Letting Go of Your Hassles: New Year 2017

Rose quartz for love, clear quartz for clarity Photo: Julianna Paradisi 2017

Rose quartz for love, clear quartz for clarity Photo: Julianna Paradisi 2017

My friend who teaches Pilates and mindfulness was approached by one of her students after class. The student said, “I really appreciated your words of mindfulness, especially the part about, “Letting go of your assh*les.”

My friend, who I’ve never heard use that particular word in causal conversation, much less during a meditation, was taken aback. She could not recall saying it. She asked the student, “What did I say?”

She repeated herself, “I really appreciated you saying, ‘Let go of your hassles.”

Hassles. Ah yes, that makes much more sense. “Let go of your hassles.”

Since my friend told me the story, I’ve considered the hassles I want to let go of in the New Year 2017.

The usual suspects come readily to mind: Rude comments from others, drivers who take my pedestrian safety into their own hands by running stop signs, miscommunications of various species, the neighbor who parties and plays loud music until 4 am on a Monday morning when I have to go to work. I considered forgoing Twitter to avoid finding out US international policy changes before I’ve had coffee in the morning, but those tweets pop-up in the national news and Facebook immediately, so there’s no point.

While reflecting on hassles, it occurred to me that letting go of mine isn’t enough. It’s a principle of universal attraction that like attracts like. In other words, we attract to ourselves the energy we send out into the world. Simply put, the only way to let go of the hassles, is don’t be a hassle. 

To not be a hassle requires mindfulness. It requires choosing to respond to hassles (especially those manifesting in the form of other people) with care and thoughtfulness. Letting go of hassles requires empathy and compassion. It requires restraining yourself from placing a wireless speaker against the wall between you and your neighbor’s home, and turning up teeny-bopper heart-throb boy band music really loud at 6 am on a Monday morning when you get up to go to work, with the intent of preventing your hung over neighbor from getting to sleep after partying all night, which kept you up when you had to go to work the next morning.

Letting go of the hassles requires not being a hassle.

Letting go of the hassles is an ongoing job, a moment by moment, day by day thing. It requires renewing the commitment to doing what’s right everyday.

It takes practice. I don’t expect to get it right every time.

“But I’m tryin’ real hard to be the Shepherd, Ringo. I’m tryin’.”

Oncology and Hospice Nurses Should Read this Article

       Okay, this isn’t the happiest subject to post on a beautiful Friday morning before a weekend, but the topic is important and it’s part of my job to know this stuff. Warning: it’s about end of life treatment for patients with terminal cancer.

      Oncology and Hospice nurses, please read this article in today’s Health section of the New York Times. Whether to turn off pacemakers in the face of terminal illness is a consideration in end of life discussions with patients and their families. Read the article:

Life Saving Devices can Cause Havoc at Life’s End

     Have any reader’s had experiences related to this? 

Whistle Blowers & Patient Advocates: When the Nurse Stands Alone

oil on unstreched canvas (detail) 2009 JParadisi

A colleague and I discussed the Winkler County Whistle Blowers case and our admiration for Registered Nurses Vicki Galle and Anne Mitchell. They brought the nurse’s role of patient safety advocate into the national spotlight.

My colleague is also a force to reckon with when it comes to patient advocacy. During our conversation she grew quiet and told me once, she had advocated for a patient without the support of her peers or administration.

The event occurred early in her nursing career, before she gained the skill and knowledge, which now empower her ability to act confidently as an advocate. In the end, she followed orders, even though they conflicted with her ethics. Decades later, she still regrets her choice.

I listened to her story, and tried to imagine her as a young nurse, uncertain and faced with a situation nursing school had not prepared her for. I imagined her alone and isolated, the only one in a nursing unit who felt, or more likely, spoke out loud the feeling that what was happening might not be best for the patient.

The Winkler County Whistle Blower case demonstrates that this kind of moral isolation still happens to nurses. However, it also demonstrates that nurses have developed resources for themselves and learned how to access them. These days, many hospitals have ethics committees and safety committees for reporting unsafe systems and behavior. Many hospitals have policies protecting nurses who refuse to administer treatments that conflict with their moral beliefs. Winkler County Memorial hospital fired Anne Mitchell and Vicki Galle when they used the hospital’s safety chain of command to protect patients, but the hospital and the doctor bringing charges against them found out this kind of punitive behavior is no longer tolerated by the court system or a majority of health care professionals. The Texas Nurses Association and the American Nurses Association said, “We are watching,” as did the Texas Medical Board. I’ve heard the conversations of doctors who ask why Dr. Arafile’s colleagues didn’t report his behavior. Why was the responsibility left to nurses? If any of these resources were available for my nurse colleague when she faced her dilemma decades ago, I would be surprised.

My heart breaks for that young nurse, facing an ethical dilemma alone and unsupported, with nowhere to turn. I told my colleague I hope she has forgiven that young, inexperienced, and frightened version of herself, with  her older, more experienced self’s compassion. I suggested that what she learned from that episode long ago has forged her into the warrior nurse advocate she is today, benefiting hundreds of patients during her long career as their advocate.

Sounds Like a Job for Health Care Reform

     A patient called to cancel his appointment for a monthly infusion necessary for the rest of his life (or until a pharmaceutical company comes up with a new medication). He’s been getting it for a few years now. The infusion made it possible for him to go to college. He cancelled his appointment, because he can’t afford the treatment at this time. He is temporarily not covered by health care insurance.

     Upon college graduation, his insurance carrier changed. He missed several treatments while his new insurance carrier took months to review his prescription and medical history,  weighing those against the cost of the medication (it’s expensive).  Eventually, the insurance company gave in, and he resumed the monthly treatments.

     Things continued smoothly, until recently. He took a new job. Isn’t that the point of a college education? Anyway, now he has to wait six months for his new insurance coverage to begin, before he can request to have his treatments resumed, after it is yet again approved for authorization by the new insurance company. The medication is too expensive for anyone but the very wealthy to pay for out of pocket (and even they might balk). So now this patient tries to maintain his health without the medication, so he can continue to work and keep his latent health care benefit.

     If only there was a less expensive health care option available…

When You Professional, Sometimes You Suffer

     It is late in the afternoon, and it has been an extraordinarily busy shift. My fatigue, along with that of my colleagues, is compounded by our worry for a much-loved coworker out on unexpected medical leave, our worth-her -weight-in-gold unit secretary is out on a planned medical leave, and if all that isn’t enough, an important and well respected physician in our oncology community died suddenly in an accident. We received the news this morning. It is a horrible, no good, very bad day. And it is so busy, we can’t take time out to give one another a hug. You can see the tears we hold back in our eyes.

     He is my last patient of the day. He needs a a blood test today, then he’ll return to the clinic tomorrow for his treatment. He tells me he feels horrible, no good, very bad today. He asks me if he can stay and begin his treatment this afternoon. I look at the clock. To honor his request means I will stay at least an hour over time. He may have seen me wince, or maybe I sighed, because I know I am going to do what he asks. A worried expression crosses his tired face, and he looks around the unit at the other patients. “It’s very busy here today? Lots of sick patients? You are tired?”

     My heart was touched.

     “Yes, we have many patients and they are very sick today, but you are sick too, and it’s my job to take care of you. I will start your treatment this afternoon. You need it.”

    He smiles with what little energy he has. He holds my hand and says, “When you professional, sometimes you suffer.”

    I squeeze his hand and walk away to send his blood to the lab, before he can see me cry.