A Tiffany Diamond Isn’t This Good

Patient-noncompliance-terrorism

I’m in San Bernardino today, working in a small community clinic. I am in the company of four licensed and practicing physicians who are donating their time. I am blessed.

One physician I’m working with tells me he has taken care of himself in his medical practice, “basically by not being a hypocrite.” He describes this by lifestyle choices of diet, exercise, etc… He likes surfing, which surprised me! “That’s why I’m skinny.” The man is not wearing california-traditional surf-wear. He’s wearing a general Sears-white button up with black slacks and comfort shoes. And he is old! He is in disguise. The age-disguise. I judge people too often by what I “see,” and this guy is a total surprise. Mr. cool.

There are medical students, college students, and nursing students here as well. One of them is a phenomenally gorgeous import to the US with a magical accent. Currently she’s eating a large bagel with cream cheese, dressed in a pencil skirt, stethoscope slung around her neck. Maybe I hate her just a little. She told me about her own “really good” personal experience with psychiatry and counselling. Her parents divorced when she was in college and “it helped” her get what she needed to get through it. Maybe I love her a lot. A woman of courage.

A patient I saw is a mother of seven. You may think, “Let’s just stop right there.” Anyone who wants to use “all her eggs” would need “help.” This woman has had to be sooooo strong! She’s been abused, used, neglected, and more since she came into this world. Even so, she pushes forward. She demonstrates self-value and Love. Where did this come from, I wondered.  Who taught her or gave her that? Today, she has even finally come into a willingness to get in the space of cultural dissonance, and consider for the first time, medical care for her emotional and behavioral needs. “I need it! I will do anything to get out of all ‘this.'” These words should come in a velvet lined blue and ribboned box. Gimme. Gimme.

We are talking now in the break room about patient and self-experienced medical health care stories. A hospitalist is explaining the difference he sees in his patients between noncompliance versus nonadherence to clinical directives. It’s a like a rocket just shot off! Every one is bothered in some way. You may remember from previous posts in this blog site about the “Number one Reason for Relapse” – treatment noncompliance. I now renege. Let it be known, I was wrong. I’d like to say, “nonadherence.” Forgive me! Noncompliance is an arrogant judgment, implying a decrease of mal intent or purposeful disobedience. There are many paradigms of reasons that interplay into any of our choices and performance in our personal medical care. I love that! Yes.

My colleagues here today, our patients, we all have much to teach each other, much to learn from each other. Today I came here thinking, I want to treasure the person in front of me “right now.” It makes a difference when I engage that way in “whatever.” #Gratitude for one more day where that happened. Those day are surrounded too often by many others when I forget.

Self-care Tip: Treasure the person in front of you.

Question: Who is in front of you right now? How can you treasure this person, this experience, this…? What are you getting from it? How is this perspective and what you get, kind to you?

Be a friend to yourself. Keep on!

Baby Nurse, Day One

The very first day I put on my scrubs I knew they were the right fit. I  look forward to connecting with patients. I find it to be a true honor and privilege to care for them at a difficult time in their life. I care for patients in pain. I advocate for the mentally ill. Most importantly, I make it my priority to make people feel like they matter. 

Below is a guest post…a small piece of my own blog at  theloshow.weebly.com

Keeping with ‘Friend To Yourself’ tips, remember to believe in yourself enough to make the smallest difference in someone’s day. The rewards are shared. 

 

It was orientation day. My family had taken a flight out ahead of me to attend wedding ceremonies. I stayed behind, pressed my clothes, prepared notebooks, and set out for a day I had been waiting for, for a long time.
Approximately 50 eager nursing students sat behind desks and quieted as the lights were lowered. The instructor played a film, introducing us to our chosen field and wanted to fill our bodies with motivation and inspiration.
You will have an opportunity to care for people that do not have the means or capacity to ever repay you.’
The film ended and my eyes were heavy with tears. I tried to open them wide, hoping the air conditioning would dry them up before my neighbors noticed.
I was so very grateful. I was excited and hopeful. I would live out my life being so very proud of my job. I couldn’t wait.
I was terrified. I barely slept the night before. I sat in my car watching the clock, hoping time would barely pass by if I watched every minute tic. It was my first patient interaction. I was at a skilled nursing facility and I was to interview an elderly patient, and gain experience obtaining a thorough health history.

