"Why is light given to those in misery, and life to the bitter of soul, to those who long for death that does not come, who search for it more than for hidden treasure, who are filled with gladness and rejoice when they reach the grave? For sighing comes to me instead of food; my groans pour out like water. What I feared has come upon me; what I dreaded has happened to me. I have no peace, no quietness; I have no rest, but only turmoil." -Job 3: 23-26
"Have you journeyed to the springs of the sea or walked in the recesses of the deep Have the gates of death been shown to you? What is the way to the abode of light? And where does darkness reside?18 Have you comprehended the vast expanses of the earth? Tell me, if you know all this." -Job 38: 16-19
Sunday, December 21, 2008
Thursday, November 6, 2008
It's Foreign On This Side
And, it's been quite some time since I've posted. The last few months have been a whirlwind as I moved into my new role and to say it's been an adjustment would be an understatement. I've worked in oncology for my entire nursing career thus far, and up until I moved into the NP role, I have always been comfortable with talking about death and dying with my patients. I guess I was comfortable with it because I am comfortable with death; it's natural thing. We all have to do it and it begins as soon as we're born.
However, I have noticed one thing since becoming a NP and achieving "provider" status (scary someone thought I was bright enough for that): While I have talked with patients and their families about the end of life as a NP, I am not as comfortable with it as I was as a staff nurse. It's like someone has turned off the switch inside my brain that allowed me to to this. It would be easy to say that you get more attached to your patients in the outpatient setting because you see them more often, but not necessarily, for I have had many patients and families in the past who I was close with because, not only was I just assigned to them as a nurse, but they allowed me into their world and seeing people when they are at their most vulnerable state is something that is precious and shows the utmost level of trust.
So, why am I all of a sudden unable to deal with death and dying in the same specialty that I have always been in and love? Well, I think I have the answer, as my attending and I discussed this today after we admitted one of our newer patients who was recently diagnosed. We thought he was going to be a routine patient because of his presenting status, and then BAM...all Hell broke loose and his disease took off with aggresion rarely seen in his type of cancer. Afterwards, my doc and I talked about how quickly he had declined and how shocking it was to the both us.
My revelation (and I've had a few this week) is that in my new role as a NP, as a provider, I am essentially in charge of my patients. So ,when things do not go as planned, or as is too often in my specialty, cancer progresses, you feel this sense of guilt and failure to your patients and their families. Yes, I felt this as a staff nurse; you can't help it, but now it really hits. Unfortunately, lately the cycle of our group is that a lot of the patients are progressing and overall not doing well. Therefore, I feel not only the inadequacy of being a new NP, but of also feeling like somehow I've let my patients down and on some level I know it's not true, but it's still there.
"Knowing is better than wondering, that waking is better than sleeping, and even the biggest failure, even the worst, beats the hell out of never trying." -Grey's Anatomy
However, I have noticed one thing since becoming a NP and achieving "provider" status (scary someone thought I was bright enough for that): While I have talked with patients and their families about the end of life as a NP, I am not as comfortable with it as I was as a staff nurse. It's like someone has turned off the switch inside my brain that allowed me to to this. It would be easy to say that you get more attached to your patients in the outpatient setting because you see them more often, but not necessarily, for I have had many patients and families in the past who I was close with because, not only was I just assigned to them as a nurse, but they allowed me into their world and seeing people when they are at their most vulnerable state is something that is precious and shows the utmost level of trust.
So, why am I all of a sudden unable to deal with death and dying in the same specialty that I have always been in and love? Well, I think I have the answer, as my attending and I discussed this today after we admitted one of our newer patients who was recently diagnosed. We thought he was going to be a routine patient because of his presenting status, and then BAM...all Hell broke loose and his disease took off with aggresion rarely seen in his type of cancer. Afterwards, my doc and I talked about how quickly he had declined and how shocking it was to the both us.
