Aspects Of My Life Research Articles

A Canadian Sexual Assault Nurse Examiner's Personal Reflection and Ongoing Questioning of Vicarious Trauma.

The objective of this article was to provide a first-person account of the vulnerable aspects of my life where I questioned if VT had influenced my thought processes and to uncover the potential health risks associated with exposure to patients' repeated stories of trauma. I questioned whether I was experiencing VT or other disorders such as burnout, posttraumatic stress disorder, or compassion fatigue. The scholarly literature was reviewed after my personal reflection to analyze my personal experiences and to gain clarity on how VT and/or other related concepts may impact the professional and personal lives of SANEs. Methods used to produce my personal stories have been done via self-reflection and journaling. Three stories that I believe may resemble VT are shared and analyzed vis-à-vis the literature. My personal vignettes are compared with signs and symptoms of VT and illustrate how they may manifest in the daily lives of SANEs. To date, researchers have neglected to explore concrete examples of the personal depth VT may exhibit in an individual's life. By disclosing and synthesizing my personal stories, I hope to encourage SANEs to be open about their experiences, spread awareness and prevention strategies regarding VT, and, ultimately, further enhance well-being and promote increased longevity in their careers.

Patients' experience of incontinence and incontinence-associated dermatitis in hospital settings: a qualitative study.

To explore the experience of patients with incontinence and incontinence-associated dermatitis (IAD) in acute care hospitals and their family caregivers, including their perceptions and management, as well as the impact on their wellbeing. A qualitative exploratory study design was employed in 18 wards across six acute/subacute hospitals in New South Wales, Australia. Patients with incontinence (with or without IAD) were invited to participate. Where interviews were not possible with the patient, their family caregiver was invited to participate. Semi-structured interviews were conducted. There were 45 interviewees in the study; 41 were patients with incontinence (11 of whom had IAD) and four were family caregivers. The experience of incontinence was captured by three themes: 'incontinence interrupts every aspect of my life'; 'actively concealing and cloaking'; and 'perceived as irreversible'. Incontinence was expected by the patients at their age and did not come as a surprise. It was normalised and approached with stoicism. As such, patients self-managed their incontinence by developing strategies to ensure they avoided episodes of incontinence during their stay. Incontinence left patients feeling anxious, embarrassed and with a sense of shame, and they did not communicate these feelings, or engage with health professionals about their incontinence, nor did health professionals discuss their incontinence with them. There was a strong sense of resignation that incontinence was irreversible and nothing could be done to improve it. All participants displayed little knowledge of IAD. The experience of having IAD was characterised by the theme 'debilitating and desperate for relief' and was experienced as a particularly painful, itching and burning condition that left patients distressed and irritable. Patients with incontinence in acute settings required further education from health professionals to reduce the stigma of incontinence, and provide further support to manage their incontinence. Health professionals can also play a key role in educating patients about the risks of developing IAD and how it can be prevented.

Life - Worth A Possibility of Education

I work with currently and formerly incarcerated women to assist in helping them regain their lives. I focus on offering specialized support and education for women whose pathways to prison or jail are often tied to domestic violence or substance abuse. Through education and wellness programs during and after incarceration, I provide the tools needed for them to become powerful change agents for themselves, their communities, and their children. Many aspects of my life occurring throughout my life have drawn me to this work that I do every day with passion and with a deep sense of purpose.

'I think it affects every aspect of my life, really': Cancer survivors' experience of living with chronic pain after curative cancer treatment in England, UK.

