Sunday, 20 October 2013

Catabolise This!


I swore I would never burn out……

            I love clinical. I love researching my patients. I love making connections with my knowledge and incorporating previous stuff, into new learning, I love learning…..and I am doing a lot of that these days. I am comfortable with the basics, and even have an awareness of areas where I excel….I am still learning about me. Ask me about the functionality of any system in your body, I can tell you exactly how it works, what is happening when it isn’t working, and how to improve your health outcomes……but before last week, I couldn’t remember the last time I felt truly happy….or more specifically…. had a second to enjoy that feeling…. I have been so focused on everything and everyone around me, on excelling as a leader, as a nurse, and as a Mother….not to mention surviving level 4! that I totally forgot about myself…… Sure I noticed that I was starting to feel more tired, I was eating and drinking more, gaining weight, and not sleeping as well….and yep, even a few more grey hairs!!, ugh….but I wasn’t making the connection. I watched as some of my friends began to experience these  same things, and of course was able to see it instantly….burn out! But not in me…. I won’t burn out…I can do everything, I can do anything….

I am so tired.

 I am busy. I have been so busy. So have a lot of you readers I’m sure….who isn’t a professional multi-tasker these days??....Well let me be the first to admit it…..I am not doing that very well. I forget  sometimes, to treat myself as my own bestie….and I deserve to be treated like that….at least by my own self!!

I had a plan, I had a handle on it all. I am doing well in all of my classes, and every time I cross another item off of my ever growing to do list, I feel a little lighter.

Catabolism- “the destructive phase of metabolism. It includes all the processes in which complex substances are converted into simpler ones, often with the release of energy, and cell respiration for the formation of ATP” (Unbound medicine, 2013)

 I have TOTALLY been trying to skip that part!!!! The part where my insane summer (and life) gets digested and broken down into smaller bits that I can actually process….. The part where all of the complex stuff I have been learning gets compartmentalized into tidy little accessible packages in the back of my mind….It’s friggen chaos in there….
I can’t not do that anymore….time to digest…..

             I have started that process, and am irritated with just how time consuming it is….hello? I have papers and midterms here!! But I have come to the realization that I am not capable of moving past experiences, unless I allow each experience to have it’s intended effect…Taking time for myself manifests as; me becoming more proficient and aware as a nurse, more sensitive and generous as a mother, and more present and focused as a leader. I get it. I just have to commit to doing it.

            It’s funny…..I guess I was never that good as an actor…. Hence the career change, lol….people who I love are starting to notice the burnout. They always told us, “fake it until you make it”…I cant fake it anymore….at least not all of it.

Since May,  I have been  put through  the wringer….intense heartbreak, was actually set on fire and suffered 3rd degree burns- in a 3rd world country with no access to pain meds, came home to be involved in a car accident- where my car was totally written off, and I sustained back injuries that are still impacting my daily life, had to replace my car, was hospitalized for a serious Strep infection that caused borderline SEPSIS, and, I know I don’t need to mention but….more grey hair!!! And the whole time I have been so tough. Maintaining the belief that there is no use worrying about the crap we can’t change…..

 I still believe that… excessive worry is not good for you….but “worrying about”, is separate from “processing”. I need to process…..Thanks to a couple good friends who have the luxury of calling me on my bull s%&*, I have started that process. Here is what I have learned....thanks to you...

“Being tough is not about being unaffected….being tough is about getting back up after being knocked down, it’s about learning from your experiences, and being your own best friend. Being tough means finding the strength to fully forgive, and it means letting go of the burden of regret…. with no looking back. Being tough requires you to be vulnerable enough to, not just feel, but to process the toughest of feelings, and to accept the true depth of your capacity for emotion. It requires you to accept yourself, and others for exactly who and what you/ they are in any given moment, without judgement, and then it humbly requests that you make the conscious decision to move forward” –Alana Smith, 2013-




 I am human, and human beings are affected by their experiences…. I can accept that.

            9 weeks in and I’m finally starting to really understand the importance of prioritizing. Not for my patients….that one is easy, but for myself…..not as easy.
Looking forward to NOOO vember, a much needed sister break to Vegas, and the healing that will inevitably follow when I get my ass back up, and offload some of the pressure caused by my mere human efforts to balance the entire world on my shoulders.





I won’t wait for the fire to burn all the passion from me, I will simply give the candle a little break, knowing that when I am fully ready to re light that flame, the fire will burn brighter and stronger, and warmer than ever before. With every new flame, exists the potential for new beginnings. I still posess the passion, the drive, and the mad skills, I quite simply need to re group….no biggie…Hope remains…. and where there is hope, there is potential and capacity for change. I am excited to be my new BFF. 

















Alana- Student Nurse -Xoxox


Thursday, 12 September 2013

No policy for that......


