commentary for “Let Her Go”

Image

Well you only need the light when it’s burning low
… you always need the light unless you really like the dark…

Only miss the sun when it starts to snow
…or when it isn’t shining at all…

Only know you love her when you let her go
…I hope you knew that before you let her go…

Only know you’ve been high when you’re feeling low
... you need to feel low to know how high feels…

Only hate the road when you’re missin’ home
…then its time to go home…

Only know you love her when you let her go
And you let her go
…then get her back.

Staring at the bottom of your glass
Hoping one day you’ll make a dream last
But dreams come slow and they go so fast

…Dreams are called dreams and not made to last…
Stop staring and dump that glass…!

You see her when you close your eyes
Maybe one day you’ll understand why
Everything you touch surely dies
…don’t worry about understanding…
… change your touch…

Staring at the ceiling in the dark
Same old empty feeling in your heart
‘Cause love comes slow and it goes so fast
…You have an empty feeling in your heart that only God can fill…
…Love can go slower if you let it…

Well you see her when you fall asleep
But never to touch and never to keep
‘Cause you loved her too much
And you dived too deep

…you can never love too much…
… why did you…

…let her go?

Doctors and Nurses

Doctors and Nurses

Image

Linked are two articles, from which all in healthcare can learn and reflect. The original article is On Breaking One’s Neck: by Dr. Arnold Relman, with a complimentary article :A Patient’s-Eye-View of Nurses by Dr. Lawrence Altman.

There are compliments in both articles for nurses, as well as warnings that should be considered.

. As quoted from the original article :On Breaking One’s Neck:

“What personal care hospitalized patients now get is mostly from nurses. In the MGHICU the nursing care was superb; at Spaulding it was inconsistent. I had never before understood how much good nursing care contributes to patients’ safety and comfort, especially when they are very sick or disabled. This is a lesson all physicians and hospital administrators should learn. When nursing is not optimal, patient care is never good.”

The review article in the New York Times, written by Dr. Altman,  brings to light the thought provoking differences between physicians and the nursing staff. Dr. Atman expresses concern at the movement towards technology, citing technology as objects that can “Deflect the doctor’s attention.”

I think that nursing as a profession should also heed this concern-does our bedside report become just a huddle in the hallway? Are we including the patient? Are we prioritizing our time between the computer and the patient?

Hopefully we are not, as nurses, using as our starting point of care the review of notes-or as Dr. Relman so memorably states:

“Lengthy notes in the computerized record, full of repetitious boilerplate language and lab data, but lacking in coherent descriptions of my medical progress, or my complaints and state of mind.”

This is referring to the MD notes-but what about our nurses’ notes? Do they adequately reflect the patient? Do they just present the data, or the whole person? I have a tendency as a nurse to at times subconsciously rely on previous documentation-but our starting point needs to be the patient, not the notes. How are we doing? Do we clarify what we saw in the record with the living person in front of us?

Another nice quote, by Dr. Altman, complimenting nurses is as follows:

“Nurses’ observations and suggestions have saved many doctors from making fatal mistakes in caring for patients. Though most physicians are grateful for such aid, a few dismiss it — out of arrogance and a mistaken belief that a nurse cannot know more than a doctor.”

I think that nurses everywhere should read these two articles and be thankful for the recognition. But we should also realize that what is wise for the doctors is wise for the nurses.

We should never forget, in this healthcare system that is changing faster and becoming more difficult every day, the patient is first-and someday the person in the bed could be me or my family.

I had a nursing instructor once that said:

When you enter a room, and you see lines, and IVs, and ‘stuff’, don’t worry about all of those lines, start at the patient, and work your way out.”

Will our patients, will we, our families, be reduced to hallway huddles and medical note jargon and technical terminology? Or will our care be about the individual, the person, with a cautious inclusion of technology as needed?

These articles provide warning signs about our healthcare and we will do well to heed them, whether doctor or nurse.

A Diverse Ramble

 

Image

Discussion swirled

Back and forth

About how some things are not

Just scientific but in fact

Unexplainable

And who could deny?

For they say

There are no atheists

In foxholes

Why would there be here?

For this is our foxhole

And truly,

There cannot be an absence

Of a Divine Order of affairs,

For the filling of the void and

The answers to the longing

That causes these questions

Is found in the One

The Logos

Who in the beginning was the Logos,

And was with God

And was God.

