Getting Past Stagnant Waters

Going back to routine in Wednesday.

Today morning and afternoon seem beautiful.

Really for a long time, I see white clouds, blue sky and very very baby green leaves.

Corners of my mouth can't help but curl into a smile.

A deep breath out, like a sigh, and my shoulders seem lighter.

The thought of going back to work is not tempting.

I don't really feel excited about going back to work.

In fact, I hope that when I go back to work this time, my emotions are less invested.

Yes, I have separated it. It is work. Nursing is part of the work.

I still love nursing, don't get me wrong.

I just don't want to feel too much with the people I'm working with.

I will leave all these emotions to nursing my patients instead, if I can help it.

Stagnancy will return. Most probably it will be staying for a long time in my life.

Getting use to stagnancy, that's what I'm trying to cope.

Not every part of my life, will have mountain peaks to climb, rainbows to chase. goals to aim.

A large part of my life, will most probably only have small hills with stairs built-in, non-adventurous garden walks.

Common people living common life.

Maybe that is it, been heavily influenced by Waltz Disney and Hollywood, that everybody is unique, everybody has this unique rainbow to chase, I yearn for it.

The notion that a common person can have an extraordinary life, awesome ambitions and exciting dreams to chase.

Ya... and they left out on the possibility of that. One in a million.

For common people to become extraordinary folk to have an exciting, awesome and legendary life is rare.

Bill Gates is rare. Mother Theresa is rare. Florence Nightingale is rare.

Not forgetting, living happily forever is a "mark" of stagnancy too, no more awesomeness and excitement, just plain routine "happy".

What should I do when my life is stagnant?

What should I do when I'm in the stagnant waters again?

Next time, I must remember not to curl up in the water and sink.

Next time, I must remember not to get too comfortable in the stagnant waters.

Next time, I must remember to swim on shore and take a walk.

Or even try different pools of stagnant water.

Or maybe invent a stagnant water game that I can play with myself?

I've sensed the child in me, when I see the white clouds, blue sky and baby green leaves.

Awhile but no doubt, that's her.

And like what Ken says I just need to get over this hump, get pass this stagnancy stage and I will be fine.

Insomnia Ramblings

Having a very bad insomnia, guess the quietness of the night and mind is the best combination to write a blog entry.

Yep in my mid-life transition and supposed to go through the 5 phases:

a) Accommodation

b) Separation

c) Liminality

d) Reintegration

e) Individuation

The stagnant water and shit-hole phase in my life is going through the phase of Liminality. That is when it strikes me to re-examine, re-evaluate my life.

My life is actually quite simple, looks like there is only Nursing and my family.

Marriage is a very important choice in a person's life. During this period of time, I often asked myself "Do you regret being married?". Sad to say, it's not a spontaneous or straight-forward "No regrets". Sad to say, I'm ambivalent. Everything boils down to choices, and living with the consequences of that choice you make. Which by God's Grace, whom supposedly had intervened, things will be fine at the end of the day. Divorce has never been an option for me or rather, at least not from my initiation.

I guess the day I got married, I said goodbye to my single adulthood and the child in me. And I hadn't say a proper goodbye to both of them. In fact I miss them at some point of my life. This new role of being somebody's wife requires me to compromise some of the "dreams" which the single adulthood elizabeth would want or set out to achieve.

Still, miraculously we had been married for 5 years, with quarrels and big small bumps. Gosh for friends who know both of us, will know once we turn nasty, the 2 of us, Ken and me are totally out of control. Emotions run high. Communication to the details. Refusal to relent. Sometimes, we do laugh over the fact that if we had a kid. That child of ours will be a very very skilled negotiator and if with bad influence, properly he will be a little Satan.

Certain values in Ken, I've appreciated greatly. The fact that he drives me to think of possible other perspectives to a given situation. The logic of processing thoughts. In short, a man who can communicate and challenge me. I've never knew I've outgrown so much till I've met up with DW and Jay. I really had outgrown, and the girl in early 20s who was so smitten by these 2 guys also seemed to be diminishing. Thus now, trying to stay at peace with her and let her go.

The next step is to TRUST God and submit to Ken. Submission, another word that is easier said than done. For this next step, it only leaves prayers and time with plenty of God's grace.

