A Machine Full of Pearls

A recent Instagram post reminded me of a blog I wrote several years ago as a nursing student. As we are on-boarding new graduates and seeing a wave of  new students making their way into the units this month I found myself reminiscing those pre-RN days. Sometimes I do this with fond memories and mostly I’m glad they’re gone. While I don’t miss being in school I do love that in the healthcare profession there is always something changing and something new to learn. I remember the emotions that come with a steep learning curve and think back on them now as I will soon journey from progressive care to intensive care nursing. I embrace the coming change, and challenges with it. I can’t help but wonder if the expectation I have now will match the memory when I am able to look back on this moment from a point further along the road? In any case, it should make for some interesting scrub pocket treasures and a machine full of pearls:

Winter 2011:

It’s always been sort of fun for me to find out what ends up at the bottom of a washing machine. The treasure trove of lost coins, pen caps, and various papers and gadgets over the years has evolved and evidenced the tales of my week. As my interests and career paths have developed, so has the range of random findings. To date, I think the worst one was a Sharpie pen and a small bag of Miracle Gro. That episode left some interesting tie dye marks on my favorite jeans. As I started my journey in nursing, I discovered it was not uncommon to find latex gloves, alcohol pads, a pen light, or my flash drive wound in with the wash. Most of these are fortunately discovered before they make it to the dryer. Unloading my latest loot, I began to wonder what other subtle changes evolved when I became a nursing student.

I think my first indication that things had changed was when I began noticing the vocabulary in shows like Grey’s Anatomy and House MD. The story lines started to make rational sense. Cor pulmonale, banana bag, pneumothorax, orders for antibiotics, suddenly the plot was familiar and much more complex. Yeah, and my friends say it’s all about McDreamy. Seriously? Then there are the ever famous calls from friends and family.  “I have this pain and I’m kind of tired, what causes that?”  First, observe the word student in my credentials.  Second, call your doctor. Third, refer back to statement one. I’m curious, does every student nurse learning IV skills analyze the veins of people they meet? When did I start giving the “what’s up” nod to avoid a handshake during flu season? Why is it that the definition of appropriate meal time topics seems to depend on if I am hanging with my medically minded or non-medically minded companions? Heaven help the awkward silence when I slip up and confuse the two! Definitely, my behaviors have changed. I’m beginning to see people in a way I haven’t before. Noticing sadness and witnessing joy where I never expected it. I struggle with what to do and say when my patient’s family comes to say their last goodbye. My heart smiles as a whole department celebrates the ICU patient grinning and crying as she returns to say thank you. The odds were she wasn’t going to make it…until she did. I cheered for the 32 week preemie going home wrapped in the loving arms of his parents and cried for the one next door detoxing off drugs he didn’t choose to take. Of course, there are also the infamous student moments. Spiking that bag seemed really easy until I realized the angle was wrong and I punctured it, showering myself in 0.9% normal saline. In moments like these, what can you do but laugh? At least my patient did during the saline fiasco.

I heard a longtime nurse say, “nursing school will be the hardest challenge you will ever love.”  It sounded cheesy and cliché to me until I lived it. Sure enough, I’ve had days where I come home exhausted and in tears. I’ve had days where my heart is so full of joy and excitement one body almost can’t contain it. It’s an emotional spectrum, and one that leaves its mark. As I celebrate the halfway point of my journey through OHSU School of Nursing it has become apparent to me in more ways than one that I absolutely love what I do.  I love every tired, funny, hysterical, crazy, amazing moment of it. One of these days I will also learn to clean out my pockets when I do the laundry. Until then, I’ll let the trail of washing machine treasures tell my weekly story and see how the next chapter unfolds.

a machine full of pearls



A Letter to Dad on Father’s Day


I write this on the eve of Father’s Day with a heart full of gratefulness. When I was little and I would fall you taught me that I was strong enough to get up and try again. In my 30’s when I fell, and my world fell  with me, you told me the same thing and I still believe you. I’m standing today because of the lessons I have learned from you.


