Saturday, December 13, 2008

Finals week and I am tired!

On Thursday I took an online final that was a mere 35 questions long. Fortunately I knew my way through the content and got an A (94.5 %) on that particular test. This weekend I have another one to take and on this content, I am not so self-assured. I’d settle for a C, just to get it over with!

Why do tests make us crazy? I know I’m not alone in this. Some folks have test anxiety so severe that they actually need medication to simply get through an exam. I’m not anxious, I just don’t like taking tests – and, maybe I’m just old, because now that most tests are electronic, I feel a little more handicapped when taking them.

I have two or perhaps three certification exams looming in my future and in today’s world those tests are all online as well. You generally have to go to a testing center to have the privilege of sitting for them (after you pay several hundred dollars) and they are timed by a proctor. The first one comes up this spring and I am not looking forward to it. The second one will occur when I complete my coursework for the Family Nurse Practitioner certification. Hopefully, that will be in the summer of 2010. Then, if I have any endurance left in me, I am considering the pursuit of a Child/Family Psychiatric Mental Health NP certification (this could take another 2 years), so I don’t expect the test will be on my calendar until 2012. Maybe if I spread them out (one every 2 years or so) they won’t seem so overwhelming!

Life is full of tests. Most of them don’t occur online, however. They happen when you make a presentation at work and everyone is judging your project, examining your worth to the organization and either feeling very supportive and proud to have you as their colleague or jealous as hell if you did a good job! Other tests are more subtle –

  • What did you do with that Christmas gift Aunt Catherine sent you (you know, the one you hated!)? Because, after all, she is coming for New Year’s dinner!
  • Where did you put your copies of those trip receipts you’d never thought you’d need? Well you need them now, because there was a small fire in the accounting department and all the work in Cynthia’s in-basket (your expense report included) is in ashes!
  • “How old are you grandma?” seems like an innocent enough question unless it is going into a report for school that notifies a whole portion of the disbelieving world that you are indeed over the age of “senior citizen” and deserving of a discount on nearly everything retail.

What tests are facing you? Will you worry that you look “fatter” when you see your friends and family over the holidays? Will you still be in love with the fellow you met at that conference last year, but haven’t seen (except in e-mail photos) in over 9 months? Will your Red Velvet Cake hold up to grandma’s standards at the holiday dinner you’re hosting this year?

We all have tests. My advice? Take a deep breath, give it your best effort, and realize, in a few years (maybe just weeks or months) no one will even care how you did on your test!

Friday, November 7, 2008

The Joys of Travel

This weekend I get to venture to one of my favorite parts of the country, North Carolina. It is not that I’ve spent a great deal of time there, but that one of my very best girlfriends lives there and I will get to spend time with her!

As I get ready for this trip I notice that preparation in mid-life is different than it was just a decade or so ago. This week, in getting ready for my trip, I saw my physician, made appointments for two steroid injections (knee & spine), renewed my prescriptions and got a new one for those “power surges” that hit you in mid-life. Hopefully, on this new drug, I will be able to sleep through the night without having to “cool the fire within” every hour or so.

Also in getting ready to leave, I had to clear my desks – yes two desks, one at work and one at home. With work projects in fairly safe array (or in good hands while I’ll be gone) and school projects on track for appropriate completion for the end of the semester, I believe I will be able to get on that plane worry-free.

The trip comes in the form of a conference for work. The best news was that it would be in my girlfriend’s home-town. Two days with her, two days for work-related business and I should be ready to return to both my desks refreshed and renewed.

Travel is an interesting thing. It is always on my “wish list” when I tabulate the things I want to do in life yet, when it comes to actually taking a trip, a million headaches come to mind. Many of them airport related: Do I have all my liquids in less than 3-ounce bottles? Remember to wear shoes that are easy to slip off and on! Shall I pay to check my bag or schlep it on the plane in the hopes that some tall person will help me heft it up into the over-head storage compartment?

Then there are the ordinary woes of just being away from home: Should I take a bathing suit for the pool (do I want to be seen by strangers looking like a beached whale?)? Do I have the right clothes for the activities; will I need a dressy outfit; is there a banquet; can I wear jeans?

And finally, there is the question that arises anytime we go to see an old friend, especially one we don’t get to visit very often – what will she think of me? Will she care that I’ve put on a few pounds (Few is a delicate word!)? Will she hate my punky, spiky hair? Will we have enough in common to even hold an interesting conversation?

All these things roam through my head, but as I zip up my suitcase and scoop up my trench coat, I remember how every other visit with her has been (visits that go back nearly 40 years) and all I feel is warmth because she and I never care about each other’s looks, we always have enough to talk about – usually well into the night! We are old friends, in the most generous definition of the term, and I am so very excited to get to see her again.

Friday, October 3, 2008

Boomer Women, Finding Our Way in Retirement

Harvard researchers recently report that we boomer women are less married, more divorced, more childless and more alone than any prior generation of women. These worrisome facts add financial and healthcare challenges to an already expanded life expectancy for all of us born in the baby boom that ran from 1946 to 1964.

Boomer women are at risk for having inadequate retirement savings, mainly because, like most women, we’ve been in and out of the workforce managing family life while we juggled career milestones along the way. Women also are notorious for being slow to take advantage of the 401 (k or b) retirement savings products when they were introduced, so our net savings in IRAs, work retirement accounts and pensions are generally inadequate.

