Thursday, January 17, 2013

Self Care During Family Medical Crisis: Part 3 At the Hospital Emergency Room

This is the third part in a series in which I am focusing on the personal lessons of self-care during family medical crisis.  The previous blogs in the series can be found here:

Having deployed for more than 30 catastrophic disasters in my career, I thought of my trip as a deployment.  I assumed the first few days would feel chaotic, but all would settle into a routine fairly soon. I was mentally prepared for the initial discomforts. 

When I arrived at the hospital it was after midnight.  The scene was shocking but not unexpected.  I am surprised by how calmly I was able to absorb the reality.   I think I was still in shock. Seeing DCR was somehow comforting yet distressing at the same time.  I can deal with most anything if I have data and seeing DCR was sufficient for the time being.  The worst feeling was helplessness.   I felt there was nothing I could do to make things better for DCR aside from being present, and that did not seem like enough.

DCR’s sister (DCRS) was staying in the ER with DCR.  DCR’s Mom (DCRM) was at a nearby hotel getting some much needed rest (we hoped).  If DCR took a turn for the worst it would have been devastating for DCRS, so I stayed overnight with her and DCR in support.  I was grateful that I could be near DCR.  Throughout the night I kept one hand on her foot, just to let her know she was not alone.  Frequently I whispered words of love, hope, comfort and support to her. 

Routine checks on DCR and nurse questions by necessity kept us awake. The sounds in the ER never stopped, making sleep difficult. Some sounds fell into the background while others lead to a startled wakening.  More than once DCRS and I lifted our heads when startled, looked into each other’s eyes for reassurance, and seeing no cause for alarm, put our heads back down.  Sleeping in a chair was difficult.  A thoughtful nurse brought me a pillow so I would have something soft to lean against.  I think DCRS and I rested with closed eyes more than we slept. I might have gotten one hour of solid sleep just before the morning activities led to increased traffic into DCR’s room.

In the early morning DCR was moved to the Intensive Care Unit.  We (DCRM, DCRS and I) were allowed to see her for a short while after DCR was settled in to her room.  The only change in scene was the type of bed. Our hearts were heavy as we returned to the ICU waiting room.  We wanted to be with DCR.  Even though she was not awake, we wanted for DCR to know she was not alone.

Tuesday, January 8, 2013

Self Care duriing Family Medical Crisis: Part 2 Elements of Self-Care

This is the second part in a series in which I am focusing on the personal lessons of self-care during family medical crisis.
Self-Care Buddy. My primary self-care buddy – my husband – was at home when I received the call.  He held me when I was shaking.  He helped me find things that I could not see but were right in front of me.  He helped me stay calm and grounded in facts.  He did everything I needed at the time and then some.  

No Major Decisions.  My husband/self-care buddy reminded me of something I teach in Field Traumatology about crises: this is not the time to make any major decisions.  I agreed to defer major decisions whenever I can, and to discuss with him and those directly involved any major decisions that could not be deferred. 

Social Media. I am a regular Facebook user.  One of the first things I did was to put out the word to my closest network of family and friends and ask for prayers.  At first I felt weird about putting such a personal matter into the larger social media context.  That feeling gave way quickly as I started receiving messages of support.  Those messages over the next few days were beacons of light nourishing me at the deepest levels.  I have a deep sense of gratitude to those who rallied around me and my family.  Thank you!

Technology. I cannot underscore enough the value of technology and social media during times of crisis.  My husband loves technology and stays current with trends.  Both daughter and husband had been encouraging me for a long time to give up my flip phone for more advanced technology.  Last year I started with the iPod Touch.  Having mastered that, I went this year for the iPhone.  This communications tool kept me in touch with my family and social support network from the moment the crisis began.

Unexpected Support. My flight north had a very tight connection through Charlotte NC.  I feared missing the second leg of my travel.  I talked with the flight attendant, asking if someone towards the front of the plane might be willing to change seats with me. I tried to manage my anxiety as we began our initial descent and I was still at the back of the plane.  Minutes before landing, the flight attendant told me there was a volunteer.  An elderly gentleman traded seats with me. 

The woman seated beside me was his wife, a hospice volunteer in the Jacksonville area who works with caregivers.  She touched my arm as she talked, and underscored the importance of touch when one is in crisis. Her gentleness and kindness touched me but also reminded me of what I needed to do for DCR: be fully present.  As we talked I noticed a piece of paper near my foot.  It was her husband’s boarding pass.  I now had  the name of the man who traded places with me.  As soon as I can I will thank them in writing for helping me.

