"Cognition needs limitation and emotion needs freedom."

A wise woman recently shared this quote with me, "cognition needs limitations and emotion needs freedom."  Over the last few months my profession has shown me multiple traumatic events, I have been a PICU nurse for about 8 years now which I have witness a lot of trauma and heart wrenching things.  It was brought to my attention that these traumatic things are similar to a battle field, the blood, the vomit, dirt and glass matted in a patient's hair, or even brain matter oozing from a bullet hole or incision, and the smell that goes with it.

For years I have been able to be a robot when trauma patients come rolling through the PICU doors, and do what I need to do for my patient, I see them in pieces not whole. Then there is a short moment when you stop doing things and look at the patient and realize it's a baby or toddler or teenager, they are human.  I remember when I first realized this is what I would do, there was a baby who was in a fatal car accident several years ago.  I was a robot when this patient first came into PICU, getting things done that needed to be done; assessing the patient, assisting physicians with lines, and so on. The neurosurgeon needed to place a bolt (measures intracranial pressure), they do this with a drill (sounds grotesque I know). As the neurosurgeon was drilling into this baby's skull, I lost my breath and started looking at her as a baby.  After that moment I hear my name being called several times and I shake it off and carry on.  There are times after a tough shift I get into my car and cry, sometimes bawl to the point where it's difficult to catch my breath, and other times it would hit me days later.

I have heard it is around seven or eight years when ICU/ER nurses experience burnout, and I have certainly witnessed it.  The unique thing about PICU is we see it all, we are not just cardiac or trauma, we are cardiac, trauma, respiratory, surgical, and attempted suicides or patients that have suicidal ideation.  I would have to say traumas are the hardest for me and have been through out my whole career, and I believe the reason they are hard is because one minute the child is healthy and in a moment they are not.

Burnout is a real thing and recently I identified it and currently working through it.  When I have witnessed it I didn't think it would happen to me.  I'm very fortunate to have the support from my unit and especially my boss.  I come from the era of nursing when senior nurses ate their young, it was a sink or swim culture.  The culture has changed, it takes a village not only to care for patients but also to care for each other; nurses, physicians, techs, dietitians, pharmacists, house keeping, respiratory therapist, pastoral care, occupational, physical and speech therapist, and child life.  This is our PICU village, and the village merges with other villages in the hospital.

I want this message to get out there so others know they are not alone, again burnout is real.  In the beginning of my PICU career I was able to shake it off.  After repeated exposure it starts to build, layer after layer until it gets too heavy.  It can be scary until you identify it, I was feeling irritated and forgetful, not like myself.  I am also very fortunate to have a good therapist that will help me through this.  I love PICU and I have many more years to give.  I want to be a nurse leader that will advocate for my fellow nurses and other health care professionals.

My Father's Love

My father is my hero, he is a protector, provider and a great adviser.  As a society we dilute the importance of a father's role, it's equally as important as the mother's role.  My father is a strong figure and role model in my life.  My father's love for me and my family has been constant and consistent.

My parents hadn't planned on having me, I was an oops.  As a child my sister told me I was a mistake, I was devastated and bawling.  I asked my father, was I a mistake?  He replied without hesitation, "Missy you were the best mistake we made."  My father is a honest man and always knew how to make you feel special.  He would work twelve plus hours a day, five days a week and also on Saturdays, but he would always come home and help us with our homework.  I never heard him complain about work, when he was home he was focused on his family.  He always told me, "the greatest thing a father can do for his children is love their mother," and he did just that.

My father was a boxer in his younger years and he also was a boxing coach.  He had a gym in our garage with a speed bag and a heavy bag.  I would watch in admiration when he would use the speed bag, it takes a lot of focus and rhythm.  I taught me to box, if you can imagine that, and I had the dream of being a female prized fighter, shocking I know.  So he taught me, he never told me that was silly or you too much of a girly girl.  I believe he was happy we had an interest together and he could teach me something.  That dream quickly faded once I learned I was a lover not a fighter.