Boomer women are at risk for requiring a disproportionate amount of long-term care since women routinely outlive men, and boomer women will be no different, our numbers as we reach our 80s may overwhelm the healthcare resources we have come to depend upon in the USA. We’ll take up more long-term care beds and, because many of us did not marry and even among those who did, many did not produce children, we may be lacking a family caregiver who will oversee our health needs as we age.

What’s a woman to do? Harvard researchers recommend several strategies that I, for one, have begun to take to heart. They remind women now approaching retirement to consider:

  • Know what your Social Security income projections. Each year, the government sends an update indicating what your retirement benefits from Social Security are likely to be. Remember those (downward) income adjustments for being widowed or divorced women can be significant. Women need to educate ourselves and plan accordingly
  • Work a few years longer. Extending worked years by even five years can push up Social Security benefits, increase your time for making considerable retirement contributions and sustain health insurance coverage until Medicare is available.
  • Save more retirement money. Utilize the generous retirement contribution rules for those over 50. Put away as much as your income will allow while there is no penalty for doing so and while your funds can still gain interest.
  • Own your home. By adding just one additional payment each year, you can shave a decade off the length of your mortgage. Whether you purchased early or late in life, this one asset can provide housing, much needed capital or simply equity for a reverse mortgage as you age.

For more information on what you can do to protect your financial future, see this report available on line:


Baby Boomer Women Secure Futures or Not?
Edited By Paul Hodge, Chair, Global Generations Policy InstituteDirector, Harvard Generations Policy Programhttp://www.genpolicy.com/
Available at: http://www.genpolicy.com/freecopy/

Wednesday, September 24, 2008

Reinventing myself in mid-life. . .

Researchers tell us that this is what we do; we reinvent ourselves because naturally life changes after mid-life. Not only do we get old, but we loose roles we’ve had for a long time (Mom or Dad) and gain new ones we may or may not be prepared for (Mother-in-law, Grandmother).

Some of us do this very well and a great deal of interest (along with several articles) is emerging about how we “boomers” will reinvent not only ourselves but the meaning of retirement.

In my case, I will strive to be as creative as possible, but I have a sense that the economic realities of life will play a much greater part in the direction I take than will my sense of adventure, freedom or wanderlust.

So far, I’ve been going about my reinvention in a very pragmatic way.

  • I came back to pediatrics (where I really have not practiced in over 25 years). This returning to my practice “roots” is not something I ever intended to do but the opportunity that presented itself was too good to resist.
  • I went back to school. Learning has been a life-long endeavor and something I truly love. That said learning in mid-life and in a new century is not so easy. I am surrounded by fellow students who are far more energetic who and have well honed skills for the technological demands of higher education today! I alas, do not.
  • I married (again), something I thought I would never do. But his son was about to have a son and I simply didn’t want to be known as “Grandpa’s squeeze” – I wanted the title, Grandma.
  • I bought a new house! Something I have not done in nearly 30 years. I’ve lived in all kinds of homes but I wanted a new house and in mid-life I found one, customized just for me. I expect I will be there for quite a while!
  • I consolidated my retirement monies and now only have two main financial repositories for my IRAs and my 401 K. Naturally, when you’re as old as I am there are bound to be little bits of money here and there (I think I have a pension with about $200 in it!), but now, two phone calls or a visit to two websites and I know where I stand (or perhaps, fall).
  • I started to write. Not that I have not always had a love for words and some hopes about writing, but now I set aside time to do it. I go to classes and discussion groups to improve my writing. I look for opportunities to have my work critiqued.

However, I know I’m not done. There are things I need to do that I haven’t gotten to yet. Certainly, a portion of that is procrastination. Another portion is surely a choice about where I will spend my time and with whom.

So what’s left? These things for sure:

  • I must commit to regular exercise. I need both strength training and cardio if I am to head into old age with a sense of wellness and wellbeing.
  • I must de-clutter. Everywhere I turn I see the burden of postponed decisions – debris in every corner of my life and space. It is time to really clean house (physically and metaphorically).
  • I must live consciously. I have no more time for the anesthesia of hurry and over-booking. I want no more running from hither to yon, I want to walk, listen to the breeze in the trees, smell the flowers, and hear the birds. I want to revel in the richness of life and relationships, not merely rush on by. I want to enjoy the journey – whether I get to the destination or not!

So, that’s enough. I think if I live long enough to do all that, I’ll be able to sit down and craft a new list. I can’t imaging running out of “things to do” but I want very much to make my focus not just what I do, but who I am being and becoming for this second half of life!

    Monday, September 1, 2008

    When did I first know I was a Democrat?

    The other day, a comentator on Public Radio asked a group attending the Democratic National Convention, “when did you first know you were a democrat?” and the question got me thinking, when did I first know I was a democrat?

    I hate now, to admit that I voted Republican as many times as I did, but my excuse is that I was raised in a Republican home, and until I was about 30, I didn’t understand much about politics. My parents were very involved in politics when I was very small. I actually remember Eisenhower’s second run for office in 1956 and I was only four at the time. We had a TV and it was on every day from dawn until late into the night if the campaign was being televised.

