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Single Mom vs. Christmas Tree: year 3.

Everything I thought I knew about parenting when there were two adults in the house went out the door with my ex back in 2020. Because single parenting is a new ballgame.

We got our Christmas tree this weekend. And it was a debacle because I wanted pre-cut and went to a place, it was cut your own, before I knew what was happening a guy was shoving a saw in my hand and the boys were running up a hill. It’s not a little hill. It’s a half mile completely up hill. Since doing this on my own I have always gotten a pre-cut tree so I’m trekking up the hill already nervous that this is going to go poorly.

We make it up the hill. We find the tree. I’m on the ground in kind of a nice outfit because I was expecting a pre-cut tree, and with my hair down. I have a lot of hair. Curly. Trees. Sap. It was a thing. So I’m sawing the tree. My son keeps trying to grab the saw to “help” and I’m like please stop because I’m going to cut off your finger by accident.

When I hear a male voice from above, “You need a hand?”

I emerge from the ground/tree. There is a very nice man and five children of various ages and a small wife all smiling down at me and my kids. He and his teenage son get the tree down within about ten seconds like freaking champs. And the family is circled around us and I’m thinking they are going to start singing a song from a the Sound of Music or something. They look picturesque and sort of whole in a way that a single mom covered in sap, crazy hair, may have been swearing at the tree, and her two twin boys…well don’t. If my sons and I would break into song it would be a song from Jungle Cruise. Because, man, we are just trying to survive.

We get the tree. Thanks to the very kind Von Trapp-esque family. The tree farm people seem to emerge out of the trees as we are dragging the tree out and take it from the boys and I and throw it on a tractor that brings it down the hill. They strap it to our car. I mean overall it was great service and all inclusive.

The hardest part was when we got home. Because then it’s just me. I set up the stand, and the boys helped me hose it off, and I drag it inside, and am wrestling with it to get it in the stand and upright. This of course is after I got if off the car.

So there I am, wrestling a tree. It was a lot fatter than it looked in the field. And I still had on my nice clothes. And I am in the damn thing. And I’m trying to drop it on center of the stand, then lean down and screw the screw things and then it kind slouches over when I think I’ve got it.

It happened then. One of my sons was standing on the other side of the fat tree. I thought he was watching his brother play a Switch game but he was apparently monitoring me quite intently. I made a noise- somewhere between a sigh/sob/groan of frustration.

It’s in those moments that- well you ever get those flashes of the most intense thoughts and emotions that sort of leak in? Like when I first got divorced I was angry, grieving, resentful all the time low level. I’m not anymore. But in those moments it comes through- a flash of all that hurt and pain and anger at having to do these moments alone. It’s quite visceral and unless you’ve experienced it rather difficult to describe.

But it’s important to name it. To write it. Because if there is one single parent out there who reads this and feels that and this normalizes it for you, then it’s for the best. We, as a society, do not talk about divorce and the repercussions of it and single parenting two and three years in because we are all just supposed to adapt and smile and post on social media pretending every moment is liquid gold.

But it’s not. Because when my son heard that sound I made he came around and looked at me concerned, “Are you okay Mama?” “Yeah baby, I am okay, some things are just really hard to do with one person, and this is one of them.” He looked more concerned even though I was trying to take deep breaths and smile and act okay. “Mommy should be here.” He said quietly. And I knew in that moment he was remembering the Von Trapps at the Christmas tree farm, and yearning for that for himself. And for me.

I had to be at my sisters within about twenty minutes, and they went with my ex that night.

I got the tree up. It’s still standing and mostly straight. But this is divorced single Mama life. Moments of utter punch in the gut raw parenthood while I’m standing there alone putting up the tree. Then I just carry that. Alone.

My kids see me. They see cracks in my invincible Mama armor because I am human and how can I not have moments where I let my feelings slip through?

Other then hugging my kids and telling them I love them there are not “happy endings” to these moments. I had to finish the tree and then move on with our day. But that was a hard one and I was not okay after that. I don’t want my ex here. The divorce was very necessary for many reasons. And I am better as an individual and as a parent without her. I am allowed to feel alone though and lonely. And I would have appreciated another person over five feet in the room helping me with the tree.

And my son saw this whole family and then saw me break a little bit.

And this is why parenting changed when I started doing it alone. This is why it became harder and I feel even more blind navigating it.

Since becoming a single parent I’ve done some research and what I found were alarming statistics including 63% of suicides are individuals from single parent households. The stress, the shame, and the loneliness of single parenting is real and of course it impacts the children in the homes. Study after study showed an increase in anxiety, depression, and substance abuse as well as poverty and welfare among single Moms. There are of course many postulations on these statistics but seeing as how I live it I want to throw my own in there.

We have to start talking about these moments. We have to bring them into the light and out of this horrible shaming mindset. Being a single parent and having vulnerability and having sad moments with our kids is okay, normal, and should be expected. Because it’s hard and there are no normalizing factors within our communities for single parents.

It was less than ten seconds. That interaction with my son while I was holding a sappy Christmas tree. I’ve had other moments like this. They are intimate and visceral and raw and they make me feel like the worst human and also the strongest and most resilient and most alone.

I have resources though. I have great friends & family who see me and support me and I engage in my own therapy and I have built and continue to build financial security for myself and my sons. I also am a strong person and I’m too damn stubborn to give up on anything but especially not on my sons and myself. But there are many parents out there who don’t have the resources and maybe are not as strong. This is for you. You are not alone. These painful moments happen to us all and you are allowed to feel that pain in the moment and you’re allowed to let your kids see you feel it too. Give yourself some grace and accept help from people who offer it. You are not alone.

988- Lifeline/Suicide hotline

http://www.thetrevorproject.org

Trans lifeline- 877-565-8860

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Salty About Stimulants…signed: a prescriber

My practice has strict prescribing practices around stimulants and benzodiazepines. People seem to get the most irritated by these practices with stimulants though. Over the years multiple therapists have voiced their displeasure at us for not prescribing a stimulant to some one suffering with ADHD because: they smoke cannabis, their urine screen popped positive for a substance, they don’t have anxiety it’s all driven by ADHD, etc.

