changes

okay, so it is cliche, but we can all agree that the one constant in life is change, yes?

the changes that have been happening to me because of the changes that were manifested (through lots of prayer and conversation with god) and then acted upon, in regards to my career, are changing me in ways that were not fully thought out. i mean, how can you really think through something entirely that hasn’t happened to you yet? some of the changes are very welcome- i feel myself resonating, vibrating, with a much slower, and relaxed energy. the difference between two minutes being too long to wait for something a patient needs and two hours being a fast turnaround for a request. the difference between having to clock in and clock out and being salaried. the difference between chest compressions and a caring conversation.

sure, there are lots of reasons that my new gig is challenging: politics, learning the tactics needed to move a large bureaucracy toward the changes it says it wants, but that all actions suggest otherwise, the inefficiencies of a clinic workflow that have gone unchecked for years. not to mention adding a new specialty area to my repertoire.

and it would be a lie if i said i didn’t miss the OR.

but this new work that i am being called to do, the new spotlight on the areas of my self, of my soul, of the way i walk through the world, it is intense. i feel directed to lean in and do some hard work on how i interact with my environment. to look at the root cause of my impatience, to explore the deepest, darkest parts of my personality and draw those places into the light.

to surrender to the imperfection, acknowledge it, and love it anyway.

and, i think my very favorite consequence of my new job is that i am really sleeping again, dreaming again. when oscar died my sleep left. don’t get me wrong, i still slept “well” because i’ve always been a strong sleeper, but i didn’t dream and explore as much in my sleep as i did before he died. that has been my very favorite change. and one i think comes from my heart being satisfied that i am on the right path.

like my nurse navigator mentor told me yesterday, “you have the heart of a navigator”. that resonates so deeply with me; i feel that. ultimately, it will be my heart that keeps me pushing forward on this new path. and, truly, i would not have the relationship i have now with my heart if i hadn’t spent the last year of my OR career working in open hearts. beyond grateful for my experience in the CVOR.

so, i choose to keep rolling with the changes. learning from life. open to the challenge. baby steps.

last day

I’ve had one other last day in the OR, in 2018, when I left the OR briefly right before Nick died. I made the leap from OR to primary care. As in ambulatory, doctor’s office visit, primary care. I remember really liking it and feeling like it had the potential to be an incredibly powerful platform to reach patients with mental health issues, but then Nick died. He died only several weeks into my transition from OR to primary care. His death by suicide, on the third anniversary of Oscar’s death, which was also by suicide, was more than I could bear and be learning a new specialty area. So back to the OR I went. I was so blessed to have an OR family that welcomed me back with open arms. I hadn’t even been gone for 3 months when I came catapulting back, on the wave of yet another personal trauma and tragedy.

The OR has been home for so long. Over a decade of my life. It felt good to get lost in the rhythm of surgery again. It helped me learn how to walk with the grief of yet another tremendous loss. Still, there was this whisper, this yearning of wanting to do something more, something different, something that would scratch the itch that reared it’s ugly head the moment that I understood Oscar was dead. I explored so many different options. Countless resume submissions to all manner of different fields in nursing: school nursing, occupational/ employee health nursing, case management, I even applied for a floor nursing position at one point when I was exploring the idea of being a nurse educator! I applied at colleges to teach, to be on public health think tanks. Zero of these ever came back with positive outcomes- I never got interviews. These serial application cycles would happen about every 6 months to a year from the time that Oscar died. It was sort of exhausting, but I felt led to do it. To get out into the job market about every 6 months or so and see what other avenues of nursing I might call home, a position that would utilize this new set of skills that I had learned related to overwhelming grief and our experience getting lost in the system. Often, when I look back at our experience the few months before Oscar died, hindsight being what it is, I see how incredibly perfectly all the holes in our slices of Swiss cheese lined up. And Oscar fell right through. Unfortunately our outcome was the worst, death.

