Worthy

What would it feel like to live life without feeling the need to prove your significance? Because don't we all feel it? That nagging need to feel important, to have our value affirmed by the people around us... Isn't that where comparison and jealousy and pride come from?  If my value is based on my appearance or my abilities and there is someone nearby that surpasses me or that I feel I surpass, they become a measuring stick of my realitive worth.Without even realizing it, so much of what we do is at some deep level motivated by our need to feel like we matter. We all chase it in different ways. Maybe if we are beautiful we feel valuable, maybe wealth or status make us feel important, maybe our work, maybe romance, maybe our art, maybe our causes, maybe even crime.

I'll be honest here. The primary way I've chased significance in my own life is altruism and religion. If I can do a lot of good, maybe that means I matter. If I give away my money, if I volunteer with the homeless, if I take care of the sick and help save peoples lives, if I volunteer at church, etc etc.... Maybe just maybe I matter.

But what if.  What if instead of pursuing significance through who we are and what we do- what if discovering the actuality of our value instead released us to be who we are and do what we love without comparison, without jealousy, without pride. Doesn't that sound like freedom? I don't have to become worthwhile, I am worthwhile and in that knowledge I can run unfettered.

Now this is where worldview matters. Because whether or not I am intrinsically valuable is dependent on my origin. If I am a product of chance and nature alone, my value comes from being valued by other people or by what I have to offer. Gold is only "valuable" because we value it, because we have a use for it or because we want it. It can't really be different for people. If there is no Intention behind the universe, than I have no choice but to pursue my worth through my relationships, looks, or talents. I will never be free, and if any of these fail me- if my husband leaves, or my friends get worn out, if my body gets crippled and I can no longer contribute, than my relative worth will be pulled out from under me like a rug.

Love, I believe, is the ultimate conveyer of significance. Nothing makes us feel like we matter more than having someone who's opinion we value love us completely.  If there is a God, which I'm convinced there is, and if that God loves you- than you are completely and intrinsically valuable. If the ultimate Opinion has deemed me worthwhile no matter what, then I am. And instead of chasing this allusive sense of meaning and importance, I can rest. I can rest in my set identity. And instead of chasing people's opinions and affirmations or even my own, that unchanging and steadfast love can set me free to serve out of love alone and not just a quest for importance. I can live a meaningful life not to earn significance but because I am significant. And this is the beauty of the Christian story.  Here there is no place for pride and no place for low self esteem, and if you really believe it, it will change your life. The Truth of God's steadfast love for you will set you free.

To Err Is Human

Medical error leads to thousands of deaths every year.  That's a scary statistic, no matter which side of the gurney you find yourself.  And it's one that has poked uneasily at the back of my mind since my earliest days of nursing.  The majority of people who enter the field of healthcare do so because they want to help people, to do their part to ease the suffering of this broken world. Imagine how devastating to instead end up hurting someone because you make a mistake. I remember a nurse who unintentionally caused the death of a 16 year old saying in court in a voice heavy with grief, that she would be serving a life sentence of shame and remorse. A seasoned, competent nurse in my corner of the country committed suicide not too long ago in the wake of a fatal error. It's a fear that plagues every one of us who has the potential to cause harm when we've devoted our lives to doing good.

It's one of those moments that is seared in my memory. I was in my early years of emergency nursing and I'd just given a handful of different medications to one of my patients. As I sat down to chart the medications, suddenly I noticed something I'd overlooked. In the middle of the list of IV medications one was subcutaneous - to be given under the skin as opposed to in the vein. But I had just given them all IV. I could feel the heat spread up from my chest, making my face burn and my legs start to feel weak as I realized my mistake. I had just made a medication error.  Was it serious? Would it hurt her? I did a quick shakey google search to check if the med could be safely given other routes.  I knew I had to tell the doctor. I didn't want to tell the doctor. She'd think I was an idiot. All that hard earned respect, the proof of my competence, I didn't want to risk losing it! The strength of my desire for self preservation surprised me. In the end my concern for the patient and my conscience won out, and the doctor responded by swinging her head back and dropping the Fbomb before trotting away to talk with the pharmacist.  In the end it turned out the medication could be safely administered IV. No harm no foul. But that feeling never left me. The shock of how quickly and easily an oversight could result in harm. How a seemingly ordinary shift could suddenly alter lives. The potential for error went from hypothetical to terrifyingly real.

