Micro Happy

Can one be macro-happy without being micro-happy?

I think I first began pondering macro and micro stuff when it came to God's love for us.  Yes, God loved the world so He gave His only Son for us... on a macro level... but He also cares for me personally... on a micro level... through the everyday happenings of my life. He cares enough to show His love for me down to the finest details of my life... even things that I didn't know I cared about or loved... He loves me enough to know me better than I know myself and He left love notes for me to find along the journey of my day to day life.  This is love through and through.  It is so much love that He IS Love. Macro and Micro Love. 

So today... I was pondering... macro vs. micro happy.  I think sometimes people give motivational speeches to get us to think about the world... to get outside of our own little comfort zone and ponder our greater existence... our greater purpose.  And seriously... I recall one Daily Bread that I read in college... I think I was probably going through a breakup and up until that point, it was probably the worst thing I'd ever gone through in my entire life... and that one particular Daily Bread challenged me to stop thinking only of myself and stop dwelling on my shame spiral and start doing things for others... to put others first before myself.  And it totally helped.  I tore it out and like stuck it on my bulletin board so I would stare at it whenever I started feeling sorry for myself.  It does help to get some perspective. 

But lately when people have been asking me how I've been or how I'm doing... I say I'm OK and I'm fine... but even as I say those words, I know it's not completely true.  I couldn't get myself to say how I really felt because I couldn't quite reconcile the macro and the micro.  If I said that I wasn't doing too well, people would ask me why... and I really couldn't give them a legitimate reason.  Work's OK.  School's OK.  Church is OK.  There's no big problems with my family.  No serious financial issues.  No HUGE dissertation issues.  There's always little things that are left up in the air but it's not like I'm running out of time on anything.  Still single.  But it's not like I'm really running out of time on that either.  Although someone did tell me that I looked 25.  CRAP.  I'm starting to look closer to my actual age.  That scares me.  When I first started working, people would say I looked 18 but I couldn't be 18 so they'd guess 22.  I suppose I've aged appropriately.  I have been working for a few years now.  But DANG.  The day I start to look my age, I think it's all downhill from there.  I have noticed also that the number little bottles on my bathroom counter have increased exponentially.  There's like whitening serum, moisturizing mask, eye cream, face cream, sunblock, foundation, concealer, etc. etc.  When I was 20, I didn't see the point in makeup because whatever I put on my face, I still looked exactly the same.  Now... it's not exactly the same.  Oh well.  Such is life.  Anyway... I have no reason to be macro unhappy.  But I've lost my bubblies.  I dunno where they went. 

I've been feeling sluggish lately.  Tired.  I don't sleep that well and right when I wake up, I'm thinking about when I can get back into bed.  I can recall a time... when I would wake up and be excited for what I was going to do that day or what I was going to eat.  I'd jump out of bed and bounce while I was brushing my teeth.  Nowadays, it's more like... rolling out of bed and the only thing that bounces when I brush my teeth are my eyelids as I try to keep them open.  At first I thought it was the move to day shift.  But it's been 6 or 7 months already.  I'm not sure if it takes that long to readjust.  I've also gained like 15 lbs.  Now I'm thinking a thyroid issue or something but my thyroid levels were fine a few months ago and I've been feeling like this for quite a while. 

Maybe pondering my macro happy will help restore my micro happy. 

If you want to test your memory, try to recall what you were worrying about one year ago today. - E. Joseph Cossman

I recently got an email from a friend.  She replied to an email update I sent her a year ago and as I read what I was dealing with one year ago in December... I marveled at how much things have changed since then.  I barely started working in the ICU night shift in December 2011.  Since then I have transferred to Cardiac ICU and I'm now on day shift.  In December 2011, I was preparing myself to leave a church I had been going to for 18 months.  Since then I spent 6 months at EV Free Fullerton and the past 6 months at Newsong NOC.  A year ago, we were preparing for the death of my grandma.  She has since passed away.  And then there was some more stuff I wrote about... let's just say I'm probably a lot more emotionally stable right now than last year.  It's not really something I'm used to, but I guess it could be a good thing.  Very low lows are not so fun.  But I have also had some really high highs.  I'm not very very low or very very high.  I'm like... moderately low with moderately high highs here and there.  I dunno.  It's a strange place I find myself in right now.  But there has definitely been a lot of progress and movement this past year.  A very auspicious start to my 30's.