And because I know

That all things were created by Him and for Him…

And that by Him all things consist,

I rest

While the questions continue,

They continue sticking their heads up

Looking about

Without any armor

And I in my foxhole,

Protected and safe,

Sleep.

 

Ref: John 1, Colossians 1

 

Glimmers of Winter

My “glimmers” as brought about by the weekly writing challenge

It was odd, I thought, that the church on the corner, built of dark red brick, was light tonight. Stained glass windows, lining the sides of the church had gold beams streaming out of them, into the darkness of the street next to them. Always I had seen this church dark, like the night and the city around it, I had never seen it with light.

I had seen it in the early morning, with its chipped white steeple standing upright like a sentry. Its windows were stark in their darkness, even if the sun was shining.

I had seen it at night, with its wooden front doors, with the  stoop full of shadows, where the homeless sat, flicking their ash on the stone steps.

Tonight I saw, for the first time, the gold and red tints in the windows, the outline of a tree through the first window, with the leaves golden yellow and the trunk golden brown and I wondered why did they design a tree in the glass?

The light shown out onto the sidewalk, catching the back of a man walking away wearing a dark hat, winter coat and red snow boots. His hands were in both of his pockets and his head was bent, and I still don’t know if it was because he was cold or because he was just not used to the light.

Earlier in the week I sat on a bench in the mall, and watched a girl walk by in a short black skirt and red, high, high heels. Her long bare legs were striding with purpose as she talked rapidly on her pink sequined cell phone. I sat, with my winter coat and hat and scarf still on, and warm boots firmly in place still trying to get warm after having to park two miles away from the mall and then hike in through the cold. I wondered-how did she get through the slushy parking lot and the chilly wind to the mall without dying of hypothermia? And I really wanted to ask her but she was gone and I wouldn’t have, anyway.

I remember the bright midnight that I saw, that same night coming home when the moon was shining so bright it was like the sun in Hawaii, except it was winter and the moon. The shadows that it caused, reflecting the trees on the hard white snow and hearing in my mind the song ” I go out walking after midnight.” The crunch of my boots on the snow walking to the house because it was so cold and realizing, that if it wasn’t eleven degrees I would go out walking, but instead I curled up under my blankets and slept, at peace because of the amazing moonlight that bathed my world in a silent glow.

The Vanity of Man as Mortal – Isaac Watts

Originally posted on Thinking on Scripture:

Isaac Watts

The Vanity of Man as Mortal

Teach me the measure of my days,
Thou Maker of my frame;
I would survey life’s narrow space,
And learn how frail I am.
 
A span is all that we can boast,
An inch or two of time;
Man is but vanity and dust
In all his flower and prime.
 
See the vain race of mortals move
Like shadows o’er the plain;
They rage and strive, desire and love,
But all the noise is vain.
 
Some walk in honor’s gaudy show,
Some dig for golden ore;
They toil for heirs, they know not who,
And straight are seen no more.
 
What should I wish or wait for, then,
From creatures earth and dust?
They make our expectations vain,
And disappoint our trust.
 
Now I forbid my carnal hope,
My fond desires recall;
I give my mortal interest up,
And…

View original 14 more words

Perspective

 

Image

I walk past

And in a moment

I see

Two worlds apart

At the same time.

You are crying,

He is laughing,

You cannot see each other

But I can see

Both of you.

How are you?

To one

Yields,

“Great! how are you?”

To the other,

“I’ve had better days.”

Your world ending,

Image

 

 

The life of one you loved

Stopped.

His world beginning,

A life with one he loves,

Started.

Image

So here I stand

With Kleenex and tears

To one

And

Smiles and laughter

To another

And I marvel

At the greatness of

The  Omnipresent,

The Omnipotent,

All Knowing,

Savior of the World

To gives to all

Grace,

Love,

Protection,

Strength,

Wisdom,

To meet

Each need

While knowing

And seeing

Worlds apart

At the same time.

 

Image

 

Thou God seest me…Genesis 16:13

Clinical Day 1: Discoveries

shutterstock_37858624

A lesson learned few years ago, but never forgotten.

“No, hon, you’re not going to want that. Those are old. You’re going to want these,” said the nurse, pointing at a rack full of thick binders on the side of the desk.
Bewildered, I put the first binder back on the shelf (it was big and heavy) and turned to face the other rack.
Not really sure what I was looking at but attempting to look professional, I grabbed the binder with my newly acquired client’s room number on the spine, clutched it to my chest, and practically ran from the nurses’ station.
As I fled back to the safety of the visitor’s room that the freshmen nursing students had confiscated for headquarter purposes, I could imagine that poor nurse’s thoughts in the back of my mind. “That freshmen nursing student, thinks that she’ll be an RN someday and she doesn’t even know what a chart looks like!” I could just see her shaking her head and rolling her eyes at the inconvenience of having to deal with a floor full of freshmen. I made it back to the visitor room and sank into a chair with the chart in my lap.