          It was 220 pm. I was busy working. I was charting the very important information for my 3rd patient of the day. The day  had been going fairly smoothly, aside from feeling like I might be forgetting something…. I checked my MARs 50 times, double checked my patient’s orders, and of course checked and rechecked my patients….I wasn’t missing anything. I was minding my own business when the Dr. walked by and said “he’s gone”….I listened for what felt like a few minutes before asking who they were talking about.- she said the bed number…. I spun my chair around and scanned the assignment board furiously…the Dr. declared the time of death just as I realized who she was referring to.

            In Nursing we have policies and procedure manuals for almost everything. Need to give an IV med and don’t know how fast to give it? We can look that up. Injections, lifts, transfers, suctioning, anything with tubes, lines, needles, drains, meds, or equipment…..there is a policy for that……


            There is no policy or procedure manual to tell you how to deal with the hurricane of emotions that can come crashing in on you, the moment you realize that the patient who’s life just ended, was the same patient you spent 2 days caring for the week before….. there are no guidelines or policies to tell you how to go about your day…. and continue to keep it together,  continue to be a great nurse and provide exemplary care, even though a very valuable, and cherished life, has literally just ended.

            That reality slapped me in the face before I had time to protect myself. My heart sank into my stomach and the air was completely sucked from my lungs. “I know him” I said as my eyes filled with tears….tears of shock, sadness and disbelief. I tried so hard to fight them and I could feel my eyebrows furrowing……I walked to the room and tried to mentally prepare for what I was about to see. Fighting the choking feeling in the back of my throat, I opened the curtains. He looked so different than how I remembered him. Only a week ago he was feisty and alert. Now his body lay there, peacefully lifeless. His eyes were closed and his mouth was wide open. I felt a smile cross my lips and a tear raced down my cheek as I admired how still and at peace he appeared. I pulled back the sheet and held his hand for a moment. It was still warm. I took a deep breath and put all those feelings on the back burner. I was so sad…..but my role was to continue to be a nurse…. I would have plenty of time to be sad later. I went and found the charge nurse…
 “so what do we do now?”  I asked eagerly…..I wanted to do whatever I could…my patients were stable and I felt I had a connection with him.
           
            I was told the procedure for getting the patient ready for the family. I removed all IV lines, put the patients dentures in and made him look as handsome as I could….the whole time reminding myself what my role was. I was the Nurse, I was not there to mourn the loss of this man as a friend or family member, I was not there to judge his life or his choices, I was not there to engage in any complex  patient care skills. My role was to be present, and that was such an honour.


            Life is  so crazy. We live day in and day out trying to get somewhere, to be someone, to get better, faster, stronger, at something…..and then in the end, there is only stillness. Everything just stops. Life continued to go on around us, as I prepared his body for his family, but in that room, for those few moments….everything was still.

I have never touched a lifeless body before today, so of course I was not prepared for the emotional upheaval that accompanied all of this, but I also don’t think I will ever “get used to it” as a nurse. I am becoming a great nurse, and for me, that means that I will always have a certain level of emotional connection to my patients.  I care for them, and about them in a very genuine way…… I learned today, that that is one of the qualities that will make me great at my job.  It is because I connected with him, because I took the time to get to know him, and because I genuinely cared for his well being, that I was able to go in that room ……respectfully, and professionally, as a nurse and a human being, and prepare him for his final hugs and kisses from his family. After I did all I could for him, I finished my shift. I charted for my other patients, removed 2 IV lines and did another set of vitals….. And then…. yes …….I cried

 I cried on the way home in my car, I cried when I got in the door and I cried as I changed out of my scrubs….  I cried for almost the whole time as I wrote this…..Because life is so precious!! Because I am a human being too…… And sometimes nursing is hard!! because sometimes no matter what you do as a nurse to ensure your patient will be comfortable, to help them get better, all of the interventions and careplans….sometimes that is not enough. And yes, I have learned about boundaries with nursing and I know enough that I will not dwell on this patient or his outcome, but that doesn’t mean I don’t feel, it doesn’t mean I can just forget about it once I leave the ward, and it doesn’t mean it wasn’t a hard ass day…..I am so thankful to him for all he taught me in his passing… I hope peace and comfort will find his family as they find their way through this time.




RIP
XOXO
Alana- Student Nurse

Monday, 8 July 2013

The Butterfly Effect


           I have sooo much to tell you about my trip and my experiences in Roatan! I have so much to share about the beauty, the culture, the experience of the clinic, the smells, the sights, the sounds, the feelings, the people….the amazing people….but my trip took an unexpected turn…..one that I really feel like I need to put on the page in order to continue to work through…. Some of you may have seen the clinic blog with a shortened version of this story, and many of you (thanks to facebook and the wonders of technology) know that I was in accident where I was badly burned,  but  I feel like I need to put the story here…. I treat this blog like a journal, so this version might be a bit different than those you have read ….

