As Frank and I embark on this new endeavor, I have contemplated a great deal about my first post. I want my passion to shine through. I love vents, ABG’s, lungs, airways, critical care and all that it encompasses. I’ve deeply contemplated where I want this journey to begin, what I want to share, teach, impart. My brain has been buzzing. And then I had a bad night.
I started my usual night trucking down the hall, looking at my list, making plans. Then I passed one of our critical care nurses who flagged me down.
“We’re bringing a bad one to the unit.”
Okay, ‘bad one’ is kind of my bag. The nurse gives me some quick details and I tell her that is sounds like the patient is well covered and that I’ll stop by, weigh in, and see if anyone needs anything.
“No, she needs YOU.”
These words have become both a compliment and a curse. I know immediately what it means. It means a complicated social situation, confusion, sickness. It means that she is dying.
In the past four years I have learned exponentially. I have honed the small set of skills that encompass my job, I strive everyday to be a better clinician. And I’m pretty competent, if I do say so myself. If you are very sick, you could do a lot worse than to have me as your practitioner. But I came to medicine from a totally different place than most. I first was an in-home counselor for “seriously emotionally disturbed” children. Bestowed that title by a GAF score, they were beautiful souls in what were often impossible circumstances. I worked with these families and individuals to improve their functional status, mental health and coping skills in a cognitive behavioral framework. Needless to say, I’ve held a lot of hands, sympathized with pain, sat in jail cells, dodged a few chairs. My history has provided me with an interesting skill set to bring into critical care medicine.
So when you need both complicated airway and ventilatory management as well as a therapist and palliation specialist, I’m your gal. And, at times, I’ve grown to hate this. I want to come in, push buttons, turn knobs, write orders and disappear like the others. To give my best clinically but to never be the one responsible for holding your pain. To not be the on call when 14 family members arrive, tearing at each other. To not be the one that helps you decide on your code status.
Now- while I deeply wanted to talk about the logistics of proning ARDS patients, feeling the rhythm of a vent to make changes, and all that I learned this week about salicylate toxicity; those things will hold. Instead, I will remind and encourage you to embrace all that you are.
Here are three key ways to cultivate the “YOU” that’s needed every day:
1. Know your strengths.
Not just clinically, but personally. Ask yourself, in the scheme of a resus team “Who am I?” Outside of your skills, what can you provide? What we can find in thoughtful meditation rather than a Sim lab is what truly makes you who you are as a clinician.
2. Find your anchor.
As you discover yourself, know that offering that part of your being likely won’t be easy. In fact, it makes you vulnerable. Know where you draw strength. The people, pets, friends, hobbies, family that anchor you and allow you shelter and space to heal and grow and laugh and love.
3. Care for you first.
Sleep, exercise, healthy food, sunshine, Netflix. Seriously.
Oh, and by the way- stay tuned, ’cause I have a lot to share about salicylate toxicity and airway management.