The Real Meaning of Brave

A wonderful post on “A Mighty Girl” today about supporting our children to be truly brave. 

There are so many ways that we can be brave in nursing.. Working with the “difficult patient” no one else wants to care for, speaking up with a physician and getting to the bottom of a patient’s plan of care, being present with a patient during a difficult time (staying with someone as they cry or when they’ve received bad news, instead of turning around to page the Chaplain for a consult), letting a bully know you’re there for your patients and won’t be abused, or being the one who turns the jaded, sarcastic conversation around instead of partaking and letting the poison touch you, too. 

Being brave is hard.

After being asked by a reader “What is Brave?”, blogger Glennon Doyle Melton recounted an experience that made her come to understand that “brave does not mean what we think it does… Brave is very specific and extremely personal.” In her post, Melton talks about her own experience with her daughters’ two different kinds of bravery, which she saw when she took them both to get their ears pierced. 

“When it was our turn, my younger daughter took a deep breath, climbed into the chair, closed her eyes and said, ‘OK! I’m ready!’ The piercer smiled and laughed and several onlookers said, ‘Look at her! So brave! That little one is so brave!’” But when her older daughter hesitated, “Everyone looked at her expectantly and the piercer waved her over, but she stood still and said in a small voice, ‘I changed my mind. I’m not ready today.’ Before I could speak, the well-meaning piercer said, ‘Sure you are, sweetie! Be brave! Your little sister did it! It doesn’t hurt at all!’”
Melton says, “We have to teach our children (and ourselves) that caution is often a sign of courage. That often NO is as brave an answer as YES. Because the little girl who says no in the face of pressure to pierce her ears or jump off a cliff might become a bigger girl who says no in the face of pressure to bong a beer or bully a peer. Whether her answer is YES OR NO — give me a little girl who goes against the grain, who pleases her own internal voice before pleasing others.”
She writes, “If we are going to tell our kids to be brave, we must also tell them what brave means…. It does not mean ‘being afraid and doing it anyway.’ Nope. Brave means listening to the still small voice inside and doing as it says. Regardless of what the rest of the world is saying. Brave implies wisdom.” So, she says, “Sometimes brave means letting everyone else think you’re a coward. Sometimes brave is letting everyone else down but yourself. [Younger daughter] Amma’s brave is often: loud and go for it and [older daughter] Tish’s brave is often: quiet and wait for it. They are both brave girls. Because each is true to herself.”
So when the piercer challenged Tish to go ahead, urging her to be brave, Melton instead told her daughter, “Wow. That is so brave, honey. Even though all these people are here and want you to do this to your ears — you listened to yourself instead of to them. I am so proud of you. Trusting yourself to make decisions about your own body is so brave. You are brave, Tish, in your way. Just like Amma is brave in her way. Let’s go. You’ll know when you’re ready. I trust you to know.” So, she says, “Brave is: To Thine Own Self Be True. And Brave parents say: I trust you, little one — to Be Still and Know. I’ll back you up.”
To read Glennon Melton’s entire post on HuffPost, visit http://huff.to/1q3Z07r. Melton is also the author of the bestselling parenting guide, “Carry On, Warrior: The Power of Embracing Your Messy, Beautiful Life,” at http://amzn.to/1maNJbq
For a humorous book that encourages kids to think before blindly following a trend, we highly recommend “Stephanie’s Ponytail” for ages 4 to 8 at http://www.amightygirl.com/stephanie-s-ponytail
For an empowering picture book about the value of being true to yourself regardless of what others think, check out “Spaghetti in A Hot Dog Bun: Having the Courage to Be Who You Are” for ages 3 to 8 at http://www.amightygirl.com/spaghetti-in-a-hot-dog-bun 
For an excellent guide for girls on staying true to yourself even in the midst of the challenging friendship dynamics of the pre-teen years, we highly recommend “A Smart Girl’s Guide: Drama, Rumors & Secrets” for ages 8 to 12 at http://www.amightygirl.com/drama-rumors-secrets
For a fantastic guide for teen girls that teaches them how to find their voice and understand its importance, we recommend “Express Yourself: A Teen Girl’s Guide to Speaking Up and Being Who You Are” for ages 13 and up at http://www.amightygirl.com/express-yourself-guide
And, for many stories for both children and teens starring brave Mighty Girls — ones who possess both the ‘quiet’ and ‘loud’ forms of bravery — visit our “Courage & Bravery” book section at http://amgrl.co/1mb6dZq

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A Box of our own Creation

It’s been said that it’s impossible to fully appreciate a situation while you’re in the middle of it – only in hindsight can we look back and tear an experience apart, measure and weigh what was said and done, shred the memories and feelings, kick our way through the rubble of what we perceived. 