Mental health prescribing is by far one of the most Monday morning quarterbacked fields of practice. Every one knows better including but not limited to Google, WebMD, ‘My Aunt/Mom/Sister/boyfriend’s sister who is a nurse’, ‘my therapist who is not licensed to prescribe medications and has no training in prescribing’, their primary care doctor, their neurologist, and any one else who wants to hop on board the “we know better than people with actual psychiatry training” train. Not that I’m bitter. Imagine me saying all of this in a very singsong smiley voice.

I did not have such strict policies when I started practicing. I’d be more open to prescribing stimulants to some one who used cannabis or would not grab a urine toxicology screen on everyone. But then shit hit the fan.

To assume you know better than some one who has been working in this field and trained in this field when you are not working or trained in this field is…annoying at the very least and dangerous at the most.

In the past 12 months alone the practice has had four urine toxicology screens pop positive for substances that were not disclosed to the prescriber in the appointment. Two of the positives revealed a significant substance use disorder that could have otherwise been missed and that the primary psychotherapist knew nothing about.

Addiction does not discriminate- and these positive urine screens were gateways to a dialogue for potentially life saving treatment for people. God forbid the other 98 people have to pee in a cup because it’s so judgmental and punitive….I’ll send 1,000 people for a urine screen because even if just one pops positive that’s one person who has been potentially struggling with addiction in the dark, alone, and is at risk of overdose and death. I can’t as a prescriber in good conscious just say, “Well I see that hurts your feelings when I ask you to pee in a cup and test it for substances before I prescribe a controlled substance you, so you’re good.” It’s not punitive. It’s just that people have lied about substance abuse and addiction. And I’m not saying that in a derogatory way- part of addiction is living with it in isolation which contributes to shame and guilt- people don’t disclose because they are ashamed. It’s part of the cycle of addiction.

Every time I prescribe a stimulant I receive a letter from the insurer- especially Anthem and Aetna- they send letters that they noticed I prescribed a stimulant to one of their members- and they name the member- then they have about two pages of why prescribing a controlled substance is dangerous and they hope I’m prescribing it responsibly and I should really consider getting the patient off the stimulant as quickly as possible. Not making this up.

Then I get an email from the state of CT who tells me they noticed I prescribed another controlled substance- and it’s in a report of all the controlled substances I’ve prescribed in the last month. It’s one of those “We see you and we are watching” e-mails. I attest to my liability company that I prescribe controlled substances. I have to sign off on federal guidelines to have a DEA. AKA it’s a big freaking deal every time I write a prescription for a controlled substance.

In case you missed it, people are dying at record numbers from drug overdoses. Guess what? Most overdoses are not just one substance- they are often multiple substances- including stimulants because people snort them after drinking alcohol to perk themselves back up, or after heroin or opiate use. Then they may want another buzz or high so they drink more or take more opiates or heroin…you can see where I’m going right? You need more and more upper to overcome the downer, and more and more downer to overcome the upper. Then you die.

So no. I do not prescribe stimulants to patients concurrently using cannabis. Cannabis=downer stimulant=upper. Also- long term cannabis use (daily for over a year) causes cognitive clouding and blunting in the form of short term memory impairment, slowed cognition and slowed reaction times, in ability to focus and difficulty concentrating….guess what all those are also symptoms of? You’re right! ADHD.

So how do I know some one truly has ADHD when they’ve been smoking weed daily for five years and did not have ADHD prior to weed use? I don’t. The answer is I don’t. And I won’t until they get off the weed for at least three months.

Next let’s talk about the world in the last few years. It’s gone to hell. The effects of chronic stress are well documented in children who grow up in abusive households, in adolescents who live in homophobic households, and in war veterans who are exposed to chronic combat stress. Guess what the symptoms are? Cognitive clouding, poor focus, poor concentration, short term memory impairment, poor organizational skills, and anxiety that can present as impulsivity….sound familiar? Yes. All symptoms of ADHD. Executive dysfunction is a symptom of chronic stress. You can’t have existed in the world since March 2020 without being under some form of chronic stress which results in executive dysfunction. So no, you did not suddenly develop ADHD at age 40. It started two years ago because that’s when the world went to hell.

People generally do not like to hear that though. They want a pill and a quick fix and a treatable diagnosis.

In the past two years I’ve had countless patients tell me they have ADHD. I disagree with the diagnosis sometimes. I decline to prescribe stimulants other times even if I agree with the diagnosis due to substance use. And then there are a couple people in the past year who came to me for “anxiety”. And within about two minutes of our intake I was thinking ‘how the hell do they exist in the world with this severe of an ADHD?’

Careful history taking, chronic struggles academically, chronic struggles socially, chronic struggles occupationally, has had people in their life tell them they have ADHD, and not nicely. They also talk non-linearly. It’s hard to describe but there’s definitely a feel to them. They often wander off from the answer they are trying to give to a question then ask “What was the question?” somewhat embarrassed. There is more to it than that, but suffice to say it’s quite overt after you’ve seen it a few times. Which I have. Because this is what I do every day all day for ten years.

These are my favorite people though. They legitimately have ADHD. They have been misdiagnosed or not diagnosed at all because they are usually female- and females are super under diagnosed for a variety of reasons- including but not limited to: it’s inattentive type, not hyperactive, and they are able to compensate in other ways that allow them to still be mild to moderately successful.

These people when I mention ADHD and do some psychoeducation around it, and say maybe the anxiety is driven by an ADHD and they have a learning disorder…they break down and cry. Because they usually have always suspected it, and they check all the boxes, and there is effective treatment. These people, when they come back after the urine screen and trial of a stimulant cry again because they are grieving that they have lived so long without a proper diagnosis and in relief at being able to function just generally better.

Do I prescribe stimulants? YES. Do I do so carefully in order to protect the patient and myself from liability? YES. Do I see how incredibly life changing these medications can be? Absolutely.

I do actually know how to assess and diagnose ADHD. I also know how to safely prescribe psycho-stimulants. And I’m not going to waver because it may cause some one to feel upset that I prescribe this way. Safely. It’s unfortunate that offends some people. But it is what it is.

So to any one out there diagnosing yourself off TikTok. Please stop.

Couple things- you can’t have sudden onset ADHD, chronic stress causes the same symptoms of ADHD, PTSD can present as ADHD, chronic anxiety also can present as ADHD. I’m not saying don’t get a second opinion if you disagree with the person you do an intake with. Get as many opinions as possible for you to feel confident in the diagnosis and treatment. But also don’t assume you know more than a provider with education and clinical training and experience.

