During my six year RN tenure at the local hospital in early 2000, the majority of my shifts were at night. I arrived at 6:30pm to “clock in” and get report from the outgoing nurse at 6:45pm. The floor was nearly always a buzz of organized chaos which could take an entire shift to stabilize.
Although not every shift was “magical” and in fact some were down right heart wrenching, there were many night shifts that seemed like out of body experiences for me. I mentioned in a previous post that I went to nursing school to honor my Daughter’s life, and all the compassionate, skilled nursing advocates that took care of Alexis and us.
When I say “out of body” experiences, I am referring to the dynamic of being the observer of a situation, even though I was also in it. As if I was doing the work but also looking at the environment in aggregate.
To start the shift, I usually had only one patient. These kids in the pediatric ICU were sick. Their major organs weren’t working and we provided mechanical devices and pharmacological support. Some had viral infections, near drowning accidents, hypothermia, attempts at self harm. Some of our infant patients couldn’t breathe on their own. Others had chronic disease that would flare up (“frequent flyers”) and they needed a tune up.
One of the most sacred PICU shifts for me would be when I had an intubated youngster, on 100% life support. I remember drawing a diagram for my Mom early in my nursing career, to give her a sense of how complicated the nursing care was. I drew a stick figure showing all the different equipment.
There were breathing tubes, multiple IVs, feeding tubes, catheters, wound drains, and easily a dozen or more syringe pumps administering powerful medications such as antibiotics, amnesiacs, paralytics, and multiple infusions that could mistakenly take a life if they received 0.1cc too much, or too little.
Back to the sacred part of the shift. The first five or six hours were always a whirlwind of getting all meds and nursing treatments administered. If things quieted down (which they didn’t always) there sometimes arose an opportunity to tidy up, not only the patient but the environment.
I took great pride in changing dressings, bedding (this is tricky when the patient is in a coma), updating pumps, relabeling them and even taking out the garbage. Somewhere around 3 or 4am there was a true silence that was palpable. Yes, the monitors still beeped, and pumps needed to be reset. But the quiet I am referring to was not an audio quiet per se, more like a settling of the dust that filled the air earlier in the night.
During those shifts I felt “on purpose.” It is impossible to describe the trust that families and medical facilities place in a nurse, when a child needs intensive medical care. The pressure and the privilege are equally immense. The look in a parent’s eye when they were about to leave the hospital and try to get a few hours sleep, as they said “thank you” was worth a thousand words.
Sometimes, an indescribable Peace could be felt. It didn’t always happen. Maybe we couldn’t stabilize that patient, or I had to re-focus my efforts on a newly admitted patient, or back up a colleague with an all-hands-on-deck situation. But sometimes, this incredible experience of Love would befall the patient room.
When I got the chance I would get still, along side the critically ill child or young adult. I was overcome with the gratitude of having the skills I needed to show up and care for this soul. I would glance around the room, and notice that the same space that had earlier been covered with evidence of a catastrophe, was now clean, organized, and running like a well oiled machine. Even if only for a little while.
And just about then, before the new day began, I realized I was exactly where I was supposed to be, serving exactly, as I had set out to do. I would glance out the window and take pause at the sun starting to peek out of the darkness. I was fully present but also outside of myself, observing the “pressure and privilege” it took to show up. I always felt warmth, pride, gratitude and hope for the day ahead, even though my patients didn’t always get though that new day.
Is there some activity you do, some care that you give, that is full of pressure and privilege? Parenting perhaps? Taking care of an elderly parent or a sick friend? If so, I encourage you to see the Divinity in the act of caring for someone’s needs beyond your own.
Not everyone is drawn to work in the ICU. But bringing a glass of water to your child that has awoken in the night, driving someone to a doctor appointment, picking up a medication for someone that can’t get to the store, or delivering a meal to someone unable to cook for themselves, are all ways that we can serve each other. Embracing the pressure and privilege of service, particularly for those who cannot care for themselves, is a fast track to feeling the interconnected-ness in common humanity. See how your energy shifts next time you volunteer to help someone in need!