Oscillation Continues

I'm working a lot right now.  Switching from thirty-six hours a week to forty is a bit of a change.  Okay, so technically I tend to get out early on Fridays, but I've also still been picking up on my old unit, meaning that once a pay period I pick up a twelve-hour shift on the medical floor.  Even though the days are technically shorter, there are more days out of the week that are worked.

It's a lot.  AND I like the variety and keeping those skills that I worked hard to build sharp and ready.  There are ways where I feel that doing those shifts sporadically makes me a better nurse, that I'm not so worn down by alarms that I can treat them with fresh eyes when I see them, even provide rest to the team by shouldering the load.  I am also tired.  These both exist in the same space.

I have not figured out writing time yet.  I don't have a pattern for walks with Luna again.  There are books I want to read.  I have not figured out when to get back to the pool yet with any consistency.  I am still averaging at least one climbing night and one cardio activity a week, but I miss immersion and taking that time to swim a mile.  The hardest part is eternally just getting to the damn gym.  In other words, there is more honing to do on solidifying a rest schedule, returning to those activities that help me find best balance.  

My outside of work attention has been spent in attempting to iron out how to do appointment scheduling primarily--these pieces were triaged higher.  Figuring out the new order of appointments or switching care providers to fit with the new schedule, it's taken some intentionality and emotional space.  That means, though, that there are spaces where the body has to play catch-up, and it is no longer asking.  And it's time to disassociate on the couch for a while or forcibly hug your pet or channel your inner Ren.  

RAGE-DANCE TIME

The pendulum oscillates wildly until it finds a center again.  I feel like I'm out of the wide swings, taking a smaller arc but still moving, kissing the center space and moving just out of reach again.  And that's okay.  Frustrating, but okay.  

In the meanwhile, I'm enjoying the work I'm doing.  I'm enjoying the people I work with.  I feel fulfilled professionally.  I'm climbing 5.10s in the silos.  I am working on a new trick to teach Luna.  I am planning new adventures that are a few months out.  I am slowly reconnecting with a few folks at a time.  

The world continues on.

Fledgling Nurse, Part 14: Closure

I am fully out of orientation at my new job!  So while I'm reveling in how I don't have a phone with me over the course of the whole day that keeps ringing incessantly with necessary but still endless demands on my time and attention, I immediately noticed a huge difference between this role and my previous one.  I had a discussion with it one day with some nursing students back on my old floor.  Hell, I've even written about it already.  It's not something that's said explicitly in nursing school:  when patients discharge from the inpatient setting, they go off into the ether.  I have no idea what happens to them, unless they're readmitted.  I only know where we sent them last, not if they have improved or declined or followed anything that we have instructed at all.  There's simply void.  

I'm not entitled to know the conclusion.  In fact, I cannot legally get into their record to find out anything about their continued care from here, even if they remained in the hospital.  The most I can do is check the obituaries for any familiar names.  There is no closure.

Now the ambulatory patient world, this is a different beast.  I have patients that come into the clinic three times a week for multiple weeks, months even.  Even since I started at the end of November, there are patients that I have been getting to know (for better or worse) and that are getting to know me (ditto).  I can see their wound improve or worsen, celebrating or mourning with them in turn.  We see steps in the journey together; we talk about how adhering to the plan is going; we discuss how to work their care around life events and vacations.  

I can see progress.  I have packed and placed the same wound vac on some people multiple times, watching as it steadily shrinks, a nine-centimeter problem shrinking to five and one and a half and then in such a way that it cannot be stuffed any longer.  I can release them from care knowing a portion of that conclusion and that they know where to find us if anything new comes up.  It's rewarding, to see something tangible change and have a small part in it.  I have a role where I couch, guide, wrap, teach, correct, encourage, and see what happens.  I have people with chronic issues that we can bound over, finding mutual empathy in that shared space.  

There are spaces where there is grieving about that chronic issue when progress feels too slow.  There are times when I cannot force someone to take care of themselves.  There are times when despite everyone's best efforts, amputation is the best option.  These exist, too.  

And then there are days where we ring a literal bell specifically for this purpose and cheer and clap to celebrate healing.  

