Transitions

I suppose I'm used to transitions now - though that's not to say I'm good at them. I can see how I've become better at them - but still not good. This last one was rough - it was difficult for Bella, which intensified the difficulty & sadness we already felt. However, it's been about 6 months now and just as I thought transitions were over, I've become suddenly aware of a transition that I'm still getting used to.

My job, but not in a way you might think of.

Working with pediatrics at an entire hospital dedicated to the specialized care of children is like living in a cup half full world. Despite the prognosis, despite the disease progression, despite the terrible symptoms, hope rises above. Love and positivity transcends it all. Parents are as much our patients as the children are and pediatric providers are trained in or have learned over the years how to provide care to the entire family - not just the little person in the bed. There is a happy air that we all breathe; the environment is upbeat, cheerful. The wings have themes, the rooms have games, the furniture is small and inviting. Patient rooms are covered in family photos, crayola pictures from classmates, toys, flowers, balloons. The families of our patients are thankful and appreciative and show it. You grow close. Compassion exudes the health care team, seeps from the decor, permeates the floors. That's the pediatric hospital that I came from.

Now, I work with adults and geriatrics. Though I'm not involved in direct, hands on patient care anymore, I go on rounds daily to each floor and there is a stark - a DRASTIC - difference that I'm contending with. As I walk around the patient floors, I hear the cries of the elderly, wafting out to no one in particular. I listen to the confused conversations of the advanced alzheimers patients. I pass the empty, dark rooms that show little signs of family. I review the charts that specify DNR, hospice, and comfort care only. I see the look on some doctors' and some nurses' faces of exhaustion, reluctance to attend to the same patient's same request for the hundredth time that hour. (And that's not to say we don't have a wonderful team who still provides the best care, but we're a tired, overworked, under appreciated and underpaid profession.) I read histories of patients who are alone, who have just distant grand-nephew's to mind them. And it is sad. It makes me sad. And, it makes me wonder about the life that we've leased here on earth. It makes me think about the choices I or my family will make for me when I get to those last years. It makes me want to make sure I take care of this body so that it can prevail in the face of old age. It makes me wish I'd been better to my grandma when I was a teen. I want to send flowers to every patient at my hospital so there's something cheerful around them.

I started out nursing in adults and I definitely did not see this in those early years. But having gone into peds and back to adults - it is hard to ignore. I can't decide which thoughts were more troubling - working with peds and constantly fearing for my own children OR working with adults and being reminded of what could come?