I Love Her Inner “B”

“There comes a point in your life when you realize who matters, who never did, who won’t anymore, and who always will. So don’t worry about people from your past, there’s a reason why they didn’t make it to your future.”

I’ve known for months “IT” was coming, however, subconsciously I suppressed my change management defense mechanisms. I respect that people have the right to make free will choices. That doesn’t mean that I have to accept them until I’m forced to. From my state of denial I was impelled to mourn her “Out of Office” message last week which stated “you’ve reached the desk of_____I am now retired.” How DARE you do that to me? Yes I am angry. Pissed off actually! BUT I do admire her BOLD courage to lead by example and live according to her intrinsic guiding principles.

Concurrently we arrived at our organization as Clinical Supervisors, in sync we became Managers, and in concert we progressed to the Director level. We actually were in competition for my position. Tiffany maintains that I got the job because I wore pantyhose to the interview. On that note, "Tiffany, you could have at least shaved your legs." Thank you for the extra pair of pantyhose, I'll wear them to my next interview.

We’re both RNs registered through the CNO and she is my “pick brain.” It didn’t matter to us as professional colleagues which nursing theorist we individually adhered to. It could have been Roy, Benner or Rogers for all we cared. For us it was always about the outcome and the achievement of client care goals. Whenever we did our pulse check, we inevitably got the same rate. We could predict pending aneurisms and identify those that would affect cardiac output. Together we managed wedge pressures, and yes at times they required inotropes. Fortunately we never had to start Levophed YET. Some have alluded that Tiffany occasionally gets into the weeds. In her defense and support... that’s the only way one can eradicate noxious weeds.

Our professional relationship morphed into a wonderful friendship inclusive of mutual respect, admiration and affection. She calls her inner bitch “Tiffany.” I adore Tiffany; she keeps our life perspective real. Often more than not at senior leadership meetings I would spew my directives only to encounter “Tiffany.” Her head cocked to the right with her left eyebrow raised, our eyes would lock and her expression said it all...”You are FUBAR”. I was never offended. I did my job; she took her baton and assumed the risk. We mastered comfortable disagreement and have always celebrated our successes. She always had my back and was the first to warn me of the vipers in my den. Ironically during our vision session last week Tiffany’s missing lens blocked the full release of Kaleidoscope prisms. I already miss my colourful protector, shield and defender.

Over the past 10 years we have shared too many days on the road to try to even count. We count them by children days. Mine from the age of 6 reaching the age of 16 and her's from tweenster times to marriage. We have ventured throughout Ontario as well as episodic visits to Nova Scotia, Alberta, and, Quebec. Tiffany has a bucket list much like mine. We have spent hours comparing travel notes and tick lists. Tiffany’s bucket list is much more defined and purposeful than mine. She always teaches me what I need to learn while discovering the world around and about me.

Last year we attended a conference in Banff. Off the cuff Tiffany booked a private chauffer to take us to Lake Louise. While we “bagged off” from the conference that afternoon, Ginger was willing an “Ethics” consultation on her 2 AWOL peers. Do I regret going? No, except for the mere fact that Ginger didn’t come with us! I loved the hairpin turns through the Canadian Rockies, finally seeing the hoodoos, identifying the image of Moraine Lake on the Canadian $20.00 bill and posing at the CN train station as the Queen Mother did in 1939. As we journeyed we were appalled to discover that during WW1 PM Borden enacted the War Measures Act and was responsible for the internment of Ukrainian Canadians. Funny how no one I have spoken to since had ever learned those facts in history class?? Shame on you Borden for violating the rights of settler immigrants! http://en.wikipedia.org/wiki/Castle_Mountain_Internment_Camp Lake Louise is the closest place to heaven on earth. God lives there. Too bad Tiffany fell on her sweet ass on the ice in front of Him. Together we were declared Haligonians, and, Tiffany we should have taken up that offer from the cool dude with the aviator glasses in Quebec City...;-) just sayin’

We are co-beach bums who love to litter the shores of Lake Huron. So what if she serves me “chilled” red wine as she drinks Pomegranate Martinis that taste more like Buckley's Cough Syrup. It’s the BEING THERE with sand between our toes that matters. She fulfilled my belaboured yearning for Skecher ass tauten thongs... Outcome >>> pedal edema. LMAO and it’s not taut yet.

