One Experience of My white Privilege.

I’m watching Netflix’s Kevin Hart’s special about Black history.

I started thinking about a conversation I had with a woman recently, she’s African American. I was talking about my blog post about white privilege getting me out of a ticket. I told her I was nervous about posting it, unsure if I would receive backlash or not for starting the conversation about white privilege as a white woman. She laughed and said, “Well some one has to start the damn conversation!”

I’ve tried to compile thoughts in my head about white privilege specifically mine.

Let’s start back in my early twenties. I went to college in upstate New York. Not a very progressive area. Lots of racial tension and roughly one Black person in my nursing program out of about sixty people.

There were discussions among the white people at my college that I witnessed about Black people and the feeling that white people in that moment were not responsible for the enslavement of Africans back in the early days of the USA and up through the Civil War.

Their defense was they were not alive so why were Black people holding them responsible and bringing up these past offenses when in discussions about white privilege.

I didn’t feel any which way about it. I was trying to survive nursing school and not get into racially charged discussions between classes. So I basically shut my mouth, dug my head into my books, and ignored all of these discussions. Thinking back I have a lot of thoughts about that. One- they were wrong. Two- so was I.

If I had lifted my head up and said anything at all, such as, you guys are idiots. You guys don’t get privilege, you guys don’t get being a minority…or perhaps something like, “So here’s the thing, my ancestors came here at the end of the 19th century and beginning of the 20th. They never owned slaves. They and myself had no part of slavery. But…my ancestors tale of coming to the USA is one of freedom. They came here from Sweden and Ireland seeking a better life. And for the most part they succeeded. My ancestors escaped hunger and oppression in their own countries and came here of their own free will as passengers on ships.

The ancestors of African Americans who came here had no choice. Their narrative and history begins in America as slaves. They came here in chains treated worse than chattel. So there is already a fundamental difference in the legends of our ancestry and the fact that a bunch of white people failed to acknowledge that is fucked up.

That I can look back with pride and say my Great-grandmother travelled here alone to meet her sister and never saw her mom and dad again, but created a better life here for herself and her children that alone is privilege. Because there are many descendants of slaves who look back and see bondage and pain.

I started watching Kevin Hart’s special because I have been thinking back to my US history classes over time. High school and college. I love history. Those civil war documentaries have got me. I started to really think about all those civil war docs though, and all those hours of classes and reading. Freaking white privilege.

I learned about Frederick Douglass and I mean we were told Harriet Tubman saved a lot of slaves, but that was about it. Every other important figure in my history lessons growing up and in all those civil war documentaries I’ve watched feature white men and women.

New Jersey recently passed a resolution to teach LGBTQ history in school. I’m honestly not sure what the requirements are for Black history, but it seems like it only comes up during Black history month. The rest of the months apparently we still only learn about white people.

There’s also privilege of being white and not Jewish. I was watching a documentary about a murder, and a Jewish lawyer travelled to Germany for something related to the case. He looked disturbed as a parade filed by in the small village he was at. Later on camera he stated he was only thinking about the many parades they had in the 40’s and the purpose behind them.

He said he never needed to return to Germany, that he felt uneasy the entire time he was there. Something deep and horrible stirred inside him as he walked the land where his people were victims of genocide.

So think about that for a moment. African American’s who live in the USA walk the very land where their ancestors were enslaved, beaten, raped, and killed on the regular.

The fact that I never owned slaves and neither did my ancestors doesn’t matter. What matters is that my ancestors came here of their own free will and I have the experience of being descended from and living in a land of my free ancestors. That is white privilege. That is something any Person of Color descended from slaves does not have. They carry the experience and history of slavery with them.

To demean that history and experience in any way is wrong.

Twelve years later. That is the response I should have had for my classmates.

 

 

 

Living With Endometriosis

I’ve written about endometriosis before and Mommying with a chronic painful illness. But I’m going to mention it again.

It’s been on my mind lately for a variety of reasons. The more I practice psychiatry the more I see how women are mistreated in our society. I mean I knew it before, having experienced it myself, but now I really see it.

It took me three years to be diagnosed with endometriosis. On average it takes about five in the United States, up to ten in England (I did my thesis on barriers to treatment and diagnosis of endometriosis, so trust me on the stats, but you can message me if you want the articles). The first diagnostic surgery was wrong in many ways- she used laser to supposedly get rid of the one endometrial spot she found, told me my ureter was malformed, and that I had minimal endo maybe stage I. There are IV stages- IV being the worst and most widespread.

Fast forward- my ureter was not malformed, I found a second surgeon because my pain quadrupled after laser and I educated myself that I needed excision not laser removal of endometrial lesions. We went for the second surgery and he diagnosed me with stage III endometriosis and excised several areas of lesions on my abdominal wall and my ovaries. He also found endometrial tissue on my uterosacral ligaments and colon.

When I woke up from that surgery I remember he told me what I had and how much he took out and I sobbed. I was so relieved. For three years I chased a diagnosis. I chased my pain.

I was sent to psychiatry at some point by my OB at the time- as many women with pain are sent to me- and was told my a therapist that I must have chronic abdominal and pelvic pain because I must have a history of sexual trauma even if I have no memory of it and no other signs or symptoms that I was a victim of sexual abuse.

I in fact do and did not have a history of sexual trauma.

I never returned to that therapist for obvious reasons including but not limited to misdiagnosis. But can we talk about how much that messed with my head?!

I would puke from the pain. I had hemorrhaging cysts and my hematocrit would drop to 23 and they would threaten blood transfusions as I lay curled in a ball and just wanted it to all go away. But of course, in that moment I remember thinking, and this is all because I have sexual trauma of which I have no memory or inkling? There are so many things wrong with those memories!

I mean the pain made it so I couldn’t think clearly. Then I had to deal with all these health care providers who were minimizing my pain because I was female. I must not have a high tolerance. I must be seeking opioids. I must have a psychiatric history that I am not even aware of. Until that surgeon who took me seriously, I literally thought I was losing my mind and making myself be in constant pain.

So he fixed me for awhile. But it never goes away. Not completely. Then I had the boys and all those pregnancy and nursing hormones kept it at bay. Then it came back. Hard. Then I went on birth control (OCP) because I thought I would give it another go. I hadn’t taken it since my early twenty’s and I really don’t want another surgery. I started it last Summer and it helped. I remembered the one of probably fifteen I tried that didn’t make me super angry and emotional.

