In sixty days, I will once again pack up whatever portion of my life will fit into a backpack, pray that my luck has not yet run out, and head east. That means there are just over....



60 days until I will hold a beautiful baby on my chest that I havn't even met yet and breath in his scent and melt inside just a little.



60 days until I will begin to yet again pay $700.00/month for my own personal unlimited supply of Nutella.



60 days until that big ocean no longer separates me from friends whose recent absence have left significant holes in my life.



60 days until I embark on the daily struggle of trying to communicate with patients in a language that, despite what the Ontario Secondary School System may have tried to teach me, I am far less than fluent in.



60 days until I go from someone who did something cool once in her life to someone who has a lifestyle that reflects who she wants to become.



60 days until I get to once again witness miraculous transformations in the matter of hours, literally before my eyes.



60 days until "going to work" will mean 25 steps down the hall, instead of a 60 minute commute through a snowstorm.



60 days until I will get to bargain and haggle for rides on slightly less than safe vehicles with only slightly above completely hazardous drivers.



60 days until my heart begins to break in a way that I know I cannot yet begin to imagine.









And I can't wait.

It finally happened.

Saturday afternoon. Mid-shift 2 out of 3. I was walking down the hall and one of the attendants asked me if the patient in Fast Track 3 had gone home.

And I, with all of the competence and confidence of someone who works in the ER and actually knows what she is doing, responded "YES!"

At which point I knew....there was no turning back. I was now officially and functionally part of the team. I knew what was going on. I didn't have to ask anyone else the answer. I didn't doubt for a second whether or not *Mr. Adams* had been discharged or not. I answered the question with absolute brilliance and continued on to do one of the eight oh-so-important tasks that where on my to-do-list.

And that one moment - amidst the thousands of "I wish I had some clue what was going on right now" moments that occurred that day - made me realize that it is only a matter of time before more ER light bulb moments occur. And that before I know it, I will wake up one day to find myself feeling like I belong there. And that once that happens, it will only be a matter of time before it all makes sense and the whole reason I decided to climb this crazy mountain reveals its beautiful purpose.

Because now that what I believed to be impossible has happened, I know the miraculous is possible.

*name has been changed to protect patient privacy. Obviously. This isn't Liberia.

As it turns out, I am absolutely scared to death of being comfortable. Because I think that comfort is ridiculously sneaky and has the potential to keep you in a place you were maybe never supposed to be.

I recently made my eternal peace with grad school (potentially an inaccurate use of the term eternal – since I have in no way resolved to never pursue graduate studies again in my life, but only to stop pretending that the pathway I was following was right, simply because I was there and doing it). This decision left a fairly significant chasm in my life.

By rights, there was no physical chasm. I actually have had a job this whole time. An incredible, purposeful, important job, where I know what to do and where I am loved like a member of an extraordinary family. A job that I should have been totally content to return to.

Given the situation at hand, I obviously began my pursuit of “what next?” (please note: I completely understand how, at first glance, this type of behaviour might appear flighty, unsettled, unappreciative, nomadic, idealistic, or even pompous….but hear me out). The initial realization that there had to be a “what next” came almost immediately following my beauty school drop-out moment. Basking in all my pink-haired glory, my thoughts went back to Africa of course.

“But I am not ready Lord, we both know that. There is so much more to learn and to know.”

It was almost humorous to me considering myself in the middle of a bush somewhere, with a cupboard full of expired bottles and viles, attempting to decipher how each (or better yet how I) might be of any assistance to anyone.

"Ok, so not now. I'll get more experience….got it"

So, where do you get experience? Where do nurses have to learn to deal with the unexpected and unknown with grace, flair, and confidence? I didn’t spend my teenage years in love with George Clooney for nothing.

"Absolutely! Emerg … perfect!"

Enter: Fear. The allure of comfort.

Emergency departments are scary. I think I remember a distinct putrid smell. Most people that come to emergency departments are irritable, annoyed, and tired. From my experience with human beings thus far, this combo doesn’t make for the most pleasant of interactions. Nurses dealing with emergencies have to think on their feet. They have to have a wealth of knowledge categorically stored in their brains for instant retrieval in the critical moment. They have to have supreme confidence and common sense. I have none of these. I desperately desperately want them (thus the decision to work in a place where I will be forced to acquire them), but I don’t have them.