I already know that Tiffany is 1 of the 5 people I will meet in heaven. Because I know her, I’ve been changed for the better and I’ve been changed for good.

In keeping with the email I received from Tiffany the other day... “Please, please come & stay with me to my future.... on the beach or whatever... where the red wine will never again be chilled :) Beyond words... and no goodbyes”

Tiffany I’m in your now and future whether you like that or not. I need you Gal, after all you’re my “pick brain” and the oxy in my hemoglobin...Meet you at the beach eh.

Cheers to Living Life Out Loud With Ya!

MWAH Sista
http://animoto.com/play/AKqR3e8VcxSkr710aW8b8w?utm_content=challenger

http://www.youtube.com/watch?v=Jx3rjS_vSM4

Only a Boy Named David

"And one little stone went in the sling
And the sling went round and round
And one little stone went in the sling
And the sling went round and round
And round and round
And round and round
And round and round and round
And one little prayer went up to God
And the giant came tumbling down."


David is my Mom’s favourite biblical character. She still nurses a marble replica of Michelangelo di Lodovico Buonarroti’s “David” that my dad gave her when we lived in Montreal in the early 70’s. I have to make a confession though...growing up with three brothers, especially my younger two, we roughhoused a lot. I, in my competitive attempt to playfully beat up my brothers I had a habit of breaking my mother’s figurines during our sibling debacles. Sly as I was at the time, I’d set the fractured figurine head or violin back on the ornament and wait until the next knock on the furniture by one of my innocent brothers and....bing ...bang...a brother was always nailed for the trauma. My father used his precise skill of crazy gluing them back together. I never confessed my sins to my mom or dad until after I got married, furthermore my brothers have never forgiven me; especially FISH. David was the only figurine I never broke. He’s still intact at home today.

In the fall of 2009 I visited the Academia in Florence. Seeing Michelangelo’s David was one of the highlights of my life. I can recount each rounded step until I laid my eyes upon him. David defines perfection. As I stood there I pondered about what David represented to my mother in particular.

If you refer to 1 Samuel 17 and old Sunday school lessons, you’ll recall the Philistine army had gathered for war against Israel. For forty days they mocked and challenged the Israelites to fight. They had a giant named was Goliath. Saul, the King of Israel, and the whole army were terrified of Goliath. David volunteered to fight Goliath. Dressed in his simple tunic, carrying his shepherd's staff, slingshot and a pouch full of stones, David approached Goliath and said "You come against me with sword and spear and javelin, but I come against you in the name of the Lord Almighty, the God of the armies of Israel, whom you have defied ... today I will give the carcasses of the Philistine army to the birds of the air ... and the whole world will know that there is a God in Israel ... it is not by sword or spear that the Lord saves; for the battle is the Lord's, and he will give all of you into our hands." As Goliath moved in for the kill, David reached into his bag and slung one of his stones at Goliath's head. Finding a hole in the armour, the stone sank into the giant's forehead and he fell face down on the ground. David then took Goliath's sword, killed him and then cut off his head. When the Philistines saw that their hero was dead, they turned and ran.

So what does David represent? Courage, he never wavered or cowered in fear, but ran to the battle. He knew what action needed to be taken, in spite of discouraging insults and fearful threats. Only God's opinion mattered to David. Faith, made David look at the giant from a different perspective. Goliath was merely a HUGE mortal man defying an all-powerful God. David looked at the battle from God's point of view. Skill, he was himself and he used his simple slingshot, a weapon he was skilled at using and God worked a miracle through him.