Dad and Liz (2)


In the mornings I saw you sitting there with your Bible open, reading and praying before the day began. You taught me to love God first and foremost. In junior high when we drove to school and my friends talked about “coach McCormick” pulling in the parking lot cranking out “the oldies” I cringed. Today I still play my car radio loud and play the finer music of Boston, and Creedence and Fleetwood Mac on vinyl because that’s the way music should be heard.  I learned the term “walk it off” from you and findEK_0046 (2) - Copy myself repeating words like “tuna lipper” and “bubblehead” and “dip stick” when I’m frustrated. I watched you coach and give selflessly in the classroom for years, my whole life really. You have a heart for kids on the fringe and you and mom always have. I watch you now, retired, still working with them and mentoring. You answer that call in the middle of the day or night because they don’t know who else will be there. You are. You walk with them in the dark places of life and even into the hospitals and jails just to let them know they have a God who loves them and you in their corner believing they can rise above. I learned that from you too. If I have learned anything about loving people, I have learned it by example.

On father’s day, Dad, there are so many things that I could say and write about the person that you are and how grateful I am to be your daughter. I know that I am grown now and capable in my own right. I still love that you will stop by to help me fix that faucet or change an air filter and talk me through a problem with your quiet logic. You don’t have to but you do, just because, and I love that.  So not just today but today especially, know how much I love you. Happy Father’s Day.

Orange VW Bus0001 (2)
Phoenix,AZ 1979
Elizabeth and Dad
Sedona, AZ 1980
Bandon, OR 2016
Bandon, OR 2016

Batter Up…Blog!

The water from the pool sparkled beneath the hot Arizona sun. Standing above it on a 12 foot dive I debated the wisdom in attempting a plunge headlong from such a point.  Sucking in a large breath I bounced once and launched forward. Timing and trajectory miscalculated, I flopped. In the second between the sinking feeling in my stomach and sheer panic I could only rationalize one thought. Bad call! My latest approach to the transition from solitary writing to posting on an online blog feels oddly familiar in that way.

I am, after all, a prolific if not somewhat disorganized writer.  Bits and pieces of my life and the moments that have made a dramatic impact on it almost always make their way to the page. It didn’t feel like such a jump to do the same thing on an online platform sharing my experiences with the digital world. Except that it was. Like showing up in public half-dressed I felt suddenly and uncomfortably exposed.

I have come to realize there is a certain security in the familiar. I type on my laptop, and more recently on a 1953 Smith-Corona manual typewriter, just to keep it cool. The sounds of the keys bring a monotonous calm and solitude for thought.  On the page it is me and my world.  An online worldwide version pushes well out of that comfort zone.  In seeking to keep the public version more comfortably private I gave myself a pen name, Eli Mac. There is a certain bit of anonymity that I enjoy in that.  Even then I questioned the wisdom of sharing beyond close friends and family the personal nature of my stories, many central to my faith and significant moments in life. With family and friends it is familiar, and safe, and cozy. I like it there. No one challenges me. Yet without challenge, how then can I expect to grow?


Now that I have taken the leap into blogging and built a site, I am looking down on it to discover the waters are much wider and deeper than I had thought.  The words I write will be read and critiqued by those with access to the global website. Once out there they cannot be taken back. Unlike my shredder, the words can only be assumed gone but may resurface in a fluke of random code. When I pulled it up this morning and my site stared back at me on the screen I froze. It was one of those moments where I could feel every heart beat and count it accurately as it pounded in my ears. Even under the assumed name, my veil of comfort was gone. I was exposed.

What I have come to realize about this fearful reaction is that the possibility of writing to the online world risks the painful reality of rejection and ridicule. I share in this collective site and digital universe with minds so complex and capable and articulate that I shrink back in intimidation.  What if I don’t measure up? What if I sound stupid? What if…I get over it and give it my best shot?  I think that is what I have learned through this most recent panic attack. Life is always going to throw curve balls at me. Am I going to duck and cover my head with my hands so I don’t get hit or am I going to grab my bat and swing as hard as I can? Sure, I fully admit the risk of humiliation and judgment.  It scares me to death. However, I also believe in a God who does not call me to be fearful. One of my favorite verses is Joshua 1:9. I need to remember this. Repeat it. Make it my daily mission. And no, I will not quote it. I want you to look it up. You’re welcome.

So I submitted my first piece to “The Dirt Road” on WordPress. Terrified? Absolutely. But I am now bounding off that ledge into the water with arms wide open. I am standing at the plate staring down the pitch and watching that ball fly forward.  Will I flop? Will I strike out? Maybe. Will I find the waters turbulent and uncharted and the crack of the bat uncomfortably sharp? Probably. Boldly I go forward with this anyway because God has not called me to lead a boring life. He has called me to step forward and take the risk, and feel the hurt, and revel in the joy. He has called me to live this life and follow it in the direction He guides. With sweaty palms I clicked on the word “publish.” Batter up….swing!


