Yeng Yang, MD reflects on sharing a stage with nurses and other members of a cast and crew in what she describes as practice in a medical theater.
Yeng Yang, MD reflects on sharing a stage with nurses and other members of a cast and crew in what she describes as practice in a medical theater.


I am not a nurse and yet I am intricately tied to nurses in all that I do, in direct patient care and in the many aspects of my other nonclinical duties at the hospital. Even in my health care MBA program, I am interacting with nurses.

What I am thinking about is the relationship between members of the medical team and our abilities, or lack there of, to be truly present for our patients and each other. A patient is not cared for by just the physician or the nurse alone; there is a myriad of other teammates who interact with our patients and with us in order to create a symphony of care. Delivering great and compassionate health care is like live theater; it needs actors (medical personnel), a well-designed set (unit), and the stage (health environment/hospital). I find that the “medical theater” delivers its best performance when the cast and crew have presence of mind, when we commit to teaching and learning from each other in practice, and when we keep our patients center stage.

It has been shown that when team members act rudely or disrespectfully, a team performs poorly, whereas when team members act more positively or receive positive encouragements, it performs well under pressure. I have found many examples of performances that do not uphold best practice. Poor performance is often rooted in the stress of practice.

In a perfect system, our attention can be devoted to one thing at a time with presence at all times. We do not work in a perfect system.  But we can choose to be the best version of ourselves in practice with each other and furthermore, in practice with our patients. We easily spend more time together as staff than we do with the patients and families we serve. It is important for us to model positive behaviors of care giving for each other as we cohesively deliver care to others.

I hope that as practice evolves, we can all perform with patience and respect towards each other. One of my professors said that in order to promote growth in those we lead, we not only have to meet them where they are at, we need to truly care about them and their development.  I have found this to be true in my relationships with those whom I lead and with my colleagues. Our patients deserve the best versions of us when we deliver care at the bedside, their most vulnerable moments.  When we commit to delivering care to each other, it ultimately reaches the patients and families we serve.  That's the brand of care delivery that merits a standing ovation.

Yeng Yang, MD, FAAP, is Director of UMP Pediatric and Newborn Hospital Medicine at Maple Grove Hospital.


Hand-stamped notecards covered my dining room table last August. Loving messages were written for a woman who was waiting for a heart. Yesterday she got that heart, and these notecards are going in the mail to decorate her hospital room.
Last August I hand-stamped a dining room table full of notecards the night before a benefit, Picnic with a Purpose. Loving messages were written by guests at said benefit for a woman who was waiting for a heart. Yesterday she got that heart, and next week I'll hand deliver these notecards to her - and to her new, grateful heart.

I work for a hospital that is sponsoring a wellness program that launched today: Attitude of Gratitude.  This self-accountability activity is one that aims to foster a grateful heart.  Tonight I reached out to a dear friend whose mom received the gift of life yesterday - a new heart.  I asked my friend if I could dedicate a blog post to her and to her mother as I reflect on fostering a grateful heart.  I'm so glad she said yes.

Two years ago Saturday I received a call from my friend Tanya.  She had just received the news that her mother needed a heart transplant.  For two years, I have watched Tanya and her mother do everything humanly possible to prepare for receiving this gift of life.  The to-do list was not short, nor for the faint of heart, but even with a heart that was failing her, Terry Olsen took stride to become the best steward she could be for an organ given by another soul.  And her daughter Tanya kept pace at her side.  Let me tell you one of the most heartfelt stories of gratitude I've ever witnessed.

A fellow nurse, I witnessed my friend Tanya read and research with a scientist's eye, the process and procedure she and her mom were preparing for.  She made countless drives with her mom to appointments, often leaving home before sunrise and returning after sunset.  She made and packed sandwiches and snacks to sustain long days of appointments and the miles between home and the facility where things were first scheduled to happen.  Then, she stood by her mother in seeking out a program and facility closer to home to endure transplantation.  This Sunday morning she met me for pancakes just three hours shy of her mom going into surgery to have her heart transplant, and I am so grateful for the window into this journey she has opened for my eyes and heart.  I have witnessed this miracle of organ transplantation through the firsthand account of my gracious friend and her mom, and I am beside myself tonight as I write this account of what it's been to witness this process.

How do you begin to follow-through on, "how can I help?" when you stand by someone who is preparing their mind, body, and spirit for what might be the best or the worst outcome imaginable in the advances of modern medicine?  This friend is the one who will swoop in on any friend to be there when the need arises.  She is the friend who never fails to send written thanks.  When preparing for the benefit I planned with others in our circle of friends, Tanya was the friend who was writing thank you notes to acknowledge the time and energy we were spending weeks before the benefit even occurred.  Little does she know, the gratitude is ours for being let in on this path of seeing what it means to foster a grateful heart.

