July 22 blog

You're Fine! (Right?!)

Have you ever used that phrase when someone hurts themself and they are getting all dramatic (in the absence of blood or imminent death) and you quickly say "You're fine' (sometimes repeated in triplet "You're fine, you're fine, you're fine")?

Well, it's become somewhat of a joke at my house.  When my children were small and they would take a tumble and immediately burst into tears I would make a rapid assessment of the situation while all the while telling my child 'You're fine, You're fine, You're fine'.  (Am I the only one?)

Now, for the most part this phrase has served me well.  For the majority of the time my children have been fine and by telling them they are fine I feel in control, I believe I am calming them down through my reassurance while at the same time keeping myself calm (they're fine  they're fine  they're fine ), and for the most part, it all turns out well.

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There was that one time I had my son mow the backyard.  It hadn't been mown in awhile so it was a bit of a big job.  My son came into the house complaining of shortness of breath and I immediately told him he was fine and sent him back out in the yard.  Several hours later we were in the emergency room.  As it turns out he was having a reaction to all the pollens and allergens in the yard, he wasn't fine after all .

Most recently I found myself digging that phrase up again, this time with regards to my new grand baby.  My daughter, a brand new mom, asked me to listen to the baby's breathing, it was stridorous, it was intermittent, no color change and I couldn't really appreciate any retractions.  The baby seemed comfortable.  I suggested she let her pedi know about her concerns and see what she had to say. In my head I thought maybe a little laryngomalacia, she'd outgrow it, she was fine.

Apparently the pedi agreed, no intervention necessary.  I was happy but my daughter was not convinced.  She said it was worse at night, she was very bothered about it, she was worried. 

She took a video of the baby sleeping and sent it along to me. I shared it with a friend of mine who was a respiratory therapist who agreed - stridor, check in with the doctor.  I shared this '2nd opinion' with my daughter.

She was thankful for the 2nd opinion but wanted more reassurance so she shared the video with a pedi airway guy she had worked with many years ago and he in turn shared it with his ENT colleague.  "She needs to be seen immediately by a pedi ENT specialist" he told her and booked the appointment. 

Within the span of one week she was seen, had a sleep study that showed severe hypopnea and obstructive apnea, was admitted to the PICU, placed on CPAP, underwent a laryngoscopy during which they removed excessive tissue that was obstructing her airway and was discharged home off CPAP.  Turns out she was not fine... but I am happy to report she is fine now, thank goodness!

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I am so grateful for my daughter's mama bear instincts. She wouldn't let it go, she knew in her heart of hearts that something needed to be done.  And I felt bad. I minimized her observations, I minimized her insights and her status as mama bear with those 2.5 simple words: "She's Fine".

This has been weighing heavily on me over this past week.  How could I minimize my daughter's assessment, her insight and intuition about her sweet baby girl? How could I dismiss her concerns? 

I think what was going on inside my head and my heart was disbelief.  I could not accept that anything could be wrong; my daughter and son-in-law have waited a long time for this special little baby, enough is enough - she's fine!

But, what I have learned or better stated, what I've been reminded is that life isn't fine, it's messy and beautiful, scary and frustrating, awe-inspiring and exasperating all rolled into every breath we take. 

With each breath, like each experience, there is an invitation to choose how we will show up.  Will we show up rushed and dismissive or patient and present?  I think the scary stuff in life calls us to courage and calls us to a higher understanding of ourselves and our place in the world.  

For my daughter and son-in-law they embraced the call to parent under pressure.  They learned how to advocate for their precious baby.  They learned that not everyone knows everything and if it doesn't feel right it probably isn't right.  These are wicked important things to learn for sure!

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For me, I've learned to walk my talk with my family.  I preach on the importance of honoring the observations and insights from the families we serve in the NICU. I emphasize that what we think about another person's experience is simply irrelevant, it's our opinion (and you know what they say about opinions).  

The patient and family experience is the centerpiece to our work.  We are there to support them through their experience respectfully, compassionately, and with dignity.   And as easy as it is to write these words, it is much more difficult to live them, to make them live and breath in every moment of our work. 

This is my daughter’s family.

This is my daughter’s family.

At the end of the day we all want the best outcome, best experience and best life for our family, our friends, our patients, for everyone.  I think we can all agree it's sad when something threatens someone's joy and sense of safety.

As nurses we want to make things better, we want to do the right thing. But sometimes the right thing, the only thing has nothing to do with 'doing' but everything to do with 'being'.  Being present, listening to not only their words but their feelings, and hear what their heart is trying to tell us. 

It just takes 40 seconds to convey compassion and that's the real game changer   . 

Take care and care well,

Mary

P.S.  To learn more about the power and biology of compassion and hope join Sharon Bonifazi and me August 24th at Summerlin Hospital Medical Center, Las Vegas NV for our very first Quantum Caring for NICU Clinicians Workshop (brochure attached )

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