My heart is in a weird place and I feel it needs to settle again.  I keep thinking of the verse in Luke 10:41, 42 ..... "Martha, Martha," the Lord answered, "you are worried and upset about many things, but only one thing is needed.  Mary has chosen what is better and it will not be taken away from her."

There are many things to "do" ... gather food, non-perishables, household supplies, (dog food!)  Check on neighbors, check on parents, check on kids' schoolwork ...

Keep up with hourly evolving CDC guidelines, gloves on - gloves off - sanitize - gloves back on - wipe with purple wipes - "oh no, did I touch that bag first?"  Don't cough, don't sneeze, don't touch your face.  Don't hug me, stand 6 feet away, "oh no, my mask broke!  Where's the stapler?"  Shit - did I sanitize the stapler first? Now I have to change gloves again ... gloves on - sanitize - gloves off.  New gloves .... Here comes another EMS gowned up ... yep another Rule Out ... back in full PPE.  At least maybe I'll sweat off weight like the wrestlers do when they wear those plastic bags ...

Come home ... shoes and clothes off in the garage (thank goodness I have a garage door!)  Scream at your youngest to hide her phone since she's FaceTiming her BFF and you don't want her to share your naked butt streaking through the house.  Streak.  Climb into a piping shower.  Scrub down ... every inch ... twice.  No three times.  Who knows what's living in my hair??  Wash it again.  Breathe. Did I get it all?  I don't know, but I hope so.  Climb out of the shower and into my pajamas, cause I'm obviously not going anywhere else.  Make dinner.  Check schoolwork - whatever, I'll give that a pass tonight!  Sit down to eat.  Kid #1 coughs .... silence.  Did I bring it home???  Did I get him sick??  Oh God .... mind racing again.  What if I did??  What if I'm an asymptomatic carrier??  Kid #1 forced to sleep in my room that night ... on the love seat ... so I can listen to him breathe.  Monitor his cough.  Check his temp ...

It's constant internal noise.  And it's been speaking over my peace and purpose the last week.  God has called us to walk by faith and in His presence ... especially in times like these.  "Rachel ... you are worried and upset about many things, but only one thing is needed."   What is that one thing?  Sitting at the Lord's feet listening to what he's saying, not being distracted by all the preparations that have to be made (Luke 10:39, 40).

The situation is real.  The fear is real.  But it does not have to control me.  Fear is always a liar intended to steal, kill and destroy the peace promised in Christ.  I am daily learning to speak TO my fear ... tell it that it has NO AUTHORITY over me.  It does NOT have the final word over my life or my family.  My GOD is bigger than my fear.  And I'm constantly having to battle that out in prayer throughout each day.   You may not believe this but up until about a year ago I had given up on praying.  For more than one reason, but I had decided it didn't work or it didn't matter.  But a whole

lot has changed in a year.  You see, this little picture below is now my favorite room in the house.    

It's where I have hashed out some hard stuff, broken some serious chains in prayer.  I've cried, snotted, yelled, cursed, screamed and slept in this little corner of heaven.  It's been my go-to for months and it's my go-to now.  Even when I don't know WHAT TO PRAY I fall on my face and weep, trusting that tears are a language God understands.  

I think God is forcing us to be STILL, to be QUIET.  To shut down the internal noise and listen for Him, to Him.  So much has been removed or taken away that we really don't have an excuse to ignore Him anymore.  If you don't know where to start I'm just going to throw out a few things that helped me over the last year and maybe they will help you too ....

These are four of the books I've read over the last few months ... they are different styles of writing and backgrounds of authors but each one has challenged and changed me immensely.  

Lastly I want to share a link to a sermon about fear that I pray will minister to you.  I challenge you to take a walk and listen.  Or find a quiet place in your house to hear.  Just 30 minutes to speak peace over your soul in the midst of chaos.  

The Invitation of God in Seasons of Fear By Jabin Chavez, City Light Church

https://podcasts.apple.com/us/podcast/city-light-church-las-vegas-jabin-chavez/id1290676886?i=1000469238388

No lie ... don't put it past me!  We are running low but we are conserving.  I've actually seen nurses staple the elastic straps back onto their masks when one breaks just to spare using another.  The outpouring from the community has been amazing ...  I have come home to find homemade fabric surgical masks made by neighbors on my doorstep, we've had numerous people bring unused or extra N95 masks for donations, local businesses are donating inventory.  And my son is spearheading a community project to deliver more than 500 homemade surgical face masks to the ED and frontliners in the next few weeks!  We are thankful, and we couldn't do this without you!