My clinic stories will come soon, I promise!

On June 24, at about 740 pm, I was watching the Boston game at a local restaurant in the West End of Roatan, when my volunteer nursing mission took on a new shape…..my priorities changed….  drastically, from helping to heal the people of the community…..to surviving what was the most horribly scary, and painful experience of my life….


I had just come to the West End from Sandy Bay about an hour and half prior, to have a swim and cool off. I had spent the day doing eye exams for kids in the community, and even made the Roatan news in a little mini interview! I had some delicious fried chicken for lunch in Coxen Hole, and enjoyed the company of fellow volunteers. It was an awesome day! But it was long. I was tired and hot. I debated just swimming off Peggy’s dock, like I had done a zillion times before, but decided that I was hungry too, and there were still so many places I wanted to eat at before my last week was over. I also needed to have some time to just be on my own. My trip was winding down and I needed some me time to take in the island. I went to the beach at Sundowners, and had a very refreshing swim. It even rained a little bit, which was extra refreshing. I decided I better venture down the street and find a snack…… I changed out of my wet bikini top, into my beach dress, re applied my bugspray, and headed off. I ran into my pal Karly and her man , who were in Roatan for a few days visiting. She was enjoying an ice cream on her way back to their hostel…..I realized that I had been on the island for a month…and still had not tried the ice cream from that little place on the corner… I made a mental note to do that after dinner….

the beach at Sundowners
I passed an agitated tourist and overheard her conversation with some locals…..she was complaining that there was no pain medication on the whole island. She had just had surgery, 27 stitches, and no meds…. I wouldn’t usually intrude, but I hate to see people in pain….plus I didn’t believe her… “Have you gone to Miss Peggy’s?, I am sure we have something there”. “Yes”, she replied…”nothing stronger than Tylenol 3”….. that can’t be right, I thought, but I was hungry and not interested in debating the issue….I wished her well and continued on my way….. By this time I already decided that if the little BBQ place that Lisa and I ate at on her last Sunday, was open, I was going there. The wings were so good, and I wanted to see what else they had to offer. I was so happy to see the BBQ smoking, and to see a few people sitting at tables. I went in and noticed there were female bartenders working. Since I was on my own, I didn’t want to take up a whole table…. So I pulled up a seat at the bar, close to the middle so I could still feel like part of the action…..and asked for a menu.  Turns out my favorite wings were on  special! I ordered and settled in.

            What followed for the next hour or so was nothing short of a nice, relaxing time. I made friends with one of the bartenders who was also a single Mom going through school, I had some of the best wings of my life and watched a little hockey. I got a call from Cassidy that everyone was at the beach house for a potluck. I hung up and decided it was getting to be time to head back. I needed a shower anyways. The place had filled up, and all the staff were working hard to keep the customers happy. Being in the service industry myself, I know how annoying it can be when people are demanding things from you, while you are clearly in the middle of something else, so I was waiting for my window to ask for my bill.

            Another bartender, who will remain nameless here, was making a drink for another table. I had watched him make one when I was first arrived and was curious about it….it looked crazy. He called it the Blowtorch. It had 2 different types of rum, some other stuff, and was set on fire. As he was explaining it to me, he walked around to the front of the bar…. About 4-5 feet away from me… some other patrons still separated him and I, and the drink that changed my life.  He decided that the fire part of this drink, wasn’t impressive enough, and asked one of the gals to add some 151……I remember thinking “bad idea to pour alcohol on an open flame”…. And like a scene from a horror movie, the 151 hit the flame, the flame jumped. It came at me like a wild animal attacks it’s prey. 


I was engulfed by the hot angry fire and there was no turning back. My whole dress went up in flames as the blaze surrounded my upper body and went up over my head. I was being  consumed and I had no where to go…..Someone screamed…. It might have been me, but I don’t remember… I tried with all of my might to back out of the situation, pushing the flames down with my forearms. It was burning me and refused to let up. I remember my face hitting the ground and someone on top of me, I remember realizing the fire had stopped,  I heard him say “ we have to go to the pool, ok?” I found the strength to stand up….. I saw a full bar of people staring at me....shocked…and it hit me,  I was just set on fire. I was angry, scared, and in the worst pain of my life.  I started to cry…. I felt so sorry for myself for about 3 seconds and then a sense of peace came over me. I kept hearing in my head “something good will come from this, everything happens for a reason, something good will come” .  I jumped into the water and submerged myself up to my lips......no relief....As the skin fell away from my body, I remained calm enough to instruct this bartender on how to find my phone, to find Peggy’s number (which just happened to be saved in there from the last person who used that island phone), I told him to call Peggy and tell her we need her to go to the clinic. I told him to call Cassidy, to call Susan, and to get me to the clinic.  When I arrived, about 10, hot, excruciating minutes later, Cassidy met me outside and brought me into the very place  where I had spent the last 3 weeks treating patients. Peggy was there, calm and cool as a cucumber. I was handed a small paper cup with 2 Tylenol 3’s...."what is this?" I thought it was a joke….I suddenly remembered that woman in the street……the horrifying realization hit me…. She was telling the truth….there is nothing on this island for pain…….Peggy’s voice echoed in my head “It’s all we have”…..
My new butterfly

