Barcelona Day 3: Elections & Opening Ceremonies

Saturday, 27 May 23:00

Before I was approved to attend and cover the International Nurses Council (ICN) Congress this week, I had no clue about many of the things I’ve been writing about for the last few days. Apart from a few friends in college who were into medical missions, nursing, to me, as I mentioned in my blog post of last week for AJN Off the Charts, was solely a local, American concern.

While the governing body of ICN announced elected board members this morning, I shamefully realized I knew little or nothing of many of the new, celebrated leaders or their respective member countries. When Pam Cipriano, President of our professional nursing organization was named elected member of the board, I wondered how many of my colleagues or nursing friends knew about her work, platform, or even of her name. As I feverishly Googled the emoji of the United Arab Emerites flag to send out a congratulatory tweet about AJN International Advisory Board Dr. Fatima Al Rifai’s similar election, I realized didn’t have the slightest idea about the UAE’s nursing population, leadership structure or professional progress. I had no clue how I would learn all of these new people and concepts, but knew, as I experienced more and more, that I now wanted to try.

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Later, after 8,00+ international attendees filled the Olympic Village that overlooks the city of Barcelona for the opening ceremonies, I watched country after country of National Nursing Association representatives (including American Nurses Association) take their places in the opening parade, and marveled at how many truly diverse cultures of care crossed the stage waving their countries’ flags into the spotlight.  My awe doubled when I, a member of the press and a nurse, was allowed backstage to the delegates VIP area, and then shorly after, to stand directly in front of the oncoming parade and honor delegates through my documentation of their participation.

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Most of all, I found it breathtaking to become a living mix of the things that inspire me daily – nursing and writing. To be a badged member of the press, but with insight and emotion about the goings on around me at the opening ceremonies, made me realize just how valuable diversification in nursing really is. If only we would start to realize that nursing is a foundation for every area of business, education, clinical practice and more, and that our true impact, as Judith Shamian, acting president of ICN, would say, is determined, not so much by who we are or who we work for, but how we choose to innovate our profession through our time and talents, not just our day jobs.

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And so, when one of my personal, early nursing heros, Dr. Linda Aiken, came to the stage to accept the “Nobel Prize of Nursing” (a description I’m not sure that I agree with, since nurses should also be winning the real Nobel Prize, no?), I clung to her words as not just a nurse, but as a nurse who is also a scientist of nursing. For the first time, I saw how important her work of science creation is, how the necessary, undeniable, extensive, replicable and global body of evidence that she led for the benefit of our profession stemmed not just from her initial clinical training, but from her passion to forward the profession as a whole, through actionable and quantifiable evidence.

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Of course, some of the nurse-centric entertainment after the awards ceremonies made this nurse cry and marvel at the magnitude of this profession that I so deeply love, but it was the presence of so many nurses communicating and celebrating together that touched me deepest. Likely for the first time in my ten year career, I connected with the need to actualize the massive, inherent value of the hard work that we must begin to do – with our voices, our written words, and our brains – together, and for each other’s future.

When I’d captured enough, I snuck out and walked to the metro with a group of international nurses that I met along the way, the city skyline closing the night in a dusky blue behind us.

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Barcelona Day 2: A Real Spanish Hospital + Art Walkathon

Friday, 26 May 23:00

The days seem endless here, in a good way. This sleepless, sun-filled city bestows enough hours of positive, brilliant energy in the day to stave off an entire season of winter blues. Right now, as I struggle to stay awake enough to keep my promise to myself to reflect and write at the end of each day, a ska band is playing a slow version of Lady Gaga’s Bad Romance  just half of a block from my balcony window. I’m officially enamored with Barcelona.

This morning, I met AJN Editor-in-chief  Shawn Kennedy at the Centre Convencions International Barcelona to observe the meetings of the Council of National Nursing Association Representatives (CNR), and check in as a member of the press. This is acting President Judith Shamian‘s final Congress, and I was sad that my jetlag kept me in bed past the opening presentation that commended her advocacy and celebrated her coined phrases – challenges to the global nursing community to act, have a voice, get involved in policy.

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After a sunny coffee break where Shawn and I caught up and made a plan for our coverage throughout the week, I met up with NYC colleages to tag along on a tour of Hospital Clinic Barcelona that Dr. Beth Oliver, Vice President of Cardiac Services for Mount Sinai Health System, had arranged for a handful of nurses through an international contact. We met with members of the nursing leadership team, who personally walked us through a presentation of the hospitals history, architecture, place in Spain’s universal health care structure, and current clinical offerings. After this, we headed to the floors, where we saw intensive care units that were higher tech and more sophisticated than any I had ever seen or worked for in New York. It wasn’t until after we finished and entered the noisy streets that Beth and I turned to each other and said, “Oh my goodness, did you notice how quiet it was in every floor?”