Also, we are so thankful for the outpouring of meals and snacks that the community continues to provide!  Chick-fil-a has fed us multiple times, Longhorn Steakhouse provided BBQ dinner one night, Congressman Lynn Westmoreland and Senator Matt Brass provided pizzas for the entire hospital, and we continue to receive various snacks, treats, and goodies from so many of you.  THANK YOU!  I promise .... it's the little things that add wind to our sails!  

Though volume and acuity in the ED are picking up, it's not full throttle yet ... we're still waiting.  The mornings tend to be "q-word" (I won't say the word) but it gives us time to stock up our rooms and PPE carts in anticipation for the day.  Patients begin rolling in late morning and it builds throughout the day with many admissions at night.  Most are considered R/O (Rule Out) COVID patients at triage because they are presenting in such a variety of ways now ... even what we would have considered a nephrolithiasis (kidney stone) patient under normal conditions are sometimes pinging COVID-19 when CT scanned now.  

It's a little disconcerting at work because fellow nurses and doctors are just vanishing ... you'll be half-way through your shift and realize you haven't seen so-and-so in a while.  When you start asking you find out they've been sent home or quarantined or developed symptoms.  You're not sure who's just not working that shift or who's sick.  And I do believe that overall management is keeping it quiet as to not create panic among staff.  It is true that a med-surge nurse collapsed in huddle the other morning and had to be emergently intubated.  It is true that several of our staff have now tested positive for COVID-19 but thankfully have been discharged home to self-quarantine til better and asymptomatic.  It is true that a float pool radiology tech was found deceased in her home last week and autopsy confirmed Corona.  The number of admitted R/O COVID patients is growing every day.

We are facing new situations unprecedented until now.  A family decided to withdraw care from a patient I was caring for yesterday but because of our strict no-visitor policy only his wife was able to tell him good-bye.   It's a harsh rule .... but it's necessary.  We HAVE to limit exposure ... we HAVE to break the chain whenever and however possible.  It's our BEST defense until we get ahead of this thing.  It's ahead of us, and until we catch up we've got to stay home and help flatten the curve ... 

Fast forward ..... It's been years since I've posted.  But times have changed, and I need a place to write what I'm experiencing without flooding FB.  There's enough stuff clogging up your news feed without me adding my two cents to it .... but if you want to to know what it's like being an ED RN in the midst of the COVID-19 pandemic, I will attempt to share with you as I can. The good, bad and the ugly ...



I slipped into a steaming hot bath tonight all the way up to my ears hoping that the water would somehow drown out what I wanted to scream.  The tears silently slid into the chasm of water softly covering the bridge of my nose.  It's okay to be afraid,  it's okay to cry I keep telling myself as I feel guilty hiding how I really feel from my children.  This IS a big deal.  This IS going to take lives.  This IS going to get worse, much worse, before it gets better.  Our world will NOT be the same after this ... just like 9/11.

I was one of those that initially rolled their eyes initially making fun of the people storming the grocery stores for TP and water (okay ... I still make fun of you because of all the things I've stockpiled TP and water are NOT one of them).  But I was angry that the flu didn't get this much attention ... and  we operated under FAR worse conditions two months ago that we are right now.  But it hasn't hit yet. The storm's not here ... it's just on the horizon.  Like one of my colleagues wrote,
"This is like standing, waiting on the edge of a storm that has undefined boundaries, countless possibilities, and an undetermined magnitude. Some of us may not even be fully in the storm yet or even nearing it but we know it's coming. For some, the tsunami has already hit and it may be the first of several waves. For others, we are watching the waters recede before the first tsunami breaks" (thank you Cristin Scarborough for letting me copy from FB post!)

