10 Ways Being a Nurse Prepared Me for Motherhood

In case you don't know, I am a registered nurse.

I graduated seven years ago with an associate's degree, got my license, and recently finished my bachelor's degree online while we were overseas (Go UMKC!). I worked in the emergency room of a children's hospital back home and loved it. So I've been an RN a lot longer than I've been a mother.

And this week, I realized being a nurse prepared me for motherhood in a lot of ways. Some of them gross, some of them sweet, but all very practical. If it makes you squeamish to read this, just wait til you're in the thick of it yourself.

1. I am extremely comfortable with poop.

As a nurse, you deal with poop. A lot. Big people, small people - everyone poops. And personally, I definitely prefer the little people. You haven't been a nurse til you've seen a digital disimpaction (don't google that. you'll never want to grow old.). So a little bit of runny breast-fed-poop? Total breeze.

2. I've been vomited on before. No big deal.

Of course, never on my bare chest while nursing. That's a new one. But vomiting is a big reason kids go to the ER, and I've seen it in all colors. Spit-up is much easier to take care of. (although literally while typing this, my son managed to spit up all.over.my.skirt but completely miss his own outfit. thanks, kid.)

3. I'm used to waiting to use the restroom for hours at a time.

It's the constant joke with nurses - when the call lights are going off and patients are going crazy, we know how to hold our bladders. And when your baby is screaming for a feed and having a blow out, going to the bathroom is just going to have to wait (at least for you).

4. Eating on the run or while standing up? Done.

I've gone nine hours on my shift without a single bit to eat. When chaos reigns, you don't get to eat whenever you want as a nurse. And it's the same for moms. I know I should be eating big meals and frequent snacks, but some days? Ain't nobody got time for that.

5. I learned to multitask and prioritize.

One of the greatest life lessons I've had as a nurse is learning how to spin lots of plates at the same time. I may have three patients, each with a set of ordered medications or tests. Which one goes first? Who is more urgent? And as a parent and homemaker, I have to figure out - what is the most important priority of my day? How can I time feeding the baby, washing clothes, going to the market, and making dinner so that everything gets done before 10pm?

This kid must be on the Poop Clean-Up Patrol...

6. I was exposed to a lot of different styles of parenting.

Working in a children's ER, you see the worst and the best of parents. I've seen parents who are belligerent, calm, furious, crying, overbearing, laid back, punching walls, swearing at me, and giving me hugs. And hopefully I've learned what kind of parent is the best to act like in a serious situation.

7. I learned what was a true emergency and what I should stay home for.

Your two-year-old has had a runny nose and low grade fever for two day? And you're in the ER...why? Or, your kid has had severe abdominal pain for three days, and you're just now coming in? We've seen it all. And I do not want to be the parent that brings their kid in too late or too early. Nursing pride, y'all.

8. I'm used to taking care of people who can't (or won't) thank me.

Babies can't say thank you, except with their smiles and coos. And I've taken care of both children and adults who were incapable of saying anything. Sometimes you aren't a nurse (or a mother) for the thanks; you do it for the calling. 

9. I learned the importance of stepping away and taking a breath.

Sometimes it gets to be too much. The angry parent, or the yelling baby. I have learned to recognize when my patience is running dangerously low, and I need to step away from the situation. Sometimes just five minutes away to calm my mind and pray is enough to get me through the next few minutes.

10. I'm used to working the night shift.

For the first few years of nursing, I worked night shift. I loved my night shift coworkers. There's just a different atmosphere in the hospital in the wee hours of the morning. And guess what? As a mother, you get work night shift every night. And day shift too. Let's just say I find it amazing how well I function with sleep deprivation.

But seriously, nothing prepares you 100% for motherhood. It is beautiful and exhausting and challenging in ways you won't find in any other area of life. There are no shift changes in nursing - and for that, I'm thankful.

Now excuse me, I've got a diaper to change.

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My Days at the Clinic Are Over

This week, I said goodbye to work and hello to SAHM-status {stay-at-home-mom}.

At 35 weeks pregnant, I decided it was time to call it quits. Andrew and I are moving to Bangkok next week to wait out little boy's arrival, and I feel ready to stop working and focus on preparing to become a mother.

But, it's still bittersweet.

