Friday, April 10, 2009

At the End of the Day

There are some days when I leave work feeling energized and elated, and there are some days when I leave work feeling as though I've been punched in the gut. Particularly difficult are the nights I leave work not knowing if patients who were in critical condition when I left will still be there when I return. 

In professions that deal regularly with matters of life and death, there is a significant amount of self-care that practitioners must do in order to keep from burning out. People often think of self-care as being something extravagant like getting a massage. But actually, self-care can be as simple as turning one's pager off and leaving work on time.

At the end of days like today, I have a lot of ambivalence about leaving my work behind. I know that the only way I can continue to do my job well is to take time away from it and all of the intensity and stress it brings, but I get so invested in the patients and families that it's difficult for me to leave them when I know they are struggling. Can they get by without my support? Of course. But if I can relieve their stress or ease their sorrow or help in any way, I want to do so, and it's difficult for me to walk away. But in order to have the energy and strength to return to work each morning, I must leave work at night and try to put out of my mind the scary and sad realities that these families are facing 24/7, with no option to escape. 

It has taken some time and practice, but most of the time I can do it. However, some days I find that my walk home at the end of the day has not cleared my head, and I am still weighted down with the reality of what I see every day. 

Last night, after a difficult day at work, I returned home and checked blog updates before I went to sleep. I clicked on flotsamblog - one of my favorites - only to find this post. It was a punch-in-the-gut reminder to me that even when babies survive through prematurity and families bring them home from the hospital - even when they are many months and even years out from having been in a hospital - they are still fragile, and there are no guarantees.

When I returned to work this morning that reminder weighed heavily on me. And as I saw my patients struggle with their individual battles, I said silent prayers for each of them that they might leave our hospital healthy and never return. 

I never knew Maddie Spohr or her parents, but from what I have read, there was a lot to love. The online community of Maddie's friends and supporters has raised over $22,000 in her honor for the March of Dimes as well as additional funds through PayPal to support her parents during this unthinkably difficult time. I am moved to tears when I think of the loss of such a small and joyful little life - and then moved to tears again to see the widespread reaction and incredible outpouring of support and love within the blogging world. 

Last night my work and my outside life collided, and at the end of today I am left still reeling from the impact. 

"The streets of heaven are too crowded with angels tonight... but every time we think we've measured our capacity to meet a challenge, we look up and we're reminded that that capacity may well be limitless."   -TWW

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