This image got me thinking about nurses who have served in the military, and those who have given and risked all to serve all.
This image got me thinking about sacrifices made by those we honor on Memorial Day and those military nurses who serve our military personnel everyday.

It's Memorial Day, and I'm off on this holiday after working the weekend.  I'm thinking about my colleagues who are working at the hospital today instead of swimming, grilling, and sipping on Arnold Palmers.  I'm also thinking of the members of service we honor with this holiday, and those who gave all.

I  can relate to the feeling of sacrifice that comes with working holidays, but I can't begin to relate to the sacrifice made by those members of service and those families who have given and/or risked all to serve our country.  I can only express gratitude and a moment to honor these brave souls.  And today, I'm thinking about those nurses who have made both sacrifices.

A Day in the Life of a Military Nurse is a snapshot moving picture that's worth a peek, featured on EveryNurse.org.  The resource serves the nursing profession with career profiles like military nursing, and more, with inspiration and aspiration to serve as a volunteer nurse beyond the borders of your everyday practice.  I especially enjoyed reading today about the history of military nursing to include the volunteer effort that started this branch of the military and the nursing profession.

This post is dedicated to those who have given their all, and to inspire new ideas for ways to serve the greater good in whatever inspires you to do so.

Editor's note: I love hearing from readers.  Have you or someone you know served as a military nurse?  Have you found another way to serve humankind as a volunteer nurse?  Feel free to comment here or to email me at: natalie@thereflectivenurse.com

 

Remembering children and families in a humble moment of service, silence, and song.
Remembering children and families in a humble moment of service, silence, and song.

This weekend I sang in the volunteer choir at the annual memorial service organized by the hospital where I work as a staff nurse.  Having one voice in a choral ensemble is a mighty humbling experience.  Amplified by the emotion of looking into the eyes of an audience of bereaved families, I'm reminded that loss and grief can underpin some of our best efforts to preserve life.  I've written about how saying goodbye to patients at discharge can be one of the hardest parts of the job.  Harder, is saying goodbye at the end of life...to patients, and to grieving families.

As hospital staff, it is a privilege to extend our support to families grieving the loss of a child with the Ribbons of Remembrance service.  I'm so grateful for the efforts of our memorial service planning committee and our chaplains for hosting a service that reflects diverse beliefs and traditions.  Singing in the choir has proven to be a way for me to process the waves of loss, grief, and bereavement that come with this work.  It's not unexpected to witness loss when caring for critically ill children.  Nonetheless, you're never prepared for the moment of looking into the eyes of parents who have just lost a child.

My aunt is a nurse anesthetist.  She's shared a lot of moving accounts with me over her 45 years in practice...some for shock value, others for instructional value.  One case she shared that has really stuck with me was how she was told by colleague to deal with her first loss and move on, because her next case was coming in ten minutes.  She shared that story with me years before I was a nurse, and I remember wondering how she could in fact move on to the next case...in ten minutes, no less.  She explained that there's a job to do, that each practitioner has a responsibility to find ways to grieve these losses, and that hopefully, you're part of a compassionate team that offers a human touch in caring for one another.

The first time I witnessed a death in my nursing career, I documented the details like a slide show in a personal journal I keep. I pulled that journal off the shelf after attending this weekend's memorial service.  I wrote about the loss the day after it happened...right after attending a debriefing for providers. The journal holds a chronological play-by-play of what I witnessed, and the details of each caring and compassionate gesture extended by the mature care-team members who knew that I was witnessing death in my role as a nurse for the first time.

What the individuals on that care team did for me when I witnessed that loss of life was instructional in action.  One nurse got a blanket from the warmer and wrapped it around me with a hug.  Another told me to take a walk around the block, and to find her when I came back inside.  A surgical technician told me that he might look composed in the moment, but that when he got in his car, he would cry; for the team, for the family we were serving, and for the child we lost.

One of the chaplains at this weekend's memorial service held a special moment for the children where he read a story by Ellen Yeomans, Lost and Found.  The story is about death, told through the eyes of a sibling.  This young voice wonders why her parents say that her sister Paige died, but her grandparents say, "We lost Paige."  She wonders if she is still a sister, and if her sister is lost, can she be found?  In the end, she discovers that she will always be a sister, and that her sister can be found in memories of the heart.

Hearing this story while standing among fellow choir members at the Ribbons of Remembrance Service, looking out into the eyes of these bereaved families while singing, I was reminded that grief is processed in waves.  I am still a nurse to those children who we have lost.  These families who came to remember their children shine a light on the places we can find them in our hearts.