I have worked with three of the staff ever since I came to Cambodia almost three years ago. We started the thyroid clinic together, learned from each other, and have shared so many experiences. We've seen visitors come and go. We've driven to the villages on motorcycles and in Land Rovers to visit patients that needed encouragement or a check-up on their health - some of them living in desperate situations I can't imagine raising a family in. 

We've taken care of our share of cute kids and said painful goodbyes to the ones that didn't make it. I've even taken their blood to see their blood type, hoping that one of them would be able to give blood to help out a critically ill patient who traveled across the country to see us. And of course, there are plenty of routine days mixed in with the exciting ones.

I've learned about Cambodian culture from them, things like why many Cambodians are afraid of doctors. I've seen the clinic doors shut for a year while the doctor went back to America for home leave, then helped reopen them when he returned this past fall. 

A video made by a friend of our first two years of clinic, 2011-2012

So many of my memories and life lessons are wrapped up in the four rooms of our small clinic on the outskirts of the city hospital grounds. I find it hard to imagine that their work will carry on, while I'm at home every day.

My last day at clinic was also the busiest of the year so far...17 patients, and no electricity all day to boot.

Wednesday night, all the staff gathered for dinner at one of the outdoor casino barbecue restaurants. We shared memories, laughed together, English and Khmer flowing in and out of the same conversation. I'll still see all the staff at church, as, thankfully, we're all part of the same community. But I'll never be part of the daily loop again.

Our last staff photo together...awful lighting, but awesome people 

Yet, what am I getting in exchange? A chance to stay home and focus on being a mom. I don't plan on returning to work as long as we're in Cambodia, because there's no one else to watch the baby. And I'm actually really grateful that I don't have to make the decision about whether to go back to work, or try to find a way to decrease my hours. And we are really fortunate that Andrew's job has allowed me to volunteer the past three years, without worrying about an income, because now I can stay home and still not worry about it.

I think God has really moved around my heart's priorities. I see our new adventure as parents as a door opening up to a whole world of new possibilities. I know I'll have days when I struggle with the everyday routine and miss the challenge of medical work. But for now, this is my role, and I'm eager to embrace it.

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Afraid of the Doctor

Just one moment from clinic this week - letting our visitor stick a vein in someone's arm for the first time!

I don't often get to sit in with Dr Rusty while he sees patients in thyroid clinic - which means I miss out on some interesting stories. Nurses are often too busy screening patients, taking blood for tests, or scheduling follow-up visits to sit and listen to a physician's interaction with a patient.

Luckily, this week I happened to pop in on a situation that illustrates the complexity of being a physician in Cambodia. Two weeks before, we'd seen a middle-aged woman (we'll call her "Syna" for a possible overactive thyroid. We took blood to check her thyroid hormone levels and told her to return this week. When she came back, Dr Rusty asked about her symptoms again. Her blood test had shown the opposite of what he initially suspected - a very under active thyroid. Syna then proceeded to take an envelope out of her purse and show Dr Rusty blood test results, done two weeks before her first visit with us, and a box of thyroid medication that another doctor had given her. She explained that about a month ago, she had seen a Cambodian doctor, who ordered the same blood test we ordered two weeks later, and gave her medication to treat her slightly overactive thyroid - the same medication we'd have given her, had we seen her at that time.

We asked her, a bit bewildered, why she hadn't told us this when we first saw her.
"Oh, I didn't dare - I was afraid!"
"Afraid of what?"
"That you'd be angry - or maybe that you wouldn't understand because you weren't using a translator."

Now, Dr Rusty has worked in Cambodia over 14 years and speaks fluent Khmer (Cambodian language). The entire conversation was in Khmer. But for some reason, at her first visit with him, she "didn't dare" tell him she'd actually seen a different doctor and was taking medication for her thyroid. Dr Rusty explained to her he wasn't angry, but he could have diagnosed her wrong and given her the wrong medication if she hadn't told him everything.

Unfortunately, her fear of the doctor's wrath may have been partially justified. I have heard so many stories of Cambodian physicians becoming angry with patients when they seek a second opinion or even ask questions about medications, because they feel their authority is being threatened. What, you don't blindly trust me enough to take this without question? You can go find another doctor you like better is a common response among doctors who don't have appropriate respect for their patients and are motivated by the money they're making than by the people they are helping. This attitude is not characteristic of every Cambodian physician, but it is common enough that patients feel intimidated by all doctors - and especially doctors whose skin is a different color and speak Khmer with an American accent. This doesn't exactly encourage patients to be honest with their physicians about their anxieties or confusion, and it can also cause patients to withhold information with possibly dangerous consequences.