And for any one truly suffering with ADHD if you suspect you have it, seek treatment! There is treatment. And it can work. Just don’t get salty if you’re asked to do a toxicology screen in order to receive a prescription for a controlled substance. These medications are serious and heavily regulated. Have some respect for that. I sure as hell do.

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Medication Management…when it’s not about the meds. From a Psych APRN.

When I worked at the hospital I used to take APRN students frequently. It was an easy place to have a student because you don’t do long term work with patients and patients in the hospital setting are used to students being present.

I stopped taking them when I moved to private practice full time but for the first time this year I felt comfortable taking one on. It’s a commitment. September-May one-two days a week for FULL days. Often shadowing, especially with some one in their first specialty year they do not have the skills to work independently.

It’s a lot of explaining, it’s a lot of asking clients if it’s okay for her to join our sessions and in between sessions it’s a lot of answering questions. It’s a lot of work.

But it’s important because everyone has to learn. And I’m kind of good at what I do. So I don’t mind people learning from me. Especially some one who is Queer.

It’s a weird thing though to have some one watch all you do. It’s a mirror really. I don’t change how I act or how I interact with clients. I’m generally bad at censoring myself.

So I’ve learned a couple things in the two days so far that she’s been shadowing me. I see a wide array of clients. In just the two days- she looked at me today and said, “You see every type, but why do you see that one? She’s not…” I interrupted her, “She’s Queer. I’ll see anyone who’s Queer.” She looked at me kind of surprised. I knew what she was going to say. The client is not my “normal” client for a variety of reasons. But I’ve treated her for two years because she’s Queer.

In just two days- roughly twenty-five client visits she’s watched me see clients who are destitute, wealthy, multiple ethnicities, Queer, healthcare providers, first responders of all types, post-partum clients, all ages, clients I’ve treated for eight years and clients I’ve treated for eight weeks. Most of them were long term though. Also coincidentally, most of them were follow-ups after a come to Jesus moment at our last visit. So there were at least four who came in saying “I thought about what you said, you’re right, thanks for giving me the kick in the ass I needed.”

I counseled some one struggling with hunger due to skipping meals in order to pay bills. I counseled some one dealing with infidelity, addiction, I said good-bye to a long term client moving out of state and she cried (after we disconnected I 100% needed a tissue) because I had seen the client through many life transitions, and so much more. That’s just two days.

It struck a chord at the end of today when she looked over at me somewhat comatosed as I asked her if she had any questions.

She said she didn’t have questions. She just was realizing it’s not about meds.

In school they drive home psychopharmacology; but it’s not about the meds. I smiled sadly. No it’s not about the meds.

It’s about forming a connection, an alliance, trust, it’s about remembering their kids names, knowing without looking at the chart when we started treatment together, how many IVF cycles they did, and that the anniversary of their Mom’s death is coming up next month.

It’s about remembering the first psychotic break post partum and how long their depressive episode lasted in the aftermath and comparing that for them to how long this depressive episode will last in the aftermath of the hypomania. It’s about eye contact. It’s about a little bit of self disclosure- like many of my long term-er’s know know I have twin boys, and they ask how they are doing. It’s about making a person feel seen, heard, and validated.

We talk about meds in our visits but there is so much more. I made very few changes to medication regimens in the last two days. It was more supportive therapy, validation, and reassurance. Many people cried. Just cried. And they apologized to my student and we both provided reassurance that just because she’s there doesn’t mean they cannot cry.

I think she was surprised at the amount of pain we hold space for. At the amount of secrets we hold for people. And at the level of connection we maintain.

I reflected that I could do 15 minute follow-ups and barely talk to people and conclude that every symptom requires a med change. But that’s not how I roll. I see people for 30 minute follow-ups, longer if needed or requested. And I talk to them. I get to know them. And in the age of telehealth I meet their partners, spouses, parents, co-workers and any one else who wonders in the background of the frame.

Not everything needs a medication change. A lot of what humans need is simply connection and validation and the feeling that one person out in the world gives a shit about them. I’m happy and humbled to be that person for my clients. I think to an APRN student who is just starting to understand our role though…it’s daunting. And if I think about it. Like really step back and think about it…it’s a lot.

It is not a coincidence that there is a mental health provider shortage. People are falling apart and we as mental health providers shoulder more and more of their burden. It becomes heavy and isolating and daunting to potential new clinicians.

Again, I’m not going to censor myself and I’m not going to make the job seem like something it’s not. It’s hard. It’s emotional. And long term outpatient work is not for everyone. But it also made me grateful for my work. I tell people all the time I still love my work. I am lucky because I am one of few people who does what I love. But lord, it’s hard and sometimes it takes a mirror of an APRN student to remind me how heavy it truly is.

homophobia · Uncategorized

Homophobia & Corinthians. It’s getting old people…My response to a Comment.

Normally I delete these comments. But I thought I’d share this one so people can understand the bullshit that Queer people deal with on the daily. Some one tried to post this comment on one of my blog posts that actually had nothing to do with being Queer. It was commented on my blog post titled “The Scent of Grief” which I then read, as I hadn’t read it in awhile, and ended up crying because it’s about the loss of my Dad.

Guess what the loss of my Dad has to do with being Queer? Nothing. My dad loved me for me, he loved my ex-wife, and he danced as long and as hard as the rest of us at our wedding. But these lovely humans who will never even post under their true blog name for me to go onto their page to respond to…Germiner….felt the need to post a bible verse. Here’s my response Germiner and every other homophobic person who hides behind bible verses because that makes it what? less homophobic? In my opinion it’s worse. Here’s why-