To explore cancer survivors' experiences of living with chronic pain after curative cancer treatment in England, UK. A qualitative study using telephone interviews with adult cancer survivors experiencing chronic pain after curative cancer treatment. Interview data was analysed using a reflexive thematic approach [1-3]. Nineteen participants: 14 female, 5 male, mean age 62.4 years, 1.5-48 years since cancer diagnosis, eight tumour groups represented. Six participants (31.6%) developed chronic pain more than ten years after completing cancer treatment (range 0-25 years). Five themes were generated which highlighted the experience of chronic pain after cancer treatment for cancer survivors: 1) 'Hear me… believe me…. Please'. Survivors felt that they had not been listened to when they tried to talk about their chronic pain after cancer treatment, nor at times, believed. 2) 'Expectation versus reality'. Survivors had anticipated returning to pre cancer quality of life yet living in chronic pain prevented them from doing so. 3) 'They don't understand…. We don't understand'. Cancer survivors did not feel informed or prepared for the risk or reality of chronic pain after cancer treatment and this compounded the difficulties of coping with and managing their pain. They felt health care professionals lacked knowledge and understanding of chronic pain after cancer. 4) 'Negotiating the maze'. Cancer survivors encountered unclear and limited pathways for support, often bouncing from one support team to another. Identifying and accessing services was a challenge, and the responsibility of this was often left to the survivor. 5) 'Validate my pain, validate me'. Palpable relief and benefit was felt when health care professionals diagnosed and acknowledged their chronic pain after cancer treatment. Cancer survivors can feel ill prepared for the risk of chronic pain after cancer treatment and can experience challenges accessing support from healthcare professionals and clinical services.

Change processes during intensive day programme treatment for adolescent anorexia nervosa: a dyadic interview analysis of adolescent and parent views.

Day programmes for adolescent anorexia nervosa (AN) can function as an alternative to inpatient admissions and/or an increase in outpatient treatment intensity. Processes of change during treatment for AN are currently poorly understood. This study aimed to explore how adolescents with AN and their parents understood the helpful and unhelpful factors and processes that impacted them during day programme treatment. A critical realist paradigm was used to qualitatively explore the views of 16 participants. Participants were recruited from the Intensive Treatment Programme (ITP) at the Maudsley Center for Child and Adolescent Eating Disorders (MCCAED) at the end of treatment. Dyadic Interview Analysis (DIA) was used to compare and contrast the narratives of the seven adolescent-parent pairs after two inductive reflexive thematic analyses were conducted for the group of eight adolescents and the group of eight parents separately. Eight subthemes across three themes were identified: 1) "Like me she didn't feel so alone anymore"-families connect with staff, peers, and each other; 2) "You have to eat because ITP say so"-the programme provides families with containment through its structure and authority; and 3) "I found that I was using the skills I learnt there like in multiple aspects of my life, not just around food"-families take in new ideas and generalize these into their lives. These interconnected themes generated hope and change. However, helpful elements individually could be unhelpful if one or more of the other factors were missing. For example, staff firmness, which participants often found helpful (theme two), could be experienced as harshness when adolescents did not feel related to as individuals (theme one). The findings can be conceptualized within recent descriptions regarding the therapeutic change, including epistemic trust and mentalization. Treatment characteristics, such as intensity and containment, as well as illness-specific factors and processes, such as control and collaboration, the role of peer support, and the potential for family members to experience the impact of the adolescent's AN and treatment non-response as traumatic, are equally important to consider.

Getting On With Pain

This paper provided the welcome opportunity to write about how I have come to understand and relate to chronic pain. My systemic psychotherapy training and interest in Narrative Practice has strongly influenced my conceptualisation of pain. I have found this useful in my experience of living with chronic pain. I hope the reader is invited to reflect on the many dimensions of pain and illness and the multitude of possibilities for understanding and relating to it. I experience pain as a very significant aspect of my life and my relationships including therapeutic relationships. For this reason, I believe it is important to talk about the therapist’s illness and health conditions in the same way that other aspects of human experiences are talked about.

The Medawar Prize Acceptance Speech 2022.

The Medawar Prize Acceptance Speech 2022.

Battle for the Faculty's Soul.