God has been very faithful.   I am on the eve of more major life changes.  January 1st will be my last shift at work as a staff RN for the time being.  My director told me that I'd always have a job there if I wanted it.  Our solution was to put me in per diem (part-time no benefits) status and for me to take a leave for the first two months of the year and see how my clinicals go.  I start clinicals the third week of January.  My clinicals should run almost 5 days a week, 8-ish hour days.  That will be a big change from working 12-hr shifts a few days a week.  But maybe it'll be easier to explain.  Maybe not.  Nothing about my education or work is easy to explain.  I think that's why nurses need to be around nurses sometimes.  No one else understands.  I think I also need to be around people in my program because no other NP student understands the uniqueness and also the unique frustrations of my particular program like my cohort does.  No nurse is an island.  Or at least we shouldn't be if we want to stay mentally and emotionally healthy. 

I think one of the most major developments this past year has been in my friendships.  In 2 years of being at a couple different churches and even working on 4 different hospital units... I have not made friendships like I've made in the past 6 months.  They're all still works in progress but there has been progress.  Since I've been going through my funk the past few months... I haven't exactly been seeking people out as much as I used to... and yet... people still continue to seek me out.  Every person who asks me how I'm doing or texts me or messages me or asks me how I'm doing outside of work or church... is something special to me.  To be remembered when I'm not seen... that is incredibly meaningful to me.  I actually hadn't exactly thought about it much until right now.  I know it means a lot to me when it happens but... to be remembered when I'm not seen... that is exactly what touches my heart in profound ways.  Love note, right there.  Each of my friends are love notes from God to care for me even when I don't exactly want to care for others. 

I've collected a lot of adventure friends over the years and over this past year as well.  All of you share the load in caring for me.  Sometimes I'm doing really well and I care for you guys and sometimes I'm not really doing well and you guys care for me.  All in all, it's been good.  Ups and downs but... very, very good.  Kinda reminds me of this passage which I've been thinking about for the past month or so...

1 Corinthians 12. One Body with Many Members

¹² For just as the body is one and has many members, and all the members of the body, though many, are one body, so it is with Christ. ¹³ For in one Spirit we were all baptized into one body—Jews or Greeks, slaves^[d] or free—and all were made to drink of one Spirit.
¹⁴ For the body does not consist of one member but of many. ¹⁵ If the foot should say, “Because I am not a hand, I do not belong to the body,” that would not make it any less a part of the body. ¹⁶ And if the ear should say, “Because I am not an eye, I do not belong to the body,” that would not make it any less a part of the body. ¹⁷ If the whole body were an eye, where would be the sense of hearing? If the whole body were an ear, where would be the sense of smell? ¹⁸ But as it is, God arranged the members in the body, each one of them, as he chose. ¹⁹ If all were a single member, where would the body be? ²⁰ As it is, there are many parts,^[e] yet one body.
²¹ The eye cannot say to the hand, “I have no need of you,” nor again the head to the feet, “I have no need of you.” ²² On the contrary, the parts of the body that seem to be weaker are indispensable, ²³ and on those parts of the body that we think less honorable we bestow the greater honor, and our unpresentable parts are treated with greater modesty, ²⁴ which our more presentable parts do not require. But God has so composed the body, giving greater honor to the part that lacked it, ²⁵ that there may be no division in the body, but that the members may have the same care for one another. ²⁶ If one member suffers, all suffer together; if one member is honored, all rejoice together.

