Specialization

 So I have had a few shifts in the hospital under my belt, now, with a week's worth of twelve hour shifts spread out over the course of the term.  As I've worked with different nurses, techs, and other team members on different floors, I like to ask how that individual landed on this particular area of nursing.  I've gotten some great stories.  Most notably, I spoke with a woman who had worked in the NICU (neonatal intensive care unit; very sick, very tiny babies) for thirty-some-odd years and could not imagine working anywhere else, for the highest high and the lowest lows.  There are others that landed where they did as a fluke, others that have moved from area to area, and some that came back.  

Sometimes, the conversation came back to me, the "well, do you know where you want to work?"  And I answer, "yes, I want to go into wound and ostomy care."  

The reactions that I get into this have fallen into a few groups:

• An air of gentle confusion, along the lines of "Oh, okay," or "Huh."  
• Outspoken confusion and/or surprise, along the lines of "Why would you want to do that?" or "I guess it takes all sorts!"
• Generally encouraging, focusing on the ability to find a position, "Oh, you'll always have something to do."  

Whether or not someone asks why, I usually follow up with some variant of "I have a permanent colostomy myself, and I want to be with people who are making that transition, to have compassion by identification."  At this point, then, the response is almost always something much warmer, along the lines of "Oh, that makes so much sense."  Then there's support, that having someone with first-hand experience will be invaluable to these future patients.  Occasionally, there is an additional acknowledgement of "yeah, no, I could never do that, but I know there are people who don't want to do this."  

I don't think I had quite realized how much specialization was available in this career.  I knew logically that there were many, many ways where I could take a nursing license, but to work with midwife nurses, for example, and see how their skillset plays in to their role, the specialization of the knowledge that they have to their area is fascinating.  What was "normal" to the NICU nurse compared to the the main floor that I had been working with, there were many different approaches to their patients, their situations, and their resources.  The range of approaches has been vastly fascinating.  I know that in time persons will look to me for different kinds of knowledge, and there will be places where I will only have the exposure that I've had in clinicals and others where I work with it on a daily basis, where I can inform and educate more fully.  I'm aiming to absorb as much as I can to help as many as I can, which puts an interesting pressure on each experience time.  

Many more people to meet; many more experiences to take in.  

Open Letter to Trump Supporters

I had a situation that happened recently that caused me some cognitive dissonance, and otherwise it gave me an important place to put-up or shut-up.  

A friend of mine and I got into an interesting vein of conversation.  I was feeling very uncomfortable with parts of their verbage, that they were embracing a philosophy that views a group of people (specifically women) as a lesser, as a commodity rather than as living, breathing persons with feelings.  After a brief pause, I found some words, stating that these were dangerous ideologies, that the consequences of which have emotionally and physically hurt people (I could easily pull evidence for this in a quick search).  I did not want this person to fall into these ideologies, particularly if it was out of ignorance, and offered that I had the vocabulary to discuss it.  They doubled-down, insisting that it wasn't "bad," and I was judgmental for saying such.  

I can understand parts of that response, that there's a defensiveness that can kick in when someone points out something that you believe, have done, or otherwise conforms to your bias is "wrong," but discomfort doesn't make that wrong thing suddenly not wrong nor does it free you from the consequences.  No one wants to be at fault nor feel the ramifications or implications of they might have done accidently or otherwise--it's embarrassing and difficult to work through--but I respect persons immensely that can hear what I have to say, apologize where needed, and genuinely seem to think about it.  I hold people in my life accountable.  When certain lines are crossed, friends and family members have been told about it.  I have friends and family that hold me accountable, too, and I can feel guilt/shame/whathaveyou in the moment, but I still listen and think about what they have told me.  

I need to be more specific about parts of this accountability and better evaluate what some of my personal lines are.  Some lines are easy:  for example, I don't care what swear words someone uses, but I don't abide words that disparage a group of people, including Gypsy, Retard, gay used as a slur, the N-word, and others.  Some people accept the correction, even if only when I'm around; others double-down and gaslight, saying "oh, you're just too sensitive," trying to control how I feel about the situation rather than respect what I'm telling them I'm already feeling or take any culpability for their actions.  

Part of why this accountability is important to me is in knowing that many times people don't realize that they've hurt others until it is specifically brought up, that being angry with someone primarily because they didn't read my mind is patently unfair.  Additionally, the excuse of "well, no one told me it was wrong" or "why didn't you tell me?" is gone--that person has actively chosen their side at that point and can no longer claim ignorance as an easy out.  