  1. I love how straight Christians think Queers have never read the bible. You asshat I wrote a paper at my religious undergraduate college entitled “Homosexuality and the Bible” and that was one of many religiously themed papers that I wrote in college because I took a religious based course every semester in my undergraduate. I also was raised Missouri Synod Lutheran. Church weekly and during some parts of the year twice weekly. I was baptized, confirmed, and attended confirmation class weekly for two years in addition to once or twice weekly church. I am fully aware of 1 Corinthians. It was written by the Apostle Paul- you know what else he preaches against in that very verse? Lawsuits. You know what happened to a Rugby Player Israel Folau, who quoted Corinthians on social media? He lost his contract for being homophobic….then he sued the rugby organization that fired him. So pardon my skepticism for anything relating to the bible. Christians notoriously and continuously pick out what works for them and when it works for them. How can he in one breath be homophobic “spreading the word of God” and in the next sue the organization that fired him for being homophobic when literally in the SAME verse the SAME voice says Don’t sue people.
  2. It’s not a “preacher” speaking in 1 Corinthians. It’s freaking Paul the Apostle. He’s writing to a community of Christians that he founded/converted in Corinth. Get your damn facts right and don’t assume that I do not know the facts. Because guess what- I confirmed my information after I wrote my first draft of this blog post. But I didn’t have to look it up to write this to start with. Because yes….I have studied religion and Christianity and the bible that much.
  3. There is an assumption that you think I think God doesn’t love me. I do not believe in the orthodox Christian version of God. The version I believe in has fate, a higher power, and love.
  4. Do you think you’re the first homophobic person to read a Queer person Corinthians? You’re not. You’re not even the fifth. I think I’m in double digits now. The first was a boy in my homeroom in tenth grade. Shoved the bible under my nose and said it says homosexuality is wrong. I smiled and said, “It doesn’t specifically say two women having sex is wrong. It seems to focus more on men.” Later my ex-mother-in-law also tried to read me the bible. I’ll tell you what- to assume a Queer person has not read the bible and does not have more education on it than you is insulting to my intelligence and ignorant AF.
  5. I’m 37 now and I attended a religious undergraduate college. I also attended church as I mentioned. This is not a novel idea. How about you quote the whole thing though. 1 Corinthians 16 vs 13 “Keep alert, stand firm in your faith, be courageous, be strong. Let all that you do be done IN LOVE”. Tell me what about being homophobic is done in love? ‘Splain it to me Lucy! Because you see I can find all the quotes about love “written by a preacher” (eyeroll) and throw them right back at you.

So to all the homophobic Christians who come creeping on this page. Bring it. I’ll be happy to do a point by point response.

Sincerely, A Smart, Irritated, Queer woman who is loved by her God and has read the bible.

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This Traumatized Nurse

Part of my practice that I never planned on but am incredibly grateful for are the nurses. Nurses sticks with nurses. So it makes sense that many seek treatment with nurse practitioners.

Nurses are a crazy bunch but we wear our crazy on our sleeve. I’ve said to nurse clients many many many times…”You have a high tolerance for crazy because of your work, so I’m telling you, what’s happening in your life- insert something crazy here- is not okay, and you are tolerating it because your ‘crazy’ tolerance is way too high.” This is actually generally well received and then we process how to address whatever issue they are dealing with.

So here I am in my therapy session today. I said, listen, there’s been a lot of crazy in the last couple weeks, but I need to focus on these panic attacks I’ve been having. I’ve never had panic attacks before, and I kept forgetting I was having them because they were so infrequent.

The first one was two years ago. I was working inpatient and a patient became agitated and stood over me and threatened me. My heart raced, I completely froze, then when I finally left the room I couldn’t calm down. I had to go outside to my car, not speak to anyone, and just sit there and let myself freak out.

When I tell you this is not me…this is not me. I was an ED nurse, I’ve worked inpatient psych, and I’ve had a lot worse situations come at me. Like actually come at me. I went home that day and forgot all about it. Thought it must have been a fluke. Then I worked inpatient again. Similar situation except this time a patient told me he was picturing shoving a knife in my throat while standing over me. Again- this was not out of the ordinary for inpatient work.

Then recently I had music playing and at the end of the song there are two men who become agitated and start fighting. I forgot the song was playing and all I heard was two men yelling at each other, and I freaked out. I looked all over the house and out in the driveway thinking there were actually people getting agitated. Heart pounding. Etc. So I tell all this to my therapist and I say, we gotta do something about this. Because I’ve never had this happen before and it keeps catching me off guard.

She asked me to describe what happened. I did. Then she said, “You know those experiences where you have people physically and verbally threatening you- it’s normal for a person to have their heart race, it’s normal to feel threatened because you were being threatened. Those are not typical panic attacks, they are normal reactions to a stressor.”

Dude. I actually argued with her. I was like, uh no, those are normal occurrences when I work in the hospital. Then she argued back, and then we literally argued about me being threatened. And of course I was threatened. Of course those are normal bodily responses to feeling threatened. What’s messed up is that I literally never thought that.

I thought there was something wrong with me for reacting to people threatening me.

Sit with that for a moment.

That’s what happens to nurses who work in high acuity settings. We are led to believe that there is something wrong with us for expecting to feel safe. I argued with my therapist about my reacting to being threatened. I tried to rationalize that being threatened is normal and there’s a problem with me- not the setting.

Is it any wonder that nurses are fleeing the profession? Why do I feel weak for having a normal physical and emotional response to being threatened? Why do I feel less than and ashamed? Because I have been trained to feel that way. I have been trained to see the problem within me instead of in the messed up hospital systems who do not protect us.

I have been- kicked in the ribs, bitten, spit on, rushed at multiple times, had a chair and a laundry basket thrown at and over my head, had a knife pulled in my office (twice), been verbally threatened countless times including outpatient “I will drop your ass” “I will fuck you up” and so much more. I have witnessed horrific assaults. I have witnessed horrible takedowns. I had a patient, most memorably, leap across a table and land on his knees nose to nose with me, hands fisted on either side of my head and say, “All it takes is a punch. And poof. You’re fucked.” I sat there and stared back at him, and as the entire staff gathered outside the door because the whole unit saw what was happening I calmly leaned in closer and said, “You done yet? Take a fucking seat.” Without blinking. When the laundry basket got tossed, I said, “Dude you are not,” He said, “Ma’am, you better put that pretty head down.” I ducked. He threw it. Not aimed at me.

So many more stories. So many more memories. So you see, when a patient stood up agitated, and I epically panicked, I thought there must be something wrong with me. Because I’ve been through so much worse so many times. I never got time off after any of those events. Except the kick in the ribs. And literally only because there was some minor damage to my liver and a visible large bruise over my right ribs. I never got debriefed after most of these events. I certainly never got a raise or hazard pay.

And in fact when I got time off for the rib kicking- my manager and co-workers made negative comments about it. As if I was weak for being told to take time off by occupational health.

It was all a day in the life.