On this journey to a new heart for her mom, Tanya became an Ambassador for LifeSource, the organization that saves lives through organ and tissue donation, serving communities in Minnesota, North Dakota, and South Dakota.  Tanya spoke to her first group of critical care nurses recently.  She reflected that many moments in a nurse's day are routine, but they are someone else's once-in-a-lifetime.

The miraculous advances in medicine that provide for transplantation are not every nurse's daily routine.  But one common denominator among nursing peers and our partners in healing is the fact that we are all on our own wellness journey while we deliver care to others.  I'm starting my Attitude of Gratitude challenge with a simple practice that is sure to be a source of personal wellness: a family gratitude journal to adorn our dining room table and conversation.  There are countless (and some elaborate!) examples of gratitude journaling, like this one from Writing Forward.  I spent less than $2 on a traditional composition notebook that is sure to hold a composition that reflects a daily Attitude of Gratitude.

This self-accountable journal practice is dedicated to Tanya, to her mother, and to the donor of Terry's gift of life.  May we all be so fortunate to be touched by stories that instill compassion as we aim to deliver our care with that touch.  To read more moving accounts of donating life, or to become involved in the mission of promoting organ and tissue donation, visit the LifeSource website.   If you have an account of a life-giving donation, of gratitude in practice, or of what's on your mind about nursing, I'd love to hear from you.  Feel free to comment here or reach out to me at: natalie@thereflectivenurse.org

Today I am grateful to know that my dear friend Tanya's mom has a new heart that is beating strong.
Today I am grateful to know that my dear friend Tanya's mom has a new heart that is beating strong.  Terry Olsen, you are the essence of a grateful heart.  Mine is forever touched for knowing both of your hearts.



Jennifer Johnson is a surgical services RN who finds a little levity can go a long way on both sides of health care delivery.
Jennifer Hall Johnson is a surgical services RN who has found that a little levity goes a long way on both sides of health care delivery.

We all have those friends who help us survive the uphill terrain in life with a little laughter to propel the journey.  Jen Johnson was one of those friends who helped me survive nursing school with her quick wit and tireless commitment to create community along the way.  It's no surprise to catch up with her over a decade beyond wearing whites in nursing school together and to find her creating comic community as an escape from the stress of the daily grind.  When Jen isn't working in the OR in her local community, she's traveling the world with Seattle Alliance Outreach or plotting her next steps in raising funds and awareness to combat the widespread affect of cancer.  When I recently caught up with Jen and asked her what was on her mind about nursing, here's what she had to say:

"Last fall, the nursing profession was front and center in the media thanks (or no-thanks) to criticizing comments made on a national talk show by uninformed television hosts.  With that press, nurses (and healthcare workers of all types) came out of the woodwork to state their opinions, good and bad - about our chosen profession.  I have never seen such an outpouring of support for health care workers, and I am grateful for the national spotlight the nursing profession had in the aftermath of said press.  I mean, nursing is a great profession!  Where else can you roll into work in your PJ's and then change into other PJ inspired clothing?  I wear an OR hat at work all day, so that saves a lot of money on grooming supplies.

That said, I have also noticed an influx of negativity regarding nursing, particularly in social media.  I started following a very popular healthcare Facebook site and what I saw alternated between making me proud and inspired, and sad.  I have heard the mantra "nurses eat their young" so many times and by so many people, yet I had not experienced it myself.  What I saw on social media last fall in the flurry of reactions to the aforementioned press was a cacophony of: "Behind my name are X amount of letters Alphabet Bashing", the old "I've been a nurse since (insert year) so don't dispute me because you don't know as much as I do," and various administrators of the aforementioned site arguing the professionalism of certain posts and comments...it was like I was watching the human equivalent of a tiger salamander (in case you didn't get that reference, they literally do eat their young).

I thought about it and realized that I wanted to do something to bring attention to all the positive (and funny) parts of nursing...so nurses and healthcare workers of all types could maybe get a laugh, blow off some steam, and not worry about being blasted by a FB group administrator for violating an unknown (and often changing) line of "professionalism".  A small way to focus on the positive rather than be bogged down by all the negativity.
I don't care what your title or place of employment is, if you work as a nurse, you have stories.  You have seen some bad stuff.  Really bad stuff.  I've had to tell people that their family member needed an emergency surgery after delivery of a stillborn baby.  I've looked into the eyes of a patient who didn't know how far their cancer had spread, held their hand as we walked down the hall to the OR, and as anesthesia took over, said a silent prayer for them.
Heck, I've BEEN the cancer patient.
I was there when my co-worker's mom went into cardiac arrest during an endoscopy.  My co-worker was standing outside the procedure room door as the code was called, and she had to make the decision to call it off after 45 minutes of non-effective CPR.  It's tough stuff.  I'm not telling you guys this so you think I'm Super Nurse or anything.  The point is, if you work in nursing (or health care), you either have seen some earth-shattering events, or it's just a matter of time before you do.  And you have to get up the next day (possibly wearing Hello Kitty pajamas) and go back and do it all over again.
The Joy of Nursing is a Facebook group I created with the intention to create camaraderie (and to blow off some steam) within the healthcare community using humor.  Focusing on the positive and the funny stuff makes the bad stuff easier to handle.  And maybe humor is a vehicle we can take to aid in not taking ourselves so damn seriously."
Jen's FB group is: The Joy of Nursing - she invites you to join her in a chuckle.
The views and opinions expressed by our guest authors and by those who comment on their posts do not necessarily reflect the views and opinions of www.thereflectivenurse.com