    My father worked as a lobbyist for the Pennsylvania Tavern Association and as a result he knew his way around state politics. I remember events at pubs and corner bars when I was very young where my parents were working to get someone elected to some local post. For me, it was always a chance to hear the music, dance, throw confetti and drink those “kid cocktails” that the bartender would keep handing to me. It was exciting and fun and I was part of the action – even if I didn’t know what all the action was about.

    In my early voting years, I think I must have voted for the names I knew and, I confess, I knew more about the Republican names than the Democratic names. I even voted for Regan, probably twice, and that would have been what, 1980 and 1984? This was probaby where my disillusionment hit me. I was working with the AIDS community at the time (1986 through 1992) and I realized that we had a president who not only couldn’t deal with the healthcare crisis of the day, he couldn’t even say the word AIDS. It was as though, if he didn’t acknowledge it, it didn’t exist. As a result, neither did any significant funding.

    So, that’s when I knew I had to be a democrat. Clinton made that easy – he was young and charismatic. Gore made it logical, after all, he’d served with Clinton. Kerry was harder to vote for – so I voted against Bush. And in this year’s election, I admit, I was a Clinton advocate, but I can and will vote for Obama.

    A word about wishing, wanting and hoping for Hillary… I doubt that in my lifetime there will be another woman candidate as gutsy as Hillary. She can stand up to the boys, she can even stand up to Bill, and that’s saying something! She made her marriage stick (something I couldn’t do in my first marriage) against enormous odds and horrible public commentary. She raised an amazing daughter (remember those early pictures of Chelsea?) who has grown to be beautiful, focused and ready to take on her own world. I may not always like Hillary, but I admire her and would have happily voted for her to be our president.

    Oh well, water under the bridge. Let’s consider Barack Obama…

    First, he was born in Honolulu, Hawaii – right away, he gets extra points for that! He’s 9 years younger than I, but that’s good. He’ll be 47 when elected and 55 when he leaves office (surely we’ll give him two terms) which is very young, and if he’s even half as charasmatic as Bill Cliniton, he’ll be headed for important work even as a “former president.”

    Also, he’s the product of a single-parent home. Well, Clinton was too, so he’s not the first, but I like the idea that women can produce a presidential offece-worthy son even when up against the hardships of doing it alone. Perhaps it will make us take a longer, national look at the plight of the single mother and the (way too) many fatherless sons in our communities!

    His mom, Ann Dunham, a White American from Kansas, died in 1995 of ovarian cancer. She was 52. That also endeared this man to me. Having worked for the Women’s Cancer Center at the Univerisity of Minnesota, I know this disease (ovarian cancer is the most covert of killers). Perhpaps this will also focus Obama’s attention on women’s cancer and add to the NIH’s coffers for the research on these diseases.

    Barack Obama went to Occidental College, one of the oldest liberal arts colleges on the West Coast, kown for its academic rigor and its diverse student body; to Columbia University in New York where he emerged with a B.A. in political science with a focus in international relations; and to Yale University where he studied law. I like a man of letters. I also appreciate that he has put his education to good use, doing good work for people far less fortunate than he.

    Has he made some mis-steps? Sure, but when I think of my own mistakes, I know it is good I will never run for office – the scrutiny of our candidates’ early choices is merciless, and done by pundits who, if their own histories were explored would be embarassed beyond belief, I’m sure!

    Okay, enough soap-boxing for this morning.
    Am I voting democratic? You bet.
    Do I hope Barack is smart enough to put Hillary in a cabinet position that permits her to use her talents nationally and not just for New York? Yes, I do.
    Will I be working locally to get him elected.? I will.
    What will you be doing this fall?

    Tuesday, August 26, 2008

    School Daze

    School starts this week and I am scrambling to understand the various connect-abilities expected of me as I take two courses at two separate universities. The software seems to be the same however the access to the applications for these two different educational purposes is apparently a major undertaking. Oh well, I’m hoping to have it worked out in time for class.


    I was thinking about why I go to school in my fifties -- not something most adults are inclined to pursue -- and I guess it is in part because I love to learn. It is also because I love to work. Given that all my credentials are from the last century, it seems I will have a much better chance of staying employed (on my terms) well into my sixties if I have a few 21st century credentials. Hence, I find myself once again a student.


    Both of the programs in which I am participating advise that the learner work no more than 0.8 or 32 hours a week in order to accomplish all the work that the courses require. Hmmmm…not likely to happen in my case, so I guess I’ll be up reading early and studying late while burning the midnight oil.


    My husband was describing to me a couple he knows (and feels bad for) who seem to be, each of them, and the two of them together, in a deep habitual rut. They work, eat, watch TV and sleep -- then they get up and start the pattern all over again. They seem tremendously older (alas, not wiser) than their chronological age and overwhelmingly listless for folks who are so young.


    He has advised the young man in question to get some exercise, turn off the TV and establish a solid sleep pattern. That’s good for openers, but along the way these two (as they are a couple) need to be managing their nutrition, their brain plasticity, their bone & joint flexibility and their finances if they really plan to be healthy! Today I suggested to hubby that one or both of them might want to pursue some education since it is apparent that the degrees they have acquired did not prepare them for the earning potential toward which they wish to live. His tongue-in-cheek reply was that neither of them would believe they have any time. Sad.


    As for me, I will be done with one of my endeavors before the end of the year -- I am becoming certified as a Wound Care nurse. This entails some education and roughly 50 hours of clinical experience with a preceptor who will mentor me through my hands-on experience.


