Guideposts

Guideposts direct the way. When we are driving the destination is a location and we rely on the guidepost placed by others to get us to where we are going. We trust the guidepost is correct in its direction.

Guideposts in a social context are people in which we place our trust. Parents, teachers, mentors, leaders, and loved ones can be seen as guideposts we trust to show us a way that works. Understanding the construction of these guideposts in not necessary. As rational beings we are still responsible for the choices we make to follow or not follow their direction.

In my nursing practice my guideposts are few but have remained steady for 40 years.

The first I became aware of in nursing school and it merely, at the time. reinforced the work ethic of my family. It can best be said as the inscription over one of the Benedictine College’s buildings: Ora et labora (“Pray and work!”).

The second I learned in nursing school and put in practice each day I did my nursing work: I am the patient’s advocate and speak for them when they cannot.

The third became clear to me during my first job, fresh from nursing school and so bursting with knowledge I just wanted to show everyone I knew how to do nursing stuff: I know very little and have a lot to learn.

The fourth also became clear to me one night at that first job as a graduate nurse: Suffering is a strong part of life and death comes to us all.

The fifth guidepost arrived while I was working in an isolation SICU tucked away in a six bed ward that always smelled of MRSA: Each time I take the time to wash my hands and keep my practice clean I do not add to my patient’s burden of infection and do not pass it on to others.

The sixth I learned when I changed my nursing profession from critical care to the operating room: Maintaining a consciousness of what is sterile helps my patient.

The seventh became clear to me as I dealt with my own cancer diagnosis and simultaneously worked to complete my MSN: Find the important work the patient needs to do so the healing happens.

The next 40 years I came back to these guideposts demonstrated by loved ones, teachers, leaders, and other nurses, testing them again and again for veracity in different circumstances, places and times.

Through hourly, daily, weekly, yearly and lifelong practice they have imbedded themselves in my unconscious and become habit. I have put forth the effort to make them so in an infintestimal way each time I care for my patient, interact with a co-worker, or push back on a bad practice.

This has made me feel like a rule follower at times. In a weak moment just wanting to give in for the sake of convenience or avoidance of conflict.

I have been called names, been looked over for projects, and accomplished little promotion in terms of position or salary. On the flip side I have built strong, directional guideposts that serve me and my patients to this day. I am content that I have done the best work I could do when I was called upon to do it.

But the work is not done, it is never done. I will continue to evaluate my guideposts and build new ones as needed. My particular brand of caring depends upon them.

Meditation

Who would have thought quietly sitting in a chair with my eyes closed and focusing on my breathing for 10 minutes once a day would make me feel better?

The whole idea of meditation always seemed too “Woo Woo” for my logical, rule following, pragmatic self.

But there has been more research on the benefits of meditation in the past decade and I couldn’t ignore what the science was showing. It made sense that meditation would be a biofeedback conduit, a way for me to access how my mind was affecting my body.

So, replacing my fixed mindset I opted to try daily meditation starting in January 2020. I completed two months of daily meditation before the COVID-19 pandemic disruptions started.

I’m so glad I had a daily mediation habit in place. It gave me time and space to experience a calm, peaceful mind; a place I dearly loved to go each morning before entering what would be an increasingly stressful, fearful, uncertain, and unprecedented way of being along with everyone else on the planet.

I became part of all the healthcare workers in outpatient care put on furlough. No longer an essential healthcare worker. Just another unemployed worker.

Initially I felt envy for hospital workers on the frontlines caring for patients infected with the highly contagious COVID-19 disease. I felt thwarted in not being able to do nursing when it was truly needed. But through meditation I realized my ego was making me feel this way. There were plenty of other ways to contribute to the community of care necessary to endure this pandemic.

Meditation is helping me see the strong value and purpose of pausing in my thinking to ask myself: What am I compelled to do right now? Then ask: What will this do for others?

These two questions accomplish confronting the ego and focusing my efforts on connecting to the community outside myself. Understanding this has reconnected me to my baseline nursing principal: I am the patient’s advocate, not mine, and provide to the patient what they realize at that moment will help them heal.

As I shelter in place with my family I look for ways to move outside of myself and focus on those around me. Once a nurse, always a nurse.

 

 

 

Pandemic Work

Don’t know which week of “Sheltering in Place” you are entering but I am starting my fourth. 40 years of nursing and the only time I have ever been out of work this long was when my daughter was born. So this feels weird.

