Lessons from the Bedside: What Foley Catheters Taught Me about Emotional Nakedness

It’s undeniable we celebrate weird things at the hospital. Things like bowel movements, being able to walk without assistance, and really big, long, straight veins. The day when patients’ Foley catheters come out also calls for celebration (except when patients are incontinent; then our little nursing hearts sink a little...)!

It was on such a day when a patient should have been celebrating his Foley catheter coming out that I learned an unexpected lesson about my emotional health.

“Please, can you take this catheter thing out?” my patient had begged all day.

Several hours into the shift, I heard from the doctor: the Foley catheter could be discontinued. I gathered supplies for wound care and for removing the catheter before knocking on the door.

“Good news!” I remarked cheerfully. “The catheter can come out!

Stock photo from Adobe

Surprisingly, the patient sighed deeply, as though disappointed. Although confused by his sudden change of heart, I proceeded to provide wound care, and the conversation turned to other things for a few minutes.

“Okay,” I finally said, “if you’re ready, let’s go ahead and take out the catheter now.”

“Do I have to take my pants off?” he mumbled as he started to roll his pajama pant legs up (up, instead of pulling his pants down).

“Um, yes.” Questions patients ask will never cease to amaze me. (Also, how anyone can wear pants over a catheter by choice will never cease to amaze me.)

“Okay. I just feel so humiliated…” More mumbling. Another deep sigh.

Finally, I understood his hesitancy. He was embarrassed and would rather wear uncomfortable, inconvenient pants than have his privates bared.

As nurses, often we forget it’s abnormal to see people’s bodies — all parts of their bodies. We wipe butts on a daily basis, put in catheters and take out catheters, and deal with every kind of bodily fluid you can imagine. Human anatomy is no big deal; it’s our job to assess it and make sure it’s functioning properly.

However, it is a big deal to most other people. Once I clued in to why this patient was balking at the chance for his number one request of the day to be granted, I was able to address his fears accordingly. Thirty seconds later, the catheter was out. Mission accomplished.

After washing my hands and stepping out into the hall, I began thinking about how this patient had considered discontinuing his Foley “humiliating.” His use of this specific word was actually shocking because to nurses there is nothing humiliating about having a catheter removed. In fact, to me the words “humiliating” and “catheter” have no reason to be in the same sentence.

Yet something about this patient’s words struck a chord with me. I knew that same hesitancy, the same feeling of being humiliated, the mumbling and the deep sighs — but not because of physical nakedness. Because of emotional nakedness.

Despite years of dealing with depression and some serious time spent in therapy, I still find it difficult to open up emotionally, even to my therapist. I still hate admitting my weaknesses and the natural anatomy of my feelings to anyone , myself included. What seemed ludicrous a moment ago when I was with a patient I now recognized in myself: I would rather wear uncomfortable, inconvenient masks than show others the fear and sadness I once believed were ugly and shameful. I would rather roll my pant legs up and acknowledge just a little ugliness than pull my pants completely down.

Yet in the same way healthcare workers in the hospital don’t think twice about seeing patients’ naked bodies, I finally realized mental healthcare workers probably don’t blink an eye at the raw, bare truth about people’s mental and emotional states. When something isn’t working right, someone has to look at it. Nakedness is simply part of our jobs.

With this perspective, I’m learning to be more intentional about overcoming my habit of stalling before getting to the heart of my struggles when I show up for a counseling appointment or pick up the phone to call a friend; I’m learning to try to pull down my emotional pants and check my shame at the door.

Is stripping emotionally vulnerable? Sure. Should we be careful whom we share our emotional and mental nakedness with? Of course. (Wouldn’t want to moon anyone by oversharing inappropriately!) Should we be ashamed and humiliated by emotional nakedness? I’m starting to understand the answer is no.

As a nurse, my job may include physical nakedness. As a human, it will always include emotional nakedness. Because of this encounter at the bedside, I’ve decided: it’s time to stop fighting it and strip right down to emotional nakedness.

