Healing Our Broken Hearts

Everyone is experiencing loss: loss of income, loss of dreams, loss of expectations, loss of health, and even the unspeakable, tragic loss of a loved one. We are witness as well as casualties of our own loss. Such double exposure hits us hard. We hurt for our patients who cannot see their loved ones, even those who are not infected with this virus. Those of us in the ICU’s ache under the heavy weight of the cumulative tragedies we struggled so hard to prevent, all the while worrying over our own loved ones. Those of us outside of COVID-19 settings feel guilty, yet still experiencing our own losses. Here are some thoughts to consider:

1) All loss is legitimate. All loss needs to be acknowledged and grieved. The loss of a birthday party to a 5 year old or a graduation ceremony to a High School student seems very trivial compared to the loss of life, but not to that 5 year old or that Senior Student. We can only understand loss through our own eyes, and all loss is valid. Comparison inhibits healing and is irrelevant. All loss needs serious acknowledgement and acceptance of those feelings, which is in itself a hugely helpful intervention.

2) All loss needs expression, which is individual for every person. Tears are always helpful, releasing the pain to make room for healing. Please remember, dear nurses, crying for your patients and with your patients is always appropriate (see previous blog on Silent Comfort). Find the modes of expression that fit you. Find an accepting and reinforcing ear. Write, paint, draw, sing, or record your thoughts, your heartache, whether big or small. Let it out in order to let it go.

3) Honor that loss. Put the energy of grief into some positive action. Send a card to someone who needs it. Light a candle. Bake some muffins. Plant a flower. Say a prayer. Doing anything helpful for anyone can be healing, and a great way to express your own pain. When you cannot take away the pain of your own loss, the next best thing is to make someone else feel better.

4) Comfort yourself. Watch feel-good movies, give yourself a home Spa Day, or read the comics online. Do something kind and pamper yourself in some way. Facetime your friends, Zoom your old roommate, connect with people who are warm and helpful near and far. Anxiety is contagious, so avoid too much time with such people, but stay connected with loved ones.

As nurse, you are experts at comforting others. Now is the time to refuel and comfort yourselves. Nourish your bodies and minds, build up your emotional reserves. Take time for yourselves, mentally and physically. You are a great treasure to all who know you, and all for whom you care. Blessings ~ Janice

Facing Fearful Families

They come to us for comfort: families who are terrified of loosing their loved one.  They want us to give them hope, or even better, reassurance that all will be well.  Sometimes, we can actually provide such optimism, but more often we cannot.  We do not have a crystal ball, nor control of health and well-being. We can only do what a mere mortal is capable of doing, regardless of our years of experience in nursing practice.  So, what do we say to fearful families with silent pleas for help?

*We affirm their feelings. Their worries are valid, especially in this pandemic, where our patients experience much longer intensive care stays with often a roller coaster trajectory of ups and downs. The family’s concern shows their love, and we can reinforce them for having that commitment to this patient. Families need all the reinforcements we can find to give them, including taking care of themselves in the midst of this crisis.

*We give them honest information, which is likely to include: “no one can predict this.”  We honor them by trusting them with the truth as we know it. We also build their trust in us by our honesty.

*We point to the positives, especially their love for this family member. Tell them what they can do: call on the phone, let their loved one hear their voice, even if the patient is in a coma.  We never know what a seemingly unconscious person may hear, physically or spiritually.

*We guide them to their spiritual source of strength. When humans reach the end of their resources, the choice is either to despair or to turn to Someone greater. If they have any tradition or inclination towards a Higher Power, now is the time to maximize that resource. If they are searching and in need of spiritual comfort but do not know where to turn, suggest they just sit in the chapel and talk to whatever Presence they feel there. Offer to call the hospital Chaplain, who provide wonderful listening presence and open minds to our patients and families.

As nurses, we cannot control the outcome of our patient’s condition, but we can provide comfort to both the patient and the family, which is in itself a powerful source of healing.  Blessings to nurses everywhere. ~ Janice

Comfort in COVID-19

Fear. Anger. Helplessness. Heartache.  These are the emotions running through us as we give all we have to fighting this pandemic, and our best is not enough.  Patients die –alone.  Families turn to us in fear, as if we have the answers.  How can we cope when we feel so overwhelmed?  Here are my thoughts… 

*First, put on your own oxygen mask, like the airlines tell us to do.  We cannot help others unless we keep ourselves functioning, and even positive.  *Distance.  When you are not at work, put all thoughts of work out of your mind, as much as possible.  Focus on the mundane, like laundry or cooking.   *Take every thought captive to focus on the positive in your life.  Start a gratitude journal.  When your mind fills with pain, focus on something for which you are grateful: clean water, fresh air, a country at peace, food, clothes, and go from there. *Get sleep, exercise and good nutrition. * Do whatever comforts you: prayer, music, meditation, comedy videos, playing, dancing, family hugs & massages.  *Stay connected with others via Facetime, Marco Polo, Google Hangouts, Skype, Zoom, or at least phone calls.  Seeing your loved ones faces and hearing their voices is critical. 