Of course, this is too simple. We’re complex creatures, and our lives are more than wonderful or terrible, tragic, canonical, inspiring, or harrowing. We enjoy a color gradient. Hair Stylists of the world rejoice: it’s an ombré life.

Our negative experiences can leave a shadow. Immediately after graduating from college, I moved to a new state, away from everyone I knew, and began a professional school program. On its face, it seemed like a good idea – in line with my interests and (still novice) skill set, good long term prospects, the hope of opportunity and career stability, and even a hint of notoriety. I’d shadowed a friend at another school in the same type of program. My pro/con list was complete and unassailable. I did my research, right? What was there to lose?

Time, tens of thousands in loans, a long distance relationship put to the test, hurt pride, the unknown. I withdrew from the program one year later. 

I never regretted my decision to withdraw, but I’ve also never regretted attending in the first place. It was a terrible year; I was alone in a strange city wondering who I was. But the hurdles made me resilient and more thoughtful. Afterward I glanced down, but dove into the mission of unearthing my passion project. And when uncovered, I attacked it fitfully, hungrily.

I wonder if today, with a family to think about, I’d be able to upend my life in the same way. 

It’s ironic to learn that despite all our experiences, we as humans are terrible at making decisions. Our emotions are inextricably linked to our decision-making, when making choices we experience reduced self-control (meaning less physical stamina, reduced persistence in the face of failure, more procrastination, and less quality and quantity of arithmetic calculations), we rely on our beliefs and expectations about social norms to make decisions, we put too much in others’ opinions and sacrifice our own instincts, and the longer we mull over our options the less satisfied we are with our choice.

In The Paradox of Choice: Why More Is LessBarry Schwartz called our modern dilemma “choice overload,” and it makes us question our decisions, set our expectations too high, and blame ourselves for our mistakes. Schwartz talks about “maximizers” and “satisficers.” You can guess who lives happily ever after.

As people have contact with items of high quality, they begin to suffer from “the curse of discernment.” The lower quality items that used to be perfectly acceptable are no longer good enough. The hedonic zero point keeps rising, and expectations and aspirations rise with it. As a result, the rising quality of experience is met with rising expectations, and people are just running in place. As long as expectations keep pace with realizations, people may live better, but they won’t feel better about how they live.

I wonder if this is especially true for nurses. We take new grads who start out fearful.. of doing the wrong thing, of losing his or her license, not catching something, not being able to keep up, unsure how to coordinate with others, and on and on. We work closely with them to grow their skills and increase their comfort level. Then the day finally comes when they feel competent, and they’re ready for the next thing. Nurses have a smorgasbord of options for that “next thing” – ICU versus med/surg (and vice versa), pediatrics versus adults, labor and delivery versus NICU, doctor’s office, hospital, travel RN, Nurse Manager, Educator, Care Coordinator, Wound/Ostomy/Continence Specialist, Nurse Practitioner, Nurse Informaticist, and on and on.

The choices are limitless, and there’s no one who can assure us that we’re making the right call. Maybe we’re young and unencumbered and can rapid-fire send out 50 resumes to competing spots. Maybe we’re a sensitive soul and perseverate about our options by shadowing, making pro/con lists, having informational interviews, and having the same circular conversation over and over with a spouse.

It’s dizzying. And people seem to regret a flurry of contradictory actions and inactions when reviewing a life. They wish they’d achieved something a little more in their careers and taken more risks, but they also wish they’d had more kids.. spent more time with their kids when they were young.. and more time with their parents.. and generally put more focus on themselves to be happy. They say to worry less about money, but they wanted to travel more. Total strangers approach me when I’m out with my kids and beg me to “cherish every moment” and warn that it “goes by so fast.”