I'm proud of our management team as they are making life saving decisions in unprecedented times.  They've had the foresight to start with our ICU and work down.  ICU is what's getting hit the hardest right now .... Of our five positive COVID-19 patients all are on vents.  The average length of stay on a ventilator for Corona patients right now is 21 days.  And they're not improving.  They are actually deteriorating.  See the virus is attaching to the peripheral lining of the lungs forming what is called "shattered glass" images on CT scans (google it .... there's lots of information and pics out there).  It basically hinders the exchange of oxygen in the tiniest vessels of the lungs.  It's being referred to as a "lung eater."   Our ventilated patients are having to be turned prone (which means face down) to improve their chances.  Research suggests that when these patients are removed from vents they are often coding because their lungs are not able to function independently any more and their cardiac EF (ejection fraction) is less that 20%.

And the virus has already mutated.  Did you know there are two strands?  One that initially presents with respiratory symptoms and one that does not?  The latter strand presents with abdominal pain and diarrhea first, then respiratory symptoms develop.  These patients didn't initially trigger protocol.  But when they went for abdominal CT scans there was enough lung imaging included to capture the "shattered glass" patterns in lower/peripheral lungs revealing they were COVID patients all along.  So it's changing ... making referred to as "slippery" by epidemiologists.

This virus is NOT attacking the elderly and the comorbid.  I take inventory of our COVID patients and Rule Out COVID patients each shift .... they range from 22 to 95 ... with a mean age probably in the 40s/50s.  They don't have extensive medical histories, if any at all.  So for those of you who think you're invincible or not in the target range think again, you're not out of the woods.

I've been exposed.  I was informed by management that I was exposed to a positive COVID patient on March 9th while not wearing any PPE (personal protective equipment).  It took occupational health 12 days to notify me due to the backlog of exposures we are now experiencing.  I now have to monitor my temp twice per day and log any symptoms.  The sucky part is that I've had a cough for 3-4 weeks now ... and I don't know if it came before or after Corona.  Tomorrow they start screening employees at the hospital employee entrance.  Anyone with temp over 100 degrees or exhibiting cough or SOB (shortness of breath) will be denied entrance.

We are running out of PPE.  Right now we each have a brown paper bag where we keep our ONE N95 mask and ONE face shield.  We are already out of goggles.  We will be reusing these for the duration of the pandemic.  Each shift we are allowed ONE surgical mask.  If it soils or tears you're SOL.  And we've been informed by management that we are going to run out of PPE before this thing peeks ... meaning in the next few weeks we will have nothing unless a miracle happens.

So ... this is a little window into the inside.  This is only a fraction of what we're experiencing.  And I'm gonna give a straight shout out to my ICU friends who are inundated right now!  They're knee deep in the battle while we're still waiting for the second wave.

If you want to know how you can help ... stay home.  I don't care how bored you or your kids are.  Please just stay home.  Pray.  Pray for supernatural protection of your front liners, pray for additional PPE to become available, pray for grants to assist financially when we are quarantined at home without pay.  Drop off a meal.  Cut their grass.  Ask to take their dogs for a walk.  Leave a note in their mailbox.  Have your kids write encouraging messages or verses with sidewalk chalk on their driveways.  Send wine!  It's the little things that are just enough to keep our tanks full!

This weekend I got to see my baby ... my big baby.  And it did my heart so much good. 

You see, I had to leave Barnabas in the care of another family when I went through my divorce and moved back home with my parents.  They graciously let me, my three kids, the Jack Russell, the two fish tanks and four turtles descend upon their rather tranquil and orderly world.  The horse (Barnabas), however, was not welcome.  Though difficult, I knew that I was "loaning" him to a family that would take excellent care of him and I would get to see him often.  Plus, is was strictly a loan, not an adoption, as I kept reminding myself.  Barn would come back home to his Momma as soon as I had a house suitable for him, or a stable, whichever came first.

For those of you who have been on this journey with me since the beginning, you already know why I got Barnabas in the first place and what his name means.  I wanted to put hands and feet (and fur) on the love of God.  You'll just have to go back and read my first post if you're not hanging with me right now.  But what I didn't expect was to learn about receiving the love of God through my four-legged gentle giant.

Much like the prodigal son, I left him.  I left Barnabas and have been living without him for the past 16 months.  And every time I go to see him, I have this deep seeded fear stirring within me that maybe he won't remember me this time.  Or maybe he won't have missed me as much as I've missed him.  Or maybe ... just maybe ... he doesn't love me any more.  When I peel back those layers of fear, what I actually recognize is my inability to forgive myself ... for leaving him, for living without him, for the sparse and hurried time that we do have together.  And I think that I must not deserve his affection any more. 