Disturbing Downtown East Murder

Disturbing. A 19 year old boy could be slashed at Downtown East in a Saturday afternoon.

Distressing. Now another 4 will be charged for manslaughter.

1 young fella died, 4 to accompany.

Depressing. What is happening to our society?

If this was in the 60s, understandable. That period of era, had these huge influence of secret societies. If this happens in Malaysia, understandable too.

Maybe should put it this way, can a secret society survive in Singapore? To be able to function, you require rank, power and financial means. Usually the financial means requires a certain monopoly of trades. In Singapore, secret society should find it very very difficult to survive.

If that's the case, what's happening to our youth?

Identity. Friendship. Family.

Sadly, these 3 things also seem to be the core variables for a patient who is depressed.

For a patient who refuses treatment.

For a patient who wants to commit suicide.

For people who are really really unhappy.

So.. do you know who are you?

Do you have close friends? Are they supporting and nurturing?

Most importantly... when is the last time you closely talk happily to your parents or siblings? Not argue.

Getting Out of the Shit Hole

I blogged on my birthday, that I was/ am in a rough patch and shit hole.

Clinically depressed to the physician.

To my loved ones, it's mid-life crisis or midlife transition.

After I go through all of them... guess this shit hole phase will be over.

Carl Jung identified 5 main phases of midlife:

• Accommodation (meeting others' expectations - actually, this takes place in the first part of life, but is the context in which midlife processes take place)
• Separation (rejecting the accommodated self)
• Liminality (a period of uncertainty, where life seems directionless and meanders)
• Reintegration (working out 'who I am' and becoming comfortable with that identity)
• Individuation (facing up to and accepting the undesirable aspects of our own character)

From: http://www.teamtechnology.co.uk/tt/t-articl/midlife2.htm

10 reasons for being a Nurse

Recalling hard... my 10 reasons to be a nurse.

Many years back, a doctor once told me to write it and keep them safe.

"They will come into good use when you start to wander away from nursing."

Such a wise man, which I only start to appreciate recently.

The paper with 10 reasons was lost.. my initial devotion or promise to that "Calling" was lost.

The reasons for being a nurse when my heart was still capable to love with much courage had been lost. Today I will try my best to recall:

1) It's a gift to be able to see blood, stools, urine, vomit, gastric juices as biochemistry materials.

No feeling of fear, disgust or disdain.

2) Nursing is a job that allows me to help people while getting paid.

3) Nursing is the job that makes me stay grounded to the pains of life and death, not materialistic, corporate ladder climbing.

4) When people are in pain, you see the "real" face. No hypocrisy, no pretense, the sincere side of every human being. This makes me feel safe.

5) Nursing is the job that my patients are my teachers of life lessons. I've seen examples of courage, love, persistence, among patients and families.

6) The thought of just doing something little is still significant to the one being sick helps my inferiority complex. Cos there's always something that is "good enough".

7) Uniforms are a blessing, it is a pain to think what to wear everyday.

8) Nursing keeps my heart alive. Most of the times painfully through grieving for my patients.

9) I couldn't really think of what else to do besides being a nurse.

10) Nursing is a job that allows me to seek God often. Question God.. The need for God as all things life, death and pain are not in our control.

Playing the Sick Role

Everybody falls sick once a while.

Some people fall sick more frequently than others.

When people fall sick, they need to play the sick role.

Sick role requires the person who has fallen sick to adhere to a certain lifestyle, new habits like eating medications, and other stuff which the professionals dictate. Which your main care-giver dictates.

Usually when you are in the sick role, you do not really make your own judgments until when you are better.

For healthcare professionals like nurses, it's harder to be in the sick role. Cos we've played the "professional role" almost everyday as out job scope. Thus, nurses are also the worst patients.

Now I am in the sick role.

Stagnant Waters versus Shit Hole (Part 2)

Today is my birthday. And I'm blogging about shit hole.

You find yourself in a shit hole, after the water has dried after a period of intense drought.

This shit hole unlike the stagnant waters, is uncomfortable to be in.

This time, the surface is far way beyond beyond reach by any possible means you can think of.

This time, it's not peaceful, in fact to a certain degree noisy.