What was I so afraid of?

I didn’t know what to expect.
I watched “Fried Green Tomatoes” one too many times, and had images of a mean old lady screaming at me, throwing me out of her room, and cursing my ill experience while throwing donuts.
I delayed no more and walked in with confidence. My name badge and clip board screamed target practice. The employed nurses love to watch you squirm.
My instructor gave me my patient’s chart and told me to go to her room and introduce myself after I gathered all the appropriate data. Her binder was thick with life’s journey. Medications, disease processes, and lab work now defined her within those walls.
“Where’s the tab in here that tells me who comes to visit her? Who takes her to the beauty parlor and church? Who tells her Happy Mothers Day?”
No such tab existed.
I walked in her room. She shared it with another lonely woman that mumbled something as I passed the curtain.
She looked old. She looked confused. She looked happy to have someone to talk to.

“Ms. Walker, may I ask you some questions about your health?”

I worked my way down the list that my instructor prepared for me.
Question 11: Do you have any STD’s?
Question 12: How many partners have you been with?
Are you kidding me? What kind of sick bastard wrote these questions for a nursing home? Can I let this lonely old woman have some secrets and dignity please?
Formalities get in the way the sometimes.
I put the clipboard down and just started to talk. I asked her questions like we were sipping tea by the shore.
We laughed. She told me stories about her life that I couldn’t possibly fit onto any sheet of paper.
I knew I’d have to make up some of my material to turn my paper in for a grade. I didn’t care, and knew my instructor wouldn’t care either.

The video your institution showed me on my first day didn’t say anything about caring more about a clip board than a person.
It was about how I made someone feel that day. She wanted to talk to a person that genuinely cared about her answers.
I left that day laughing at myself for being so nervous. I chose this profession because it allowed me to be free of clipboards and formalities. It’s about making people feel good.
In the spirit of Nurse’s Week…Remember how the profession began. It’s about being at a person’s bedside when their loved ones cannot. It’s about giving your attention when someone needs it most.
Be that person, and protect the integrity of the initials that follow your name.

{Nurse Leslie}

When we feel whispered about, undervalued and misunderstood

http://bit.ly/14uwdV7

The girl, with her thin lashes and small eyes, looked at her.  What was her name again?  Bee?  Bernice?  Benny?  Something with a B.

Angelica looked back and waited.  “Helloooo?!” she thought to herself, and wanted to knock back as if to say the punchline to a knock-knock joke.

Oh mercy!   This job was getting to her.  She was at the same level as her five-year-old nephew who made up what he thought were jokes, like,

“Knock-knock.

(Mommy say, Whose there?)

‘Whose there?’

Robby.

(Mommy say, Robby who?)

‘Robby who?’  Robby poopy face!”

The kid had a brilliant career in comedy coming.

Brianna was still looking at her and Angelica finally asked her how she could help her.

“It’s your note, Maom.”  Bernice, or was it Brenda, had this way of calling her mom and ma’am all at once, reminding her that she was too young to be either, but she may have well of been since she couldn’t remember the note or many other details about her colleagues.  She’d always been like that though.  It bothered her as she became more aware of how undervalued she thought she was.  All Angelica did notice were the criticisms that came to her from administration.  It made her feel like everyone was talking about her behind her back, but she knew she couldn’t be that special.

Angelica shifted in her chair.

The last boss-message was verbally delivered about when she took her lunches.  She had sat there and taken it.  Wondering, where had all the hard work gone, she gave what she thought was a polite smile.  Where was the appreciation?!  Angelica replied with thanks for the feedback and that she would continue to work on her timeliness.  Yes, she would like to revisit this in a month and how supportive that was, boss-man.

Beonca was holding her hand out and Angelica reflexively shook it.  Wait!  Was she crying?!  Hold on here.  And now she noticed that B was swiping her nose with her sleeve.  Oh hell.  Was she sick?  Great!  Now she’d get it.