After the first rehearsal I attended in preparation for the memorial service, I cried in my car the way I sobbed on the drive home after being involved in my first case that ended in loss.  I was reminded that there's a place we tuck grief that re-opens over time.  I felt it open up again when I recently received a call from a nurse I've had the honor of mentoring over the past couple years.  She was sustaining her first loss in the patient-care setting.  We cried together.

Like so many other aspects of nursing, what helped me feel prepared to process this loss with my mentee was the human touch modeled by members on that care team who helped me begin to process the first death I witnessed.  Digging further back to the instructional value of my aunt's first account of dealing with a patient loss, I heard myself recount the advice that we have a job to do and a responsibility to find a way to process losses.  This journey has not been as lonely as I once anticipated, thanks to opportunities like singing in the hospital's choir and thanks to being a part of a compassionate team who cares for one another.

Editor's note: I've found the article, "Strategies for Teaching Loss, Grief, and Bereavement," in NURSE EDUCATOR, Volume 28, Number 2, March/April 2003 to contain some helpful exercises and resources on how caregivers can work together to process loss and find comfort in these most difficult times. 

I love hearing from readers.  How do you process loss in your career?  How do you practice self-care while extending care to the patients and families we care for in these most difficult times?  Please feel free to comment here or to reach out by email at: natalie@thereflectivenurse.com

1

Editor's note: Double feature on the blog today in honor of Mother's Day!  Jenny Sackey's son Calvin is following in his mom's footsteps in health care career aspirations.  Some excerpts from a recent scholarship essay Calvin wrote pay special tribute to the insights he has gained from his mom. Beyond the meaningful reflections shared here below, Calvin's essay highlighted how he is channeling his life experience to find a volunteer opportunity to mentor biracial students who may be facing some of the challenges he either experienced or witnessed in his formidable years.  Calvin's remarks demonstrate that what we show our children in our actions will forever speak louder than our words.  Thank you to this mother-son dynamic duo for staging this Mother's Day blog takeover!       

UMD sophomore Calvin Sackey reflects on how his Mother, Jenny Sackey is always behind him.
UMD sophomore Calvin Sackey reflects on how his Mother, Jenny Sackey is always behind him.

"I am a sophomore in college majoring in biology, attending University of Minnesota – Duluth in pursuit of my dream to become a Physician’s Assistant or a Registered Nurse.  A lifetime of admiration for my mom has inspired my career aspirations.  A lifetime of watching her model the best advice she’s ever given me is helping me to reach my goals.

Before college, I remember receiving advice from respected coaches, teachers, and mentors who encouraged me to look at college as a full-time job.  I don’t think I fully understood the advice before getting into the context of university life, and I struggled to balance the new freedoms and responsibilities that seemed to be placed on me all at once.  I realized in my struggle that it was not just advice I needed to get me through the challenges, it was a role model.

Anyone who knows me well will tell you I have always been a ‘momma’s boy’ – I’ve always looked up to my Mother with immense admiration. While she was pursuing her Associate of Science degree in Nursing at North Hennepin Community College to become a Registered Nurse, she was also busy mothering three young children while working a full-time job as a Certified Nursing Assistant and trying to live a “normal” life as well. She consistently demonstrates that the only way to balance multiple responsibilities and to be successful is to develop a disciplined work ethic.

An important accompanying piece of my Mother’s best advice that has always helped me when making a decision is to ask myself, “How will this affect me in 10 seconds, in 10 days, and in 10 years?” My Mother modeled this advice.  By way of watching her overcome the challenges related to balancing so many caregiver roles, I’ve seen her model the advice to look at balance as a full-time job.  It is from my Mother where I was inspired to learn and mimic her work ethic and to follow in her career path. More, it is from my mom that I learned that it is my duty to pass what I have learned through experience to help others when they are struggling to have their brightest future possible."

2

Jenny Sackey
Jenny Sackey, RN, ponders the dynamic topic of disparity in this guest reflection.  Inspired by hearing a local physician speak in her place of faith practice and her place of nursing practice, Jenny listened with her head and her heart to statistics and to a message she is responding to with this guest blog reflection.  Read on to see how Jenny processed questions about racial disparity that she is now posing in her practice.

On a recent Sunday morning, my husband and I headed into town for one of our favorite weekend activities: Sunday service at St. Joan of Arc church.  I was particularly enthusiastic to hear the featured guest speaker this occasion, Dr. Stephen Nelson, a local pediatric hematologist-oncologist.  His talk, 'Racial Disparities in Health Care,' was right up my alley!

