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an open letter to America from an ER nurse

Dear America,

It’s time for us to be honest.

We love what we do, most days. We love your stories, how you brought your pet squirrel, now dead, into our rooms to see if we could test its brain for rabies. We love hearing your trampoline and alcohol story. Or how you tried to be “hip” in front of your teenage son and face-planted off that longboard. Or how you set down the grease spotted McDonald’s bag before climbing on the gurney with belly pain. Or how you took the time to pack two full suitcases before calling 911 because you plan on staying a few days. Case closed. Not an emergency if you have time to pack.

These are the fun times. But there are other times.

We have run down hallways pushing your loved one toward the cardiac cath lab, telling them to keep their eyes open, to keep talking to us, stay with us, don’t go, we’re getting you the help you need.

We have loosened tourniquets around your arms and when the blood sprayed, we put our hands in front of it so you didn’t feel the warmth of your own humanity against your chest.

We have ran with your nearly faceless daughter in our arms to the nearest room when a clay pigeon thrower automatically fired one into her face.

We don’t say these things to make us seem great. We say these things because these situations are the ones that make a difference in the scope of this one precious life. And in these situations, we are grateful, to the very core of our being, that we get to do what we do. We are committed to you. With empathy and compassion, we do our job and when we go home, sometimes we pull over on our drive because the tears just keep falling and we have lain awake in bed at night and prayed for your children, knowing you left them on this earth when a drunk driver killed you.

We hold these things all within us.

You might say we are brave for doing what we do. That’s not true. We were trained to run toward disaster when others run away.

That’s not what bravery is.

Bravery is when we decide to go on living to the fullest after witnessing so many horrific things. Bravery is getting on a motorcycle and blocking out the time brain matter fell on our shoe. Bravery is sticking up for the lady with the stammering talk at the party because we can see the way her hands tremble when she reaches for the cake. Bravery is deciding to love people so fiercely while knowing we are all just one phone call away from our knees.

But we need to talk about something that’s causing our bravery to falter, dear America.

We need to talk about the increasing violence we are facing. How according to a recent study, nearly 55% of ER nurses reported being verbally or physically abused in the last week. The last week. Think about that. So that nurse who comes into your room and smiles and is kind? Remember to thank them. They likely were just yelled at moments before. And it takes an incredible amount of strength to care for people who so often don’t care in return.

In fact, violence happens so frequently that studies show nurses new to the ER are starting to consider it a normal part of their job.

That’s just downright horrible, America. Should violence ever be normalized?

We need to talk about the opioid crisis and how we are taking the brunt of your angry rage but you know what? You said too many people were dying in the streets due to opioid addiction and then you scream and swear at us when you’ve had enough. We need to talk about the times you’ve said, “Get the **** outta my room” when something doesn’t quite go like you wanted it to.

We need to discuss the many times you complain about the wait. I can honestly, deeply say, we are tired of the wait too. If we could get you and your complaints out the front door faster, we would. So often, just after you arrived in your bed, a lady unconscious from a car wreck comes through the ambulance bay or the gentleman mowing his lawn down the street just falls over dead. These will always take top priority. If we aren’t all surrounding your bed, it means you’re one of the lucky ones who will live to see tomorrow.

But most of all, we need to discuss why so many of us are walking away.

What then, America, when we aren’t there?

Because we’re leaving. In droves, we are walking away. In fact, it is estimated that one out of every five nurses will quit within two years of becoming a nurse. Other nurses are advancing their careers. Not because they wanted to but because they’re tired of being treated poorly. And the baby boomer nurses who make up a large majority of the workforce? They’re ready to retire. All that said, the US Bureau of Labor Statistics project that by 2022, there will be more registered nurses needed than any other workforce. Some politicians are finally acknowledging this as a national crisis.

It pains me to know that so many talented, smart, compassionate people are quitting. It pains me to know that when my fabled day comes and I need critical care, all that might be left are the new ones who aren’t yet, tired. New nurses with perfect intentions and brilliantly smart but lacking that thing called experience.