But then I stopped losing weight, and gained some back. My blood pressure has been creeping up. I knew it was from the OCP. So I stopped it two weeks ago. The last two days have been horrible with the pain.

I read this piece once by someone with endometriosis, she wrote the “pain is like an old friend,” and I was annoyed and horrified by that ten years ago, but now I understand it. The hormones, the side effects to OCP, the pain meds, the surgeries: all of that crap is foreign and scary. The pain is familiar. I know what to expect with it. Crippling at times.

Like I stood up during yoga class today at hot yoga, and I instantly dropped back to my knees. The pain shot through me like fire from my leg to my abdomen. The boys have seen me drop down to the floor very suddenly when it hits like that. Jackson comes and rubs my head. Declan asks if I’m okay. I grit my teeth and smile at them, a smile that doesn’t quite reach my eyes, and tell them I’m fine, and within a few seconds to a minute it always passes and recedes into a duller pins and needles pain.

Pain meds don’t work. Advil and tylenol are like spritzing a wildfire with a little spray bottle. I can’t take narcotics because I’m a Mama and they don’t really work either. They just numb me out for a period of time.

I said to my wife, “So I’m fat and hypertensive or I’m in pain.” She told me to be fat. That she hates seeing me in pain.

But it’s not that easy for me to accept being overweight and hypertensive. It’s not good for me in the long run. I guess neither is being in pain. But like I said, the pain is like an old friend. Wrapping around me with fiery tendrils.

These days when it’s bad I can’t always focus on the boys. I can only focus on my next breath, my next step, my next move. I feel awful for that. That I’m not myself. I can get into my head about it and have quite the pity party. But then I’m a firm believer in the everything happens for a reason concept.

I think I wouldn’t be able to help the numerous women who end up in my office after a shoddy medical work-up because no one could see past her gender and take her complaints seriously, and truly try and get to the bottom of her presentation and symptoms.

I don’t tell them they must have sexual trauma if they have chronic pain. I tell them I want all of their records. Then I review them all, and I run labs for anything that possibly has been missed, and I refer them to specialists who may think differently then a primary care MD or an OB and who may do different work-ups.

When I offer them alternative work-up ideas and different diagnostic ideas and different doctors to see and alternative therapies to try…I always see something in them that I know all too well. Hope.

When that surgeon told me it was stage III endometriosis with the pathology report and surgical pictures to prove it I felt such relief. Such hope. I knew it was a chronic illness, but at least I had an answer. I had a name for the pain, and an understanding for the underlying cause.

I wasn’t crazy.

That we as healthcare providers are more comfortable telling women to seek psychiatric care then to do an adequate if not thorough work up for them disgusts me. I like to think in my small office, in my own way, I am giving back in a way that only one surgeon ever did for me.

So for now, I’ll embrace my old friend endo armed with my hot water bottle on the front and heating pad on the back. I’ll embrace the good days and not live through them by dreading the bad ones to come and I will take the bad days knowing there will be good days to follow.

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Rebuilding Broken Girls

Do you know what it’s like to sit across from a teenage girl and tell her that what she experienced was not her fault, no matter how many drinks she had, no matter how stupid she feels for getting into his car, that the fact he raped her while she was slurring “No,” is not her fault.

Because I do. I know what that looks like, feels like, sounds like.

Soft crying usually. Not a lot of noise except the sound machine outside my door.

I’ve already kicked the parents out because obviously there is more to the story then what they are willing to say in front of Mom or Dad.

There is always so much tension when the parents are present. They leave and it’s like a weight is lifted, the kid breathes, and tells me the truth. I don’t know when that happens. When the line is so clearly drawn between parents and kids.

So the parents are outside the door while their child tells me about a night when they….drank too much, got a ride home with some one they thought they could trust, stayed overnight with a friend with an older brother or friends of the older brother…the stories are all the same and the girls all feel the same. They feel ashamed, guilty, and alone.

They all say “I know it was my fault…I shouldn’t have…” I let them tell their story. I sit quietly and hear the whole thing. I don’t hand them tissues. I let them just cry it out all ugly with mascara dripping if they are wearing any. There are tissues in front of them on the desk or table but they never reach for them.

It’s like I’m not even there sometimes. They are remembering the night, the moments, the pain, the afterward, and how it sometimes took them weeks or months to even acknowledge that what happened qualifies as rape.

I wait for them to reach a closing point in their narrative. They usually look up at me, with trepidation. Fear. What am I going to say? Think? Do?

I always hold their gaze. No looking away. Got to maintain eye contact. I have an excellent poker face. So while on the inside I am screaming to find the little shit that did this to them and tear them limb from limb, on the outside I am composed. I use their own language to say something like, “To be clear. I mean very clear. It’s not your fault.” They always try to interrupt me and say “But I drank” or “But I got into the car” and I interrupt them and say something like, “You got into the car because he offered to drive you home. Because you needed a ride home, he was a friend of a friend, and he should have kept his dick in his pants. Just because you were in his car did not give him the right to pull over and rape you. That’s fucked up. It’s also illegal. You are not wrong. None of this is on you. There is a code in society that we can trust other people not to rape us when we are intoxicated or in their car. Don’t own this responsibility. It’s not yours.”

I always talk about pressing charges if they want to, but I don’t pressure them. I tell them we have to tell their parents at some point, especially depending on their age and the perpetrator, some times I am legally obligated to tell their parents and DCF.

I’ve had a hard time coming up with a blog post recently because this topic has been on my mind. This topic of our girls our teenage girls taking responsibility for boys, teenage boys who are unable to keep their penis’ to themselves. What the everloving fuck.

It’s horrifying to me. As a mom of boys it’s horrifying to think my son’s would ever do that to another human being. But boys are doing it. On the regular and girls are swallowing down the hurt and pain and remaining silent because they don’t want to “snitch” they don’t want to be called a “liar” and they don’t want to go through it all again.

I want to reach a day where I don’t have so many girls on my caseload with silent rape histories. Rapes that they and myself and a man somewhere out in the world are the only three people in the world who know about it. I want to reach a day when boys are not rapists who get away with it.

I want boys to be taught to not rape women.