    The other course of study will likely take until the spring of 2010 at which time I should emerge ready to sit for the Family Nurse Practitioner certification examination, something my particular Master’s degree (some 30 years ago) did not prepare me to do.


    Most co-workers ask me the typical question: “Then what?” And, while I wish I could give a definitive, precise answer, I can’t. I suspect I’ll practice where I now work. I envision a role that expands to permit me to add to my current administrative duties a host of clinical jobs that allow me to move from office to bedside to clinic room and back to the office with relative ease. I’m old (56 remember?) so I’m not holding out the hope that I’ll become a whiz-bang specialist in the years of clinical practice remaining to me. Even though I work in a world of specialists, I imagine I will become something of a jack of all trades, able to fill in wherever the organization needs me. That flexibility along with the diversity it would offer will certainly be enough to hold my attention for years to come.


    For this week however, I’m going to have to master my usernames and passwords to multiple gateways just to gain access to the preliminary course materials I’ll be expected to master within the next few days!

    Monday, August 18, 2008

    Summer Adventures with a Five-year Old

    It isn’t just being in my mid-fifties, peri-menopausal and overweight that leaves me tired. This summer, I agreed to make two (not one, but two) trips with a five-year old grandson. Now that’s enough to make anyone tired, and cranky!

    The trips are done (may the heavens be praised!) and I am exhausted. So tired in fact, that I am actually looking forward to the semester’s work and school schedule as a return to normalcy! Here’s what I have to report about our summer adventures. . .

    Duluth may look like a big city, but it functions like a BIG small town. We arrived in town mid-day on Saturday only to learn that:

    • The accommodations we’d planned to use were clearly not going to work!
    • The lines for the event we’d come to see (Tall Ships in the harbor) were averaging five-hour waits!

    Neither of these bits of information spelled “good news” from the standpoint of having a five-year old in tow. Waiting is definitely not his strong suite and, along with that, patience is definitely not mine. Hubby dear was a willing participant and, I must add, a great babysitter while I was on the phone for over an hour searching for a place to lay our heads.

    We worked it out (as resourceful people always do) but suffice it to say, Duluth, the town proper, did not make our access to options particularly easy. We found a motel; bare-bones and definitely not someplace we’d choose if there were choices. And, we decided to do our darnedest to be first in line on Sunday morning, even if that meant getting up before the crack of dawn.

    Hence, our merry band made the best of our time together. The grandson saw some lovely sites, climbed some metal sculptures, got generally dirty as a five-year old can get and ate reasonably well given he was with two old and travel-worn visitors to this Never-Never-Land.

    The second trip was the Big Train Ride, or perhaps more well stated, the ride on the big train! This was an all-day Saturday affair that also had a few hitches in it. What looked at the start of things as a well made plan, turned out to be an endurance test that finally ended late Sunday evening.

    We began our journey by car, driving from our Southwest Minneapolis suburb to the Eastern edge of St. Paul where the Amtrak station is well disguised as a wear-house or a homeless shelter. Arriving 45 minutes ahead of our planned departure, we ended up waiting over an hour in St. Paul due to unexpected and unavoidable train delays.

    Once on the train, we found three seats in relative proximity and made friends with a jovial conductor/steward who immediately presented our grandson with an honorary, your-first-trip-on-a-train cap which he proudly wore for the rest of the weekend. We ate breakfast in the dining car, sat and watched the scenery from the snack lounge, and whiled away the time with crayons as the train jostled down the track toward LaCrosse, Wisconsin, our exotic destination for the day.

    Once in Wisconsin, we found the train station to be something out of a Harry Potter story. It was oak and brass with an ancient clock that still kept time and welcomed weary travelers such as we. Plus, it had restrooms large enough to accommodate an adult and a child which is very useful when one of the travelers still doesn’t quite have the hang of all the steps involved in assuring hygiene in public places.

    We found a taxi cab, already burdened with passengers, whose driver assured us she would return for us and take us to our destination – the local scenic tour trolley. She did return but, alas, dropped us off at the bus station, not the trolley stop and so we missed that connection. Plan “B” turned out to be a walk down to the river where a blow-out celebration of summer was in play with sandcastles, games, a circle-the-park play-train ride and several of those brightly-colored, enormous, blown-up, jump-and-bounce energy expenders. These behemoths were our salvation because they served to wear the five-year old down and keep his energy in check throughout the day.

    Having avoided all the sugary options that filled the riverfront park, we set out at the end of our afternoon to locate a real dinner. To the adults, this meant finding a place where libations could be sipped and composure reassembled in relative quiet. We found just such a place and had a lovely round of drinks while waiting for a table. There, we hurried our way through a meal meant to be savored but enjoyed the flavors anyway.

    The restaurant hostess called a cab for us and we were off to the antique train station to wait for our locomotive which was, once again, unavoidably delayed. The best part of this waiting was seeing the five-year old’s eyes light up when he saw the train engine approaching. He had not seen the front of the train on the earlier trip, so waiting for it, seeing it arrive and finally boarding it was an unusual pleasure to watch him enjoy.

    The ride home was mostly endured in darkness. Proximal seats were more difficult to find and when we did find three nearby each other, they were across from the doorways that permitted access from our car to the next. Each time these doors opened the temperature changed and the noise increased by several decibels. All that aside, the five-year old made good use of his time drawing and coloring pictures of trains, boats, cars and, strangely enough, cactus.

