goal update

Goal update :)

Respect - for others, for myself, demand respect from others for myself, boundaries

• I have always demanded respect for myself.  My difficulty is communicating this to others without emotion or just avoiding all together.  As you can see in my earlier post, I am still working on this.

Meaningful work - putting my heart and soul into my profession

• I am so excited!  I stepped up and volunteered to create the poster for our Nurses Day Celebration!  I'll post a pic as soon as it is complete.

 

Relationships - family, friends, co-workers, acquaintances

•  Meeting up with friends or family once a week.  I have been so neglectful of my friends, especially during this past year with school and surgery.  Had lunch with a high school friend last week, painting with an old friend the week before (you've seen my koi!), another lunch date this week.  I really missed my time with friends and really appreciate their friendship.

 

 

 Fun - creativity, humor, child-like

 

• Have you ever been to Teatro Zinzanni??  Fun and child-like!!!with feathers in our hair!  This is my friend for 28 years - love her!

 Growth - physically and personally including education, spiritual and reflective 

• Let me see.....oh, ya - BSN program at UWB!!!  I love school!  I plan to take the Spanish for Health Care Workers during winter quarter at EvCC.  Spiritual - meditating (or trying to..) by doing the 20-breath countdown.  Reflective.....this one is a process!
  

Update on the Koi.......they still don't look like fish!!!  I found myself becoming so frustrated with my lack of ability to paint the darn tails!!!!  I think I'll switch to painting flowers.  I set my expectations way too high.  but it's OK - I can just move on :)

This is my first attempt!  koi on crack.....

the tail is looking better....

fat fish - bad tail!

double koi

not quite done but I am frustrated in the tails so I"m going back to flowers

So I've learned that being creative can also be frustrating.  I have a habit of setting high expectations for myself - this might be a nurse thing, we are all high achievers - but am learning to laugh it off.  Just look at those tails!  funny!

more reflection...

so I thought I had it down....fierce conversation and such.  you do know that I would rather cut my arm off than confront anyone.  I rationalize that it is OK to lose a friendship rather than confront.  I have always been the peacekeeper - we don't do that....that confronting thing.  It's much better to stuff your anger and let it eat away at you. 

Here's what happened....

I have been working on a poster project for work, based on an EBP in nursing.  I chose the CAM tool for delirium.  Now I have been printing journal articles, reading them, highlighting the stuff I want to present, spending a lot of my spare time on this project.  I had the poster pretty much completed when I asked our CNS in psych if she had any graphics I could add.  Well - she got really excited about my poster (that I had been working on for ~6 weeks) and said things like "I want to add....", and "we should put in....".  I was stunned!  but rather than using my fierce conversation skills, I meekly (I know, me meek!!) said I'd "see if it would fit on the poster" and I would "look into it".  Inside I was feeling threatened - I wanted to just give up on the project.


I submitted the poster this morning.  She called me in the afternoon asking how "our" project was coming along.   We had a conversation.  


Here's what happened....

I went to the CNS asking for help.  She was excited that a nurse was presenting psych stuff and was eager to help.  She offered suggestions she thought would really help my project.  I didn't object so she thought we were a team.  When she found out I had submitted the poster without sharing with her, she was hurt.  We had a conversation.




So....here I've been thinking about how to make this right.  You do know that we have "do-overs" in life?  You just say - "remember when ________?  Well, I want a do-over".  and you make it right.  I will make it right.  I really value our friendship.


on a side note....for my creative goal I am painting a Koi a day for seven days.  


they don't look quite like fish yet.....
 

Reflecting using Gibbs....

I think I'm a good nurse. I have clinical experience, new nurses come to me for advise. I think I learn from my mistakes. I think I am forever learning. Let's see....

A couple years ago I had had a patient named "Glen" who was developmentally disabled.  Glen was in his mid-40's and was admitted for CAP - community acquired pneumonia.  Glen arrived on our floor mid-morning, O2 via NC at 2L, able to communicate and make his needs known.  Glen had a foley catheter in place and was complaining that it hurt “real bad”. I got an order for topical lidocain, hoping for some relief. Nothing helped. Glen kept complaining, louder and louder. I called the wound care nurse for a bedside consult to see if there was anything else we could do. She noticed that Glen wasn't circumcised and his foreskin had not been pulled back into place. She tried to put it back, the charge nurse tried, I tried. Nothing. I investigated and found that the ER nurses had tried unsuccessfully many times to place the foley and ended up calling in a urologist to place the catheter. He hadn't replaced the foreskin. I made a phone call to him, furious, and explained the situation. He seemed uninterested. I left work that day feeling like a failure. My patient had spent the day in miserable pain, ending with an emergency circumcision.