We’re All Doing the Best We Can.  During times of extreme stress it’s common for people to become crabby or short in tone or forgetful or make errors in details.  My first challenge came at my destination airport, when I discovered someone else’s luggage in the back seat of my rental car.  I had to walk back to the airport terminal in the cold at 11:30 p.m., dragging my bags behind me, fearful that the car rental agent may have left already since it was so late.  The agent was on the phone as I approached her desk, talking to the person who had placed his luggage in the car next to the one he rented.  Gee, he must have been really tired or stressed to not notice.  The agent accompanied me back to the car, and I drove her back to the terminal  I was not happy about the delay but was able to stay civil and grateful for her help.

I went to the hospital address given to me by a family member.  DCR was not there.  After a few minutes of confusion, reception kindly located DCR at another local hospital which was not far away.  The correct address and GPS in hand led me to DCR’s location.

I told these stories to several folks, partly because were it not for the circumstances they were amusing.  It was when an apology was offered about the wrong address that I said “We’re all doing the best we can.” At times like these we need each other.  Mistakes happen.  And good self-care requires that we let them go.

Next: The Hospital Emergency Room

Self Care During Family Member Medical Crisis: Part 1 Reactionss

My blogging plan for the New Year has been derailed, and a new one defined.  A family medical emergency changed my focus.  My blog – at least for now – is very personal though my intent is for it to be educational. I will focus on the successes and challenges of attending to my self-care during this difficult time. This ties in to the original blog focus on self-care. The original blog plan will be back on track in due time. Now that I have written the first 3300 words, I know it is therapeutic.

The Crisis

On Thursday, January 3 at 4 p.m. I received the phone call none of us want to get: one of my dearest close relatives (DCR) was admitted to the hospital with life threatening double pneumonia.  The distressed voice on the phone let me know the severity of the situation within seconds. My voice and body started shaking. My normal work day turned into a focused quest to travel north immediately.  My blog, drafted and planned for Friday, was the last thing on my mind.  

To fully understand the situation one must know that DCR is multiply handicapped.  Her rare condition leaves her susceptible to a cascade of additional life threatening medical issues. Resolving double pneumonia is only the first step in her recovery.  While I may mention DCR’s condition generally to create a context, details about my family and the medical issues will be omitted out of respect for their privacy. 


Anyone who has received shocking news will understand my reactions.  It took about 15 minutes for my body to stop shaking.  My thinking was both focused (I must get there as soon as I can) and disorganized (I felt like I was going in circles trying to get things done). 

Focus prevailed when it came to scheduling a flight.  I went to the Delta website and saw immediately that their schedule did not accommodate my needs.  Using a website like Travelocity seemed too overwhelming.  Our family has a AAA  membership so I called AAA Travel Services.  The kind woman on the other end of the line was able to get me to my destination at 11:15 p.m.  My 6:20 flight gave me little time to pack and drive to the airport.  There was no time to think about what was going on, though every cell of my body was reacting to the news.

Packing was a different issue.  Decisions about what to take were difficult to make.  Thank goodness the laundry was done and I had plenty of clean clothes.  I packed my favorite new sweaters and the jeans our daughter  suggested I try.  At least I would feel good about how I looked while the rest of me was a jumble.

Next: Elements of Self-Care

Friday, November 2, 2012

Green Cross Deployment - Hurricane Sandy - Recruiting Volunteers NOW


If you are available to deploy in the next few weeks, please let us know As Soon As Possible.

We will start processing the testing procedure today, and hopefully have a number of persons ready to deploy by Monday, November 05th.
As with most of our deployments, we will probably be into this for a few months, so if you are available with any time from now through March, let us know ASAP.

Post your available at the Green Cross Academy of Traumatology Facebook page or send an email to Green Cross Office Manager:
Include your level of certification and periods for which you will be available.
PS  If you want to deploy as a Compassion Stress Manager and are not yet certified, take Figley Institute's Compassion Fatigue Educator online course at a 25% reduction: promotion code Sandy.  Go to   

Friday, June 29, 2012

Picks of the Week: Post-Traumatic Growth

A while ago I clipped an article from USA Today titled "Living with Combat Stress" which included a section titled "Changed, but stronger".  This concept, called "post-traumatic growth", focuses on the positive changes which result after a traumatic event.  If one turns to theology, the concept is framed as "spiritual transformation".  Part of my doctor of ministry studies included the course "Theology of Suffering" in which we studied Henri Nouwen's work, and spiritual transformation. Whether approached from a clinical or spiritual perspective, traumatic events have the capacity to foster life-changing positive outcomes.

The path to transformation was discussed in research published in the Journal of Traumatic Stress:"The degree of rumination soon after the event and the degree of openness to religious change were significantly related to Posttraumatic Growth. Congruent with theoretical predictions, more rumination soon after the event, and greater openness to religious change were related to more post-traumatic growth. Present findings offer some confirmation of theoretical predictions, and also offer clear direction for further research on the relationships of religion, rumination, and post-traumatic growth."

A Google Scholar search produces a lengthy list of research articles which focus on circumstances after which people experienced post-traumatic growth, e.g., war-time experience, medical trauma (e.g., cancer, brain injury), childhood abuse, and the terrorist attacks of September 11.