I've read this many times over my lifetime but for some reason... a few weeks ago... when I read that "our unpresentable parts are treated with greater modesty, which our more presentable parts do not require"... I thought about what part I am.  In general... I think I'd probably be a more presentable part.  If I thought about what part of the body of Christ I might be... I thought I could be a hand or something like that.  Hands are usually uncovered.  And it is the hands which do many things... but it is the hands that cover the unpresentable parts.  Those parts are vulnerable.  Maybe shameful if they were exposed to the world.  Those parts need to be protected.  And I took it as a charge from God to be a good hand and protect the vulnerable parts.  I've been pondering how I can protect the vulnerable.  I can't protect everything but for those things that I see very clearly... I need to take steps towards protecting them and keeping them protected.  It's something I'm pondering this year.  How to "protect" generously and care for the body of Christ.  

I'm thankful that Newsong has been a place where I can serve and be served.  I've been pondering this church since December marked my 6 months at this church and I've been evaluating my progress every 6 months.  It's the first time in a few years where I've felt like I'm interacting with the community and the community is interacting with me.  It's mostly in small ways but there is a give and take that I haven't experienced in a while.  I liken these churches to soil and me to a plant.  Church is to soil as Tiff is to plant.  The Tiff-plant can grow in many kinds of soil.  Maybe certain types of soil were necessary at certain growth periods... and the soil that I spent 20 years at... when I cut those roots to transplant somewhere else... it was painful and incredibly disruptive.  When I transplanted to Cornerstone... I recognized it as good soil... but for some reason I couldn't interact with the soil too much.  The roots didn't spread even though the plant was growing.  Same thing at EV Free Fullerton.  Tiff-plant grew but the composition of the soil somehow didn't jive as well with the Tiff-plant.  And I think that it had a purpose in it.  The roots didn't stick because that's not where I was meant to be.  I was meant to be there for that time period but not for very long.  Every transplant was difficult... but necessary.  It was like the soil was resisting my roots... but it was probably because I wouldn't have kept looking for different soil if the roots had spread.  I might not have moved on and I wouldn't be where I am today.  And where I am today is a good place.  The soil is not perfect but it's a good composition for the time being. 

I don't think I'm done pondering the year but this might be the last post of 2012.  It's also way past my night-before-work bedtime.   It does help my micro-happy to ponder macro-happy.  I'll have to keep pondering micro-happy to figure out how I can get macro and micro to get in sync. 

I heard this on the radio today and I wanted to ponder it a bit more so I made a mental note to Google blog it... 

May You Have
Unknown

May you have……
Enough happiness to keep you sweet,
Enough trials to keep you strong,
Enough sorrow to keep you human,
Enough hope to keep you happy;
Enough failure to keep you humble,
Enough success to keep you eager,
Enough friends to give you comfort,
Enough wealth to meet your needs;
Enough enthusiasm to look forward,
Enough faith to banish depression,
Enough determination to make each day better than yesterday.

2012 has been more than enough.  

lots to ponder...
<3 p="p">Tiff

I'll take the diarrhea

You may have an inkling of what your day at work will be like when you utter those words as your team leader is assigning patients at the beginning of shift. 

I'll take the diarrhea.

Backing up just a bit... 

Examine yourselves, to see whether you are in the faith. Test yourselves. Or do you not realize this about yourselves, that Jesus Christ is in you?—unless indeed you fail to meet the test! I hope you will find out that we have not failed the test. But we pray to God that you may not do wrong—not that we may appear to have met the test, but that you may do what is right, though we may seem to have failed. For we cannot do anything against the truth, but only for the truth. For we are glad when we are weak and you are strong. Your restoration is what we pray for.  2 Corinthians 13:5-9

I've been feeling a lot lately that my spiritual lessons are being mirrored in my workplace.  Or maybe it's that I'm learning the lessons in two places... one in theory and one in practice.  A lot of what Paul has been telling the churches has been extremely relevant between me and God and between me and my co-workers or me and my patients.  I can see very clearly how being a good worker is not separate from my relationship with God, but a significant part of it.  God says to love the Lord your God with all your heart, soul, mind, and strength... and also to do whatever you do with your whole heart.  I think that if you love the Lord with all your heart, everything you do will also follow suit.  