Crockpots were lined up as far as the eye could see at this week's potluck on our nursing unit.
Crock pots were lined up as far as the eye could see at this week's potluck on our nursing unit.

The thermometer read -8 degrees when I hopped out of my car on Sunday morning to brave the walk from the parking ramp to the hospital entrance.  I ran into two of my nurse colleagues in the stairwell upon arriving.  They were robed in Vikings apparel and each of them had a crock pot in tow.  The home team may not have won this weekend, but our Sunday potluck was a win on many fronts.  The impact of the nursing unit potluck on morale is what's on my mind about nursing, this week.

"I don't even feel like I'm at work," I heard one nurse say as a couple of folded bed-sheets were fluffed open and made to function like fine, white, table linens as we set up the spread in the break room.

"I'm not gonna lie, this turned into a $40 dip," another nurse roared as she stirred her (delicious) buffalo chicken dip.  One of our star clinical support assistants had us hanging on every word and every bite as we savored a sneak preview of his homemade bone broth soup.  American dim sum, we jokingly labeled that moment of taking some quick nibbles on morning break of all the goodness that awaited us on our lunch break.  This, people, is a taste of the palpable energy that is potluck day on a nursing unit.

The unit potluck is an opportunity to dedicate break time and some time on the home-front to prepare a little dose of TLC for the colleagues who affectionately become the work family.  Thanksgiving Day, Christmas Day, and game day in recent weeks on my calendar have been exponentially heightened by the feasts that have come together in the name of camaraderie.  Potluck days are sure to bring an added moment of levity...and whether you're showing up with the chips or the aforementioned $40 dip, your contribution is part of a whole heap of food and fun to be had by all.

I've seen the unit potluck play out in a variety of forms and fashions.  There's the case study of what Mighty Nurse calls, "The Potluck Nurse" - where a unit can count on one brave soul to rally a menu and a mentality for coming together to break, and to break bread.  SignUpGenius can whet your appetite with their rave round-up of 50 Creative Potluck Themes and a modern day version of the break room sign up sheet.  Or, I once worked on a unit where our "potluck nurse" would plan and prepare a sign-up list detailed with everything needed to pull off a feast, divided into equal cost-to-create contributions.

A couple current work-family friends of mine and I have taken our affinity for food-shares to a down-sized potluck concept on our rotation of working every-other weekend.  We created a private group on social media (The Lunch Ladies) to communicate about what's cookin' as we go into our weekend stretch...and then we swap our respective contributions once we get to work.  It's a win-win, because you cook one thing and you end up with three home-cooked dishes to enjoy over the weekend.  Planning to be at the hospital for three consecutive 12-hour shifts (where you are away from home for an average of 14 hours a day) can feel like a business trip where you are prepping your own meals.  And if you enjoy food prep and consumption as much as the three of us do, the variety in the swapping is the cherry on top of this make-ahead-meal method.

Tactics for raising morale on nursing units is well documented in academic journals.  But today's reflection is boiled down to the basics.  There's just nothing quite like a unit potluck (for three or for thirty!) to rally spirits, satiation, and sustainability for a long shift.

What's on your mind about nursing?  Commenting here or on the Facebook post adds to the potluck of thoughts about the work we share.  Or, email me at natalie@thereflectivenurse.com to volunteer a guest blog post to answer this pressing question.




Jennifer Quade, RN, BSN, HNB-BC Board Certified Holistic Nurse Revolutionary Women's Holistic Health Care Holistic Stress Management Instructor
This week's guest blog reflection is written by Jennifer Quade, RN, BSN, HNB-BC.  Jennifer is a Board Certified Holistic Nurse with a passion for traditional healing and wisdom. She runs a thriving practice in Minneapolis, helping people find balance through self care.

Hi Natalie! Thanks for your invitation to be a guest on your blog. I really believe having dialogues about our practices is super important to keep us connected, cared for and inspired as we do our work.

