"Home is Where Your Rump Rests"

Quoth Pumba the warthog in Lion King.

Last weekend I went home to Pennsylvania. It had been nearly 9 months since I was last there. This visit, however, was not one of lazy lounging and going from place to place. My mom is moving to Arizona...which by the way is awesome and I can't wait to visit her...and we spent part of the weekend packing up boxes and transporting stuff out of her house.

In the ten years that I lived in Columbus I moved a grand total of 8 times. One of those moves was out of my Bon Air home into the aforementioned home in Portage in the summer after my Freshman year. I remember being pretty cranky about the entire experience...believing, at the time, that it mattered where you lived.

But it doesn't. Home is not made up of walls, knick knacks, dishes and familiar neighborhoods. Home is that quiet place where you return to when the real world is just a little bit too loud. But for me...no one building has offered me the same amount of solace and peace as any of my family and friends. When I am feeling "home sick" it isn't the structural stuff I miss. Its the people, laughter, and random activities.

I remember a discussion in my Palliative Care class last spring about attaching emotion to objects. There is a little exercise that spurs the discussion...but it boils down to really examining what is important. For those who are curious...I have the exercise...really very powerful...shoot me a post and I can email it to you. Basically you have a list of 20 things from various categories that you "treasure" as the exercise continues you are forced to cross things off that list. In the end you have nothing (symbolic of someone battling a chronic illness and eventually dying). I remember two of the "objects" that were on my list. The first was my wedding band (my husband and I were still living in different states at the time) and the second was my Teddy Bear (Victor, who I have had for 25 years). It took me a very long time to cross these things off...until I realized that I would still have my marriage if I lost my ring and I would still have the happy memories of my childhood without my bear.

I could tell that packing up her specially customized little house was hard for Mom. I remember packing to leave PA to move to OH (kicking and screaming) and then packing to leave OH to move to NC (remembering the previous kicking and screaming). It's never easy to pick up and go. But thanks to technology we can always call "home." We can always hop on a plane and be surrounded by "home" if we need it. Or..."home" can come to us.

Its not about your house or your job or your car. Just like its not the ring that makes the marriage. Its the people, experience and memories that make home, and life for that matter, what it is.

As I prepare to move...again...into my brand new home in a few months, I think back to all of the places that I lived. Rarely can I really picture the actual building, but you better believe that I can see the faces of the people, smell the smells and hear the sounds that are associated with them. And though there have been a few bumps in the road here and there...I wouldn't change any of those residences because now they all hold a little piece of my ultimate "home."

Good luck in your move Mom! Save a room for us! As for those pieces of my "home" that are scattered all over the country and world...I miss you all! And for those new pieces that I have just met or are still waiting....I welcome you!

Taking the Time

Yesterday a family member thanked me for explaining what I was doing and why. I paused for a moment (as admittedly I was a little tangled up in some IV tubing that I was trying to prime) and cocked my head to the side. I asked her what she meant. She said that often people come in and out of the room and randomly do things without so much as introducing themselves, let alone taking the time to say what they are doing.

This struck me as interesting...not because I was really surprised (okay I was)...but because she was the 4th person to actually approach me and thank me for that exact same thing since I started working on my unit in February.

To defend my fellow staff members I told her that since I was still new to the field that I often explain things that I am doing as a second check to myself (this is half true...as IV tubing...though rather cumbersome when you are short...really doesn't take much thought). But I did stop to think...do people really just walk into rooms, hand someone a pill or draw blood without explaining what the medication or the procedure is? I can't imagine that they don't at least give a brief synopsis.

Maybe I am naive and just new. But I think that someone deserves to know. We tell patients from the start that they have the right to refuse treatment...but how can they if they don't understand what the treatment is? We as health care professionals have a huge amount of power that we often don't recognize. People come to the hospital and count on us to "just do what's best" without considering that we are human and can make mistakes.

This isn't just a phenomenon in health care. I fall victim to it when my car breaks down or my computer does "interesting things" (and more recently trying to navigate the home loan universe). I am not a mechanic nor am I an IT person. When things break I trust my toys to the professionals, but when they call and say the "thingy that turns the doo-dad" is broken...I appreciate an explanation that does not leave me feeling like the dumbest person that has ever walked the earth (and oh...by the way...that thingy is $600!).

It is no secret that I went into nursing with the intent to be a patient educator. I love to teach and nursing was my way of doing it (people under the age of 18 really are too daunting for me). I truly enjoy being able to alleviate fears and (hopefully) improve health behaviors by taking the time to explain the importance of what I am doing and why they should do it at home. Knowledge is power. I want my patients to feel like they can ask me anything...and I hope that I can give them an answer. If I can't...I'll find it.

Yes, more days than not I am still charting when everyone else has long gone home, but I really don't mind if it means that I spent that extra 45 minutes helping someone understand what they need to do to keep him/her out of the hospital (or worse) next time.

Are there moments when I would really rather get caught up on paperwork instead of sitting down and explaining atrial fib for the 400th time...you bet. Are there times when I have something that is really important that I have to do instead of teaching...yep. Does that matter to them...not a bit.

I think that when people do a job for a long time...they forget that each person that crosses our path is new to the situation. I have seen nearly 100 chest tubes at this point and they are essentially unexciting to me but for every new face that rolls into our unit after surgery...likely this is the first time they have ever had one. It is so important to remember that what is common to some is scary (and painful) to others. It is not okay to go about doing your job and getting through your routine if the person you are serving is left completely in the dark and too afraid to ask for help.

Am I wrong? Is this why I am the last to leave? I would like to think that in the end...I was able to get through to someone...and that would make it all worthwhile. And for the record...I don't believe for a second that I am the only person on our team that takes the time...I see my fellow nurses do it every day.

Cheers!

Reading...

I just finished "The Last Lecture" by Randy Pausch. I would recommend this book to anyone I know. Talk about getting your priorities straight.

In a world where we are so often consumed by details...that in 5 years we will have totally forgotten...he reminds us that the big picture is the most valuable. He gives a lot of thoughts about life that we all know and we all think are great ideas...but somehow we never really follow through with them because there is always something "more important."

The book reminded me of the "Bucket List" in a way that maybe only my weird associations can. The obvious connection is that both deal with people who are living with terminal diagnoses. Both focus on the positive ways you can live out your life once you have been given a finite amount of time to live.

It made me wonder why, when there are obvious benefits to having a positive outlook, that we are often so easily drawn into negative behaviors. Why do we sulk and whine when we don't get our way? Why do we continue to cry over spilled milk and constantly try to blame someone else for it spilling?

I have met only a few people in my life that are genuinely positive people. I am not one. I am not fraught with negative energy...I think I am more neutral that anything. After some thought and consideration, I think I am going to try this positive thing out. No, I am not going to be overly cheerful and annoying about it...but I am going to try to emulate those people that I know that are positive and good at it. They have a "let's find the good in this" attitude that does not come across as "let's be unrealistic and naive."

Since no one really reads my blog...I can start my trial of positive without too much scrutiny. =)