So here’s my plea to you, today. From one emergency room nurse to you, the soul and body of America, just… be kind. We’re tired. We want to love you. If we can ease even a little of life’s hurts, we will do it gladly. We aren’t asking for a miracle. And we know we see you only on your bad days. But just because it’s a bad day, doesn’t give you the right to be rude, or worse, violent.

Lights are going out across America as nurses aren’t available to keep the hospitals going. It’s likely your small town hospital will be shutting down yet another section of the hospital in the near future. Night is coming, America.

And we might not be there.

Sincerely,

An Emergency Room Nurse

P.S. This week is National Emergency Nurses’ Week. If you know one, remember to thank them. It just might keep the lights on in America a little longer.

P.P.S. The views expressed are my own and do not reflect on my employer in any manner.

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References:

Ashton, R., Morris, L., & Smith, I. (2018) A qualitative meta-synthesis of emergency department staff experiences of violence and aggression. DOI: 10.1016/j.ienj.2017.12.004

Copeland, D., & Henry, M. (2017) Workplace violence and perceptions of safety among emergency department staff members: Experiences, expectations, tolerance, reporting and recommendations. DOI: 10.1097/JTN.0000000000000269

Haddad, L., & Toney-Butler, T. (2018) NCBI: Nursing shortage. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK493175/

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church, mental illness, understanding and grace

You lock the door; wish for deadlocks.
You wish for the satisfying clunk of knowing the world has been turned out.

You stand at the window. Night steps from behind the gnarled trees on the far side of the road, watching you. The moon brandishes its white grin, admiring its reflection on the black, gleaming mailbox.

Your phone chirps. You turn it off, not looking at the message.

This is who you’ve become lately.
Weary. Isolated. Paranoid.

Just a man padding around his house on wooden floors that creak in the silence.

You sit on the edge of the mattress, check the locks on the window one more time, slip an Ativan under your tongue and wait for sleep to overtake you.

The demon’s slow whisper becomes the wind outside, and the wind becomes a breeze, and the breeze becomes your breath, in and out, in and out, and you’re riding this Serotonin hit into the depths of night.


This is the first thing I notice, always, when my mind starts to get sick.

Paranoia.

My body instinctually shuts down, shuts out the world, and it’s a terrible thing because in shutting out the world, I shut out the beauty right as I’m shutting the pain. Like cancer, mental illness attacks my life cells, the ones that make a person smile and hug and laugh. And I kill them off, one by one, watching the way they shrivel, this dance of death and life just withering away.

But tonight, although I may not smile, I am safe.


It’s hard for the church to separate spirituality and mental health. Instinctually, we assume these two points correlate on a graph somewhere next to our names in the Book of Life. Like maybe God, in his spare time, has developed an algorithm to chart the dedication one has to His plan. Thus, if someone becomes depressed, surely their enthusiasm for God’s plan must be waining. If someone struggles with anxiety, surely their trust in God isn’t intact. If someone struggles with guilt, assumedly they don’t believe in the repentant plan of Salvation.

And the someone steps up and points out that cortisol, dopamine, serotonin and brain mapping can be used to diagnose these things and the algorithms are briefly consulted, and we assume God puts an asterisk on the bottom of the chart which reads: Tread gently. Love carefully. Question everything. Not all is as it may seem.

But what I think God means is this: The ground is always level at the foot of the cross. Grace abounds there for everyone who might reach for it. Love first. Understand maybe. Do your best. It’s okay. I’ve got the rest.


Then you find this friend. Maybe two.

You find this person who wears Jesus on their sleeve, and when you show up at their door, they pull you in and find a Kleenex box because they know by the look on your face that you’re about to destroy their living room with your grief. But none of that stops them. They give you a steaming mug of coffee and you cru into it and tell them how you wish you could be healed, and you beat back the paranoia and try on this new cloak called Trust because these people have only and ever shown you love. Love without judgment. Love without, even sometimes, answers. Just the kind of love that listens. And you weep together and not once do they tell you that Jesus is lacking in your life or tell you that you’re doing it wrong but they just keep pointing to Him and it’s all you can do from just pulling a throw blanket over yourself and falling asleep on their couch because this, right here, is a safe place.

And the next day, you can’t text anyone, and you turn off your phone again, and it makes you sad because you remember how it felt to be heard. You remember how it felt to be loved and it makes you ache somewhere between your soul and your head.


