by Paula Manuel Staff Nurse Interest Group

Tis the Season

The holiday season is for the child within us, the wonder of receiving, giving, sharing, and celebrating.  A significant portion of my professional life was spent in paediatrics–neonatal and critical care, so I know the holiday season can also be traumatic, poignant, sorrowful, and painful.  It never became easy to witness parents in anguish upon learning of a life-altering diagnosis whether cancer, congenital heart disease, or any number of conditions that would place a child on a path of palliation or death.

For many it is not a comfortable topic, indeed the practice of nursing is in part challenging because we not only bear witness, but also have to intervene, and we need to be conscious of the stressors that can lead to burnout/compassion fatigue.

How to counter the effects of stressors? It takes practice to be undaunted, to thrive rather than survive, to choose to conduct oneself with honour and integrity, maintain autonomy, acquire clinical wisdom, and reach deep understanding that caring achieves excellence.  Now to reach this state I experienced my share of adversity, experienced burnout–overcame it through exquisite self-care and the investment in a team of caregivers to help me achieve a transformed state of physical, emotional, and spiritual health.

One of my patients “G” was one of my masterpieces, his life spanned 4 months and I was one of his core nurses for three of them. The two of us connected and his parents reached a state of great trust in me, as I provided care with knowledge, skill, advocacy, and empathy/compassion.  I felt a physical pain in my heart the day I realized there was no hope for his survival, there had been a number of troubling signs; one of the most significant he had not smiled.  A milestone that tipped my analytical scale that the health care team needed to investigate the inside of his head.  Concurrently “G” had other signs; the failures to wean the ventilator settings, the degree of abdominal distension consistent with right-sided heart failure, poor weight gain, and along with the missing smile a lack of eye contact.  A CT scan and a cardiac diagnostic procedure confirmed the worse, severe brain atrophy and elevated right sided heart pressures with no hope of recovery.

I was on duty the day treatment was stopped, I spent time with his parents no longer a sentinel but a caring, empathetic presence in the midst of a devastating event.  My grieving occurred later, my reflections on the work I had done, my role conflicted as a caregiver and prolonging pain and discomfort.  Yes I advocated for the final investigations, showed leadership, and I also know “G” was a watershed for me–just over two months later my paediatric practice was over.  The departure was wrenching, but it provided the means to renew my commitment to nursing and practice in a new environment.

Are you the kind of nurse you would want taking care of you? Life is precious, as nurses we’re accountable for providing dignity, being professional, committed, caring, deliver excellent nursing care, be knowledgeable, possess advanced communication skills, build and sustain therapeutic relationships with patients and families, and strive to deliver these elements in every moment of care.

Here’s a New Year’s Resolution to consider–Practice “being in the moment” for each task, communication, appreciate the sacredness, be mindful of words/actions, connect to your healer self, remember to take care of yourself and recognize when you make a difference, repeat p.r.n.

Merry Christmas to all, and to all a goodnight.

Comments on: "Tis the Season" (2)

  1. Thank you Paula. I admire your wisdom and tenacity, the TLC you give your patients and yourself. Have a great Christmas and a beautiful 2015.

  2. Thank you Jody, I hope all is going well for you too. All the best for 2015!

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