So why am I surprised that every time my mother or our family faced a giant that she walked forward gallantly with courage, skill and faith? Why am I surprised what David meant to her life? This in turn affected all our lives. She is David.

Last week I returned to Florence. I took my daughter to the Academia to see David. Not because the biblical David represents anything to her, but because, as an art major she is obsessed with Michelangelo. She sat on the floor beneath David for over 40 minutes in awe of Michelangelo’s skill and perfection as a sculptor. As I observed her awe and wonder, I regretted for the first time keeping her away from religion and wished instead she could have experienced David’s courage and faith. I also wished my Mom could have seen the real David herself. Even if I took her today, her eyes would fail to see his divine perfection, even though he lives in and through her. She is grace.

Take your skill in faith and use it courageously... and I’ll try not to break anymore of her figurines.

Learn to Be Still

“You just keep on running, keep on running”...Don Henley

It’s a week into 2010 and I haven’t made any resolutions. That isn’t unusual as I never make them. I prefer positive affirmations and to follow my heart and gut. They never fail me. As the New Year slid in, I reflected on 2009. With a labour disruption and accreditation, it was an interesting year of chaos, uncertainty, waiting and finally victory.

The most valuable lesson I learned was that my friends and family made the greatest sacrifice to support me professionally. I am grateful for their undying commitment, faith and tolerance of my frequent physical absence from daily life in the ranks. I learned my friends will share their bubble to banish collective fear and that the only thing to fear is fear itself. Those friends know just when to call and when to hold the flashlight up in the tunnel so I can see “into the shining sun”. Those friends know when to take the wheel and yield when I’m directionally challenged. Those friends are the first to celebrate my successes. Those friends forgive, accept, support, love and challenge me to greater heights.

I was in the East Coast, the West Coast and every nook and cranny of Ontario, went to England, Italy, Croatia, Turkey, Greece, France, Monaco and Spain and in between enjoyed those endless summer nights at Kettle Point. In total I only slept in my own bed approximately 100 nights in 2009. It was a year of self discovery that I will never forget.

So 2010...what will it bring? I can’t watch paint dry or feel grass growing under my feet, but my inner voice tells me I need to “learn to be still”. That’s not easy for me. I will slow down and savour the gifts and people in my life. I will love and accept love freely and with my whole heart. I will accept people unconditionally. I will not tolerate injustice. I will keep my mind and heart open to possibilities. I will lift people up, build bridges and support their pillars when the winds around them blow. I will always be true to myself. I will have the courage to leave behind that what no longer nourishes or enriches my life. I will believe. This or something better now manifests itself for me in totally satisfying and harmonious ways for the highest good of all concerned.

I wish you a happy and productive 2010!
Gotta run now...MWAH

Believe

“Christmas gift suggestions: To your enemy, forgiveness. To an opponent, tolerance. To a friend, your heart. To a customer, service. To all, charity. To every child, a good example. To yourself, respect." ~ Oren Arnold

It’s that time of year again. The time that forces all of us into the fluster and panic in our search for the perfect Christmas gifts and menus to satisfy all tastes. The older I get, the more I dislike it. Sunday my daughter and I spent the day planning and decorating outside. She had a vision of what we needed to do. She bantered with me about what I needed to buy, what we had to bake and who we had to visit over the next few weeks. She was contagious. I actually absorbed some of her enthusiasm.

Ever since she was young we have tuned into 98.1 CHFI right after the Toronto Santa Parade as they suddenly become “our official Christmas station” with non-stop Christmas music. http://www.chfi.com/

I wasn’t surprised when driving home from the store that she set the station to 98.1 only to hear Josh Groban singing “Believe”. I love that song. It has special memories of us going to the IMAX to watch “Polar Express” in 3D after my sister-in-law’s mom’s funeral. You might think that seems like a strange thing to do after a funeral, but it was my daughter’s first experience with loss, and she adored Maria. There was something magical about hearing the bells and rediscovering belief through that movie. So she and I sang along to “Believe” as loud as we could. I actually felt a bit of Christmas as we pulled into the driveway.