Perhaps we as a society just think boys and men know this intuitively. Clearly they don’t. Clearly there needs to be overt conversations with boys who will become men about never having sex with a woman or girl when she is saying No. Never have sex with a girl who is intoxicated and can’t consent. These are simple rules to live by.

Instead of all the girls on my caseload, where are the young men? Where are the rapists? Protected by wealth, parents, and race. The perpetrators of the majority of my cases are white, middle to upper class, boys of wealth and privilege who if there are charges pressed will have a team of attorneys to make sure it is expunged from their adult record.

To change this it would require a major overhaul of our discussions with boys and girls, men and women, about sex, consent, and rape.

For now, I sit with and I hear their stories. I help them rebuild themselves. I help them heal. I carry their pain and I see their tears. I support them during police investigations if they choose to pursue it.

But some days it’s too much to carry. Some days the stories add up and weigh me down. Yet even then I can’t zone out. I can’t call out of work. I have to be there for them. For their stories. For their trauma’s. For their healing.

That’s what it is to be in psychiatry. To be there. To watch broken girls build themselves into strong bold young women. Even when it feels like too much to bear. Because in those moments I have to remind myself that they lived it. That their trauma is more than I could ever imagine. That the retelling of it to me is nothing compared to the actual assault.

But what I’m really thinking about at the end of the day is that I want to raise my sons to be good men. I want all parents to raise their sons to be decent, kind, respectful men. That I want the rapists to stop raping. Because if we focused on the rapists, and not the victims, we would have empowered women and respectful educated men.

To all the young girls out there. It’s not your fault. You are not alone. Don’t take your life because you were raped. Tell some one. Talk about it. Cry ugly tears. Press charges. Take the control back, give the the shame away where it belongs, and live. Because there’s no greater moment than when you can rise up and give death the middle finger because you choose to live without fear.

Most Memorable Emergency Department Moments Part 5/5…The Christmas Party

I think there’s a thing about nurses, specifically acute care nurses, that we see so much shit that other people cannot even begin to imagine. There’s sometimes no way to process it; no way to sit with it. So we party. Hard. We dance. We drink. We sing. We sometimes get into bar fights (kinda more often than you might think). We get kicked out of bars. And a lot of nurses are kinky. A LOT of them. In fact the only in home sex toy parties I’ve gone to have been with nurses. That’s an aside though.

I have some memorable escapades with my ED buddies. The Christmas party my last year there was one of the best. Lots of people attended, there was a lot of hot gossip going on at the time so it was interesting to see who arrived with who and who flirted with who (spouses are NOT invited to ED parties….for…reasons) and considering we all spent a minimum of forty hours a week with each other it’s always a big deal when we pay to see each other outside of work. But pay we did for the open bar and food.

I drank a lot. Two residents came who didn’t pay. Myself and the nurse who organized the party confronted them. We take money very seriously as nurses. We are generally cheap and as I said- it’s a big deal for us to pay to spend time together. So pay up.

I laid into them hardcore about being entitled asshats until they coughed up the 30$ each. The nurse who organized it thought I was awesome and we took horrific selfies in the bathroom together.

One resident who I made pay then hit on me, and when I told him I was married to a woman he said, and I quote, “I like ’em feisty,” and smiled at me like he thought that was a great pick-up line. I mean really Grey’s Anatomy isn’t too far off reality. I picked up a pool stick within reach and casually leaned against it, and told him if he came within six inches of me I’d show him what it means to be feisty and there were about fifty people here who would all pretend they didn’t see shit because they had my back. So back off.

That was the end of that.

The end of the night my friend drove me home, dumped me on my lawn, screamed at me for losing my purse as I was screaming at her that I lost my purse, my wife came outside and screamed at us both to shut up because it was 2 AM then my purse was catapulted into my face and my friend drove away. It apparently was on my seat. My bad.

So why was this the most memorable night for me. Couple things.

That year had been particularly gruesome with cases that left us all scarred. There were more deaths than usual, all around the holidays, and there were at least three times in the last two months I personally had done CPR- as in the actual chest compressions. And I knew that was only three out of eight cases. We were all beat up emotionally that holiday season because the deaths were just more and more painful.

There was an abuse case where a child died. Where the parents were in our ED and where the parents were the perpetrators. We had to stand there in the room and watch a child die standing shoulder to shoulder with their murderers.

I mean if you sit back and think about that. It’s fucked up on many levels.

A few of our own were going through ugly divorces, we were starting to see a huge turnover in nursing staff that would only get worse in the coming year, and as always management was up our ass for things out of our control and never appreciative for the lives we saved that were within our control.

We needed that night. We needed that night to remember that we were all just human beings. That we can laugh, cry, blush, play pool, joke, and do all those things that normal human beings do. It was a huge catharsis and relief in a sea of chaos.

I also realized right there with the pool stick in my hand that I wasn’t lying. All of those people would have my back in a hot second. Because that’s what we did for each other.

There is nothing that can quite describe the bond that develops in acute care, the closest I can come to describing it is that moment. Knowing I could pound this asshat with a pool stick if he tried anything with me and that not only would every one in that room defend me in every way, they would all have stood in front of me before I even needed to use it. That’s some serious loyalty right there because I know for a fact not everyone in that room liked me and the feeling was very mutual. But we were family. You don’t mess with our family.

A few years after I left, a nurse I hadn’t talked to in awhile messaged me on FB. She was going through some bad stuff. She poured her heart out to me, and I called her, and we cried together because it just killed me to know she was suffering. We hadn’t talked since I left the ED. Three years earlier. But that’s how it is with the people I worked with there. They reach out to me sporadically now, and when they do it’s like we know we are there for one another. Nothing has really changed. I could be in a bar twenty years from now with a pool stick in my hand, and if one of them was there I know in my heart they would be next to me in an instant no questions asked.

That’s what I gave up leaving the ED. The family and connectedness. That’s what I miss most. It’s just all the other shit that takes over your brain when your in the thick of it. The safety, management, violence, safety of my license practicing with a shortage of nurses, and the patients. The patients who touch you in ways that fade over time but are never truly forgotten.

People always ask me if I miss the ED. I don’t miss the violence. I don’t miss the fatigue emotional and physical. I don’t miss looking murderers in the eye. I don’t miss the ego’s and the pissing matches between specialists and medicine. I don’t miss watching patient care be put to the back burner while politics of a hospital plays out.