    Arriving back in St. Paul around eleven at night, we scooped our weary five-year old up and got him into his car-seat. The journey home was mostly traffic-less and we arrived tired and dirty but relatively undamaged. We slept until eight in the morning (a luxury in our house any day) and used the first two hours of our Sunday to read the paper, watch the news, fix some breakfast, shower and dress us all for church, in downtown Minneapolis.

    We are Catholic, our grandson’s parents are not so, going to mass is always an interesting adventure. Fortunately the enormous church organ with its beautiful and bellowing tones captured his attention right away. And while I would not say the hour flew by, at least it did not seem like a torturous event to him.

    Sunday afternoon was devoted to the air-show at the local community airport. Grandpa and grandson lasted two hours at this grand gala and the rest of the afternoon was devoted to napping in an effort to catch up on the rest we all seemed to need to recover from our journeys.

    Would I do it all again?

    Probably not, unless you give me a few months to recover and ask me when the neck-pain and the bruises have faded. Then only the nostalgia will remain and I, like all the other doting grandparents on the planet, will happily sign up to do some new and exciting adventure with the little guy who reminds me why childhood is so magical.

    Wednesday, August 13, 2008

    What’s Love Got to Do with It?

    Human behavior is a mystifying can of worms.

    Why do we do what we do? Why do we say what we say; react to stimuli in given ways or reach out to or shy away from opportunities that present themselves to us? “Human nature,” you say, well of course it is. But that doesn’t really get at the WHY of it all.My take on all this is that we humans operate on a set of paradigms – not all of us on the same paradigms, I might add. And these paradigms (or belief systems) steer our actions and reactions in predictable, repetitive patterns.

    Applying this to my own rationalizations, I suspect that my main paradigms are these:

    1. Life is as rich an experience as I choose to make it – it is no one else’s job to craft for me the life I might want or expect.
    2. People are genuinely interesting and the diversity we encounter should make us more curious than furious, especially when we are met with ways and behaviors that seem foreign or unfamiliar to us.
    3. Friends want to be important and helpful in my life, but they don’t want me to wear them out with incessant expectations and demands – nothing kills a relationship quicker than a demanding individual.
    4. Work is part brains, part brawn and part bargaining. No one really gets much work done alone. Being smart about your work, being long on endurance toward your work and being able to collaborate with others is where achievement is assured.

    By now, while you may be intrigued, I’ve surely got you asking, “What’s Love Got to Do with It?” and why this crazy title anyway?

    Well love lies right at the core of these four paradigms: Love for life, Love for people, Love for friends and Love for work. These are the values that make my life tick. They are, I am sure, the belief systems that determine why I do what I do in life, in love and in work.

    What are your paradigms? What beliefs drive your actions and reactions? What would you change about yourself if you could? And what new paradigm might you have to adopt in order to reshape yourself?

    Summer Trips (with a 5 year-old!)

    This summer, hubby and I have decided to take our 5 year-old grandson on two great adventures of his short, sweet lifetime.

    He is absolutely in love with trains, addicted to Thomas the Train by age 3, he’s been filling the family room with wooden tracks since he opened his first boxed train set. Acknowledging that love, we decided that a BIG train ride was in order.

    It has been a very long time since grandma and grandpa rode a train. For me, the most memorable train ride was in 1981 from Indianapolis to Minneapolis and back within 24 hours. This wasn’t a joy ride. I took this trip to catch up with the communications theorist I was relying upon for my doctoral dissertation. He happened to be addressing a conference in the Twin Cities and could offer me one hour of his time. I took him up on it and made the whirlwind trip without enjoying much of the scenery, happy to be given an audience with this world renowned writer.

    We decided that a trip to Chicago would be a great way to spend a day with the grandson. But, as I ploughed through Amtrak’s website I became increasingly confused by the host of accommodations, prices and on-train options. What didn’t confuse me was the realization that spending eight hours on a train with a 5 year-old required more patience than grandpa and I could muster.

    I searched for a date that would allow us a family sleeping room primarily so we could contain the chaos that was bound to ensue two hours in to an eight hour ride. Then, we would need a hotel room somewhere near the train station with the intention of turning around and heading back the very next day. This was clearly becoming our worst idea of the year!

    Poking around the myriad of train options, I came across La Crosse, Wisconsin. This was a destination to be envied! Just a few hours from home, it offered a lovely opportunity for scenery without the endless hours of time on a train with a crazed child. It offered lunch and a few brief hours of strolling around town before we would need to return. It allowed the perfect balance of time on the train with time on the ground and hopefully, if we work it right, time for a nap!So we settled on it -- La Crosse it would be. Now all we have to do is pick the dates, buy the tickets, pack up the kid and be on time for our St. Paul departure. Not as simple as it sounds, but surely it beats a 16 hour round-trip to Chicago even if the museums there are fabulous. We’ll do that when he’s eleven!

    The other grand adventure we’re planning is to visit Duluth harbor when the Tall Ships are in port, August 1st - 4th. We of course decided this after seeing the write-up in the Sunday paper, by which time all the hotel rooms within a ten mile radius had already been filled.

    I was whining about my dilemma to a friend at work who said, “Why don’t you use our cabin? It is just 30 minutes outside of Duluth!” I couldn’t believe my ears. Such a deal, we would use her very rustic cabin, for free no less, and have a wonderful quiet retreat from the noise and excitement of the day spent with the madding crowds along the harbor. It will be splendid.