Dr. Nelson was given all of about 15 minutes to express his message.  He did not disappoint.  A few compelling statistics coupled with his insights on biases left me with one question: why?

Why do we make judgements? How do judgements impact our subjective assessments – especially in a clinical environment? What is at the root of our categorical assessments based on race?  These questions swirled in my mind in the context of being a nurse, a mother, and a citizen.

Dr. Nelson offered a comparison scenario: caring for a child of a 17-year-old single Black mother from North Minneapolis versus caring for a child of a Caucasian mother from Edina.  He admits to catching himself making those quick judgements towards the 17-year-old Black mother. "Does she have insurance?  Will transportation be a barrier to make appointments? Will she comply with treatment plans?"  Dr. Nelson’s transparency helped me shift my question from why to whatWhat do I do with the recognition of biases I’ve discovered?

Soul stirring talks like Dr. Nelson’s – receiving a message that marries my values with my faith while forcing me to evaluate how my convictions are exercised in my career…this is what privilege feels like.  Being in a moment where I can look at the gaps that exist in our society, and thinking about how those gaps impact societal values, faith, and conviction...I felt truly privileged to entertain all these thoughts.  I told my husband that we had to stay to meet this speaker.  I had to thank Dr. Nelson for pushing the envelope on my thoughts.

The line to meet and greet was long and the opportunity to express my gratitude felt swift.  Upon meeting and sharing with Dr. Nelson that I am a nurse - and that his talk would impact my practice, he asked where I worked.  What a treat to learn next that he was scheduled to come and speak at the hospital where I’m employed!

Fast forward three weeks.  I went in on my day off to hear Dr. Nelson expand his experience with confronting racial disparities in health care in a different dynamic environment: my workplace.  The context of hearing what he had to share in my place of faith context held up now in my place of employment was rich.  There was more time at this presentation – and I was astounded by the unabridged variety of examples Dr. Nelson shared to illustrate the struggle of racial disparity in this nation and in my home state of Minnesota. I’ll try to recap some of the examples from my notes (without specific citation) that were hardest for me to digest.

  • I would not have guessed that Minnesota has one of the highest rates of racial disparity in the US.
  • Minnesota is a national leading state for education. Yet for our African American population, the 4th grade reading level is the same as in the state of Mississippi (who has less dynamic educational outcomes to herald). Fourth grade level is a significant turning point for students transitioning from word recognition in reading to reading comprehension.
  • African Americans have a 3:1 unemployment rate ratio.
  • There are 10 times as many African Americans incarcerated versus Caucasians.
  • On any given day in Minnesota, a Black person is 20 times more likely to be stopped for a traffic offense than a white person.
  • African Americans have a higher infant mortality rate.
  • African Americans wait longer in the ER than a Caucasian patient.
  • It takes 3+ hours longer for the African American to go to the the ER for an injury v.s. a comparable injury that a Caucasian patient would go to the ER for, likely due to socio economic barriers.
  • It takes 20 minutes longer for the hospitalized African American patient to receive pain meds when calling out for them.
  • In 2004, there was eight times the financial support for Cystic Fibrosis research (majority Caucasian persons-affected disease) versus Sickle Cell Disease (majority Black persons-affected disease).  Sickle Cell Disease also has a higher population of patients than Cystic Fibrosis does. Today, there is 11 times the financial support for CF.
  • There has been a decrease in Black Registered Nurses and Black MDs from the University of Minnesota. Last year, The UofM graduated one Black doctor.

I felt a rush of emotions as I listened to these statistics, took notes, and considered what I was hearing in relationship to the privileges I’ve appreciated as a White female.  I felt disheartened and almost guilty.  Since hearing this impactful message from Dr. Nelson that day, I’ve been moved to channel the impact of the chord that was struck in my personal and professional life as a nurse.  I strive to be more intentional.  I follow Dr. Nelson’s plea to anyone pondering privilege to ‘lean into’ observations of disparity.  My hope is that with my newly heightened awareness, I become more active in my voice against racial disparity and less tolerant of observations to this end.

This topic also has immeasurable impact on my personal life.  I am the wife to a kind-hearted African man.  I am the mother to three beautiful biracial children, and the grandmother to one adorable biracial grandson.  I work with intelligent, talented, African Women, and I have many African friends I hold dear.  I’m deeply saddened to consider how the aforementioned statistics have or might impact their lives.  As I read this post to my husband to seek his thoughts, he said, "It's very simple. Treat others the same way you would want to be treated."