My need to stay in my comfort zone was very quickly overcome by my clinical instructor’s orders to “Find your client’s medications from the chart and write them down.” Then she added with a touch of sadistic delight, “Some of these clients are going to have a lot of meds. One student last year had a client with twenty medications.”
Staring at my instructor with disbelief coupled with shock, I tentatively opened my patient’s chart. Pages and pages of information jumped in front of my eyes. Words that I had never seen before, much less understood, attacked me from the pages. I had no idea where to even begin looking for my client’s medication information.
Suddenly remembering that I would need more care plan information about my client than just medication info, I was struck with the bright idea of taking my client’s chart into her room and sitting with her while I attempted to decipher this terrifying binder. At least I wouldn’t be under the eyes of some of the more experienced freshmen or my clinical instructor. I was still delusional enough to think that my classmates were less confused than I was. If I had actually looked around I think that I would have seen the same deer –in-the-headlights-look on their faces that was so evident on my face.
Quickly sucking in my breath like a diver ready to jump, I rose from my chair, slammed the binder shut, and started walking briskly to my client’s room. As I left the visitor’s room I suddenly felt a surge of confidence. After all, here I was, in my new uniform, young, full of ambition and I had almost four weeks of classrooms lectures and lab time behind me! My self-confidence was returning! I felt knowledgeable, smart, and self-sufficient.

Then I passed the nurses’ station where I had gotten my chart. My confidence quickly dwindled as I walked, no; I sneaked, past that station. No snappy uniform or college based confidence could stand in the face of plain old experience that was represented by those sitting behind that desk. I quivered.

Still clutching my binder, I made it past the nurses’ station and arrived safely, albeit somewhat un-confidently, at my client’s door.
I then gave myself my one thousandth pep talk of the morning. “You’re doing fine, everyone feels like this on their first day. Just relax.”
We had been taught to always knock before entering a client’s room, however, upon meeting my client earlier in the day I had discovered that in my client’s instance that little textbook jewel could be thrown right out the proverbial window. I would have to hit that door multiple times with a crowbar before my client would even hear it. The dear woman’s hearing was not very good, and so, I concluded that all textbook information could be adapted to meet specific client needs. Looking around me, half expecting, half afraid to see my clinical instructor behind me, I discarded textbook policy, and walked right in. I walked up to my client, being careful to approach her from the front so that she could see me clearly. Leaning towards her, I raised my voice ever so slightly. “Hello, Ms. So and So! My name is—— and I am a student nurse. I am going to take care of you today!”
That was my very first ever clinical experience. I wrote about this experience very shortly after it happened. I have learned so much since that day; it would take me thousands and thousands of words to even begin to scratch the surface of all that I have learned since that first clinical day.

First of all, I learned that I was not alone in my feelings of nervousness.

I learned that I was not the only freshmen nursing student in the world to have felt so illiterate at the clinical setting.

I learned that my instructors were and are not sadistic, but in fact want to push me to my limits and challenge me with new experiences.

I learned that my instructors were approachable when I was unsure of myself.

I learned that my instructors didn’t mind me ‘adapting’ textbook policy (within reason of course!)

I learned that it was possible to understand a client’s chart!

I learned that the clinical staff can be invaluable tools for learning.

I learned that if I didn’t know anything, I should ask questions.
And the most important thing I learned that day was how to apply my textbook and lecture knowledge. I learned that no matter how much I learned in school, or how much I knew, when it came down to the client, it had to be personally applied to that client.
Although in the school lab, I would lose points during a re-demo for forgetting to knock on a client’s door, in the “real world”, if my client couldn’t hear me, I had to find another way of making my presence known respectfully without knocking on the door. I had to adapt my knowledge to meet a specific situation.
That little lesson turned the ‘light bulb’ on for me, and helped me to understand the nursing process.  It helped me to understand how to critically think a situation, even in a very small way.

I think that I learned more in that one tiny experience, with a hard of hearing lady in a nursing home, than in four hours of lecture on critical thinking. And, small as it was, I know that I will remember what I learned on that first clinical day for the rest of my life.
~SarahLee,RN