Tag Archives: injections

Of Flicking Bubbles and Wrangling Babies

12 Oct

Jesus asks for childlike abandonment to the providence of our heavenly Father who takes care of his children’s smallest needs (CCC).

One of the hardest things to teach beginning nursing students is how to get rid of syringe bubbles. It’s an important part of learning to give shots – but not for the reasons you’d think.

Student nurses are like most folks in assuming that those renegade bubbles are really, really dangerous. “What if one gets into a vein or something,” they ask, eyebrows raised. “An air bubble can stop the heart, right?”

Wrong. It would take a whole lot more air than a tiny bubble’s worth to do that kind of damage – probably it would take a big syringe full. Our blood already carries a whole bunbuble-syringe-out2ch of dissolved gas – oxygen, for one thing, and CO2 for another – so a bit of air in a shot, even if it made its way directly into your blood vessels, would be absorbed pretty quickly and you’d breathe it out.

The more pressing concern with syringe bubbles is dosage accuracy. If a patient is supposed to get 20 units of insulin, for example, and a bubble displaces what would’ve been 2 of those units, then the patient actually ends up getting 10% less than he needs. In the case of some brittle diabetics, that could be a big deal indeed.

So, to preserve dosage accuracy means getting out those tenacious bubbles, and that entails flicking – no doubt you’ve seen nurses do it many times. With a fingernail or a pen, she’ll flick, flick, flick away at her syringe until the bubbles rise to the top and can be pushed out. After that, she can finish drawing up the correct dose of the medication without fear that extra air will mess things up.

Flicking bubbles effectively, however, is a tricky skill because it requires holding the syringe in such a way that it shakes a bit in the nurse’s hand. This takes some finesse, a light touch, and lots of practice: The nurse has to maintain enough control to prevent the syringe from flying across the room with the first determined flick, and she simultaneously has to allow movement to create adequate agitation within the syringe barrel. Without that gentle turbulence, the bubbles will cling to the sides of the barrel like barnacles, and the nurse will be flicking away until the proverbial cows come home.

New nursing students grasp the importance of eliminating syringe bubbles, and they take to the flicking with relish. What they don’t take to as readily is the idea of holding the syringe in such a way that it can move a smidgen with each tap. Instead, novice shot-givers have a tendency to clench their syringes – no doubt out of a healthy respect for family-in-church-202x300the sharp needles that are often attached – and so frustration abounds when the bubbles won’t budge, despite vigorous, even aggressive, flicking. Eventually, though, the students catch on, and they will all go on to develop great agility in holding while allowing movement.

This is precisely the same skill all parents learn when it comes to holding babies, especially in church – something I was reminded of recently when I had the privilege of holding my squirmy godson at Mass. Even though it’s been a number of years since I had to manage my own infant children in a pew, I think I did pretty well – like riding a bike, it’s a knack that comes back to you pretty quick. I held Dominic lightly, at one point encircling him under his arms but not embracing him, and then later placing him on my lap, but not actually holding him. Instead, I kept my arms out and about his frame, holding up my watch’s flex band for him to play with, and always on the alert in case he suddenly flung himself in one direction or another.

If you’re in church, and you have a fidgety kid, holding him tightly and restricting his movement too narrowly will only lead to squalls and maximum disturbance – in other words, papoose holds have no place in the pew. Instead, the key is to allow movement and activity, but within a limited range. You supervise the young’un, keeping him safe, preventing his fall or escape, but giving him as much freedom as possible to explore and manipulate his environment as you attempt to pay attention to Father’s homily or the canon of the Mass.

Perhaps, in time, after years of this kind of loose supervision, the child will, of his own accord, attend to what the parent seems intent on – namely, God. Until then, patience is a must, along with an unconditional surrender to distracted worship. Children for the most part will eventually follow the cues of the grownups in their lives, and they’ll be still when their parents are still; they’ll contemplate what dad is contemplating; they’ll attend to what mom is attending. But it’ll be the kids themselves who chonicolaesmaes_christblessingthechildrenose to be still and contemplate and attend – not because they have to, but because they want to.