“Your note was so sweet!  Thank you for giving that feedback on my job performance in to boss-man!”

Oh yah!  Now Angelica remembered.  After she’d last gotten the pearls thrown at her regarding lunch hour timeliness she had decided to put some words on paper that were good.  Since nobody was noticing her goodli-lishissness she’d notice theirs and start her own powerful paper trail.   Just cuz.

One of their customers who was giving Angelica a hard time was really happy with B and had told Angelica about it.  Instead of losing brain time on wondering what the customer did not like about her, Angelica had put in a note about how much the customer had liked B.

Since then, Angelica kept a stack of customer feedback slips handy to fill out any time she noticed a colleague and/or herself doing “it” right.  She was going to overwhelm boss-man with good stuff and just enjoy knowing that the stuff had been noticed and said.  No more would she be unappreciated.  Even if only by herself.

Angelica looked at the crumpled paper in B’s hand and read,

“Germaine is an excellent worker.  She found merchandise a customer wanted with speedy response today and the customer specifically told me about it.”

Germaine!?  Ah well.

Angelica leaned over and gave her own wet-eyed sticky hug back.

It is universal for all of us to feel whispered about, undervalued and misunderstood.  And then what?  Let us give it the elbow jab and be our own advocate.  Put it on paper.  Say it out loud.  Be grateful about it and ruminate the gratitude.

Personalizing what is not about us gets worse with brain illness.  It is almost pathognomonic for it in fact, when it gets to the point that it cannot be redirected by conscious decision, when it interrupts interpersonal relationships and when it takes away our ability to feel pleasure.  Taking medical treatment can change the way we feel and behave without beating ourselves up over it and moralizing what is not moral.  However, this kind of elbow jabbing Angelica decided to do is just plane friendly.  And if you want…?  Well?

Questions:  Have you felt whispered about, undervalued and misunderstood?  Have you been able to get friendly with it?  Or do you feel the victim?  Please tell us your story.

Self-Care Tip:  Acknowledge yourself and others.

Hermes’ Shoes

Repost of sorts.

Today I find myself walking with Hermes’ shoes on. Bits of fairy dust seem to have caught in my hair like shards of light in a forest of tight mountain pines. 3 hours into my day, I discovered I was full of gratitude. Where did it come from? I would like to find this spiriting again. I can’t help but admit, being thankful must be good for me.

People talk about gratitude to the fellow traveller of life as if it were pill, or morning chore to get over before play. But today, it came to me like a music-gram at my door. And there it is, the opening of the door.

Today my kids reminded me that no matter how much we get in life, (the little cherubs!) we will always want more. Coming out of Barnes and Noble post cookies and purchases, they were still listing off their desires. Us adults are not so different, we just package our orders differently. However, wanting more and ingratitude are different and not necessarily related. We agree with Nathaniel Hawthorne in “The Birth-Mark,” that we can have gratitude despite it.

“My poor Aylmer!” murmured she.

“Poor? Nay, richest, happiest, most favored!” exclaimed he. “My peerless bride, it is successful! You are perfect!”

“My poor Aylmer,” she repeated, with a more than human tenderness, “you have aimed loftily; you have done nobly. Do not repent that with so high and pure a feeling, you have rejected the best the earth could offer. Aylmer, dearest Aylmer, I am dying!”

So how do we “open the door” to gratitude amidst the wanting? Open your door any way you can, my friend.  I’ll watch and hope to learn from you.  Today mine opened without me even realizing the part I played.  Thinking back now, I remember that last night I asked my husband to pray for me. I believe that was the way I opened the door. It was a friendly thing to do.

Self Care Tip – Cultivate being thankful. Be a friend to yourself.

Questions:  How do you open the door to gratitude in your life?  How do you want more without losing gratitude?  Please tell us your story.

Summarizing What You Say About Friendship With Yourself

Friendship

Image by Rickydavid via Flickr

In Summary:

Q1:  What does being “a friend to yourself” mean?

  • self-awareness
  • Acting on that self-awareness
  • Grieving who I wished I was
  • Valuing Me

Q2:  What helps?

