity: I don’t know about you, but I love the slower pace of summer. Fresh fruits and vegetables, summer salads, and simple light desserts grab my attention during the hot summer months here in Texas. And as much as I love cooking, I don’t want the homemade ice cream-making process to last all day. When it’s hot (it’s been 103 here in Dallas this week!) and I don’t feel like slaving away in the kitchen, I turn to my classic recipes that combine a few simple ingredients and a cold dessert always sits at the top of the list. When I first opened The Dairy-Free Ice Cream Cookbook, I was beyond relieved to see that Kelly has made it simple and straight-forward. She gives you instructions on how to make the process run smoothly, lists her favorite equipment, and uses only a few ingredients in each recipes- most of which you might already have in a Paleo kitchen. Coconut milk? Check. Cocoa powder? Check. Dates? You can pretty much already make any recipe on a whim and the only facilitating piece you need is the ice cream maker itself. Compared to some of the other Paleo ice cream recipes out there that require multiple trips in and out of the freezer, Kelly has fashioned her recipes so that you can make a batch in only a few hours with relatively little effort.

DSC_1364Frozen Mint Chocolate Whoopie Pies from her book

Creativity: When you finally took the plunge and committed yourself to an un-processed food lifestyle, did you ever think you would eat Brownie Batter ice cream again? How about Mocha Almond Fudge or Gingerbread Cookie Dough or a “Peanut Butter” Chocolate ice cream cake? And have you ever even heard of flavors like Fried Banana or Honeysuckle or Persimmon Sorbet? Yeah, I haven’t either. Do I even need to elaborate further on this point? I have a huge amount of respect for those inspired people who take their recipes to the next level, the level that propels them from “good” to “great” and I think Kelly has accomplished that in this book. Just check out the endless flavor list and you’ll agree.

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Brownie Batter ice cream from her book

Flavor: I test the strength of a Paleo recipe by feeding it to non-Paleo eaters and gauging their reactions. Since I consider it my personal goal to convince people that eating healthy doesn’t mean losing flavor, I often experiment with treats on others and ask for opinions (people other than my husband who, after seeing all the dishes piled up in the sink and the distraught look on my face, will gladly say anything is superb). I made the frozen mint chocolate whoopie pies for our home group weekend getaway and they were a hit! I’m looking forward to moving into our new house with our new kitchen so that I can host bigger gatherings and continue my social experiment and brain-washing further (muah-ha-ha). Seriously, these homemade ice creams taste better than any store-bought brand and are so much healthier for you than that giant waffle cone stuffed with three thick flavors at Cold Stone. (Kelly has a waffle cone bowl recipe too!)

If you’re looking for an easy way to make a summer treat with little effort that will satisfy even the harshest dessert critic, start with The Dairy Free Ice Cream Cookbook. I promise you won’t be disappointed! Let’s just say I’m not putting down this book anytime soon.

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All photos belong to me and if you want to see more tasty food photos, follow me on IG!

Human Problem-Solving Experts

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We’re all familiar with the insane nursing shift, the one that brought a TV shows worth of drama and unexpected catastrophe all before you ate lunch that day, the one you won’t soon forget. While many patients and situations follow conventional patterns, humans, the business of healthcare, are inherently unpredictable and often choose to exercise that distinctive quality at the seemingly most inconvenient moment. The range of disturbances can vary from a minor disruption like a patient vomiting in the middle of shift report to a random line of V-Fib resulting in a messy code and a tragic death. We can’t control our patients or foresee the various ways they surprise us on a daily basis and so we learn to evolve in our profession in order to maintain our sanity. As nurses, we become intimately accustomed to the frantic and indeterminable pace of life in our unit and come to expect the unexpected. It’s always better to be prepared for the worst.

Humans aren’t programmable like a computer or machine. They don’t fit a mold and for the most part, can only be generalized in the broadest fashion. Each one is unique from the start and only develop more idiosyncracies along the way including mental problems, chronic conditions, and self-care deficits. People are literally constantly moving and changing as cells duplicate and die, babies are formed and grow, and cellular mutations arise. With so many actions and reactions occurring in people’s bodies every second, it’s not surprising that we often hear unexpected news or detect a suddenly abnormal lab value. It’s actually amazing that so many aspects of our nature go according to plan.

We are all too familiar with our own changes as we have a growth spurt or detect a new wrinkle or realize we can’t run as quickly as we used to as a teenager. Because we understand the human condition personally and because we’ve been wired to respond to challenges with solutions, we can define ourselves as nurses as human problem-solving experts. Sometimes I think nearly everything I do in a twelve-hour shift is responding to one problem after another.

As nurses, we learn to input new information, form a plan of action, and adapt to the changes. A nurse with honed critical thinking skills, the seasoned ability to process information quickly and respond correctly, is worth his or her weight in gold. Many brand-new physicians owe their success (and prevention of killing someone) in their first years of practice to such aptly observant and smart nurses.

As a novice nurse right out of school, you probably don’t already possess those critical thinking skills. Those specific talents can be taught to some degree but are mostly developed and refined through experience. After working for five years on your unit, you now know how to easily handle a situation that would’ve sent you into a panic attack your first several months. Compared to your innocent days, you now know how to talk to difficult patients and get them to comply with a suppository. You’ve inherently absorbed the ability to manage predicaments that would’ve sent you to the bathroom crying previously. Like any profession, nursing hopefully follows an upward curve, with more experience leading to more knowledge and better patient care.