But now that I do mostly outpatient, and I’ve had space and distance and time to heal. My body and my brain are telling me this is fucked up. When I go back to inpatient and am threatened I apparently react appropriately now. I’m not in survival mode, so I can’t just compartmentalize it out.

I am not sure what the answer is. I do not want to give up inpatient. But my therapist seems to think it’s kind of a messed up place to work. And after much reflection I don’t disagree. It makes me sad to realize that this work I used to love is actually totally ass backward and so detrimental to people’s mental health. Nurses. To nurses mental health.

Even writing this feels bad. I feel shame? for having such a perceived weakness. Then I think this is soooo messed up that I think a weakness is having a normal physical reaction to being threatened. I’ve been told it’s not a panic attack when it’s a normal stress response to being threatened. So my not-panic attacks suck. Being threatened sucks. Being a nurse who thought there was something wrong with me for having an emotional and physical response to being threatened…is just tragically sad.

To all my nurses. It’s not you. It’s them. You are not wrong or bad for demanding safety in your workplace. You are not wrong or bad for having feelings in whatever capacity about being unsafe in your workplace.

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30 Days Without FB/Insta/Snaps and How My Dog Handled my Nightmares

Sometimes I haven’t blogged because I’ve been busy and I seem to spend my nights lately posting ERA payments to accounts, reviewing accounts receivable, and all the endless micro-details of running a private practice. But the past twelve months when I’ve sat down to blog I have also generally written pretty damn depressing blogs.

I usually end up crying and it’s all just horrible. Then it’s another week before I get time to write a non-crying blog but end up still writing a horribly depressing piece. There are a few reasons. 1. Since 2019 when my Dad died, life has been generally rather depressing in some ways. Actually three major events that are not really bloggable due to NDA’s, my children one day reading this blog, and general violence that is rated R or maybe even…What’s the one that’s worse than R? I dunno. See the great thing about me is that you don’t know if I’m kidding or not. (I’m not;)

Life’s been rough. What’s ironic is that my life outwardly looks like I have made huge strides in the last three years. My kids are thriving as is my business. I am up to ten? employees. I think ten. I just hired another one and I can’t remember if they make ten or eleven. But it’s a thing in small business when you hit ten employees. It’s a landmark.

I am opening a second location for my practice, and making plans for 2023 for a third.

I decided recently to take a 30 day social media break. No snaps, Insta, FB, and…well that’s all the social media I use. I’m on day 4. It was Christmas Eve at 5 AM as I lay in bed that I made the decision.

I may not go back to it at all. Nothing is missing. I realized how incredibly fake it is. I was writing one of those super depressing blog posts that will never be published and realized how my two closest friends at the moment are not even on FB. Well, one is, but she rarely posts anything and only follows dog mom groups. I realized that the people who show up for me will keep showing up for me whether I’m on social media or not. And the people who judge me, hate me, fear me, whatever, will still do all of those things except they won’t “like” or “love” my pictures and posts pretending to care about anything I have to say or do.

My day to day hasn’t changed. Except I don’t spend minutes mindlessly scrolling through posts. And as I said, my communication with my friends hasn’t changed at all. They are still my friends. We still text and talk and see each other. I just don’t talk to or hear from any one else whose presence in my life was a facade.

I got a dog 5 weeks ago. I’ve never been a “dog person”. In fact I still probably am not a dog person. But I like my dog. I’ve had nightmares as long as I can remember. I can go months without one, and then have three in a row. Completely unpredictable. A couple weeks ago I shot up in bed, heart racing, palms sweating, terror gripping me as it always does. I’m 36 and a nightmare can still completely wig me out. Over the years I’ve learned I have to get out of bed and walk around. Usually I have to walk about the whole house and catch my breath and ground myself to reality.

But that night, my dog lifted her sleepy head and looked at me as a I breathed frantically in and out; reliving whatever terror I just dreamt. It’s always tornadoes, tidal waves, or a grisly death (You can die in your dreams. I’ve done it. Many times- being stabbed is my least favorite). I reached out and hugged my puppy and she rested her snout on my shoulder. I felt her breath on my back and my heart rate slowed down, and I could breathe normally. I laid my head back down on my pillow and she scooted over to put her whole body up against my back, and for the first time I can remember I was able to fall back asleep almost immediately after a nightmare.

It was an odd, intimate moment that I shared with my dog, Cheetah. She’s only five months old. She drives me insane in many ways. And she’s a big baby in many ways. But in that moment she was wise and grounding and real.

I’ve been through a lot in the past three years and what I’ve learned is to lean into what’s real. Lean into who shows up. Lean into who can handle your darkness because they can help guide you to the light.

Cutting out social media is a reminder for me as to who my friends are and to invest my time and energy into people who are truly here for me. It’s a grounding exercise to remind myself whose presence in my life is grounding versus not. That moment with Cheetah reminded me of the moments in the past three years that I’ve felt terrified and alone. She reminded me to focus on who helped me through those times and to appreciate all I have instead of staying stuck in the dark.

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Raising Kids Lesson #45732…

When I worked in the ED there was a tech who came out of a room after I had been in for my initial assessment. The kid was sick-ish. Meaning probably admission material but not ICU level and potentially could go home if he had a robust response to treatment. I was maybe twenty-five. I was good at what I did. But I was and still am in a sense; controlled chaos. I remember the tech came out laughing and I asked him what he was laughing at? I was assembling my IV equipment, glucose machine, i-stat for chemistry, and an 02 mask. He said, “The parents, they looked like woah! When I went in right after you walked out, so I told them, ya know she’s good. That’s just how she is. Your kid is gonna be the best taken care of kid here though with her as your nurse.”

I remember I stopped what I was doing. I had big curly hair. Still do. It was everywhere. I was sucking on a cough drop because my asthma was acting up and there had also been a GI smell I just couldn’t get out of my nostrils earlier from another kid. I had a pile of stuff on my IV cart. Other nurses would, set things up, make it all pretty, put the tubing in the same spot every stick etc. I don’t think it was ever in the same spot. That tech held for me for countless IV starts. He knew to just hold the kid. That as much as it looked disorganized I was actually crazy like a fox and never dropped anything on the floor. And if I did I had a spare. In my pocket. He’d had to fish out a spare from my pocket. Once. Maybe twice.