  • Knowing where emotions and behaviors come from
  • No self-injury or aggression to others
  • Knowing God
  • Gratitude/self-inventory
  • Support from outside of Me
  • Personal check-points in place to offensively guard again self-sabotage

Q3:  What doesn’t help?

  • Perfectionism
  • Ingratitude
  • Untreated or treatment resistant brain illness
  • Stigma
  • misdirected efforts to feel empowered (such as, preoccupied thoughts = control)
  • isolation
  • habit

Q4:  What helps despite this?

  • Self-forgiveness
  • Realism/Without catastrophizing
  • Tenacity
  • Remembering what your self-care has done
  • Presence

Q5:  What is the relationship between biology and choice when it comes to understanding where emotions and behaviors come from?

  • Biological template determines function
  • Choice is there for using that template

The 12 Steps To Serenity

Ben‑Enwonwu‑Negritu

Self-Care Tip #154 – Go towards Love.

I realize that many of us talk about the 12-Steps, we know people working the 12-Steps, we even recommend the 12-Steps but have never read them through.  So here they are.  For all of us.  A wonderful walk with and towards love.

The 12 Steps To Serenity

  • Step 1 – We admitted we were powerless over our addiction – that our lives had become unmanageable
  • Step 2 – Came to believe that a Power greater than ourselves could restore us to sanity
  • Step 3 – Made a decision to turn our will and our lives over to the care of God as we understood God
  • Step 4 – Made a searching and fearless moral inventory of ourselves
  • Step 5 – Admitted to God, to ourselves and to another human being the exact nature of our wrongs
  • Step 6 – Were entirely ready to have God remove all these defects of character
  • Step 7 – Humbly asked God to remove our shortcomings
  • Step 8 – Made a list of all persons we had harmed, and became willing to make amends to them all
  • Step 9 – Made direct amends to such people wherever possible, except when to do so would injure them or others
  • Step 10 – Continued to take personal inventory and when we were wrong promptly admitted it
  • Step 11 – Sought through prayer and meditation to improve our conscious contact with God as we understood God, praying only for knowledge of God’s will for us and the power to carry that out
  • Step 12 – Having had a spiritual awakening as the result of these steps, we tried to carry this message to other addicts, and to practice these principles in all our affairs

Question:  What do you think of these steps?  Please tell me your story.

Your Personal Fight For Emotional Freedom

crochetingingeorgia.blogspot.com

Self-Care Tip #151 – Fight to be a friend to yourself.

My friend Carl, after reading yesterday’s blog-post, introduced me to this gorgeous song.  I found it on YouTube connected to a slide show of our soldiers.  Thank you to our courageous American troops fighting for the freedoms we enjoy and take and take and take.  We know that when you fight, there are losses.

We all are soldiers of sorts, fighting in life for our own selves for so many reasons.  But it’s not about the reasons or motives.  God takes care of those.  So regardless of why, thank you to all of you out there fighting for your own selves.  You who want your own emotional freedom.  The good that comes from this courageous fight ripples on the life-waves and reaches us.  Thank you.  We know that when you fight, there are losses.

Carl, thank you.  Your personal fight, your courage, touches all of us.  What you do is self-care, is care for us, is care.

Let There Be Peace on Earth, by Gill Vince

Let there be peace on earth
And let it begin with Me.
Let there be peace on earth
The peace that was meant to be.
With God as our father
Brothers all are we.
Let me walk with my brother
In perfect harmony.

Let peace begin with Me
Let this be the moment now.
With every step I take
Let this be my solemn vow.
To take each moment
And live each moment
With peace eternally.
Let there be peace on earth,
And let it begin with Me.

(child)
Let there be peace on earth
And let it begin with Me.
Let there be peace on earth
The peace that was meant to be.
With god as our father
Brothers all are we.
Let me walk with my brother
In perfect harmony.

Let peace begin with Me
Let this be the moment now.
With every step I take
Let this be my solemn vow.
To take each moment
And live each moment
In peace eternally.
Let there be peace on earth
And let it begin with Me.

Question:  How do you see your personal fight for emotional freedom rippling into the space of others?  Please tell me your story.