The following day, you send a text message and thank them for being there for you, and it feels good to have a friend like that.

But you don’t stop there. You hug a coworker you know is hurting, and your world is a little bit better.

church, mental illness, and grace photo 1 church, mental illness, and grace photo 2

You’re out snowshoeing with your dog, and you’re staring up at the sky when you trip landing on your knees, and it’s then that you pray: Help me, Lord, you pray. “Help me to trust others a little more. Help me to love others as You’ve loved me. Help me to listen to the hurting world first, to never be critical because a critical spirit will never help a critical situation. Help me to… you pause… well, help me to always and forever look in your direction. Because the road to the cross isn’t a highway but instead, a narrow footpath of faith. Help me to remember, each night, to lock up the world away from me but never before inviting you in first.” You get distracted then because your dog has found a possum that’s still, curled up in the path with its tiny hands resting on its chin and you wonder if it’s really dead. And since you’ve lost your train of thought, you murmur, “And God? I don’t ask for a miraculous healing, but I do ask you continue to show me sure steps toward living a better life of service to you. And since we;re on our knees anyway, Lord, could you heal Ervin’s back hip and make it easier to lose this belly fat and thank you, dear Lord, for making dark chocolate and cheese.”

And you laugh. And it’s the most honest laugh you’ve heard in a longtime, and the sun is setting, dripping all this contentment over the western sky and you suddenly think that it might be the last sunset you’ll so you just take it in… And the beauty is so raw and real that your breath catches in your chest and you wonder if this is the last breath you’ll take, so you just breathe it in…

And you are grateful. Grateful for trust. Grateful for friends. Grateful for the church of people and couches and shoulders to cry on and all this messy grace that blankets your life. You’re grateful for healing, even in minuscule amounts and you’re grateful for second and third and fifty-seventh chances in spite of yourself.


Then Jonah prayed unto the Lord his God out of the fish’s belly, and said, I cried by reason of mine affliction unto the Lord, and he heard me; out of the belly of hell cried I, and thou heardest my voice. For thou hadst cast me into the deep, in the midst of the seas; and the floods compassed me about: all thy billows and thy waves passed over me.

Then I said, I am cast out of thy sight; yet I will look again toward thy holy temple. The waters compassed me about, even to the soul: the depth closed me round about, the weeds were wrapped about my head. I went down to the bottoms of the mountains; the earth with her bars was about me for ever: yet hast thou brought up my life from corruption, O Lord my God. When my soul fainted within me I remembered the Lord: and my prayer came in unto thee, into thine holy temple.

They that observe lying vanities forsake their own mercy. But I will sacrifice unto thee with the voice of thanksgiving; I will pay that that I have vowed. Salvation is of the Lord.

Jonah 2:1-90, KJV

 

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how I wandered into the woods and found grace

“Three times I pleaded with the Lord to take it away from me.”

2 Corinthians 12:8

My brother and I are on an overnight hike along the Superior Trail. We laced up our boots and told ourselves that morning we would go until we couldn’t go anymore because neither of us knew what we didn’t know.

how I wandered into the woods and found grace photo

 

We had whittled away at our packs, the night before, sawing the ends off our toothbrushes like the experts said, leaving behind the bulk of our clothes, determined to not carry any unnecessary weight. I had laid out the contents of my pack and sitting there, right on the top, next to the cookstove and ground coffee, were my journal, guidebook and William Faulkner’s As I Lay Dying.

My books were going. Words can lighten someone’s load or crush someone beneath them, and it’s up to us to determine which of these it’ll be.

So we set off. Past boulders and sometimes over them, their gray masses like checkpoints along the way. Past pine trees looming. Past tumbling, gurgling, and roaring rivers. Over snakes, shy under foot. We walked until blisters started to form on our feet and our minds were numb from exhaustion, and then we fell, into our tent, eating protein boosted Mac N’ Cheese, and I read these words:

“This is the way the world ends
Not with a bang but a puzzled whimper.”

T.S. Elliot

I turned my head away, turned off my lamp, and let the tears fall, slick against the sheen of the sleeping bag because this is how I felt: my world was ending and I was standing confused on the brink of ruin, knowing only that I knew nothing about how to stop it.


