Nurses’ Week

12695034_10102397385921327_1431669702564425491_o

I’m so ashamed to say that I once (internally) judged some of my high school friends for going into nursing programs at university. I thought they were all so smart and talented that they should have been doctors instead. I think back on this now and cringe.  They may have confronted this opinion elsewhere, maybe from teachers or even parents.

I now know how wrong I was for two reasons. One, because I spent the last 15 years since high school ended submerging deep into all kinds of strains of feminist thought. Nursing continues to be a feminized profession in most cultures, and therefore taken less seriously by many of us. And two, because I had a baby in a hospital where I was attended almost entirely by nurses and midwives, and that baby needed a 72-hour stay in the neonatal intensive care (for a fairly minor issue, thankfully). I wish I could go back and slap my stupid teenage self.

The NICU nurses were beyond impressive. I don’t know how they do what they do, how they continue to do what they do day in and day out. Cliches get thrown around a lot, and some of it is condescending and maudlin, but nurses are super heroes. We should take some of that rah-rah spirit we as a country are constantly expected to show to our military, and bestow it on nurses. (This is not zero sum, and clearly there are many nurses in our military, and I don’t mean to disrespect them). This is the level of recognition I’m proposing. We are so lucky as a country that so many of the best and brightest women in my high school class went into nursing. These people save lives every single day.

NICU nurses have incredibly specialized skills. I witnessed in it during my time there. They can insert IVs and needles in the tiniest veins. They can perceive something is wrong with the tiniest changes in impossibly little bodies. I asked my friend Micheline, a nurse who spent five years working in the NICU at the only children’s hospital in the Maritimes, now studying to become a neonatal nurse practitioner to shed some light on just how NICU nurses do it:

She said: “Babies can’t tell you if something is wrong. Assessment skills are a NICU nurse’s biggest asset. You have to continually assess your patient through the day and know what their baseline was at the start of your shift or over the days of caring for them. When babies get sick in the NICU it can be very subtle. Maybe their stomach is a little more distended than before, maybe their heart rate is up a  little higher for no notable reason- those tiny little things that in the adult world would be ignored could mean a baby has an overwhelming infection.”

And about the tiny IVs: “Those are skills that are gained over years of experience, we use the smallest IVs and the hardest things with babies is that the veins are fragile so they don’t last as long as you would like. Everything is small. Even isolating heart sounds with a stethoscope or listening to all the lung fields can be difficult because a chest is so tiny. The NICU is full of lots of technical skills that although they may not be specific to the area ( like said iv) they require different procedures, policy and techniques to perform safely and successfully on a baby.”

Mich is now working as an air transport nurse for critically ill babies, children and pregnant women, bringing them to the IWK. So picture doing all that in a loud helicopter in the air:

“I can tell you without my experience in NICU I would never be able to do my job . My assessment skills are key when I am in a helicopter that is too loud to use a stethoscope. They also help us decide what to do first when we get to the patient and they are in a critical condition. Also to safely transport a patient we have a policy that they must have two working IVs- it’s harder to put one back in when you are in the air and your patient is secured in an incubator or on a stretcher. Without my nicu experience two IVs on a tiny baby would be close to impossible.”

She says the job has incredible rewards and heartbreaking challenges:

The NICU is a complex environment; it takes a lot of people, skills and technology to make it buzz. One of the best parts of working in NICU compared to maybe some other nursing areas is the multidisciplinary teamwork. RT’s, RN’s, NPs, pharmacy, physician’s, residents, OT, physio, surgery, social work and even house keeping all work together towards the common goal of optimizing a baby’s condition, empowering their family and helping them get home to live their very best life with the very best future they are able to have. Teamwork like that doesn’t always exist in healthcare. I love that. I also like being able to advocate for babies and their loved ones, especially because they are often unable to do so for themselves. I think that is a very important job considering the extremely vulnerable population. It is a challenging place to work; no baby is the same, no NICU stay mimics another. It is unpredictable, fast paced and high intensity at times but it is also filled with many special moments. I think the very best aspects of the job are those moments. Watching a new dad see his baby for the first time or helping a new mom finally have a snuggle when maybe their baby was too sick to be moved for weeks can be extraordinary experiences. Witnessing the babies and the families you have cared for reach their goals and meet their milestones is also at the top of the list. Whether it is drinking a full bottle, finally latching well during a breastfeed, having a surgery or procedure go well, having their IV taken out, breathing without assistance from a machine or even something as basic as finally having a poop after days of waiting for one- they are all things to be celebrated. At the very top of the list is seeing your patient finally going home with their family. It doesn’t matter if it was a baby who was in NICU for 2 days or 200, it is special every time. The neonatal unit is a very rewarding place to work.