My revelation (and I've had a few this week) is that in my new role as a NP, as a provider, I am essentially in charge of my patients. So ,when things do not go as planned, or as is too often in my specialty, cancer progresses, you feel this sense of guilt and failure to your patients and their families. Yes, I felt this as a staff nurse; you can't help it, but now it really hits. Unfortunately, lately the cycle of our group is that a lot of the patients are progressing and overall not doing well. Therefore, I feel not only the inadequacy of being a new NP, but of also feeling like somehow I've let my patients down and on some level I know it's not true, but it's still there.
"Knowing is better than wondering, that waking is better than sleeping, and even the biggest failure, even the worst, beats the hell out of never trying." -Grey's Anatomy
Tuesday, July 29, 2008
What's In Your Wallet?
Randy Pausch: Oct. 23, 1960 - July 25, 2008
Randy Pausch passed away July 25th at his family home in Chesapeake, Virginia. He had been fighting pancreatic cancer for the last two years. He is easily the most inspirational man I have ever heard speak and I am sure he will be greatly missed. However, his words, made famous by his "last lecture" will live on forever.
http://www.youtube.com/watch?v=kjZwhcWY-KE
Randy Pausch passed away July 25th at his family home in Chesapeake, Virginia. He had been fighting pancreatic cancer for the last two years. He is easily the most inspirational man I have ever heard speak and I am sure he will be greatly missed. However, his words, made famous by his "last lecture" will live on forever.
http://www.youtube.com/watch?v=kjZwhcWY-KE
Wednesday, May 14, 2008
Starin' out into the wild blue yonder...
So many thoughts to sit and ponder.
Well, I did it. I finally graduated from Duke University with my Master's degree. Holy Crap! And to top things off: I made a decison on jobs. I know, huge right?
Now for the first time ever, I will only have work to focus on. Well, I have my certification exam to focus on for now, but after that is said and done, then I will have nothing, but work to focus on. Weird. I have never known what it is like to just work. I have always had school and/or multiple jobs at once. So, I have finally moved into the adult world.
Wow, I'm an adult. When did that happen and how do I make it stop?! It feels odd, yet exciting to be stepping out into this unchartered territory of the Monday through Friday working world. I've been here before, but again I had other jobs and school, so it wasn't the same. Now when I walk out of the office on Friday afternoon/evening, I'll be looking towards two days of errands, cleaning, playtime, and of course, hanging out with my friends...the people who have helped me survive and maintain sanity (relatively speaking) throughout the last 2.5 years of the grad school gauntlet.
Right, so it is going to be interesting seeing how I transform into this new role of normalcy.
"Choose the life that is most useful, and habit will make it the most agreeable."
Sir Francis Bacon
Well, I did it. I finally graduated from Duke University with my Master's degree. Holy Crap! And to top things off: I made a decison on jobs. I know, huge right?
Now for the first time ever, I will only have work to focus on. Well, I have my certification exam to focus on for now, but after that is said and done, then I will have nothing, but work to focus on. Weird. I have never known what it is like to just work. I have always had school and/or multiple jobs at once. So, I have finally moved into the adult world.
Wow, I'm an adult. When did that happen and how do I make it stop?! It feels odd, yet exciting to be stepping out into this unchartered territory of the Monday through Friday working world. I've been here before, but again I had other jobs and school, so it wasn't the same. Now when I walk out of the office on Friday afternoon/evening, I'll be looking towards two days of errands, cleaning, playtime, and of course, hanging out with my friends...the people who have helped me survive and maintain sanity (relatively speaking) throughout the last 2.5 years of the grad school gauntlet.
Right, so it is going to be interesting seeing how I transform into this new role of normalcy.
"Choose the life that is most useful, and habit will make it the most agreeable."