As we interviewed faculty candidates, each asked a similar question: What was the most challenging part of becoming a faculty member in an academic medicine setting? I know the answer without having to think because the scar from the battle for my faculty soul is still relatively fresh. Forming my identity and a picture of what I wanted my work as a member of the faculty to be and mean was (and is) the most challenging aspect of my life as a faculty member. From my first day, I heard rumblings that the institution was embarking on a mission to place a greater emphasis on scholarly work from all faculty—including those in the school of health professions. I observed that the faculty were uncomfortable with this transition and argued the importance of teaching as the focus of being a faculty member. A natural helper at heart (I am a physician assistant after all), I committed myself to teaching and education and labeled any and all other pursuits as distraction and noise. Scholarly pursuits were selfish—existing solely for the game of self-advertising that is promotion and tenure. The game of academia. I eschewed these pursuits as beneath the nobility of being an educator. But as I developed in my facultyhood, I grew increasingly curious about pedagogy. Like a young wizard discovering Diagon Alley, I could sense a world beyond this one that called to my sense of wonder. That call was too strong for me to resist. I started to explore the science of teaching and learning and as I embarked on writing my first manuscript, I noted creative parallels to my teaching practice that ignited flow states and left me wanting to practice the craft of scholarship. I began to take on more projects and explore issues outside my designated work time. Several times, colleagues warned me I was taking on too much and that it was a recipe for burnout, and I worried they might be right. Simultaneously, the rumble between faculty and the leadership push for scholarly work reached a nadir. The conflict over scholarly work felt almost oppressive to me. So too did the conceptualization of my work as a 3-legged stool with education, scholarship, and clinical work as the base—as distinct entities that require siloed time and attention. So often, we are pushed to imagine opposite forces in our lives being in balance. We are often confronted with the notion of work–life balance, for example. And here specifically, I was confronted with the notion of balancing my educational practice against my scholarly work. The premise I perceived was that one would take from the other and that they could not both exist in harmony. Further reflection made me think about reframing this battle of balance. Why a battle at all? Why not conceptualize our work as academics as a garden with scholarly work and educational excellence as inhabitant plant species? The garden will have seasons where one of the inhabitants will need more attention than the other or be more prevalent than the other. But the 2 exist in the space in symbiosis. If a faculty member works to ensure that one nourishes the other, the garden is that much more resilient and beautiful. Thus, the real work of a faculty is in that space of intentional craftsmanship. Six years after the start of my journey as a faculty member, I arrived at this peaceful overlook. During those 6 years, I felt torn in 2 by what was presented to me as a battle for the 2 parts of who we are as educators in an academic institution. What I realized was the noise was not the battle, the noise was outside forces trying to dictate what should be planted in the garden of my work. When I listened to what inspired me, I heard what truly mattered and was able to plan what I thought the garden should look like and how each part might synergistically contribute to my overall well-being and satisfaction as a faculty member. More importantly, I learned that this synergy could be my contribution to making the world a better place. When faculty members open themselves up to the idea that the work we do in seemingly different realms can actually enhance our practice, we arguably do our greatest service to the development of others’ gardens.

Thirty-one and counting in the shadow: A teacher’s autoethnography

In this autoethnography, I explore the ways in which my dual teacher identity, that of a Greek state school EFL (English as a Foreign Language) teacher and that of an EFL private tutor in the ‘shadow education’ sector, has impacted and shaped various aspects of my life throughout my career. To that end, I rely on data from my daily planners I have been using for three decades, as well as my own memory and recollections of events occurring in parallel with, or as a result of, my professional life. Moreover, treating the SE literature as another data source, I position myself within this educational framework, reflect on my actions and choices over the years and draw conclusions indicating that my private tutoring has consistently provided me with illegal income almost twice as high as my official salary, and has, thus, been a priority over my official teaching obligations; has offered me professional satisfaction deriving from my students’ success; and has fatigued me physically, mentally and emotionally over time. Any ethical concerns have been pushed aside in view of the financial gain and the idiosyncratic nature of the Greek educational context where fee-charging tutoring appears culturally and socially accepted.Key words: autoethnography; Greek educational system; English as a foreign language education; shadow education; private tutoring; dual professional identityPart of the special issue Autoethnography in online doctoral education <https://doi.org/10.21428/8c225f6e.9415e58d>

The multidimensionality of anxiety among nursing students during COVID-19 pandemic: A cross-sectional study.