In short, I am liking my new job.

Commute

When I was considering the transfer from Bromenn to Carle Foundation Hospital, there was one resounding question:  what about the commute?

Bromenn is a whole six minutes from my house--the car scarcely has time to warm up.  I actually could bike to work if I felt inclined.  It's nice.  I could forget something at home and know that I could dart home over a break and pick it up.  I hadn't bothered to look much at the weather, even.  At most, I was vaguely aware of the weather to offer our home to anyone that needed to travel a longer distance.  Ultimately, there would be enough people talking about upcoming weather at work or in other outlets that I could plan the small difference of time to start and scrape the car.  

Well, there is more to consider for a fifty-mile drive.  I've been working through the calculations on timing for when the weather turns gross.  I have backup plans for when the weather is very gross.  I have managers who think ahead and get patients rescheduled so we don't have to come in on those very gross days at all, as proved by the pre-Christmas storm warning response.  

There are times when I really would rather be checking something on my phone or completing a task I could do if someone else was driving.  Driving into the sun both ways also has its challenges.  But there are also times when it's...nice, for different reasons.  I sip my breakfast and pick an album to listen to that I haven't heard in an age.  I've left the radio off and let my mind simply wander for a bit, process and decompress.  I've restarted the Welcome to Night Vale podcast and am revisiting those spaces.  I have made many catch-up calls on the drive home, enjoying a reconnecting space.  

And I have seen many lovely sunrises.

Yes, the photo is a repeat
But it was still a gorgeous morning

The twelve-hour workdays resonated well with me, so I do miss that, and on the other hand I am (now that the holidays are over) starting to find an actual pattern again, which was not something afforded to me by that schedule.  I'm rearranging how I approach appointments, which will take some figuring, but I have been able to figure it out before on an eight-to-five-Monday-through-Friday pattern.  

I'm in the malleable part of the process, testing what patterns might serve me best and slowly adding in new pieces again.  There is no normal yet, but there will be.  And then there will be healthy deviations from that normal.  

It's good to take advantage of that space and simply enjoy the drive.

Mandatory End of Year Reflection, 2022 (A Peterson Family Update)

So, yes, I have fallen off of the face of the earth lately and hadn't posted any blogs for all of December to this point.  I haven't figured out a writing schedule with my new position as of yet, particularly with the extra frills of the holiday season.  

It's been another eventful year.

The new view on my way to work

On Loss

Grandma Peterson died last year, the first of Andy's four grandparents to pass.  Given the vaccination status of some family members, I was not able to attend the funeral without risk to myself (as an immunocompromised person) nor my patients, tangentially.  This was its own source of grief, to emphasize that one of the loudest lessons I've learned through the course of the ongoing pandemic is that many people would not do the bare minimum to keep others safe, even others that would actively drill holes in their own lifeboat in the name of selfish freedom.  I have seen firsthand what the long-term effects of COVID can look like in the hospital setting and have no need to roll the dice there, subsequently meaning that I have less guilt in removing myself physically from certain situations and interactions.  It's a complicated grief, all the same.

Additionally, Andy and I have two other grandparents with waning health--there is an anticipatory grief in these circumstances, a quiet preparation for eventualities.  For my last remaining grandparent, my mother and I have had frank, clinical conversations on what pattern we see happening, acknowledging that knowing is both comforting and not.  These thoughts linger in the back of my mind, quietly simmering as I see other patients enact the same process in the hospital setting or in the occasional family mass text update.  

Certainly, though, the most significant upheaval in our home this year was when Andy was let go at Rivian.  There are still moments when it catches us, where we go "why Andy, of all people?" who proselytized Rivian with enthusiasm and joy.  But it happened.  And the logistics had to be addressed, allowing space for the emotional components to process.  There was a lot to think about, including (but not limited to) household needs, identity, and the health insurance we had been getting through the company.  