    The down side is that the cabin has no running water and thus, only an out-house for life’s necessities. This will be good, we thought. We know how to manage with just an out-house and teaching our grandson how to rough it will be a great life lesson for him as well!We’ll see how this goes.

    Both trips are coming up in August and grandma and grandpa are clearly more excited than the 5 year-old who barely understands the implications of travel with extended family. This could be wonderful, this could be terrible!

    I am hopeful about these trips because I believe that time spent with grandparents teaches (or can teach) kids things that are not as easily learned when in the presence of their parents alone. Some of these lessons include:
    • Gaining the perspective of another generation
    • Seeing places that may not appeal to mom and dad
    • Trying new foods that would usually not be on the family’s menu at home
    • Stretching to learn new things and experience fresh ideas
    • Experiencing the history of a place through the eyes of older people

    I am confident these summer excursions will test the metal of both my husband and I but the gifts they will give us will out-weigh any discomfort or distress a 5 year-old can impose on his loving and proud grandparents.

    Hateful Work Can Be Fun?

    In my current role at work, one of the jobs I like least is policy writing and revision. And, that’s not because I’m not any good at it. It is simply that I hate doing it. As a chore, it doesn’t bring me the kind of job satisfaction that other elements of my work consistently do.

    Well, the other day, I proved myself wrong. I pulled together a policy that had been chewed on by at least six nurses and probably three physicians for a period of roughly five months and still hadn’t been brought to conclusion or completion.

    Now for those of you who don’t work in healthcare, you’re probably thinking, “What is she talking about? You mean all these professionals can’t get their heads together and figure out how to write a policy any more efficiently than that? And we’re trusting our lives to these people?”And, you might be justified in thinking that but, in their defense, in this particular matter, they were working against 50 years of practice history (the way we’ve always done it) and at least a one-inch-thick stack of literature offering somewhat contradictory evidence on how we need to change our practices. In addition, there had been an “incident” one that required the attention of the hospital’s liability lawyers which, in and of itself, puts everyone on edge.

    So, now we get to my part in all this.

    First, I took the work document everyone else had been mulling over and re-wrote it. In doing this I made the language throughout the document consistent and removed all the abbreviations that would certainly have confused someone relying on this document for guidance.

    Then, I circulated my draft to the top four or five folks who I knew had a vested interest in seeing this project finished. They gave me feedback and offered constructive criticism.

    Finally, I built an algorithm for the new practice (a flow chart of the preferred process steps we want clinicians to now follow) for the interested parties to review.

    Right away I got a piece of feedback from someone I didn’t expect I’d even show it to – our new DNP (Doctor of Nursing Practice) who saw that the new protocol asked for a daily abdominal x-ray. She indicated that while the radiation dose from such an x-ray was quite minimal, it would be even better if we could eliminate that step. Her wisdom was to investigate whether the ultrasound imaging machinery we use for bladder scanning might afford us the safe, effective verification we wanted without the need for x-rays.Now, I’m not sure yet if we can incorporate what she has recommended, but I certainly am going to find out. This would be splendid for several reasons:


    • The patient avoids the radiation
    • The nurse doesn’t have to chase down a physician order for x-rays
    • The physician can simply count on the nurse to use the ultrasound machine to accomplish the work without involving the cost or complication of the imaging (x-ray) department.

    Even more importantly, it occurred to me that personally showing this document – still in draft form, mind you – so rapidly to so many clinicians, and especially the DNP, gave me very rich input in just a day or two. Far more information than we had been able to pull together in the previous five months.

    Now, are we done yet? No.

    We’ll get the key players to sign off on the new process next week. We’ll run a pilot for at least two weeks or maybe a month, to see if we’ve got all the details down with sufficient clarity that even a novice would know what to do. THEN, we can publish it as a policy and roll out the instructions to the various departments who will need to change their behavior in order to accommodate the new practice.“So what?” you ask.

    The so what is this. . .

    • I got to do something I really dread AND found I could enjoy it!
    • I found highly engaged colleagues who, when I asked them to focus on and review the work, did so willingly and with insight.
    • I got feedback that was targeted, innovative and highly helpful.
    • I found clinicians eager to map out a better way to get the intervention accomplished and with the least possible danger to the patient (there’s always some danger, especially when the patient’s care is highly complex).

    So I went home at the end of the day totally amazed that the one chore I simply hate doing, brought me, on this day, the kind of job satisfaction that many other elements of my work consistently do.

    Who knew that is policy writing and revision could actually be fun?

    Managing Stress. . .

    A nurse-colleague asked what she should do when, much to her dismay, her husband got angry and distant because she talked too much each evening about her trials at work. She is employed on a high-stress unit, where death of a patient is a frequent reality. She works hard, loves her job but acknowledges, the stress can suck her down by the end of the day.

    What follows is what I told her as a nurse who has also worked in high-stress, high-death jobs with patients who had AIDS or ovarian cancer (both very deadly in the day I worked those kinds of cases). Also, I explained, I speak as a nurse who is on my second marriage. My first one ended amicably enough, but I was married very young and hardly understood the kind of maturity I needed to bring both to my job and my relationship at the time – how could I? There was no one to teach or advise me.I still haven’t heard back from her to know if she appreciated or hated my response to her question.