BackgroundOver the past year, healthcare workers constantly report their COVID‐19 anxiety. However, this concept remained understudied among nursing students (NSs).AimThis study investigated the difference between NSs' three types of anxiety and their profile variables during the COVID‐19 pandemic.MethodsThis study used a cross‐sectional, descriptive‐correlational design. Three instruments were used: COVID‐19 anxiety scale (CAS), COVID‐19 anxiety syndrome scale (COVID‐19ASS), and short health anxiety inventory (SHAI) to collect data from 484 Saudi NSs. We applied the Mann–Whitney U test and linear regression to analyze the data.ResultsAcross the three instruments; CAS, Item 1 “I feel bad when thinking about COVID‐19”; COVID‐19ASS, Item 11 “I have imagined what could happen to my family members if they contracted COVID‐19”; and SHAI, Item 17 “A serious illness could ruin many aspects of my life” yielded the highest means. COVID‐19ASS showed a significant difference for the profiles “known positive” (p = 0.05) and “action taken after with testing” (p = 0.05). NS, who knew someone with COVID‐19, was the only predictor of CAS.ConclusionOur study concludes NSs experience anxiety symptoms. Anxiety is specific to COVID‐19 or a set of similar anxiety symptoms. Further research is needed to explore the anxiety state of NSs during the pandemic.

What Would Janeway and Roslin Do?: A Sci-Fi–Watching Library Historian Confronts COVID-19

What Would Janeway and Roslin Do?: A Sci-Fi–Watching Library Historian Confronts COVID-19

Human Suffering and Human Dignity

Human Suffering and Human Dignity* Gerry O’Hanlon SJ The immediate trigger for these reflections is the Dying with Dignity Bill 2020. This Private Members’ Bill intends to give patients with a progressive and incurable terminal illness a choice to avail of ‘assisted dying’. Its chief sponsor, Gino Kenny TD, has acknowledged that this is ‘a profoundly difficult subject, no matter what side you’re on’ and called for ‘a respectful, rational and meaningful debate’.1 I think most of us will empathise with the concerns underlying the bill. Pain, suffering and dying/death are universals, which affect us all deeply. We are treading on sensitive and sacred ground here, not least as we draw on our own experiences and those of our loved ones. As human beings we commonly resent dependence on others, being a ‘burden’ as we often express it. This is so particularly as we get older and, as our powers begin to fail, irritability and grumpiness easily morph into mild and even sometimes severe depression. When this pattern of human decline, irrespective of age, reaches for some the more critical points of loss of control over bodily functions, incipient and progressive organ failure, acute pain and mental deterioration, we find it hard to understand how such conditions are compatible with human dignity. It can seem compelling in these circumstances that the most compassionate, loving response is some sort of legally acceptable assisted dying, as indeed has been introduced in many other countries already. When one digs a bit deeper, however, it strikes me that a major premise of this response is the assumption that there comes a point where pain and suffering, especially when involuntary, are incompatible with human dignity. It can be spontaneously assumed that the indispensable essence of human dignity is autonomy. This was well summed up by a doctor from the Netherlands who commented on the legal practice of assisted dying in that country: ‘I think it fits with the modern time: people who are autonomous and decide things for themselves also want to decide about their death’.2 But what if pain and suffering, even involuntary, have meaning and value and can be considered compatible with human dignity? So, without Studies • volume 110 • number 438 158 commenting directly on the Dying with Dignity Bill as such, I want to offer some reflections on how Christians might deepen their own understanding of the relationship between involuntary suffering and human dignity, given the undoubted influence on us all of the prevailing culture of autonomy as central to dignity. Autonomy in a broader context Some may recall the classic song by Bob Dylan from the 1970s called ‘Forever Young’. The lyrics are in prayer form, and early on he sings: ‘May God bless you always / May your wishes all come true / May you always do for others / And let others do for you’ (my emphasis). ‘Let others do for you’ – this strikes a counter-cultural note, opening up space for a less exclusively autonomy- centred anthropology. Padraig McCarthy, in a letter to the Irish Times, commented on the Dying with Dignity Bill, ‘I depend on others in almost every aspect of my life’.3 Even when my autonomy is at a ‘normal’ level I depend on others – we are, after all, inherently relational beings and our autonomy functions best in the context of a mutual giving and receiving that takes on different forms as we progress through infancy, childhood, adolescence, adulthood and old age. We have learned this again in this time of Covid-19, even the most fiercely independent have been freshly alerted to our reliance on hospital doctors and nurses, porters, cleaning and catering staff, check-out and other staff in food stores, operators of public transport, collectors of refuse and so on. Similarly, McCarthy argues, pain is an integral part of human life – ‘the human body is closely integrated with the world around us, and is affected by wind and rain and viruses’. All of us experience this from time to time, and we trust that our diminished autonomy on such occasions does not rob us of our human dignity. This pain can be very distressing and, particularly in end-of-life...