But when I do see him, it's pretty much like a 747 of slobber and legs locks its sights on me and will not relent until I am sprawled out on the ground and gasping for breath.  That's pretty much what his love looks like.  He pursues me.  He relishes my attention.  He is giddy with affection.  And I lose all sense of self-loathing in his company. 

I bet that's what it feels like to be in God's presence.  Wow.  I wish I could take a nip of that every day. 

All my life I've heard that there's nothing like the unconditional love of a dog ... just three tiny letters that can be rearranged to represent so much More.  Maybe I was working from the wrong side of this equation all along ...

Elephant in the Room

There were four blind men wandering in the jungle.  They came upon an elephant.  The first blind man ran into the side of the elephant and pronounced, "This must be a wall because it is hard and flat."  The second man grabbed the elephant's tail and said, "This must be a vine because I can swing it."  The third blind man felt the elephant's trunk and said, "This must be a snake."  And the fourth blind man felt one of the elephant's legs and remarked, "This must be a tree trunk because it is round and immovable."  Were any of them right?

No, none of them were right because none of them could comprehend the entire animal.  Each had limited information and presumptuously made hasty and false judgement.  Their conclusions seemed right at the time, given the experience and information that each had, but each was only a small piece of a very large beast that they were critiquing.

Likewise, there are many situations in life that we cannot understand.  Many circumstances that appear to be one way when they are in reality a completely different animal.  We may come upon an obstacle in our path and have no idea how to identify it, how to interpret it, how to understand it, or how to respond to it.  We grasp for what little understanding we can and try to reconcile it with our world view or compartmentalize it somewhere that it seems to fit neatly and tidily and tuck it away.

Most of the time we may only be privy to a tiny bit of information (and false information at that), and as we all know, a tiny bit of information can be a dangerous thing.  I've heard it said many times over the last few years that perception is reality ... but it's not.  Were any of the four blind men right?

I say this, because there are many out there  wrestling over recent decisions made in my life.  Many are struggling with questions about why and how, fumbling with small bits of information and trying to make sense of it all.  Depending on which angle you're coming from, you may see a completely different animal that the man beside you.  It's not going to make sense to you, and it doesn't have to.  No one is going to be able to comprehend what happened, what truly went wrong. 

It's an elephant in the dark, and no blind man can assess it correctly.  Only God knows what happened, and only God is worthy to stand in judgement.   

You Cannot Lose My Love

Finding comfort in a favorite song of mine that I haven't listened to in years ... with Barnabas curled up (in a rather large curl) by my side : ) Needing to be reminded of God's love for his children.


You Cannot Lose My Love by Sara Groves

You will lose your baby teeth • At times you'll lose your faith in me • You will lose a lot of things • But you cannot lose my love • • You may lose your appetite • Your guiding sense of wrong and right • You may lose your will to fight • But you cannot lose my love • • You will lose your confidence • In times of trial your common sense • You may lose your innocence • But you cannot lose my love • • Many things can be misplaced • Your very memories be erased • No matter what the time or space • You cannot lose my love • • You cannot lose • You cannot lose • You cannot lose my love • •

Birthdays and Bucket Lists

Well, my big boy celebrated his first birthday this week, and now we've rolled over into a new year. It's been fun and hectic and full of family and friends, but now I am ready for the quiet that follows and the slightly dreary pace of winter. I seem to need that time to recoup and refocus. I like drinking hot coffee or tea throughout the day and sitting down to a steaming bowl of butternut squash soup for lunch. And I don't mind when it rains .... it just makes me want to light a fire or make a craft with my girls. Maybe it's my melancholy personality that makes me feel at home during the winter .... it's the one time of the year that the outside world matches my inside world, and I can just slow down a little.

Looking back on the last seven months since Barnabas came into my life, there have been plenty of funny stories and experiences, some that hurt and some that didn't : ) The top five might include ...

1. He gave me my first shiner with that hard head of his.
2. He knocked me and my two-year old down a flight of stairs.
3. He successfully destroyed three very good dog beads, including two crib mattresses.
4. He taught us the hard way that his stomach can really ONLY handle dry dog food.
5. He outgrew the doggy door AND outgrew me in weight.

