I Know How You Feel

Natalie-17

Not very many people can truly say to an ICU patient, “I know how you feel.” Even when they do, most patients roll their eyes annoyingly thinking, how could you possibly know what this feels like. And for the most part, they are right. People often, in good intention, try to develop that sense of communal suffering to show compassion and empathy, as if your high-speed MVC with an ex-lap, multiple rib fractures, and head injury is synonymous with their tonsillectomy. The well-meaning visitors don’t intend to be insensitive or trivial, but you can’t compare most medical situations and there’s really no point. Often people just want your presence and support and an acknowledgement that yes, this situation is terrible and I’m sorry.

Nurses have learned not to utter the phrase to patients, “I know how you feel,” because we realize that we vastly have no understanding of the pain you feel with every breath or the shock of waking up with a permanent colostomy or the difficulty of remembering your name through your hazy head trauma. We recognize our inability to relate and mostly give thanks that we’ve not found ourselves in the patient’s position.

Families present a different situation. Many of us have in fact watched a family member pass away at the hospital or had a relative who was an organ donor or an aging parent with a debilitating illness. In those situations, it’s easier to utter that phrase because we have a better idea of the range of emotions and hardships that run concurrent with such challenges. Often, families are appreciative and take comfort in knowing that they’re not the only ones having to endure such suffering.

But sometimes you find yourself in a desperately unique situation, one that after time comes full circle and makes you realize that life is both ironic and intentional.  It becomes one of those moments that you look back on and see that it shaped you, made you the person you are today, and despite sadness or pain, it turned out perfectly with some perspective. Did you know that I have such a secret? It’s one that probably the vast majority of you don’t know because I’ve never told it on the blog. It’s a tale that’s not too rare but also not extremely common. A story that means I truly can say to my patients, “I know how you feel.”

As I sat in the big hospital auditorium months before my college graduation, resume in hand, watching the other applicants rise to the front as their names were called, I thought about the irony of my situation, the irony of me applying to work in the trauma ICU. The fact I had been there before, as a patient, nearly eight years prior to my hire date.

One minor decision lead to one miscalculated turn, one uncontrollable gravel slide and then one major accident. My dad pulled me out from between the parked car and the go-cart as I gasped desperately for breath. It was a strange feeling: hyperaware yet in a daze. I even thought to myself, “what if I die from this?” I had never seriously considered that question before in my fourteen years of life. A ninth-grader with little awareness of my mortality.

I remember few scattered memories during my care flight transport to the hospital and admission including feeling self-conscious as they cut my clothes off in the trauma bay. I recall the cute male flight nurse, wondering to myself, does my hair look crazy? I remember he feeling of wanting to wake up but being unable to; fighting against my own battered lungs for air.

I don’t recall the sticks and blood draws or invasive lines. I can’t remember any doctor or nurses name. And thanks to modern sedation and pain medication, that’s perfectly acceptable. I didn’t understand the severity of my accident or the whispered conversations being held by nervous physicians. I was ignorant of the entirety of my trauma, sleeping away in my sedated state.

After a fairly severe accident, I had come out with a punctured and partially collapsed lung, several broken ribs and a liver so damaged the doctor told my parents it looked like someone dropped a watermelon on the ground, letting it shatter to pieces. Thankfully, your liver is the only organ in your body that regenerates and literally re-grows itself so I at least had that advantage. I was also young and athletic, my body poised and ready for a rapid recovery.

Everyone monitored my blood levels meticulously as they dropped, point by point, down to a critical low…then began to rise back up. My body triumphantly won, allowing me to avoid surgery and a huge resulting abdominal incision. It was a gamble on the doctor’s part and I’m so glad they bet on me. Again, I didn’t understand the medical language or the purpose of the daily procedures. But when I managed to open my heavy eyelids from time to time, I noticed the fear and worry stencilied across my parent’s faces. They were desperate for any positive sign, any sign that I would make it out of this predicament unscathed and alive.

Ironically, stronger than any of the pain or discomfort or emotional heartache was my desperation for water. I was insaitably, irrationally thirsty with strict instructions not to take one sip until the team was convinced I wouldn’t require surgery. Even with continuous intravenous fluids keeping me hydrated, I craved the wet taste on my tongue, the relief of that clear liquid.

Water: it’s something you completely take for granted, until you’re banned from it.

A few ice chips may have slipped by here and there at the hands of my compassionate mother but it’s comic to me that out of that entire experience, my most vivid memory is craving the world’s most standard resource.

Cards and flowers showed up with neighbors and friends. The principal, the pastor, the complete entourage of those dedicated to visiting the sick. Ignorant of the severity of my condition, I didn’t quite understand everyone’s enthusiasm for my well-being as I graduated out of intensive care.