I got the line in that kid in one smooth shot. By the time the Attending saw him he was sleeping soundly, his parents each had a coffee in hand, and they all had blankets. The kid had 02 going and fluids and meds. He went home five hours later.

I’m still sorta that way in psych. Sometimes I think clients don’t know what to make of me. I still am completely unable to recognize how chaotic I can seem but in psych I think it’s more maybe I seem detached, distracted. When in reality I’ve already got you assessed and am narrowing down my medication options and also deciding what gem I’m going to slip in to shatter your defenses to get you to really feel something and maybe by default cry.

I don’t realize that I have a style or a way or a presence until people tell me. That moment was eleven years ago. I still remember the look on the tech’s face, and can imagine the look on mine. First off I didn’t realize I came across like a tornado in that room. Second I had no idea the tech thought I was good at my job or that he remembered after hundreds of lines where to find the spare three way stopcock I always kept in my pocket. Never know when you’re going to need to push adenosine. Just saying.

In psych though clients have a different relationship than in the ED and different expectations. Over the years I’ve been asked directly by a few clients at the intake what my assessment is, diagnosis, and some have even asked what I think their personality traits are. It’s kind of fun for me. I may totally geek out in the moment when I get to be like the cop at the end of a case explaining and divulging all the things I’ve picked up. The ones who ask after one appointment ask because they are skeptical. Skeptical that I’m paying attention. Skeptical that I know what I’m doing. Skeptical that I could get to know them enough in sixty minutes to make recommendations like medication. I get it. But I kill it. Every time. Because hello people. Since 2007 I’ve done nothing but rapid assessment in one form or another every day for hours a day. I also got a couple degrees and training in it. That moment when I relay straight faced, with eye contact, everything I’ve observed, surmised, and suspect and how that relates to my recommendations they usually stare back, jaw drops a little, and sometimes their eyes well up with tears, sometimes they just open in surprise and sometimes a little hint of admiration. It’s that moment they feel seen.

I felt seen by that tech in that moment eleven years ago. It doesn’t happen often that some one catches me off guard. I generally think I’m invisible so am always surprised if some one reflects something incredibly accurate about myself back to me. The scariest time that happened was last week. In the car. With my sons.

I asked the boys if they like living in our town. I bring it up now and then because I’m not sure if we will move or not. They rambled on in their 5 year old way about yes, maybe, no, but we should live next to their cousin, because that’s their lifelong goal and dream to live next door to their cousin. I laughed and said, well if we move with your Aunts and cousin you won’t be in school with…then listed their friends. Then they were contemplative, and I said somewhat surprised, “I kinda like living here.” Never thought I would like rural living. Declan says, “Because there’s no people Mama. You don’t like people. That’s why you like it here.” I looked in the rearview smiling and surprised, “What do you mean baby?” “You don’t like big crowds, (how the hell did he know the word crowd?!) that’s why you didn’t want to go to the Fair. It’s why you like to just be by the pool. It’s okay Mama. We like living here.” Damn. Just like that. I was actually speechless.

None of it was wrong. I don’t like people. Especially big crowds. The pandemic didn’t help. I also blame working in healthcare. We see the worst of humanity. Makes it hard to want to really engage with random people. And yes, the yearly town fair is the bane of my existence. I will not work at it. I will not attend. In every way it is completely abhorrent to me. Cow manure. People. Bees. People. Hill. People. No parking. People. I also do prefer my pool. To everywhere in the world. My two favorite people are my sons. After that there are maybe ten-fifteen people I think I need regular contact with (Yes Mom. You’re on the list;).

Aside from that though, the point is my son. I think I am raising a future mental health professional. Because he saw me. What’s funny in those moments is his twin brother is totally silent. He’s the observer. He’s going to be the politician. He doesn’t agree or disagree outwardly but I know if I asked him he’d know his brother was spot on. He just wouldn’t be the one to call me out. Twins. It’s a whole thing. I am so often trying to survive the grind of single mom-ing, business owning, and being a clinician that I forget they are watching. Seeing. Learning. They know me as well I know them. It’s a scary thing. This vulnerability with our kids. I feel it more as a single mom. Because they spend 85% of their time with me. And I with them.

These boys are perceptive and caring and it’s weird to start to shift from thinking of them as these dependent beings to independent beings who can make assumptions about me. Learn from me. Emulate me. They did not get my general disliking of socializing. These boys talk to every one about everything. It’s cool that they can see this part of me, and be different from me, and we can all be okay with that.

That moment in the car was a parenting first. Feeling “seen” by my kids. In a way I really hadn’t ever experienced with them. I just keep hoping what they see is good enough, wise enough, and strong enough for them. It’s such a shift from childhood and seeking our parents approval, to adulthood and seeking it from our kids. It’s part of parenting I didn’t expect and still find it hard to define at times.

This is one parent’s reminder. They are watching. Always.

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Laughing At Myself…(it involves falling)

There are moments on a daily basis that people actually wouldn’t believe occur to the same person over and over unless you spent an extended period of time with me. For example, one of my best friends in high school spent a lot of time with me. Small town. Limited things to do. Lots of time. As we grew up and grew apart, we still touch base at least a few times a year. He always asks how I’m doing then eventually I will share a story of something and he laughs and says “It literally has never stopped with you has it? Your life should be a reality show.” When my admin started she spent the first few weeks working out of my house. She was definitely with me at least 4 hours a day 4 days a week in my home. This was the month in between office spaces when we were still fully remote. As I stumbled through the house one day and ran to my car because i was running late for a doctor’s appointment…she looked at me said, “Wow, you really are a total hot mess in a super funny but also somewhat unbelievable way. Like people who just meet you would never know.” I proceeded to run back into the house three times because I forgot my keys, forgot my phone, couldn’t find my phone, searched the car, came back in to find my phone again, then eventually found it in the car.

Tonight was one of those moments. I brought the boys to their first official karate class. We did an intro session on Saturday just them and the instructor. They of course loved it, are obsessed with it, and want to be black belts. I’m not social. I talk to people all day about their deep emotional traumas. When I leave work I’m not into making small talk with Moms. 1. They are usually straight. 2. In my town it’s 50/50 that they support #45 and think we have a fake President. 3. I’m usually just freaking tired.