That last one in particular, I have been running orange for a while, just a gentle shove away from red-overwhelm on my internal status bar, watching the internal rpms of my brain and body rev to some dangerous sounds.  It is not healthy to run the system at that degree of stress for a long period of time, but I could not be settled until we were settled with specifics on insurance.  Now with a plan set in place, the system is still in the yellow until I see the household figures after the first month, but yellow is at least edging back toward a healthier green.  The survival voices have been loud the last few months, and the great injustice of how expensive I am to keep alive because of a disease that is not my fault, well, it's galling to say the least.  There is more grief here than I know what to do with, especially knowing how proactive I am toward my health.  There is no moral failing in having a human body that needs care.  There is a terrible moral failing in taking advantage of that to profit oneself.  

In short, we started the year as DINKs with a clear plan on a relatively viable (for this country) healthcare plan and our financial and personal goals laid out.  We end it still sorting some pieces out, having lost a degree of security in that upheaval.  My experience with the unknown means that we have had strong safety nets that have held us above immediate danger, but there is a degree of bitterness in needing to use them.  

Nothing is wrong with Andy's leg!
He's a good sport for letting me practice.

On New Adventures

So, we actually paid off the Rivian this year.  That's some crazy shit, yo.  We are Millennial Unicorns.  Our remaining debt is my nursing school student loans and our mortgage.  Depending how the student loan forgiveness elements shake out, we could potentially pay off my student loans by the end of the year.  Comparing to where we started our marriage to where we are now, it's extraordinary to see the progress we've made.  

We've had some great adventures this year, including a family vacation to Pigeon Forge, a few trips to the Twin Cities to hang out Josh and Morgan to seem them in different productions, an adventure to the Wisconsin Dells around my birthday (involving an escape room, axe throwing, and Wizard Quest), and a couples trip down to St. Louis to hit all of the Upper Limits gyms that direction.

Ah, yes, we started rock climbing this year.  Hard to believe we've only been doing that since May.  Andy--who never does things halfway--has been especially taken with it.  After a cooling period post-Rivian, Andy now works at Upper Limits.  I've been envious of the opportunity he has to climb, certainly, but delight in his excitement and my own milestones.  He's finding his footing.  

The increased exercise has done Andy a lot of good; I have also found a nutritionist and have made some good strides there.  It's been very gratifying to see some physical results of our mutual progress.

And because we cannot do household upheavals one-at-a-time, I switched from inpatient to ambulatory nursing working at the Wound Healing Center.  I'll have some further specifics on the new job in some upcoming blogs, but the short version for the moment is that I am delighting in expressing nursing in some of the ways I specifically went to nursing school for.  I still have one foot in the inpatient world and the relationships I've made there, and simultaneously I'm finding a groove in my new place.  Now that I've been a nurse for over a year, I'm simply amazed at how much I've grown and learned in that time, what tricks and processes I've learned in that time, how I've solidified setting boundaries, and so many unquantifiable workflows I've refined in growing my professional practice.  There is a rightness here.  

Mike started a new adventure, too, working toward radiology at Heartland, seeing his preparation pay off in completing his first set of required classes.  It's been fun talking biology with him, to share those spaces and even a couple of my textbooks.  

On Continuing Adventures

Luna is still and adorable little derp.  That's a beautiful constant at the moment.

We had to delay our Iceland trip originally planned for the beginning of December.  We probably could have made it work, but in retrospect it would not have laid nicely with my orientation to my new position--when we were juggling many things, it was a ball we could put down for now.  We'll be looking at doing that at some point in the next year.  

I had a wild hair the other day and bought hockey tickets for a Blues v Blackhawks game in January--looking forward to that mini-break already.  I have some additional ideas for upcoming hijinks but also finding the odd joy in being able to do weekend things, too.

As I've been continuing to think about the ridiculous amount of money that we spend to keep me alive in this country, I also cannot help but continue to think about leaving it for another one, finding what steps it might take to do that.  There's a lot to think about here.  

And Where it Leads Us

There was a lot of growth this year in unexpected places.  And all of it was certainly in that feeling of "becoming."  This year, I look forward to "becoming more."  Specifically, I would want for our household to work on becoming more of whom we are meant to be.  The three of us are in different transition states--I'm excited to think about what that can look like in another few months.  When I have my feet fully underneath me at the Wound Clinic, how will I move in that space?  How will Andy inspire his team and improve in his climbing?  How will Mike express his new learning spaces and enjoy the clinical time in the program?  