In my twenties I had my heart broken by a boy, I don't remember all the details of that day but what I do remember is I walked my pups to my parents house then got angry about something.  My father was going to drive me home and being stubborn I stormed out and started walking home.  As I was stomping home, my father drove up beside me in his truck pleading with me to let him take me home.  After several minutes of him following me I got in his truck.  Almost immediately I started crying and eventually told how heart broken I was.  He told me he was sorry and just let me cry, he let me release my sadness and sat with me, always being constant.

Last Sunday my parents and I were having a discussion on the recent tragedies in Orlando, by the end of the conversation it boiled down to my father still wants to protect his family from the cruel world.  His children are grown and he still wants to cushion us from bad things.

My father's love has always let me be who I am, and he has encouraged me to be a strong woman.  I love this picture because it speaks volumes about him as a father.  He teaches, encourages, and again is always constant.

My Mother's Love

I have been thinking about this post for a while, and not sure how to put into words what my mother's love has done for me, my family, and anyone who considers her a friend.  Her love is generous and never runs out.  Her love is supportive, nurturing and gentle.

I was a thumb sucker from day one, and she always says I was the best baby.  My mom didn't push me to stop and would tell whom ever had an opinion about it, I would stop when I was ready.  My father would try to put the bitter nail polish on and I would endure the bitterness until eventually it wore away.  I understand where my father was coming from, probably thinking this child is going to need braces, which was the case.  I did eventually stop.... in fifth grade.  One of the beautiful things about my mother is she lets me be who I am.  When I wanted to change career paths and leave Iowa State after attending for only two weeks to pursue a nursing career, she said ok without hesitation.

One of the hardest things I ever had to tell her was I choose not to have children of my own.  I actually made sure her and I had a glass of wine before I had the conversation.  I didn't want to crush her dreams of being a grandma once again, one of her favorites things.  After I bravely got it out, she told me, "Miss I support your decision."  

My mother has loved me through some ugly moments, especially in my teenage years.  I remember wanting independence so badly from my parents when I was a teenager.  One time when I was probably sixteen I was going to the mall with my good friend, and really we were just going to the mall.  I didn't want to tell my mom where I was going because I didn't feel like I should have to.  Well my friend came over and my mom asked her where we were going, and needless to say I didn't make to to the mall that day.  I am sure I did not give that one up without a fight, but she loved me through all the fights I put up.

I love this picture of her. I found it a couple of years ago, her beauty and that smile takes my breath away.  My mother's love has taught me to be maternal in other areas of my life, as an aunt, sister, daughter, friend and especially a nurse.  Medicine can do some amazing things but doesn't compare to the love of a mother.  

I'm proud to say I am a product of her, and I thank God she is mine.  When it comes to mothers and daughters, we are the perfect fit.  

Letting Go

I have let go of a lot of baggage, and it wasn’t until recently I let him go.  When a relationship ends for me I have a hard time letting the fantasy of the relationship go while the reality of the relationship is screaming at me “Let GO!”  

Several months ago I found out truths about a man I was in a relationship with, and for months those truths picked at me.  I had a lot of questions, and I tried repeatedly to let those questions go and settle with no answers.  I questioned how he really felt about me, was what he said true or was I just another woman on his list?  I felt these questions weighing me down, and it was affecting me living my life.  I was curious, scared and heart broken.

Finally I mustarded up the courage and called him.  At first he was nice and acknowledged it took courage for me to contact him and he was going to give me this conversation.  I asked the burning question, did I matter?  He told me yes and I gave him hope.  Then I asked if I still mattered?  He replied very quickly “I’m not in love with you.”  A stab to the heart, that is not the question I asked.  When I pointed that out he got agitated and explained I needed to be specific with my questions.  Wounded I found myself asking for more hits, so I asked the question, do you miss me?  Again he quickly and directly replied, “No, no I do not.”  Then he told me he didn't want to have this conversation anymore.  I certainly didn’t want to force it, I only felt hurt and I told him I would let him go, it took a moment then I bravely hung up.  