From there, I parted ways with my US friends and spent the rest of my day walking the city. I hiked up the hill (and stairs!) to the Museu Nacional d’Art de Catalunya, watched the city behind eager tourists taking selfies, and perused their collection of international art, particularly enjoying a simple, small exhibit by a Barcelona native, Torné Esquius, called “Poetics of the Everyday.” The empty halls of the museum posed a stark contrast to the heavily trafficed museums back home, and I enjoyed taking my time to look at pieces, or taking no time at all.

While I love site seeing and art viewing, my favorite part of my second day in Barcelona was spending time learning from other nurses at the hospital. I most enjoyed hearing the details of the Spanish health care system, and the structured take the government has on educational levels, specializations, labor agreements, and advanced degrees. I marveled at the detail of the presentation materials given by these nurses who spoke of their many degrees and accomplishments, seemingly spurred on by the laws in place here in Spain that systematically move nurses through required educational minimums for practice; structure that we sorely lack in the US.

I also loved “collecting” the simple design solutions that this hospital had mastered: Huge numbers on each glass sliding door of each room. Buttons that made the lights in the ceiling mimic the pattern of the sun to decrease delirium. Basic, clear hand hygiene signs. Plastic, easily cleaned room-dividers instead of fabric curtains (brilliant!). A code cart with a compartment that had a clear, locked lid containing the intubation blade and battery pack in plain view, right next to the defibrillator. Even in rooms so small that bed rails touched each other, I didn’t hear a single call bell ring, and nurses seemed engaged and happy, even with patient rations higher than our own.

Perhaps I am just seeing everything with vacation eyes. I don’t know. Either way, the day brought me closer to the realization that there is so much to learn, so many perspectives to consider, so much to be open to. I can hardly wait for the day tomorrow, when thousands of motivated nurses will end their journeys together at the Congress’ opening ceremonies. Being here makes me remember why I love our profession so much, how unifying it is, how our common struggles, maybe not exactly the same, only bring us closer together and more apt to move in unison.

 

Day 1: Barcelona, ICN 2017

Thursday, 25 May 23:00

On my calculation, I’ve been in Barcelona for about 15 hours now. Minus the few winks I managed between backaches in my cramped coach class seat, I think I’ve been awake for going on 36. If that’s not any forwarning about the quality of this blog post, I’m not sure what to tell you.

All in all, I’m here, and had a great first day in this city that is new to me. I spent the day with nurse colleagues breakfasting on a rooftop overlooking the ocean, traipsing around tourist sites and hidden local shopping jems, drinking a glass of Cava, and talking nursing in preparation for the International Council of Nurses Congress, which starts Saturday. I’m here reporting for the American Journal of Nursing, and so far, I’m impressed with the city.

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Barcelona is clean, modern, accessible and easy to navigate. People are helpful and cordial, and the food is good. I have yet to encounter a Barcelonian who doesn’t speak English; I feel no shame (or impossibility) maneuvering my way through dinner-ordering and direction requests in my native tongue.

This Americentric mindset makes me reflect, always, when I travel in foreign lands. My recent international experience is mixed, albeit not that vast – in Brazil, the majority of people speak very litte or no English, and so speaking my preferred tongue is simply not an option. I must stumble through broken fragments of mispronunciations mixed with fervent body language. In contrast, when my husband and I visited Portugal last year, I was able to poke my way around in cautious, respectful English, for the most part. Here, there’s no hindrance, and I find myself not really even trying to inflect or attempt. The acceptance of English dominance is apparent, expected, perhaps even embraced, at this first glance.

It’s interesting, to start this week of covering an international meeting of nurses by thinking about the insecurities of inter-linguistic maneuverings. Should I assume, like I too often do with varying foreign language travel requirements, that my naturally dominant perspective is the best? The one to mimc? What can I learn from the culture here, the collective narrative of health? How is my own native perspective getting in the way? How can I, in preparation for talking with some of the most prominent and accomplished nursing leaders of the world, remove barriers to my own opennness and recognize the things I, as a member of a global community, need to start stretching myself to do and learn?

New Days, New Ways

img_1411A promotion at work started 2017 for me, dropping me into a tidal wave of new learning and stretch assignments that I continue to float within now.

Evenso, I was lucky enough to sneak up to Boston last week and complete my second residency week of the certificate program at the Center for Narrative Practice, which I have studied in since August. The faculty, largely led by Columbia University’s Narrative Medicine folks, led us through a hands-on curriculum, designed to equip us with the practical tools required to lead narrative exercises in our unique clinical settings.

