forever devoted to those committed to my care

While talking on the phone to a patient’s family, they tell me that it makes them so happy knowing that I am there taking care of their loved one.

And in that moment, I am reminded of just one of the eleventy million reasons why I am lucky to have the best job ever.

Eleventy million?

Yes, in spite of my suspect math skills I know that isn’t a real number. But it should be as it represents a virtually infinite number of reasons why I love what I do. Every day there is something to remind me like hearing a parent express to you their trust and their gratitude.

It’s what I do and I love that I get to do what I do. It’s what I pledged to always do almost 25 years ago when I received my nursing degree, as I recited the Nightingale Pledge.

I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.

Composed in 1893 by Lystra Gretter, an instructor of nursing at the old Harper Hospital in Detroit, Michigan, it was first used by its graduating class in the spring of 1893. It is an adaptation of the Hippocratic Oath taken by physicians. While the words are dated, the meaning rings true today as I put on those scrubs, pick up my patient assignment each night and spend the next often exhausting 12 hours caring for tiny humans and their families.

Coincidentally this past week in Michigan, the Michigan House of Representatives, led by Speaker Jase Bolger just passed the bill, HB5958, that would allow discrimination to become sanction by the state. The Religious Freedom Restoration Act, akin to one that made nationwide headlines in Arizona but was vetoed, appears to merely force the government to step aside if a person’s “deeply-held religious beliefs” mandate they act, or not act, in a certain manner. Although subject to legal interpretation, under the Religious Freedom law, a pharmacist could refuse to fill a doctor’s prescription for birth control, or HIV medication. An emergency room physician or EMT could refuse service to a gay person in need of immediate treatment. A school teacher could refuse to mentor the children of a same-sex couple, and a DMV clerk could refuse to give a driver’s license to a person who is divorced.

Personally I share the frustration and outrage expressed by friends who identify themselves as LGBT over this legislative action. I doubt seriously they will seek out a church who preaches hate from the pulpit to preside over their wedding vows, or a ultra-conservative Christian bakery to make their wedding cake or do any other business transactions with those that openly expresses such hate. But imagine an openly LGBT person seeking emergency care in a hospital. Can a healthcare worker really refuse to provide emergency, life-saving care to them because it goes against their deeply held religious beliefs? Would a god actually condemn someone who has studied and pledged to provide care for all individuals needing it?

In 1950, The American Nurses’ Association adopted a Code for Professional Nurses that applies to all nurses, including those involved in patient care, administration, education and research.

Provision 1:
The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.

Provision 2:
The nurse’s primary commitment is to the patient, whether an individual, family, group, or community.

Provision 3:
The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.

Provision 4:
The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse’s obligation to provide optimum patient care.

Provision 5:
The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth.

Provision 6:
The nurse participates in establishing, maintaining, and improving healthcare environments and conditions of employment conducive to the provision of quality healthcare and consistent with the values of the profession through individual and collective action.

Provision 7:
The nurse participates in the advancement of the profession through contributions to practice, education administration and knowledge development.

Provision 8:
The nurse collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs.

Provision 9:
The profession of nursing, as represented by associations and other members, is responsible for articulating nursing values, for maintaining the integrity of the profession and its practice, and for shaping social policy.

As an American, I am thankful for the First Amendment affording me and all American citizens the right to religious freedom…praise god for that! As a person who mostly identifies as a Christian, I am compelled to live by the Greatest Commandment especially in loving others as I (should) love myself. As a Registered Nurse, I am equally compelled my vocation, my pledge and my code to provide the best of care to each and every tiny human who passes through the NICU where I practice, regardless of who their parents are…whether they be straight, gay, married, single, under-age, US citizen, immigrant (legal or illegal), homeless, addict, mentally ill or convict. A life is a life and always precious and worth preserving to the best of my abilities as a nurse. Discrimination of any kind has no place anywhere in this day but especially in an acute care setting where I do what I do. Shame on Michigan House Speaker Jace Bolger and the Michigan legislature as well as anyone who cloaks themselves in such a ridiculous, hateful, discriminatory law in t6he name of whomever they choose to worship!

Let us be anxious to do well, not for selfish praise but to honor and advance the cause, the work we have taken up. Let us value our training not as it makes us cleverer or superior to others, but inasmuch as it enables us to be more useful and helpful to our fellow creatures, the sick, who most want our help. Let it be our ambition to be good nurses, and never let us be ashamed of the name of ‘nurse’.

~Florence Nightingale

photo dump: the thankful edition

It’s Thanksgiving Day so I’m going to give thanks, as one should on Thanksgiving Day…and every other day.

For Thing 1 and Thing 2, generously provided by my employer and a co-worker who has no use for the 12 pound turkey they handed him as we left work early in the morning last week. Yes, I named them, as I do every year. Deal with it! Meanwhile, Thing 1 and Thing 2 are currently soaking in an icy cold, brine-y bath waiting to be properly roasted.

For bringing sexy back in the way that only Personal Protective Equipment can. This look is hot. No. It really is hot.