I want to strive for excellence in all areas of my life.  It is my intention... but sometimes you gotta know when to give a little and prioritize a bit.  Work is usually near the top of the list.  However...

When I first took this job, I did it more because I needed to.  It was an answer to prayer... a part-time day shift position that would give me a little more time to breathe and to focus more on school.  Also, since I interviewed for this position and made it very clear that I would need to quit or severely reduce my hours starting in January, it was generally agreed upon that I'd take the easier patients and that I probably wouldn't necessarily be trained to take on the more difficult or complex patients... just get exposure to them.  

I was thinking about last Sunday's sermon.  I remember movie titles.  I had to glance back at my notes to remember the things that stood out to me though.  At the top of my notes was a line I jotted down about momma birds making their nests prickly so that the babies will leave the nest.  I tried googling it and found a couple of blogs about "the way of eagles"... and how eagles teach their young.  First, the nest is really comfy.  The babies are well fed and cozy.  Sounds nice.  But eagles weren't meant to sit in their nests the whole time.  They were meant to fly.  The parents will then stop bringing food to the babies. They will also fly around the nest so that the babies can see them flying. And then the parents will grab the babies with their talons and place them at the edge of the nest so they can view the world from their perch... usually from really high up... like in a cleft of a mountain or something.  They were forced by necessity and placed in an opportunity where all they'd have to do is jump and let their instincts take over.  

I feel like my managers have been like... partially pushing me to the edge of the nest and partially preparing me to take bigger stuff and it's partially intentional and partially due to necessity.  I'm pretty sure it's about efficient use of resources... and also that my unit was semi-short-staffed... which is also why there was an opening for me to work there.  I was pretty happy to just sit back and take the "easy" patients and finish out my 7 months of work in relative peace and calm.  Fortunately or unfortunately, my nest got a little prickly and I've been taking some patients that I'm not necessarily comfortable with but I've always been given enough resources around me to be able to learn on the spot and get through it.  I can't say I've been perfect but I really do try my best every time I work. 

Anyway.  We had an exceptionally rough set of patients yesterday.  Even though we only take a max of two patients per nurse, usually, we'll try to pair a harder one with an easier one and not assign someone with two hard ones or two easy ones.  It took us 15-20 minutes to even decide which patients to match (usually takes less than 5) and then to assign which nurses would take those pairs took an additional 5 minutes based on who could take which, who would be available to do what at a later time....  Regardless of how hard the patients are... no one really likes to take the patient who's having diarrhea.  It is part of the job but it's a lot nicer when we have patients who don't need to be cleaned as frequently.  So I said the words, "I'll take the diarrhea".  

I thought the whole day woulda been giving fluids and cleaning poop but it was a whole lot more than that... talk about false advertising.  But just like Forrest Gump says about life and the box of chocolates... you never know what you're gonna get.  

It took me an hour or so (after I finished cleaning diarrhea twice) to fully assess both my patients and figure out what my plan was for that day.  I distinctly remember looking at the monitor... looking at my patient... and images and stories from lectures were flashing through my mind.  Tachypnea... tachycardia... no fever... but two criteria is enough to meet SIRS (systemic inflammatory response syndrome) criteria... and he's hypotensive and on a vasopressor (to bring up his blood pressure...)... if it was just dehydration, the fluids woulda been enough... but he's still hypotensive and... looking at the vitals from when he first came to the unit last night... it's getting worse.  And he's got an infection.  And he had diarrhea for 3 weeks.  My gut was telling me something was gonna start going seriously south... but all my co-workers were busy running around and putting out fires of their own... and their fires were serious emergencies.  I did have a little more time to ponder mine.  And ponder I did... until I found a few minutes to ponder with my manager and that's when everything started to happen.  