A sort of breaking point for me was when I didn’t get promoted past boardrunner/ charge nurse in the OR that had welcomed me back with open arms after Nick died. I wanted to lead that department with such a deep desire, but my director didn’t think I was ready. So, when I didn’t get hired as the OR manager in that department, I decided it was time to do something that I had always wanted to do in surgery: open hearts. I researched programs in our local region. St. Luke’s Mid-America Heart Institute was the only choice hands down. I applied. Was offered a job. And I turned it down the first time because I was SCARED! 3 months went by, I was incredibly stressed and stretched to my limit working 12 hour shifts 3 days a week as boardrunner/ charge nurse for an OR that ran 12 starts daily with, more times than not, 50+ cases. We would be balls to the walls busy from 7am to 7pm (and after) more often than not. When I finished my BSN program at the end of 2019 I applied to the CVOR (cardiovascular operating room) at Luke’s again. Immediately got an interview. Second time around I accepted. Time to face the fear and trust the process; embrace the lifestyle of CVOR nurse.

My time in the CVOR over the past year has been an incredible learning journey. I have learned this amazing specialty. I have learned a lot more about my own limits. I have learned what I really want to focus on in patient care. That has been the most exciting. I have been pushed to learn more about myself as a nurse and what really makes me tick. What makes me excited about what I do and more convinced than ever that I have been called to this profession. I feel, more than ever, that I was made by Him to be a nurse. And just how important my voice as a strong nurse is to the patient care TEAM. The team isn’t just docs. It isn’t just nurses, or techs. It is all of us, each one with a different way of seeing the patient’s experience. I did my best in the CVOR. I learned how to really pray, each call shift stretching me to my personal limits in handling stress in a healthy manner. I participated in some of the most incredible, and life-saving, patient care of my career. I learned to understand how to monitor critical patients and what it really means to have someone’s life in my hands. I will never, ever regret my time in CV surgery. In fact, I believe without any doubt that my time in the CVOR is what opened doors to me to my forever career path: patient navigation.

There were so many conversations I had with the staff in the CVOR that helped me to find my place. From my manager, to my charge nurse, to my fellow staff nurses and techs, to the nurse liaison for our department, to the docs, to the physician assistants, to the anesthesia providers, to the perfusionists. Every single person was open and receptive to me exploring life outside of our department. That meant so much to me. It says a lot about the overall culture at St. Luke’s and why I am so incredibly blessed and proud to be a St. Luke’s nurse. I started keeping an eye on the job site at Luke’s in the fall of 2020. I applied for case management positions and a nurse resource position. No bites. I decided to fully commit to the OR and give my all in my current specialty so I applied to test for my CNOR (certified nurse operating room) certification and began studying OR standards and guidelines. I became involved in a system-wide committee to standardize our malignant hyperthermia preparation and response. All the while keeping an eye on jobs at Luke’s. That was the one thing I was sure of: I wanted to stay with Luke’s.

I first noticed the Thoracic Center Patient Navigator position a month before I applied for it. I stalled that long because I had seriously just made the commitment to stay in the OR and I was insecure because I had already been passed over for case management positions. This position kept coming up for me, though, because it was posted under education and the job description sounded exactly like what I wanted to do. It would incorporate my communication and leadership skills and also grow my coaching and education skills along with challenge me to develop a new role for the center. And, I was fairly certain it would build on my relationships that I had already established with some of our cardio-thoracic surgeons. The thing that finally pushed me to apply was a conversation I had with my child, Viv. They got real with me and that made me realize that it was really time to get serious about changing my work lifestyle. I needed to dial down the stress and uncertainty and dial up the consistency. So I finally applied. Had an incredible journey to my job offer and just finished my second week in the clinic as the Thoracic Center’s new Patient Care Navigator.