But I miss the people. I miss the family. I miss knowing I could yell out “suction” and it would be in my hand. I miss having an Attending look relieved when I come in the room to start an IV or draw up a medication because they had confidence in my skills and knew I could manage things when shit went down. But most of all I miss the cases that didn’t break my heart. The cases that gave me hope that humanity still existed with kindness and compassion.

I miss knowing that the people beside me were part of an epic team of which I was a member- our mission- to literally save lives.

The better question is not do I miss it, but knowing that I would see the worst sides to humanity, knowing about the blood that would stain my clothes, the tears I would shed, the bodies we would try and pound life back into, the violence I was victim of and witness to…knowing all of that would I do it all over?

Hell yeah.

That night. The Christmas party. I knew my time in the ED was coming to an end. But I also knew I wouldn’t trade it for anything. And anytime I see any of you waving a pool stick around in a bar, I got you.

 

 

*** The picture was taken just about four years ago when my friend the nurse who drove me home and dumped me in my lawn, and I, took a vacation together. Considering I irritate her in many ways we travel very well together!

 

Most Memorable Moment in the Emergency Department Part 4/5…

The blood and the guts don’t actually matter in this story. There were four moments that mattered that night.

1: We were in radiology with the patient in the CT scan machine. Massive head trauma. Adolescent. I was in the CT room as the heart rate was unstable. I already pushed epinephrine once. We were waiting to pounce on the patient to start CPR. The Mom stood just outside in the hallway with the patient’s teenage siblings. Dad hadn’t made it yet. He would. I knew the neurosurgeon was on the phone with the emergency department fellow. I was watching her. Everyone who knew what was going on was watching her. It was one of those moments. Those Grey’s Anatomy moments where there should have been a camera. She was standing up tall on the wall phone. Perfect posture and fit. She turned to face the wall. Away from the nurse’s and the respiratory therapists’ knowing eyes. We couldn’t hear a thing. But we saw her lean her forehead against the wall, lift up her left arm bunch it in a fist and pound the wall.

We collectively exhaled and some of us had tears welling in our eyes. None of us needed to be told. She came into the CT room from the reading area and had quickly regained her composure. “Let’s get him to the PICU.”

2: We dropped him in the PICU thankful he was still alive. Thankful we didn’t have to be the ones to call it. But the nurse who was there for the end. She was one of ours. Some one who floated between units. She came down to see us all later. She told us that as she was trying to mop up the fluids coming out of his nose and both and ears so that the Mom and Dad could see him as their child and not a trauma…she felt a hand on her shoulder. The mom’s voice cut through the room, “You don’t have to do that,” she said quietly, “I’ll never forget how beautiful my baby was.” 

3: Two siblings who worked in the emergency department sobbing in the medication room. It was the only space where you could sort of have maybe some privacy. They had watched our patient’s sibling watch our patient dying. It was heavy. Makes shit real when the family gets there. Every time. Until the family gets there it’s just an anonymous person. The family gives them a name, an identity, a history, and what should have been a future.

4: The friends. There were about five friends who showed up just after he died. They didn’t know yet. They were so young, so hopeful. After several checks with the PICU staff and family we walked them up to the room where the family was. I still remember the looks on each of their faces as they realized they were going into a conference room and not a patient room. I had to leave because I just couldn’t take in any more pain that night.

This was a particularly horrible trauma. For a lot of reasons. The family was so composed and so gracious and they made me want to do better for their child. But I couldn’t. None of us could. The injury was too massive.

Yesterday we lost power due to an ice storm. I had a fire going in the fireplace and the boys napped on the floor in front of it in their sleeping bags while I dozed on the couch above them. They both fell asleep and with the crackling fire and the even sounds of their breathing I felt content. I felt like this was a moment I wish I could freeze.

Working in a pediatric ED changes people. Because we don’t live in a bubble. We live having faced a harsh and stark reality. It can either make us go a little crazy or it can make us focused on the present with an uncanny ability to filter out what the future may bring. Or perhaps both.

It changed me for sure. It made me realize I could never work there after having my own children. It made me appreciate every moment I have with my sons. It made my eyes well up with the sheer joy of hearing their breaths in and out in front of a crackling fire while the world ground to a halt outside in the ice and snow.

Most Memorable Moments in the Emergency Department Part 3/5…The Blizzard.

At some point during my tenure in the ED there was an epic blizzard that covered our state in roughly four feet of snow and ice.

I of course was at my first shift of three in a row twelve hour day shifts.

The hospital made it clear that we were all expected to make it to work. We were essential personnel and we could sleep in the cafeteria on cots if it meant we’d be there in the morning for our shift.

Another nurse and myself ended up splitting the cost of a hotel room that was about a five minute drive from the hospital. The hospital shuttle driver assured us he would grab us in the morning, he told us there were chains on the shuttle and no matter what he’d make it to the hotel and get us. There were about three dozen of us that stayed there that night, not all from the emergency department.

I only had one change of clothes with me because we had never seen a storm bad enough that I wouldn’t be able to make it home the second night.

We woke up in the morning and we could see the highway from our hotel room window. There was a tractor trailer truck jackknifed blocking all three lanes and other dots of cars stuck on the highway in mountains of snow. We knew this was going to be bad.

We went downstairs and met up with our other nurses and waited. And waited. We called the hospital. The shuttle was stuck. The bed manager told us to stay put that her husband would get us. We looked miserably outside thinking we were all going to be fired…as the hospital had threatened to do just that if we didn’t make it back.

We would later find out that all the plows were broken down at one point so there was literally four feet of snow on the roads, minimally if plowed at all, some tire marks to follow here and there, and cars just stopped in the middle of the road stuck in piles of snow.

We all were contemplating walking there when a white suburban roared up to the hotel. I swear to you it slid in front of the double doors. The window rolled down and a guy in his pajamas yelled, “You guys for the children’s hospital? GET IN!” I’m not religious but I crossed myself. I also put my seatbelt on and pulled it tight.

That man got all of us to the hospital. We literally slid all over the capital city and avoided hitting cop cars multiple times, during which he would roll his window down and yell at the cops to get out of his way because he was carrying nurses and the cops would look at him like he was nuts trying to decide if they should stop him or not.

