She never saw me watching her.

She was an older woman in her 50s, who didnt' have that many friends in our shul. Her family had switched from a different shul nearby and i recalled heearing her husband and son's comment that they never felt fully welcomed. But she was sitting in shul with her chumash and listening the sounds of the leining coming over the partition from the mens' side. It was simchas torah night and while the dancing had finished, the shul was still noisy and bustling with women still chatting, and little kids running around, full of candy and the excitement of staying up way past their bedtimes. Half the chairs were still pushed back against the wall but she sat calmly amidst all the bustle with her finger moving along and she mouthed the words that were read out loud. I had been davening in the shul practically all my life but there was something on her face that i didn't see on the faces of the other women who sat around me. It was practically glowing. As the last words of Sefer Devarim were finished i saw her look up with a smile on her face and tears of joy in her eyes and for the first time in my life, i saw a woman who truly understood the simcha in simchas torah.

Mom, Dad, I love my name. I think it's beautiful, and it encompasses my personality. But sometimes I wish you'd named me Sara.

I've never had an issue with my name before, and I never had to fall back on an English name in college (good thing, because I don't have one). But somehow over the phone it is impossible to catch my name, no matter how slowly i say it, or how many times i spell it out. Sometimes i have to laugh at the odd variation that people come up with, and sometimes i grit my teeth when my patients ask me *yet* again, to spell my name out for them. It's five letters. And it causes so many problems. But nothing is as funny as the time someone called me and bungled my name, followed by "did i get that right?" i never bother to correct people over the phone unless they ask, so i corrected her and spelled my name correctly, to which she replied, "um, no that's not what you told me".

as the teenagers today like to say, smh.

Sometimes things don't turn out the way you expected them to. When i graduated from nursing school I always thought I'd end up working in a hospital. I wanted the experience of working alongside seasoned nurses (even though they're said to eat new nurses for dinner), and see different things. But I ended up working in homecare, and I went from seeing patients in their home, to doing coordinating of nurses' visits in the office, to doing case management from my dining room. While the mother and housewife in me is thrilled to be able to stay home with my 15 month old and get laundry done while working, the nurse in me every so often wonders if i'm really happy. Some days i feel like i work in a call center. I case manage about 60 patients, which means i field phone calls for questions like "I need to see a dentist who takes my insurance" to "my aide didn't show up today" or "my mother's incontinence briefs are the wrong size". In between those phone calls I check up on my patients monthly, review their medication, make sure all their services get authorized, and generally try to keep my bosses happy. Since my homecare agency partners with a managed care company, I have two supervisors and two directors to answer to, which can get stressful. But then I stop to think about why i'm working in the first place. Yes, i want fulfillment. But i think i get that from my family and my hobbies, so i don't need to get it from a career. it might seem old fashioned, but i think my values allow me to be happy even if my "career" isn't what i thought it would be.

Right away, I knew something was wrong.

I'm a morning Facebook checker. I log in every morning before i get my day started. When i opened my Facebook app, i saw ten new posts. and i knew right away that something bad had happened. most of my friends and acquaintances live in the same time zone as me, so not much usually happens overnight. and then i saw the stories. and the pictures. white siddur pages, stained red. Tzitzis strings, also stained bright red. a man lying in a pool of blood, still wrapped in his tallis and tefillin. i felt what i always feel when i hear about these attacks. shock. horror. pity for the victims. compassion for their widows and orphans. and more recently as of late, anger. a slow burning inside. hate for someone who can so coldly take a life. and then sadness again, that there are four less people who will daven mincha this afternoon. four kedoshim, who were taken back while they were in the middle of morning prayer. four people whose last moments were as holy as possible. it's a small comfort for those of us who will probably think about it once or twice throughout the day, maybe another time during the week, and then move on. but how much of a comfort is that thought to the wives who sent their husbands off to shul, not knowing they would never see them again? to the 20-something children who are now fatherless?

that is the thought that i want to hold on to, so that i think of these four men throughout the whole day.

may their blood be avenged.

     Starting out in a new office is always an adjustment, and working in home are is no different. Because I'm in orientation I've been spending a lot of time at the office, desperately trying to learn everyone's names. I'm constantly being told to "give this to Deana" or "go ask Carol". It's not helpful that there are two Carols at this office. Learning names was hard enough, but last names too? Double the work!the. There's Maureen and Monique, and by the time I learned the difference, I found out that  Monique was resigning. What a waste of brain cells. Of course now I can see that Maureen is clearly the one who has long red hair, pictures Irish clovers hanging over her desk, and a last name of McSomething. Silly me.

     I didn't end up doing the start of care on my own because the patient canceled. I see that being a nurse requires more than compassion and the ability to look at blood. It calls for patience. A lot of patience. Patients don't pick up their phones when you're trying to schedule a visit, they don't have their meds together and spend half the visit scrambling to find them, and they shove pictures of their grand kids in your face when you're trying to take their blood pressure. So being a good nurse means you schedule extra time in the visit to help them gather their pill bottles, and smile politely and tell them that yes, it is definitely the cutest kid you have ever seen. Because that's the proper way to treat people. With the dignity and respect I would want a nurse to treat me when I get old. 

I'm doing my first starter case today! Starter cases are the admission cases, when the nurses from the agency go to the patients' house to introduce them to the agency, get them sorted out with medical equipment and medications, assess their ability to adjust back to being home. Often times patients come back with a new diagnosis, a shopping bag of pills, lists of instructions from the doctor, and are feeling very overwhelmed. Yesterday the patient we saw had to learn all about how to take her blood sugar and administer Lantus every day. It really is going to be her husband's job, and I could see the worry in their daughter's eyes, wondering how her parents were going to manage on their own. I want to be the nurse that sits down with the patient and their family and tells them that it will get easier, that they'll eventually be able to list all their meds by heart, that taking their blood sugar will be something they can do while reading the paper. But getting a diagnosis of diabetes when you're over 70 can be something you never get the hang of. That's why I want to be the nurse that helps make everything seem just a bit easier to manage.

My preceptor told me she's going to have me go through all thr consent forms, look over the medications, and do the physical assessment. This is whole job is a big step, not just for me but the agency as well, because they never hired a 'brand new' nurse before. And trusting me to handle something as big as this really gives me the confidence that I'm getting the hang of things.

I'm excited. 

Yesterday was my first patient visit. I didn't go solo of course, which made me feel a little better, because i think there's always a part of you that's nervous whenever you start something new. It kinda felt like the first day of clinical all over again. I mean I've done vital signs on countless people in the last three years, but I still felt my heart beating a little faster as I listened to my patient's heart and lungs, felt a little shaky as I took his blood pressure. And though I've felt for countless pedal pulses (on the feet), I still found myself praying that they'd be easy to find (which they were). I was supposed to see a couple, but the next patient wasn't available and the nurse I was with got a flat tire so she sent me back to the office where I'm waiting to receive my second PPD shot. Tomorrow is my weekly meeting, and then off to see more patients. So far I'm doing well!