The technology is impressive and not a day goes by where I am not amazed at the things we are capable of because of continued research and advancements in practice (especially considering neonatal medicine is considered relatively new medicine). That said, some of the hardest aspects of the job surround when technology fails or when it isn’t sufficient enough for a baby regardless of the advancements that have been made. For all the special and wonderful moments, there are still devastatingly hard ones. Watching a parent learn their baby may not live or that their child likely won’t function in the same ways as their peers as they grow up is very hard. Helping a parent say good-bye to child is always gut-wrenching and never gets easier. It stays with you. Luckily, those moments are far less frequent than the good ones. It is also sometimes hard watching babies experience pain, endure procedures, disrupted sleep and all of the negative things often associated with an intensive care unit. We do everything we can to keep our patients comfortable, prevent and treat pain and optimize their development but some things are unavoidable no matter how hard you try.

Honestly, I could list one hundred more things that are incredible about the job but I guess in the end, NICU is a very privileged place to work. As a nurse you share in the very best and the very worst days of people’s lives and I feel that it is truly an honor to be able to do so.”

I also discovered that some NICU nurses are experts at dealing with the fragility of brand new mothers, especially the nurses who work on the night shift. I would shuffle over the NICU in the middle of the night, careful not to aggravate my C-section incision, and feed my son while he was hooked up to the machines. The third night after having a baby is a notoriously difficult night: the vast amounts of hormones that were required for labour and childbirth now have nowhere to go, and they flood around your body making you extremely emotional. This made me cry/laugh almost in hysterics for four straight hours for no discernible reason. I couldn’t stop crying no matter how hard I tried,but when I shuffled down to the NICU for the 5am feeding, my favourite night nurse was there. She could tell I was totally overwhelmed and while I fed my baby she and I talked about everything but babies – mostly our dogs. Hers part-beagle, mine full-beagle. She showed me pictures of her dog on her phone. I showed her mine. She intuited that I just needed a mental break from the whole vast terrifying exhilarating process of becoming a mother to just look at pictures of cute dogs. An hour with her in the early morning hours was more mentally restorative than anything else at the time. I left her a thank you card when we were finally discharged.

So don’t just thank a nurse this week, although do that too: please try to fully appreciate how specialized their skills are, how they keep us alive, how they put us back together again when we are so, so fragile. It seems like the most vital work there is. 

You’re never through with surprises til you’re dead…

I’ve been reading up on Lucy Maud Montgomery lately for a piece I’m writing. I’ve learned a few sad, surprising, and interesting things.

One, she didn’t write Anne until she was 30-years old. Her first novel (AGG) wasn’t published until she was 33-years old. This makes me feel like slightly less of a loser.

Two, she likely died by suicide, 75 years ago today. I remember when this news came out back around the Anne centennial in 2008 but I had put it out of my mind. Her life in Ontario seems quite lonely and full of hardships, mostly domestic.

Three, her archives are at the University of Guelph, 45 minutes from my door. I must pay a visit.

And four, the Emily series, my absolute favourite, was her most autobiographical work. Emily was a dark little weirdo writer I always strongly identified with as a young person. I recently re-read the whole series for the first time in 20 years and loved it just as much.

Thanks, Maud, you strange little Island weirdo, who made millions of us feel less alone.

Maud_at_9

What kind of worries are these?