This change in my career path has been a long time coming. I feel more certain with each day that I have made the right choice and that I do, indeed, have something really special to offer patients. With my combined professional and personal history, my ability to grow through post traumatic stress, along with my ability to communicate clearly, succinctly and efficiently, interwoven and enhanced by the amazing Thoracic staff and our doc champions that keep the clinic humming, I have faith and hope that we will be able to build an amazing, world-class Thoracic Navigation program at St. Luke’s.

Oh, and did I mention I start my MSN in Care Coordination at Nebraska Methodist College in August?!

This is going to be fun! 😉

time

There has been this pervasive thread of discussion throughout my life: time. My relationship to it, how my relationship to it affects others who weave in and out of my life, and it seems to be a popular subject no matter the season of my life. I called it pervasive because it usually comes up for others who observe me in my life and think poorly of the way I interact with it. I don’t go slow as a matter of course. There have been many times in my life that I fit the cliche about fools rushing in. As I grow into advanced age I feel that there are not so many times now that I jump based on feelings and intuition, at least compared to how I used to be. Someone looking at me now that doesn’t know me would probably think, “holy sh*t, if this is even half as much as she used to jump in then I cannot imagine what her life used to look like.” Ha.

Time is a funny beast. Sort of reminds me of grief in a lot of ways. Time has a sort of ever-changing nature a lot like grief. Certain moments can feel overwhelming and like they are going so so fast and you wonder what happened to those past three hours and then in other cases it feels like it doesn’t move even when you will it to.

Lately I have been enjoying the quickly changing nature of my life. I have said for several years now that you know you are an operating room nurse when two minutes feels like an hour. And maybe that is one of the reasons I was initially attracted to the OR- time is very much on purpose. It matters that things move as quickly as possible. As much as perhaps I have a natural affinity for moving quickly, the OR has also influenced and reinforced my continued development of this particular personality trait.

And it drives some people nuts.

Seriously, it was one of the reasons I knew deep down, before I committed to the decision, finally, that Grant and I weren’t going to make it. No matter how hard we tried. No matter how much work we put into our romantic relationship. I move too fast. I just do. It is a deeply ingrained part of my personality and because it is reinforced in my career it is a super strong piece of who I am.

Don’t get me wrong, there are lots of times that it is important to slow down enough to see the details. Like just now, I sent a text meant for the man I am dating to Grant by accident. Oops. But those little mistakes because I am not going slow enough are so much better made in my personal life than at work when a little mistake like that could mean a truly life-altering mistake. Like wrong procedure or wrong medication. So I take it as it comes and try to learn, always.

Since I made what seemed like a fast and furious decision (it was actually a decision that I had been struggling with for weeks) to stop trying to make my romantic relationship with Grant work I have seen so much growth in myself! I have been focused on caring consistently and deeply for my body by running regularly. I have been finding myself in a sort of “do it and get it done” mode. I haven’t been one for sitting and writing and it has been difficult to maintain my Bible reading daily because I simply feel the need to do! I feel all action right now. I have been funneling that energy into taking much better care of not just my body, but my kids and my home. I have been decluttering and reorganizing my space. I have been making it make sense for who I am today, not who I was four years ago when I moved into this space.

I have also been funneling that energy into dating. Some would say it is much too soon to be dating again. But I move at the speed of life. And when my brain finally completely acknowledged what my heart and soul had known for years, people, years, I felt an amazing finality to what had come before. I feel like I worked through all of the big important issues about me in relationships and had come out on the other side with the understanding that I needed to be cognizant of my attachment style and also the attachment style of those that I choose to date. Truly I felt ready to start dating again right away. Oh, and I am not getting any younger, honey!!

I had some really great conversations with lots of men right off the bat, thank you FB dating. I had probably a dozen conversations going for a short time. One by one they all weeded themselves out. Some went way too fast wanting to meet me after introducing themselves, and some going way too slow. I felt like Goldilocks! Somehow out of that chaos I met someone really special. Our initial connection was super fun. He made me laugh. And then we would alternate between super fun conversation and pepper it with super serious conversation. He thinks about the same stuff I do, he doesn’t like sports for similar reasons (what?! come again?), he cares about his physical health, and he has an amazing vision he brings to life through art.