...I think given the title of this post, we can all see where I'm going with this.  There is a saying, that the German people have a word for persons that eat at the same table as Nazis:  that word is "Nazi."  The same goes for racism, sexism, transphobia, homophobia, etc.  I want to make racism a lonely hobby.  I want to make homophobia a lonely hobby.  I want to make bigotry in any shape a lonely hobby.  I am willing to discuss if the discussion is from a place of genuine openness, but otherwise I will be putting some additional distance between myself and persons who are Trump supporters.  

Why?  Firstly, I signed petitions against Trump regarding his sexist and racist behavior long before he announced his run for presidency--these traits are not new revelations.  That's reason enough there.  He refused to condemn white supremacy at the first presidential debate recently as a fresher example.  Racism is systemic, subtly embedded into policies and mindsets until we begin to think of its hallmarks as "normal."  If we tolerate racism, we are racist.  I do not condone this behavior.  To pull in a Wesleyan tradition, "Do no harm" means more than not harming someone through our direct actions, but also ensuring that our inaction is not harming someone.  Silence will always benefit the oppressor.  A vote for Donald Trump hurts multiple demographic groups in different ways.

I have those that I love that are afraid of what the state of the country means to their marriages and their rights as members of the LGBTQIA+ community.  As I love those persons, I cannot be silent when they are threatened, when there is already discussion about reversing previous rulings on same-sex marriages.  A vote for Donald Trump hurts these persons directly.  

I have love for myself and others like me who have a chronic illness or will become sick at some point in their life (i.e. everybody).  The Affordable Care Act is back in the courts again now.  This could thrown millions of Americans off of healthcare in the middle of a pandemic.  If you have a pre-existing condition--such as, oh, lingering coronavirus symptoms--then you are guaranteed no protections without the ACA.  Also, healthcare costs are certain to rise when insurance companies and healthcare providers are less restricted in how they set prices.  I have MANY thoughts about the state of our current healthcare system as it stands (exhibit A, exhibit B, exhibit C):  while I know that Obamacare was not perfect, there are many important foundations that we need to continue to build upon and maintain the security of its presence in the interim.  A vote for Donald Trump hurts me directly.  

Gaslighting is all we're getting out of this administration, eroding our trust and understanding of our own reasoning skills.  This is psychologically damaging to all of us.  Here is an older but still unfortunately relevant article from Psychology Today that breaks down more of what that means.  Anyone who has been a victim of abuse (emotional, physical, or sexual) has likely been greatly triggered by the proliferation of the repeated lies, gaslighting, and all else.  A vote for Donald Trump contributes to your own emotional abuse.  

Yes, Donald Trump is a symptom and not the system himself, not instilling these problems necessarily, but allowing us to see the severity of the existing problems in greater focus, when allowed to run unchecked.  Sending a signal that these actions are not acceptable is important.  Choosing that we will no longer tolerate these immoralities is important.  A vote for Donald Trump extends and emboldens these problems.

Now, let's address an elephant in the room.  I know some persons considering voting for Donald Trump specifically with their eye toward the issue of abortion.  Mostly, I see these persons eager to see the dissolution of the Roe v Wade decision, as though this is the only way to possibly attack this concern.  This would eliminate abortion the same way that prohibition stopped alcoholism--it seems simple, but it would greatly increase the amount of unsafe abortions and therefore maternal death rates.  (Check out the highlights section of this document from the UN.)  If one truly wants to reduce the rates of abortion, then supporting education (including vasectomy), access to birth control, and bettering social safety (such as maternity leave, access to health services including screenings, etc.) are the more complicated but true answers.  These policies more frequently align with the democratic ticket.  In short, a vote for Donald Trump does not further the goal of reducing the rate of abortions.  

SO.  What does all this mean?  The short version is, please, as you love me, others, and people in your family, do not vote for Donald Trump.  I will also be retracting myself from persons who support Trump--no, I'm not disowning these persons over politics; I'm disowning these persons because of morality.  Politics are disagreements about the best way to zone the new park; questions about whether my gay friend is entitled to the same rights as someone else is a morality question.  We can argue about the best ice cream place in town; someone who thinks black lives aren't as important as white lives will be eating their ice cream without me.  