Can you reflect on a time when you have witnessed racial disparity in health care?  Think about how that realization felt. Could you have leaned in to make a difference in yourself or in the situation? It's never too late.  Please, lean in.  Please, ask why.

Please, ask, “What do I do with the recognition of biases I’ve discovered?

***

Editor’s note: Jenny Sackey has been a Registered nurse for nine years. Jenny went back to school to complete her nursing degree while she was raising a family, as it was always her desire and goal to be a nurse. Prior to going back to school, she worked many years as a nursing assistant for Presbyterian Homes and Services. Her first job as a Registered Nurse was at North Memorial Medical Center on the Mother Baby unit, where she worked for three and a half years.  It was always her dream to work with new moms and babies. In 2010, Maple Grove Hospital opened.  Jenny had a strong desire to be a part of that new hospital, and soon thereafter accepted a position in the Family Birth Center.  This past year she accepted a position as a PCF, (Patient Care Facilitator), a leadership role for the unit. Jenny loves being an integral part of this fast paced unit, and will tell you she has the best colleagues to be found.  She is honored to be a part of her patients and families birth experience.  Jenny describes this as being privileged to be a part of one of the most special life events a family will ever encounter.  Jenny never loses sight of the privilege of impacting this precious milestone in patient and families’ lives. 

Mercy Hospital, Coon Rapids, was among countless institutions who featured a ceremony to collectively honor upwards of 30,000 organ donations that occurred in 2015.
Mercy Hospital, Coon Rapids, was among countless institutions who featured a ceremony to collectively honor upwards of 30,000 organ donations that occurred in 2015.

Editor’s note: The Reflective Nurse supports Donate LifeNational Donate Life Month (NDLM) is recognized each year in April, featuring an entire month of activities to help encourage Americans to register as organ, eye, and tissue donors. Reflecting on NDLM 2016, I’m grateful for receiving my first invitation to a Gift of Life Ceremony by way of my friend Tanya, a LifeSource Ambassador who shared her family experience with organ donation at the Gift of Life Ceremony at Mercy Hospital, Coon Rapids, this past week.  Tanya and I took pause to merge and ‘dual sig’ the following reflections on this moving event.

DonateLifeLogo Color PMS

My reflection:

Epictetus said, “It’s not what happens to you, but how you react to it that matters.”  Insightful guy that Greek philosopher, Epictetus.  What a moving privilege in this life to see people bring this insight to fruition.

I’ve written about my dear friend Tanya, who serves as her mother’s primary caregiver in the journey through a heart transplant that happened earlier this year.  A nurse with critical care experience at the bedside, Tanya has confided private details of her latest critical care experience: providing primary care for her mother.  I am consistently moved by how she has reacted to all that’s happened to her mom, to her immediate family of five, and to herself on this road that has required an all-terrain approach.  So when she asked me to come hear her speak publicly about her passion for sharing the message, “Donate Life,” it was kind of a no-brainer.  I was there.

In the 20-some months since Tanya’s mom learned that she needed a heart transplant, Tanya has reacted with a posture of propelling most of her work and volunteer efforts toward the cause of donating life.  She donates blood.  She made a shift in her nursing career to have a hand in the critical, behind-the-scenes work of bone marrow transplants.  And she volunteers in the community as a LifeSource Ambassador, giving public speeches about becoming a donor.  It’s not what’s happened to Tanya, it’s how she’s reacted to it that matters.

The opening remarks made by hospital administrators at Mercy Hospital’s Gift of Life Ceremony heralded the life-giving power we can sustain once we’re gone.  We have a choice to become a donor and to make that wish known on our licenses and to our loved ones.  But why would we do that?  Enter the personal stories shared by Tanya, daughter of a heart recipient, and Brian Salisbury, cornea recipient and donor father.  Different accounts but same message: the foresight of reacting to loss of life by giving the Gift of Life was what we were all present to honor with donor families at this moving event.

The, “Donate Life” flag was raised in front of Mercy Hospital to close the Gift of Life Ceremony.  Names of the five donors cared for at Mercy Hospital this year were read, and we paused in a moment of awe for the twelve lives that were changed forever for receiving the Gifts of Life given by these donors. Donating life does not remove the pain of losses sustained.  But there is power in knowing that in moments of great loss, we can give great gifts.