Happily, Syna came clean about her other doctor. She decided to stick with Dr Rusty, as his clinic was closer to her home, and we were able to give her the right medication - and not the one that would just exacerbate her condition. I wish this was the first time we'd had a patient intentionally leave out important details when talking to us about their health, but it's not. Patients aren't always completely honest with their healthcare providers for a variety of reasons - I'm sure this surprises none of the medical professionals reading this!

This story illustrates why it is so important for those working overseas to understand all the cultural nuances that affect how patients view us and communicate with us. It takes a lot of patience and language study to reach that understanding - as well as a willingness to ask the same question over and over to the same patient and not act surprised when we get different answers!
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Halfway There

I hit 20 weeks - halfway finished bakin' this baby.

This is a post-dinner bump, which is always more impressive than my first-thing-in-the-morning bump. I swear it gets bigger throughout the day... I'm feeling healthy, and check-ups are all looking good, although no news on the gender front. My doctor here in Poipet refuses to call it until he's 99.9% sure, so we may have a few more weeks to wait! 

This week, we've continued to see some new patients at the thyroid clinic. We haven't even begun to call the 75 patients who need to come back and follow up. Although we saw over 300 patients during our first term open, only 75 of those need to come back and continue to be seen by Dr. Rusty. The other 200+ were patients who really didn't have thyroid problems, had masses that were benign (non-cancerous) that didn't need follow up, or who passed away. Currently we have three nurses who will be at the clinic full-time and one back-up nurse, as well as our doctor and three Cambodian staff. It's exciting to start fresh this year and look at ways to improve our clinic processes, such as how we get labs reported, which patients get seen first by the doctor, etc. 

One thing that everyone sees as important is excellence in ministry and medicine. Our medical work isn't just a "front" for sharing the Gospel. If we do a poor job taking care of people's medical problems, we have no right to speak into people's spiritual lives (let alone take care of them at all). But we are fortunate that all our staff and volunteers are highly motivated and excited about their jobs. I know we'll encourage each other when the work is difficult or we're tempted to cut corners.

This week, Andrew has also been helping coordinate flood relief in the Poipet area. Remember all that rain last week? It affected others far worse than us. Samaritan's Purse has received funding to provide hard-hit families with food and mosquito nets to get them through the flood season. Many have been forced to leave their homes and take up temporary shelter in other areas. But it can also be difficult to reach families, as the same floods driving them from their homes make the village roads impassable.

Last week, I captured this photo as we were driving down the main road in Poipet. Despite the floods, people keep getting things done, and kids learn to hold their own IV poles. I can't even imagine ever seeing this on a street in America!

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Open for Business (Again)

It stopped raining! I just thought I'd give that update first, since some of you were wondering if we were still flooded in. There's still a lot of water out there, but we no longer have to wade through it to get in & out of our house. That is a major blessing, considering the nightmares I've been having about parasites and nematodes squirming in between my toes from all that nasty water...

The clinic staff on the first day

In other news, the thyroid clinic is officially open this week! Dr Rusty, the American missionary doctor with whom I worked two years ago, has returned and set up shop to once again treat the masses of Cambodia (literally and figuratively). In our first year, we saw over 300 patients with a wide variety of thyroid disorders (overactive, underactive, cancer, masses, goiters...). And I'm guessing this year won't be any different - if anything, it will probably be even busier. On our first day open, without any advertisement, we saw three new patients and two patients from last year - ok, not super busy, but I'm not even sure how they knew we were seeing patients again.

Foolin' around with sunnies. Uncle is happy clinic is open again, too.

I'm super pumped to get back into hands-on clinical nursing. Teaching about health is fun, but I like taking care of sick people, to put it simply. Although I probably will only work for another 2-3 months before the baby comes, I hope I can enjoy the time I have. My time will be split between two days at thyroid clinic, one day of general clinic, and the rest of time taking care of Andrew and the house and nurturing this little life that's growing inside me.

(Before you ask, yup, we did an ultrasound last week, but the result regarding gender was inconclusive. Stay tuned next month for a gender update!)

And by the way, if anyone has tips on how to paint your toenails while hugely pregnant, please share them. I'm rapidly approaching the point of being too big to do it, and trust me, your eyes will suffer...

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