He made about four trips back and forth and God knows how he even got into the city from his house, but he did. The day shift made it in. Nights was relieved. Some night shift people took day shift people’s hotel room keys and crashed there during the day. A lot of OR scrubs went missing because none of us had clothes.

So we all showed up for day shift and people who hadn’t stayed at the hotel were helped by strangers when they got stuck on on-ramps and off-ramps and one person’s neighbor even drove them in because he didn’t want her in her little car and he had a truck. It restored my faith that day in good samaritans and in people helping people in the cold and snow, helping nurses get to work.

It was a slow day but not as slow as you might think.

My two most memorable encounters were one patient and one staff member.

There was a car that pulled up to the ambulance bay doors. A Father got out and opened the back door and pulled out a young child bundled up from the cold. We let them in. The Father was humble and quiet and his child had cancer, was on chemotherapy, and spiked a fever that morning. He knew he had to take them in. He told me where he lived, and I knew it was a solid hour without four feet of snow. I asked him how the hell he made it here!

He put his child on a sled under blankets to get to a main road. He walked two miles through thigh high  snow. Neighbors saw him, some who knew him and some who didn’t, and they all came out to help him- taking turns pulling the sled and making sure his child was comfortable.

His sister and her husband showed up at the main road and piled them into their truck and drove them the rest of the way. He said they got stuck many times and each time he and his sister and his brother-in-law would shovel out the truck and he said every time other cars stopped to help. I said something like “That’s amazing. You are a great Dad.” He smiled and said,

“She’s my daughter. She had to come in. I’m not great. I’m just her Dad.”

Later in the day an ambulance came in and I had seen the EMT a few times. She looked haggard. I asked if she was okay, her eyes welled up and she said, “We couldn’t get to a call in time. Heart attack. We got the stretcher out, the road wasn’t plowed, it took us forty-five minutes to walk to the house with the stretcher. He was dead. We should have been there, we should have saved him,” She cried then.

I’m not a hugger. But I gave her a hug. Eventually she wiped away her tears and her partner sorta slapped her on the shoulder in an awkward, please God stop crying before we go back to the ambulance type of way, and then they went back out into the snow.

I have to be honest. The third day shift after my second night in the hotel I didn’t wear any underwear. I only had enough for one overnight not two. And twelve hour shifts don’t leave a lot of time to get laundry done. I had to choose….sleep or clean underwear. I chose no underwear and doubled up on the OR scrub bottoms.

Couple things about this whole experience. The hospital never offered to help pay for the hotel fees; not even partially. I think they gave us a 5$ voucher for lunch. They sure as hell didn’t have clean underwear on hand. But they expected their staff to eat/sleep/live at the hospital as long as they needed to in order to make it to our shifts. They just didn’t want to help fund it. I would have had far less of an issue paying for all my meals, a hotel room for two nights, and scrounging for food and clothes if I knew my employer was 1- grateful 2- going to take some sort of financial responsibility.

But they didn’t. The people who took it upon themselves to help us were strangers who dug out our cars and in some cases drove us to work.

I don’t know why it takes a natural disaster for people to show their true good colors. But it does sometimes. It also takes a natural disaster for a hospital built as a corporation to also show it’s true colors. We were told that we could be fired if we didn’t show up, yet the hospital shuttle never came to get us and the hospital never gave us a viable solution that would allow us to spend the night and actually sleep and shower and eat.

Instead a maniac in his pajamas who didn’t know us at all, who only knew his wife was a bed manager who also barely knew us, but called him forty minutes earlier and said, “Honey, I need your help,” showed up when we needed a miracle.

He never asked any questions. He swore at cops and buses to get out of his damn way and yelled that he had some nurses to deliver…he saved our jobs and the night shift nurses from being stuck there.

It takes a lot for me to admire people and a lot for me to judge them. I had already started to realize hospital systems are about the bottom line and not actually about supporting nurses. That day was another nail in the coffin for my view of my employer.

I came to admire the Father who would not take praise for doing the right thing. He was freezing still when he came in but he was only concerned for his child. He played it down like it was no big deal to get there. We all knew it was. His child was admitted inpatient because unfortunately they were very ill.

The EMT and her partner who trekked through four feet of snow carrying a heavy stretcher and gear only to find their patient dead. Then shedding silent tears as they trekked back with a body instead of a person. I felt true admiration for the people I encountered that day and  pride to be working beside them. I also had never been so incredibly thankful for all the strangers who stopped and helped all the nurses get to and from work that weekend. As essential employees it was another way in which our bonds were strengthened. We all were there for each other in so many ways that weekend and that’s part of what makes working in acute care so incredibly powerful.

p.s. because if I don’t mention this my friend will freak out…I also appreciate the nurse who lived in my hometown (literally the hardest hit in the state with 4-5 feet everywhere) who with my wife shoveled out a spot in her apartment complex so after my third shift I could finally go home. I zigzagged down the highway and slid off the exit ramp and I parked in her complex and she dropped us at the end of our unplowed street where my wife and I trekked through waist high snow (Yes I did not have underwear on and still only two scrub pants on no snow pants, so yeah I was cold) to get to our house. Thanks dude;)

p.p.s. The benefit to staying in the hotel instead of on a cot was they served wine at the hotel. And because there were a bunch of nurses there…they served a lot of it that weekend.

Top Five Most Memorable Emergency Department Nurse Moments 2/5…

Night shift changes a person.

Not only because it permanently messes with your sleep schedule and actually takes years off your life (Yes that is scientifically proven) but because, well at least for me, it made me a nurse. Not just an average nurse. But an I can handle mostly anything you throw my way kind of nurse.

Night shift is when shit hits the fan. Sometimes literally. Or maybe the wall.

I switched to nights from evenings after I had been working for roughly two years on evenings. In ED terms that’s still relatively new. I was just starting to work in triage, which significantly honed my assessment skills, and had never truly been on my own. Because in the ED you really shouldn’t be. It’s a team setting. So people don’t die.

But nursing is always a shit show. So while there are patient/nurse ratios they are more of a guideline not a hard and fast rule.

So a few months into night shift I already learned that I needed to get good at IV’s fast. I was decent but night shift made me one of the best. Because if I missed there literally might not be anyone else who could do it if there were enough call outs. And trust me, people get pissed if you stick them with a needle more than three times. Especially when it’s their kid.