Ironically the following day, she had an anaphylactic reaction to peanuts which she is allergic to. Her school Vice Principles took charge of the situation and administered her Epipen and activated EMS. Suddenly Christmas presents and food don’t matter. Humanity and goodwill and doing the right thing matter. This Christmas I am grateful for her as she is the greatest gift I have ever been blessed with. I am grateful to Mr. Morgan and Mr. DeBoer and the EMS staff. People like that make you “Believe” whether you want to or not.

Merry Christmas!

Patients or Standards?

“I think there's more to this hobbit than meets the eye” ~ Gandalf, The Grey

My daughter “HD” is known to her friends as ‘hildow’ or to me as my ‘Hobbit Diva’. She always has a way of bringing things home for me. She has challenged my career decisions ever since I left the ICU bedside. To her what I do ‘now’ is nebulous and meaningless. For her saving real lives is what matters. I can recount the many times she has asked me if “indirectly helping people with activities of daily living is as significant as direct intervention/life saving measures? “ I can’t answer that question. My passion has and always will be direct intervention; however, keeping people safe at home abates the inevitable direct interventions.

Yesterday while chauffeuring HD to one of her many activities, she asked one of her profoundly dreaded questions; “What are you most passionate about, people or standards?” I didn’t answer her; I had to think about that for awhile.

The College of Nurses of Ontario (CNO) assists nurses in providing safe, effective and ethical care by developing and setting standards for the profession. Those regulated Standards of Practice legislated through the Nursing Act 1991 http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_91n32_e.htm and the RHPA 1991 http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_91r18_e.htm have guided my professional life. I have always practised safe effective ethical care according to the CNO practice standards and guidelines and applicable legislations. So HD even while I was in direct care delivery I practiced according to standards.

On the other hand Accreditation Canada's sector and service-based standards help organizations assess quality at the point of service delivery. They are based upon five key elements of service excellence: clinical leadership, people, process, information, and performance. While my current work focuses on these serviced-based standards, my patient outcome goals remain steadfast...SAFE, EFFECTIVE and ETHICAL care.

So HD, patients or standards? Without standards, safe patient care is inexistent. "Would I rather enforce compliance to standards or feel the pulse of a patient?" I think you know my answer. I’d rather nurture my patient but for now I’m doing that by ensuring that standards are adhered to and patient care outcomes are met. Believe it or not, it’s another way of saving lives. It will never replace the feel of a pulse, breath or smile. Thanks for reminding me why I do what I do.

So Long Kiefer (1962-2009)

“No one ever dies unless they are forgotten.”...Ojibwa legend

I learned years ago that in Ojibwa there is no word for “goodbye”. I think that very premise is what drew my fascination towards Ojibwa culture, history and rituals in the first place. Six weeks ago our beloved Kiefer went to meet his “Maker”. Cancer kicked him down too young and left the rest of us wondering why...

As rituals go, surrounded by friends and family, I paid my respect to him that weekend. Kief and my husband were best friends for over 40 years; I had the privilege to share in that friendship for the past 20 years. Unfortunately I’ve been in a phrenic work state of mind these past few months and failed to pause long enough to honour a friendship that selflessly taught and nurtured us.

Kief’s birthday was this week; he wasn’t here to celebrate it. Kief was known as our noble “Kraut”. Tomorrow marks the start of Oktoberfest and Thanksgiving weekend, Kitchener Civic Square will be bustling with pomp and ceremony, music and dancing. As the fanfare of trumpeters sound off the official opening of the 41st annual Kitchener-Waterloo Oktoberfest, and the mayor taps the keg and says “Willkommen to Oktoberfest”...I promise Kiefer that I won’t say “now go home”.

Our memories of you are precious and hidden deep in our hearts. We miss you. Happy Birthday! As we give thanks this weekend, we will remember everything you have given and shared in our lives.

