Self Care

I’m feeling guilty for not having done much of anything with my past 2 days. I’ve been extraordinarily fatigued, so I’ve spent the major part of my time either on the couch or in bed. I know the sudden surge in fatigue levels is partially due to my hormones, and I know it will come to an end (or at least be more manageable), but there is so much I have to get done that just isn’t getting done: ACLS studying, filing the family taxes, batch cooking, helping mom organize her expense ledger… and that’s just the beginning.

If this was someone else’s blog, I’d leave a comment about self care, and that sometimes that means that in doing nothing, you’re doing something: you’re giving your body the time and rest it needs in the moment it needs it. I’d go on to say something about how our society celebrates the idea of running ourselves into the ground, and how that serves no one in the end: not the individual, and not society.

I need to learn to listen to my own advice.

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That’s not how it works…

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Any given day, I fluctuate between a 5-7, which is a vast improvement from what life was like before diagnosis and treatment, when I was 0-3. The response I got when I posted this on FB? “This year’s goal, a 9!”

Um, that’s not how chronic illness works. I’m no longer in treatment, and I’m coming to terms with my own limitations. I appreciate the positive attitude and well wishes, but to tell me that I should be aiming for a 9 perpetuates the idea that I’m not doing enough, not being enough… Just. Not. Enough.

I could go on, but I wont. Not at this time. Besides, I know many others who have faced similar situations and have more eloquently discussed why this pervasive “do more” attitude actually does more to hurt than to help.

Disconnected

I’ve been feeling disconnected for quite some time. Since this summer really. And it’s been hindering my ability to write.

I used to write quite a bit. It was how I processed thoughts, emotions, stress, etc. I created this blog to help me record and process my journey with Lyme disease, and my continuing journey to become a health care provider to other sufferers. I wrote through bouts of brain fog. I wrote through stressful moments like final exams. I wrote in an attempt to distract myself from the unending pain. But lately, I’ve largely been silent.

Journaling is something our nursing instructors encouraged us to do after every shift when we finally landed our first nursing positions. They used to tell us that the day would inevitably come where we’d be brought before a judge in some legal case and need to defend our actions and our charting. But if you were to look at my nursing journal, you’d barely see more than a week or two of entries.

Why?

I’ve noticed my writing slipped to the wayside this past summer. And a couple of things happened this summer that might be at play here. First, the new nursing job. I’m an RN on an intermediate care unit and I work night shift, 7p to 7a. When I asked a fellow RN (who graduated with me and we started our jobs at the same hospital the same week) if she was feeling a similar disconnect, she reminded me that I “give so much of myself at work, that whatever is leftover, I save for myself.” And that feels like it could be part of the answer, but I’m not convinced it’s the only thing going on. It is true, however, that I give wholly of myself on each shift. So much so, that I need to be completely alone for a few hours before my shift, and when I come home, I eat and collapse in bed, avoiding discussion about my shift beyond a grunt or two.

But something else happened this summer. Something that was wonderful and painful all in the same breath. A special someone from my past that had resurfaced months before was now planning a visit to my home. And every moment that we shared was beautiful and exciting and completely loving. But after the visit was over, and without going into too much detail, phone calls were painful. They were hurtful, and even hateful. I remember breaking down into tears more than once while words were exchanged between us.

So we don’t talk like we used to before our visit. Thoughtful texts from time to time, but not a single phone call. I’m left with beautiful flashes of moments shared between us, which make me ache inside for reasons I have yet to really tease apart. But those moments are tarnished with the recollection of hurtful words spat at each other, words that caused me to make the decision that there will be certain subjects that will forever be off limits should we ever speak again.

One of those subjects? My illness. Lyme disease. Something that *is* such a huge part of my life, not just because of the physical toll it has taken on my body, but the direction my life has taken because of it: my current nursing career and my future goal as a nurse practitioner.

Another friend of mine thinks the disconnection has more to do with the latter scenario… That I need to properly grieve and work through this pain before I reconnect with my own thoughts and write the way I used to. And this also feels like a reasonable piece to the puzzle, but it’s not the entire answer.

And so I feel stuck. I need to figure out a strategy to deal with the changes and lingering grief, and reconnect…

 

So much exhaustion, so much pain…

I hadn’t written in some time, maybe because I don’t want to confess to the difficulties I’m currently facing, but sometimes all it takes is a few words from someone who can empathize with your struggles to free the words and give voice to so much silence.

I’m 4+ months into my new job as an RN. I work two twelve hour shifts a week, which is part time, since three 12 hour shifts a week is full time. And I’m not sure if it’s the job or the weather or the fact that I’m on night shift (and probably all three are factors), but my pain and my fatigue is getting to disheartening levels.

Chronic pain is depressing. It’s demoralizing. It’s exhausting.

And I feel horrible complaining because I know all my co-workers, to some extent, deal with pain, too. So I don’t complain. Or at least, I try really hard not to.