Sir Francis Bacon
Friday, April 25, 2008
I'm the Narrator and This Is Just the Prologue
As I am nearing the end of my grad school career (thank goodness), I am having to come to some serious life altering decisions, mainly where to next? I feel as though it is only recently that I have become comfortable in my practice as a nurse just as I am about to wipe out face first into the sand so to speak. I have been riding that comfortable wave of balancing school and work and not really focusing outside of the two for so long that once I graduate I fear that I may not be overwhelmed, but feel a loss. However, the positives in this are that I can revisit some of the activities that I have enjoyed in the past: volunteering for Habitat, playing softball, golf, going to the beach more often, church, etc. Things that I have put off to the side that I once brought me joy.
Well this all sounds well and good, but at present it is not. Currently I am having a bit of a dilemma during my quest for an advanced pratice position. I thought I had found the perfect job, well actually it had come to me.Things were going smoothly: I had shadowed in clinic, had a few heart to hearts with the NP and MDs, talked with administration, etc. Well, during all of this and being the well-rounded person I like to think I am, I decided that it would be to my benefit to interview for other positions to get the experience. Well, this has backfired big time. I know find myself in the middle of two phenomenal positions with amazing attendings. The dilemma: the second position offers more intellectual stimulation in my research interest and passion, enables me to work side by side with an amazing attending who is also head of the program, and exposes me to a world in oncology that I have always wondered about. Both sounds fantastic, right? Wrong. One of these would result in me leaving my place of comfort, my home, Duke. It also leaves me with the chance of losing some of my most prized friends, colleagues, and mentors. However, it also entitles me to going to a place where there are no predetermined expectations of me, except those of any advanced practice nurse. However, should I stay at Duke, there is a plethora of people with expectations of what I am to become as an advanced practice nurse, i.e. my fate at Duke is already predetermined by the powers that be and I'm not talking about spirituality here, I am talking about my superiors in the health system.
Now these expectations have their own set of pros and cons. See, I have spent the last 2.5, almost three, years working my butt off and networking to secure my place in my specialty and opportunity for advancement within it. Now I have connections throughout the oncology system at Duke, have met some amazing people who have helped me grow as a person, nurse, student, etc, and know how the system works. Makes sense, right? It's great...sometimes. Enter the flip side of these expectations: I am viewed as "the baby" of the oncology NP program at present, many people want to have an impact on my growth and development as an advanced practice nurse (not always a bad thing), and they expect me to be at a higher level than other new graduate advance practice nurses because of the experiences I have had at Duke.
My dilemma in short form: my heart and my brain cannot come to a concensus on my next step in life. So, "if all of the strength and all of the courage" were mine during this time.
"Heaven bend to take my hand and lead me through the fire. Be the long awaited answer."
Well this all sounds well and good, but at present it is not. Currently I am having a bit of a dilemma during my quest for an advanced pratice position. I thought I had found the perfect job, well actually it had come to me.Things were going smoothly: I had shadowed in clinic, had a few heart to hearts with the NP and MDs, talked with administration, etc. Well, during all of this and being the well-rounded person I like to think I am, I decided that it would be to my benefit to interview for other positions to get the experience. Well, this has backfired big time. I know find myself in the middle of two phenomenal positions with amazing attendings. The dilemma: the second position offers more intellectual stimulation in my research interest and passion, enables me to work side by side with an amazing attending who is also head of the program, and exposes me to a world in oncology that I have always wondered about. Both sounds fantastic, right? Wrong. One of these would result in me leaving my place of comfort, my home, Duke. It also leaves me with the chance of losing some of my most prized friends, colleagues, and mentors. However, it also entitles me to going to a place where there are no predetermined expectations of me, except those of any advanced practice nurse. However, should I stay at Duke, there is a plethora of people with expectations of what I am to become as an advanced practice nurse, i.e. my fate at Duke is already predetermined by the powers that be and I'm not talking about spirituality here, I am talking about my superiors in the health system.