Soft sounds become accentuated, loud sounds come with booster.

Emptiness echoes tinnitus in your ears. No peace in fact in pain.

Not the sharp pain that will kill you. But a long dragging kind of ache that will not disappear.

Aching everyday, first thing you notice when you wake up. And the last thing you feel before you sleep an unsettling sleep.

Everyday, the noise of emptiness, and ache just deplete your energy, day by day.

Minute by minute.

Till when you feel you are counting second by second, you know... you've changed.

You know something is awfully wrong. You want to get out of this shit hole!!!!

But by then, it is too late, cos the shit hole is too deep.

And you most probably will be in it for a long long long time..............

Stagnant Waters versus Shit Hole (Part 1)

It has been some time since I blog, by typing random thoughts and feelings. And it definitely has been a while since I blog with a prayer in mind.

It has been quite a tough road to walk on the side of my rainbow.

I've been in stagnant waters for a period of time. Yes quite a while.

Submerged in the waters, I could hardly hear any nosies, or sounds.

I could hardly see above the waters. There was no movement. Very silent, very silent.

Occasionally, I managed to emerge out of the waters to take a deep breath.

Rapidly, I sank back into the waters staying still. With no energy to move.

When you are in stagnant waters, time slows down.

Every second, your lungs need to cry out for oxygen, yet getting to the surface is difficult.

When you are in stagnant waters, nothing seems to matter.

Conflicting it sounds, but that is the most peaceful place you will be away from the nosies above.

Trapped. Alone. No intention to change. Status Quo.

At that time, I forgot how to pray. Nor did I really intend to pray.

Anyway, You most probably have forgotten about me.... or so I thought.

Stagnancy is the prelude to the dearth of life... soon it will seeps through you and become a shithole.

Nursing in Singapore -- My National Day Dream

National Day. 45 years of Independence.

A mixture of emotions of this day and to Singapore Nursing.

Happen to read this blog entry from our Health Minister while watching National Day Parade.

"Live our Dreams. Fly our Flag" is this year 2010 theme.

I had this dream then when I was 15 in year 1993, 17 years back. Wishing that there was a Nursing Degree course in Singapore and a faculty of Nursing. It was ONLY in 2002, when we had our own Master nursing postgraduate degree in NUS and shortly after that the establishment of Nursing Degree course.

Amidst my joy, it's the hard knock of realisation to accept the culture of Singapore. We are known in among South East Asia countries to have high standards of over many areas; defence, tourism, education, housing, etc. Yet I had to watch in envy at age 15, people in Philippines, Hong Kong, Australia, UK and US to be able to study in their own countries to pursue their nursing career. While I had to plan my savings, to study overseas to pursue my dream.

Singapore did fulfil this dream of mine, only about 10 years later. And in a weird way, which academic faculty will have a Master program fully running before a Degree program? Guess, "It's better late than never".

My dream now is hope that Singapore Nursing be comparable to US, in terms of quality standard, autonomy, social recognition and consumers' confidence. There's many many things to be done. I salute my nursing seniors whom had laid the foundation for this profession. And I do see the weaknesses of my current generation of nurses. Unlike our seniors, we are trained "multi-tasking". While learning our basic clinical nursing, we are trained to do teaching, research, certain administrative tasks like quality improvement projects. Though, we learn other aspects, they do compromise our basic nursing foundation. And they do compromise speciality nursing knowledge. Time used elsewhere means less time spent in clinical, which equates to less experience and exposure to people and diseases.

The push for nursing autonomy might seem unavoidable in the next 5 years, pressure from increased burden of chronic diseases and elderly, need for cost containment and to balance healthcare resources. All I hope that RIGHT steps will be taken in steady pace to fulfil this dream of mine. A pace, a steadfast rhythm. Not the fast-fix, out of rhythm "solutions", trouble-shooting methods.

The reflection today only makes me realise how much more nursing has to catch up within Singapore and with the rest of the world. After all, NUS Medicine celebrated their 100 years a few years back... And NUS nursing, we are hardly 5 years in history.

I hope this dream of mine will be fulfilled in my Happy Birthday Singapore wish.

This time, it is fine if it takes more than 10 years. As long as Nursing in Singapore stays strong and growing in a right direction.

