You cannot step into the same river twice. ~ Heraclitus

Just as the river flows along, so too does life. And blogging apparently...

A year has come and gone - who I am now is, I believe, a very different person than who I was a year ago. And yet this blog has always strayed back into my mind and so here I find myself once again. At the same river, but stepping into different waters.

When I tell people that I work with cancer patients, it is obvious that they have no idea what to say to that. The general reaction seems to be something along the lines of "Good for you, that must be so difficult. You must see some hard things." - true statements, but hardly a summary of what I do, what I offer to and receive from this job. I then follow up my initial comment with a statement explaining more about what I do; specialized chemotherapy protocols, in depth assessments of critical patients, stem cell transplants, etc... That gives people more room to work with, something interesting they can ask about; something to focus on that is not the dreaded "c" word - the silent elephant in the room.

Oncology nursing is something that, for me, is infinitely difficult to verbalize. It teaches me so much more than I think I can ever offer back in return. Patience. Perspective. Love; of people, life, myself. Joy. Compassion. And yes, it does on occasion take me to a deep and sorrowful place, where it seems as though all the pain in the world is reflected back at me through the eyes of another human being.

And that would be why I took a hiatus, if you will. I was worried that if I admitted to the the world (haha, if there is anyone who actually reads this) that oncology nursing has some incredibly difficult and painful moments, days, weeks and months, that I would be playing to what everyone already seems to think - that it is depressing, horrible and bleak.

What I have come to realize over the past year is that everything is all about balance. Everything is a smaller version of the bigger picture, the micro to the macro. My job has moments of indescribable depth, to a degree that most people will probably never experience in their lives. In one breath, it can show me a beauty in humanity that I never knew existed and in the next, heart-wrenching grief that takes the colour out of the day.

Both can bring tears to my eyes; neither would exist without the other. And that realization is what brings me back to the edge of this river, watching the waters flow by.

Zen is not some kind of excitement, but concentration on our usual everyday routine. ~ Shunryu Suzuki

Nurses must frequently deal with difficult situations; a family or patient in distress, a difficult task or procedure, a problem that needs solving. It does not help to panic, micromanage or become defensive. Instead, a little concentration is called for.
Often when we are confronted with stress, our first reaction is to do. And not just to do one thing, but to exhaust all possible avenues of resolution at once. It is beneficial to take a breath, center ourselves and focus on what we are doing at the moment.
One thing at a time.
Breathe in, breathe out.
Blood goes round and round.
The most important task is the task that we are performing in this moment. With our focused attention. What we frequently discover is that our calm becomes contagious - to the family, the patient, the situation. And that is never a bad thing.

The grateful heart

Nothing is more honorable than a grateful heart.

~ Seneca saying

A patient just dropped off a huge platter for dry ribs and garlic toast tonight. The night shift is often overlooked as patients usually visit during the day and the day staff often hear the thanks and reap the tasty rewards. It is always touching when past patients remember the night workers.
I often find myself wondering what sort of difference I actually make in a patient's life. Am I helpful, do I improve the quality of their stay? I know that many of my patients have touched my life in deep and thought-provoking ways...they are not merely faces to me.
Gestures such as the one tonight reassure me that I am not merely a face either.

The window

Most human beings have an absolute and infinite capacity for taking things for granted. ~ Aldous Huxley

When you have a body that works more or less the way it should, it is one of the last things you spend your time thinking about. You are not really conscious of your toe unless you stub it, your fingertip unless you cut it. Everything functions predictably and you go about your daily life preoccupied with other thoughts.

A patient of mine remarked to me tonight that when she looks out the window at all the people driving their cars across the bridge, she wishes they knew how lucky they were to have a body full of healthy red cells and clotting platelets. The longing to be one of those people again, with bone marrow that produces it's own healthy cells, instead of being dependant on blood and platelet transfusions to get through each day, was so poignant.

We are all those people driving on the bridge. We are also the people looking out the window.

Another cog in the wheel

There is no such thing as an insignificant life, only the insignificance of mind that refuses to grasp the implications. ~ Laurence Overmire

You've had a long day.

You're ready for a nice, comfortable sleep in your beautiful bed.

And you find yourself making your lunch, putting on your scrubs and getting ready for a nice all-nighter at work instead. Just what you were hoping for, right?

Walking in to the hospital, you look around you at the dozens of other people doing just the same. Faces in the crowd - some weary, some energetic. Most clutching a cup or three of coffee. You marvel at the way the machine rolls on and wonder if anyone actually knows who you are, what you do on such a regular and repetitive basis. Probably not. You too are just one of the many faceless faces in the crowd.

The shift begins and winds down the familiar path...inflate, deflate, poke, prod, in, out, ask, listen. You try to find a few zen moments in there. The sound of clear, deep breaths through your stethescope reminds you of the ocean. But you have medications to hand out, you can't stand there and listen forever.

Everyone has settled in for the night (which is what you are not so secretly wishing to be doing yourself!) and you pull up a chair and a shelf full of charts. The paperwork begins predictably on time and you make good progress, except for that patient in room 9 who keeps ringing the call bell every ten minutes. The jarring noise interrupts your charting flow just when you get to the good part - Is patient X the one with C.Diff? Or was he the one who wanted senna for constipation? The answer comes back to you three minutes later and you straighten it all out. Problem solved.

The night crawls along. A few medications here and there, checking to make sure bed 4's nausea has settled, bed 20's pain is better controlled in between your rounds. You look out the window at the sparkling golden lights over the city and feel at once blessed to witness such beauty and cursed to be awake at this time of the morning to see it.

You long for sleep but know that a nap will only tempt you and make you crave it all the more. So it irritates you when your co-worker hogs the staff room, turns off all the lights and goes to sleep for the next hour. Isn't this a communal room?! You want to eat your lunch and maybe have a stimulating conversation with a co-worker about how to beat the night-shift food cravings...maybe tossing in a little late night philosophical discussion on the merits and perils of relationships. Grr.

Bloodwork time. You pray that everyone has a functioning vascular access device and that you won't have to spend three quarters of an hour trying to doctor the line to spare them another poke from the lab. You make it through unscathed...for tonight.

The clock ticks onward. You count some narcotics, forcing your foggy mind to prove that it can still perform some basic math operations. Or maybe not. You stare at the same box of hydromorphone for two minutes before you realize that there's a whole other box in the cupboard. That would explain why you seemed to be missing 10 precious little vials.

The day shift start to flow in...all chipper and perked up on caffeine. You envy their vitality, as your achy, sleep starved body begins to mummify. Report off and you are on your way.

As your body sinks deeply into the soft comfort of your bed, you are mildly astounded that you survived another night and that your shifts always seems to come to an end, no matter how busy or slow. You remember the hug you gave to a grieving patient who just lost a precious pet, the joke you shared with another. You center yourself with some deep, nourishing breaths and feel the lightness of sleep overtaking you. You could live in this peace forever.