Three weeks at home is a lot of time for thinking. Also a lot of time to observe from a distance what other people are saying, doing, not saying, and not doing.

What I observe is the world being educated on viruses, focusing on interactions with viruses, and a lot of arguing about the first two.

I also observe human creativity, community strength, and the placement of healthcare workers on pedestals.

The first two I applaud, the last makes me feel uncomfortable. Uncomfortable because healthcare workers have always been unsung “heroes”. We feel called to do our work not out of the need to make a lot of money but to teach others how to reach for health. But praising healthcare workers publicly is excellent for morale.

Each day we go to work not knowing what pathogen we will encounter. Pathogens are invisible and don’t smell; making their way into the body with ease if we are not doing our hand hygiene, sterile technique, and precautions every time, every patient, every room, every day, every month, every year, year in and year out.

All healthcare providers are advocates for infection prevention and control because they know so much more about the WHY of doing it than any other people on the planet.

I have been monitoring my social media apps. I take any chance I see to clarify thinking about social distancing, wearing masks, washing hands, covering a cough, and disinfecting surfaces.

I think as healthcare providers we can reach out and keep our communities clear on the basic care we all need to do during a pandemic.

After all, this is just a practice run for the big one.

Weighing and Measuring Life

I struggle with not eating a meal as soon as I come home from work.

What can I do to eat my dinner meal at 17:00 instead of once I enter the house, which may be anytime from 13:00 to 16:00?

My mind says:

  • you just had a hard day at work
  • you have nothing else to do
  • you are tired and need energy
  • you need comfort
  • you need the food to relax
  • you deserve a meal now

But I want to answer the WHAT question above, not listen to my mind.

I do meal prep and write down my meal the day before so I do not need to spend any time in the kitchen.

In order to support my 17:00 planned meal time I must go somewhere else in the house and complete other things.

I can do the following actions to counter what my mind says:

  • work on a quilt
  • talk to my husband
  • write in my blog
  • walk in the park

I have a short list now but I know the list will grow as I come to value the time between lunch and planned dinnertime as time I can use to weigh, measure and accomplish the other things I want to do in life. I may not yet know what all of them are but as I add them to my list I will see I am living my life instead of just weighing and measuring food in the kitchen. WHAT I can do is take my focus off food and into the rest of life.

 

What is the Value of Going Slow?

What value does slow have in our modern society?

Slow has a negative connotation.

Slow is old, stodgy, unwanted.

Fast is new, exciting, trendy.

In my nursing career I can call to mind a few instances of wrong site surgery related to me by co-workers.

In each case root cause analysis indicated speed led to lack of mindfulness during the time out period that preceded a wrong site surgery or injection.

Speed is not a friend to true mindfulness. It is the cohort of mindless, automatic, unconscious behavior.

Today, something became clear to me. Speed in weight loss is the antithesis of success in weight loss. For myself, the faster I desire to lose weight the more frustrated I become with any lack of progress. This leads me to find another method of losing weight that will work faster and therefore better. This is a habit loop I have recently discovered in my brain which will invariably keep me on the same treadmill of weight loss followed by weight gain.

To step off this treadmill I have started a program of meditation, 10 minutes a day, first thing in the morning. A simple, easy to implement habit to calm my mind and begin to implement patience with myself in my weight loss.

Five weeks into my new meditation practice I am calmer in the mind and starting to connect with my body. I still feel frustration with the slow progress. My brain tells me several times a day that I’m not losing weight fast enough, I should be farther along, I can find another way to speed things up!

However, I remind myself to take the time to be mindful of what has really happened in the past five weeks:

  • I now fit well enough into my OR scrubs where the waist tie doesn’t feel like a tourniquet by the end of the day.
  • My cravings for sugar and flour foods are completely absent.
  • Feelings of hunger outside of my 3 meals a day is gone.
  • I have energy for 16 hours a day (previously only 14).
  • My ability to focus and keep information in my head has improved tremendously. I no longer forget what I am doing during a complex task even though I may be repeatedly interrupted.
  • Work feels calmer despite the fact we are now constantly dealing with shortages in the supply chain, partially due to the coronavirus in China.
  • I drive a slower speed to and from work, saving me a quarter tank of gas a week and about $20/month!
  • I am 10 pounds lighter than 5 weeks ago.
  • My neck is no longer stiff and my joints no longer ache.