12 Reflections on the Past 24 Months

I turn 24 today. Two years ago I was fresh out of nursing school and two days into my first nursing job. One year ago I was living in Cambodia celebrating with Khmer friends over a dinner of bun xeo. This year I'm laying in my Cambodian hammock at a park in Waco, sipping Dr Pepper and crunching on baked Lays chips (don't judge. I exercised...sometime this week...). So much has happened and I've learned so muchin the past two years! Here are 12 reflections on the past 24 months:

1. Therapy is not for the faint of heart. I used to think asking for help was weak, but now I know it's one of the wisest things we can do. It's also one of the hardest things. I mean, who wants to spend an hour with someone pushing you to exit your comfort zone (even if it is the healthier thing to do)?

2. Switching cultures can trigger my depression. It's no secret I've struggled with depression overseas, in the workplace, and just in general. I've learned a lot about coping mechanisms and mental health, and I've also learned about triggers. Switching cultures between the States and Cambodia is one of the most thrilling and life changing experiences, but it's also extremely stressful and can trigger unhealthy habits and thinking patterns in me, leading to depression. 

3. Nursing is hard. Every nurse I've met had said they didn't know what nursing was like until they were in the middle of it. I didn't really know what to expect, but it's certainly up there on the list of physically and emotionally demanding jobs. 

4. Boundaries are also hard (but necessary). "Part of being an adult," my friend Jena recently told me, "is knowing what you need and asking for it." I hate causing others inconvenience, but I'm learning doing what's best for me doesn't just benefit me - it benefits all those around me too. A prime example is quitting full time nursing because that’s what benefits me, my patients, and my coworkers most.

5. It’s okay not to be okay. Nursing, along with some rough experiences in a Cambodian hospital, brought out my belief I could be a superhuman (and super nurse). In the past couple years, I've had to face the reality of my humanity and begin to embrace it, leaving people pleasing and HCAHPS scores behind.

6. Khmer language. I've learned lots and lots of Khmer language. I've learned how to make new sounds that aren't in the English language, and I've been stretched to acquire vocabulary because I love the people of Cambodia, and I want to be able to communicate with them.

7. Life as an expat is hard, and so is life in the States. It's all hard because I will always be missing someone. Yet, it's worth it, and it's the people around me who help me make it through the hard parts.

8. I’m not meant to do any of this (life) alone. My friend Erin told me that a long time ago, and it took me a couple years to figure out it's actually true. Jesus wasn't messing around when he prioritized community, and even He allowed Simon of Cyrene to carry his cross part of the way to Golgatha. Life isn't just harder if I do it on my own; it's impossible. 

9. I’m beautiful. The past couple years I've come to peace with insecurities about my ethnicity, culture, and heritage I didn't even realize I had. This has made me more confident and allowed me to relate to others a little more from a place of love and a little less from a place of fear.

10. Rejection. I applied for a job last fall working with students in an after school program, and they never called me back. This program was one of the reasons I felt God has called me back to the US, so it was s pretty big disappointment (ok, also rage-inducer and self-esteem-crusher) not to get the job. However, in lieu of the job I started volunteering at the Cove with high school students, which had been incredibly rewarding and one of the best experiences I've ever had with students!

11. Loving and investing in people is always worth it. I wondered if it was worth loving others when I experienced the pain of leaving and the grief that came with moving back to the United States. I wondered if it was worth loving myself when I was in the pits of depression. In the end, though, it’s worth it. Because loving others (and myself) is only possible through Jesus, and practicing love brings me closer to Jesus. And knowing Jesus more? Knowing Jesus more is always worth it.

12. Fulfillment and meaning aren’t found in a job or a community or a relationship. As “millennials,” we’re often stereotyped as job-hopping to find meaning in the workplace. I wonder though if a cultural shift away from spirituality is the culprit behind what appears to be an enigma. I know it’s true for me—when depression and doubts cloud my view of Jesus, I look to other things (including switching jobs), trying to figure out what needs to change for me to find meaning in life. But when I know I have Jesus, nothing else matters; as long as He’s here, I have everything I need and more, regardless of job, geographical location, culture, or financial status. With Him, I have everything I need and more.

