When Patients Become Family

At home I hesitate.
At home I analyze.
At home I watch my back.

I've learned that Nursing is Nursing wherever you go.  To be put in a situation in which one can use the tools and knowledge that they have gained to provide care and compassion to another is virtually universal.  The manner in which an individual decides to disperse this knowledge and kindness however is enormously dependent upon the surroundings.

I think the hardest part about working in a hospital in the States is the fact that I am continuously looking over my shoulder.  I have been taught to dot every i and cross every t, not because if I don't a patient will feel the effects, but because I will get reprimanded, sued, or even fired.  Nursing has gradually drifted away from patient care and has eased it's way into a more politically driven profession.  Although I'm quite the rule-follower, I refuse to forget why I chose the nursing profession in the first place.  Often times all it takes is a brief thought about how I would want my family member to be treated, and I quickly throw the politics in the back seat and continue on with what I love to do.  Of course I love cuddling babies, snatching kids from their beds to rock them to sleep, and hugging or high five-ing the adults as they waltz by.  At home though, I am forced to consider what that looks like to those around me.  Did I finish charting my assessments?  Will I be done rocking him in time to hang a feed for my other patient?  My mind has been trained to think about the tasks at hand.  I have to consciously remind myself about what is important.

The time I've spent on the ward on the Africa Mercy has been just the opposite.  The patients that we have had the privilege of treating have become family.  Mothers have willingly handed their babies over knowing full well we enjoy and sometimes need the extra cuddles just as much as their child.  Parents reassure their children that we are only trying to help get them better and place a trust in us that is never taken for granted.  The adults get comfortable enough to tell us to get cracking on finding a husband and start our own baby making - typical family conversations.  Thankfully, my time in Africa has reminded me of the relationships we, as nurses, are blessed with.  I can only hope that I will bring what I've learned here, back to my future patients.

A few of my favorite moments:
When Hosanna's Dad and Emmanuel's Mom referred to me as Mama Kariiiiiin.  It was all the proof I needed that they trusted me with their children.  I was happy they could see the love I have for their boys.

 

 

 

When the three lovely ladies, Florence, Habiba, and Bijoux went all "Mama Bear" on me and showered me with gentle eyes and encouraging hugs when I visited the ward after Becky had left the ship.

 

 

When, on my final evening shift, I asked Habiba how many children she had.  She held up one finger as she was smoothing out the blankets on her bed.  I asked her, "Can I be your second child?"  Without missing a beat, and with a stern and very serious face, she looked up and said, "You already are my child."  She shook her head at me, as if to say - Seriously Karyn, you really had to ask that?

 

I'm beyond grateful for the relationships that were created during this experience.  Here on the Africa Mercy, my work nor my motives have been challenged or judged - and that makes a difference.  It allows me to make a difference.  This is what I hope to bring back home. 

 

 

Impending Transitions

Now that there’s less than a month left in this insane experience, I can’t help but get all melancholy and reflect a bit. 

People say that the transition period from ship life to my once familiar life on land may be difficult.  They say I should prepare myself for a time that is inhabited by overwhelming change.  I should be ready to face the shifts in support systems, adapt to new daily routines, and stand guard for the emotional turmoil that can erupt at any given moment.  Sounds like quite the picnic if I do say so myself…

I mean people do it all the time, right?  It’s a natural progression in life to experience one stage and move on to the next.  It’s normal to have a sense of reluctance to start something new and uncomfortable.  After all, I did just that when I came to Africa eight months ago.  But what about having anxiety about leaving something that was once so uncomfortable and foreign and returning to the only life you’ve known for the previous 26 years?  I’d love to say that I’m full of relief, that in less than 30 days I will have the freedom to eat whatever I want, whenever I want it.  I can hop in my car, turn the radio on and cruise with the windows down inhaling fresh clean air.  I can call my family and friends without counting my fingers to figure out the time difference, heck I can go see my family and friends.  So why then do I catch myself becoming frustrated at the fact that I’m actually a little scared about going home? 

Is it the work? 