‘I wanted to be white’: understanding power asymmetries of whiteness and racialisation

ABSTRACT This article uses a self-reflective autoethnography to critique colonisation and whiteness as systems of marginalisation and racialisation. I examine concepts grounded in post-colonial and anti-racist theories, and I interweave these with my experiences in white spaces in Colombia, the USA and Canada as an educator and researcher. I provide personal examples as data to explain how colonisation and whiteness have paved the road to my professional ‘success’, and I also illuminate how these have taken me away from understanding my cultural and linguistic roots. Contrary to conventional wisdom that formal education is empowering for racialised peoples, this article asserts that critical education has been fundamental to challenge inequality and power asymmetries. Finally, in reflecting on the depths to which whiteness has been entrenched in all aspects of my life and other racialised peoples, I seek determination and liberation by calling into question the normative historical raciolinguistic ideologies of whiteness.

When I compliacted understood loss and grief.

A parent's mental illness was viewed as a loss, like a death, causing profound grief. I learned how important parent-child communication is as an important factor in managing my own grief. A child's grief, in this case, from loss of a parent due to mental illness, as in death, was profound at the time and did affect many aspects of my life. The failure to intervene in a timely fashion impaired effective resolution of that grief. Assessment of family dynamics and communication is critical to building coping skills for any young child dealing with loss of parental support due to mental illness. Early intervention with young children in need of emotional support and security is needed to assist them with effective adaptation to grief and loss. It is expected that loss of a parent from death will undoubtedly cause children to grieve. With supportive interventions, children can recover and grow into healthy, well-adjusted adults. Severe mental illness in a parent, however, also creates loss by altering the parent-child relationship, often leaving children confused, frightened and feeling alone. In the past, family members, especially the remaining parent, might not have recognized the symptoms of a grieving child and the system at that time was not well prepared to assist them in meeting that need. This is the story of one such child.

Compassion Fatigue Among RNs Working in Skilled Nursing Facilities.

Nurses employed in skilled nursing facilities (SNFs) are at risk for developing compassion fatigue. Compassion fatigue negatively impacts patient outcomes and is associated with decreased quality of care. Some nurses leave the profession due to compassion fatigue. There are no published studies in the United States focused on compassion fatigue among SNF nurses. The purpose of this interpretive phenomenological study was to identify the shared meanings of compassion fatigue among RNs caring for residents in SNFs. Shared meanings among participants were identified as: (1) I feel conflicted, which causes my compassion fatigue; (2) I feel physical and emotional manifestations of compassion fatigue; (3) Compassion fatigue is infused in every aspect of my life; and (4) We are trying to cope with compassion fatigue. Of paramount importance was the desire to make a difference in the lives of residents. Three participants sought employment outside the SNF setting due to compassion fatigue. Further research and education are needed to improve knowledge, policy, and practice. [Research in Gerontological Nursing, 13(6), 320-328.].