Thus the dilemma: which is more risky – doing something that is intimidating or being comfortable? The allure of comfort is just so strong. The desire to stick where I am with what I know. To stay where I am comfortable and loved. But, how thankful I am to have a God who convinces me that the not doing something because I am afraid is so much more dangerous. Because there is a path that I need to walk down, and apparently there are some things I need to learn before I can head out.

It seems that God and my Starbucks cup were thinking along the same lines today: “Failure's hard, but success is far more dangerous. If you're successful at the wrong thing, the mix of praise and money and opportunity can lock you in forever”.

And so, here I am: afraid. An ER-nurse-to-be (as of Tuesday). Unsure of what to expect. Convinced that I am going to be overwhelmed. Confident that there are going to be a million things to learn. Fairly sure that there are going to be moments that absolutely blow chunks (probably literally). And, yet here I am, wholly convinced that doing anything less would scare me to death.

There’s this secret they don’t tell you in nursing school. I am guessing that they fail to elude to it in med school, physiotherapy, occupational therapy, respiratory therapy, or social work programs either. It hits you like a hurricane at first. You adapt to it over time. Then sometimes it comes out of nowhere and knocks you off your feet all over again, sometimes even stronger than the first time, because you thought you had it beat.

Nursing school did its best to prepare me to do thorough physical assessments. Conscientious tutors laboured over nursing theories that may or may not have no degree of relevance to anything I do now. Anatomy & Physiology profs taught me why sodium-potassium pumps are important. I learned Piaget’s development from Dick Day and 43 278 other Psych 101 students. At some point in the 4 years, I apparently figured out how to give medications, start IV’s, take vital signs, wash my hands like a pro, and sometimes, if the wind is blowing in just the right direction, even offer an effectively therapeutic word of support to a grieving family. As much as I may have doubted it throughout the process, I came out with some degree of an idea of how to be a nurse.

But, nothing prepared me for the overwhelming sense of failure that would come along with it. Four years in, and I think I am just starting to realize its legitimacy and influence in all of our careers.

I am beginning to wonder if that feeling ever goes away – or if it even should. That feeling that things go wrong with a patient as a direct result of my own personal incompetence. I am completely aware that in 99.99999% of cases, this is absolutely not true. Things happen to sick patients because they are sick. People don’t end up in the hospital because they are well. The simplicity of the matter makes its mention almost futile. Nevertheless, I have yet to win the mental battle with myself. Shows like ER, and Grey’s Anatomy, while grossly dramaticized, hollywoodized, and romanticized, elude to these same types of emotional struggles. And despite the exaggerations, the fact that these struggles are reenacted on film means that the emotions portrayed were originally felt by someone – in all probability some other health care worker who, like me, has a hard time moving past his or her insecurities.

And, lets just say that hypothetically, one was able to deny or overcome all of his personal insecurities – and wholeheartedly believe that he had mastered all components of his professional domain. The reality is that said person remains a flawed human being who, despite overwhelming confidence, will still make mistakes.

Take today for instance. In the course of my 12-hour shift I:
- Dropped about 14 things on the floor (arousing plentiful questioning about the potential of my being pregnant – of which there is none)
- Missed my attempts at getting venous blood
- Came down with an acute inability to complete relatively simple mathematical equations – which is actually a required skill in the NICU

If I put any amount of consideration into it, I know I could put together a more thorough list – but, no need to hound on the already unfortunate. Today was challenging in a number of ways, and I walked out of the hospital feeling beaten. Things go wrong. Sometimes because I am human – most times because we are always dealing with people who are already unwell.

But, this is the part that I wish I had known. I knew that being a new nurse would be hard. I knew I wouldn’t know what to do, and I would be overwhelmed and confused and incompetent.

I figured all of that would change when I “grew up”. I feel like I am still waiting. Because I am no longer confused. Most times, I feel fairly competent at what I do. And the majority of the time, the most overwhelming thing I face is how to strategically space the food I bring in my lunch pack throughout the day so that I don’t have a sugar-crash on the drive home.

And yet, despite all of that, I can’t overcome this overwhelming sense of failure. Sometimes, I wonder if it is just human nature and our desire to control situations. When things don’t go the way we wish, we look for ways we could have acted differently and how that might have changed the outcome. Or maybe it is the human tendency to dwell on the negative – despite 99 flawlessly executed acts, we perseverate on the one thing that didn’t go according to our plan.