Now these expectations have their own set of pros and cons. See, I have spent the last 2.5, almost three, years working my butt off and networking to secure my place in my specialty and opportunity for advancement within it. Now I have connections throughout the oncology system at Duke, have met some amazing people who have helped me grow as a person, nurse, student, etc, and know how the system works. Makes sense, right? It's great...sometimes. Enter the flip side of these expectations: I am viewed as "the baby" of the oncology NP program at present, many people want to have an impact on my growth and development as an advanced practice nurse (not always a bad thing), and they expect me to be at a higher level than other new graduate advance practice nurses because of the experiences I have had at Duke.
My dilemma in short form: my heart and my brain cannot come to a concensus on my next step in life. So, "if all of the strength and all of the courage" were mine during this time.
"Heaven bend to take my hand and lead me through the fire. Be the long awaited answer."
Tuesday, April 8, 2008
I Watched the Proverbial Sunrise...
33 days until graduation. 33 days until I am done with school for awhile. 33 days until I have to really start making some important decisions that could definitely impact the rest of my life and career path. Wow.
For possibly the first time in my life, I have recently noticed that I am happy. I am stressed over events that have happened in the last few months, but a the same time I am satisfied with where I am in my life at the present. I have my wonderful family, amazing friends, a career that I love, and a world open to possibilities.
After discussions with some people whom I admire most, I realize exactly how blessed I am in life. I am without a doubt grateful for this and have finally learned to cherish it and have an appreciative awareness about it.
So, while I really haven't written any epiphanies in this blog, I hope that reading about my realizations will help you all take a step back and ponder your own world and its greatness.
"At the end of the day: Did I laugh and dance enough? Did I tell my friends how much they really mean to me? At the end of the day: Did I really push myself or was I too afraid to give my heart away? At the end of the day." -Kellie Coffey
For possibly the first time in my life, I have recently noticed that I am happy. I am stressed over events that have happened in the last few months, but a the same time I am satisfied with where I am in my life at the present. I have my wonderful family, amazing friends, a career that I love, and a world open to possibilities.
After discussions with some people whom I admire most, I realize exactly how blessed I am in life. I am without a doubt grateful for this and have finally learned to cherish it and have an appreciative awareness about it.
So, while I really haven't written any epiphanies in this blog, I hope that reading about my realizations will help you all take a step back and ponder your own world and its greatness.
"At the end of the day: Did I laugh and dance enough? Did I tell my friends how much they really mean to me? At the end of the day: Did I really push myself or was I too afraid to give my heart away? At the end of the day." -Kellie Coffey
Sunday, February 24, 2008
26.2 for a Cure
Hey Everyone!
As you may know, in a short time (May!), I will be graduating with my master’s degree from Duke University. I am pursuing my Masters of Science in Nursing in the role of an adult oncology nurse practitioner and clinical nurse specialist - yes, double major - insane! I also work full-time at Duke University Hospital on one of the adult oncology units, specializing in solid tumors (i.e. cancers of the breast, lung, colon, etc).
In the midst of all of this, I have begun to run more often for fun and fitness, usually running in local 5K and 10K races for various charities, mainly the Susan G. Komen Race for the Cure and the Free to Breathe 5K for lung cancer.
So, you are probably wondering where all of this extraneous information leads. Well, I will be running a marathon - 26.2 miles! Now you are asking yourself-“Is she nuts?” Why possibly so.
Before I get too far off track, let me explain. The Rock ‘N’ Roll marathon is sponsored by The Leukemia & Lymphoma Society (LLS) and will be in San Diego, CA on June 1st. As a member of Team in Training (a program through LLS), I have a very supportive group of fellow runners and friends, mentors, and coaches to help me through the next four months of miracle working in preparation of the big day.
Guess what! I will be running this with two of my best friends, Sara and Aline. Our training and fundraising have officially begun. I think this will be a great capstone to my graduation from Duke and it's for such a great cause: CANCER RESEARCH! My goal for fundraising is $5000...minimum. I've attached a handout regarding blood cancers and the Leukemia & Lymphoma Society for you.