For more adventures from the past couple years, check out my ebook or other posts (and be on the look out for new ones soon!), email me, or get coffee with me in Waco!

Why I Quit Full Time Nursing—And What I Learned From It

A year ago today I worked my last shift as a full time registered nurse in Waco. I resigned so I could move to Cambodia for a few months to teach English and work with a church, which was one of the best decisions I could have made.

When I returned to the States, I decided not to go back to full time nursing, which was also one of the best decisions I’ve made but one that surprised quite a few people around me. Currently, I’m PRN (as needed), and I love it. Here’s what I’ve learned since quitting full time nursing.

                                                          PRN

It seems crazy.

It seems crazy to quit a full time nursing job for a variety of reasons: my education is specialized and specific to nursing, nurses make a fair amount of money, and the schedule is, for the most part, convenient and flexible. Plus, nursing school was a lot of work.

At times I feel pressure from others and society in general to work full time. But if I’m being honest, most often the pressure I feel comes from within. “I’m young, healthy and able to work,” I tell myself. “I’m lazy for not working at the hospital more.” When I think these things, I have to walk myself through the steps I took to decide not to work full time. Step one is remembering:

Nursing drains me.

After a long shift a couple weeks ago, I came home and told my roommate that nursing drains me not just physically but also emotionally and even spiritually. Part of this is due to the nature of nursing—the emotional and spiritual components to caring for people—but part is also due to the way nursing plays to some of my greatest weaknesses.

For example, when I’m at work, I’m the point of contact for my patients’ care, and my patients are constantly changing. Being the point person for anything (or anyone) isn’t my natural bent, and neither is investing in short-term relationships with patients. Though these things are easily overcome with a little extra energy and effort, all the “little extra’s” start to add up.

However, since I quit working full time, I’m getting to live out my dream jobs, and that fills me up.

A couple months ago when a coworker asked what my dream job would be, I was excited and surprised to tell her, “I’m living them out now: working with at-risk students and writing." I paused before adding, "Nursing wasn’t ever part of my dream, but it finances what I really want to do.”

I regularly spend time writing and volunteering with students each week, and though they don't pay the bills, these activities are more than rewarding. They help fill me back up, and when I show up at the hospital I have a surplus, not a deficit.

This makes me a better nurse and a better coworker.

When I started back at the hospital after returning from Cambodia, I found the time away had allowed me to recover from burnout. I was less cynical, more compassionate, and could maintain my sense of humor even on poopy days (literal and figurative). I had the energy to help coworkers if they need a hand, which I’m extra glad I could do because I work with some of the best nurses out there! Though I still have rough days at work, I’ve found having a few extra days in between shifts keeps the burnout at bay. When I’m not burned out, I’m closer to being the nurse I want to be, the coworker I want to be, and the person I want to be.

Overall, I’m less stressed working PRN.

I’m less stressed when I’m at work. I like that it’s my choice to sign up for a shift instead of having to show up a certain number of times a week and work certain weekends. It helps me not dread going to work and not blame the workplace if I have a bad day—because I chose to go in that day. Nobody forced me.

I’m also less anxious when I’m not at work. Fewer shifts and more time to do what I love means less stress. I’m learning a season with a slower pace of life is perhaps the healthiest thing for me right now—physically, mentally, emotionally and spiritually.

Because of what I've experienced, I'm redefining success.

I've struggled with guilt over not having a full-time job, and I've questioned my work ethic and my sanity. I've had to decide what success would be to me. Success could be the numbers in my bank account, the letters after my name, the hours on my time card, and the reputation as a hard-working employee. Or it could be who I am and how I am.

It's worth it.