I Survived ACLS

I wrote this almost four years ago, a timid senior nursing student trying to branch out from my pursuit of psychiatric nursing. Recently I took the re-certification for ACLS and laugh reading this as I still felt many of the same jumbled emotions. Real codes and the processes and pharmacology are more familiar to me now. I can decipher a first degree from a third degree block and the motions and drugs and differential diagnoses now come easier. Easier but not easy. At that moment three years ago I would not have imagined myself a critical care nurse. Not in my wildest imagination. If memory serves me right I left that first day almost in tears, convinced I did not have what it took to master skills at that level. If I have learned anything in these beginning years it is a stronger self awareness that I am a victim of my own doubts. Perhaps that taunts all of us. I can’t say. Stepping through the fear to the unknown is a risk. This class was one of the first times I took a leap through fear to do something that challenged me. I have made a commitment to continue to take those steps despite the risk and the fear that they hold. 

“Your patient is a 58 year old male presenting with chest pain 8/10, pulse is 190, BP 80/70 and respirations of 40,” the instructor said. “Suddenly he snorts and collapses; you see this rhythm. What do you want to do?”

I swallowed and looked down at the pasty plastic face of the mannequin and watched as little black lines squiggled their way across the EKG monitor with an impending sense of doom. Somebody call a code, I think I’m having a heart attack!  SVT, V-tach, PEA, Amiodarone, Adenosine, Atropine…my brain raced through a jumble of names and acronyms and symptoms and algorhythms.  Just like a TV medical drama, the world suddenly seemed to move in slow motion around me.  The sound of my own heart thundered in my ears.  I was running my first simulated major code!

For the first three days of Christmas break, I decided to tackle the challenge of ACLS certification. I signed up for the course eager for a chance to learn more about EKG interpretation and to practice more advanced nursing skills. I was not disappointed.  The challenge on day one was absorbing a mountain of information and forcing myself to sit still for the better part of 8 hours. After deciphering what must have been miles of rhythm strips, I was still at a loss to identify runs of PAC’s from third degree heart block. I left, slightly disheartened (pun intended) with rhythm strips and terminology scrambled in my mind and all over my notebook. I had even drawn a bundle branch block on the back side of my hand when the margin of my paper was full.

As we settled into day two, things picked up. We were no longer sitting in desks and squinting at squiggly lines on graph paper. No, this day we would practice! I was eager for some hands on learning, that is, until I was I was handed the leg of a mannequin and told to pick up a drill. I stared at the large bore needle and again at the leg…this was going where? Don’t we need an anesthesiologist first?  I felt for the flat space on the bone just below and slightly medial to the knee cap.  Squeezing slightly, I started the motor. I inhaled as I felt the slight resistance of the tibia against the needle’s edge, then exhaling, I felt it give way. Ok, breathe. I had just started my first intra-osseous catheter!  I decided that was possibly the scariest, coolest experience in my nursing education thus far!

Day three began where we had left off on day two, minus the drill. Simulated codes and various scenarios were run time and time again until our arms hurt from repeated compressions and our reactions to “code blue” were immediate. It was time to test. I was the first to be called for the check off. Taking a breath, I began to mentally rehearse my H’s and T’s and then I heard my instructor ask…

“What do you want to do?”

I knew, despite my pounding head, that H’s and T’s didn’t stand for” headache” and “tired” but somehow that’s all that came to mind.  It all moved very quickly then.  I heard my own voice saying, “We have V-tach, that’s a shockable rhythm, charge 200…can I get 1mg epinephrine and have 300 Amiodarone on hand in case we need it?”  That fast, I passed my first simulated major code. I sighed with relief; my mannequin would live to arrest another day. Leaving the room on the last day of ACLS, I have more confidence than when I went in. In no way do I claim to be an expert; far from it. In fact when I witness my first actual code, I think I’ll probably still feel like I want to heave.  I figure that’s normal.  The confidence comes from having pursued something I was intimidated by and succeeding despite the fear. That has changed the way I look at things. I learned two very important lessons from ACLS.  First, only defibrillate dead people.  Second, I can’t possibly know what I’m capable of until I’m willing to risk disappointment. This course taught me the benefits of experience are worth more than the fear of failure. In the mail today was an envelope with my official certification inside.  Staring at the little red card I smiled. Christmas came early this year.