Eventually I would put an IV into a child’s pinky. Literally. And the mom would request I do the IV every time they came in. She knew I could get it even if all I had was her child’s fingers.

But my most memorable night shift didn’t revolve around IVs. Shockingly. It was a night with a lot of call outs and no one would be coming in at midnight when evening shift left. Myself and two other nurses were covering a full floor of for once, medically ill, not psychiatrically ill, kids. Overnight there was only one Attending and one resident.

Midnight rolled around. Evening shift was antsy to go, so they left. The second Attending hung around charting. Thank God. It had been busy, but nothing life threatening. Until twelve thirty AM when evening shift was gone and it was me and two other nurses. For a packed floor and full triage bays.

I like being busy so it wasn’t horrible. Until I walked in the room of one of my patient’s and they weren’t breathing. It was a baby. The mom was asleep. I started bagging the baby while trying to flip the brakes off the stretcher and yelling at the mom to wake up.

Luckily our Attending was walking by and saw me bagging a patient, said, “OH!” and my team was there. Unfortunately that left the rest of the department manned with only one nurse and one attending (for some perspective day shift could have up to 14 nurses on at once). For awhile.

We had to intubate the baby and admit it to the ICU. By the time I made it to my next patient’s room an hour had passed and I walked in, it was a teenager, and for fuck’s sake they weren’t breathing. We had already diagnosed a double pneumonia. Apparently they decompensated in the last hour.

I started bagging my patient. Fumbling with the damn brakes on the stretcher again, yelling at the damn parents to wake up, and who should walk by but my Attending. She did a double take. I think she thought I was pranking her at first. But I wasn’t. We intubated a second patient.

I walked into my third patient’s room an hour later. The parent’s were pissed. I hadn’t been in for two hours. The one nurse on the floor had hung some IV antibiotics an hour ago though. I didn’t blame them but thus far he was my only patient that was breathing so he had to wait. They didn’t really care though.

I checked his blood pressure and it was wicked low. Tachycardic. Somewhat delirious. Fuck. I shook my head. Unlocked the brakes and rolled him to our resuscitation room and called a medical alert overhead. My other nurse and my Attending whom we had just intubated two patient’s together rounded the corner looking haggard and pissed even though it seriously wasn’t my fault that all my patient’s tanked that night.

He was in septic shock. Perforated bowl. Went to emergency surgery.

Now I don’t remember that night because all my patient’s were close to death. I remember that night because myself, two other nurses, and one Attending were all that stood between them and death. If that’s not absolutely terrifying and amazing and awful and awe inspiring…I don’t know what is.

That’s when I felt it. I knew I wouldn’t forget that night. I wouldn’t forget the teamwork with those two nurses and the Attending. We forged bonds in a battlefield of dying sick children that cannot be described fully.

The most fucked up part about that is how much money I was making. I was getting paid roughly 29$/hour that night plus maybe 7$ night shift differential. To save children’s lives.

Obviously it’s more than minimum wage. But is that what a life is worth to us? My work that night was solid. But in my “yearly review” my manager never brought up that night. She brought up the ED’s budget and nonsense that I had no control over. I was never thanked by management for working my ass off that night understaffed and underpaid and saving lives.

In fact I wasn’t given a full raise that year because the ED had failed to meet some of it’s budget requirements. That never made sense to me. My raises were based on objective financial data. Not the number of lives I saved or who I saved them with or perhaps more importantly who I saved them without.

Nursing makes a person jaded. It certainly made me very cynical. I saw the value large corporations place on human life. Because hospitals are just that: corporations, and it didn’t add up to me.

That night I breathed air in the lungs of patients who couldn’t breathe on their own. I sounded the alarm and helped stop them from dying. That night shaped me as a nurse. I saw the limitations to nursing and I saw my full potential starting to shine.

I didn’t feel new anymore after that night. I felt like I could handle kids not breathing. I felt like I earned the trust and respect of the nurses and Attending that night as they earned mine. I felt simultaneously like the coolest person alive and also the most underpaid.

I remember thinking this is it. This is why I became a nurse. To save some lives. And there I was doing it.

p.s. on non-busy nights when we didn’t have patients trying to die left and right…we did prank the shit out of each other certain pranks involved moving peoples cars in the parking garage pretending they were stolen while others involved body bags. As I said night shift changes people…makes you a little darker.

 

Top Five Most Memorable Nurse Moments From The Emergency Department…Part 1/5

The most memorable moment for me in the emergency department was unfortunately not a happy one and it haunts me to this day. In fact I avoided writing this for awhile as I just didn’t want to. But it’s a story that needs to be told. Over and over. Because I don’t sweep bad stuff under the rug. I broadcast it.

I was in triage. The panic alarm went off, which meant something was happening with the psychiatric patients. I work in mental health now. I love it. However, it was the reason I left the emergency department. In the ED it’s containment, not treatment. It’s dangerous. I had been kicked in the ribs already, and had friends punched and kicked and bitten. But nothing could have prepared me for that night.

I turned the corner and two nurses who I knew very well, one of them who I had helped train, were bleeding, screaming, crying, in the hallway outside a psychiatric patient’s room. They had been horribly physically assaulted.

I worked in pediatric emergency, but a pediatric patient can still be over two hundred pounds and over 6 ft tall. There were too many people watching, patients, families, staff. I grabbed them and put them in a big walk in closet near by with an Attending who was trying to comfort and assess them.

Then I called a nurse manager I knew was in the office, I told her to go to the ortho closet now. She did. They thanked me later for doing that. Getting them out of the craziness and into a closet. It felt wrong to shove them in there so I was grateful later to learn that they appreciated it.

With my heart pumping I walked into the room of the patient. There were about six security guards holding the patient down. The patient was still straining and fighting. There was blood on the faces of at least two security guards. One had his glasses broken and hanging off his face. These were all people I had worked with for over five years.

With tears brimming in my eyes I used gauze to dab at the blood so it wouldn’t drip down their faces onto the patient. I tried with all my might to ignore the clumps of hair and scalp on the floor from my friends now in the ortho closet. There was blood spatter on the walls.

The worst part. The ultimate horror of that night was seeing the fear in my all of my co-worker’s eyes. Fear and anger and hurt and knowing there was not a damn thing we could do about it.