My own Mom is one of those people who will chat with someone in line at the grocery store or anywhere for that matter. Then she asks all these questions, and smiles…and yeah literally the opposite of me as I slink off to find a freaking self check out so I can talk to no one. Sometimes she asks me follow up questions about an interaction I have with some one and then I just stare at her and then she remembers that I in no way went further in the conversation then I had to.

This week I had to sit on the soccer sidelines and go to karate class. I have somehow become this Mom of creatures who are social and like other kids and stuff. I don’t know where they come from.

I’m also a business owner. So I’m on all the time. I get a call from the landlord who is discussing my latest request which is insane. I own that. I make insane requests. He laughs at me. He realizes I’m serious. Then we put our heads together and figure it out. I’m a good and profitable tenant.

Anyways. I get the phone call, I’m walking outside, I have a mask on so I can’t see below me, I have my AirPods in so I’m all discombobulated anyway because my freaking phone keeps putting the sound on my phone then back to my AirPods and I’m looking at my phone, trying to rip the mask off as I push open the door…and then epically fall.

There’s a step.

I have on flip flops. I’m holding my brand new iPhone which I do NOT let drop on the ground can I get an amen! So my left hand was on the door handle, my right hand held the phone, my mouth was open behind the mask going “AHHHHH” my body swung, literally swung, with the door, my flip-flops got all bent and crazy, my ass did not hit the ground, I was actually able to stay in a squat like position. But it was intense and there was rain and the door swinging and my body flying around.

So inside were a few parents who clearly, I mean clearly, saw the whole thing because I actually held eye contact with one of them as it was happening. Then the rest of the parents were sitting in running cars facing said door and sidewalk I just fell onto. Then there was my poor landlord John. He also probably thinks I am not okay. Because unfortunately he has spent enough time with me on the phone designing my current office space, and now designing our add on space, that he knows random crazy shit is going to happen while we talk.

I literally scream/yell. Pull myself up. Realize that no parent is going to ask if I’m okay. I am also cracking up because if any of my friends were there they would have been breaking my balls hardcore. I finally get John the landlord into by Airbuds. After being like “Can you hear me” a million times, and he’s trying not to laugh at the chaos of the last two minutes, he was like “Uh yeah, I could hear you the whole time.” silence. Me cracking up. “Dude I literally just fell out of my kids karate studio. I can’t.” He sighs like he’s not surprised at all this is happening and then asks about my most recent completely irrational and costly update I requested to the new space we are designing.

The problem with AirPods and holding the iPhone anywhere is that I can talk with my hands. I’m a big walker and talker with my hands. I’m not Italian. I’m Irish and Swedish. Literally the least emotive people. But there I was. Walking and talking with my hands waving them around, running them through my massive humid induced curly hair head and trying to convince him it’s maybe not that costly or irrational. It’s maybe a six minute conversation. I am animatedly making my case the entire time after recovering from my fall.

When we hang up I stop. I look around. I realize all those parents who are sitting in their cars who saw me fall just also saw me have a very animated conversation with my hands, barefoot, because apparently at some point I kicked off my flip flops, as I paced on the sidewalk in front of the very large karate studio picture window where the parents sitting inside also had a great view.

At that point I start cracking up again. I apparently had also ripped off my mask which I picked up off the sidewalk next to my flip flops. I am obviously very passionate when I’m making a case for more things and less money after heinously falling and screaming in the beginning of our call.

With as much dignity as I could muster I put on my flip-flops. I put on my mask. I walked back inside and returned to my chair. No one said a word. Not a word. I texted my friends and told them I fell and they sent me GIFs of models walking the runway and falling. It was amazing.

I gotta be honest. I’m sore. My back and shoulders and somehow my arm took a beating. I told the boys after karate and then walking out I almost fell a second time. Damn stair. I blame the mask. But yes I’ll keep wearing it even though no one else was wearing one because Delta. Covid. Science. Blah blah blah.

My point to this rambling retelling of my epic fall out the karate door on the phone with some one who could cost or save me thousands of dollars is…be real. I am not fake. I have never hidden from any one the hot mess that I am. It’s just a matter of who I let in that sees it.

I love my life. I love my kids. I love that I can laugh at myself stumbling onto a sidewalk in the rain. Laugh at yourself. Laugh with your friends. I was going to say talk to other people at your kids sporting events, but that would be super hypocritical. Baby steps. I’m just not there yet. Oh, and always fight the good fight for seemingly irrational requests that cost a lot of money. Know your worth because I know my mine. (it’s a lot).

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Dear Americans,

I read an article about what Europeans found the most shocking about America. One item was the “number of American flags. They are just everywhere.” I thought about it. I would have to agree with that assessment and until 2016 I never thought of that as a bad thing.

As I drive into work every day I pass through mostly rural communities. Many houses have flags. A few in particular have an American flag, underneath which is a “F&ck Biden” flag. I gotta be honest. That irks me. I had to reflect on it for awhile to come to a non-partisan rationale as to why it irks me.

I am the granddaughter of a World War II veteran. I am the daughter of a Vietnam veteran. My Dad also served in Utah as one of the first homeland security details for the Winter Olympics. My Dad was an epic patriot. And it was one area in life we never fought about. I respected, and still do after his death, his love of his country. One of the most meaningful moments at his funeral were three of his former Army friends showing up in dress uniform and seeking me out of the crowd. Saluting me. Asking me politely what happened to their friend and their utter dismay at finding out my Dad at the very end made it clear he did not want a military funeral.

I’m still unclear why my Dad declined what he was entitled to with more than half his life given to the military. His feelings toward the military were complicated by the men he lost in Vietnam, the men who died for him to live, and later on they were further complicated by his understanding of Agent Orange and how that impacted his health until the day he died.

My grandpa and my Dad both kept quiet about their service but they did not ever hide their pride in their service and in their country. I grew up watching them march in our Memorial Day parades. Attending military ceremonies whenever my Dad would be promoted. I visited armories with him throughout the state over my childhood and it was a normal occurrence for me to be around men and women in fatigues. When I went to work with my Dad some times I remember sitting in armories and chatting with soldiers.

When I married a woman nothing about my relationship with my Dad changed. Nothing about my relationship with the American flag changed either. I was raised to be proud of the service of my family members. My Dad served under many Presidents he disagreed with in terms of rhetoric but we did not disrespect a President in front of my Dad. We could disagree with policy and opinions but if I ever said F&*$ Bush my Dad would have slapped me in the back of my head. Because he got that even if we disagree with policy he is still the President and he is deserving of the respect of that office.