I remember my kind nurse on the floor who stroked my hair and spoke gently to me. I remember feeling self-conscious about the thin gown covering me as my friends from school came to visit. I remember one of my friends trying to hang Christmas lights in my room along with a bursting collection of student-made posters, only to be informed it was all a fire hazard.

I eventually stumbled home, reasserting myself on the couch for another couple weeks as my teachers excused me from my assignments. As muscle spasms settled into my shocked body, I gasped for air through the pain, forcing myself to take slow shallow breaths until the cramps subsided. But day by day I improved and grew stronger. I remember those incremental instances of my improvement well.

Walking to the mailbox, a victory!

Going to see a movie, incredible!

Journeying back to school, looking like an emaciated ghost, a bag of pale bones. Deciding to attend the school dance in an impromptu fashion, despite my convalescence.

As you can imagine, the experience wasn’t quite so innocuous for my parents. They gripped my tiny hand every hour of the day at the bedside. They prayed and cried and let themselves rest on the shoulders of others. They hoped and, thanks to the miraculous nature of the self-healing human body, watched me improve back to a shadow my initially healthy state.

I cant imagine the horror they went through, but I understand it much more now as I watch families of young patients suffer in the ICU. My parents sat where they sat and someone cried with them and tried to reassure them. Probably a nurse like me, now. The tears of a parent can be the most bitter and desperate, but also the most hopeful.

Now comes the even more strange part. About a year after my recovery I had a dream, a strange, oddly clear dream. I saw myself lying in my bed on the hospital floor ward, the same bed I had inhabited during my time there. But I also saw myself standing over in scrubs as the nurse. I played both roles, the patient and the nurse, mirror images. And from then on, I knew my future profession. I didn’t question it or give it much more thought; I just knew I would take on the responsibility and privilege of nursing. God used that trial to show me who I would become.

Years later, when I interviewed for the position, I suddenly realized my extreme advantage, the fact that I could truly say to the patients lying in those ICU beds, “I know how you feel.”

Now I can say those words with honest compassion and empathy, although there are still aspects of the ICU that I didn’t experience. The words aren’t just a cliché uttered by a well-intentioned staff member. I know how uncomfortable it is to get a tube shoved down your nose into your stomach. I have experienced the sting of IV needles and ABG draws. I distinctly remember the embarrassment of a bed bath. Our attending physician, who was only a resident when he took care of me, and I now laugh about how I cried when he told me I couldn’t be a part of cheerleading for a while.They are true words from my mouth proclaiming hope in the midst of a tumultuous place, a light in another’s darkness. Not everyone has such a story and while it was painful, I don’t regret it and I’m glad I’m able to relate my patients in that way, although I don’t share that story with them very often for one reason or another.

I hope for your sake that you can’t say, “I know how you feel,” but don’t think that your presence is any less valuable or your words any less meaningful. Be assured that your actions at the bedside everyday are enough, more than enough as you pour out yourself for your patients and families. They notice your kind words and your expertise and appreciate it more than you can imagine. Believe me, I know. I felt the very same way.

 

How To: Handle Emergencies

 

Natalie-8There are certain days that stick in your mind permanently, days full of crash carts or emergency intubations or the unexpected stroke. Sometimes no one saw it coming or maybe you work in intensive care and were waiting nervously for the patient to crash with a syringe of epinephrine in hand. Whether you’re fresh out of nursing school or a seasoned RN, you’ll probably never forget a defining moment of your career: your first code, or a similar experience of critical importance. Your hands were shaking, pulse pounding, and it took you several days to process through all the emotions surrounding such a traumatic and exciting experience. I know I’ll never forget my first code, which I relayed in this post.

Handling emergencies of any type takes practice in both physical and mental skills. You review a checklist of actions and run through scenarios in your mind. You probably practice chest compressions in a lab with an instructor or observe the rapid response team as they move frantically around your patient. Having a steady hand when your critical moment comes requires time, effort, and thought, and developing those instinctive reactions doesn’t happen overnight. Many times you won’t even realize you’ve acquired those skills until you’re in the moment. Suddenly you know what to do, where to move, and when to call the physician. Without anyone telling you to, you titrate, do chest compressions or support an emergency response team at your facility. But how do you get to the point of instinctive reactions? When do you “cross that line” from novice to experienced in these matters and what steps can you take to be prepared? If you have little exposure to emergency situations in your area, is it really that important to be proficient in those skills?

Regardless of your clinical area or the degree to which you encounter emergency situations, in my opinion it’s extremely important to know how to react, because one day you might be at the mall or a baseball game when someone arrests or your child might choke at home. Emergencies are not limited to the hospital and as nurses, I believe it’s our responsibility to maintain our knowledge base for such a crisis. Many of you do this through professional certifications like BLS or ACLS but we all know performing CPR on a mannequin in a lab is vastly different from the bedside. Plus we’ve all heard them call a code blue from a clinic or the lobby of the hospital so you never know when V-Fib might attack. And you just hope and pray that they don’t (or secretly wish that they would) call for a nurse on a long airplane flight and suddenly you’re on stage, needed and necessary, armed with only a basic first-aid kit and your nurse brain.