In the end I was thankful for that close call. Because I think one of the best safeguards to error is a healthy sense of fear. I don't mean anxiety, but an ever mindful respect for the potential for catastrophe that keeps you a little more alert, a little more attentive, a little less auto pilot.  When I first learned to drive I remember being acutely aware of the amount of power and speed a vehicle has and how easily a mistake could result in harm or death.  But the longer you drive you start to lose that sense. You get comfortable. You stop paying as close attention, your mind wanders,  you shoot off a couple of texts at 65 mph. And most the time, this doesn't result in harm - adding to your false sense of security until it's too late.  As healthcare workers I think a little bit of fear is our friend. Fear alerts you to danger and makes you pay attention. People's lives are in our hands, and there will always be danger. Ours can never be 'just another day at the office', the stakes are just too high.

How Primary Doctors Set ERs Up For Failure

I know they don't mean to. I know they are trying to do their best by their patient and can't understand how it feels on our side- but here is a way that people's primary doctors set ERs up for failure, and it can basically be summed up in this phrase: "I'll call the ER and let them know you're coming."

Every day, several times a day, those of us working the front desk will hear these words, strong and filled with confidence of the power they surely contain, "My doctor sent me. He called, you should be expecting me." No other explanation should surely be needed, open wide the gates and let me pass! Usher me past all these poor waiting souls who were not likewise sent by their doctor. How disappointing when the poor chap at the desk has to say, I'm sure they did, but you'll have to get in line. Because you see, it's all good and well for your doctor to send you to the ER if they have concerns that can't be addressed in the office, and if they want to call us about it that's fine too, but very rarely will it change anything about the ER process. You will still have to be triaged, and you will still be sorted according to the actual urgency of your condition.

But when people hear 'go to the ER we'll let them know you're coming', they hear "you need immediate treatment and you will get that as soon as you walk in the doors". But that is a faulty perception, because lots of people get sent by their doctors offices, few of them need some immediate treatment or testing, and rarely will their doctors call "bump them ahead" in line if there's a wait. But since before entering our doors they have that expectation, any form of waiting or perceived lack of urgency on our part will mostly be interpreted as negligence.  People seem much more likely to be angry or indignant at waiting if they were sent by a doctor who 'called ahead'.

 There is also the perception that since their doctor called, as soon as they state their name we should know their story.  "Oh Mr Jones, yes! We hear you may have a kidney stone! Come this way please, excuse me everyone! The doctor is waiting for you..." I can't tell you how many times someone comes to the front desk and states their name confidently, pauses awkwardly as they await recognition, then state a little perplexed- "My doctor should have called..."  Immediately set up for disappointment.   I can understand its a good customer service move on the PMD end of things as no one wants to hear they should go to the emergency room, and no one wants to hear they may end up waiting a couple of hours once they get there, so an offer to call ahead seems caring. But the problem is that it rarely makes any actual difference on our end, it just creates an expectation that too often can't be met, and a faulty perception that leaves the ER looking like the bad guys.

So there ends my rant. Just remember that if your doctor sends you to the ER, you should go. But if they really think that you need treatment that cannot wait, they will call you an ambulance. If they do not call you an ambulance and the ER is busy, you may still have to wait.

Eye Of The Beholder

There are some people in my life that I love very much.  These people have in various ways and manners throughout the years caused pain and struggle in the lives of some other people I love very much.  There was a time when the hurt party would talk to me about the offending party- hurt-filled, angry, almost venomous words.  Being on the outside of the hurt, I could understand the offenders. I was acquainted with their faults and weaknesses, but also so acquainted with their beauty and graces. And there was much beauty and grace. But I learned something. Some say love is blind- I say so is pain.  Love closes it's eyes to the faults of the beloved, wanting only to see their virtues. Pain on the other hand can no longer see the virtues, only the faults. It's as though we are afraid that seeing and admitting the virtues of an offender will lesson their offense, or the right we feel to that pain.  Being a witness to this made my heart very heavy.  I wanted to affirm the hurt but also defend and support the ones who did the hurting, but nothing outside of divine grace could make that possible, only supernatural grace could bridge that chasm. But the grace did come and so did healing.