The patient was under eighteen. And with documented mental health diagnoses. No one would press charges against them. We had been down this road before. This horrific crime that left two nurses injured for months with neck injuries from being thrown around the room by their hair, punched in the neck, and more…it would go unpunished. Forever.

All the nurses that were there that night; we all quit within six months.

It was too brutal. Too real. Too fucked up for us to forgive and forget and brush under the rug. It also showed how the hospital would never have our backs if assaulted in the line of duty. It showed how the system just lets that go.

I can tell you the patient was in their right mind. Not psychotic. I can tell you that though every single person who worked in our department wanted revenge we swallowed our rage and took excellent care of that patient for the next week they were in our department waiting for an inpatient bed.

I never had to wipe the blood off my co-workers before, and while I have unfortunately, had to do it again during my career in inpatient psychiatry it was never quite so traumatizing as that night in the ED.

I returned to work the next day. There was another nurse standing outside the ambulance bay doors. Just standing there staring. She had been there with me last night. We stood there together for several minutes. Not talking. Building up the courage to swipe our badges to go inside. We never spoke. We didn’t need to. Eventually she swiped her badge. We went inside.

I realized in the days following that it reached a point where I was scared to go to work. Every time I heard the panic button I saw the image of them sitting screaming and bleeding. We were all more cautious, more jittery, more likely to give a PRN (as needed medication) for agitation much faster than we ever had before.

Eventually they came back to work and I was incredibly awed by their strength and bravery. Balls of steel was my actual thought. I don’t think I could have done it. Come back from that.

It shouldn’t be this way. Nurses should not be assaulted/attacked/abused. But we are. On a daily basis.

That day should not be my most memorable. I have fantastic memories of so many funny times and good friends and good talks and pranks on night shift and moments of absolute teamwork that can only be done in an acute care setting. Moments when everyone comes together like a well oiled machine to save the lives of children who were dying. Those moments were breathtaking.

I remember when I was new in inpatient psychiatry. There was a medical emergency. I yelled out what I needed and held my hands out and waited…and nothing. I looked up and there were psychiatric nurses staring back at me like I was nuts. I realized then I missed the ED. I wouldn’t have even had to speak in the ED. We all just would have done our thing. It’s a security blanket I didn’t realize I had until it was gone.

Yet the night I remember most wasn’t saving a life. It was watching lives being shattered. Watching my co-workers and friends broken with their blood on my hands. Literally.

When you ask some one what’s the craziest thing they’ve seen as a nurse. They won’t tell you these traumatic memories. But it’s what we are thinking.

I didn’t leave the emergency department because I didn’t love it. I did. I didn’t leave it because I even wanted to. I would have stayed forever. But not after that night. That night changed something inside of me. Changed my perspective of nursing and how our society treats nurses. That night broke me a little.

To all my fellow emergency department nurses out there. I see you. I know you. I value you. You are epic.

Conversations With A Three Year Old. About Fathers. When He Has Two Moms.

I’ve been watching “Tidying Up” on Netflix. I like her style. I took her method to my son’s closet and dresser. I took all the clothes out. Packed up two massive garbage bags for goodwill and one plastic container for Summer stuff that will still fit them. Then refolded all their shirts, Tidy style, and I was feeling very proud of myself putting all the shirts neatly folded into their dresser. Declan was in the room with me, chatting with me and playing intermittently.

He took a toy and pretended it was a phone, he was whispering, “Hi, is Mama there?” he wasn’t looking at me. I was chuckling to myself still putting clothes away, “Okay, bye,”. The one sided dialogue was cute, and I turned to look at him when it was over, “Who were you calling baby?” I asked. Thinking I already knew the answer. Me. Mama.

His answer floored me.

“My Father,” (But it sounded like My Fawder because he’s three and talks funny).

Me (trying to act very casual and not freak out): “Who?”

Declan: “My Fawder,” he smiled.

Me: “Oh, uh, who’s your Father baby?”

Declan (takes a moment to ponder this question): “Uhhh, Mommy!”

Mommy is my wife. Who was not home at the moment. Declan was all smiles, glad he figured out who his Father is and resumed playing.

I sorta sat there for a minute with my perfectly folded shirts and wondered how or if I should pursue this line of thinking. Then I thought. Fuck it. At least he knows I’m not his Father. I mean sheesh. I’m Mama. My wife has short hair and no boobs hence I’m sure the confusion. Three year old’s don’t get gender and he probably just thinks she’s the male-ish figure.

I know other lesbian couples where the kids call one partner (generally a more butch-y partner) Daddy and they just let it ride. So that’s what I do.

I told my wife when she got home. She thought it was hilarious. She asked Dec who his Father was, and he smiled shyly and said, “Mommy,” and she smiled and gave him a hug.

Declan is wicked smart. I’m not just saying that because I’m his Mom. I’m brutally honest. Trust me I would say if my kid wasn’t smart. His brother, Jackson, also wicked smart, but lazy. He can do as much and say as much as Declan he just chooses not to unless or until it benefits him. Potty training. Didn’t do it for M&M’s or chocolate chips. Wasn’t the right motivator.

He did it when we started not allowing him to watch any movies until he went on the potty.

Jackson is a cuddle bug. That boy will cuddle with me at any time of day or night that I sit down. He’s attached to me. Declan will snuggle occasionally. And it’s not because he doesn’t like to snuggle. It’s because he’s so damn busy. He’s always taking toys apart and putting them back together. The other day I went into the other room and he had half of a jumbo 24 piece puzzle together. It was hard. It was the jungle. It all looks the same. The kid did it by himself. I’ve never even shown him how to do a puzzle and he wasn’t looking at the picture on the box to guide him.

But I digress.

My point is that he figured out kids have Moms and Dads. Mothers and Fathers. Then he tried to fit his family into that social construct. Mama is a girl obviously. I have long hair and I breastfed him for a year. I wear necklaces and he’s always touching my hair telling me he loves it.

But Mommy, that’s debatable in his eyes. Short hair. Dresses like she works at a paint store (because she does) and wears work boots and no jewelry.

So there you go. She fit the Father mold a little better than Mama (which is fine but for real I’m the one that uses the power tools). Then he assimilated that into a fact in his head and bingo bango a Father is born.