And I don’t even complain on my blogs anymore, because for starters I don’t feel “safe” anymore on one of them. I feel judged. Someone I know who reads them has said hurtful things, mean things, and so I don’t share like I used to. I probably shouldn’t allow anyone to take take away what was once a helpful coping mechanism, but I’m just not sure how to navigate the possible fall out of that right now.

I’m not in a good place right now. I’m too tired and too sore and I’m taking more pain relievers than I really want to just to make it through. And I’m tired of being thankful and I’m tired of staying positive and I really want to complain a whole lot to anyone who will listen. But I’m not sure it will do any good and I’m not always certain anyone wants to hear it…

Small moments

I had a patient last night who had been in the hospital for nearly three weeks. Poor prognosis. Family at the bedside since the beginning. I had taken care of him once before, a couple of weeks ago, but this time, report came with the warning that family was beginning to get impatient and rude to the staff. I appreciate those personal notes from report. It means I have the opportunity to change the direction that the relationship they have with the staff around. I may not always succeed at it, but at least I know to include as much TLC and patience as I can in my care for him.

The night started off chaotic, with one discharge, and one transfer and one admission all coming in within an hour or so of each other, and of course that’s when the PICC line on my other patient fails, and so I need to also place an IV before I can administer the scheduled antibiotics. Thankfully, my charge is the bomb. Seriously. This woman is like the calm in the storm, and while I was getting people in and people out, she placed the IV for me and started the antibiotics. (Because frankly, my IV skills are still very new, and I would have been wasting precious time trying something I had little chance of landing anyway.)

So amidst the chaos was this family, and I took every opportunity (between the 3 or 4 code browns that happened in his room that night) to make my interactions meaningful. I reassured him in his confusion. I validated his frustration. I scratched his scalp. I sat opposite his wife, each of us with his hand in ours. I treated him as I would my own family member. I think sometimes that can make a huge difference for struggling families. I think it made a huge difference with this particular family last night.

His wife had been refusing palliative consults. And within a few hours of my shift ending, after I felt like I connected a little, I brought the subject up.

I explained how palliative is not the same as hospice, and how it’s a specialty unto itself, just like cardiology or neurology, and work together and alongside those teams to give the best possible care to their patients. I also went on about our palliative care team, as I had interned with them, and that they are some of the most compassionate and caring medical professionals I know. (And they are all that and more.)

She didn’t say much. But she didn’t cut the conversation short, either. Just nodded and listened. I may not know if they choose to take advantage of our palliative care team, but I feel good that I at least got the vibe from her that she *was* listening. And considering.

And she thanked me. She didn’t have to. She didn’t need to. But I hope that I made a difference for him and his wife last night.

Feeling Broken

It’s been awhile since I posted, and so much has happened in that time. I passed state boards, and began my first job as a registered nurse at a local hospital. I was hired part time, but I didn’t realize that my 12 week long orientation would be full time. Now, I feel as if my body is falling it apart from the demands I’ve placed on it.

I hurt. All over. All the time. When I was in nursing school, I would have bad flares, but usually I was able to get through the day, both a class day and a clinical day, with a little Alleve and I’d recover in a day or two, at most three. Now, I can’t shake the pain. I wake up in pain, I go to sleep in pain, and while I make it through my work day with NSAIDs and adrenaline, I haven’t been able to recover, because before I know it, I have another 12 hour shift upon me.

And so the pain has slowly been building. I’ve been drawing on my reserves to get through orientation and now I have a debt to pay back. And I’m not sure how or when I will be able to pay that back. I need a plan, and I don’t even have that.

All I do have is a date. I get off orientation this Sunday, October 8, and then I finally move to part time, which is two 12 hour overnight (7pm-7am) shifts a week. I’m hoping that I can slowly repay the energy and pain debt I’ve accumulated, maybe with the help of more regular Epsom salt baths. But ultimately, I may need to make an appointment with my LLMD to see what she recommends to manage the pain more completely.

In the meantime, I’m open to ideas.

Nursing is the second hardest job I’ve ever had. The first was motherhood. And both can be incredibly frustrating, and incredibly rewarding.

Yesterday was my third shift of my week, and I found myself getting frustrated because I was so far behind in my duties, and my confused patient would close her mouth every time I approached her lips with the spoonful of applesauce that held her crushed medications.

And then something stopped me. And I put the applesauce down, and I stroked her hair. And I spoke softly to her, and I held her hand, and even though her eyes were closed I felt her squeeze my hand back and her grimace soften ever so slightly.

My preceptor had entered the room without me noticing, and watched this interaction, and commented on it. “You’re very sweet.” Or maybe it was, “you’re very kind.” It really doesn’t matter.

I was thinking about this today and realized I do this partly because I lost my own grandmother in 2013, and mostly due to illness that prevented me from travelling, I wasn’t able to spend much time with her in her last years.

So in that moment yesterday when I put the applesauce down, and ran my fingers through her hair, I remembered that woman is somebody’s grandmother, somebody’s family.

I’m learning that tasks don’t always get done on time, that meds will sometimes be late, and charting may not get done until very late into my shift. But what I need to remember is why I love nursing: the potential connection you can make with a person who is vulnerable… and using that connection to heal more than just the physical body.