The Little Things.

“Yesterday I overheard a nursing student snark, “yeah, this is why I’m in nursing school – so I can pass trays.” And if I hadn’t been up to my eyeballs in other things to do for my patients, I would have stopped and said: You’ve already missed the point entirely.

I’m not sure why you DO think you’re here. If you hope to be a good nurse (or coworker, or person with a heart), you’re going to spend the majority of your working life doing things you SO mistakenly think are beneath you. You are going to pass trays with a smile – excitement even, when your patient finally gets to try clear liquids. You will even open the milk and butter the toast and cut the meat. You will feed full-grown adults from those trays, bite by tedious, hard-to-swallow bite. You will, at times, get your own vital signs or glucoscans, empty Foley bags and bedside commodes without thinking twice. You will reposition the same person, move the same three pillows, 27 times in one shift because they can’t get comfortable. You will not only help bathe patients, but wash and dry between the toes they can’t reach. Lotion and apply deodorant. Scratch backs. Nystatin powder skin folds. Comb hair. Carefully brush teeth and dentures. Shave an old man’s wrinkled face. Because these things make them feel more human again.

You will NOT delegate every “code brown,” and you will handle them with a mix of grace and humor so as not to humiliate someone who already feels quite small. You will change ostomy appliances and redress infected and necrotic wounds and smell smells that stay with you, and you will work hard not to show how disgusted you may feel because you will remember that this person can’t walk away from what you have only to face for a few moments.

You will fetch ice and tissues and an extra blanket and hunt down an applesauce when you know you don’t have time to. You will listen sincerely to your patient vent when you know you don’t have time to. You will hug a family member, hear them out, encourage them, bring them coffee the way they like it, answer what you may feel are “stupid” questions – twice even – when you don’t have time to.

You won’t always eat when you’re hungry or pee when you need to because there’s usually something more important to do. You’ll be aggravated by Q2 narcotic pushes, but keenly aware that the person who requires them is far more put upon.

You will navigate unbelievably messy family dramas, and you will be griped at for things you have no control over, and be talked down to, and you will remain calm and respectful (even though you’ll surely say what you really felt to your coworkers later), because you will try your best to stay mindful of the fact that while this is your everyday, it’s this patient or family’s high-stress situation, a potential tragedy in the making.

Many days you won’t feel like doing any of these things, but you’ll shelve your own feelings and do them the best you can anyway. HIPAA will prevent you from telling friends, family, and Facebook what your work is really like. They’ll guess based off what ridiculousness Gray’s Anatomy and the like make of it, and you’ll just have to haha at the poop and puke jokes. But your coworkers will get it, the way this work of nursing fills and breaks, fills and breaks your heart. Fellow nurses, doctors, NPs and PAs, CNAs and PCAs, unit clerks, phlebotomists, respiratory therapists, physical and occupational therapists, speech therapists, transport, radiology, telemetry, pharmacy techs, lab, even dietary and housekeeping — it’s a team sport. And you’re not set above the rest as captain. You will see you need each other, not just to complete the obvious tasks but to laugh and cry and laugh again about these things only someone else who’s really been there can understand.

You will see clearly that critical thinking about and careful delivery of medications are only part of the very necessary care you must provide. Blood gushing adrenaline-pumping code blue ribs breaking beneath your CPR hands moments are also part, but they’re not what it’s all about. The “little” stuff is rarely small. It’s heavy and you can’t carry it by yourself. So yes, little nursling, you are here to pass



Reposted from: Whitney Koenig

Neo-Liberalism And It’s Impact on Mental Illness.

What greater indictment of a system could there be than an epidemic of mental illness? Yet plagues of anxiety, stress, depression, social phobia, eating disorders, self-harm and loneliness now strike people down all over the world. The latest, catastrophic figures for children’s mental health in England reflect a global crisis.

There are plenty of secondary reasons for this distress, but it seems to me that the underlying cause is everywhere the same: human beings, the ultrasocial mammals, whose brains are wired to respond to other people, are being peeled apart.Economic and technological change play a major role, but so does ideology. Though our wellbeing is inextricably linked to the lives of others, everywhere we are told that we will prosper through competitive self-interest and extreme individualism.

In Britain, men who have spent their entire lives in quadrangles – at school, at college, at the bar, in parliament – instruct us to stand on our own two feet. The education system becomes more brutally competitive by the year. Employment is a fight to the near-death with a multitude of other desperate people chasing ever fewer jobs. The modern overseers of the poor ascribe individual blame to economic circumstance. Endless competitions on television feed impossible aspirations as real opportunities contract.

Consumerism fills the social void. But far from curing the disease of isolation, it intensifies social comparison to the point at which, having consumed all else, we start to prey upon ourselves. Social media brings us together and drives us apart, allowing us precisely to quantify our social standing, and to see that other people have more friends and followers than we do.

As Rhiannon Lucy Cosslett has brilliantly documented, girls and young women routinely alter the photos they post to make themselves look smoother and slimmer. Some phones, using their “beauty” settings, do it for you without asking; now you can become your own thinspiration. Welcome to the post-Hobbesian dystopia: a war of everyone against

Is it any wonder, in these lonely inner worlds, in which touching has been replaced by retouching, that young women are drowning in mental distress? recent survey in England suggests that one in four women between 16 and 24 have harmed themselves, and one in eight now suffer from post-traumatic stress disorder. Anxiety, depression, phobias or obsessive compulsive disorder affect 26% of women in this age group. This is what a public health crisis looks like.