Honestly it was several years in intensive care before I felt like I could instinctively respond in a code situation. As a new nurse, I watched others and marveled at their ability to infuse and flush and yell all at the same time in a flawless motion. They were all so smart, so seamless, and I felt like a fish out of water. I wondered if I would ever gain real confidence and it wasn’t until I became an ICU charge nurse that I felt like I got real, frequent exposure to those types of situations. After doing my charge training we had five codes on back-to-back days and while I wanted to run and hide in the bathroom, I was forced to step up, take control of the situation, and utilize all those skills I had been developing for years.

Here are a few tips I’ve picked up along the way, mostly from mistakes I’ve made or things I wish someone would’ve told me. And while we all have moments where we feel overwhelmed, I’m confident that with some practice and preparation you can feel ready to take on those emergency situations.

Know your resources. By this statement, I’m saying know who you can rely on for help when such a crisis arrives. We all can easily pick out those more experienced nurses who are skilled in responding critically. Even if you don’t know what to do, grab someone who does and learn from them. Sometimes those nurses may not follow an exact routine because they are able to put many pieces of information together at once and assess needs simultaneously. Sometimes they will simply remind you to put the defibrillator pads on your patient’s chest as you stand there in shock and awe. You’ll learn more than you realize by observing and copying the actions of those seasoned nurses around you. Don’t be afraid to ask for direction if you get stunned and find your feet glued to the floor. Running a code or responding to an emergency situation is a team effort and more than likely you always have a charge nurse or manager who can help you out.

Try not to panic. This one is easier said than done, especially if you don’t encounter many critical situations. As we know, there’s a level of good stress that stimulates adrenaline and helps us to move effortlessly and quickly. But that same adrenaline can paralyze you and hinder you physically, mentally or emotionally from being able to fulfill your role. Recognize that a code blue is a life-and-death situation and that you need to move quickly but don’t let that overwhelm you to the point that you shut down.

Practice the what-if’s. I used to do this very often as a new nurse and I still do sometimes for fun (fun?). I think to myself, “ok, what if this man stopped breathing?” or “what if he suddenly went bradycardic?” Then I would process through my reactions, making sure I was attending to the most important needs first like an airway or emergency medications and then running through secondary needs like an OG tube or chest X-ray. I would also review what medications I would give in what dosages because that can get confusing, especially if you have to calculate based on weight. You can also perform this mental exercise at a public function like a college football game by paying attention if you see an AED or an emergency tent. It might sound over analytical and downright nerdy but if that moment ever comes, you’ll be prepared and I’m pretty positive some unlucky person will thank you for it.

Know your equipment. I’m still surprised at all of the goodies that lay buried in the depths of the crash cart so if you get an opportunity, familiarize yourself with the location and variety of the contents. I always advise new nurses to dig through a crash cart after a code situation is over to see what is where and how they could use it. Also, don’t ever leave your unit to travel without your emergency equipment! When your vent stops working in the elevator and your patient bradys into the 30’s, you’ll be glad you have it (yes that happened to me). You don’t want the one time you forget a piece of critical gear to be the one time you need it.

Remember to process. After the rush and adrenaline of an emergency is over, you can be feeling a million different emotions. You might feel relief, pride, or loss depending on the patient outcome. You might feel frustrated or overwhelmed or even excited. Any reaction you have is valid so take some time to process through what you feel and why. It might take some time but by reviewing not only the scenario but also your own personal experience, you will be better prepared for future crises. If you find yourself particularly upset or stuck on a certain event, reach out for someone who understands, whether that’s a coworker, a family member or someone designated by your facility to help you cope.

I could give you many more tips but your instincts will mostly come with time and countless emergency intubations. Give yourself grace if you don’t have much experience with emergencies, recognizing that each time you will be able to react faster and more proficiently. All you can do is be prepared and do your best when that situation arises, even if you’re stuck on an airplane.

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…

DSC_1429

Interview with NurseEyeRoll: Becoming Nursey

unnamed-1

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!

unnamed

Pregnancy and Paleo: Second Trimester

DSC_1355

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!

P1110304

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

P1110295

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.

DSC_1473

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.

DSC_1338

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

Natalie-15

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

Natalie-8

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

IMG_3548

 

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!

 

IMG_3561IMG_3544

IMG_3595

P1100985P1100982

IMG_3599P1110003

P1110006

P1110024P1110027

P1110073

P1110117

P1110143IMG_3614P1110221

P1110250P1110276

IMG_3670

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.

DSC_1349

 

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