My wife doesn’t care. In fact we’ve talked about utilizing Father’s Day as her day and Mother’s Day as my day so we have separate days to celebrate one another. My kids sure don’t care. But there’s something niggling at me (yes that’s a word).

Why are society’s constructs so rigid that a three year old gets them better than he does his own family composition?

Sometimes people get mad when I reference heterosexual privilege. But I’m going to do it. Because hetero’s have privilege. EVERY movie in existence that is mainstream and three year old appropriate has hetero families and love interests. The boys love Disney movies. Guess what. All male/female. Everywhere. And when, God forbid Disney had Lafou dance with a man, there was moral outrage from every homophobic twat in existence. It was a dance. Not even a long dance. I wouldn’t even have recognized it as a gay moment if I hadn’t been looking for it.

Our society makes a two mom family seem less than, unequal by not giving my sons the same opportunities to see two mom families as hetero families in everything from the media to books to magazines to movies to filling out forms for freaking vaccinations. It’s always Mother/Father. What about Parent/Parent?

My three year old shouldn’t think he’s supposed to have a Father. But he does.

He’s just also smart enough to realize he has two parents who love him, and one of them obviously would fill the Father role better than the other one. Touche Dec-man.

(The picture is Dec reading to all of his doggies. I heard chairs scraping and came into the foyer to find the dogs lined up and him reading. He is defying gender stereotypes by reading from the Disney Princess Encyclopedia)

Not Your Typical “Facebook Happy” New Years Post.

I’m quite realistic. It’s something people either love or hate about me. When I see the sappy posts on facebook about how perfect everyone’s 2018 was…yeah that’s not how I roll.

I don’t ignore bad things. I face them. I won’t say 2018 was a great year for myself or my family. Because in all honesty it wasn’t. But it could have been worse. And scattered through hard times were good times.

Between the screaming three year olds who fight sleep like it’s the plague, there were hugs and cuddles and the first time they said “I wuv you Mama.” Between watching my dad battle a chronic illness that is stealing him away piece by piece, there were lucid conversations; actual conversations where I spoke and he answered and it was rational and normal and I realized how precious the ability to converse with loved ones truly is.

We’ve had struggles within our marriage that are painful and challenging. But I’ve learned to have empathy for my clients who feel shamed by the struggles within their own marriage, who feel they can’t talk to anyone about it except for me because they know I am outside their circle of perfect married couple friends. I’ve heard, “You must think I’m crazy for staying,” through tears more times than I can count.

I learned a new response, “No, I think you have a decade or more with this person, children, good memories, not just bad, and it seems like you’re not ready to give up on it yet. That’s okay. You have to do everything in your own time.” I preach acceptance to individuals struggling silently in their marriages. Because I know that feeling and I wouldn’t dare to judge anyone else’s decisions within their marriages.

At some point in December we got bookshelves. I’ve been waiting a year and a half since we moved in to get them. My books are like my babies. Yes. I’m one of those weirdo’s who has piles of books around her house. Except for the last few years they have been in boxes. It has been killing me.

So we unpacked them into the bookshelves that I put together in our foyer while I swore a lot because seriously we can never just get a piece of furniture to put together where all the pieces fit perfectly. I always have to pull out my drill and make my own damn holes to finish it off.

Anyway I came across my favorite books. I always come across them when I need them.  It’s the Fever Series by Karen Marie Moning. And I read my favorite quotes and cried through my favorite parts. Usually late at night after everyone was asleep.

“Some people bring out the worst in you, others bring out the best, and then there are those remarkably rare, addictive ones who just bring out the most. Of everything. They make you feel so alive that you’d follow them straight into hell, just to keep getting your fix.”
Karen Marie Moning, Shadowfever

“Although it may not seem like it, this isn’t a story about darkness. It’s about light. Kahlil Gibran says Your joy can fill you only as deeply your sorrow has carved you. If you’ve never tasted bitterness, sweet is just another pleasant flavor on your tongue. One day I’m going to hold a lot of joy.”
Karen Marie Moning, Bloodfever

“I’m sorry your pretty little world got all screwed up, but everybody’s does, and you go on. It’s how you go on that defines you.”
Karen Marie Moning, Bloodfever

When I feel like I’m brought to my knees in my life I am reminded that every one is at some point or another in life. That it is how I get up and go on that defines my life.

In 2018 I am grateful for the pieces of joy that overcame the spaces of darkness. I am grateful for my sons even though they drive me insane. Literally. I am grateful for my marriage because it does make me stronger, better, and there are times I just have to be reminded that we started out addicted to one another and it’s still there. It just gets buried under twins and bills and everything else about adulting that sucks.

I am grateful for my house and the life we have built together. I am grateful for my business which is thriving. I am grateful for my dear friends  who have seen my through so much in the past year. I hated making two trips to the emergency department one for my son and one for my Dad, but I am incredibly grateful that both times there were people who I knew taking care of my family members because I worked with them in the past in the emergency department.

I love that Blue Planet II came out. I hate that I showed my sons who were scarred by the whales tearing apart the bird. Mom fail. I miss the arrogance and freedom of my twenties, but am grateful to have lived to 33 as I have now seen too many young people die from heroin overdoses by 25.

I hate watching my Dad decline but I loved the conversations I got to have with him when he seemed back to his old self. One at my dining room table, one in the emergency department, and one sitting in his backyard on his birthday.

I hate the state of our country. But I have hope that 2019 will bring change. I hate that my Lesbian Gay Bisexual Transgender Non-binary Queer clients/friends/family live in fear. I have hope that we won’t one day. I hate that hetero-cis individuals belittle our fear when they have not felt the sting of discrimination ever.

I hate that Ellen D. came out with an awful stand-up routine that did not in the least address the issues the Queer community faces today. I love Hannah Gadsby’s Nanette and I applaud her for facing the tough issues.

I hate hard times in my marriage but I love coming out the other end stronger for it.

“I wish you a marriage peppered with bad days in order to make the good days even sweeter. I wish you the best marriage filled with love in all forms- so powerful that it hurts, and so pure and good that even on the hard days you know you will make it through and come out maybe a little stronger, a little darker, and with a love so strong you can’t live without it.” (me to my sister at her wedding in 2012)

I’m bracing myself for 2019. But as I said. I face shit. So bring it.