Life is like a box of Derwents - An Autoethnography Colouring in the Life of Child Sexual Abuse

This autoethnographic study contains vignettes from my life of unrelated but interconnected experiences of sexual abuse which profoundly impacted my life through moments of epiphanous transformation. I am using my voice as the researcher and researched to write authentically and evocatively as a way of truth telling about a difficult subject. This autoethnography invites you to walk in the shoes of myself as the storyteller and for that reason the vignettes are deliberately provocative and expose aspects of my life that have previously been hidden. The vignettes weave together stories that have had a profound impact on me which eventually led me to a career in education. I contend that these experiences laid the foundations for what kind of educator I would become.

Celebrating 150 Years: A President’s Perspective

Celebrating 150 Years: A President’s Perspective Susan E. Belangee It is hard to imagine my life without Adlerian psychology, because for the last 22 years, it has been central to everything I have accomplished. From career to family to friends, Adler’s theory permeates all aspects of my life. Now as president of the North American Society of Adlerian Psychology (NASAP), I feel honored to share some thoughts to commemorate Adler’s 150th birthday. One of the greatest things about Adlerian psychology, in my opinion, is its easy application to real life. During my doctoral program, I was encouraged to relate Adler’s theoretical concepts to my own life experiences to facilitate learning. For instance, growing up in an extended family with many strong women significantly influenced how I viewed myself, especially the messages of “You can be anything you work hard to be no matter what anyone else says.” I certainly followed in my female relatives’ footsteps, becoming strong, independent, and driven. Adler would say that this is evidence of how family constellation played a role in my lifestyle development. The enduring nature of Adler’s views regarding inequality between the sexes also resonates with me. As a resilient woman, it was encouraging to learn that Adler (1956) recognized the plight of women living in patriarchal societies and that “the arch evil of our culture [is], the excessive pre-eminence of manliness” (p. 55). In his book Understanding Human Nature, Adler (1927/1992) wrote that “there is almost universal dissatisfaction with the feminine role” (p. 114), and “until we can guarantee each woman absolute equality with men we cannot ask her to subscribe to all the expected patterns of behavior that make up our society” (p. 115). These ideas affect me deeply, personally and professionally, because there are still so many mixed messages (certainly in U.S. society) about what is acceptable behavior especially for women. Given my expertise in working with clients (mainly women) with eating disorders, I see firsthand the struggle to achieve society’s fabricated ideals about body shape and appearance and how women are encouraged to make this their prime focus and to disregard the value of their intelligence. Even 100 years later, Adler’s ideas are still profoundly relevant. [End Page 4] As the 11th female president of NASAP, I am humbled by those brave women who came before me—Alexandra Adler and Lydia Sicher were the first two presidents of NASAP. How courageous they must have been in the early 1950s to hold a powerful position like this one. I am hopeful that in another 150 years these struggles will be long behind us and that Adler’s concept of social interest will have emerged as the “universal existence . . . that binds humanity together,” for it is “this social feeling, or community spirit [that] is at the root of all the great accomplishments of our civilization” (Adler 1927/1992, p. 156). References Adler, A. (1992). Understanding human nature. Rockport, MA: Oneworld. (Original work published 1927) Google Scholar Adler, A. (1956). The Individual Psychology of Alfred Adler: A systematic presentation in selections from his writings (H. L. Ansbacher & R. R. Ansbacher, Eds.). New York, NY: Basic Books. Google Scholar Copyright © 2020 University of Texas Press