The perfect pick-me-up after running 4 miles before you work your 4th 12 hour night shift in a week. Hurray for Snickers and for running and for a busy, busy full NICU which means work!

For kick-ass looking compression socks to wear after running a few miles before working hard on your feet for 12 hours all night long. Oh, and, give thanks for the break relief RN who makes the moment where you get to put your feet up for 20 minutes.

Be thankful for the 2 hour nap you had after working all night before you take the time to drive your favorite Princess 125 miles in the rain and wind and fog across a couple bridges during drive time Bay Area traffic so that she can attend two hours of Princess training.

It’s totally worth it when she sends you this picture of her being fitted for the wig of her favorite princess, one of a few who she will be portraying. Yes, you can almost hear her squeeing with delight from the only open cafe in the area where you sat and waited during those two hours. Worth it. Totally. So was her telling you how much she loved you and was glad you were driving as you drove across the Richmond-San Rafael Bridge in the 0.25 mile visibility fog.

This card with this name on it which we waited for for 12 years because no matter what the social workers tell you, it isn’t as easy as it should be to get your child’s social security card with his name on it after the adoption is finalized because government agencies can be so frustratingly dumb sometimes. But not Maria at the Manteca Social Security Administration office. Sure it took her several hours to figure a way around the bureaucratic walls but she did it because, as she humbly put it, “there’s always a way around walls.”

Remembering when you said you couldn’t wait for your kid to outgrow his shoes and clothes before they wear out when you see that the shoes that you just got him are too small. Human Growth Hormones, we are so thankful especially when you see your son’s height and weight plotted at <1%ile on the growth chart because look at that, the kid is almost finally plotting on the normal growth chart!

Pretty scarves and jewelry and makeup and clothes that flatter what your mama gave you, no matter what your age is, that you wear for no other reason than because you want to; which has nothing to do with completely unwanted attention from any stranger who imagines that you got all dressed up because you want their attention.

Yeah.

No.

Taking the time to catch part 3 of the 4 part Hunger Games Trilogy with this child of yours because that is what the two of you do together after the husbands and kids are asleep.

Running this for the third holiday season because otherwise you might just murder someone…or at least given them a really big hug with your hands around their neck because it is the holidays and because you like to eat and to drink because it is the holidays and because you like to run…a lot.

Moments of relaxation and the cat who makes you sit still and enjoy them. I plan to do just that today after I run a 10K and get Thing 1 and Thing 2 into the oven.

Happy Thanksgiving y’all!

 

potential dress code violations

Sitting in Hollie’s chair:

I know. I’m sorry. It’s absolutely frightening how I look without makeup. Still I don’t care because…

I’m getting PAMPERED!!! As I should be. As I deserve to be.

And then Hollie says to me, “I just LOVE how you let me do whatever to your hair.

I nod because it’s true. And then I catch a glimpse of…

OMG! Purple!! Purple like…

Sure it’s the IT color right now from fuschias to lavendars to deep purples to silver tones. It’s hot. Of course Hollie is fast becoming the go to person to get these luscious, colorful locks here in the Central Valley. But…dress codes…”natural hair color”…Absolutely I am a woman of a certain age who could wear the blueish-purplish-silvery hair and it would be totally legit…but, I don’t know.

“MOM! Stop peeking!!!”

I confess that now I am nervous but I keep repeating to myself how much she loves that I trust her…over and over until…

Signature copper with deep violet-red roots painted on as if baby I was born this way.

Naturally!

I may save tiny human beings but my girl makes me beautiful and that, based on the presented photographic evidence is truly miraculous.

 

 

this week on the iPhone

I may not take as many pictures with my Canon as I used toand I should be taking more…still I manage to take pictures because there is always my iPhone close at hand and Instagram.

She really is a pretty little thing and not nearly as bendy as the haters say that she is.

Rain finally came to to the Valley and I did ask my darling husband if he would rather take the car into work in the Bay Area rather than the bike because I could easily get up at o’dark thirty to take Jodie to work and then go home to sleep until it was time to take Daniel to school. No big deal. Jodie would have a triple latte ready for me when it was time to pick her up.

No was his answer.

He got soaked.

Oh well!

The morning after the rain is the best when everything is so fresh and clean…except the mom-car.

Oh, and sunrises as I leave work in the early morning are the best because, yes, I worked! I worked callback which is even better!!

The sunrise view in my mirror reminds me that my day is done…as soon as I drop my son off to school.

This son, my favorite son, who every day, all the time reminds me how lucky I am to say that I am his mom!

But LITERALLY the most exciting thing happening under the Big Top this week was these salt and pepper grinders.

Really!

Follow me on Instagram.

 

 

play it again: behind that NICU door

On call for work tonight. The census has picked up and, yes, I’m (finally) working more doing one of the things I do best. I can’t even begin to describe how good it feels after literally weeks and weeks to be doing one of the things I am most passionate about. This job reminds me every day that not only is life is precious but that human beings are a helluva lot stronger than most people can ever understand…especially tiny human beings who literally fit into your hand when they are born 4 months too soon like the bravest, strongest human I know, my son, Daniel.