I’ve been thinking about the class since returning to my new job this week, itching to test out my new learnings. With my title comes some freedom to fashion the meetings that I’m responsible for, and a group of bedside nurses selected to drive quality improvement across my organization seemed the perfect group.

Today’s meeting was our first together, and after some expected technical difficulties and “Why are we here?” questions, I posed the choice: Should we proceed with didactic training via a colorful powerpoint I have prepared, or take a more creative route to understanding quality by…reading a poem?

To my surprise, the group wholeheartedly embraced the literary choice, and together, we read, discussed and wrote reflections on George Ella Lyon’s poem, Where I’m From.

Our rich discussion, which ranged from literary analysis to family history, ended with one nurse’s summary: by witnessing each other’s stories and recognizing our own, we see and remember that each of our patients comes from somewhere, too, and that asking them the simple question – “Where are you from?” – might lead to beautiful, unexpected findings.

It goes without saying, but I’ll say it anyway – I couldn’t have dreamed for a better, more engaged synopsis and group response, and I am excited to find ways to create more and more space for this important, meaningful, new way of seeing into my new days.

My reflection to the reading:

Where I’m From (RN)
I’m from coffee tables &
journal lines, cold sun and
strange premonitions,
I’m from unknown motivation,
near failure & forgotten
Anatamoy & Physiology,
I’m from anxiety and
sepsis-training, Roto-prone
beds and hemorrhagic strokes,
I’m from long
nights & longer days,
doctors’ rounds and
curt comments,
I’m from plaits & shaving cream,
poop-stained shoes and
CPR,
I’m from a long ago test and
a daily drive,
I’m from the bedside
I’ll go to next.

Mindful Gratitude: This Blog in a Book

Two years and two weeks ago, I published the blog post, “The Poetry of the IV,” on this site. In it, I reflected upon the thoughts I was having while placing IVs during shifts in the cardiac cath lab where I worked at the time.

Shortly after the post went live, an author from Ireland named Carmel Sheridan contacted me to see if she might excerpt it in her forthcoming book, a primer about nursing mindfully. After some dialogue, I agreed. Since then, she’d update me on the book’s progress from time to time.

Today, I received an unexpected package from Ireland in the afternoon mail. In it, I found an autographed copy of Carmel’s book, The Mindful Nurse: Using the Power of Mindfulness and Compassion to Help You Thrive in Your Work, along with a beautiful card from Carmel.

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My excerpt in Carmel Sheridan’s new book: The Mindful Nurse: Using the Power of Mindfulness and Compassion to Help You Thrive in Your Work. Rivertime Press, 2016. 
As I searched for my excerpt, I enjoyed what I saw. Just this morning, I had strained to think of ways to conjure up mindfulness in the many moments that I found myself feeling impatient; while filling up the watering can to water my plants, waiting for the shower to get warm, standing in line at the store. I was sure I had learned something about finding beauty in these moments, but couldn’t conjure it. As I read her book just now, I saw that many similar moments for mindfulness were outlined alongside practical strategies, and ones to maintain mindfulness in far more complex scenarios, too.

Perhaps my struggle for mindfulness in the mundane today is not much different than the premise I wrote of in this excerpted blog post – I had been inserting many IVs at that point in my career – almost too many. The rote nature of the intake & recovery area of the cath lab that I worked in was getting me itchy. I liked my colleagues and the new kind of setting, but I missed the intricacies of the ICU that I knew so well.

Being mindful with IVs helped me refocus and enjoy my patients and my work – not the skill or task, so to speak, but the connections I was able to work at creating with my patients while inserting them. By seeing past the work and into its elements, I found beauty where I might’ve only felt boredom or frustration.

I am happy to see the paragraph about these connections on one of the pages in Carmel’s book. Looking back, learning to use IVs (and any other skill or task, for that matter) as a moment for laughter, conversation, silent assessment, became one of the most important lessons in mindfulness that my bedside practice has yet to teach me:

Now, IVs are a chance to chat – to talk with patients about where they live, what they do, how they feel. It’s amazing how easy the moments become – even when I miss or blow a vein – if I focus on talking with people. I enjoy myself, the pressure lifts, and I assess through our conversation. Patients bare deep wounds amidst these tiny moments.

Feels great to hold this book in my hands and see my name in it within the chapter, on the reference lists, and in the index. I started this blog as a way to vent as a new graduate – as healing for myself. To think of its contents resting in the hands of others as they read, teach, workshop and grow is a privilege and encouragement.

Check out Carmel’s book, folks – great stuff. You can find it on Amazon, or here: www.nursingmindfully.com