My reflection on this event is dedicated to my friend Tanya, who has reacted with her whole heart to express gratitude for the heart her mother received.

Tanya's reflection:

“I was honored to be asked to speak at the Donate Life Ceremony this week at Mercy Hospital to celebrate Donate Life Month.  When the email came through, I replied and accepted with only enough pause to ensure that it wasn’t a night with 4 kid activities (only 3!).

I have only had the opportunity to share our story of organ donation on one other occasion, in a completely different setting.  In December I spoke in a hospital setting to a very small group of new ICU RN’s who were receiving their required training on when to initiate a call to LifeSource.  I am a nurse, so I felt safe and secure speaking to a group of peers…a small group of peers! I brought photos and choked back tears through almost the entire time I spoke. Speaking of my speaking; I plowed through my story at a blaring speed and I don’t even know that they were able to decipher my words. They did see my tears, they did see the photos I brought, and I did see one RN wiping away tears.

This upcoming speaking engagement would be very different. Speaking to donor families, recipient families, and hospital staff. They anticipated a group of around 50 people.

When I spoke in December, it felt good to talk. It allowed me to give something back while waiting for this gift. I was able to share the story, spread the word, share the hope and stress the importance of nurses in caring for those who are waiting.  Putting a face to the story of transplant.

Fast forward to this past Thursday. I felt rusty. I felt unsure and I was a ball of nerves. Frankly, I asked more than once, “WHY did I think I could do this?”  I hadn’t spoken since my mom received her Gift of Life. And can I tell you, it has been a very long road post-transplant. I was terribly worried that if I shared the story, the journey, and the challenges of recovery, I would make a donor family feel that in some way I (*we) were ungrateful for this tremendous gift.  In addition, I was moderately terrified that our donor family would be in attendance.  I would hate for the dates to line up and have something click when they heard my story. So I made the timeline vague and hoped for the best.

Upon arrival I saw the LifeSource hospital liaison I know (she’s awesome), and the chaplain (also quite incredible). Both came over to say hello and I met my fellow speaker who was both a Corneal Transplant recipient and donor father.   Things were falling into place.

I was very nervous before I spoke. Heart pounding, shaky knees, quivery voice.  I was grateful that Natalie agreed to join me at this event.  It was calming to know that I was not alone in this big auditorium and to know that someone believed in my ability, my story, and my strength.  As I continue to find my voice and what this life experience is teaching me, I am so grateful she has been willing to encourage me and hold me up on terrifying days just like this.

I was the 4th speaker, following two medical directors from the hospital.  I had written a long, detailed account of my mom’s journey to transplant (3.5 pages single spaced. Seriously?!)  Of course, upon standing in front of this room full of donor families, my reading completely went out the window. I paraphrased, jumped all around, and skipped some rather pivotal pieces (in my opinion) of our story.  I choked up twice. Twice? No, maybe thrice. Be that as it may. I didn’t make a big, ugly cry face. (Also a huge concern) …I was able to keep sharing.  I had revised my story on the train just 2 hours before and as I closed I was so very grateful my very jumpy and emotional brain remembered what I had added so hastily on the train.  I think it was the very most important part of our story and I think it was so important on this, of all nights to say:

“As I acknowledge every milestone in my mom’s healing from her heart transplant; one month, two months…I hold our Donor Family in my heart, as they too are acknowledging their own milestones in loss and healing.”

What I find more important than sharing our story leading to transplant is ensuring all donor families know that their decision and gift means something. Not just that day, but every day. The day of transplant I thought of our donor family all day.  The day after, and every single milestone I noted for my mom’s recovery, I have held the family with me as they grieve and heal and miss their beloved family member.

I am so very honored to share our story, to express gratitude for the Gift of Life, and to hopefully sway one more person to have the conversation with those they love before they find themselves in a dire situation.

Please, Donate Life.”

Editor's note: I love hearing from readers.  I'd especially love to hear your account of participating in lifesaving actions as listed and linked below! Are you a donor?  Do you give blood?  Have you considered joining the Bone Marrow Registry?  Opportunities to Donate Life abound.  I welcome your comments here, on Facebook, or, feel free to reach out to me at: natalie@thereflectivenurse.com

Register today to be an organ, eye and tissue donor

The need is constant. The gratification is instant.  Give blood.  (American Red Cross).

Take your first step to being someone’s cure by joining our bone marrow registry today.  (Be the Match).

Be a LIFESAVER.
Be a LIFESAVER.