Reflection

Beautiful Easter garden from my wedding 4/23/11 

Some people have blogs entirely devoted to a certain topic/hobby...like food, crafts, etc. I have never been that organized, and if you know me well enough you know that I am random and quickly jump from one idea/thought to the next. We all have a different style...instead of me trying to be someone I'm not, I am going to be myself and this blog will be a reflection of that style. Maybe Nick will even post now and again. He doesn't enjoy writing as much as I do, though...so I expect his posts will be few and far between. Overall, I think I'm good at not letting my work get to me. I also don't let my personal life (if I'm having a rough day or something) interfere with the care that I deliver. But I'm human, and sometimes I have days where I dwell on my patients' concerns. Usually this leads to me being grateful for what I have and not worrying about the small stuff. As George Carlin once said, "Don't sweat the petty things and don't pet the sweaty things." He also said, "If humans came from monkeys and apes, why do we still have monkeys and apes?" but that is a topic for another day :-)

Tuesday was too humid for my taste. It doesn't matter if it's 5 below zero or 95 degrees, I am always warm when I am working. Even when I'm driving! So when patients ask me about the temperature of their home (wondering if it's too cold or warm), I don't have the most accurate internal thermometer. When a patient asked me today if her house felt humid--I was suddenly at a loss for words. I didn't want to complain or to have her feel obligated to put on the air conditioning, but I also didn't want her to think she was imagining the heat!. And since I wasn't sweating, I just explained I have an inaccurate internal temperature on work days--I always feel warm. The same patient said she couldn't believe how windy it was today and preceded to tell me what is the ideal weather. Other patients talk about how nice it looks outside and how they wish they could go for a walk. Some weeks we don't get enough rain for the garden, and other weeks it's like a monsoon.. Warning: I am about to make a generalization. Everybody in Minnesota has an opinion about the weather--whether good or bad (or should I say "weather" good or bad...dad, that pun is for you!). 

More beautiful flowers for Easter weekend. Our wedding was 4/23/11. For me it marked 21 years of being cancer free!!

The reason I mention this is that not everything I talk about with patient is health related--sometimes they bring up the news or local issues--but the biggest non-health topic is the weather. Elderly people love to talk about the weather. When I was younger, every letter from my grandparents would include something about the weather, which made a lot of sense because they live on a farm--farming is largely affected by something we have no control over--the weather. I think that is what makes it such a common topic--it's unpredictable, but we can all relate. It's a comforting feeling knowing we are all dealing with the same thing. On a smaller scale, when I find myself sitting in bumper to bumper traffic on the highway in the middle of winter as snowflakes pelt my windshield, I feel more connected to my fellow drivers. We are all dealing with the same thing.

Like "tiptoeing" around a subject

Unlike the weather, a person's health--such as depression or a new diagnosis of cancer--is not always an easy subject for people to broach. We may all have different opinions, but no longer is it as impersonal as the weather. We can try and put ourselves in people's shoes, but we cannot know exactly how they feel. With that said, however, I think it is important for us to put ourselves in their shoes for a moment. This gives us a better awareness for empathetic listening. Too often we are worried about saying the wrong thing, when really we can ask a question, listen, and respond based on their reaction or thoughts. 

Many people do not know what to say to someone who has cancer. Some people are afraid of saying the wrong thing so they don't say anything at all. There isn't always a right thing to say. I've told people that cancer sucks. I say that it's not fair, they don't deserve it, and I will help in any way I can to make it less scary and more manageable. I say that life is unpredictable and we do the best that we can. I carefully remind them what is going right (such as good lab results, clear scan), and discuss with them what they would like to go better. I have hope while remaining realistic. I explain that they are in the driver's seat, that they are the most important member of the team,  and that I want them to have all the cards in front of them to make their decisions (an example being choosing whether or not to have a surgery). I was nervous today about asking a patient about his understanding of his diagnosis, prognosis or life expectancy, and his treatment options. I didn't know what can of worms I could be opening. However, I asked him the questions respectfully and informed him of why the questions were important. And, lo and behold, the discussion went much smoother than I anticipated. I ended up collecting very valuable data with which I shared with his doctor, and it appeared that the patient and his spouse were able to talk openly about his condition.

I think that the intention behind words and actions goes a long way. I pray that I say the right thing and that I help my patients. I fumble with my words and it doesn't always come out right, but in the end it seems to all work out. Nobody expects perfection. I believe that people have a right to be vulnerable without being judged, to know their options and who can help, and to be respected as a person with individual wants and needs.

I updated my status on Facebook tonight with something that was on my mind, in fact it was what led me to post on my blog today. Post from earlier this evening: "As a home care nurse I see joy and sorrow...my patients laugh and cry. They share with me their concerns, questions, and innermost feelings. I feel privileged to work with patients--who welcome me into their home--and to help them as they work to manage their health. I love what I do. We never know what tomorrow will bring, but at 26 I truly appreciate my life and each day that I am given. I look forward to each new life experience and I try to make the most of every day." --Emily Kremer 8/24/11

Dreaming of the future while still being present in the moment