Life Lessons and Truck Stop Wisdom

Most of the time when I write I am inspired to put a voice to insight learned through simple things. This is how I process and make sense of the noise that is chronically in my head. I value that part of my brain but sometimes I think a story just needs to be told for what it is, a short snippet of life that weaves itself into the fabric of memory. It becomes something that we look back on and smile at every now and then just because. My move to Oregon in the summer of 2008 is just that. I packed what I could fit into a pickup truck and headed north to Oregon from Arizona to figure out how to pick up the pieces of a broken dream. It’s ironic that in a period of so much pain, I look back on this trip as one of my fondest memories. For the 1300 miles that span between Phoenix, Arizona and Medford, Oregon it was me, my truck, a Stevie Nicks CD and miles of open highway.  With each passing mile my soul found solace and I at last felt free.

I think in a lot of ways that stretch of highway north represented a significant direction change in my life.  Looking back on it now it was the beginning of a huge directional shift in who I would become both personally and professionally.  I recognized at the time that things would never be the same and that I risked both huge success and heartbreaking failure as I stared toward the future through my windshield.  I remember poignantly some of the people I met during that trip as they made impressionable memories that I carry with me to this day. I came across an old handwritten journal page I had stuffed in my Bible at some point during this time.  From my notes, the memories of these people jumped out at me from the page. Each one of them held a piece of a lesson that I hope someday will fill in an amazing landscape for my life.

One of the first people I met was Sheila, a local from Wickenburg, AZ.  Standing on the sidewalk in a neon pink, zebra striped cowboy hat and black alligator boots I assumed she was one of the tourists passing through.  I had pulled into a spot along Main Street to tighten some cords that had come loose on my load.  She crushed her cigarette and offered me a hand.  Sheila bred and showed quarter horses on a ranch outside of town. She laughed at my handiwork and taught me the finer points of securing a load to a pickup-truck bed.  I remember her comment when I complimented her hat. “Why not have some fun and make a statement?”  She lit another cigarette and waved me on as I caught Hwy 93 toward Interstate 40.

Photo credit Google Images

Catching Hwy 58 on my way towards Bakersfield, CA I found myself fascinated by the tiny little towns along the way in this arid, nearly desolate landscape that the monsoon rains had clearly forgotten.  Boron, Mojave, Tehachapai. They seemed as roughshod and toughened as the people that lived there. How different these lives were from the hustle and spread of the greater Phoenix area! In many ways life must seem simpler, but in other ways I wondered about the burden of living so seemingly off the grid.

Finally making my way north off of 58 to Interstate 5 I stopped in a little down about a mile south of Sacramento. Santa Nella, California is a farming town tucked in the spread of the San Joaquin valley.  It’s most distinctive feature was the musty smell of farm land and cattle that hung heavy in the July heat.  I stopped at a truck stop to fill up and found myself wandering into the attached diner and sitting down at a horseshoe shaped counter along with a group of truckers. I glanced at the woman behind the bar. The woman’s name was Bess. I came to learn that she had worked there nearly two years and the San Joaquin valley had always been her home. There was a sort of unspoken bond between her and the men sitting there as she bounced back and forth filling coffee and handing out plates of onion rings. Their conversation was friendly and familiar like I had taken a seat at the family table, not a nearly empty truck stop in the middle of the night.  They bantered back and forth about places they had been, close calls encountered, and perceived injustices suffered via permits, scales and state troopers.  In the midst of it was Bess, laughing and scolding, in a motherly way, this group of rough- and- tumble men.  She smiled at me and said “what will you have?”  My instinct was to say “all of it” but at the late hour coffee and a bowl of fruit seemed more reasonable.   In my fatigue my memory serves a poor record of most of the conversation I had there.  I do distinctly remember one thing Bess said and I carry it with me in my patchwork of lessons learned.  “I love the highway” she commented “if you’re ever in the wrong spot, pick up and keep going, there’s always a new direction to be had.”

I made it to Medford, Oregon tired, confused, and feeling like I had lived 100 years in the span of 48 hours. The memories I have play back in my head like an old film reel, patchy and skipping at times.  The lasting impressions remain with me and from them I have learned this:

  • Have fun and make a statement.
  • Sometimes it’s just necessary and appropriate to wear a zebra striped hat. 
  • Even in the most desolate of places, life moves on. 
  • Most importantly, when you find yourself in the wrong spot, coffee gets you going until you find the right direction. 

