In all my 14 years of PICU nursing, I’ve never quite experienced the overlapping volume and intensity of suffering, moral distress amongst nurses, death, and anger from patients’ families that our unit experienced this past August – October. The bike accident that snuffed out a teenage life in a moment. The newly diagnosed cancer patient whose treatment plan went from cautiously optimistic to utterly devastating within two months. The parents who nit-picked at every nurse who tried to help their children, and screamed at the doctors that they didn’t know how to do their job. The patient who was just awake enough to know she was miserable but her parents remained in denial of her pain for months.

We as the nursing staff were teetering on the edge of our sanity. Almost every person I talked to said, “If I start talking to you about how I’m doing, I may never stop crying.” We scrambled to arrange impromptu debriefings, which I believe were helpful for what they were, but I also knew that we were only barely scratching each nurse’s story, only carrying a fraction of the weight.

“That day when room 3105 died was the worst patient scenario I’ve ever been involved in. Dad was screaming up and down the hall. People couldn’t believe I came back to work the next day, but I think I needed to be around my fellow nurses in a context where I had a relatively light patient assignment. Then I was off work the next few days, and strangely thought I was fine. But then I couldn’t stop thinking about her, and when you all offered the debriefing, I realized that all my unresolved feelings were still there and it helped to talk through the case with people who had been there that day.”

This is the thing about the way we carry our grief and secondary trauma from some of our hardest nursing experiences. It can seem surprisingly easy to tuck away in that work compartment, but then it quietly resurfaces in our thoughts, our overblown irritations, or the surprise tears that spring forth from the most innocuous trigger. A sentimental commercial on TV. A passing comment from an acquaintance about how “your work must be hard sometimes.”

This is why I’ve made it a habit to go on a personal retreat twice a year, where I go to a place of solitude and am intentional about doing the real heart work of assessing what I’ve buried deep down inside, and how it’s been affecting my day-to-day being. As I settle into the quiet stillness, emotions inevitably begin to arise and I don’t fight them. I lament to the God who I believe hears and knows me, and I let myself shake my fist at the sky, or I name names of patients whom I’ve been holding in my heart, and I let myself weep for them. I journal about what comes up, mainly so I can gain clarity to what otherwise just feels like a tangled knot of thoughts, questions, longings, and consolations in my heart. Rather than pretending I’m something I’m not, I let myself be fully honest and thus reorient myself to where I’m actually standing. This is the only way I can know how to actually then start to move forward again.

And with every single retreat, I am ultimately always drawn to beauty. I sit on a bench overlooking a quiet valley, and I watch the sun rise or set without my help. I watch the hawks soar through the air. I listen to the wind, the frogs, the crickets, and sometimes the rain. I remember that as overwhelming as our nurse-world full of brokenness and suffering and death can seem, that there also still exists a beautiful world of which I am also a part.

And so, I’ll leave this post with these final reflections that came as I walked in solitude around the breathtaking campus of my retreat site.

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Ask me about beauty and I’ll speak to you of healing

Ask me about solitude and I’ll speak to you of kindness

Ask me about reading and I’ll speak to you of listening

Ask me about rest and I’ll speak to you of grace

Ask me about silence and I’ll speak to you of clarity

Ask me about grief and I’ll speak to you of incarnation

Ask me about lament and I’ll speak to you of communion

Ask me about anger and I’ll speak to you of longing

Ask me about sacrifice and I’ll speak to you of a pledge

Ask me about gratitude and I’ll speak to you of brokenness

Ask me about gentleness and I’ll speak to you of wisdom

Ask me about inattentiveness and I’ll speak to you of loss

Ask me about attentiveness and I’ll speak to you of richness

Ask me about hope and I’ll speak to you of security