Eager Expectation

"Oh come, oh come, Emmanuel; and ransom captive Israel, who mourns in lonely exile here, until the Son of God appears."

Today is the first day of Advent, the official season of preparation for the joy of Christmas. Of course, commercial preparations for this holiday have already been underway for over a month with “Holly, Jolly” being blasted through many major retailers as soon as the pool noodles were packed away.  Advent may feel like a bit of an afterthought, or even a reaction to the busyness of the holiday season, but it is truly an ancient tradition that predates Christmas trees, stockings, and even the works of St Nicholas. Although this holiday season is not decreed by Scripture, it traditionally has been a time for the Church to reflect on God’s faithfulness and to celebrate the mind-blowing fact that he came to earth to save humanity from our sin.

I have always liked Advent – not just because it is a way to extend the “Christmas spirit” for an entire month, but because it reminds me of several important things about God.

1)      Advent is a season of longing and waiting. It is nice to remember in this microwave-ready world that waiting is not a bad thing.

   Although we only celebrate Advent for about a month, God’s people had been waiting in expectation for thousands of years prior to the fulfillment of God’s promise through the birth of Jesus. Many generations of people lived and died waiting for the Messiah, and they no doubt wondered what God was doing. However, scripture is clear that Jesus came “at just the right time” (Romans 5:6). God’s timing is always better than our best plans.

2)      Advent reminds me that God's plans don't always work out the way I expect them to, and that he brings about his Kingdom in ways more miraculous than I could ever imagine.

To people who thought that their only hope was a military leader who would free them from Roman rule, God sent a fragile baby, born to a poor family. During the days leading up to the first Christmas, God’s people longed for freedom – and little did they know that the freedom that was coming would be of a deeper nature than mere political liberty.

This makes me wonder; what am I longing for that God is going to fulfill in a way that I could never foresee? Am I, like the first-century Israelites, looking for a solution to my longings that is the opposite of what God intends to use to accomplish his purposes?

3)      Advent can rekindle a longing for Christ’s second coming.

Sometimes when I’m overwhelmed by yet another news story about the brokenness and heartache so prevalent in this world, I find myself feeling much like I imagine the ancient Israelites felt as they awaited the messiah. Although Christ has come and we have the benefit of having a personal relationship with him, the fact of the matter is that we still live in a fallen world where things are not the way they are supposed to be. Our deepest longings for peace (true shalom) and happiness are those that can only be filled by the presence of God.

Scripture says that “creation waits in eager expectation for the children of God to be revealed.” (Romans 8:18) It is this “waiting in eager expectation” that is captured in the season of Advent. We can be reminded at this time that God has promised to return and fully make all things right and whole again.

4)      Advent helps us remember that God can show up at any moment.

As we consider the events leading up to and surrounding Christmas, we can see that God chose unlikely ordinary times to preform one of his greatest works. Mary, Joseph, and the shepherds certainly did not expect the amazing events that changed their lives forever.  In this way, we can see that God will often show up and reveal his glory to us at times we least expect him to.

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Some things are worth waiting for. As you wait for some fresh-baked Christmas cookies to come out of the oven, or wait for family to arrive at your home, or wait to open that large gift under the tree, remember how God works some of his greatest wonders during times of waiting and eager expectation.

Happy Advent and Merry Christmas!

"He who testifies to these things says, “Yes, I am coming soon.”  Amen. Come, Lord Jesus." Revelation 22:20

My thoughts on Brittany Maynard's choice

This story has been weighing heavily on my heart for the past few days since I first heard about it. As both a student of bioethics and as a nurse working in palliative care with many terminally ill patients, this story strikes at a particular passion of mine.

My heart and prayers do go out for Brittany and her family. I can't imagine being faced with such a diagnosis. Perhaps this story hits an even stronger emotional chord with me since Brittany and I are so similar in age. However, I strongly believe that her choice to commit suicide is not one to applaud.

Planning for one's death is a good thing, and a brave thing - although we don't like talking about it, it is a great and loving idea to discuss (better yet- put in writing) our end-of-life wishes with our closest loved ones. This can save a family (and healthcare team) a lot of stress and anxiety since they can know that they are honoring your wishes. There are aspects of Brittany's "death plan" that are bitter-sweetly beautiful, but much of these things could be accomplished without the use of suicide.