So, where do you come in? Let's make a deal: I will take care of the time and effort (...and blisters, leg cramps, bum knees, twisted ankles, groaning, wheezing, and complaining) if you would join me in spirit by contributing a donation. Any amount is helpful and VERY MUCH appreciated. Just return the enclosed form to me by May 15th (don't forget ALL DONATIONS ARE TAX DEDUCTIBLE). I can accept cash, checks, or credit cards. You can also donate on the web at:
http://www.active.com/donate/tntenc/jabanwell
Thanks!!!!!
Jamie
As you may know, in a short time (May!), I will be graduating with my master’s degree from Duke University. I am pursuing my Masters of Science in Nursing in the role of an adult oncology nurse practitioner and clinical nurse specialist - yes, double major - insane! I also work full-time at Duke University Hospital on one of the adult oncology units, specializing in solid tumors (i.e. cancers of the breast, lung, colon, etc).
In the midst of all of this, I have begun to run more often for fun and fitness, usually running in local 5K and 10K races for various charities, mainly the Susan G. Komen Race for the Cure and the Free to Breathe 5K for lung cancer.
So, you are probably wondering where all of this extraneous information leads. Well, I will be running a marathon - 26.2 miles! Now you are asking yourself-“Is she nuts?” Why possibly so.
Before I get too far off track, let me explain. The Rock ‘N’ Roll marathon is sponsored by The Leukemia & Lymphoma Society (LLS) and will be in San Diego, CA on June 1st. As a member of Team in Training (a program through LLS), I have a very supportive group of fellow runners and friends, mentors, and coaches to help me through the next four months of miracle working in preparation of the big day.
Guess what! I will be running this with two of my best friends, Sara and Aline. Our training and fundraising have officially begun. I think this will be a great capstone to my graduation from Duke and it's for such a great cause: CANCER RESEARCH! My goal for fundraising is $5000...minimum. I've attached a handout regarding blood cancers and the Leukemia & Lymphoma Society for you.
So, where do you come in? Let's make a deal: I will take care of the time and effort (...and blisters, leg cramps, bum knees, twisted ankles, groaning, wheezing, and complaining) if you would join me in spirit by contributing a donation. Any amount is helpful and VERY MUCH appreciated. Just return the enclosed form to me by May 15th (don't forget ALL DONATIONS ARE TAX DEDUCTIBLE). I can accept cash, checks, or credit cards. You can also donate on the web at:
http://www.active.com/donate/tntenc/jabanwell
Thanks!!!!!
Jamie
Monday, January 7, 2008
Oh The Melting Pot
Apparently the Melting Pot can bring out the craziness in all of us. However, here is what happens when you send the Blonde (me), the Brunette, and the Crazy Brazilian there for a little Christmas festivities and dessert (also we were a bit punchy all day long).
"PLEASE take your shirt off!" -Sara to me before we go running
"My cherry's defective." -Aline referring to her cherry on the cheesecake
"It's like diabetes in a pot." -Aline referring to the pots
"Wait 'til you put it in your mouth." -Me to Sara referring to the Bailey's & chocolate
"You got a little wrist action going on there." -Sara to Aline as she's spinning her fondue
"I have a small chest." -Me to Sara after we inspect our photo
Lastly:
Me: "I think I'm in DKA."
Aline: "Don't go to sleep."
Sara: "Can someone check my blood glucose."
"PLEASE take your shirt off!" -Sara to me before we go running
"My cherry's defective." -Aline referring to her cherry on the cheesecake
"It's like diabetes in a pot." -Aline referring to the pots
"Wait 'til you put it in your mouth." -Me to Sara referring to the Bailey's & chocolate
"You got a little wrist action going on there." -Sara to Aline as she's spinning her fondue
"I have a small chest." -Me to Sara after we inspect our photo
Lastly:
Me: "I think I'm in DKA."
Aline: "Don't go to sleep."
Sara: "Can someone check my blood glucose."
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