    Here’s what I said – you tell me, was it a fair and balanced response?
    As nurses, we work in a field where so much is at stake.Two things to take into consideration:


    A. We're not the only profession in this predicament.
    B. We certainly have job choices within a wide range of high-to-low stress.

    When you choose a high-stress job (even when it is a position you love) you owe it to yourself and to others in your family to develop effective strategies to deal with your job-stress. I think it is unrealistic to expect your spouse to grasp, appreciate and help you manage your own distress, especially when s/he is not working in the same sort of capacity. And, even if your spouse were also a nurse, it probably isn't fair to "dump" your day on the other person, just because you need a compassionate ear.

    What can you do to manage your stress and remain in the marriage and the job you love?You might try:
    -- A support group (sometimes a grief group is useful, especially if you work in an area where death is a prominent feature).
    -- A "girls-night-out" where your friends from work gather to get the stressors of the job out of their systems without taking it all home to the family who also needs their full attention.
    -- A threapist. Yep, someone you PAY just to talk to! Sometimes a therapist can help you reframe the situation that stresses you out and help you re-establish a sense of control and equilibrium in your life and relationships.
    -- A self-care technique like exercise, meditation, guided imagery, music, a power-nap, etc. that you can rely on to dissipate the effects of stress and return to a "normal state" before you try to interact with a loved one who may also have had a trying day!

    You might also want to re-examine your belief-system about marriage. Since when did we come to believe that one's spouse can meet every need we might enounter? We need lots of people in our lives to meet the many needs that we as humans experience. Your spouse is only ONE of those supportive-persons and should not be asked to bear the brunt of every negative emotion you carry around with you, whether the result of your job or your personality.

    Take good care of yourself AND your marriage. A good marriage is hard to come by and requires a serious investment of time, energy, effort and understanding on each participant's part. That's the only way to sustain the relationship, grow it through a life-time and build a solid foundation that can withstand the hardships that will naturally come your way!

    Cherish the love you have.

    --p

    PS -- Don't talk casually about your marriage challenges at work. It is an easy, lazy thing to do. It can cause greater harm than any other choice you make. If you have a good friend, with whom you can speak in confidence, that's one thing. But do not risk your marriage becoming a topic of idle gossip at the workplace -- there is nothing more disrespectful to your spouse than that.

    Oldies but goodies. . .

    My car-pool buddy asked me what I might suggest she do on behalf of one of our growing departments at work. She explained the situation she was facing...She’d been asked by the department head to participate in a retreat day he was planning in order to build teamwork among department members. He had packed the day's agenda rather full with day-to-day business of the deparmtnet and invited her to speak for 45 minutes, and make a presentation that would pull the group together, get them focused and motivated to work together. In other words, cure world hunger in an hour. Lovely assignment.

    My buddy didn’t want to say no, but she also didn’t want to attempt the impossible which was, after all, what this department head was asking – absolutely the impossible! Hence, her question to me, “What would you do with 45 minutes?”This particular department has been growing by leaps and bounds. It has probably tripled in size over the last 5 years. The age range in the department runs from 26 to 62 and, as you could bet, the 62 year-old is the department head!

    What’s more, the newcomers to the department have their own ideas, their own styles of creativity which, apparently, run perpendicular to “the way we’ve always done things” according to the department head.The behaviors in the department, according to the manager, were leading to major upsets among the staff. People all wanting their own way had begun to act out like children, sabotaging department achievement in order to satisfy individual agendas.

    This is no way to run a department!My friend summed up the problems noting there were several dichotomies: There’s 1) the new employees vs. seasoned employees dichotomy, 2) the younger-worker vs. nearing-retirement dichotomy and 3) the fresh-ideas vs. the way-we’ve-always-done-it dichotomy – a formidable triumvirate of troubles, and the manager wants the problems addressed (and resolved) in 45 minutes!

    One might suspect there is also the imaginary-world vs. real-world dichotomy going on inside the department manager’s head based on his ludicrous request he'd made of my friend!

    So, my friend is stuck. Say “No” because she recognizes the task is an impossible one, or say “Yes” because she realizes the problems will persist unless someone tries to intervene. But what is the reasonable organizational development intervention she can provide within a 45 minute window jammed up in a full day of a department “retreat”?I could totally appreciate her dilemma.

    My advice came from deep inside my memory bank and involved a technique I’d used dozens of time – often with children. Since this department’s difficulties reminded me of those that emerge among children, I figured I’d offer the exercise to her and let her decide if it might work.

    Here’s what I advised her to try:

    Ahead of the event (a week or so in advance) ask that each member of the department respond to TWO questions about every other department member. Those questions are:
    1. What is one contribution that this person makes in the department that you genuinely appreciate?
    2. What is one request you might make of this person that would improve your relationship with him/her in the department?

    Gather those responses and generate a sheet for each member of the department that has on it ALL the accumulated responses. Use these sheets on the day of the retreat to illustrate the kind of feedback that is possible when co-workers behave honestly and openly toward each other.

    Contrast that, to the typical “childish” behaviors we exhibit when we are being passive aggressive, sullen and sulking from not getting our own way, or pouting and whining about other people in the department – all behaviors evident in this department, all disruptive to any sort of departmental success!