I hope someday I get there. That place where I am absolutely alright with it all. Where I know that my best is all I can give. When I give my best, I am satisfied. Where I know that what I have to offer is just as important as what everyone else has to offer. Where I know that stuff happens – and it is my responsibility to help it, but won’t always be able to fix it. Where I truly recognize that we are all functioning in this less-than-perfect system and that we would all be better off if we recognized it and helped eachother thrive. Where I realize that Mr. Rogers, my mom, my dance teacher, Big Bird, my Grade 8 teacher, and God weren’t lying when they told me that nobody is perfect. And that that truth needs to be taken, not as an excuse, but as an encouragement to persevere through the moments when a failure is all you see.

Because, as far as those of us in this crazy world of health care are concerned, it is going to be tough. At the end of the day, I know that people get sick because there is something wrong with their bodies. And people die because they are sick. And, we get this incredible opportunity to intervene at an absolutely critical moment of their lives and sometimes improve it in a physical, tangible way. And, with this knowledge, I also recognize that viewing every turn for the worse as a failure won’t cut it.

I am not going to even suggest that I am there. It’s probably a long road. Maybe even an unrealistic goal. But, all I will ever be is this passionate, yet so obviously human, nurse – and hopefully someday that won’t feel like a failure.

It's been two whole months. Much to my despair, I have become 100% acclimatized to Canadian life once again. I drive on the highway, diligently follow SYTYCD Canada in real-time, eat fresh vegetables, speak like a grown-up, use the term "beach" to refer to sparse patches of sand along the Great Lakes, spend 98.9% of my time reading articles comprised of words I never knew to exist - let alone have any meaning in my life, shower almost every day, and make decisions all by myself.

I sort of feel like I have everyone fooled. Somebody even decided that I was qualified enough to shape the lives and minds of wanna-be nurses in the School of Nursing.

To be completely honest, I think this is the most challenging thing I have ever done. Despite ample warning from well-meaning friends and mentors about the culture-shock of returning to "normal" life; coming home for me, was relatively smooth. But, after the hype of the transition, everything just goes back to normal. After the new beginnings, the newness wears off, and it just becomes life. After the novelty of the restaurants, stores, cities, outings, Independence, parties, and everything I craved while I didn't have it wears off, none of it seems like much of a big deal. And as it turns out, this so called normal life takes quite a bit of investment.

It is competitive. A competition of who is willing to sacrifice the most amount of personal time, social time, and sleep to get ahead. It is stressful - in a way that I had almost completely forgotten about. There is an obsession with a definition of success that I am not so sure I buy into. Everyone, it seems, has something to prove. It's harder than I anticipated.

I think it is because my heart is in Africa. I check for updates on Ali's blog almost every day. I have yet to get through one without tears in my eyes. It makes me feel like I am there, experiencing a small part of it with them. But I think, even more importantly, it helps me remember and embrace a way of thinking and a way of life that I am not willing to let go.

I don't think I could have prepared myself for this feeling. For being involved in a world that is doing everything it can to make me forget. My first encounter with almost everyone when I got home involved two questions: "How was your trip?" and "Did it change your life?" Without a doubt - "amazing", and "absolutely".

I think changing your life is one of those "much easier said than done" types of things. Because, here I am, absolutely saturated in a world of academia that is as far from the world of West Africa as you could imagine. And, as much as I want to be that person whose life was changed, it gets easier and easier every day to be the North American grad student who is pursuing a life of success and status.

Last night, I read through everything I wrote while I was there. In hindsight, it seems that I foresaw a little bit of what was to come. But I also apparently was excited....in my own words:


"This is what Africa has been for me. A realization and understanding of God in a greater way. Life lessons that have nothing to do with a geographical location. A chance to see people in a completely authentic way.

It makes going home exciting. Because, I am still me. I will take this part of me with me. And I cannot wait to see how it will be used in the rest of my world"

I was talking on the phone the other night with a friend from the ship and she had a quote that we both found particularly relevant for this unique stage that we find ourselves in: "Wherever you are, be all there".

I guess I need both: Friends who can take my heart to Africa, and friends who bring me back here. Because somewhere in the middle is that perfect balance of where I should live. Living life to the fullest, exactly where I find myself. Embracing the ways my life has been changed. Maintaining and applying the sense of purpose that should drive our lives despite circumstances. Again, obviously easier said than done. But, I feel like it is worth giving it a shot.

http://www.alirae.net/