When I first started in the ICU, I was terrified of starting an IV line, mostly because I hadn’t gotten much experience in nursing school. After a few epic failures at the cost of my patients, a kind coworker pulled me aside and showed me where I was operating in error and how to insert the catheter effectively. Thankful for his instruction, I gained a skill that had otherwise been obtuse to me. Months later, I was struggling to keep my patient’s IV line patent as he kept bending his arms and thrashing about in the bed. Rather than trying to insert another line somewhere besides the crook of his arm or use a more effective restraint, I sat at the bedside encouraging him to remain still and restarting the pump every few minutes like a well-qualified babysitter. Even later in my career, I received a patient with absolutely horrible veins, attempted several sticks, then stopped completely, paging the doctor to inform him that I needed more advanced access.

Can you see the progression? As with any job where you start from the bottom, you learn basic skills then develop more eloquent ways of using them to solve your problems. In the beginning, I wouldn’t have recognized that my patient with horrendous veins needed a central line rather than sticking him ten or twelve times. I didn’t have the mental and physical resources to come up with an alternative solution that would’ve proven more beneficial for both my patient and me. I was green and nervous and now I would like to say I’m much more confident, although you’ll never know all the answers. There’s always room to learn.

One particular day will stand in infamy in my mind. I was new, inexperienced and submerged deep in a host of problems much too complex for me at the time.

I received an admission from the ED, a teenager who had swallowed a bottle of pills in a desperate but ineffective attempt at attention. While they had intubated him downstairs and pumped his stomach full of thick, black charcoal to absorb the overload of medications, the tubes and lines only agitated him more. He came up thrashing about, yanking at the restraints with all his available strength and looking at me with manic eyes. With the help of my coworkers, we managed to stifle him with more IV medications and he drifted off into a sedated sleep. Not quite trusting him, I frantically charted an assessment, keeping one eye on his four soft restraints.

Then I turned to my patient in the opposite room.

In the midst of the drama with the teenager I had almost forgotten the depth and magnitude of pain throbbing at the next bedside. A man had suffered a stroke, one that the doctors deemed “incompatible with life.” They offered no surgical option and no medication could be tried. As the pressures built up in his brain, the life was literally being squeezed out of him. And we were all helpless to do anything about it.

His family wailed at the bedside. They laid hands on him, pleading with God for a miracle, some sign of a chance. They wrestled hope desperately, trying to catch it before it slipped away completely. As I tiptoed around the room, trying to be quiet and respectful, more visitors arrived. Then more, and then more. I believe the entire church had stuffed themselves between the cloth curtains as I stood innocuously outside of the room. I wanted to give them their privacy and give the patient the respect owed to a dying man. So I let them gather and pray and didn’t interrupt.

Meanwhile, my teenager awoke in a fury. Banging his hands and legs against the bed, he raised his head up and I saw the inevitable with awful dread. With a thrust of his stomach, he began spewing black charcoal out of his mouth, out his NG tube and onto the bed like a scene out of a horror film. The black spread everywhere instantly as we rushed towards him, trying to keep him from hurting himself. An IV came out along the way and blood entered into the mix. As my coworkers and I grabbed at any available flying limb, one nurse clamped down on my arm with her bloody glove, gripping it with all her strength.

“Yeah, that’s my arm, not his.”

“Oh sorry! That’s gross.”

I washed my arm as someone gave him more medications.

Directly opposite, my dying patient’s family members grew louder and louder, wailing and screaming and beseeching God. Someone started chanting in another language and my coworkers stared at me. I was afraid someone was going to produce a snake out of a purse. With one hand still on my teenager, I panicked, unsure of how to proceed. The disruption was growing to a disturbing level and I felt solely responsible.

My teenager vomited black charcoal violently, staining the room with the mess.

The family members yelled and shrieked at an unmanageable volume.

There was too much noise, too much overstimulation!

And I simply stood in the hallway between the two rooms, literally helpless against the situation. I couldn’t help but laugh, as I truly didn’t know how to handle two such dramatic instances at once. How did I get myself here? What did I sign up for in taking this job? And could you ever imagine such a horrible day as this one?

My manager heard the commotion and came out of her office. After glancing between my patients, she immediately called the charge nurse and someone came to relieve me. It was three in the afternoon and I hadn’t eaten lunch or gone to the bathroom since the start of my shift. She jumped into action, knowing intuitively what I didn’t. She had the benefit of experience that was still foreign and vague to me. I had problems that, with my limited knowledge, I couldn’t solve on my own. I needed help and thankfully, found it at the hands of those around me.

We’ve all had those overwhelming days, those stories you will tell at family gatherings for years to come. We’ve gone home and cried, or called in the next day, unable to face it again in the midst of our exhaustion. We’ve thought maybe we were crazy in signing up for this profession. No one said it was going to be easy. No one said it would come naturally. But as the years and months pass, as we grow more proficient at managing the insanity around us, we become better people, better nurses. We learn to solve problems of every shape and size and do it well.

And as a concurrent benefit, you’ll always have a good story to tell, those stories you will never forget.