wisdom in the wake of the beatdown

the last two nights at work were brutal. someone called in sick sunday, and i got saddled with 19 or more patients on the cardiac unit, followed by monday where 2 people called in sick and one was late and we just got creamed, every last one of us; it was just brutal.

medicine is hard in ways that nothing else is. one - you need to understand complicated medical information; two - you need to negotiate with patients who are sick, afraid, angry, stubborn, sometimes demented and they have family that have a whole other agenda and range of emotions about the situation; three - the doctors don't tell the patients ANYTHING, and if they do? well it' not in english (or spanish, or russion, or hatian...) it's in medicaleese; four - whatever you may need, whatever your emotional state is in that 12 hours, it takes a back seat to caring for everyone else; and lastly - even with shift work, when you get to turn off your pager, walk out the door without work to take home - you take it home, if only in the exhaustion of having cared all 12 hours long, for a multitude of people.

things happen in a medical setting that don't happen anywhere else, for the most part. bleeding, vomiting, excruciating pain, wound care, intubation, tube feeds, cardiac arrest, reaction to medications - seizures, respiratory arrest, skin rashes...oh and the infections of all shapes and sizes and infectious paths. how this manifests in our minds, on our emotions - both in and out of work, yield gallows humor, misplaced anger, the desperate need to talk about anything else, the desperate need to talk about it, the desperate need for silence.

there was a poster around EMS after 9/11 that said "you take care of them, who's going to take care of you?" i thought about it a lot. i thought it was brilliant.

I have walked a long, long road to learn to recognize the value in self-care, that there was such a thing as self-care. I learned early on that i sucked at it. So it was quite a big deal that although I'd signed up for overtime for tonight a few weeks back, that when it came in the wake of these two brutal shifts; that i thought well enough to cancel it. It took a conversation with a wise woman in my life - we spoke not directly of it, but eventually. She asked me pay attention to the joy in having the choice to make regardless of what i decided to do. She would never suggest a course for me, it's why she's so great.

I stayed home and now i'm trying to decide, chinese of indian? the snow is falling and i'm in love with it. Self-care, how fantastic.