Fundamentally, the thing that disturbs me most deeply about the idea of ending life on our own terms is that it neglects to realize that beautiful things can come even from disability and suffering. I worry about the kind of message we send other terminally ill patients as we applaud Brittany's plan - in essence we are saying to them "Your life is not worth living because you are no longer beautiful, strong, pain-free, and of sound mind. It probably would have been better if you had ended it all sooner so you wouldn't have to suffer and wouldn't have been a burden to your family." I can say that I have met some of the most beautiful people in my past couple of months as a palliative care nurse -  to me, the truly dignified and brave ones are those who carry through the loss of both "form and function" onto the end. It has been said that "there is no shortcut through grief". The shortening of a life does not equate with the lessening of grief for those bereaved. 

I also worry that the legalization of physician-assisted-suicide is the beginning of a slippery slope towards euthanasia (the taking of someone's life when it is deemed too painful to be endured). Although current law prohibits this type of action, it is only a baby step from applauding someone's choice for suicide and applauding a daughter's choice to end her mother's suffering and slow decline into debility from Alzheimer's.

For those who might have a loved one facing terminal (or even chronic-to-terminal) illness, I encourage you to seek out a good palliative care team (www.getpalliativecare.org) Different than hospice, palliative care is appropriate at all stages of a serious illness and is compatible with aggressive disease treatment/management. It combines expert symptom control with a truly holistic approach to healthcare. The goal of palliative care is to improve both the patient and family's quality of life for however long they have left together. If you want more info - feel free to message me.

Now, that being said - there is an important difference between ending one's own life and allowing natural death to take place. It is totally ethically and morally acceptable to say - "I'm done with this intense treatment - please let me go naturally." Or "I don't want to live on a ventilator or have CPR preformed if I should experience cardiac arrest." This too is a brave option. In my personal Christian worldview, I do not see a reason to cling to this earthly life like it is all I've got - I have the hope of heaven. :)

This is a difficult and emotional topic and I thank those of you who have read my comments to the end. In closing, I encourage you to check out this beautiful and eloquent open letter written to Brittany by a young mom facing terminal breast cancer.

Turn, turn, turn

To everything - turn, turn, turn
There is a season - turn, turn, turn
And a time to every purpose under heaven

~The Byrds (based on Ecclesiastes 3)

I have a new job!!!

Ok, details first. I will be working as a palliative care nurse coordinator at Greenville Memorial Hospital in Greenville, SC. The palliative team there works with ICU and Oncology adult patients, so it is going to be a huge change from what I’ve been doing with the babies for the past 8 ½ years, but I think I am going to do very well in my new role. I’m still waiting to hear from their HR department, but I think my start date there will be July 7.

I knew that I would find a new job sometime this year – I’ve loved my time with the babies at LCH, but I definitely wanted to be able to use the skills and passions I’ve developed over the past three years through the work for my bioethics degree. It is hard to believe that I actually am done with grad school, and now that training is going to pay off!

Transitioning into palliative care will be an exciting process for me. I have greatly enjoyed my time with the babies and will definitely miss my NPCN family, but I can’t wait to see what God has for me in this new place. For those who are wondering what exactly palliative care is, check out this link to the WHO definition of palliative care. I’ve studied quite a bit about palliative care during my masters work, and feel that I have a good foundation to build this new step in my career on.

Along with the new job comes a whole rush of other new things. New house, new city, new church, new friends – it is easy to feel a little overwhelmed by the rush of new coming at me all of a sudden! I’m thankful that I’ve already made some friends in Greenville, and glad I will be able to count on them to support me though this transition. I know that my boyfriend, Steve, is super excited that we will live closer together as we explore God’s plans for us both individually and as a couple.

Along with all of the newness comes some loss as well. I am going to miss my friends and family in Charlotte very much! I am so thankful for all of the love and support each of you has shown me over the years. This move is not the end of our friendships by any means, though – you will be expected to come visit me often! Greenville is pretty awesome, and I can’t wait to show you guys around!

To My Patients on Nurse's Week

To my patients (and their families),

This is nurse's week, and I have to say it is nice to be celebrated. A little appreciation goes a long way and I love to know that what I do makes a difference in your life. This year, nurses week is a little extra special for me because, come August, I mark 10 years since I passed the dreaded NCLEX exam and could write "RN" behind my name for the first time. But as I think about what it means to be a nurse and what makes nursing unique among professions, I realized that it is you, my patients, who make this career so special.