Though these pinpoints might make him look like a destructive beast, he really isn't and I am so glad that he is a part of our family. He is gentle, patient, needy, sweet, a snuggler and best of all ... a momma's boy! Check it out ...

Speaking of which, I haven't had straight A's on my report card this past year either. Let's just say I've had a few "instances" that probably knocked me out of the running for "Mother of the Year," but I'm okay with that .... I mean .... nobody's perfect!

For instance, it is just plain common sense that you don't mess with someone's child. Because if you do .... the mama bear instincts that take over are not pretty. I mean, it's one thing when your child gets bullied by another kid at school, but it goes to a whole new level when an adult does the bullying! So ... I discovered a whole new side of me. There was this person, who I will refer to as "White Trash Rach," that came exploding up from somewhere deep within, and all I've got to say is ... WOA! (For a split second there I thought I had nine-inch air brushed fingernails waving all up in yo face) ... But for the sake of myself (and everyone else), I'm really hoping that she was a one-shot-wonder, and that she won't be making any other appearances, cause she really was foul. I admit, it was not one of my classier moments, but then again ... use some common sense people!

Then there was that day that my two-year old set her hair on fire .... Yeah, it was pretty horrific for a few split seconds. I mean, I'm making waffles for my seven-year old son because he's the only one who has to get up and go to school that morning and he's ticked. So I'm trying to make the morning as painless for him as possible. I've got music playing on the radio, a new pumpkin spice candle lit, warm ovaltine in the microwave, and homemade waffles on the iron. I let Barnabas in to say good morning, which turned into the girls squealing and running in horror because drool that early in the morning was just more than they could bear. So I set Sarabelle on the kitchen island to keep her from getting trampled on or drooled on. Good idea, right? Yeah ... except for the lit candle next to her part. She apparently wanted to give it a sniff and leaned over a little too close, letting her hair fall onto the burning wick. All I know is, I hear this faint squeal, and when I turn around, she looks like a human candle with 6 inch flames above her head!! There are not words to describe my horror. It was instantaneous .... I just grabbed both sides of her head with my hands and screamed. Fortunately, that's all it took to put the flames out and her head was not burned at all. It must have just singed off the top layer of hair (or hairspray) and you can't even tell when you look at her. Whew! That could have been soooooo bad. Nevertheless, not in the running for Mother of the Year, but don't worry, I am still capable of handling play dates and babysitting your kids .... really!

Oh life .... it just has it's way of taking you in unexpected directions! Looking back over my life this last year has made me realize that I'm thankful for all the craziness and laughter, the ups and the downs. It has not all been easy, but I'm still breathing, so it must not have killed me. You know, when I first got Barnabas, I was really excited about training him to be my running partner. I mean ... he's got four legs as long as mine, so he should at least be able to manage a few good miles with me : ) But my online research taught me that you really shouldn't run a Dane until they are at least 18 months old. Why? Because the pressure on their joints is too much just from simply growing. The added pounding of running would be too much on their joints during their biggest growth spurt. So you are encouraged to wait until they are able to bear the load well. Hmmm.

Maybe that's where I've been these last few years. Waiting. But on what? Waiting for my soul to settle down? Waiting for some storms to pass? Waiting until I am strong enough to step back into life without being crushed? Sometimes surviving is enough. And I am not ashamed to say that surviving was my best some days. But I think I'm past that now. I think I'm ready to step back into the world of living and go for some things that I want. After all, living is so much better than just surviving. So what do I want? Here's a peek at a few things from my bucket list for 2012 ...

• Start blazing a trail towards nursing school ... I've got five pre-reqs to knock out prior to entering the BSN program. My first class starts one week from tomorrow!
• Complete Tough Mudder GA 2012 ... rain or shine : )
  
• Climb another Colorado fourteener this summer.
• Kayak trip with Aunt Exie and friends.
• Light up the night with sky lanterns : )
• Write at least six chapters of the book I've started.
• Maybe take a friend up on that spear fishing invite?

Why not? I'm a 35 year old mother of three ... my life is just starting! You're never too old to learn new things or chase new dreams. So get after it ... Happy New Year my friends!!