What new elements of self will we all discover in the process?  

So I approach the new year with optimism and curiosity, ready to probe some of those spaces.  ...And to find a new pattern for writing again.

Transition State

How's the new job going?  Great question!  Glad I pretended you asked.

Originally, I was supposed to start my new position at the wound clinic Thanksgiving week.  It happened that there were a few courses I needed to complete first before I would be allowed to work with patients--the way that timing worked in this case, I suggested that I take off the rest of the days during Thanksgiving week and then start with the classes the subsequent week.

So on the one hand, yay, surprise vacation!  On the other, well, the existential dread starts to creep in.  I get confused with time off and a little bit paralyzed with how to fill it.  When Andy was let go from Rivian, I was insistent, probably to the point of annoyance, that he take time to simple be and process the change and the grief.  I am shit at taking my own advice in these places.  

I've worked on the inpatient side of things, been a medical floor nurse for a year and some change now.  I have learned a ridiculous amount of things in this time, delighted in teaching the nursing students that came through in particular, and shared in many, many stories with peers.  There is a particular kind of grief in leaving that behind.  I have been avoiding processing it, for multiple reasons.  I am curious to see how I might process it given a bit more temporal space.  

And at the same time, I've got that roiling excitement and anxiety about starting the new position.  Hammering out the little details of when the first day is and logins and lockers and starting those new relationships on the best impression possible.  I think I've prepared just about everything I can:  we're simply in the waiting phases.  

Waiting is not a passive thing.  Waiting is active.  Most every piece of preparation that can be done has been done.  It's time to let things happen and absorb all of that I can.  I am going to continue to be unsettled for a while now, and that is okay.  Expected, even.  And in the same breath, I know that my body does not sort out "excitement" and "danger" correctly sometimes.  There's a lot happening in our lives right now.  And it's okay to let that be.  I am feeling anxiety, but I am not my anxiety.  In the same breath, I'm certain that we'll work out all the kinks as we go.  Through all of those acknowledgements, it occurs to me that it is time to take that advice, to greet those parts of myself and name them.  

It's another period of transition and transformation.

...and before I can even gather those thoughts together, the week is done.  I've had my first full day shadowing and am just beginning to see the flow of the floor.  I'm trying to absorb EVERYTHING.  And it's exciting, and my brain hurts.  I'm also trying to get to know my new peers and to not be the "well, at my old job, we did it X way" person while also acknowledging that that is my basis for comparison.  This expression of nursing is different, has a different pace and utilizes different skills.  I have so much to learn.  

I feel uncertain in my steps but confident in my direction.  And that's not nothing.

All the THINGS

I've been working on processing a particular kind of grief lately.  

I froze to death and drowned quite a
few times with this one

When I read choose-you-own-adventure books growing up, I wanted to know all the possible outcomes, which lead to some very complex book-holding techniques as I had different fingers in past major decisions so that I could go back to them when I hit another dead-end.  Significant early decisions were granted a slip of paper for the next read-through.  Certain page numbers became recognizable as I flipped through again, fingers contorted in strands of plots and pages. 

I love learning.  When I meet people, it's something that sits in the back of my mind, wondering what kinds of new things they can teach me, what niche subject they are quietly passionate about until someone asks the right question.  And by listening, I learned a lot of random things over time.  Sometimes only enough to ask halfway intelligent questions; other times building off of past conversations.  

This made the idea of choosing a career very daunting.  In choosing a college, I knew I found the right place when they didn't bat an eye when I said I wanted to double major in biology and creative writing.  It was important to at least keep learning a vast breadth of things while sorting out the larger questions.  I remember hearing "Jack of all trades; master of none," and feeling the gentle censure, that I should knuckle down into a specialty of knowledge or skill.  But then I heard the rest of the phrase that is commonly left off:  "but better than being a master of one."  