I’m thinking back to a previous post now: “Maybe what’s special about being human is our ability to make ourselves crazy.”

Let Barry Schwartz free us of this spin cycle. We’re not going to achieve life’s perfect brew – 1 cup of career advancement, a dash of parents, two tablespoons of children. Even if we did create a recipe for happiness, the minute we’ve tasted it our expectations rise and we’ll want more (please pass the travel).

My husband can be maddening in this way but perhaps he has it right (don’t tell him I said so). In the rare moments we get to have an extended, uninterrupted conversation, I want to play favorites or hypotheticals – “what are your all-time favorite movies?” “what would you do if you could have any job at all?” “where would you want to live if you could go anywhere?”

These questions that seem harmless and fun to me, seem fruitless to him. He’s just not interested. Why indulge? It’s choice overload, it’s maximizing. It’s chasing a white rabbit. Let’s talk about right now. Why is that so hard?

Over the course of a life, we’ll make hundreds of decisions. We’ll come from a place of rational truth, of heart, or both. We’ll pine over choices, or we won’t. We’ll feel good about the outcome, but maybe we’ll question the path. All of this is good if it gets us to a better sense of who we are and what we truly value (goodbye, should).

“There is nothing either good or bad, but thinking makes it so.” – Shakespeare, Hamlet

It’s About Power

Hospitals are finally realizing the problem of nurse burn-out; likely because it’s getting expensive to hire and orient new nurses in a time where most health systems are looking to tighten belts (blame or thank the Affordable Care Act and pay-for-performance). New grad RNs at my hospital receive a minimum of 10 weeks with a preceptor, but often several more. This is something my unit is good at and pride ourselves on, but despite our best efforts (following all the recommendations of New Grad Residency Programs, mentorship, flexible scheduling, etc.) if a new grad still only stays 1-2 years, we gnash our teeth and feel defeated.

In a quasi-leadership role, I feel the frustration of the constantly revolving door. So now we’re talking about it, but the resolutions feel hollow. We can’t treat this with band-aids.

Yoga matstabletop waterfalls, penlights with our hospital name, cutesy t-shirts extolling the martyrdom of nurses.. these things won’t cut it. “After awhile, you start to realize it is just a game of smoke and mirrors.” Nurses are even “storming” the U.S. Capitol to call for better nurse to patient ratios. Coming from a unit with generally favorable ratios of 1:4 or 1:3, I can unfortunately tell you that med-surg RNs are still coming and going in droves.

I’m currently reading Krista Tippett’s Becoming Wise. Last night I read a passage that talked about words as containers, and asked how many times have you waded through flowery prose and politicking only to ask “doesn’t it feel to you like there should be a thought bubble over it that says, “what I really would say if I could say it is…”

What I would tell hospitals is that, surprisingly, we can’t throw money at the problem (though sure, it wouldn’t hurt to have safe staffing… and what nurse doesn’t love a new coffee cup?).

Though the moral distress, the 100 tiny cuts per shift of slights and frustrations, the long hours and variable pay all add up, the root is poisoned. No matter what administrators say in flowery prose and politicking, nurses are misunderstood and disrespected. Physicians do not fully understand what we do, we do not fully understand what they do, and so we jockey and work against one another.

At a teaching hospital, we see hundreds of physicians come and go. I work in med/surg, and we have 11 different medical teams that come through in two week rotations on our unit. Each team has an attending and several residents, interns, and med students. They round with a Care Coordinator and Pharmacist, but how can a nurse round with 11 teams who come at different times? How can we form a meaningful relationship with the hundreds of people passing through, only to have to start all over again in two weeks?

I hear it’s better in the ICU. Fewer people coming and going, at least the illusion of teamwork. Many new grads will flock there.

But in med/surg, when we send two or three pages in an hour and don’t get a response, we snap and snarl. When the physician is getting paged about something deemed unimportant because he or she is admitting a patient or running a code, they snap and snarl at us. We complete our work mostly in silos because anything else is almost entirely impossible by design.