I had wandered into these woods, broken, confused, belittled by the darkness of this world and all its angst. I had wandered, trying to shed the weight of who I was and who I wasn’t… the bulk of yesterday’s guilt and misunderstandings, the many failures. The endless, anxious murmurings.

The debilitating depression. I had stumbled time and again under the weight of my anger at a God who allowed that to happen to me. Why me had become my daily mantra, this bitter replica manna I ate from in desperate attempts to believe I didn’t deserve hardship and surely I was owed something good to outweigh the bad.

“Be careful,” my brother said as I walked casually out over the gorge, onto the boulder, hundreds and hundreds of feet to fall with one missed step.

how I wonadered into the woods and found grace photo

I didn’t care if I fell. Something was freeing in the spreading of my arms and lifting them high, tempting myself to cannonball off the edge, to feel the air hurtling past me as I fell into the freezing waters below because I wanted to feel the end, to catch it within my hand and squeeze it tight, to learn every sharp pain of bitterness in acknowledgment that here I was, a human, completely and utterly undone and alone.

One shaky step.

Then two.
Closer to the edge.
Daring. Tempting.

A startling, cold breeze.

A knee buckling.
And yet.
Determination to live.

To keep breathing.
Sitting down on the edge of the boulder, I gave up.
Shoulders shaking.

Sometimes it’s only in the breaking of one’s will that we collapse against this earth. And it’s here, in the moment of surrender to a God who cares… I find it: less of me and more of You, Lord, I pray. Please give me hope for tomorrow, for courage to go on despite adversity, for Your redeeming blood to drench my life and cause a tiny bit of growth, this seed of faith unfurling.

Giving up sometimes looks like giving in, and God sat down next to me, then, on that large slab of stone, and I felt His presence in the wind, in every tree swaying, in every comforting beam of sunshine.

Grace, I’ve learned, is the conclusion to every battle between our broken humanity and God’s love.

And grace always, always wins.

Still shaking, I crawled on hands and knees back to safety.
I slung my pack onto shoulders sore.

It seemed lighter somehow like I might be able to actually carry on.

But he said to me,
“My grace is sufficient for you,
For my power is made perfect in weakness.”

—2 Corinthians 12:9


What I’m Reading This Week

Sing, Unburied, Sing: A Novel by Jesmyn Ward

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how we can hope for a better tomorrow

We’ve packed up our little life and moved.

Packed up the china, the folding chairs, the plaques; stuffed a thousand memories into a jar and pretended it didn’t bother us that they were held captive there, their lights slow and steady at first, then quietly dimming, their wings beating desperate like butterfly kisses against the glass.

We pretended the sadness didn’t pervade then, when we flipped off the lamps, shut the curtains, turned the thermostat to “off” that warmed our tiny house.

We pretended until one day, upon waking in our new house, we looked at all we had been given and murmured, “This is home.” Because a home is more than the sum of memories but is also where hope burns passionately for the future.

how we can hope for a better tomorrow photo

I have found this about hope. It is something I come to now, today, without shame because in the past, I had always believed a person like me didn’t deserve goodness, didn’t deserve mercy, didn’t deserve all the blessings God somehow kept giving.

I still don’t believe I deserve anything. But I am learning to be hopeful of everything. Because through this God I serve, everything is possible… everything is hope-filled. (Matthew 19:26)

He is, ultimately, in the business of restoration. Of redemption. Of hope. And He is completely and utterly delighted in me. And you. (Psalms 18:19) He is enamored in the restoration of all the thousand mistakes, of all the broken pieces you see looking back at you in the puddle of your despair.

Life has met this rhythm for me, once chaotic with highs and lows, now the steady hum of one lost in a trance and I keep waiting for the shoe to drop, per se, for this hope to collide hard against the floor of my optimistic soul.

But it hasn’t happened.
And I keep waiting.

I find this anticipation every morning upon waking as if it were lying next to me, its sour breath upon my pillow, willing me to accept the reality that today, definitely, will be the day when all goes bad.