Little do you know that you have given to me more than I have ever given to you. It is interesting that I know so many of the intimate details of your existence, down to how many times you've peed in the past 24 hours, and you know so little about me. I know about your blood counts, your (sometimes embarrassing) family dynamics, what makes you feel good, and how to trick you into eating. I've listened to you vent about your fears and frustrations, and offered as much hope and comfort as I could give. I've shared my knowledge and spent time teaching and reteaching you (trust me, that CPR video does not become more exciting with each re-watch!). I've stayed late at work, worked extra shifts, and eaten M&M's for lunch more times than I'm proud of so that you would have excellent care. Although it is sometimes very hard to roll out of bed at 5am to come spend the day with you, you need to know that it really is a pleasure to serve you.

They called it "therapeutic relationship" in nursing school - this giving of self without expecting anything in return - but they never explained that through this giving it is the nurse who can grow and heal in unexpected ways.

You've taught me that hardships are simply challenges to be overcome and that even the biggest poop explosion can be cleaned up. On days when I've felt unwanted and as plain as the dust under my feet, you made me feel special by asking me to be your primary.That genuine first smile came at a time when I needed some brightness, and your invitation to play living-room-floor baseball years ago healed my broken heart in ways you never could imagine. You've shown me the miracles that dedicated love can achieve and your implicit trust in my judgement has helped me learn to trust my own instincts. You've accepted my meager offerings of love and care, been patient with me when I've had to do painful things to you, and given me a chance to learn so many interesting things. You've taught me not to be ashamed of weakness and vulnerability, because it is through those thin places that God's glory can shine brightest.

Most importantly, caring for you has often forced me to take my focus off of myself and the petty day-to-day frustrations that sometimes threaten to overwhelm me. Thank you for allowing me into your life and giving me the chance to serve you.

You are the reason I am proud to be a nurse.

Time

Happy 2014!

It is hard to believe that almost a month has passed since my first post here. Inevitably, the holiday season always tends to fly by way too fast. My weeks were joyfully filled with the birth of a precious new nephew, time spent celebrating with family and friends, and a trip to Florida for more celebrating with new friends.

In the midst of all of the busyness of the season, I found myself thinking a lot about time. Time is a funny thing – consider way it sometimes stretches on and on (like the last 30 minutes of a slow workday) or how it compresses itself into a tiny fast-moving target when there is a deadline to meet. It is a resource like air or gravity – simultaneously essential to our being and easy to take for granted.

In addition to thinking about the steady march of time, I've been thinking a lot about the timing of events. God’s timing of events, to be specific.

A couple of years ago, a phrase from Romans 5:6 leapt off the page for me in a new way. “You see, at just the right time, when we were still powerless, Christ died for the ungodly.” Just the right time… although God’s people (and all of creation for that matter {Rom. 8:19}) had been waiting for ages for the restoration of God’s relationship with His people – there was apparently something special about the timing of when Christ lived and died on this planet. Paul further expands on this idea in Galatians 3:4-5 – “…when the set time had fully come, God sent his Son, born of a woman, born under the law, to redeem those under the law, that we might receive adoption to sonship.” The idea of time “fully come” suggests that certain things had to be in place or developed, much like a ripened fruit being at its peak after a certain number of hours of sunlight and fresh water.

These verses make me think of the way I treat time in my own life. All too often, I let myself become frustrated by the ridiculous speedy-when-I-have-work-to-do and slow-when-I-want-something-to-happen nature of time. I want to learn more about trusting that the God who created time and is himself timeless really does have a plan for “just the right time” regarding the events of my own life. After all, Christ himself said that there is no point in worrying about time (Luke12:25).

Are you, like me, waiting for God’s timing to bring certain things into your life? Or perhaps you are frustrated with certain events that seem to be occurring at such a wrong time for you. Whatever you face, rest in the knowledge that ‘“For my thoughts are not your thoughts, neither are your ways my ways,” declares the Lord. “As the heavens are higher than the earth, so are my ways higher than your ways and my thoughts than your thoughts.”’ (Isaiah 55:8-9) We may not understand God’s timing, but we can rest assured that He knows what He is doing. May God show you how he is bringing about “the fullness of time” in your own life in a fresh way today!