I was so upset and hurt, I got home and walked my pups, probably the fastest, most intense walk they have ever been on, they want to smell everything and sometimes for 10 minutes, no sniffing around for them.  I was pissed and thinking after all I did for him, how could he treat me like that?  And if I truly mattered to him, how could he say such hurtful things?  

I’m not sure why when a relationship ends we want closure, and I realized this was my closure, this was my ticket to let it go. He was showing me who he was, and multiple times he has shown me who he was.  Remember I am a competitive person, part of my agenda to having a conversation with him was I wanted to win.  I was looking for the answers that he was hurting and struggling, instead the truth of him was screaming at me, painful but the cold hard truth.  In reality I don’t want him back, part of me was seeking to win and find it very ironic that me letting go is surrendering to the truth.

I have been holding on to a lot of guilt because of the decisions I have made and people I hurt.  Some of my intentions were not good when it came to my relationship with this man.  In a way I was punishing myself, I think back to times when I let him project his anger on me.  I was not the woman I wanted to be.  The recent conversation I had with him was what I needed, I was seeking an excuse to let it go, longing for it actually.  I came to the conclusion I need to stop punishing myself and I need to forgive myself so I can go live.  

My hope is this post enlightens anyone who’s holding on to things holding you back, forgive ourselves and be the woman we want to be.

Photo Credit: Sparrow & Bean Studios

My Sister

Recently I watched the movie Sisters with Tina Fey and Amy Poehler.  I was surprised how the sisters personalities were similar to my sister, Jen, and me.  The older sister Kate (Tina Fey) was a hairstylist and had a spontaneous & adventurous personality , like Jen.  The younger sister Maura (Amy Poehler) was a nurse and had a cautious & composed personality, like me.  After watching the movie I thought about Jen and I's relationship.

Jen has been a strong female role model to me.  Growing up Jen was a tomboy playing with the boys and she couldn't understand why when playing shirts versus skins, our mother wouldn't let her take her shirt off.  She was a tumbler, I was always fearful I was going to hurt myself, no gymnastics for me.  Our father bought her a mat and she would spend hours working on her tumbling until she got it right, I have always admired how brave and daring she is.  In high school Jen was popular, she hung out with all crowds and nice to everyone, she was my cool big sister.  Jen has never met a stranger.

At least a decade ago Jen, myself and her boys were ice skating, I was so nervous I was going to fall, I was hugging the wall, probably white knuckling it.  Jen came up next to me and simply said, "what's the worse thing that could happen? You'll fall."  I thought how true, so I let go of the wall and fell like ten times but I had a blast.  Jen has taught me to relax, go with the flow and have fun.

Jen has taught me to not judge a book by it's cover, I judged her and was angry with her for a long time, and it wasn't until I made my own mistakes that I realized no one is perfect and good people can make bad decisions but that doesn't mean they are bad people.  Jen has fought some tough battles in her life and I admire her courage to rise above.

Jen is a great mom to her boys.  She's the fun and crazy mom, sometimes I catch them looking at her when she's not looking and you can see how much they love and admire her.  Jen has always been open and honest with them.  I believe she was meant to be a mother to boys, she got the energy to keep up with them.

I cannot thank God enough for her and she has modeled what it means to be a strong woman.

Photo Credit: Sparrow & Bean Studios

"Joy is what happens to us when we allow ourselves to recognize how good things really are." ~Marianne Williamson

Today is the first day of spring, and I can't help but feel good things are coming.  It's refreshing because lately I've been in a funk.  I'm ready to enjoy warm weather and the activities that come with it. While going through my funk I realized how important it is for me to do things that bring me joy, and I thought of a list of these things, so here they are in no particular order:

1.) Coffee!  I love the way it smells and truly get excited to drink it in the morning and have my afternoon pick me up.  I've found a nice balance in the morning and reduce to a tall non fat latte in the afternoon.  It warms my heart.