The dog growls grumpily, begging me to open the door.
The poof of his tail, flouncing, nails clacking across the floor.
The sunshine spilling through the door, warm upon bare toes.
Coffee sputters, the fireplace dances.
Life, in all its wonder, continues to be a joy.

This life, I’ve learned, is under no obligation to give us what we deserve because there are no limitations to God’s love.

I sit here this morning and I find it: hope. And I open my heart to trusting that tomorrow and the next day, this promise of love will settle comfortable where fear once resided in my heart.

“Live, then, and be happy, beloved children of my heart, and never forget, that until the day God will deign to reveal the future to man, all human wisdom is contained in these two words, ‘Wait and Hope.”

Alexandre Dumas

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how you can live free in this raging world

When I roll back the curtains covering this one little slice of earth, I see her, the fog, how she came in the night, how she crept beneath bushes and over barbed wire fences making her way to our house. She is tranquility exposed, peace visible and I want to stand there, sipping my coffee and watch her, the way she waltzes with such grace, so effortlessly in and amongst and around.

How you can live free in this raging world photo

I reach out my hand, rest it against the cold glass, these fingers smudging, pressing, reaching for so much peace, and I wonder if maybe God Himself isn’t tired too? If perhaps He doesn’t wish to spend a little more time in the snow-crusted fields of Northern Iowa this morning instead of on the raging streets of Washington D.C.

Maybe you’ve been reading the news, too. Perhaps you heard about the marches, the fight against misogyny and bigotry, the flags being lit up, this tiny spark of rage becoming this uncontrolled wildfire. Maybe you’ve also read about the foreign affairs, how relationships are changing, and nuclear warfare, and its all just one tricky line to walk because no matter how much you trust, no matter how much you guard against fear, it slips unnoticed sometimes into your heart.

I turn from the window, sit next to the dog snoring softly, head on the pillow, and I pull the Book toward me, this life-raft in this raging world.

Maybe it’s the coffee, lackluster in its bravado. Maybe it’s the snores of Ervin. Maybe it’s the fog floating across the river, but the Book slips, falls with my eyelids.

A scream. A yell of triumph. Pain. Maybe fear. I cannot tell.
A battle cry, this time, I’m sure.

I search madly, run down the streets, and turn to see the masses walking along this street. It’s paved with the gold and glimmer of broken souls, these souls once meant to be free but now shackled, splintered – all this shimmering brokenness being trodden on by boots, marching, polished, a rivalry of soldiers yelling, “Hail, Trump. Hail to the Führer.”

And the church doors swing open. Loud, they bang like a cannon fired. The people spill into the street, fists raised and signs high for human rights. Their voices get louder. Their leader is a lady yelling about her God-given rights, and it’s the only time God is ever mentioned, there at the top of their screaming, teeming madness.

And then I see her, this veil of white rolling in and I think maybe it’s tear gas, desperate attempts to control the riot, but then I watch as she tumbles in and around and among the people, how she cloaks them in peacefulness, waltzing this way, waltzing that way. And she wears a coat of many colors, of every race and gender and personality, how she is one being, but so many of everything put together in this beautiful, messy existence of perfection. She tosses her hair, then, laughs, places her hand against her heart, and I see it then, this trail of blood-red she drips wherever she walks.

And the people are confused, the church-goers and the liberals, the politicians and the self-righteous and one small child breaks free from the jostling throng, falls, touching his lips to the trail of blood and then, he too stands and starts to dance.

Only a few follow the boy.
Only a few shimmer in white.
Only a few dance free.

Only a few, there in the middle of that street paved with gold.

I wake slow, unsure of reality, my heart thrumming wild against my ribs. The fog has left for the day. She has slipped silently toward the horizon while I slept. My coffee is now cold. The Bible has fallen.

I sit up.
I shake my head, dizzy.

Oh, how I wish to dance free.

“For the Lord is the Spirit, and wherever the Spirit of the Lord is, there is freedom.”

2 Corinthians 3:17 NLT

“Blessed are the peacemakers: for they shall be called the children of God.”

Matthew 5:9 KJV


Photo courtesy of Pexels.com. Licensed under CC0.


What I’m Reading This Week

To The Bright Edge of the World by Eowyn Ivey

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