So what is on my mind about nursing?

Self care.

I personally feel that this might be the most foundational, important aspect of nursing.  If we don’t give ourselves excellent care, it’s nearly impossible to give others our best.  Do you know the feeling of trying to give from an empty gas tank? I bet you do...and it doesn’t feel so great. I’ve been there...and I have to constantly be on alert to make sure I’m not slipping back into over-giving. When I feel irritable, depressed, or experience body pains, I know it’s time for some serious self care. No more "sucking it up" or dealing with the imbalances.

I have been a nurse for 10 years.  After my first few years of working on the Float Team at Children’s Hospital in Minneapolis, I was burning out because I truly didn’t know how to care for myself at the level that I was giving. That’s why I embarked on my own healing journey. I have dedicated my life and my private practice to learning how to care for myself, to staying in balance, and to supporting other women, caregivers, and nurses to do the same.

Why? Because I’m interested in living a vibrant life...living my dream. I want to see nurses fully realizing their dreams, too. It has to begin with self care, which includes self awareness..."know thyself." What do you want? What do you need?

Self care...it sounds like a simple concept, but it can actually be pretty difficult to put into practice, especially when there are so many demands on our time and energy. And since nurses are amazing and are generally good at just about everything (if I do say so myself), the demands are increased! Everyone wants a piece of the action.

Take a moment to consider where your creative energy goes. Be honest with yourself. Reflect on this: am I making myself a priority?  

After years of practicing basic self care techniques and receiving support from integrative therapy professionals and traditional healers, it became clear to me that what I really wanted in my heart of hearts is to take an extended time away from the winter to travel south. After 5 years of writing about it, praying about it, talking with friends who have done it, and saving for it...it’s happening. In one week I leave for a three-month, extended trip to Costa Rica, Columbia, and Hawaii.

I’m thrilled that I have found a way to make this dream come true and I’m also excited about what this will mean for my practice and my work. I have been preparing to launch three signature speaking programs especially for nurses and caregivers. I’ll be taking time on my journey to put final touches on them so I can begin to share this message of mind-body-spirit emotional healing and self care with larger audiences.

Coming to a hospital near you in 2016:

Become the Eye of the Hurricane: Managing Stress Amidst Chaos

The Art of Self Care for Nurses

Stress & Human Spirituality

Taking three months away from my daily work is something I have never done before, so of course I have had to navigate fears and doubts along the way. Will my clients receive what they need while I’m away? Can I afford it? Am I being selfish? And more...

When these thoughts and fears arise, I take a deep, soft, belly breath. I feel my heart...and I remember why I am taking this time for myself: to fill my fuel tank so I have more to give upon my return, to take space to create my speaking programs from my center, to study with indigenous healers along the way, and to have fun. I'm realizing I can't afford NOT to do this for myself!

Let’s face it -- nursing can be (and often is) intense and exhausting. But we do it, because at the core, we have hearts of service. It is vitally important that we tend to our hearts.

Consider reflecting on the following:

  • What is your heart calling for?
  • If you had a magic wand, what would you change in your life?
  • What is one simple self care practice you can weave into your day today?

Also, consider looking at the resources page on my site. You will find a generous list of resources for self care. Enjoy!

If you’re interested in connecting with me about my speaking programs, please visit my website.

Take Care and Happy New Year!

Jennifer Quade, RN, BSN, HNB-BC
Board Certified Holistic Nurse
Revolutionary Women's Holistic Health Care

Holistic Stress Management Instructor

The views and opinions expressed by our guest authors and by those who comment on their posts do not necessarily reflect the views and opinions of www.thereflectivenurse.com


A cherished personalized necklace from a crafty friend will forever remind me of the power of this one little word in 2015.
A cherished, personalized necklace from a crafty friend will forever remind me of the power of this one little word in 2015.

It's the final hour of 2015.  Although my husband and I are spending New Year's Eve in different locales for the first time in over 10 years...I'm in a happy place: reflecting and writing.  He's at a family wedding on the East Coast, and upon tucking our daughter in, I settled in with my hot date (my laptop) to recount some highlights of 2015 and to dream up some highlights yet to unfold in 2016.  The present moment is so quiet, all I can hear is the calendar page turning from 2015 to 2016.

For three years now, instead of amassing New Year's Resolutions, I've picked One Little Word a la Ali Edwards' online class.  The idea is to pick a word that represents what you want to attract more of in your life.  The online course delivers prompts on the first of each month to spark ways to live with your word through journaling, activities, and reflection as you go about your daily life.  My 2015 word was reflect - and I dare say, I rocked it.

Santa stuffed my stocking with some cards to help me bring others into the forum I've created to reflect and connect on practice.
Santa stuffed my stocking with some business cards to help me bring others into the forum I've created to reflect and connect on practice.