I have been doing what I do for over 24 years and although some days (nights) can be horribly tough and emotionally exhausting I am so grateful that this is what I do. I am also kind of surprised that not everyone in my life really gets what it is that I do…nor do they appreciate what it is that Daniel (and his parents and sisters) has lived through. Then along comes something like this that (hopefully) opens their eyes to perhaps some understanding and (maybe) appreciation.

It’s the best job ever. It’s the hardest job ever. It’s what I do and it’s what I love.

originally published September 29, 2013

Heading into work the other day, I walked past a group of people gathered in a small circle just outside the entrance of the NICU. Another Labor & Delivery tour in progress. I know this because most of the ladies in the group are visibly pregnant and because I hear their tour guide explain that behind that door is the Neonatal Intensive Care Unit, where if a problem with their baby should arise, they will receive the very best of care. As I swipe my badge to open the door and enter the unit, I see out of the corner of my eye the expectant parents lean forward a little to get a peek of what exactly is behind that door. Some rest their hands protectively over their pregnant bellies as if to somehow keep their babies out of there.

I smile to myself because I get it. I did exactly the same thing while on a Labor & Delivery tour of the hospital where I was planning on having my baby girl, Hollie. I was definitely curious as to what was behind that door but the last place I would want my baby to be was behind that door.

Then I discovered my passion, working as a Neonatal Intensive Care Registered Nurse in that very unit. It really is, to me, the best job ever. A job that no one close to me has ever completely understood unless they found themselves in there, behind that NICU door. I have done this job long enough to know this to be true with my closest of friends, my darling husband, my children, my family. Unless one works there or has sat vigil beside the isolette of a sick, tiny, fragile human they don’t know what I do behind that NICU door. Nor do they understand truly what my son’s life was like behind that NICU door…or his parents’ lives…or his sisters lives. They have no clue of the rush of adrenaline and trepidation I feel when I get the assignment that is listed as “23-24 weeker”. Nor do they understand the helplessness Bill and I felt the night my water broke 14 weeks too soon while I was pregnant with Jodie as the neonatologist on duty came in to talk to us (to Bill) about the very real possibility that our baby would be admitted into the NICU and all the potential complications and disabilities she would face. It’s scary stuff no one understands unless they spend any length of time behind that door.

Check out NPR’s Radio Lab this Sunday.” was the message I received. Curious, I do. You should too…if you really want to understand what it is that I do…what I have been doing since 1990 when I started my career working in one of the 500 hospitals in North America, Europe, and Japan that had been enrolled in clinical trials of different surfactant replacements, many of which also gained FDA approval.Or maybe you wonder what it is really like to be a parent of a tiny human born at the cusp of viability…a baby who is more fetus-like than newborn baby-like. The story that belongs to Kelley Benham, Tom French and little Juniper is not new to me. I read Kelley’s three-part series, Never Let Go several months ago thanks to a posting shared in the Micropreemie Parents Facebook group I help moderate.

I certainly can imagine all that Kelley and Tom went through as the mother of my own micropreemie. Bill and I too have jumped at that middle of the night call telling us we need to come to the hospital now. Our family learned to accept and understand Daniel’s real age and his adjusted age. And we celebrated too that day we were able to disconnect Daniel from all the monitors and remove all the wires and took home our baby boy.

I also know too well how hard it was for Tracy, Juniper’s primary nurse, to take on the responsibility to be her primary nurse. I totally get why she worked overtime, not wanting to leave Baby Juniper when she clearly was going to die. Like Tracy I also enjoyed many conversations with the babies I have cared for and their parents. I also have enjoyed dressing up “my babies” and taking pictures of them to share with their mommies and daddies the things we did together in the middle of the night when the rest of the world slept. I’ve listened to mommies sing hymns, sweet lullabyes and even Guns n Roses “Sweet Child of Mine“and daddies read countless stories while keeping watch over their tiny ones whom they could not hold. I’ve fallen in love with many of these babies and their families…yeah, I fell completely in love with one whom I now call son too.

While I would never, ever want to experience the absolute fear that I had the night my water broke much too soon while pregnant with Jodie, I am thankful that it did happen. Thankful? Yes, so very thankful. It is because of that Bill went behind that NICU door as a parent to see where his baby might end up and listened to the doctor discuss percentages, potential outcomes and disabilities. That NICU tour and discussion Bill shared with the doctor on duty prepared him, prepared both of us to be parents for a baby born on the edge of viability with pretty much most odds against him. Only days old, when Daniel precariously clung to life, needing emergency open heart surgery, Bill declared that the tiny patient I fell in love with who was all alone needed a father, needed a mother, needed a family and we should be that for him. If that was Jodie wouldn’t we be doing just that regardless of the overwhelming odds that she would have died or be profoundly disabled or moderately disabled, he argued. Yes. Yes we would and so we did just that for Daniel as parents who end up behind the NICU door do.

Check out Radiolab’s 23 Weeks 6 Days