The Post-Traumatic Growth Inventory may be found in a self-scoring version online

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Friday, June 1, 2012

Picks of the Week: Practical Tips for Hurricane Season


Mother Nature kicked off Hurricane Season early, with two Tropical Storms: Alberto and Beryl. FEMA, the American Red Cross and the National Hurricane Center answered with an abundance of information during Hurricane Preparedness Week.  Here are some of the best resources for addressing what we all hope will be a relatively easy Hurricane Season.

Tips from the National Hurricane Center

Visit the National Hurricane Center's website to watch video or listen to audio (short clips available in both English and Spanish) or read about the topics as listed below. 


Get A Plan! Take Action

Evacuation - Flat Stanley has some ideas for getting citizens involved in planning

Regardless of information made readily available to the public, preparedness planning and evacuation plans are one of the weakest points due to citizen apathy. In the FEMA Blog Lessons from Hurricane Andrew, CNN reporter John Zarrella underscores the importance of evacuation planning and his concern about citizens' who choose not to evacuate. Check out FEMA Administrator Craig Fugate's 2012 Hurricane Season message; Flat Stanley for some smile-making evacuation planning tips for children, adults and families, or watch the video of Flat Stanley's recent FEMA visit.

Social Media: The Good, the Bad, and the Ugly is the FEMA go-to site for a well-organized information about emergency preparedness and recovery.
Social Media Links include smartphone, apps, text, blogs for updates before, during and after a disaster.
To apply for Disaster Assistance: Online at; via a smartphone at;or by Phone: (800) 621-3362,TTY (800) 462-7585 for people with speech or hearing disabilities. 
Fake FEMA websites and Phishing make recovering from disaster more difficult for those who recovering from disaster. is the official FEMA site.

Excellent Resources for Post-Disaster Stress Management and other Disaster-Related Issues

David Baldwin's Trauma Pages are the best collection of disaster-related links and materials available, dealing with stress, emotional challenges, and healthy coping strategies.  An added plus is the list of disaster related websites.   

Here's wishing all a fun-filled, disaster-free summer!

Monday, April 2, 2012

Zimmerman, Bales and Mother Nature: The common thread

Zimmerman, Bales, and Mother Nature
The first three months of this year wrapped up with news which has an international focus.  Media images provide us with almost daily updates in the cases of Zimmerman  and Bales, and the details of the notable weather pattern change which caused early spring-like weather that generated destructive tornadoes.  I’ve been thinking about these three events for several days now, looking for the common thread that unites the three. 
The most obvious thread is the emotional pain of those most affected by these traumas.  Each event meets the first criteria when screening for PTSD: an event occurred which threatened bodily harm to self and/or others, and the response to which includes intense fear, helplessness, or horror.  As bystanders observing media images, or listening to various broadcasts, we slowly learn the impact via unfolding event details.  We, too, must come to terms with the reality.
When being interviewed about trauma, Charles Figley routinely underscores the importance of answering Five Victim Questions”:
 -What happened?
-Why did it happen?
-Why did I behave the way I did then?
-Why am I behaving the way I am now?
-What will I do if something like this happens again? 
Most people can answer these questions sufficiently to acquire peace of mind and become survivors. The process requires deep trust in the practitioner (psychological or spiritual), and/or deep faith in one’s capacity to overcome the trauma.  Answering these questions when one is ready is both powerful and transformative.  
One tool to help victims become survivors and create a healing theory is the Spiritual Intelligence Self-Report Inventory.  The inventory measures four constructs, quoted here from King’s website:
I. Critical Existential Thinking: the capacity to critically contemplate meaning, purpose, and other existential/metaphysical issues (e.g., existence, reality, death, the universe); to come to original existential conclusions or philosophies; and to contemplate non-existential issues in relation to one’s existence (i.e., from an existential perspective).
II. Personal Meaning Production: the ability to derive personal meaning and purpose from all physical & mental experiences, including the capacity to create and master (i.e., live according to) a life purpose.
III. Transcendental Awareness: the capacity to identify transcendent dimensions/patterns of the self (i.e., a transpersonal or transcendent self), of others, and of the physical world (e.g., holism, nonmaterialism) during normal states of consciousness, accompanied by the capacity to identify their relationship to one’s self and to the physical world.
IV. Conscious State Expansion: the ability to enter and exit higher/spiritual states of consciousness (e.g. pure consciousness, cosmic consciousness, unity, oneness) at one’s own discretion (as in deep contemplation or reflection, meditation, prayer, etc.).
The scores may be used to identify areas in which an individual remains strong after a traumatic event, or to monitor growth post-trauma. 
My hope in sharing this tool is that you will find it useful when working with someone who is traumatized.  I am very interested in hearing your feedback about its application.