After reviewing this list I would have to be crazy to not want slow progress in my weight loss. Look how much it has gifted me. I am using meditation to remind myself that I am enough, my patience has already been rewarded, and I can keep on my current path, slowly seeing how it unfolds.

 

Automaticity

I have been on a NO SUGAR NO FLOUR diet for the past two and one-half weeks. That means no processed foods. If it doesn’t look like the original food, I am not eating it.

I have passed the fatigue period many experience when coming off the dopamine stimulating effects of processed sugar and flour.

I did not experience strong cravings like others talk about because my diet was pretty clean to begin with. My addictive foods were savory in nature, potato chips, fried foods, and bread products slathered in oils.

I have experienced a release from thinking about getting these processed foods in my diet. I don’t plan and think about when and where I can get my favorite potato chips. Just thinking about potato chips started an endless thought loop about them that built a craving and led me to go get some. I didn’t realize how much time I spend thinking about these foods. Not thinking about potato chips and processed foods has FREED UP space in my mind to think on others things!

I let thoughts of these foods run amok and have free reign in my head, letting them rule my actions.

That activity is done with as I have decided these foods are addictive for me. ANY amount of these foods will light up the dopamine addicted neurotransmitters in my brain and I will binge.

So the answer for me, like any alcoholic or drug addicted person is – NO MORE, EVER, NONE, NADA!

I calm my frantic brain right now by reminding it that I gave it this crappy food to eat for 50+ years and that has been long enough!

My next step in the week ahead is to build automaticity into my meal planning and preparation.  Early on this looks like listing the proteins, whole grains, legumes, fats, vegetables and fruits I enjoy and bundling them into meals. This will guide my shopping and advance meal preparation. It will also greatly reduce the amount of time I think about food.

I want to be free from food thoughts as they have ruled my mind for so many years. I am excited to see how I can use my mind once there is so much more thinking time for other endeavors.

Overthinking

I have been quiet for two weeks because I needed to evaluate a problem.

A mind clutter problem I needed to clean up.

This past Friday I was breaking the circulator in the Lithotripsy room when the doctor came storming into the room verbalizing her upset over a conversation she had with the next patient on the schedule. “I told her over and over what needed to be done and she just couldn’t understand my explanation, I don’t know what else I can tell her! I just don’t understand her!”

I listened while the doctor paced and ranted and when she turned to me with the last rant I stated: Perhaps she just wanted a different answer?

The doctor stopped in her tracks and said, with much emotion, “Oh my God, that is exactly what she wanted!”

I have been searching this past year through all the neurobiological and psychological ways I could find to solve my overeating. I finally understood this search did two things for me. First it expanded my knowledge of how my brain works. Second it fed my addiction to knowledge and my need to find a different answer.

I love going down rabbit holes to get at a deeper understanding. This helps me comprehend the depth of something and I thought it would help me understand the importance of something to my situation. However, that has not necessarily been the case.

For example, does the knowledge that fast-spiking interneurons exist really help me structure a habit change?

For some people yes, for me not so much.

What can I do to get my fast-spiking interneurons leaky to a better habit? The answer for me is better self-talk.

Five years ago I read Dr. Shad Helmstetter’s book What to Say When You Talk to Yourself?  and wonder why I just didn’t do all his recommendations back then?

My understanding five years later is that my primitive brain rules and most of what I think and do goes undetected by my higher level thinking brain.

I can choose to accept this as SOMETHING I CANNOT CHANGE, or I can continue searching down the proverbial rabbit hole hoping for a different answer.

Like the lithotripsy patient who had to accept she had a stone that needed treatment on her left side despite her thinking she needed it on the right side, I need to just go forward with the brain I have and follow the advice of smarter people that me.

This past week, after a serendipitous set of circumstances, I stopped eating all sugar and flour, cut back coffee from four cups a day to one, and started back on three meal a day.

One week later I have lost SIX pounds. Never in my life have I lost that much in one week, at least as much as my faulty memory remembers:)

Next week I will see, I am not wondering about it or worried. I am taking one day at a time, keeping to my plan as outlined above and will do the work.

 

Interests of a Lifetime

When I was little my first interests were building mud pies, cooking grass stew, walking along Highland Canal off Panama Drive, and eating.

These interests moved on to window shopping, avoiding ridicule and punishment, reading and eating.

College found my interests to be eating, friends, boys, and biochemistry.

Young adulthood found me interested in flying, neurotrauma nursing, and home building.