The stress, the frustrations, the long hours, AND the feeling not being understood or valued… the indifference.. sometimes even the contempt of our colleagues. If at the end of the day we can’t feel like we were part of a team, like we completed some collective good, if our career of caring is reduced to tasks (chart this, check that, program the pump, pass the med, don’t bother the doctor), then nurses will never feel good about what they do. And those bad feelings will eat away until we pack up and try again on another unit or in another hospital; or worse, we hang up our scrubs and leave the profession entirely.

It makes it that much harder for those of us who are hanging on, hoping for better days ahead.

Don’t give us a free breakfast or a t-shirt. We don’t want tolerance or saintly status; we’re asking for something much scarier.

Aretha called it: Respect.

noun a feeling of deep admiration for someone or something elicited by their abilities, qualities, or achievements.

We’re asking you to recognize that we’re educated, competent individuals.

It’s going to take a lot to get there. We’ve got to wash away years of sexy nurse Halloween costumes and ill-informed television shows.

Not to mention the whole culture of devaluing “women’s work”:

Culturally, we have a deeply ingrained, often subconscious contempt for women and for the things women do. That’s why when something is marked “feminine,” it becomes humiliating or emasculating for a man to do it. It’s why we smirk at the idea of Bill Clinton taking over Michelle Obama’s vegetable garden.

…If he really wants to challenge gender divides, Bill Clinton should take on these traditionally female obligations. He would send a powerful message: There’s no such thing as “women’s work” and “men’s work,” “women’s issues” and “hard issues.”

I couldn’t agree more.

Maybe there’s even more tied up in this election than I previously thought..

 

Run and Stumble

Maybe what’s special about being human is our ability to make ourselves crazy.

We take something simple.. we analyze it, replay it, assess and place value on it.

I love the internet, but it provides a constant feedback loop and yardstick. A quick search will provide a long list on the psychology of facebook:

The Anti-Social Network: By helping other people look happy, Facebook is making us sad.

How Facebook Makes Us Unhappy

Facebook Makes Us Sadder And Less Satisfied, Study Finds

How Facebook Warps Our Worlds – It not only makes us comparative and unhappy, it even stifles our individuality and influences us to conform.

Kitschy titles aside, the sentiment is real.

Yesterday someone asked me about my hobbies and what I do for self-care. Do you remember the early incarnations of Facebook where we eagerly and painstakingly crafted our list of hobbies and interests? But yesterday, that question made me pause and reflect on life since college.

An idea! Run, run, run. Grasp! A satisfied pause. Look around. A troubled pause.

An idea! Run, run, run. Repeat.

An article I stumbled upon today, while chasing a new idea, hit home:

But if you live for external achievement, years pass and the deepest parts of you go unexplored and unstructured. You lack a moral vocabulary. It is easy to slip into a self-satisfied moral mediocrity. You grade yourself on a forgiving curve. You figure as long as you are not obviously hurting anybody and people seem to like you, you must be O.K. But you live with an unconscious boredom, separated from the deepest meaning of life and the highest moral joys. Gradually, a humiliating gap opens between your actual self and your desired self, between you and those incandescent souls you sometimes meet.

And a later passage:

External ambitions are never satisfied because there’s always something more to achieve. But the stumblers occasionally experience moments of joy. There’s joy in freely chosen obedience to organizations, ideas and people. There’s joy in mutual stumbling. There’s an aesthetic joy we feel when we see morally good action, when we run across someone who is quiet and humble and good, when we see that however old we are, there’s lots to do ahead.

The stumbler doesn’t build her life by being better than others, but by being better than she used to be. Unexpectedly, there are transcendent moments of deep tranquility. For most of their lives their inner and outer ambitions are strong and in balance. But eventually, at moments of rare joy, career ambitions pause, the ego rests, the stumbler looks out at a picnic or dinner or a valley and is overwhelmed by a feeling of limitless gratitude, and an acceptance of the fact that life has treated her much better than she deserves.

Those are the people we want to be.

I was attracted to the nursing profession for many reasons, among them the hope that it would take me away from the computer and pull me out of feedback loop. Like a rat in the pleasure center experiment, I could keep clicking “refresh” to the point of exhaustion. To a point, nursing fulfills this promise. Being present with a patient and putting out (figurative) fires within the hospital doesn’t allow the mental space to worry about November’s election, to consider whether I’m building a “moral vocabulary” worthy of an “incandescent life,” or to pass judgment on my performance as a wife and mother of two children.