I've dreamed about creating a forum for nurses to connect and reflect on practice since I was a student nurse.  Nursing school was way off the grid from my undergraduate degree (communication with an English writing minor). My exposure to nursing in my work as a volunteer coordinator (for the pediatric hospital where I am now employed as a staff nurse) inspired my passion for this profession.  Practicing in other settings, earning my MSN, teaching, and advising students in advanced degree programs are opportunities I've had along my path to open my eyes and heart to some incredible nurses and partners in healing who further propelled my desire to start something I believed I could do.  So I did it!  This year I built a website, a blog, and a community of nurses and our partners in healing to grow the reflections and connections that deepen our relationship to practice.  It's been great fun - and it's only just begun!

The Reflective Nurse forum has served as a springboard for me to host nursing salons in my home, to dabble in blogging, and to collaborate with others who wish to enhance practice in between shifts and amidst the other joys and challenges in life.  I've had a rough couple months recovering from pneumonia in November, so I recently reached out to one of my favorite holistic health nurses (Jen Quade) to tap into her wisdom surrounding holistic compliments to Western medicine.  The outreach  lead to a collaborative effort to host an event in December featuring a class she designed.  Stay tuned for more offerings in this vein in 2016!

If you are interested in upcoming CEU-adventures, stay tuned to the blog or ask to be on The Reflective Nurse mailing list by emailing me at: natalie@thereflectivenurse.com

My article, The Nursing Salon Experience: A Tale of Hosting Conversations, appears in Creative Nursing, Volume 21, Issue 4. 2015.
My article, The Nursing Salon Experience: A Tale of Hosting Conversations, appears in Creative Nursing, Volume 21, Issue 4. 2015.

Dabbling with my blog got me warmed up to live my dream of becoming published in 2015.  I was tickled to be invited to submit an article to my favorite professional journal, Creative Nursing.  This exercise provided me with a platform to reflect on what's inspired and sustained my professional pursuits and it got me in back in touch with a couple key mentors.  When I went to school for communication and writing, I remember thinking, "now I just need something meaningful to talk and write about."  Insert nursing career, here.

The Writing Habit was a class-offering by Rosanne Bane at The Loft Literary Center this past summer that reignited my love of reading and writing.  What I learned in class primed my pump for my 2016 One Little Word: WRITE.  Being a part of a writing community reminded me that reading and writing are two of my most cherished joys.  Upon asking another writer what she does to sharpen her writing skills, she answered, "I read" -- insert 'aha' moment, here!

Three nurse-blogs I follow include:

Nurse Eye Roll, Marie Manthey's Nursing Salon, and my new favorite, End of Earth Nurse.  I'm inspired by these ladies.  Reading what they have to say about our profession encourages me to ask more colleagues and partners in healing the key question we ask and answer at nursing salons I host and attend: "What's on your mind about nursing?"

The Reflective Nurse is now seeking guest bloggers to join and spark more conversation around the reflections and connections we make in our profession and practice.  I'd love to read your response to, "What's on your mind about nursing?"  Please email me at: natalie@thereflectivenurse.com to volunteer your voice!

A snapshot from The Reflective Nurse conversation salon in July 2015 -- we may not be able to carve a whole chicken together on the blog but we can still ask and answer the question, "What's on your mind about nursing?"
A snapshot from The Reflective Nurse conversation salon in July 2015 -- we may not be able to carve a whole chicken together on the blog but we can still ask and answer the question, "What's on your mind about nursing?"

In the meantime, look forward to guest posts from three dynamic and wandering nurses during the month of January...intrigued?  You should be!  I'm excited to feature posts from one nurse who is about to take the expansive, enriching, hiatus of her dreams, from another nurse who uses humor as an escape in her daily grind, and mission trips around the world in her vacation time, and finally, from a young nurse who has found a way to merge her dreams of practicing nursing AND yoga on new horizons beyond her wildest dreams.

Happy New Year!  I've effectively reflected and written my way into 2016...bliss.  Join me for more in the coming year.


Back-to-school is a time of year that has assumed a season in its own rite.  Sandwiched between summer vacation and the official start of fall later this month, a wave of nostalgia is sure to be resonating as fleets of yellow buses are back in mainstream traffic.  Social media outlets have hosted the annual surge in snapshots of students adorning backpacks and displaying homespun signs to mark the occasion of the coming school year.  This week I caught up with Tanya Ingvaldson, a dear friend and nurse colleague who proudly displayed her chalkboard proclaiming her first day of graduate school as she embarks upon her Master of Arts in Holistic Health Studies degree.

Registered Nurse, Tanya Ingvaldson embarks upon a journey to a graduate degree!
Registered Nurse, Tanya Ingvaldson embarks upon a journey to a graduate degree!

