patient stories

Hold onto the Good Ones

I’ll never forget my first patient as a newly graduated nurse. Mary was a twenty-something like me, recently out of college, and trying to figure out what she was going to with her life. She had unexpectedly broken her back after a rock climbing accident and ended up on my general care trauma floor. Despite the unfortunate situation and her constant pain, she was always very kind.

Her mouth dropped when my preceptor (mentor) congratulated me on completing my first real patient as we discharged her together. “You’re brand new at this?” she asked. I nodded, smiling. “Wow! I never would have guessed!”

I left her room feeling like I could make a difference in every patient’s life, become the best nurse possible, and otherwise conquer the world. My wise preceptor knew not every patient was so kind, so tolerant of pain, so introspective of their new-found helplessness. “Hold onto the good ones,” she warned me. “They’re not all like her.”

I quickly learned Mary was the expectational patient, not the typical one. Trauma happens to anyone and everyone: the drug addict, the barely functioning alcoholic, the self-employed business man, the college student, the elderly lady at the nursing home, the cognitively delayed, the brilliant, the young, the old, the farmer, the city worker, everyone. And everyone handles it differently.

Unfortunately, most cannot handle it at all, taking their anger, frustration, pain, and everything else out on the very people trying to help them, including fresh-out-of-nursing-school me.

Hold onto the good ones, I’d tell myself after being cursed out of the room. Hold onto the good ones, I’d tell myself as a man old enough to be my father made lewd remarks. Hold onto the good ones, I’d tell myself as I needed to give yet another sweet elderly lady painful heparin to prevent blood clots and made her cry. Hold onto the good ones, I’d tell myself as a patient incredibly lucky to be alive without any disability would complain about the food. Hold onto the good ones, I’d tell myself as yet another resident was rude to me. Hold onto the good ones, I’d tell myself as I did not have a good, quality patient interaction for weeks on end.

Hold onto the good ones?  I asked myself one night as I was staying up late for my night shift. What good? It was summer. It was hot and sticky even in the dead of night. I had been at my job a year, been in my college town for five years.  I was restless, uneasy, questioning if my job, my town, my life were what they were could be.

Yet, I was comfortable. I was getting into a groove at work, really understanding everything that was going on. I loved my co-workers. I loved my roommate. I loved my boss. I liked my paycheck and benefits. I loved that I only had to work every third weekend. I loved that my one of my best friends from high school friend lived in town.  Sometimes, I did like my patients. It isn’t all that bad, I rationalized.

But holding onto the good ones as my preceptor advised was becoming increasingly difficult. My high school friend moved. My roommate got engaged and moved into an apartment she’d soon share with her husband. Some of my co-workers left for other jobs and opportunities. Rotating night and day shift became more difficult. Work was becoming very routine. I was running out of good to hold onto.

By the next summer, I was living in Connecticut, travel nursing in a sub-acute section of an intensive care unit, wondering what good I had to hold onto there. I worked every other weekend. My bosses did not care what my preferences for shifts were at all. I floated to different units almost every other shift. The pay was not great. The medical patient population was worse than my trauma surgical population. Sure, New York City was a train ride away and I had some friends, but I was running out of good to hold onto.

That fall, I was living in the San Francisco Bay area in California, travel nursing in a surgical intermediate care unit, figuring out what good I had to hold onto there. I worked every other weekend. I only had 3 patients and finished the majority of my tasks around 10pm during my night shift. The rooms were incredibly tiny. The traffic literally made me cry. The pay was better. I had great roommates, good friends, and warm weather, but I was running out of good to hold onto.

This winter, I was back home in Wisconsin in a new city, working in my dream job of an Emergency Department. I work every third weekend. My bosses are investing in me. I have benefits again. But the pace can be maddening, the amount of tasks overwhelming, and the complaining (oh, the patient complaining!) is never ending.

Yet, now, despite whatever horrific things happen at work, I have an abundance of good to hold onto. It’s not the job. It’s not the place. It’s not the people (though my co-workers, past and present, are wonderful). It’s not the benefits. It’s not the pay. It’s not the patients.

It’s my perspective and my attitude. 

Ever since I decided to become a nurse my senior year of high school, I’ve clung to certain expectations of what my career would be. I pictured saving lives, changing people’s perspective of their health, really making a difference. I pictured being thanked, being appreciated, being important.

Actually working, I’ve experienced the opposite. I’ve seen people die. I’ve seen people leave against medical advice. I’ve seen people care so little about their bodies that they poison themselves near death with drugs and alcohol. I’ve seen people not take my advice and come back again with the same complaints. I’ve seen people want help desperately who will refuse everything I have to offer to actually help them. I’ve been cursed at, taken for granted, felt so small and worthless that sometimes I have not even wanted to come back the next day and have seriously considered changing my career.

No wonder I found it so hard to hold onto the good ones. The good ones are the exception, not the typical. I was expecting the good ones to be the typical. When I found the opposite, it was hard to let go of my expectations and accept the reality of my career instead of the fantasy I had built up in my head for years.