I don't take this lightly--it's going to be tough as we're approaching the holiday season.  I've been frustrated at myself for not posting something sooner.  There are going to be difficult choices.  I will disappoint some persons with this stance and persons that I did not expect will disappoint me.  Here's another portion of the Wesleyan tradition:  "Do all the good you can."  Not harming is not enough--a vacuum of "lack of injury" requires proactive steps to sift out the negative and replace it with a positive.  Love can still be there; love can look like holding someone accountable and letting them serve the consequences of their choices.  Love can also look like respecting yourself enough to distance oneself from hurtful persons, family or otherwise, intentionally harmful or otherwise.  I have to cultivate a healthy circle, mindful of the company I keep as a reflection of myself and where I want to grow.  I will still continue to recognize the humanity of persons that I may now exclude.  I wish those people well, and I am accessible for earnest discussion and rekindling down the road.  

The excuse of ignorance is no longer there.  If we're honest, it's been gone for a while now.  I have no idea whether folks will double-down from here or pause, but my silence would be doing both myself and others a disservice.

Please vote.  And please wear a mask.  

Compliments

I can have a hard time accepting compliments.  There is a pattern, though, where I find that I have an easier time accepting praise for what I've been mentally labeling "transient things."  Transient things--a fashion choice for the day or a clever move in a game--are small, chewable, a direct result of my recent choices; longer term pieces or elements that are more permanent to my character--adjectives like kind or witty or references to overarching ideas--I have had a hard time saying a simple "thank you" and instead reflexively resist them in some capacity.  I have worked on this with some some intentionality, but I am still at a place where if the praise is "too big" I'll deflect it.  I have gotten to a point, too, where I can recognize where that line of comfort is and choose to ignore it on occasion.  

I have not much assessed the why, why there are feelings of discomfort in accepting praise.  To some extent, it can be simple anxiety, a complex blah of "they're going to think I'm full of myself if I agree with them" and a whole swirl of overthinking that can come with it.  I don't want to get to a point where I become so full of myself that I take myself too seriously.  I am ridiculous in a number of ways, and I find that laughing at myself is a great source of enjoyment.  I find it gives me a good grounding as I grew and continue to grow in self-confidence, certain of who I am and what I'm about at the end of the day.  And yet, I still find that some of the things I like most about myself, when someone points them out, I have a hard time agreeing with the complimenter, downplaying the compliment or making a flippant joke.  As an example:  I was discussing some of my clinical experience with my therapist, particularly that I had the opportunity to pause and really talk to a couple of patients.  I talked to them about their emotional experience with where they were in the hospital.  More importantly, I took time to earnestly listen to them.  Both of them told me in their own words that I was well-suited to the nursing profession.  To my therapist, I expressed my wish that I hope I don't lose the humanity of my patients in the minutia of their care.  He then replied something to the effect that he recognized and honored my compassion.  Initially, I deflected it, that this was no big deal, basically.  Then I stopped myself, said "Actually, no, I don't have to fight you on that, and I agree with you.  Thank you."  

There is a part of me that is afraid of seeming egotistical.  I feel that most people wrestle with something similar but all of us to different degrees and in variance to how we may be feeling that day.  There may be some correlation in accepting a compliment with what degree of self-confidence is present in that moment.  On some level, one may need to feel good about themselves to accept that others appreciate things about them.  I like things about myself:  to what degree am I allowed to celebrate that?

Upon reflection, I have witnessed a swath of reactions to praise.  I have a few people in my acquaintance that cannot take compliments well, for different reasons.  Some are gracious and do not seem to be bothered, pleased to be acknowledged.  There have also been some persons in my life that deflected compliments as an underhanded way of asking for more attention, a means to procure additional praise.  There have been others where an individual's sense of self was not in a place to accept praise.  There have been some that were simply conditioned not to, even though they had a decent self-image.  I wish I could always tell these apart, but it doesn't necessarily matter--I want to continue to voice praise where I see it and not because of some outside pressure.  

What kind of outside pressure?  As an example, I've noticed a pattern people feel that if they receive a compliment, they have to give one in return.  I've been trying to stop this habit in myself unless I have something genuine to add.  I want my compliments to be sincere rather than generated out of necessity.  This is coupled with an objective to voice more of the positive things I think.  

In short, once again way too much overthinking into a small set of interactions, but it is so very fun to dissect those moments, to inspect our own wiring, training, and experiences.  How much is trained?  How much is cultural?  Which of these habits is worth changing?