Tanya has let me in on some of the most profound moments of her internal and external evaluation of pursuing this advanced degree at this time in her life.  I'm humbled to feature her story this week as she faces a most personal phase of her understanding of health and healing in her role as primary caretaker for her mother, who is awaiting a new heart.  In the commentary following Tanya's essay for admission to her MA program, she lets us inside her pause to question whether this is the best time or the worst time to move forward with thoughtfully laid plans to expand her personal and professional horizons with a degree in holistic studies.

Deep thanks to Tanya for sharing the following pieces: her entrance essay for graduate school and her raw and honest assessment of taking the plunge in the weeks leading up to her successful start of graduate school, last week.  Tanya, here's to your successful finish as you move toward sticking the landing on this next leg of your nursing and personal journey.

A Personal Essay for St. Kate's MA in Holistic Studies by Tanya Ingvaldson

"My interest in Holistic Nursing started quite accidentally. Over the last two years I have been seeking ways in which to lead a healthier lifestyle and how to implement a healthier way of life into my family’s routine. During this time I was seeking new ways to care for myself and my family, essential oils took over my workplace. After a great deal of reading and talking to friends who were well versed in the many uses of oils, I took the leap and watched the essential oils work right before my eyes. It was in that moment of watching the oils work for my daughter that I became a believer in the potential and the power of essential oils and alternative modalities in care.

This revelation prompted me to start looking deeper into all of the alternative ways in which I could care for myself and I was exposed to a world in which I had no prior knowledge and a significant amount of skepticism. Our daughter suffers from Juvenile Idiopathic Arthritis.  During the same time that I was learning more about alternative modalities, she suffered a significant flare. We sought out alternative approaches to compliment her medication regimen.  It was my hope we could find an alternative that would offer a more immediate improvement while we waited for the systemic medications to take hold.  We began taking her to a chiropractor and saw a tremendous improvement with her level of pain, her mobility, and her overall wellness. The dramatic change I saw within her only furthered my belief and curiosity!

During this same time of discovery and interest, I have found myself at a professional crossroads. The realization and acknowledgement of my situation has given me pause and has both forced me and empowered me to examine what I have a passion for, and what I want to spend the second half of my career doing.  As I began to learn more about alternative modalities, I felt as though an entire new world of possibilities had opened up that I had never before considered.

As an RN, I have a strong belief in the validity and necessity of modern medicine. That being said, I also believe that there is a strong body of knowledge that tells us that traditional approaches to health and healing have validity.  I know there is a way in which we can reach a balance an acceptance of alternative modalities, which at one time, were mainstream modalities to help our patients, and ourselves to be healthier, happier and more enriched.  This new personal realization has led me to ask more questions about the place that Holistic Nursing can fit into my life and my practice. Within myself I see and feel that the more information I gather, I am left with more questions and more excitement for the possibilities that lie ahead for both my future and the future of the nursing profession.

My nursing career began in a Level III NICU. I have been a NICU RN for 15 years. In the last three years, I have also had the opportunity to work with new moms as a postpartum nurse, giving me an entirely new view of nursing care.  As my journey towards Holistic Nursing has progressed, I have been reminded of a pivotal day I experienced as a new nurse. As a new graduate nurse, so many days were spent learning from individuals from various care areas. Although we met with many people, I continue to come back to the day we spent with the Occupational Therapist. Our day was spent learning about the developmental care of the tiniest of patients. What has so strongly remained with me over all of my years of practice is the power of touch. We were taught on that day, and during many other days to come that our tiny patients required a light touch. We were taught to be ever mindful of the weight and strength of our hand. We were taught to be mindful that these tiny patients cannot talk and we must watch and be aware, and as your are laying your hands upon them to realize how heavy they were and then readjust. It has always been important to me to be careful, mindful and aware of my touch.  As I reflect on Holistic Nursing and what that path might look for me in the months and years to come, I continue to be drawn to Healing Touch and all of the possibilities it holds.

While the idea of graduate school is daunting, I feel that I am ready for the challenge. As I approach this process, it has helped me to know that I can pursue the Certificate program, lessening the weight of my decision to apply for school. Furthermore, while participating in the Enhancing Practice Through Holistic Nursing class this spring I met with two women who are currently in the Holistic Studies program and are attending part time. This further propelled me to follow this path and reassured me this is a feasible and positive decision for me at this time in my life. Despite the fact that I have external stressors in my life, I know that I can work at my own pace. I know there is no deadline I must meet, because when all is said and done, I am doing this for myself. What I find appealing and reassuring is while I hope that this can lead me onto a a new career path, I also know that what I will be learning will be beneficial to me, as a person to care for myself as a whole, for the rest of my lifetime."

