I’m Fine

By: A Nurse Leader

Several years ago, my husband, Bobby, and I were sitting on the bed talking as I was folding laundry. As we were talking, he said he had a very strong feeling he was going to die at a young age. We were far too young to think about one another dying, and I told him not to say things like that or even put thoughts like that out into the universe. He told me if anything ever did happen to him, he wanted to be buried next to his mother and, because the cemetery is in the middle of nowhere, he did not think anyone would ever visit him. I told him I promised I would visit but all of this discussion was unnecessary as we were young, healthy and had many years ahead of us. A few months later, we would celebrate our eight-year anniversary, which was the best we had ever had. Six days later, a drunk driver would run a stop sign and change everything in my life and also make him right. I hate how often he was right.

At the time of his accident, I found myself in a completely new and frightening situation. I had been with many family members and loved ones as patients had passed away, but it was completely different when the loss was so deeply personal. My entire sense of stability and direction in life was gone. Foolishly, I did not see the benefit of seeking out professional help to support me through this situation. I thought back to the mental health portion of nursing school and assumed I knew what I would be told by a professional and I did not seek out help. I never truly worked through the grief I had and suppressed so many of my thoughts and emotions for years after his death. I told myself: I’m fine.

More recently, I found myself in a completely new and frightening situation as the pandemic started in early 2020. There was so much death around us, so many unanswered questions as we were fighting the unknown and no time to process thoughts and feelings as everything unfolded around us. Again, I suppressed so many of my thoughts and emotions, and I was not alone. Many of us were doing this and trying our best to piece everything together to meet the needs of patients and families. It felt as though there simply was not time to stop and think about ourselves. The unhealthy cycle I had started years before continued and I told myself: I’m fine.

In April 2021, I made one of those promised trips to the cemetery in the middle of nowhere. It was such a quiet, peaceful place, and for the first time in a year, I had a moment to pause. I had a moment to be still, think and sit in silence. As I sat on the bench behind his headstone, my mind began to race. All of those thoughts, emotions and feelings I had suppressed over the last year, and years before, began to build pressure like a dormant volcano about to blow its top. I leaned forward on the bench and braced myself on top of his headstone and burst into tears. I cried harder than I had in a very long time and let so much out over the next hour. I found myself inconsolable for the rest of the day and could not understand why I could not get myself together and get my emotions in check. Still, I fought myself about going and asking for help and told myself: I’m fine.

The following week, I returned to work and called our HR department to obtain contact information for our Employee Assistance Program (EAP). Several weeks would go by before I would overcome myself and pick up the phone. The EAP connected me with a professional who specialized in grief and managing loss. At that time, I thought the two were one in the same and I had no real concept of loss. I scheduled my appointment and had anxiety build over the coming days as the time to meet this person approached. I felt as though I was weak having to seek out help. I was going to have to be vulnerable and open up to a stranger about my feelings and emotions. I thought of the saying we often hear in leadership about how we do not grow inside our comfort zones. Well, I must be in for some significant growth because I am definitely uncomfortable. Uncomfortable as I may be, I’m fine.

As I arrived for my first appointment, the prior patient was walking out as I was walking in. Immediately, I recognized the voice of the patient as a co-worker and dear friend. As she rounded the corner, we were face to face with one another. We were both a little startled and somewhat surprised to see one another. My stomach jumped between my ears and I was so embarrassed for someone I knew, someone I worked with to see me at the counselor’s office. What if she thought I was crazy? Am I crazy? Will she tell anyone she saw me here? What will they think? I was battling a significant and common barrier to seeking out mental health support: stigma. Stigma; it is so strong and so powerful, only if we allow it. Still, I’m fine.

As I started my sessions with Jennifer, my counselor, she pointed out something so incredibly obvious and profound. Take a moment to think back over all of the education we receive in our careers as students. From elementary school to high school, undergraduate through graduate programs, I have learned so many things. We learn about literature and math, science and social studies, government and economics and the agony of statistics (anyone else?). In all of this learning, we are never taught about how to properly address grief and loss for ourselves or others. All right, Jennifer, I am listening.

Over the next several weeks, we explored how I and others commonly approach loss because many of us do not know how to handle it. If someone gets a divorce, we tell the other person they will find someone better or their spouse did not deserve them. If someone has a miscarriage, we might tell them not to feel bad because they can still have children. If someone loses a pet, we might tell them it will be OK because they can get another pet. While well-intentioned, what horrible responses. I have said similar things to people because I did not know what else to say. When I lost Bobby, I had others make these types of comments. He would not want me to be sad. I was still young and I had plenty of time to find love again. He would want me to move on. I knew they were coming from a good place, but they were completely ignoring my feelings and what I was going through. Now, I recognized all the times I did the same thing to another person.

Jennifer had me explore my losses over my lifetime, and I felt like I had, overall, lived a pretty lucky life where I did not suffer many losses. I lost my great-grandmother when I was young, a dog in college and Bobby. This was such a primitive way to explore my own feelings around loss because it is not just about death. Grief can occur with any loss and is not just about death. Loss has tentacles that are far-reaching and run deep, like the roots of a tree. When I lost Bobby, I did not just lose him. I lost the plans we had for our future, the hopes we had for starting a family, the celebrations we would have for successes yet to come, my support person for when things got tough and my very best friend in this world. From each of those levels of loss, there was another, deeper level and a deeper level after that. There were so many levels to so many losses I had never addressed. There were things that had happened in my life I did not even recognize as a loss but were, unbeknownst to me, having an emotional impact on me. The pressure of the pandemic and everything associated with it had pushed the past and the present to a breaking point. Now, I realized, I am not fine.

After each session, I could not help but think about what I had learned and how I might apply some of it in my role as a nursing leader. Loss was all around me. It is still all around me. The obvious is the loss I see as COVID takes another life and shatters another family. My team members no longer feel like they are helping others heal and recover from a variety of conditions as they have now become the last face a COVID patient sees as they transition to the hereafter. New members of our profession have been thrust into the chaos we are all currently living in and do not know what “normal” looks like. My leaders no longer have the comfort of feeling like they have answers and the ability make everything better. Now, they come to work every day trying to hold it all together. The impact of what we are living through has changed everything around us, both in our personal and professional lives.

On this journey to support my own mental health, I have been given a completely new perspective for my team, our patients and their families. The stress and circumstances of our current times can exacerbate so many unhealed moments from our past and make it difficult to deal with those in our present. We are all managing all kinds of loss, some we may not even yet recognize. As a leader, there are so many things I cannot control right now and, at times, I do feel helpless. What do I do? What can I do?

What I have done and what I am doing now is opening up and sharing a little from my own experience in hopes that it will help someone understand they are not alone. Truly, we are all in this together. Asking for help is not a weakness. We are all going through so many things in and outside of our profession, and it is completely healthy to ask for help to manage it all. Mental health is every bit as important as physical health. The next time you ask someone how they are doing and they respond, “I’m fine,” remind them, it is OK not to be fine. Work to recognize the compounding layers and sources of loss and use that to strengthen your empathy toward others. My heart goes out to all of you and I am in this with you. Take care of yourselves and each other.