I can lean in during my three 12 hour shifts at work and present an employee who is a composed, decisive, and forward-thinking leader and peer. I can cultivate my mothering tribe on my days off, planning play dates full of outdoor exposure sufficient to raise a Viking child. During nap time, maybe I’ll cook.. clean.. consume social media or click bait. I will race until I pause. The pause will be one of feeling full and grateful, or of a longing to be filled again.

I can find comfort returning to David Brooks’ piece:

The people on this road see the moments of suffering as pieces of a larger narrative. They are not really living for happiness, as it is conventionally defined. They see life as a moral drama and feel fulfilled only when they are enmeshed in a struggle on behalf of some ideal.

This is a philosophy for stumblers. The stumbler scuffs through life, a little off balance. But the stumbler faces her imperfect nature with unvarnished honesty, with the opposite of squeamishness. Recognizing her limitations, the stumbler at least has a serious foe to overcome and transcend. The stumbler has an outstretched arm, ready to receive and offer assistance. Her friends are there for deep conversation, comfort and advice.

Running is okay, but not in a straight line. Goals are important, but there really is no finish line.

A great quote that stuck with me from Tuesdays with Morrie is, “you have to be strong enough to say if the culture doesn’t work, don’t buy it.” I don’t have to worry whether women can “have it all” if I refuse to by into the question.

I don’t need to have a ready-made answer when someone asks me about my hobbies and self-care because it’s not about the individual segments, but the unbroken whole. It’s one cadence, one dance. To separate out my day-to-day in my nursing career from my time at home with my kids is to imply there’s a definite start and stop to each. Some of us might be adept enough to leave all work at work, but in reality someone from work is texting us on our day off. And our child’s daycare is calling us at work. My patient is watching Donald Trump with Megyn Kelly on the tv. My Facebook newsfeed shows me a former classmate’s promotion at work. In that yoga class I signed up for in order to place a check next to the self-care box, I find a colleague on the mat next to mine. The mom’s at the playground want to ask me about their concerning health symptoms.

Life isn’t designed to be fragmented and neat. In fact, it’s becoming more integrated every day. The integration causes stress because we can’t evenly measure the pieces. Pick, pick, pick.

When I pick at the individual pieces, that’s when I’m unhappy. Seeing a friend post a photo from her “girl’s night out” reminds me about my stunted social life. Reading about how much fun was had at a playdate that occurred while I was working reminds me of my long hours. But when I step back and look at the whole picture, I’m happy. I’m whole right now. Maybe instead of that girl’s night, I read a story to my child and watched her eyes flicker with delight. Instead of the playdate, I advocated for a patient and her family who had been feeling neglected.

 I don’t need to define my hobbies or myself, because I’m stumbling.

“To be great, be whole;

Exclude nothing, exaggerate nothing that is not you.

Be whole in everything. Put all you are

Into the smallest thing you do.

So, in each lake, the moon shines with splendor

Because it blooms up above.”

― Fernando Pessoa

Both holy and primal

“I was stubborn in my pursuit of an unmedicated delivery… People ask me regularly (still!) why I chose to go that route, and I don’t have a good answer other than to say I had a deep, instinctive desire to do it that way. And I’m glad I did: [they] are without question the two most empowering experiences of my life. They shaped who I am and I’ll never forget anything about those passages, when I touched another world, felt something both holy and primal.”

– See more at: http://www.adesignsovast.com/2016/04/every-mother-counts/#sthash.AsKQ8Ojt.dpuf

Things I love tonight

Surviving my first solo parenting day with a toddler and a newborn, my oldest and I re-bonding and her saying some awesome and beautiful things to me “thank you for making it, mommy!” (Re: dinner) and “I had a great time with you today!”, becoming more firmly ensconced in a tribe of amazing mamas who also strive to make the world a better place, my local coffee shop, the way my oldest makes friends with ease and approaches others with such confidence and hope, my newborn taking a bottle for the first time, my oldest giving my newborn her blankey when she kept crying, and holding my children with my hands and my heart.