Behind the polished essay...there are raw emotions.  Tanya shared the following excerpt about two weeks before class started.  I include it here with her permission to highlight the range of hues in certainty when taking the leap to pursue an advanced degree.

"The elation I felt after sending off my essay and having my interview for grad school quickly fell away. I was excited for a few weeks. Onward to new adventures! Tally ho! I am on my way! But after the excitement fell away and I didn't have an answer to, "So, what are you going to DO with your degree?" Why must SO MANY people ask this question? The luster wore off. Following the loss of excitement, full-fledged indifference took hold of me. What WILL I do with this degree? Why am I spending so much money on this…right now? Insanity!
My decidedness about this program promising to provide a lens of holistic reasoning that could be applied in any future role I serve…suddenly felt empty and flimsy. I was nearing my grad school orientation day. It had been on the calendar for two months. It was placed there with such anticipation, excitement, and promise. Now it sat looming as another thing to do. Orientation was another task to complete before I was able to move along to the next thing on the to-do list. In the two to three weeks preceding orientation, I had decided that I would defer my enrollment by a year. I had misgivings, worries. What if the other program at the other university was a better fit for what I envisioned? What if this truly was the worst time EVER to launch into such a big endeavor? Instead of the excitement, wonder and vision of what lie ahead, I was really feeling like this was a chore, and a bad one at that.
In the week preceding orientation, things were crazy at home, further propelling me to decide this was the worst decision ever, capped off with my 12 year old declaring with indignation the night before orientation, "WHAT? You are going back to school? You are NEVER home already!" Her assertion confirmed all of my doubts. I explained that I was going to go to orientation and we would decide after that. So, I set out to pack myself up, listen to what the nice people had to say, and then find the necessary people to defer my enrollment.
On the morning of orientation, unbeknownst to me, seemingly EVERY FREEWAY in Minneapolis had a detour, I was in fact CERTAIN that God was confirming my thoughts. This was NOT the time to go back to school. I arrived on campus late. You don't know me, but I am never late. Never. Being late just felt like another sign of this not being the right time to embark upon another adventure in an already-full life and schedule.
It was within moments of sitting down that I felt the familiar comfort of being "back to school". I was surrounded by like-minded women, (albeit younger women), and a few men. I spent two hours listening to volumes of information, offerings of the University and the amazing potential that was ahead of me. Halfway through the day we split off with our cohort groups to hear about our specific programs.
Those 2.5 hours were amazing. From the beautiful space in which we met, to the incredible energy generated by those of us who gathered together. The panel of professors shared about themselves, the program, and what to expect in the years to come. We all introduced ourselves and I was astounded by the variety of professions represented in this small space! I was surprised to learn there were only 3 RNs in this group of 22. The energy, excitement, and wonder were palpable. As we all talked and listened -- it was most reassuring to learn that not many of those around me had an answer to, "So, what are you going to do with this degree?" Even those on the student panel had no idea what they were going to do. All felt firm the path would open before them when the time was right. Their unwavering confidence and positivity about the path ahead made me more excited and confident than ever. This was the path for me! Right now. I knew after spending the time in that space, and in that company, that I was setting off on a course I couldn't quite see...but I knew it was right for me."

Tanya Ingvaldson is a NICU nurse, a mother, a daughter, a wife, a friend, and a graduate student.  Go, Tanya!  -TheRN

Thank you to Penny Peterson, MSN, RN, for jotting and sharing these reflections on her journey home from her service adventure.

"As I make my journey to home I am reflecting on the plane about my time spent in Guatemala. I am wondering what change it may make in the trajectory of my life. It is only fitting that as I reflect, I am reading the Creative Nursing journal given to me by my dear friend Natalie Lu as I departed on my journey. The journal speaks about many things, but the focus of this publication is Social Justice and Nursing. It provided more food for thought as I began my journey home.
I went to Guatemala to do a site visit to Mayan Families in Panajachel. The hope is that this will become a place to bring students during a Global Health class. I could never have imagined the poverty and the need of the people of Guatemala before visiting the area of Panajachel. According to Watson (2008) 60% of the people of this world live on 6% of the income. This is ever so evident in the region of Panajachel. I could never have imagined people living in places with a dirt floor and a leaking tin roof. The water (if there is water in the home) is contaminated with parasites. Watson spoke about holding other's lives in our hands and caring for humans when their survival is threatened. This we must do while having respect for another human being.
So a question to me personally is how can I make a difference? I began by co-sponsoring a student with another faculty that joined me on this journey through Mayanfamilies.org. When we met him and his family we brought a food basket and a water filter so they have clean water to drink. While these were wonderful gestures, it is not enough to do these things and walk away. Mayan Families works to develop programs that can be sustained and empower people through education. My thoughts right now are trying to figure out how I can help them in that mission."
Watson, J. (2008). Social justice and human caring: A model of caring science as a hopeful paradigm for moral justice for humanity. Creative Nursing: A Journal of Values, Issues, Experience & Collaboration, 14(2), 54-61.