*Second, let go of control.  We are not God. We cannot control life and death. We never could, although we always try.  Trust in whatever spiritual Presence you know to have greater wisdom, even in the face of suffering.  There is always a bigger picture that we cannot see. Remind yourself of that. Turn to your faith, and perhaps focus on spiritual  development during this time.  Out of adversity comes our greatest personal growth.

My prayers are with you all!  Janice

Invisible Wounds

Loss leaves us with invisible wounds, some very deep and painful.  We want to bury them and ignore them, hoping they will just go away.  Friends feel helpless, without any solutions or ideas how to comfort us.

The loss of a child is arguably one of the most enormous of such wounds.  As I found my way through this pain, I discovered ways to comfort and ease my distress, and shared them with other bereaved mothers. So many people told me to write a book, that I finally did: Surviving the Unthinkable: the Loss of a Child,  a gentle, practical guide for grieving mothers, friends and family.  This is a “how to continue living” guide, not denying the catastrophic loss, but offering concrete ways to soften the pain and deal with emotional and social situations common to bereaved mothers of all ages, young and old.  The second part of this book provides a short, practical guide for friends & family on how to support this mother now and over time.  These evidence-based recommendations may also be helpful to health professionals. Please remember this resource the next time you hear of a death at any age in which the mother is still living. Please share this book to that mother, available on Amazon.com. No matter how young or old the son or daughter, as mothers we share the same invisible wounds.

Silent Comfort

In the face of “extreme devastation”, this young nurse brought “pure comfort” to a grieving son. This son recounted the pouring of emotions he felt at the time of his father’s death.  The family was gathered around the ICU bed when he saw the tears in the nurse’s eyes, and he felt deep gratitude toward her. Eleven years later, he told me this story of the impact moment that will never leave him: the feelings of “safety and comfort” provided by that nurse.  He could not remember one word, for her deep, therapeutic intervention at the time of crisis for this family came not in sound, but feeling.  He told me over a decade later of his gratitude to that nurse who was “willing and open to experience my pain.” He appreciated that she chose to enter into his sorrow and be vulnerable to cry, taking the toll of grief on herself in order to provide him and his family with precious, unspoken comfort. 

            So, my dear nurses, you do not need to have the right words, for you already have the right heart.  Please continue to have the courage to walk with patients and families in their pain, even though it hurts. Please never forget that probably hundreds of people remember you as “that nurse”, that special person who touched their hearts at the most critical moment, even though you may not have realized it. You only hear back from a tiny fraction of people whom you impact, but never doubt the power of your unspoken comfort that radiates from a caring heart.  All my blessings to you!  ~JBM

Pot Shots

Anytime you stick your head above a crowd, someone will take a shot at it.” Donna Diers, PhD, RN, FAAN.

Nurses are leaders.  We advocate for our patients and their families.  We make decisions regarding the best care and form clinical practices and institutional policies.  We enter the profession to care, to nurture, to heal, and to have a positive impact on those in pain and suffering, as well as promote health for everyone.  Most often, we fail to expect the pot shots: the criticism or push-back from our most helpful and altruistic efforts.  Taken by surprise at the rebuttal, we easily feel crushed, misunderstood, confused, and discouraged.  Remembering the words of this famous nurse leader reminds me that conflict is part of leadership.  Criticism accompanies decision making. All famous leaders and innovators faced harsh disapproval and huge road blocks.  They believed in what they were doing and kept going.   We must do the same.  Focus on the joy of knowing you are helping others in the best way that you can do so!   Remember that you are uniquely educated and skilled in the nursing arts and sciences, in the therapy of healing and caring, and specifically equipped in attributes that are uniquely you!  We all bring our own magical insight and interaction to our nursing practice, and so do you. Expect the pot shots, but don’t let them stop you.  The world needs nurses, our talent, our gifts, and our caring.   The world needs you!  ~ JBM

Calm in Chaos

Many years ago, I stood at the crash cart in the middle of resuscitation. A patient had collapsed in a bathroom, creating one of those awful situations where a team of people were madly working on him on the floor. Someone shouted, “I’ve got a pulse!!”  Instead of barking an anxious order, the lead person responded calmly, “Good, let’s discharge him.”  A soft, nervous chuckle rippled through the group, and I felt myself feeling calmer.  Everyone seemed less tense, quieter, and more in control.  I reflected later at that joke in the middle of a resuscitation.  Had a family or visitor witnessed the comment, they might have been appalled.  But everyone knew that lead professional wanted the patient to survive as desperately as we all did.  The discharge remark displayed the lead person’s control over his own emotions, not any disrespect for the severity of the situation.  Such a display of quick wit provided a sense of command to the entire team, helping us all to function more effectively.  No one can control the outcome of a resuscitation.  Life and death is not in our hands. We do ourselves and our patients a huge disservice when we begin to think we can control life itself, or the behavior of others.  The only person we can really control is ourselves.  That lead professional communicated a calm by injecting humor, and that composure effectively rippled through the team helping all of us to work more effectively.