In the eyes of a money-chasing, corporate-ladder-climbing society, my lifestyle makes no sense. But to me? My lifestyle is wildly successful. Life probably won’t always allow me work PRN, but for now, I’m so grateful for the chance to live my dreams.

To me, quitting full time nursing is worth it. It’s worth it to get to follow my passions and serve students. It's worth it to allow myself time and space to reevaluate what career fits my talents and gifts. It’s worth it to be a better nurse and a better coworker. It’s worth it because I’m convinced my choice to quit full time nursing is helping me become the person I was made to be.

Beyond the Smiles (Part II)

(For Part I, click here.) 

I remember him laying there. The bare white mattress in the Emergency Ward. The blanket stained with sweat and dirt wrapped around his waist. His ribs protruding from his thin, malnourished frame.

I remember him turning onto his side, obviously in pain. I remember his mother standing at the bedside, anxiety and fear written clearly across her face.

A group of American healthcare workers, part of a medical mission team I was working with, flocked around him and hooked up an ancient ECG machine to confirm a diagnosis of pericarditis—a diagnosis for which nothing more could be done in this rural Cambodian hospital. 

As they gathered around the bed adjusting ECG leads and talking among themselves, I stood in the back. Listening, observing, and praying.

I took in a deep breath, and I let it out. This young man was dying. There was nothing we could do about it. With all our knowledge, with all our experience, with all our compassion and good intentions, there was nothing we could do to prevent this man’s suffering and death. 

There was a time when seeing a patient like this young man broke me. It led me on a journey of desperate brokenness and incredible healing. It led me to face truths concerning what I believed about God and myself. Ultimately, it led me to rest in knowing I don’t have to be enough.

This time, as I stood near the patient's bed, everything was different. Outwardly, I was surrounded by Americans, and I was grateful to be with so many whose education and experience exceeded mine. Things had shifted inwardly, too; I found I had courage to reach out to this patient in a way I was too timid to do before but was incredibly important.

When I close my eyes, I am back in the hot, humid, Cambodian Emergency Ward. I breathe in deep, and I choose to rest in this truth: I don’t have to be enough, for Christ is enough. When I stop worrying about how much I can’t do because I am not enough, I hear Jesus’ quiet invitation to sit in His presence, even in the midst of such deep suffering. And I accept. 

I sit in His presence and bring this young man to Him, praying he would know the peace of Jesus’ presence, too. I sit in His presence and bring myself and my broken heart to Him, finding space to grieve and freedom to be sad because when I’m with Jesus, the lie that “I have to be the strong one” crumbles. Jesus is the strong one. I never have to act like I have it all together—because I don’t. Jesus knows this. He's okay with this.

The Americans clear out, and it’s just my dad and me left. With the help of our friend and translator, Dad explains why the American team is there, to teach and work with the local doctors. The patient’s mother looks up tearfully and asks if her son will live.

All our knowledge, all our diagnostic powers, all our education and good intentions—it means nothing in this moment. We have nothing to offer this woman and her son. Nothing except Jesus. So we ask if we can pray, and I reach out my hand to touch this patient’s dirt-smeared blanket and lift him up to Jesus.

And I know in all our heartbreak, in all their heartbreak, Jesus is enough, and He is with us. 

His presence is so strong. It always is, if we'll just acknowledge it. If we'll just accept His invitation and stop our striving to be everything, fix everything, and know everything. Perhaps this is the most important thing I’ve learned about poverty in the past few years. Poverty and suffering highlight our sense of helplessness, and so often our response is to push this uncomfortable feeling down and ignore it or to grit our teeth and take it upon ourselves to eliminate disparities. Yet I’ve found no freedom there. 

No, freedom is found in Jesus' presence, in trust. It's found in trusting God is enough, trusting He cares and is big enough for all the hurts in the world and my grief over poverty and suffering and death, and trusting God is, indeed, good.

He is good. Even when everything around us seems to be wrong and impossible and heart-wrenching and clouded with evil. He is, indeed, good, and He is enough.