A year later, it happened again. I had a patient, “Joe”, admitted for a somewhat emergent fem-fem bypass. Joe was an alcoholic on the withdrawal protocol with Ativan on board. The NOC RN, a male, had placed the catheter the prior evening. When I came on shift in the morning, Joe was complaining that his catheter hurt 'real bad'. Flashbacks of my experience with Glen raced through my mind as I, somewhat angrily asked the male RN if the patient was circumcised or not. He said he “didn't remember”. Really? I thought – how can you not remember that? Especially coming from a male nurse. I was furious – again.



So here I am, dealing with a repeat situation – I should have learned from the first. Had I doubted the patient because he was dev delayed? I should have been able to recognize the fact that the patient wasn't circumcised but it really is had to tell. I should have questioned the need for the foley in Glen's case – for pneumonia??? In the second situation, I was furious! How could a male nurse not put the foreskin back in place after placing the catheter!!!!! And then tell me he didn't know? I should have learned from the first situation. I should have learned.



Advocate for the patient, believe the patient. Don't let my emotions dictate my actions. Act, don't re-act.



My anger and frustration came out so strongly with my interactions with the urologist and male nurse, no wonder they were immediately on the defensive. If I could do it over again, I would approach them possibly in the SBAR format – situation, background, assessment, recommendation. The outcome of the first incidence really influenced my behavior in the second.
What happened – lack of communication led to a man being unnecessarily circumcised. Lack of communication led to unnecessary pain and suffering for a patient already in pain, scared, facing surgery. Lack of a communication resulted in anger, resentment and disrespect between two colleagues that lasted several years.

goal #1

One of my goals is to discover, understand and live by my core values.  I have a work sheet that lists about 100 core values.  I circled the ones that I thought reflected my values and what I hold true, group values with similar meanings together into five groups and label each group with a value that encompasses the group.  This was really eye-opening!  Most of what I value has to do with meaningful work - maybe that's why I quit working at Boeing (making silly airplanes!) and went into nursing.  My next heavily represented category encompassed the values of loyalty, open and honesty, truth.  Pretty good - yes?  The remaining three categories are equally filled with relationship, creativity/fun and personal development - my other goals for this quarter.  I can now say I have my core values - and it's not that I didn't have them before, I just didn't have them in a structured way that I can define my actions by.  It's like having many pairs of black shoes in a big box and feeling disorganized and lost when you try to find a pair.  You know you have them but it's difficult to grab without sorting through the others.  Now I will tell you what my core values are....:) not in any particular order.....

Respect - for others, for myself, demand respect from others for myself, boundaries

Meaningful work - putting my heart and soul into my profession

Relationships - family, friends, co-workers, acquaintances

Fun - creativity, humor, child-like

Growth - physically and personally including education, spiritual and reflective 

OK - a bit of honesty here....I am starting to cry just looking at this list.  I feel like a huge weight has just been lifted off of me.  I have felt so much like a whirlwind in my mind, heart and life and I finally feel like I am finding my core and truth.

I think I'll go meditate for awhile!

Spring in my front yard brings me joy

Magnolia Tree - beautiful flowers, very large leaves that scatter everywhere

My absolute favorite flower - Peony - starts out spindly and freaky looking but you just wait...beauty is right around the corner!

Why is this so hard?  To bare my soul, to express my deep feelings, hopes, goals with a few people I trust?  I have thought and though about what to write here - not wanting to bore you, not wanting to reveal too much.  It's hard to focus on a goal when I am just treading water, trying to learn, work, raise children, keep my house in order, recovering from surgery.  But what an important assignment to undertake.

So....here they are, my goals:

Explore what my core values really are and, once revealed, live by them.

Live my true self, not dependent on the approval of others.

Re-discover my artistic side.

This will take a lot of self-reflection, self-discovery, letting go of old habits, learning new.  This will take distancing myself from unhealthy relationships and nurturing new relationships.  

Undertaking a new journey that will influence the rest of my life is both scarey and exhilarating.  Will you join me?