About this time last year, when I was living in California and making all sorts of little major decisions about the rest of my life, I stumbled upon a book I could not put down in a used book store in downtown Campbell, a sleepy suburb of San Jose. It had a picture of Jesus with a crown of thorns on His head and was called The Wounded Healer. I had never heard of the author Henri Nouwen before, and I debated buying it because I did not know what it would be about.

But the title resounded with me. As a nurse, I like to think of myself as a healer, but many patient interactions had shown me that sometimes I cannot and do not heal. After months of introspection and travel, I knew I was wounded myself. Despite my faults and weakness, despite my failures, despite my many patients who had gotten I felt had gotten worse under my care instead of better, I still had a great desire to heal. The Wounded Healer seemed like a great name.

I had no expectations reading the book. I had never heard of the author before, and the back cover did not really explain what it was about at all. I had not a clue what I was getting into. Yet, I credit this book for really changing my perspective on my career. I credit Nouwen, a Dutch Catholic priest, professor at the University of Notre Dame, Yale Divinity School and Harvard Divinity School, and a prolific writer, for really changing my perspective on my faith. If I’m ever blessed with children, I’m highly considering naming one after him.

One line in The Wounded Healer that really stuck out to me was:

“Building a vocation on the expectations of concrete results, however conceived, is like building a house on sand instead of on solid rock, and even takes away the ability to accept successes as free gifts.”

– Henri Nouwen, The Wounded Healer

Nouwen is referencing the parable of two foundations found in Matthew 7:24-29 and Luke 6:46-49. Jesus tells the crowds that those who listens to His words and acts on them are like houses on solid rock while those who listens to His words but does not act on them are like houses on sand. When the storms come, the houses built on sand are washed away while the houses on rock stand firm.

When storms come, when difficulties arise, when something unexpected happens, when tragedy strikes, where is our house? Where have we built up our expectations? On the rock of Christ or the sands of false gods, false comforts, false expectations?

I know I built my career expectations on sand. I expected good patients. I expected praise. I expected respect. I expected good hours. I expected a lot. Thank the Lord that nursing has failed to meet my expectations. Building a career on the expectations of good patients, praise, making a difference, everything was me building a house on sand instead of on the solid rock of Christ.

Jesus never expected anyone to appreciate Him. He watched the rich man walk away, the Pharisees walk away, even His beloved disciples run away.

Jesus never expected praise. He bore spitting, buffets, scourging, insults, and every shame imaginable.

Jesus never expected respect. Instead, he bore the cross, a symbol of humiliation, without a word of grumbling.

Jesus never expected good hours. He’d rise early in the morning to pray, preach all day, even heal on the Sabbath, a day of rest.

Jesus never expects anything from us, not even our love. Instead, He accepts everything, everyone, as a gift. Even when we don’t meet the expectations we think He requires of us to be worthy of His love, He never stops loving us and never stops being open to receiving us and our love as a gift.

No wonder I could not hold onto the good ones. I was holding onto sand. As soon as I realized good patients, good hours, respect, praise, and everything else I wanted so badly from work was a gift, not a right, I stopped clinging so desperately to them. Once I let go of my expectations and concentrated more on giving than receiving, I found that I had better patients, better hours, more respect, more praise, and an abundance of everything I wanted.

Now, even the smallest smile I cherish. Now, even the smallest compliment I appreciate. Now, even the smallest step in the right direction I admire. Previously, those little things I missed out on because I was so focused on getting the large, good things I expected.

Sure, I have my days where I grumble, where I hold onto sand much too tightly, where I otherwise am expecting to receive instead of give. But I have learned this one essential thing: Good things in our lives are a privilege, not an right.

When we stop taking good for granted, we can finally lift our eyes up and see the abundance of good around us. Hold onto the Good One, not the good ones. Holding onto the good ones, the good things we expect, can prevent us from seeing all the good that actually exists, the good that our Good Lord has put in our lives.

Even when we hit rock bottom, it can be a beautiful time of transition. Rock bottom can set us free from the sand we have built so much on. As one of my favorite childhood authors, J.K. Rowling once said of her rock bottom:

“I was set free, because my greatest fear had already been realized, and I was still alive, and I still had a daughter whom I adored, and I had an old typewriter and a big idea. And so rock bottom became the solid foundation on which I rebuilt my life.”

– J.K. Rowling

Rowling wrote the fictional series Harry Potter. She first conceived the idea for Harry Potter in 1990 on a delayed train from Manchester to London’s King Cross station. For 5 years, she planned the 7 books. During those 5 years, her beloved mother passed away at the young age 45, she moved to Portugal, married, gave birth to her daughter Jessica, divorced, and returned to England a poor, single mother. Yet, those 5 difficult years became the foundation for her successful writing career. She had nothing to lose and everything to gain. So she wrote, so she went from publisher to publisher, so she took every failure as an opportunity to learn, and J.K. Rowling became the famous author she is today.

Letting go of sand is extraordinarily difficult, yet we have nothing to lose and everything to gain. Letting go of expectations is not the same as letting go of our standards. It merely frees us to accept gifts in our lives that we have been blind to.

Let go of the sand, and build your expectations, your hopes, your dreams, your house, on the solid rock of Christ.  Hope in Him will never disappoint you (Romans 5:5).

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