Liz's composition: 淚滴

Weird youtube doesn't accept this video!!

Anyway..... here's the lyrics.

滴滴滴, 窗外雨的聲音.

忠是會想起你. 眼淚又再一次落地

在雨里. 尋找你的痕跡

不願意去相信, 再也不會有你消息

恨自己, 沒將你好好珍惜

現在不管多努力, 還是回不了過去

深呼吸. 我不能再哭泣

不要讓你傷心. 因為我擁有你給的勇氣

曾有你, 陪我走過雨季.

你的甜蜜. 你的溫心.

永遠都是那最美的記憶.

你的甜蜜, 你的溫心.

永遠都是我微笑里的淚滴

JUST a nurse and proud of that!!

This is the first time I broke down since working in TTSH last year.

I know at the back of my mind she doesn't mean it.

"Why you don't want to be a doctor?" "Why you go and be a nurse?"

"Talk so much for what you are not a doctor."

"Your grades are so bad.. that's why cannot become doctor become nurse."

"And as a nurse you go round cleaning people buttocks and serving bedpans."

It has been such a long long time since I heard such remarks.

I heard alot of these 10 years back, mostly from taxi-drivers..

Do I need to retort back? I didn't this morning.

Do I need to declare my commitment to her care as her nurse?

I gave my nursing pledge to serve all with just due care, and advocate for all.

Do I need to do that?

I'm angry ... yes cos after all I'm only human.

When her doctor thinks that it's no use giving her too much treatment cos she will not comply.

I advocated for her despite all.... cos I'm her nurse.

But today, I need to thank her cos I've forgotten... no matter how much credentials I had... having a Masters degree, doing advanced role... I'm still and "just" a nurse.

I know.... and as I cried these angry tears...

I want to tell her that ... "you know what I'm proud to be a nurse and I'm happy about that... so stop being Jealous!!!!"

A Little Bit Too Late

"You are the doctor, if you cannot help me who can?" She said that repeatedly.

Her creatinine is 800 plus, dialysis is her only option.

Her doctors told her, but she refused strongly.

"Aren't there any medications I can take?"

"Didn't you say there's medications to prevent my kidneys from worsening?"

"You told me to control my diet, I had been doing that.. can't you just give me any medications?"

A little too late. Another case of a little too late.

Diabetes for many years.

Poor, bad sugar control for many years, except 2009 with extremely good control...

I wish I can cry for her, I wish I can tell her that "yes we have this medication, here take it"

I'm not sure how many doctors and nurses had seen her in these many years of diabetes treatment.

I'm not sure how many had tried to tell her earlier that prevention is better than cure.

I'm not sure how many of us had sometimes looked into her record and said "she's not going to change"

I'm not sure... really.. and it's scary cos maybe by the time we want to go that extra mile, that extra minute to see if we could touch her heart, engage her to do something for herself in the earlier course of disease, it's a little bit too late.

I had celebrated a miracle earlier this week, an Indian man with inferior AMI, defibrillated 7 times. Yes 7 times, and survived. I ended the week of regret from this lesson I learnt from this 52 year old auntie. She's younger than my parents. And I can only pray for her.........

Year 2010... some thoughts

It's so funny the beginning of Jan 2010, there's nothing much listed in my calender.

Nothing to look forward to... in terms of nursing.. no huge projects.

Since 2005, one thing led to the next and there was so much anticipation and expectations for the next year.

Graduation from APN course. Getting Married. Going on Honeymoon. Doing APN internship. Completing 12 case studies, quality project, research projects and conference presentations.

APN Exit interview. Switching Organisation.

Now.. things start to slow down. Suddenly, it feels so empty... not sure if that is a good sign.

But it sure feels different.

Year 2010. Some thoughts on what I might jus do.

Personal

Handmade cards and sent out the cross stitches I had done.

Learn pop piano formally (still considering)

Lose weight... well who am I kidding... jus start exercising 1 time per week

Nursing

Really... I need to start reading, writing and stop bitching.

Aim to write to ADES Newsletter, Singapore Nursing Journal.

Do a proper quantitative research project related to Diabetes, with a good sample size.

Not sure but some thoughts for comparison near the end of the year.