All of this to say I'm processing a degree of grief at the moment in changing positions that I've been struggling to find a way to articulate.  This is my last full week on my floor.  Naturally, I think of my favorite workmates first when leaving a job--I will miss seeing and supporting a number of people on and adjacent to MOSU.  And I'm also frustrated that I'm leaving after I've been finding such a good groove lately.  I enjoy working with students.  I have almost all of my assessments done before ten-thirty each shift, usually two or three done before eight-fifteen.  I am learning how to pay attention to clues on when someone is ramping up on both pain and anxiety and preempting those spaces, setting better boundaries.  

It seems a terrible time to leave, when I feel like I'm coming into my own.  I have had a couple people tell me that I would be a good charge nurse, and I think at its right time I would enjoy it, finding ways I can support my peers.  

And in the same breath, I am immensely excited to start working with wounds, to learn all the nuances and tricks in this expression of nursing.  

I grieve that I cannot do everything.  There is simply not enough time to do everything.  And that is a particular kind of grief.  There are so many things I could do, and even things I could be good at:  I have to choose.  And I'm happy with my choice, but also am sad to leave things behind.  They exist in the same space.  My plan is to keep a foot in the inpatient world by picking up occasional shifts on my old floor, a beautiful intermediate and merging of worlds, and yet I know this won't be the same as it was before.  

There isn't enough time in life to do everything.  I have to choose how I want to spend it best I can.  I have pulled the metaphorical strips of paper out of the choose-your-own-adventure book on some past decisions, choosing to hold the book in such a way that gives my full attention to the pages I'm currently reading.  There is a grief, but there is also a particular kind of wonder in accepting the present whole-heartedly.  I want to find the best way to honor my transitions grief, while also acknowledging this side frustration of limited time on earth and the impermanence of existence.  

There is not enough time in life to do everything.  And that's okay.  

Dichotomous Thinking

I am not a fan of absolute statements.  There are a few absolutes out there, but there are a lot of things that have exceptions.  I like to leave space for those.  This frustrates Andy to no end when he's trying to get an answer out of me.  He'll ask me if we can do X or Y tonight and I'll reply with something akin to "most likely," not because I'm trying to be coy but because I cannot predict the future to know if some emergency will pop up or if either of us will run out of energy by that point or whatever else.  Sometimes, these are exercises in abstract thinking, I confess, trying to find the obscure reason why something is/isn't or will/won't, as my dedication to the idea continues and just the way my imagination works.  More often, though, it's about that space, leaving room for deviations and exceptions.

Consequently, when I hear someone use "this person ALWAYS/NEVER does X" or "people are either Y or Z" without acknowledging even backhandedly that there are other choices and shades of grey out there, I tend to feel a degree of doubt creep in around that speaker and their assertions.  Sometimes it's a sliver of doubt; sometimes it's a hefty helping of doubt, depending on the context.  

The world is richer in greys than it is in black and white.  Subtle value adds depth, adds meaning, when viewing the full picture.  

But we like our false dichotomies.  "If you're not with us, you're against us;" "my side or their side;" "democrat or republican;" "dog person or cat person."  These are easy.  They are comfortable.  We like patterns as humans, things that help us quickly put situations and people in boxes.  These don't serve us in all situations.  In fact, they are counterproductive in many.  We lose that value, that depth, and often someone's humanity in those spaces.  

There is a difference between a declarative statement and an absolute, and there are places where they can be confused.  An observation of the moment or circumstance can have a declaration.  If it then becomes something permanent, that it is the only way or generalized to all circumstances, that's where we negate other possibilities and create a false perception.  

I want to be precise in my language, which sometimes means I fail at being concise--I'm working on this.  Sometimes, I feel a rewording or adding in the full scene is helpful but respect that the recipient may hold a different opinion.  Ultimately, leaving space also furthers honesty, attempting to be more transparent by acknowledging the edges.  It is meant to further clarity, assert sincerity, rather than muddy the waters, though I know that's not always the impact.  

I tell my patients that I know better than to speak many absolutes in my field, when they are trying to pin my down on answers about timing or why their doctor is doing X or what will happen after Z.  I tell Andy a percentage when I don't feel I can give an authentic, firm yes or no.  And I tell myself that keeping a space for new ideas means that I can continue to grow and find those different perspectives.