If social rupture is not treated as seriously as broken limbs, it is because we cannot see it. But neuroscientists can. A series of fascinating papers suggest that social pain and physical pain are processed by the same neural circuits. This might explain why, in many languages, it is hard to describe the impact of breaking social bonds without the words we use to denote physical pain and injury. In both humans and other social mammalssocial contact reduces physical pain. This is why we hug our children when they hurt themselves: affection is a powerful analgesic. Opioids relieve both physical agony and the distress of separation. Perhaps this explains the link between social isolation and drug addiction.

Experiments summarised in the journal Physiology & Behaviour last month suggest that, given a choice of physical pain or isolation, social mammals will choose the former. Capuchin monkeys starved of both food and contact for 22 hours will rejoin their companions before eating. Children who experience emotional neglect, according to some findings, suffer worse mental health consequences than children suffering both emotional neglect and physical abuse: hideous as it is, violence involves attention and contact. Self-harm is often used as an attempt to alleviate distress: another indication that physical pain is not as bad as emotional pain. As the prison system knows only too well, one of the most effective forms of torture is solitary confinement.

It is not hard to see what the evolutionary reasons for social pain might be. Survival among social mammals is greatly enhanced when they are strongly bonded with the rest of the pack. It is the isolated and marginalised animals that are most likely to be picked off by predators, or to starve. Just as physical pain protects us from physical injury, emotional pain protects us from social injury. It drives us to reconnect. But many people find this almost impossible.

It’s unsurprising that social isolation is strongly associated with depression, suicide, anxiety, insomnia, fear and the perception of threat. It’s more surprising to discover the range of physical illnesses it causes or exacerbates. Dementia, high blood pressure, heart disease, strokes, lowered resistance to viruses, even accidents are more common among chronically lonely people. Loneliness has a comparable impact on physical health to smoking 15 cigarettes a day: it appears to raise the risk of early death by 26%. This is partly because it enhances production of the stress hormone cortisol, which suppresses the immune system.

Studies in both animals and humans suggest a reason for comfort eating: isolation reduces impulse control, leading to obesity. As those at the bottom of the socioeconomic ladder are the most likely to suffer from loneliness, might this provide one of the explanations for the strong link between low economic status and obesity?

Anyone can see that something far more important than most of the issues we fret about has gone wrong. So why are we engaging in this world-eating, self-consuming frenzy of environmental destruction and social dislocation, if all it produces is unbearable pain? Should this question not burn the lips of everyone in public life?

There are some wonderful charities doing what they can to fight this tide, some of which I am going to be working with as part of my loneliness project. But for every person they reach, several others are swept past.

This does not require a policy response. It requires something much bigger: the reappraisal of an entire worldview. Of all the fantasies human beings entertain, the idea that we can go it alone is the most absurd and perhaps the most dangerous. We stand together or we fall apart.

Reposed from:


There’s been quite a bit on my mind lately, but there’s always been one reoccurring thought that has consistently returned to me over the past few months. Betrayal. How does one look into they eyes of someone that has once betrayed them and forgive them. I guess I would assume the answer is time and pushing someone out of your life or mind, but what happens when that person comes back into your life to ask for forgiveness? Do you forgive them going down the morally acceptable route or forgive them out of fear that it’s “essentially” the only way to move on? Or do you completely switch gears and choose not to forgive and let both parties settle into a pit of unforgiveness and despair?

To give a bit of context this all occurred late at the end of 2014. An apology I had waited over a year for suddenly appeared from someone I had once cared very much for. At the time I chose to forgive, in the thought that in the moment it is what I had wanted most and at the thought that it was the morally acceptable thing to do to allow someone else to “move on” with their life peacefully. The truth is, over the past few months I have come to the conclusion that I really haven’t forgiven them. in fact I think i’m incredibly bitter over the whole matter. At the time I would have preferred to sit down in person at some point and hear them out, but instead I chose to settle for an online video chat to help them get over their guilt that they had been feeling over the holidays. I’ve had to teach myself that I didn’t deserve to be treated like crap by someone I cared about, regardless of what had been going on in their mind. Do we excuse people who choose to commit violent acts in order to address a situation? Do we accept the husband or wife that chooses to slap their significant other in the heat of the moment? The answer is no. While I understand I was at a low point trying to battle the depression I had been dealt with, that still doesn’t excuse the racist and derogatory comments I was dealt with to try to “rid” themselves of me. It was weird and awkward to have an apology come up because of the guilt someone felt a “year” after all the negative events transpired and their guilt over reflecting back on everything had come to them. I was scared to say what was on my mind and in some ways, maybe i’m still scared to admit that in fear that it makes me seem weak or “obsessive” over something that occurred so long ago. The truth is what was said in those moments I was so depressed still reach deep into me at times almost like lashes that i’m undeserving of any happiness that falls into my life. How do you forgive someone for this?

Although they encouraged me to reach out to them and essentially allow them to help rectify any matters that was connected to that time period, how do I go back and do this? Both parties have clearly moved on from that time period and so little is exchanged between the both of us, that it would be awkward and me bet with the likelihood of resentment from everyone in the situation. The truth is when they asked if I lost out on opportunities because of what transpired and I said no, that was a lie. I have lost out on opportunities and while I could never place all the blame on them for some of the things I have lost out on (as depression generally isn’t caused solely by one event), it definitely contributed to it. But even if they were to somehow ask “what can I do to fix the problem”, the answer is I don’t think they can do anything, it’s already too late. I got the apology they wanted to get of their chest to move on with their life, but now I’m stuck here trying to figure out what to do with mine. A skype apology was more then enough for them, but honestly it did nothing for me but leave me with more questions.

So how am I able to forgive?