We met last Monday. It was truly magical for me. I sent him flowers the next day! I have never done anything like that before. I find myself doing lots of things I have never done before with him. They are all good things. I catch myself wondering if this is what a healthy relationship feels like. Throughout all of this acknowledged super fast development I have kept myself grounded by maintaining my self-care and also staying focused on secure attachment. He boosts me in ways that I didn’t really understand I needed, or perhaps I understood I needed, but stuffed it down because I was convinced it was never going to happen for me. He makes me feel sexy, desirable, heard, and comfortable. It is early yet, but so far he is able to tolerate the big, scary, immense impossibility of my grief.

So, why do I write about this? This thing that is happening for me romantically ties right into time. This pervasive thread that runs through my life. I want to LIVE! I want to make the most of the time I have. Right now, especially now, I feel strongly that the time I am putting into this spark of a romance is time well spent. I am learning so much about myself and about what it means to be in a healthy partnership. The future is unknown. I fully understand, and accept, that it could be next week that I am writing about how this spark of a romantic relationship has already burned itself out. But for right now, while the ember is still hot and I see flames starting to take hold I am going to enjoy it. I am going to nurture it and show my gratitude through transparent communication and a commitment to my own health. One other thing that I have made a commitment to do differently this time is be mindful of my attachment style and mindful of his. Secure attachment can happen even for those of us who have been anxious or avoidant in past relationships, if you can keep perspective and awareness of your emotional responses.

Time. I am doing my damndest to make the most of what time I have. Tricky at times considering my experience as a bereaved mama and suicide loss survivor. It would have been tricky enough as a recovering addict and abused wife. Tragedy and beauty, loss and joy can co-exist. That is what the past nearly five years have taught me. Oscar’s memory glows inside me. He is a driving force for all that I am, all that I do, and all that I will become. I feel his blessing on me.

for the mouth speaks what the heart is full of

Right now I feel like writing all the time. Certain topics seem to bubble up more easily than others. I know I need to keep writing about my time with Nick, but every time I think about it or look at it I think about how drained I was after the first, and only, time that I wrote and I push it away. Writing about my dreams was as close to writing about Nick as I have come since that first installment of my not-a-memoir. The blog that I wrote about those dreams helped me quite a bit. Mostly reminded me that I need to give it up to God. Turn it over as I first heard in 12-step. So I started praying about it. And I feel better. I felt a little bit self-conscious about my last post. What keeps resurfacing for me is that blogging is apart of my process, I find it cathartic, and transparency is one of my hallmark personality traits. I do question, though, whether or not my blog could be considered gossip. I didn’t understand until very recently that gossip is a sin. And I have been a gossiper my entire life. I had no idea that what I was doing was a deep sin, but now that I know that to be true, I can see how this part of my personality must be surrendered to God. I know Jesus will help me to understand where the line is if I can get quiet enough to hear Him. Also, I am not making anyone read this stuff.

Lately I have been thinking a lot about Oscar’s death, well I always think about it, it is hard to explain, but lately it has been surfacing in a more vibrant fashion. It ebbs and flows, like all things in this existence of ours. The thoughts have mostly been details about finding his body. And my screaming. I have never screamed like that. I hope to never again. Blood curdling, “NO, NO, NO, NO, NO, NO,” as I was pumping on his chest too fast for CPR because my adrenaline was hurling through my veins. My sweet, beautiful boy. I remember his eyes after he died. How badly I wanted life to flicker back into them and for him to gasp for air and say, “Mom, Mom, I am so sorry, thank you for saving me.” Alas, that was not my reality that fateful morning. My experience finding Oscar dead has been kind of on a constant playback in various forms and various intensities since it happened. Visions of the basement and how it looked. What he was wearing. The way his body was positioned. It hurts. It is the deepest, darkest pain that you can’t ever imagine. I still cry a lot, well, at least I think it is a lot. I remember when I first saw his body lying there and immediately thinking, “Oh honey, I probably won’t be able to get you out of this one.”