As the Irish blessing goes, “May God hold you in the hallow of his hand until we meet again”. Love you always and forever...meet you on the rainbow bridge and we’ll do the chicken dance...

"And here I am - knocking at your door with expectations of my own.
Knock
Knock
Knock"...Ojibwa legend

Cheers ;-)

“In Queue” Etiquette a la Madeline

"In an old house in Paris that was covered in vines
Lived twelve little girls in two straight lines
They smile at the good, and frown at the bad
and sometimes they are Very sad
In 12 straight Lines they break their bread
Brush their teeth and go to bed.
They leave the house at half past nine, in two straight lines.
The smallest one is MADELINE!”... Ludwig Bemelmans

I have a pet peeve that has been driving me nuts and into a “Rick Mercer” rant for years. My rant is all about queuing etiquette. “Queue “means to form a line, and to wait for services.

When I was young my mother read me the “Madeline” book series; when I was able, I read them myself; I read them to my daughter; when she was able, she read them herself. Not surprisingly, the key lessons for me all had to do with structure and formation especially when “something is not quite right “such as forming proper line-ups.

I learned early on through Miss Clavel and my kindergarten teacher how and why line-ups/queues are formed. The rules are as follows:

1. Get in line
2. No jumping, butting, budging, skipping, ditching, breaking, shorting, or pushing in at any position other than the end of the line.
3. Sometimes you can "back cut" – if you have permission to enter behind the person who was asked. This is only considered fair if each person behind the one being "cut" allows it.
4. You can “cut in line” if someone is saving your place in line and you are both conducting one transaction.
5. You can leave the queue to use the bathroom and then return to your original place without having to ask permission.
6. You must respectfully allow pregnant women, adults accompanying small children, and the physically disabled to be serviced prior to everyone else.

These are fair rules that have served me well since my early “Madeline” days. However, something changed in the 90’s. I have not been able to ascertain if these changes are reflective of the dot com era or the Ritalin Generation. I can only state that I don’t like the change.

When I started my working life at McDonalds, I worked the “window”, which was teller. This was long before the drive-thru days. Patrons came into the restaurant, got in line and placed their orders. When I was going through Nursing I worked at Eaton’s...same thing, customers got in line at a cash register and waited to be served. This linear queue sequence is dependent on the structure of 2 or more cashiers. This linear queue sequence provides equal opportunity to all as well as fairness to the customers due to a slow cashier and/or customer clog. Then...the dot com and/or Ritalin Generation went parallel which lead to the cattle herding lines and merges waiting for the call out of “can I help the next customer”. This is the sequence that drives me nuts. I only accept the linear queue sequence as it supports semblance of societal order.

Recently I followed suit and lined up behind a patron who was in linear queue formation at the LCBO, when a clueless gentleman walked by and somehow managed to time his arrival at the exact moment the cashier at asked “May I help whose next.” Of course, he’s somehow next by the magic of the Gods at power (parallel line up). Normally I would say something and make sure that I was indeed next, but I figured that’s ok I’ll be nice today. He was abiding by the parallel line up theory. Patiently I waited for another cashier to say the magic words; unfortunately two university students walked by and somehow swooped in at the sound of those magic words by an unsuspecting cashier. This is when I decided civil justice must prevail. From my sentry I announced that indeed they were not next, and that I was. I continued to explain the linear queue sequence theory and mentioned that by listening in school they would have known such earth shattering mathematical concepts. Of course as expected they looked at me like I was from some other planet. Needless to say, I got my Little Penguin before the stupid university students got their beer.

Unless you see a “please form line here” sign or a cattle herder barricade, just pick a line and get it in. No jumping, butting, budging, skipping, ditching, breaking, shorting, or pushing in at any position other than the end of the line.

So Madeline, let’s form the world in two straight lines. One line with an appendix and one line without. Somehow that would be quite right. Muuah girl…and Maddie if we fail...We’ll call Rick Mercer to rant for us.