2016 changed my Dad. He was still with it enough to know that this was bad. I think that also contributed to his decision to not pursue a military funeral. He had never come against some one who disrespected the office of the President as much as he felt it was disrespected during that administration. But I still would never have used the F word in the same room as my Dad in regards to the President. No matter how much we may agree that administration was not okay. We still had some level of respect and decorum for the office.

When I drive by a flag that has the F word on it (and I swear a lot. So if it bothers me it’s bad) that not only names our current President but also is touching the American flag. Every atom of my being rebels. I feel like my Dad and Grandpa are turning in their graves. Because how disrespectful is that to our flag, our nation, their service, and the office of the President of the United States of America. That is not patriotism. That is hateful and overt disrespect to every veteran, every active service member, and every person who has held the office of the President.

After I had this heated discussion in my head about how and why this was bad, I thought well their response could be they feel the same about seeing the Pride flag with an American flag. That was a head scratcher for me. I can say that, I hear you. I get that. BUT, at the same time- the Pride flag does not disrespect the office of the President. The Pride flag creates safety and perhaps can start to acknowledge and thank all the Queer servicemen and women who have served our country just as proudly and bravely as my Dad and Grandpa. It also doesn’t place the F word in line with our flag. Our flag is a symbol of unity. To have its counterpart say F our President sews divide. It literally does the opposite of what we are supposed to feel when we see our flag.

Somehow “Patriots” have become these neo-nazi homophobic, anti-semitic people like “Proud Boys” who spew hate and division. Well I won’t live in fear of our flag. I am proud of the American flag and I challenge any one flying anything so disrespectful as F Biden next to our flag to remember our veterans. Remember the men and women who served and died under our flag. Because I remember my Dad and his pride in our country and our flag and I urge you to take the parties and politics out of our flag because all Americans are united under one flag whether we like it or not.

And listen, I may disagree with what you do and say, but I’ll defend to the death your right to do it and say it. But in this case, I’m going to call out general bad form; and hope that you can open your eyes to maybe taking things a step too far. Maybe disrespecting the American flag is actually not patriotic but in fact insulting to many fellow Americans.

Sincerely,

Irked In Rural America

#COVID-19 · Uncategorized

How I Sew My 5 yr Old Sons Favorite Masks

I taught myself to sew when I was in high school and college. During a lonely Summer when I was doing an internship in nursing I spent my days with my cats sewing curtains for my apartment. I’ve sewn scrub tops when I worked in the emergency department and fleece tops and bottoms. Never did I think I would be sewing masks.

Obviously March 2020 threw me for a loop. I hauled out my sewing machine and every scrap of fabric I’d saved over the last ten years suddenly made sense. Perfect sizes for masks. I also started saving Joann Fabric coupons and buying kid friendly fabric with Frozen themes, Spiderman, Paw Patrol, etc. I ordered a lot of elastic. Some from sketchy places. I have to say though the sketchiest order I placed is the one that pulled through and delivered a large spool of elastic six weeks later.

I watched a lot of YouTube videos and read a lot of articles. I tried multiple patterns and had multiple failures. When I perfected the cotton with elastic mask I watched videos on how the filtration effectiveness of rayon blends aka chiffon are significantly higher than cotton and the closest to an N95 that fabric can make.

I bought more fabric. I had one lovely cashier who gave me 60% off my entire purchase. So much fabric.

I struggled with the chiffon. I had many failures. I actually stopped trying with two particular fabric patterns because I think they are bad luck. I literally could never make a functional mask from them. Eventually I got it though. I watched a youtube video on making a single layer chiffon mask and looked all over the craft passion website at the many mask patterns. I found that my way works best for my now 5 year olds, then 4 year olds which is a combination of many instructional videos and patterns.

The pattern is the Olsen pattern found on craft passion website.

Outside of Mask after long edges are sewn

The wire is roughly 10 or 12 gauge framing wire. About 4-6″ pieces. I cut scraps of fabric into 4-6″ rectangular strips. Then I iron them in a trifold pattern. Then I sew the piece of wire into the trifold cotton strip. If you angle the pouch correctly you can do the whole thing in one go, you kind of curve around the wire. Make sure both ends are solidly sealed because you don’t want the wire poking out. (pictures are below)

I like to sew several wire pouches at once so I have a nice stash of them. It is more efficient in the long run.

I do a double sided mask. One layer is a chiffon (rayon blend) and one layer is a character cotton fabric such as Spiderman or Frozen. For Halloween I used a pumpkin/witch fabric on top with a brown chiffon/jersey type fabric on the back.

I cut a bunch at once. I fold the fabric twice so I can cut four pieces at once- right side together. (picture below)

Then I sew along the curve of the mask pieces- 2 right sides together (pic below).

Then I take two of the sewn pieces and put right sides together, make sure center seams are aligned, and I sew the top and bottoms together. When I sew the top pieces I hold a wire pouch on and sew it onto the two pieces.

Then I turn it right side out, and fold over the edges to cover the raw edge, and form a channel that the straps will go through. Make the channel wide enough to get a safety pin through. I sew it so the “inside” of the mask is the jersey fabric, as that will be softest against the face.

The nice part about these is they are very forgiving. You don’t have to sew a perfect seam in a perfectly straight line. The more you do the faster you will be able to go, and the straighter the lines become.

So I take a safety pin, pin it through some of the chiffon/jersey fabric that I cut in thin strips along the edge of the fabric and run it through the now sewn channel. Up from the bottom for both ends. Then you should have a neck strap, and two ends at the top that can be tied around the head or I use the black buttons so kids don’t have to tie a bow they can just tighten or loosen as needed.

I’ll add a video to this. If you have questions just ask.

Below you can see finished products- I make them for me and my family and I wear mine as a double mask/top layer when I work at the hospital. Declan is running in the arcade with it hanging around his neck- that’s one of the nice parts is it doesn’t fall off. Declan as Batman has his on inside out so you can see the under seam where I lace in the fabric for around the head. My sister prefers the ear piece be around the ear with an adjuster there, so I do that kind for her and my niece and sister-in-law. My son’s and I like it around our head so it doesn’t bother our ears. You can see in yoga class I have mine tied on the back of my head, as I said the boys I use a button.