I have been off my self-care game lately. I had gotten into this amazingly vibrant routine that included running at least once per week, but when I was really on it I was running three times a week three miles per run, regular journaling and reflection with my Silk + Sonder, reading my bible daily (my mom and I are reading an incredible plan by the BibleProject that will get us through the entire book- you can find it on YouVersion), and deeply studying the bible at least once or twice a week. And by deeply studying I am referring to a mix of weekly online church services at Vineyard Overland Park, Vineyard Institute classes, Esther Dorotik materials (this is where my focus on gossip has come from, I have deep gratitude for Esther, I am sure I will mention her more in future posts- you can find her shop, EstherDorotikShop, on Etsy), and a program called Churches That Heal by Dr. Henry Cloud. I have been generally surrounding myself with Christian resources- I even joined Nurses Christian Fellowship. These activities have become my spiritual foundation. If I take good care of my spirit I can take good care of my life. When my self-care routine is not on point my spirit suffers and so do the people I love most.

I blogged about it my first blog back a week or so ago, but the reason I am currently off my self-care game is because Grant, Phoenix, and I spent most of June together. Since Grant decided not to move in and we have started couples therapy I suggested that we go back to following the parenting plan and slowly start seeing each other more, but with stronger intention of actually seeing each other, as in on dates, instead of him and Phoenix spending loads more time here like he has already moved back in. There has been some discomfort around my insistence on this tack, but I feel really good about it because I am getting my alone time again! Oh how I missed taking good care of myself and my spirit. As we continue to heal our relationship we will need to find ways for me to consistently and regularly get time alone to spend on journaling, exercising, and bible study. I think finding alone time is a common problem for mothers today, but in my case it is absolutely devastating if I do not get the time I need for self-care. It just is. I think those of us who have a strong and prevalent history of trauma need more time for self-care. Looking back over the past nearly five years since Oscar died all the times that were the most chaotic and turbulent can be directly correlated to a lack of consistent and regular self-care. It just is.

If I don’t take care of myself with a diligent self-care practice my heart fills with the dark memories associated with Oscar’s death and with Nick’s death, for that matter. Grief begins to take over my path. I have been working hard for the past almost five years to be able to walk next to my grief. It has taken a lot of effort to deeply understand that even though grief will be a constant companion for the remainder of my life, it does not deserve to overwhelm my life.

This is the statement that Jesus made at the end of Luke 6:45, “For the mouth speaks what the heart is full of.” The entire verse is as follows, “A good man brings good things out of the good stored up in his heart, and an evil man brings evil things out of the evil stored up in his heart. For the mouth speaks what the heart is full of.” This is such an amazing observation, isn’t it? This is the kind of stuff that makes me so excited to understand the bible better and to become closer to Jesus. I love this idea, that the mouth speaks what the heart is full of. When I write about my grief experience and the memories that fuel my negative reaction to the events that have happened in my life, like my memories of finding Oscar dead, it is because that is what my heart is full of. Sharing my experience helps to release it from my heart and actively hand it over to God. I also hope and pray that through sharing my experience as a bereaved mama and a suicide loss survivor others will feel less stigmatized to share their experiences. We need to open up about suicide and suicide loss in our culture. We need to make this conversation that nobody wants to have into a conversation that can be easily discussed. It is simple to share our truth, not easy. I want to encourage all of my fellow suicide loss survivors to share the truth of your experience!

The picture is of me and Oscar I think about two years before he died. My sense of time since 2012 is a little skewed, and it is hard for me to remember when certain events occurred. We were at my parent’s house on Foster in Bremerton, Washington. I miss those big eyes. You can see how sad he was. Looking back with hindsight being what it is I wish I had done so many things differently. I pray a lot about those things and the only relief I have is when I let God carry it for me.