Wednesday, November 30, 2011

heart, head, hands

Wow.  So it's been over a month since I've last updated you all.  Sorry for the delay.  

I've been taking a class which requires me to introspect a LOT and write papers at least weekly... between that, group work, mountains of reading, and keeping up with friends... I haven't had much energy to blog.  I fell asleep while doing situps one time this past month.  I have not developed acute narcolepsy... I think I'm just tired.  

I also don't drink coffee and I've stopped drinking tea.  I've never been a coffee drinker and the tea I've stopped a while ago.  I sleep to stay awake.  If I'm tired... that tells me...to sleep more, not drink more coffee.  Somehow, everything always gets done.  Miraculously more often than not, especially when it comes to my papers.  

So... a few major updates.  

I interviewed for an ICU position on August 1st.  I blogged about it (reference: work stuff, August 22, 2011).  I am FINALLY starting my ICU training next week.  My director wanted me to transfer to COU (the Cardiac Observation Unit) first and then move to the ICU.  COU and ICU are run by the same director.  A lot of the nurses float between the two units often.  I don't know if it'll help that I did it that way, but I've definitely tried to make the most out of my waiting time on COU.  And the acuity of the patients is a little higher.  I've had more codes and/or rapid responses in the 3 months I've been on COU than I had in 1.5 years working on telemetry on Tower 2.  Might have been luck of the draw for my patient assignments though... or maybe it was God training me not to freak out as much when a patient is crashing.  

new bling for a new badge
So I've been in a state of flux since I interviewed for ICU (about 4 months).  Communication had been really bad with regards to letting me know what was going on.  I didn't even hear directly from my director that I even got an ICU position.  My director told my friend who told me.  I didn't know if I was going to start on COU days or nights, I didn't know when I was going to transfer to ICU... I've just been... going with the flow... and just flowing wherever someone tells me.  I think that ordinarily or maybe even in the past, this would have really upset me... but I kinda just take it nowadays as... slightly frustrating, however... it makes me feel a little bit more like the Israelites sojourning all over the place.  Maybe like Abe too.  God called him to move away from his homeland on just a promise... and by faith he left.  My situation is nowhere near as crazy as Abraham's but... it's how it kinda feels sometimes. 

I was told (at the most absolute last minute possible) that my first night on COU would be right in the middle of a 4-shift work week for me.  So I worked 2 nights on Tower 2 and then my 3rd and 4th nights on COU.  When I work like that, I don't do anything in between except sleep.  You know... that is exactly the situation that God arranged for me during my ICU interview too.  I had absolutely no time to prep.  I just had to wing it and attribute my survival to God's grace alone.  So I woke up and got ready for work before that 3rd shift and as I was driving... I realized that...I needed to park in a different place than I've been parking for the past few years...that it was going to get a lot harder to see my co-worker/friends... and that my entire "life" at work would be changing and I wasn't ready yet.  I started to cry in the car.  I thought I could handle it by the time I got to the floor but... no.  I was still crying.  Good thing my friend was there on her first day on COU too.  She held my hand and prayed for me in the hallway.  I found out that they weren't even ready for me to work that night either which made me feel even less wanted at a place I didn't even want to be.  Not to mention that I never got a proper orientation to the floor.  They let me work with another nurse that day but she either didn't know how to handle a crying nurse or she was just horrible at orienting a new person on the floor, but she taught me absolutely nothing about where things were or how things were done.  I just had to figure it out myself.  And I was incredibly frustrated.  My confidence was shaken.  I was acting like a new nurse who didn't know anything, had no common sense, no priority-setting ability or foresight...I was HORRIBLE.  I'm glad I didn't kill anyone that night.  It rocked my world though.  I was so comfortable on Tower 2.  Throwing me into COU with no orientation period... without me being mentally prepared... I felt like all my years of experience had been wiped away and I was starting at square one again.  I wonder if that's what Abe or the Israelites felt whenever they had to pick up and move again.  I had to build my tents all over again... make new friends... learn the ways they do things there... remember new phone numbers, new door codes... not knowing where things are, having to rely on others for every single little thing I need... it's just a little bit stressful.  There were nights where no one talked to me.  I began to miss the sound of my own voice, believe it or not.  It was lonely. 

But I adapted.  I figured it out.  God also found ways to encourage me through the roughness of the transition.  For example, for the two times I actually had to code patients, one of my favorite co-workers was there with me and she helped me SO MUCH while I was running around trying to either get work done, care for my other patients, or scramble to get through.  I also rarely work with her.  I heard that she told someone else, "I don't know how Tiffany comes to work every day with all her unstable, coding patients".  When we were switching mattresses on one of her patients (on another day...not when my patients were coding), the mattress guy asked the two of us if we were new nurses.  She said, "yes" and I said, "define what you mean by 'new'?" and she said, "oh you're not new...you're too good."  I laughed.  But it was encouraging.  At least one person thinks that I'm competent on this floor.  