Queen's Luxury Spa

Queen's Luxury Spa Ji Hyun Joo (bio) Unbeknownst to Mother, I plan to live with her indefinitely. I moved in with her, occupying the futon in her newly purchased one-bedroom apartment, after my divorce was finalized a week ago. Of course, Mother doesn't know about the divorce because she doesn't know that I was married. Before you envision a scrappy wedding at some chapel in Vegas with the names of the bride and groom written in chalk, I assure you that wasn't the case at all. I married a man I had dated for two years in an intimate barn ceremony in New Jersey, surrounded by our friends and his family. We were married for six months before he filed for divorce. The reason I didn't tell Mother about the marriage is simple: she is firmly against my marrying anyone who's not Korean. Mother is narrow-minded in this way. During the course of the divorce, I lost the apartment, got fired from my copywriting job, had two bouts of the stomach flu, and accumulated a ghastly amount in overdraft fees. Eventually, I got my head together and decided to come back home to collect myself. When I informed Mother I was going to be staying with her for a few weeks, she lingered in her silence for so long I had to ask if she was still on the line. Then she cleared her throat and stated that it's been three years since I'd seen her or been back home. When she's not playfully berating me, she lists facts. Mother speaks in code, a language I've studied arduously between the ages of thirteen and eighteen. It's my job to read between the lines and find the messages hidden deep within these bare facts. In this case it meant that she welcomed me into her home with open arms. The sudden announcement of my descent into Koreatown, Los Angeles, did raise two questions, "What about your job? Did something happen to your apartment?" I reassured her that I'm simply using up my vacation days and that the apartment is in fine condition. I plan to take the next two weeks to come up with another lie to extend my stay. Mother is not one to fact-check. For the first four years after I moved across the country to New York for college, she took time out in her workday to call and ask if I'd eaten breakfast. She didn't ask about any other aspects of my life, but I decoded that breakfast meant: how are you? I was accustomed to not revealing much information about myself to Mother, so I kept the conversations brief and to the point, "Yes, I had cereal." As I remained many states away from her, visiting her less and less, she distanced herself, calling me once every other week to ask if I'd eaten breakfast. [End Page 83] Mother now lives on the second floor of a garden-style apartment complex. When I arrived, I was shocked at how pristine it was. Other than having her body scrubbed at the bathhouse on Saturday mornings, Mother rarely did anything nice for herself, so I assumed she had purchased a run-down property she would have to fix up. The bushes outside are manicured into perfect squares while vibrant tulips surround a welcome sign. There are bits of marble placed throughout the apartment to give it a touch of luxury. Mother, however, has not changed. She still wears sweatpants that sag at the knees and a Cornell University sweater that's severely frayed at the neck. I've told Mother that I would order another for her online if she threw that one out, but she stated it was the sole item she purchased that one time she visited me on the East Coast. My Ivy League education automatically makes me appear trustworthy and responsible. I'd like to think it balances out the sloppy mess I'm finding myself in now. If Mother knew the whole story, I'm almost sure she'd agree. ______ Mother is...

THE SHARED MEANING OF COMPASSION FATIGUE AMONG REGISTERED NURSES WORKING IN SKILLED NURSING FACILITIES

The purpose of this hermeneutic interpretive phenomenology study was to describe the shared meaning of compassion fatigue (CF) among registered nurses (RNs) who work in skilled nursing facilities (SNFs). The specific aims were to describe: 1) contributors (triggers, situation, or patient characteristics) that cause symptoms of compassion fatigue, 2) associated physical and emotional symptoms, and 3) the short-term outcomes of unresolved compassion fatigue impacting nurses and patient care. CF can negatively impact patient outcomes, is associated with decreased quality of patient care, and can be a reason why nurses leave the profession. Eight participants were interviewed three times each, while concurrent data analysis helped to formulate mutual understanding of the phenomenon and informed subsequent interviews. Self-reflection, journaling, record keeping, and use of direct quotes enhanced trustworthiness. Four shared meanings were abstracted:1) I feel conflicted and that causes my CF; 2) physical and emotional manifestations of CF; 3) CF is infused in every aspect of my life; 4) we are trying to cope with CF. The participants shared their central desire to make a difference in the lives of their patients, which was of paramount importance. When participants felt they were unable to make the desired difference, they began to develop symptoms of CF. Symptoms were compounded when they experienced frequent patient deaths. A resiliency program specifically addressing the needs of SNF nurses, incorporating individuals and their organizations, could positively impact the nurses’ professional quality of life. Future research is needed to better understand CF and interventions specific to SNF nurses.