    On the day of the event I suggested she teach about the JoHari Window, a two-by-two grid that was developed in the 1950’s (an oldie, but goodie) to explain that OPENNESS in any relationship is a choice. The JoHari Window offers two tools, Self-disclosure and Invited-feedback, to enable anyone of us to enlarge or shrink our own openness and thus change the dynamic of the relationship. It is a choice. How you use these two tools determines not only how you will interact with others but how they are likely to respond to you as well.

    The pre-retreat feedback sheet is not “Invited-feedback” in the JoHari sense of the term, since the comments on that sheet will have been solicited by the facilitator, not the individual. However, since we humans are not very good at inviting feedback, having someone else get the ball rolling on our behalf can be a very helpful strategy.

    Also, whether the people involved are children or adults, we all (ego-centric creatures that we are) like to see in writing a bunch of compliments about ourselves. With this exercise, in a department of 25 people, that’s 24 nice things that co-workers have said about you – a pretty good deal for almost anyone!

    The “requests” side of the sheet may be a little harder to take, but, realistically, the reader has to ask, “Don’t I already know this about myself? Do I really need my co-workers to tell me that if I was more polite, more considerate, less intrusive, interrupted others less, etc., etc. that I’d be a much easier person with whom to work?”My friend thought about it. She said, thinking back over her own years of work in the field, that she probably already had a file on the JoHari Window (most of us in organizational development have used it at one time or another).

    Combining it with the “Strengths Sheet” as we call it seemed like a good way to demonstrate the value of inviting feedback regularly.I don’t know if she’ll take my advice and use these tools, but I was happy to offer them given her request for help.

    After I got home, I thought of a number of ways a facilitator could address the problems my buddy was facing. Each strategy I considered was, I realized, something I had learned decades ago.

    • One could teach a model like Mazlow’s Hierarchy of Needs and elicit needs each member of the department experiences, demonstrating what contributions we all need in order to reach toward “self actualization”.
    • One might take the approach of doing a “Survival” game and noticing whose opinions were most trusted in the group, whose assessments of survival strategies were most effective, who surprised you with his or her resourcefulness?
    • Or, one might explore the communications within the group, looking at how members spoke to each other using a Transactional Analysis approach.


    Then, I realized that ALL of these strategies were ancient history! Hence, I have to admit that much of my wisdom (if you can call it that) comes from a period of history most folks can’t remember – the mid-20th century writers and proponents of what was called the Human Potential Movement. I was fortunate that my professors in the 1970’s relied heavily on these writers and taught me most of what I know about human development, interaction and personal growth. I still use (as you can tell) many of the tools they taught me in my early graduate-school studies. And, surprisingly, they still work!

    Oldies, but goodies. . .It will be interesting to see what my friend, my car-pool buddy, decides to do with the 45 minutes in which she’s been asked to work a miracle. I’m glad she asked for my assistance because it made me muse on where my own techniques and tools come from and how long I’ve relied on models I learned in my youth!

    Craving just a little conversation. . .

    As I recall, the definition of insanity is doing the same thing over and over but expecting a different outcome. My recent repetitive behavior has been to visit a group of nursing chat sites and either login or lurk to see if anyone is making interesting conversation. Much to my chagrin, I am repeatedly disappointed.My responses, when I find something juicy enough to address, can range from friendly to feisty and sometimes, I confess, I am out-right, in-your-face furious for the inane things people (nurses!) do online. Here's a typical sampling. . .

    I have this assignment for class . . . could you do it for me?

    This line of thinking leads the writer into a request that his/her readers explain the school assignment to her; tell him or her what to write his or her paper about; go to a website and take an inane survey s/he has devised; or, my favorite -- explain the meaning of terms used in class.
    This week the winning thread was about discerning between the terms "strategic plan" and "operational plan". The writer wanted readers to tell her the difference and explain the relationship between the two. My blistering response said that as her audience, we had already earned our credentials and that we were not interested in earning hers as well. I advised she at least Google the two terms in question and return to the chat boards when she had a well reasoned question to offer!

    I don't like the way people treat me at work. . .

    If you follow these sorts of threads very far, they tend to become a litany of everyone's complaints about co-workers and the dreadful way everyone is behaving at work. Rarely (if ever) is there a respondent who offers an iota or self-reflection. Blaming is the modus operandi and seems to offer no solutions either to the initiator or to contributors along the way. What became of nurses having problem solving skills?

    Where I work, things are terrible because. . .

    Now, I will be the first to admit there are some dreadful work-places in healthcare. But what I can't abide is the assumption that the poor, pitiful nurse who is writing has NO other option but to be an indentured servant at this particular facility s/he is describing.

    Where are the nurses asking clinical questions? Why aren't we raising issues about ethics, politics, public policy or public health? Where is the art of conversation among educated women (and yes, many of these nurses have at least a baccalaureate degree)? And what became of scientific inquiry and the ability to ANSWER questions, not merely ask them (expecting someone else to offer you the solution on a silver platter)?

    You can tell, I get wound up about this.

    Maybe I shouldn't. Or at least maybe I should avoid the chat sites for a few months just to let my jets cool. I could leave my conversations to my workplace where nurses of all varieties do seem to know how to think, ask, ponder and respond in ordinary, thoughtful and conversational ways.

    So, enough rantings. It is time to leave the computer for today, go out into the world, do something physical with the remains of my day and leave all the nurses online to their just desserts. Perhaps someone else will pick up where my usual tongue-lashings leave off.