I was able to go to an awards ceremony for my friend/colleague at our hospital last month.  We started working as RNs at the same time.  I met her in new grad class.  While they were talking about her and as I heard her story, I realized how blessed I am to be working at my hospital.  She's been working on COU for a long time.  She volunteered at the hospital before nursing school, she was a unit secretary, and then a RN.  I was pondering how she was like a flower seed and our unit was like fertile soil.  Lots of things can grow in fertile soil, but she really took to the soil and grew into something magnificent.  And she's not done yet.  She's at the beginning of her career, just like me.  

My hospital isn't the best place to work if you look at it on paper.  There are plenty of other places that pay more, have better benefits, have pension, have better equipment, more compensation and incentives for education and certifications... and maybe I would have taken to that soil just as well... but I'm grateful for the soil I landed on.  I'm grateful for the location and the timing as well.  

I can't really tell if I would have been OK anywhere or if this place in particular has just worked out super well for me... but maybe it's both.  Maybe God knew that this would be the perfect place to plant me... that the combination of nutrients and deficits would be perfect to grow me and also challenge me.  As far as school stuff and work stuff... personal stuff... I see how all of it has intertwined and one thing supports the other, which supports the other... I cannot deny that God, the master planner, has arranged it all to take amazing care of me.  

I was talking with my friend the other day and she was commenting on how well God takes care of me.  I totally agreed.  It seems like... God just... turns the dirt under my feet into gold as I step on it.  Even if it seems like dirt in the beginning... it's all a golden experience... whether to learn by or to grow by or to simply enjoy the beauty of.  Everything just... works out.  Even if it seems problematic... it all somehow works itself out and I never had to worry.

And you know what?  My waiting period on COU... has been good for me... but the timing of my orientation on ICU is also very... timely.  Sorry.  Couldn't think of another word.  So last year I had to work all 3 winter holidays... I've also worked every single mother's day and father's day... I always miss everyone's birthday party... even my own parents' because I've had to work.  So this year... because I'll be orienting through Christmas and New Year's... I WON'T HAVE TO WORK EITHER HOLIDAY.  I did work Thanksgiving and black friday this year but still.  I was bursting-out-of-my-skin excited when they told me that they don't orient over holidays.  It's cuz they pay time and a half for holidays and it would be financially unwise to pay two nurses time and a half to take care of the same amount of patients.  SUPER SWEET.  Merry Christmas to me... and a happy new year too!  I'll actually get a chance to spend time with family on the actual day of the holiday!  

I know this is getting pretty long but there was one more thing I wanted to update about.  I don't know if you remember from this blog post (reference: Purple Flowers, September 16, 2011) where I had the opportunity to present in front of the nursing managers about one of my school assignments?  Well, because of that, I got asked to present again in front of the ancillary managers at my hospital (the non-nursing directors) and it happened... this morning.  It's also pretty "funny" or possibly providential that in the class I'm taking right now, this week's discussion topic was on "how to engage your stakeholders".  Everything I've been reading about for this class has been on leadership, character, systems, motivation, innovation, etc. etc.  It's pretty amazing that I get a chance to put into practice precisely what I'm learning at this very moment.  See how all my "worlds" are colliding and how one helps support the other?  

Everything I write about for school has been about either my nursing experience on the floor or my experience caring for Anderson and being on the "other" side of care at the hospital.  My entire dissertation is based on it.  I get to do my clinical dissertation at the hospital where I work.  I'm attending all these meetings with executives and all that... and I also get to work on the floor so I get to see a little bit of the boardroom and the bedside and the disconnect that goes on between them.  Not to mention that nursing challenges me to grow in my weaknesses... it gives me opportunities to present in front of strangers... to interact with directors, executives... outside my comfort zone... to network... and do all kinds of crazy things that I never would have if I weren't being asked to write about it for assignments for school.  I'm super glad that I don't have to just write about it in theory... I get to think about how it applies to my clinical setting and then I have the opportunity to DO IT.  