Take the leap.

I had never jumped out of a plane before. I was not a thrill seeker, and I disliked heights. But I had decided that I would learn to skydive. I volunteered to be the first in the group to jump. My instructor nodded reassuringly, and suddenly I was outside the plane, in shock, kicking and fumbling. But within seconds I found myself floating in midair, smiling so wide that by the time I landed, my face felt stuck in that position. I felt such elation I decided to jump again. Something inside me had shifted. Unexpected new possibilities seemed open to me. It's a feeling I have come to embrace in all aspects of my life, including my career. ![][1] ILLUSTRATION: ROBERT NEUBECKER > “I knew how to pull my parachute cord and land safely.” My parents and I immigrated to the United States from Cuba when I was barely old enough to start school. Like many Cuban immigrants, I was led to believe that the only acceptable career options were doctor or lawyer. I enjoy science, so I entered college with my sights set on medicine. In the course of exploring career options in the medical field and participating in a summer research internship, I discovered the Ph.D. track, and I seized on the idea of a career in biomedical research. A postbaccalaureate research program dampened my enthusiasm, however. I learned a lot in those 2 years, but I found the culture and expectations of biomedical research to be frustrating. Ultimately, I decided it wasn't the right career direction for me after all. I gave up on Ph.D. programs or anything related to medicine. Part of me felt that I had made the right decision. The weight of expectation had been lifted off my shoulders and I felt free for the first time in my life. At the same time, I had never felt such shame and failure. I was half sure I was being naive and ruining my life. I still loved science; would I be able to go back if I changed my mind down the road? I was also scared—directionless and on my own in an unknown place. The postbaccalaureate program had taken me to Arizona, where the heat was stifling and the mountains were glorious—very different from my flat and swampy South Florida. I had two options: I could give in to the fear and go back to the safety of what I knew—Florida, science, academia—or I could explore the unknown. I faced my fears. I stayed in Arizona and took a nonscience job outside my comfort zone. I began to explore the mountains around me—and I learned how afraid of heights I was. Going up was easy enough, but descending required mental gymnastics to convince myself that I wouldn't fall to my death. But the fear was nothing compared with the joy of accomplishment. I took pleasure in pushing my boundaries. I began to rock climb, and I made my first skydive. This exploration helped prepare me for another leap: A year ago, I went back to science, starting a master's program in environmental engineering. It's not the type of graduate degree I envisioned pursuing 5 years ago. Instead, it is a culmination of many of my interests, including my consistent love of science as well as my newer passions for making the outdoors accessible to all and trying to address the disproportionate impacts of environmental problems on some communities, especially disadvantaged ones. So far, my new path has felt like the first time I skydived: It has exceeded expectations and delivered new thrills and challenges. But the thing about fears is that they never go away. On my third skydive, I froze up on exit and cannonballed out of the plane. Hurtling through space, I thought I was going to careen straight into the propeller. All I could see was swirling blue sky. I closed my eyes, reminding myself that all that mattered was that I knew how to pull my parachute cord and land safely. The 60 seconds before my chute opened were the longest of my life, but I regained my confidence and trust in my abilities and made it down in one piece. Some days I still feel lost. But when that happens, I listen to the voice inside me—the one that knows how to land safely on her feet. That allows me to appreciate the free fall, confident that I have the skills necessary to save myself. [1]: /embed/graphic-1.gif