I have the privilege of saying that I am a nurse and I love my job.  Prior to coming on the ship I had been enjoying the perks of travel nursing.  I’d like to believe/I’m psyching myself up and telling myself that traveling is still an option once I get my feet back on the ground and catch my breath.  And catching my breath is exactly what I am expecting to have to do.  I’ve been volunteering as a nurse onboard a hospital ship that is nothing like I’ve ever known.  It’s a place where patients stumble in hiding behind a scarf or a dim smile and waltz out with a new found confidence and sense of hope in their eyes.  It’s a place where selfless volunteers come together to serve others because they believe that is the right thing to do.  And it’s a place where love is given out freely without the expectation of anything in return.  So although I’m petrified of reentry into the PICU world after 9+ months, I still am excited and grateful to be involved in a profession that has needs to be filled.  I’m hoping that excitement will serve as the enabling factor that is necessary to lead me back into the intensive care setting. 

Is it the living situation?

As of right now, my plans are to move back in with my long term roommates (AKA my parents) until I figure out where I’m headed next.  Thankfully my parents and I have an amazing relationship, so I’m not too uptight about the new living situation.  In fact, I’m actually looking forward to it and my Dad recently assured me that they haven’t rented out my room yet so I should be good for a little while.  But again, it’s another hefty transition.  It’s similar to moving back home after college, only multiplied by 1000.  What is it going to feel like opening a refrigerator with only my food in it, none of which is labeled with a name and date?  As irritating as I think the dining room hours are, will I find myself eating meals at the assigned times onboard?  Am I going to dance around the house barefoot, sleep on my couch, or go for a midnight swim just because I can?  But where do I go when I have a sudden urge to check in on a patient to see how their day went?  Living and working in the same environment and seeing the same people on an hourly, never mind daily, basis can become somewhat suffocating.  But what about when I walk down the hall and my ship family is nowhere to be found? 

Is it the How was Africa?

As I evaluate and somewhat obsessively think about the next couple of months, I always hit a wall when I think about this question.  It’s a legitimate question; after all I have been living here for over eight months.  Of course my friends and family would be interested in my unexpectedly extended time away from home.  But how interested?  How much do you really want to know?  Will you be expecting me to be an African expert?  Because quite frankly, most days I feel like I’m living on an American ship that is docked next door to Congo.  It’s a very unusual phenomenon.  Will the conversation be limited to the weather in Africa?  Will you want to hear my stories from the fun visits we had to the orphanage?  Are you going to be interested in how the children became orphans, or what Mama Pasculine taught me?  Or will you simply be satisfied with pictures of children laughing and playing games?  Is ship life something of interest?  Will you want to know what it’s like to live and work with the same individuals, if so will you really understand what a challenge it actually is?  Can I adequately describe what it’s like to work on the ward?  Will you want to know about the lack of resources and the short cuts that have to be taken because there simply isn’t another way?  Should I discuss some of the difficult cases – the no’s that had to be handed out to the hopeful hearts?  Is it fair to let you in on the heart wrenching situations that didn’t go as we had wished?  Or do I tell you about Andredi, Grace, Chantal, Ghislain, Paul, Ruffin, Junior, Mahamadou, Emmanuel, Hosanna, Habiba, Epiphane, Natacha, Florence, Bozi, Rovel, Alice, Siara, Theresa, Nadine, Angelique, Mervielle…

I am scared.  I’m afraid of sharing so much that you lose interest and become distracted.  I’m nervous that my feeble descriptions of my experiences won’t suffice.  I’m slightly troubled by the realization that I may become frustrated simply because there will be instances in which you just will not understand.  But most of all, I’m afraid of falling back into my routine that was so comfortable before I left.  This experience wasn’t just a time-filler, it wasn’t just something I did in between travel assignments.  I don’t want to ever feel like I’m describing it as such. 

So as I prepare for life on land I have a few requests:
Tell me about what has happened in your life over the last nine months – I’m genuinely interested and nothing is insignificant.
Be patient as I try to steady myself.
Give me grace.  Give me time to find my words.

I’m not the same – I’m not even sure what that means…but ready or not, it’s almost time for that picnic.