IMG_20170414_145908.jpg

At first I was worried that all the good motherhood stuff has been already written. But then I realized, just like every person writes about childhood differently – think David Sedaris vs Dorothy Allison – everyone can write about parenthood differently. There are a million ways be a child. Yes, there are shared responsibilities that link most parents across the board (the non-negligent ones, anyway), there are also a million ways to be a parent, and a million and a half feelings you can encounter along the way.

The question is, why I have internalized it any differently? Clearly when society devalues mothers they devalue their stories. Are fatherhood stories dismissed the same way? Unlikely.

This is why I should stop worrying and start writing.

And if a nice White lady writer from Nashville can be called dangerous…

The way Ann Patchett wrote about Lucy: I, and many others, loved it.

Some people very much didn’t like it. In an essay called “The Love Between Two Women Is Not Normal” from This is the Story of a Happy Marriage, Patchett writes about the backlash she received when Truth and Beauty was assigned to incoming freshmen. A protest was planned.

My friends from New York offered to go with me to South Carolina, expecting a gladiatorial match I would surely win. My friends from home read drafts of my speech and howled over the ever-growing stack of newspaper clippings. My friend from Mississippi told me not to go. “Cancel,” she said. “Cancel, cancel, cancel.” Mississippians tend not to be cavalier about the dangers of bigotry in the Deep South.

And why the fuss? It doesn’t surprise me:

“The love between the two women is not normal.” The reporter and the seventeen-year-old had finally come out and said the thing that no one else had had the nerve to mention: Lucy and I must have been having sex with each other. That was the only explanation for our loyalty, love, and devotion. Sex was the payoff for a difficult relationship, and without the sex the whole thing made no sense.

She went, she gave her speech with a bodyguard there, and she notes there wasn’t much protest. She admits to spending a huge amount of time on her speech, hoping it would persuade young hearts and minds to avoid censorship, but ultimately doesn’t think she changed many minds, which is indeed a topic for another day.

In my better moments, I tell myself what happened was a noble battle between freedom and oppression, but I knot it is equally possible that nothing so lofty occurred. Some people find sex and suffering and deep friendship between women unpalatable subjects, and seeing these subjects bearing down on their children, they no doubt felt they had to try and stop it. They didn’t succeed, but I seriously doubt that anyone was harmed by completing the assignment. If I am the worst thing the students of Clemson have to fear, then their lives will be very beautiful indeed.

 

Oh Ann Patchett can soothe the soul…

I mentioned in the last post how vital and beautiful Ann Patchett’s writing about female friendship is. It’s also unique, as Erin Wunker pointed out. When Ann met Lucy:

When I turned around the say hello, she shot through the door with a howl. In a second she was in my arms, leaping up onto me, her arms locked around my neck, her legs wrapped around my waist, ninety-five pounds that felt no more than thirty. She was crying into my hair. She squeezed her legs tighter. It was not a greeting so much as it was a claim: she was staking out this spot on my chest as her own and I was to hold her for as long as she wanted to stay….

I do not remember our love unfolding, that we got to know one another and in time became friends. I only remember that she came through the door and it was there, huge and permanent and first. I felt I had been chosen by Lucy and I was thrilled. I was twenty-one years old and very strong. She had a habit of pitching herself into my arms like a softball without any notice. She liked to be carried.

I’ve read Truth and Beauty: A Friendship at least six times. That bolded line has always, and will always stick with me. It is one of the best books I have ever read about beauty, and about  love. It is a memoir about two women best friends.

I did Lucy and myself a great disservice our second year at Iowa and left the house on Governor Street to move in with my boyfriend, who lived in a small cottage behind a larger house a mile away. This act of packing up an leaving home set in motion a much larger mistake that would take years to correct. At the time I thought this was my big chance for love, that I was doing something very romantic and important, but looking back on it now, it all seems part of a very simple equation: I left the house where I lived with someone who loved me to go to the house of someone who did not love me at all. Wasn’t it more important to live with a man, a man who was certain to wake up one day and be happy because I was there with all my good intentions sleeping beside him? Wasn’t that more valuable than staying with a friend who made me laugh, who made me think about everything, but was, in the end, just a girl?

Ann Patchett has this language that Erin Wunker seeks, but is one of the few.