After some particularly meaningful patient care experiences in the last few weeks, I’ve found my mind coming back to the comment we PICU staff often hear from the general public, “I don’t know how you do your job.”

There are endless strings we could pull on, in unpacking that comment and our responses, but here I will simply pull on two.

1. Oh, if I could only explain what a privilege it is to do this job.

When patients with craniofacial malformations get a massive surgery to reconstruct the bones in their skull and face, they often have to wait through a delicate post-operative period lasting a few days. During this period, ideally with moderate to heavy sedation on board, they have their eyes sutured shut (to help deal with the swelling in their face and protect their corneas), a breathing tube (necessary but silences their voice), and restraints on their hands so they don’t startle awake and try to rip out any tubes or lines.

I could “do my job,” and simply go in to check on them, give medications, change their diapers, and turn them every couple of hours. But even under considerable sedation, these patients are completely neurologically intact, which means when stimulated enough, they can and will wake to the constant, unexpected jostling of some stranger who has total control over what’s happening to them. They can’t see, can’t talk, can’t ask questions, can’t defend themselves.

I could just “do my job” and just keep the patient safe and stable. An important baseline, obviously.

But what a privilege to care, really care, for a little girl described as “the sweetest girl in the world,” “the best big sister to her younger siblings,” who has lived her whole life to date looking “not normal,” who was so nervous about this surgery. What a privilege to shape what could be a terrifying, dehumanizing, rough, disrespectful experience, and come in with tenderness and sensitivity, and put her (and her parents’) anxious hearts at ease for an entire 12 hours.

What a privilege to be trusted with this kind of thoughtful care for the most vulnerable.

2. While this job most certainly comes with plenty of very hard and sometimes traumatic circumstances to process, I can also say I have been so deeply formed for the richer – in ways nothing else could have formed me.

This is a response that I can only provide having now spent over a decade as a bedside PICU nurse, and having done some very hard work of grappling with hard questions, deep processing, and tender conversations with my therapist.

I learn to serve sacrificially. This is not to glorify or martyr nurses in unsafe staffing. It is simply to say that there is something formational about learning what it is to sacrifice, and offer up all the strength and perseverance you can, for those who are utterly overwhelmed by disease and fear, and who do not have the expertise we have do the things we are doing.

I learn to think about quality of life so differently. It doesn’t have to be the Instagram version of “living your best life.” Quality of life can co-exist with severe disability. It can be the fruit of just one deeply devoted relationship (in our case, usually parent/child). It can be comprised of the smallest delights, sweetest connections and slivers of hope even in a terrible prognosis. My experiences have humbled all my entitlement and assumptions that I just need to get all my things “together” to feel I have good quality of life.

My job teaches me to listen and consider perspectives from people I would never, ever have otherwise encountered or considered.

It teaches me about our mortality, how and why we need to humbly number all of our days and ask God for a heart of wisdom. My patients and their families taught me how to cope with my own health crisis with more courage and peace. Regular exposure to the realities of mortality and death humbles us.

This post only scratches the surface of this discussion. It is true that in the hardest times, I wonder how I can continue to do what I do. It is also equally true that the more I reflect, the more I see what a privilege this work is, and how this work has indeed shaped me for the better.