2.) Wine, it also warms my heart for different reasons.  Wine is there to give me a pat on the back at the end of the day saying "good try, tomorrow is a new day" or it's there to help me celebrate. :)

3.) Fashion, I love high heels, dresses and handbags.  I love the way I feel in them; I feel tall, feminine and powerful.  My mother tells me when I was a young child I would dress up and change my outfit three to five times a day, so thanks ma for letting me explore my own style.

4.) My home, my home is my sanctuary.  As much as I love to socialize I equally love being home.  I feel safe and myself.  I particularly love my bed, after a stressful and tough day, there is nothing better than to crawl into my comfortable and warm bed.

5.) Shopping with my mom brings me joy.  She gets me and my style.  While in Chicago I bought a DVF wrap dress and my mom was with me in the dressing room and I know deep down she was just as excited as I was when I try it on.  I love her for being with me and playing along with my crazy excitement.

6.) My Eberjey Kimono robe.  I bought it for myself this Valentine's Day.  It reminds me to love myself.  It's soft and feminine which warms my heart.

7.) Laura Mercier souffle body creme, for years my all time love was Almond Coconut, but this past weekend I discovered Tarte au Citron.  It's a citrus smell that reminds me of spring and summer.

8.)  Girls night with my nieces.  A few years ago my brother called me and asked if I would spend time with my niece Cate, she was going through some things as most young tweens do and wanted me to be a mentor to her.  I was overwhelmed with this honor and it turned into me taking Cate & Megan for a girls night where we can spend one on one time.  These two amaze me and appreciate their unique talents they offer the world.

9.) My pups, they get excited every time I come home.  Some days after a long and tough day it's refreshing.  They have been with me through some pretty tough things and always loved me through it.

10.) My loved ones (family and friends), they mean the world to me all for different reasons.  I won't be where I am today without them, they have loved me through the highs and lows.

Finding joy helps make the funks and tough days more tolerable.  My hope is you will make a list and on the difficult days do the things that bring you joy!

My life for the past couple of months have been a constant on the go.  I've done a lot of exciting things but really have not had a day to relax and rejuvenate.  Tuesday I was grumpy, I felt myself losing my patience.  I didn't get into town late Monday evening, had no food and my pups were still at the kennel, I couldn't pick them up until Tuesday.  I miss them terribly and had guilt that they were stuck at the kennel for another night.  Work has been busy lately so I was anticipating a busy day on Tuesday.  As I worked through Tuesday I couldn't shake off my grumpiness, I told one of my coworkers I needed a time out.  There was another coworker who picked up extra, walked into PICU with doughnuts in hand with a smile on her face.  I asked her, you brought doughnuts and you are working extra?  She replied, "yes, it's been busy and we need doughnuts when it's busy."  I thought dang she's working extra and she's got a generous attitude, I admired her for it, and wished my grumpiness would go away.  I ate a doughnut hoping it would rid of my bad attitude, nope it didn't work.  I look around and have such admiration for my coworkers, they are hard working, team players and so eager to learn in the mist of stress and heavy loads.  

I had a conversation with a locum physician, who by the way reminds of Dr. Napa, he wanted to talk to me for a few minutes.  I thought oh crap what did I do??? It turns out he just wanted my opinion and thoughts on things.  This conversation turned a different direction and he reminded me of something very important, we need to have different outlets so we can enjoy our professional lives.  I realized I lost my focus, I was so worried that I was going to have to do it all, and a lot of times I put that pressure on myself and it makes me grumpy.  It's funny how things work out, and like I've said I love how God works. This physician was giving great wisdom like Napa would do. I told him I was going to call him Napa #2.  

I love my profession, but I need to remember that I need to take time to do the things I enjoy.  A wise women once told me, "Melissa we can do a lot but we can't do it all."  I might need to plaster that on my office wall.  I work with amazing people, I love watching the PICU nurses grow and become strong nurses, at times when I observe them interacting with staff, patients, and their families it makes my heart swell.  

I will also take time to do things I enjoy so I can "keep calm and carry on," and I hope you will do the same.

Photo credit: Sparrow & Bean Studios