I know I've probably posted this before... but it's one of my favorite nursing quotes...

the beauty of nursing is the combination of your heart, your head and your hands and where you separate them, you diminish them - Virginia Henderson
Even in thinking about my degrees... biology, public health... nursing is like the melding of the two.  I get to utilize everything... nothing has been wasted no matter how much time I spent hopping from one degree to another.  
Anyway... so I've been going through a Bible reading plan on wisdom.  It's made me ponder God's wisdom... His leadership... also in light of the world's writing on leadership which I've been reading about for my class.  It's so funny how my professor picked this book for us to read called the "21 Indispensable Qualities of a Leader" by Maxwell.  I'm pretty sure he's a Christian author.  All of the indispensable qualities... can be found rooted in the Word of God.  And for all the other readings... about transformational leadership... about Theory U... about how to engage your stakeholders... how to work together... about the "faces" or personalities which make up an innovation team... I totally laugh to myself as I realize that... Christ is the ULTIMATE leader and innovator.  He totally thinks outside the box.  He knew exactly how to engage His audience.  He respected and listened to His team... He even knew how to answer and how to quiet all the opposing arguments that people intentionally threw at Him.  He talked to us about how much the heart matters far more than anything else.  So.  I somehow feel like I have a headstart.  I'm already striving to be more like Christ... and because my foundation is on the Rock... no matter how hard life or school or anything else hits me...I'll be OK. 

Anyway... so back to my original point about the presentation... I thought I would be more nervous.  I was such a wreck before the first presentation... I cried through the entire thing.  I didn't really want to cry through this one.  I also had time to make a PowerPoint presentation.  A lot of my school presentations are done in a style which is quite different than any other style I've ever presented with.  They also have us watch a lot of TED talks.  So we were assigned to read these books by Duarte on effective presentations since our very first semester.  I have a feeling, they can tell who's read them and who hasn't... and also who applies what they've been reading and who hasn't because... it's way obvious in the amount of TEXT people put on their slides... myself included.  I never touched those books.  I did watch one talk about presentations and it pretty much changed the way I thought about presentations... that and a feedback comment by my professor letting me know to move away from the text (which I thought was pretty minimal) and focus more on the content of what I'm trying to say.  I kinda wished that I had read those books earlier.  It was so obvious that I hadn't.  I'm sure our professors chuckle or maybe even get frustrated as they try to get us to present more effectively but we still present the same old boring way.  So... I decided to try it out with this presentation.  It's actually kind of hard to find pictures which visually display the points you're trying to make.  I felt like it took me 10x longer to make this PowerPoint than any other I've made.  It also forced me to practice, practice, practice because I couldn't just read off the slide anymore.  Aye yai yai, this whole thing was stretching me in new ways... but I'm glad I got through it.

Because I actually practiced, I was able to just talk for the majority of my presentation.  Because I was talking to them and LOOKING at my audience... I was able to see them nod... and see them engaged in what I had to say.  I heard people "awww" when I put up our wedding pictures and I actually saw people with tears in their eyes when the showed them the picture of me and Anderson with him intubated in the ICU.  After I was done... I heard someone say, "excellent".  :)  Quite a few people came up to hug me too.  My presentation also spurred someone else to share a quote that touched their heart because she said that my presentation reminded her of it.  Someone else said that it was the best thing they've heard in a long time.  Someone even walked (out of their way) with me as I went to my unit so that he could talk to me and get to know me better.  Someone gave me their card and asked for my slides.  I honestly didn't know if ppl wanted these slides because all they were were pictures... but sure, why not.  Here are a few of my slides:

Purpose: ppl are more than meets the eye. you don't need to know their story to know they have one.
Purpose: Intro Anderson, emotional connection, make a stark contrast between the beginning of our marriage and the end.

Purpose: build emotional connection, build credibility.
Purpose: comparison of our experiences at UCLA and MD Anderson.  I couldn't decide if I should have one side weigh more and have that be better or worse...

Purpose: integrate concepts from different disciplines. Explain things in different ways to help reinforce understanding. Jewish prayers prayed with intentionality and direction of the heart keep the meaning when prayers are repetitive.  Work is repetitive.  How do we keep it fresh; how do we instill meaning into the things we do day in and day out? Intention and direction... towards our patients.

Purpose: the heart makes the difference.  Two ppl can do the exact same things, but one has the right heart and the other doesn't. The one with the right heart does a better job.  There is joy in it.  Remind you of doing things out of love and doing things out of obligation?  Legalism?  LOL.


Anyway... so it went really well.  I think I did an adequate job of engaging my stakeholders this time around and introducing myself... introducing my dissertation topic... building my "street cred" or... my character... or reputation.  There's really no cool way to say that, is there? 

The pharmacy director told me, "we need you on days!".  My CNO said, "we need her everywhere!".  Someone told me they were so sorry for my loss.  I said, "it's ok.  I'm making lemonade".  She said, "you sure are."  

So who knows if I would have had anything to talk about at all if Anderson never happened in my life... if I never started a doctoral program... if I never began work at this hospital in particular.  OK.  I guess it's been a pretty long post.  I guess that's what I get for not updating in over a month. 

Most memorable comment made after the presentation: You've got a lotta heart, baby. 

:D  God... you done good stuff in and through me.  And I'm not done living yet.  If God could take widowdom and brain cancer and turn it into this... I'm sure there's plenty more good stuff to come. 

Until next time...

<3,
Tiff