Nurses walk into chaos every day: hysterical families, disoriented and agitated patients, and sudden medical emergencies. If we think we can control these situations, we do ourselves harm. We can only control ourselves, keeping our composure and doing what a skilled, knowledgeable, mere mortal can do to ease the situation. Our primary goal needs to be our own inner peace, bringing this calm to a sometimes uncontrollable situation. My only suggestion for accomplishing this difficult feat is to remember you are not God.  You did not cause the chaos and you cannot contain it. Instead, bring your healing, composed self to do some good and make a dent in the bedlam, and that is your second goal. Aim for calm in the midst of chaos, accepting that uncontrolled turmoil is sometimes inevitable and unavoidable, in spite of our best therapeutic efforts. Sometimes, keeping yourself at peace is the best anyone can do, and the most any nurse can offer. Peace.~ JBM

Peace: A Scientific Solution

We all want peace, that feeling of contentment that all is right with the world.  Even more, we want to help our patients find peace!  Meanwhile, we live in a world filled with conflict, aggravation, overwhelming demands, discomfort, and suffering. What a contrast!  A just published research study*  illustrates how to find peace, even in the most difficult of circumstances such as the end of life.  In this case study, a young college student uses ancient wisdom to focus on the positive.  In her private conversations with God, Melissa voices her concerns, but then deliberately turns to gratitude for all the positive aspects in her life, even as she battles cancer.  Thanksgiving is the path to peace, both for our patients and ourselves.  We cannot often change the problems in our circumstances, but we can always change our perspective.  Acknowledge the difficulties, but then focus on the good.  Like many other research studies, this qualitative analysis showed that when we gear our thoughts to the positive, our emotions will follow. Wishing you peace. ~ JBM

Finding the Words

A comment from a new Nurse Educator triggered my awareness of the need to find the right words.  She recounted that she searched for the best vocabulary to give written positive feedback to her students.  I have long emphasized the importance of focusing on the positive in others, and reflecting those thoughts back to them.  Now I appreciate the need to develop better terminology  to do so!   Do I have more words readily available in my head for criticism than for compliments?  Maybe, but I can develop more elaborate and sophisticated skills for affirming the specific talent of others. I just need to pay attention to how I communicate.

To patients, I can reinforce them for persistence in trying to move, determination to be independent, and the amazing grace to display gratitude in the midst of pain when they say “thank you” for handing them the glass of water.  Patients show patience when they wait for us, courage to face another procedure, and wisdom to accept the inevitable disability.  We see this almost every day. We greatly augment our therapeutic presence  and impact when we reflect such noble characteristics back to our patients with verbal, specific affirmation. 

To my co-workers, I can appreciate a well-organized report, a detailed care plan, and an insightful assessment. I can verbalize every time I notice a kind action or compassionate act to patients and families.  Yes, that is our job!  But we all have emotional tanks that get drained.  Why not put some fuel into another nurse’s tank?  If you notice something positive, share it. Everyone needs more positive feedback then they ever receive.

We live in a culture of criticism, not compliments. Saying a positive thought about another person may feel awkward and uncomfortable, because so few people do so.  I walked into a store last week with a friend, and approached a young woman behind the counter whose appearance struck me.  “You are stunningly beautiful,”  I told her, after the initial greeting and with a matter-of-fact tone.  Her face lit up. “Thanks, you made my day.”  Although I often hesitate at first, after I take the chance to share my sincere positive thoughts, I am always glad I did.  Add to your list of remarkable interventions, making someone else’s day. You will be glad, too. ~ JBM

Sustaining Our Hope

We’ve had a long, hard winter in New England, slammed by snow and attacked in our workplace. As healers, we live in sacred space of suffering, life, and death within a context of cost containment, short staff, short budgets and, sometimes, short tempers. Sustaining a positive focus can be really challenging. When I feel the most stressed and drained, I know I need to make space for two things: the important and the positive. During stressful and demanding times, the first entities cut from our time budget are sleep, rest, reflection and play, which are really necessities after all. We need to try to claim some of those back into our schedule in order to sustain our hope. Cut back on commitments where possible in order to make time for you. Develop the habit of a gratitude list, journal or conversation. The more we focus on the positive and meaningful elements in our lives, the more powerful the antidote to stress and enriching to our life and relationships. Sending you my most heartfelt wishes for sound sleep, great laughter, and many hugs. ~ JBM