All my previous interests led me to marriage and childrearing which dominated my adult years for the next two decades.

Persistent areas of interest that have morphed over my lifetime: 

  • examining different ways to be a nurse
  • reading for enjoyment and learning
  • sewing clothes and costumes for necessity and then quilts for pleasure
  • Learning brain anatomy and physiology and how they are altered by trauma to learning about psychology and how the brain directs our actions
  • Eating whatever was there or tasted good to eating for my health and bodily needs
  • Wanting more stuff to wanting less stuff
  • Ignoring the need to have my own purpose in life and following the dictates of “others” to examining myself, my values, my purpose
  • Keeping blinders on to everything except my wants to knowing when to not wear blinders and when to put them back on
  • Exercising in a gym to long walks in nature

How did my interests develop?

What was it about each interest that gained my attention?

What interests have I enjoyed my entire life?

Reading. Learning. Psychology. Behavior. Food. Nature.

What about these interests makes them enduring for me?

  • Food = comfort, activity
  • Reading = escape
  • Learning = entertainment and growth
  • Psychology = understanding motivation and anticipating direction
  • Behavior = clarity and acceptance
  • Nature = connection and silence

Mostly my interests are gentle and rarely involve failure. Some of my interests have forced me to face a fear. Learning to fly a plane and doing my first solo flight despite a fear of failure and death upon take off. Changing nursing careers despite the fear of failure in starting over without the support of co-workers. Moving away from home across the country to another culture, fearing for two years I had made a huge mistake. Recently I faced a fear that I do not count as a human.

This past year I have realized I do count just because I am. Each person counts as they are just because they are. I don’t need to agree with who others are but I need to agree with who I am.

What a relief! Upon reflection I see where my interests have taken me. They have been the expression of my values to myself, that what I do counts to myself and that is enough:)

 

 

 

 

 

 

One Year On

It has been one year since starting The Healthy Nurse Project.

You know how the news channels do an end of year review; people that died, bad news, good news. I’m going to review all my thoughts that died this past year as a result of my reading, thinking, and learning. Next, I’ll list the thoughts I wish had died but probably won’t die till I die. Finally, there are the new thoughts I want to keep that make my living better.

Thoughts that died:

  • The government knows about nutrition
  • Animal fat is bad
  • I have to eat breakfast
  • Skipping meals is bad for me
  • It’s hard to eat healthy
  • My memory is accurate

Thoughts persisting in my head that I wish would die:

  • Fasting is hard
  • I can eat whatever I want
  • I have earned a food reward
  • I can’t do this
  • I’ll start over tomorrow
  • These potato chips are the healthy version
  • Food keeps me from being bored

Thoughts valuable to me I want to keep thinking:

  • My perspective is real to me and no one else
  • Food is my medicine
  • Eating healthy is my lifestyle
  • Animals, nature, and people are the best anti-depressants

Do your own end of year review. I was surprised at the consistent thoughts that are inside my head, both good and bad. I will work on the helpful ones this coming year. Happy 2020 to all!

 

 

 

Autophagy for All

Autophagy is Greek for “to eat one self”.

No, not a form of cannibalism.

A form of cellular rejuvenation where old components are digested.

Housekeeping for our cells.

Autophagy is turned on during fasting, like overnight while you are sleeping. Longer fasting extends autophagy.

While the study of autophagy in humans is fairly recent (the 1960’s) it holds promise in the understanding of disease progression.

Autophagy is a counterbalance to the aging process.

Normal cells have evolved to survive autophagy whereas cancer cells are unable to adapt to this style of housekeeping.

In a recent study, it was shown that postmenopausal women over 50 reduced their risk of breast cancer if they lost weight. Adipose tissue produces estrogen which feeds certain types of breast cancers so losing fat can only help.  Perhaps reducing caloric intake or fasting boosts autophagy and cleans out cancerous cells before they take root.

In my own example I lost 20 pounds since my breast cancer 10 years ago. It has been work to keep it off. So far so good with my checkups the past 10 years considering I was given a 20% chance of recurrent cancer within 5 years.

Interestingly enough, 10 years ago I was given no information that my diet or weight could affect my chances of remaining cancer free. I have lived long enough to remind my doctors that my diet and lifestyle changes did make a difference. I hope they are passing on this import self-care information to their current patients.

So here’s to autophagy! Lose a little weight and maybe live longer:)