It was non-stop running to keep my patient alive for 8 hours... it was a really rough day which was riddled with complications.  Nothing went smoothly or as expected, for me or for every single one of the nurses on my unit... actually everyone... respiratory therapists, xray techs and secretaries included.  I'm not sure if it made it worse or better that there were nursing students there... (actually better... I did need an extra set of hands quite a few times yesterday)... AND people going around doing audits and taking up computers and space in the nursing station.  I had never been so behind on charting, nor scrambling so much for so long.  Thankfully I had a few grown-up eagles there to help me along.  I would NOT have been able to survive the day without their help.  I stayed two hours longer after my shift in order to catch up on 12 hours of charting for two patients.  I never clock out late.  Yesterday was pretty... exceptional. 

It was textbook sepsis... rapidly deteriorating to septic shock.  At the end of the work day... after I finished giving report... I looked at my patient... he went from 2 IV pumps to 8, he went from breathing 2 liters of oxygen with a nasal cannula to having a breathing tube and a ventilator, he went from no isolation to contact isolation for C. diff (a really nasty bug)... it was a big change in just a few hours.  My heart was still racing from being in emergency mode for so long.  And at the end of the day, I had a gut feeling that he wasn't going to make it through the night despite my best efforts.  I kept thinking to myself... how it all started when I said, "I'll take the diarrhea".  

I haven't had such a sick patient in a while.  After such a whirlwind events, I was laying in bed pondering everything that happened.  I kept trying to think about what I should have done, what I could have done better, what I could have done faster... what should have been done in the ER... where did our system fail us... could we benefit from more education?  Are there any systematic changes that could be implemented to improve outcomes?  

I've been considering the same thing in my own life.  What am I doing... what could be done better... in what ways can I systematically prepare for a more successful outcome... what do I want... what am I passionate about... am I living a life full of love... and what do I love... who do I love... a lot of times, my actions show what I love without me consciously thinking about it... anyway... it's a lot to ponder and sometimes I end up feeling overwhelmed but... I think it's a good way to think.  To test myself.  Analyze and evaluate... and then form an action plan.  With deadlines.  

Or I could just wing it.  

Speaking of winging it... I was reading about the eagles and someone had written that eagles fly directly into a storm instead of seeking shelter and riding it out... the gusts and torrents actually provide lift and help the eagles soar higher and fly faster.  If I want to be the kind of eagle that soars high and flies fast... I think I'm gonna hafta push myself outside my comfort zone and fly directly into the storm... or maybe to a trauma 1 hospital for training.  I am scared that I won't be good enough... but I won't know what I'm good for until I push myself to the limit.  Yeah.  It sounds good in theory.  We'll see how I feel when I'm perched at a precipice with miles of space between me and the ground...with dark, thunderous clouds in front of me... and torrential winds blowing straight at me.  Or maybe it'll just seem like storms when in actuality, it's just a gentle breeze and a passing cloud as I'm perched on a low-hanging branch of a tree in a park.  

I'm thankful for so much.  Thankful for my co-workers... thankful for that my other patient got through his day smoothly and without crashing... thankful for the doctors and their help... thankful for training... thankful for remembering that story about the septic lady that I heard in a lecture... thankful for experience in the ICU... thankful that I wore the more comfortable shoes that day instead of the ones I almost wore (which probably would have made me fall since I was running back and forth so much), thankful for the nursing students who helped me do blood sugar checks and helped me turn my heavy patients... thankful that my mom packed me lunch that particular day so I could eat it for dinner after work cuz I had no time before life group to eat anything else... and also thankful for life group so I could calm down and be around people and laugh and chatter about all kinds of stuff non-related to hospitals and dying patients... and just overall being thankful for a job... thankful to be a nurse... thankful to be an ICU nurse... thankful that the sons of my patient were able to make it to the hospital and that they seemed to have effective coping mechanisms and thankful that I had good rapport with them as well.  I'm thankful that I went to work yesterday even though I really didn't feel like going to work when I woke up.  All in all... a good day. 

Still pondering...
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Tiff