As I write this I am well on my way. To where, I’m still not sure.  That’s life for you though, isn’t it? Lessons learned through the wisdom of truck stops until we finally arrive home.






The Three Year Itch

I was perusing some of my previous blogs written during nursing school the other day. As I scrolled through I found myself smiling, I vaguely remember that nursing student. She was full of spirit and faith and gung-ho on building a solid psychiatric nursing career. Naïvely she believed in a practice without bias and thought that burnout was a condition that would happen years down the road, or never. Only three short years ago standing there in a cap and gown was a new graduate nurse with a mission to cure the world and look darn good doing it too!

She is a far cry from the critical care nurse I saw in the reflection of the hallway mirror as I crawled through the door after what felt like the longest 12 hour shift in weeks. I found it only mildly surprising to find that my hair had wigged itself out of its braid into a frizzy halo and my eyes were bloodshot from fatigue.  I peeled off my scrubs and threw them in the washer thinking that perhaps an autoclave might be more appropriate. I remembered, vaguely, texting a friend that short of amniotic fluid I think I had been hit with every other possible bodily contaminant. Even the loaner surgical scrubs felt filthy.  As I got in the shower part of me wanted to cry and the rest of me was just too damn tired to muster the energy. The sun had dropped below the hills and my day was at long last at a weary end.

If nursing goes in phases, I call this phase the three year itch. That period of post-graduation where the honeymoon of new-grad nursing is over and reality sets in, harshly. I guess at some point I had been warned in class about all of this. Higher nurse to patient ratios, charting for core measures, patient satisfaction surveys …it all sounded do-able then. Ignorance truly is bliss. I was so darn cute when I was naïve!  I was confident it would be no problem. I’d get in my groove during orientation and then I’d hit the floor with a plan to manage every disaster.

I knew I’d have bad days but I was certain the good I was doing would outweigh them. I would make sure I gave every patient the time they needed and there was no IV pump or computer program I couldn’t figure out. Lately, I’m learning not to feel like a failure when my most stable patients see less of me.  I do my best carrying three critical care patients but I can’t be with all of them at once. Not with what feels like millions of charting details and screens to fill out and the hundreds of times I go chasing after bed alarms and call bells, monitors and IV pumps that insist they are occluded despite every possible intervention.

Those are just the routine shifts when by the grace of God no one codes or needs a rapid response. All bets are off when the code chimes toll. I’ve learned I don’t really have a game plan for chaos. When the “code brown” hits the fan, I roll with it and prioritize…and on a good day it stays off my scrubs. Even now I fully expect to make not just a few mistakes. With any luck I will learn from them and be that much smarter the next time all hell breaks loose.

Looking at my reflection in the mirror, I looked beat. I am not beaten however. Underneath the frizz and the bloodshot eyes, you will most likely find my spirit laughing. I’m laughing at the oddities of people and just how fascinating I find them. In my three years of nursing I’ve met some interesting characters and had a lifetime of laughs. I once had the chance to talk fishing with a man known only as “catfish”. I’ve worked IV lines and monitors around team sweatshirts and jerseys because the big game was on. My patient with an open wound left AMA because elk sea


son started. A senior patient of mine was covered head to toe in body art and piercings, complete with nipple rings. I had the chance to hear a veteran of Vietnam recount first hand the experiences he had during the war, making history come alive in a way a textbook never had. Perhaps most memorable was the visitor of a patient wearing a pink adult one-piece pajama suit. They carried with them a small deceased animal in a plastic bag. Diplomatically I had to insist they leave and dispose of it immediately. Just when I think I’ve seen and heard it all, something else leaves me speechless.

In all of this I gratefully call “friend” a team of coworkers that have had my back the entire course supporting, encouraging, and teaching me. These are the real heroes. In a moment I would trust my very life to them. As a nurse, these are the memories and things that I cling to. These are the moments I need to remember when I feel like giving up.

I went into nursing because I like people. Everyone I meet has a story and I find that inspiring. Being a nurse is the hardest job I will ever love. Some days I feel invincible. Sometimes I just need to find an empty supply closet and cry. If I have changed at all in my transition from “new grad” to “newbie” nurse it is this: I don’t believe I am single handedly going to change the world. The best I can do at any time is change a moment.  If that moment makes a difference in some small way then I’ve done the best I can at what I am called to do. I’m no superhero.  I’m a nurse and I wouldn’t have it any other way.