I have felt that same heaviness as I've met and heard the stories of people hurt by the church.  And by "the church" I mean by whatever grouping of Christians they were associated with. Because I know the offenses are real. I know the community of Christians has done things and said things and rallied behind things that have left people hurt and rejected and angry. But I'm also intimately acquainted with the beauty of the church.  My church growing up was no perfect community, but when I remember that church I remember the toothless, shabby homeless man that was always welcome in our pews and at meals around our tables. I remember the children from rough neighborhoods that got Sunday lunches on our buses. I remember high risk children that were taken in by families and loved like their own. I remember people being given second chances. I remember my pastor standing on his toes to hit the high notes of songs and crying on his knees when he believed he'd made a mistake.  I remember frustrating my Sunday school teacher with my hyper ness so badly she turned purple, yet somehow never doubting she cared about me. When I think of my experiences with Christians I think of young people who give away some of their hard earned money to help the poor. I think of  so many families who have loved abandoned children and made them their own.  Of the people serving the homeless, seeking out the lonely, loving the forgotten.

It breaks my heart to constantly see the failures and oversights and offenses of the church shouted from the proverbial rooftops knowing that enough are real and legitimate, but wishing there was a way to remind of its beauty without glossing over its offenses. But I know where there's pain it's hard to see beauty. At least outside of divine grace. And how I pray for that grace, and for that healing.

Where God Is

Here is a truth: God can be found at the end of our abilities and along the painful edges of our weakness.


There have been two distinct instances in the last several months where I found myself at the end of my rope.  The first such instance involved my kids.  I was slowly recovering from that good ol' "pregnancy sickness" that plagues reproducing women worldwide, and as you can imagine, feeling sick day in and day out gets old. And if you have preschool aged children you know that their capacity for sympathy is about the size of a thimble.  A preschool sized thimble.  On this particular day, my kids and their preschool sized thimbles of empathy were hounding me one after another, seemingly nonstop, with wants, needs, whines, cries, and ridiculously over dramatized arguments with each other.  I was so incredibly frustrated and spent, I shut myself in the pantry, tears burning my eyes, and screamed silently. And it took all my remaining sanity to keep them silent. I wanted to run away, I wanted to hit something, I wanted to send my kids with a one way ticket to grandma's house. Or anywhere. But instead I prayed.   I don't remember the exact words, but it was something like, "God I can't do this. Please help me."

I have rarely experienced instant and dramatic answers to prayer, but literally the next second I was okay.  My frayed nerves had been soothed, and I was just... fine. I didn't feel impatient, I didn't feel angry, and I didn't feel like screaming anymore. It was really a drastic difference in how I had been feeling, but the change was so natural. It's not like angels appeared and gave me a hug or anything, it was like I had never been frustrated in the first place.

The second instance involved work. Still pregnant. I'd been working a 1pm-1am shift in our lovely ER and I was on my 4th and last shift.  The problem with working until 1ish in the morn when you have kids is they still get up at 7. And they still decide to interrupt your sleep at random. My son had sabotaged my sleep the night before, and I was headed into the busiest day of the week and a shift split between a role I like but is stressful and another role that is stressful and I loathe. Think den of angry lions. Angry lions coughing flu viruses in your face.  I was tired. I had no energy. I was completely dreading the next 12 hours. I wanted to crawl into a hole where no one could find me - and take a nap. But instead I prayed.  Something a little bit like the other prayer - "God I can't do this. Please help me."

I drug myself across the street from the parking garage to the ambulance bay of our department. I walked un-enthusiastically through the sliding glass doors. And suddenly... I was fine.  The foggy weight of fatigue lifted. Bounce showed up in my dragging step.  In the next 12 hours I would be stressed and I would be tired, but never too stressed. Never too tired.

These moments stand out to me because I rarely feel completely at the end of my rope.  I get frustrated and I get tired, but rarely to the extent that I think I can't keep going. I've prayed for strength and for help in the past, but these times where I felt completely spent and unable are some of the only times where I had such a day and night experience. My fingers slipped from the frayed edges of my abilities and I didn't fall.

So don't be afraid to come to the end of your abilities. Because if you look for Him - that's where God is.