This past three months I tried something new. It wasn’t so much a moving towards as a moving away from something else, yet it turned out to be one of the best choices I’ve made in my life. I became a clinical instructor.
One thing I decided was really important to me to teach my students this semester, was to understand people through story. And so, “storytime with Jenn” as we fondly began calling it, began. (There was also glitter and q-tips but that’s a whole other story.)
Although I read them a great excerpt on how needles were prepped in the 1940’s the day they began giving injections, the bulk of our storytime came from a book called “Fallen” by Kara Stanley. The story of a man who fell, his journey through ICU, Acute Care, Rehab and home, through the eyes of his wife and himself.
However, I promised my group one last story as the semester draws to a close so here it is. It’s my story.
Over the past 12 weeks, together we have grappled with what makes a good nurse, how do we translate book learning to practice, how do we relate to challenging patients? How do you buddy with nurses who don’t seem to want to teach? How do you cope when the patients or your buddy nurse are having a rotten day? Most of all, how do you recognize your own feelings of being burnt out.
I preached (sometimes better than I practiced) self-care from day one. From taking your breaks to coping with a patient’s death. As the semester drew on I realized that I had earned this group of students’ respect, maybe even admiration. I felt their gratitude and I realized in some ways they looked up to me.
My passion was to be their mentor and their guide, but I was surprised when it happened. Throughout the semester I shared many many stories from years of practicing, I shared lots of my own challenges and experiences. I even shared my mistakes, but I didn’t share what I thought was my biggest failure. I realized that for them to truly understand why self-care was so important to me I would need to share my story of what happens when it’s not made a priority…
I’m not sure when it started. Sometimes, I think nursing school.
“Maybe you shouldn’t be a nurse, you cry too easily.”
Words stick. Those ones especially because deep down I believed them. I didn’t understand how to love and take care of myself. I hated a part of me that was at the core of who I was and the more I fought it, the more fractured I became.
I was like a glass vase, lots of hairline fractures. On the outside I looked whole, I had even begun gluing some of the weaker pieces together when it all came crashing down.
Last Spring, I found that someone who had encouraged me greatly through nursing school had taken her own life. Someone with whom I had always identified with, had looked up too. She took care of everyone and did it well. I remember her struggles with her job and they echoed mine. Loving the patients, therefore tolerating bad behaviors from colleagues and managers.
I found myself just barely coping with today, hoping that somewhere down the line it would get better. When she died she was living with extreme chronic nerve pain. As nerve pain shot down my arm on a regular basis from a work injury, I wondered when or if it would go away. When I knew I shouldn’t go to work, I did anyway. When I needed a break I felt stuck between taking one and getting my work down. When I found out she had died I cried and then sucked it up and went to work because that’s just what you do.
The vase that looked whole, but wasn’t, got bumped that night. It was one harsh word after another. One code blue too many, adrenalin up, then down.
Just getting through. I’ve got this because I have no choice but to hold my shit together. Until I didn’t. And I couldn’t. Until I left the unit sobbing, declaring I wasn’t coming back the next shift. And I didn’t.
This may be taking the vase metaphor too far, but I could no longer hold water. This wasn’t a small leak here, a big one there. This was broken pieces and ugly, not safe to drive crying. Smashed water bottles and broken, bleeding fingernails.
A friend recently compared stuffing emotions to the mentos and coke experiment where once you reach a certain pressure it all explodes. If you’re my students and caught my under breath comment I said “or like a Bisacodyl suppository when you’re full of shit.” Either way. A bit of a mess.
The next couple months were spent painstakingly gluing the pieces pack together. The glue of self-care which I realized was a lot more work when you are putting the pieces back together that have been shattered. There were doctor notes and politics. Rest and relaxation. Lots of tears. Music. Counseling and yoga and in the end walking away.
I worked one more shift and as Gabor Maté might say, my “body said no”.
In the Memoire “Fallen” Simon remarks that the rehab mantra was to not let your injuries define you, but he found it problematic. He remarks that the injury is now a large part of his identity. He says:
“I described it initially this way: When your life shatters, and you survive it, at least you get the option of choosing which broken shards and fragments you want to put back to together.”
Will I go back? I don’t know. Do I have PTSD? I don’t know. Do I consider myself to have a work injury? Yes. Does my doctor and Union rep agree? Yes. Am I now making the effects of trauma the center of my life’s work? Possibly.
This I do know. Repetitive big and small trauma broke me. I didn’t have the skills to take care of myself before I went into nursing, let alone cope with the weight of caregiving where you are expected to always be the strong one.
I also know this, the last three months have been healing. This group of students has shown me that we do learn from story, and that I can share my story and encourage students to develop the skills I didn’t have or get in nursing school.
I can create safe and supportive learning for them instead of traumatizing them through intimidation. I can help them normalize their emotions and help them see it is our emotions that make us good nurses so we must steward them accordingly.
So, next semester, here I come!