I reluctantly accepted the reality (because I clearly had no choice) that if I was going to get through this, I needed to focus…. I needed to NOT feel sorry for myself, I needed to NOT worry about the final outcome, or question “why me”, I had to gather every ounce of strength and faith that I had, and I needed to get myself through this night. I borrowed some strength that night. There were people in that room, supporting me, caring for me, helping me cope. My fearless instructor, Susan, who used many of the skills that she had spent the previous semester teaching me, to try and keep me in an ok place mentally, my friend, and SN superstar Cassidy, the poor guilt ridden guy who not only set me ablaze, but who also happened to save my life.... the always strong and clear headed Miss Peggy, and Dr. Raymond…..the most genuine, honest, skilled, and caring Doc that I have ever met. Manu…..who I had spent not only that day, but also a good portion of the last 3 weeks with,  watched from a distance…..he didn’t say much, but I knew he was there…..his presence speaks volumes. Dr Eric, who I was just having the pleasure of getting to know was there for a bit as well…. I borrowed from each of them…. I borrowed strength, I borrowed bravery, and I borrowed peace. I borrowed from my family too.  Although I didn’t sleep that night, I survived. My heart continued to beat on its own, my lungs effortlessly filled with air, providing my body with the necessities of life…. I was grateful for each and every breath. I didn’t understand how it was possible for my bottom lip to be burnt, my right nostril to be burnt, but my lungs to be completely unaffected….  How did fire shot up over my head, but leave my face and hair almost entirely unaffected……I was filled with gratitude and awe……I thought about my Mom and how I didn’t want to tell her because I knew she would be sad and scared. I thought about Paige, and tried to find the right words to explain to my little 7 year old, the nightmare that I had just experienced. I thought about that bartender….and how every moment in my day…and likely my life, had let me to that barstool at that exact moment. I thought about Alex,  about how we were supposed to go snorkeling with little Ashley….I thought about everyone who had supported my year long efforts to get to this place, so that I could help this community. I thought about how I was now getting a very different perspective on the clinic and the irony made me smile.
         I was in so much pain, and each day, people came to see me, they offered prayers and love, and anything else they had. Dr. Angela stood up for me, and my needs with the insurance company, and I am so thankful she arrived the same night of the accident. It was becoming clear that there way too many “coincidences” which I don’t believe in anyways, for this to be some random freak accident…. It was supposed to be me in that bar stool, I remembered that I am always exactly where I am meant to be for my journey, and I began to dig deeper….

            What is the point? What is really going on here? What is the message?  It just wasn’t possible  that  something bigger  wasn’t in the works……..The project that evolved  can be found at the bottom of this page. I don't want to imagine what would have happened if that clinic wasn’t there, or if I was just a tourist and didn’t even know of the clinic….. they need help to sustain the level of care that they provide.

            They need a trauma center….or a trauma….area, that is capable of dealing with this type and any other type of emergency situation…. This is going to take a lot of time….alot more money, and a lot of  teamwork, but I know that those things…..much like the events that led to this whole ordeal… will line up exactly when they are meant to.

            When I arrived in Roatan on May 25 2013, I was full of hope, excitement, and gratitude. I felt a strong connection to the clinic long before I arrived and every day I was thankful to be a part of it. I made lifelong friends at that clinic and soaked in every second. When I was rushed to the airport and flown out  4 days early, I was filled with those same feelings….. hope, peace, gratitude, and excitement for what is possible.......


 The doctors at home were impressed with the work of my Honduran care team. They were very impressed with the speed of my healing…..which is thanks, in part to you….I am humbled by the amount of love that was sent my way. Thank you. It’s proof enough for me, the power of thought and intention. Everyday I get better but I will never ever forget.


              The word Kaizen means “small continuous improvement” which I think is very fitting…thank you for your support- please share this link with all of your friends!

           
“Fire symbolizes renewal, creation, and destruction through transformation.  A passionate polarity that offers emotional power and drives heartfelt endeavors”

- Kelly Oswald- Buddha Nature- awaken to your life-



XOXO- Alana-Student Nurse