Travel bug, anyone?  The gateway to summer has opened.  Plans, maps, and visions for escape are unfolding in preparation for one of the hottest vacation periods of the year.

Penny's poolside postcard from Panajachel.
Penny's poolside postcard from Panajachel

An eyeful of images from a friend's trip to another spot on the globe is all it takes to spark an urge to fly, to inspire the pondering of our personal borders, and to double-check our passports to ensure they are ready when we are if the travel bug bites.

Antigua, Guatemala
Antigua, Guatemala

A new road has risen to meet the armchair traveler in light of social media, phone technology, and the internet.  My cherished scrapbooks are adorned with paper postcards from places that piqued my interest by way of others' travels.  This week, my friend and nurse-colleague Penny upped the postcard-ante by bringing her postcard moments to life from Panajachel, a town in the Southwestern Guatemalan Highlands near Antigua, and about 90 miles from Guatemala City.  On most days this week, Penny and I have poured over the details of her Guatemalan adventure via Facebook messenger.  The live chats over our morning coffee and evening tea have inspired my heart's desire to get going on a service trip again...best I check my passport, now.

Some 14 years ago, while serving as a volunteer coordinator for the pediatric hospital where I work today as a nurse, I started planning a volunteer trip of my own to Tutova, a small Romanian town that is home to Tutova Hospital.  By way of Global Volunteers, a local tour operator for volunteer vacations, I partnered with a GV volunteer coordinator to travel with a group of hospital volunteers, nurses, and support staff to embark upon a two-week Adventure in Service.  Following a brown-bag lunch hosted by the volunteer services department to promote this trip, the overwhelming interest from staff filled not one, but two trips during that calendar year.  Fast forward a couple years, and the organizational demand to offer more opportunities for this kind of affiliate volunteer travel paved Adventures in Service to Ecuador, and later to Brazil.

Taking flight for Romania in 2002 with a group from Children's Hospitals and Clinics of Minnesota
Taking flight for Romania in 2002 with a group from Children's Hospitals and Clinics of Minnesota

My postcard chats with Penny this week inspired me to dust off my photo albums from these volunteer trips, and from service trips I did with Habitat for Humanity back in my college days.  I even turned up this little You Tube gem, an interview I did with Alix Kendall on Fox 9 Morning News about the trips I helped coordinate and served on in Romania and Ecuador.

Nurses volunteering in Romania
Some traveling volunteers teased that there was plenty of room in their suitcase for our new Romanian friends

Looking back over these memories, I am hit with the same sense of wonder I experienced on flights (or bus trips!) back from faraway places.  I wondered, what do I do now that I know about the need that exists in...(insert any locale of any service trip host, here).  Today, I'm as eager to explore this wonder with those of you who have been bit by a similar travel bug...what do we do with the exposures we've had  in service travel?

Penny and her nurse colleagues Cindy and Mary meet with staff at Mayan Families to set the course for their week of volunteering and plans for future visits
Penny and her nurse colleagues Cindy and Mary meet with staff at Mayan Families to plan for their week of volunteering and for potential future visits

I asked my friend Penny to expand on the postcard thoughts we exchanged during her trip to Panajachel.  Volunteering her nursing skills in this faraway place has fueled some new aspirations.  Come back to the blog next month to hear how Penny plans to further propel her answer to the call she heard from this community in Guatemala.

You can learn more about the host organization for Penny's volunteer trip at: www.mayanfamilies.org

You can even volunteer resources to this Guatemalan community from your armchair.

A favorite memory from my 2002 trip to Tutova Hospital's failure to thrive clinic, rocking this sweet one to sleep each day for naptime
A favorite memory from my 2002 trip to Tutova Hospital's failure to thrive clinic, rocking this sweet one to sleep each day for nap time

If you have reflections on how travel has impacted your vision for your place in this world, I'd love to hear them here.  If you've always dreamed of going on a volunteer vacation, tell us where you would like to go with this vision.  This space is yours to reflect.



Over half my middle-aged life ago, I was gifted a copy of a poem with the title, "Man in the Glass".  I was a freshman in college trying to sort out who I was becoming, what I wanted to major in, and what motivated my impressionable sense of self.  Homesick for the identity I felt graduating high school, I burned through calling cards (that was a thing when I was in college) with a cherished gal-pal from my hometown.  We were on campuses separated by hundreds of miles and a state line.  But we called 'home' the same place, and we held up the mirror for each other in those marathon phone dates to reflect on who we were becoming in our respective new contexts. ...continue reading Reflection in Practice