It’s basically the template for all parenting, right? The delicate balance of healthy limits and true freedom is as elusive as it is essential, and even though it’s incredibly difficult to peg, we have to constantly recalibrate our parenting approach in order to achieve it as nearly and as often as possible.

In this, God the Father, not surprisingly, is our model and our only hope, for it’s exactly how he treats us as his own children. Yesterday at Mass, we heard St. Paul express it this way to the Galatians:

Before faith came, we were held in custody under law…. But now that faith has come, we are no longer under a disciplinarian. For through faith you are all children of God in Christ Jesus.

Like any good dad, he grants us plenty of freedom, but not without his constant superintendence and influence. By walking this divine tightrope, he somehow manages to give us the time and breathing room we need to choose what he would otherwise choose for us anyway. “God is the sovereign master of his plan,” the Catechism teaches us. “But to carry it out he also makes use of his creatures’ co-operation.”

Think of it: The Creator of the universe bestows on us – bestows on me of all people! – the audacious privilege of cooperating with him in running the world. It’s wild and seemingly foolhardy, but there’s method in his apparent madness. Again, the Catechism:

This use is not a sign of weakness, but rather a token of almighty God’s greatness and goodness. For God grants his creatures not only their existence, but also the dignity of acting on their own, of being causes and principles for each other.

It’s a dignity rooted in freedom, not compulsion. He nudges instead of regimenting, and the bubbles of our wounded and weak souls rise to the surface and dissipate. He gives us leeway to rebel, to make mistakes and learn from them, which allows us the time and space to adopt his divine will of our own accord.angel__guardian-basilica_window_detail_

It’s all gift, all grace – the light touch of the Father. Providence is another word for it, and we see it at work all the time in our lives: “Chance” meetings that lead to serendipitous relationships, even marriage; “coincidences” that alter the course of our careers, our fortunes, our lives; “accidental” events that clearly couldn’t have been accidents.

Ah, and he’s clever how he goes about it – very cagey and subtle – but we have the inside line on one aspect of his modus operandi: angels.

Just last week, we celebrated the feast of the Guardian Angels – the Church’s universal acknowledgement that God is intimately, quietly involved in our puny lives day to day, hour by hour, even minute by minute – remember your bedtime prayers?

Angel of God, my guardian dear,
To whom God’s love commits me here,
Ever this day, be at my side,
To light and guard, to rule and guide.

The guardian angels are God flicking at our bubbles; they’re God encircling us with his divine superintendence without smothering us. We grew up relying on God’s providence because we grew up believing in our guardian angels – talking with them, arguing with them, laughing with them.

Keep believing, and pass it on.

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A version of this essay appeared on Catholic Exchange.

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Of Giving Shots and Making God

21 Sep

“Do not neglect the gift you have.”
~ St. Paul

Our skills lab for nursing fundamentals starts at 7:00 a.m., and so students frequently have trouble staying awake during our tedious PowerPoints and videos. We try to keep them engaged – regaling the students with hilarious anecdotes from our own years as staff nurses, for example – but there’s only so much you can do to make things like bed baths and body mechanics interesting.

nursing-practice-shots-nurse-oceancity'10-275Nobody sleeps on injections day however. Eyes are open wide; attention is rapt. “This is important,” their demeanor suggests. “We’re learning to give shots.”

They’re right – it is important. Of course, we think that everything we teach our beginning nursing students is important, yet there’s no denying that shots are different. Not only does it involve the administration of potent medications – important enough in itself – giving shots also involves jabbing strangers with sharp objects.

The surprising thing, however, is that the teaching part isn’t all that difficult – in fact, it’s actually a lot of fun. Each new detail is like a revelation to the students, and we nursing instructors get a kick out of seeing their reactions. We put syringes and needles in their hands – wonder of wonders! The students watch us demonstrate proper technique by administering injections to manikins – fascinating!

And then the moment comes they’ve all been waiting for: Stabbing a needle into a vial of fluid, drawing up a mock dose of medication into a syringe, and giving that first shot – into an injection pad, granted, but still an honest-to-goodness shot!

It’s all very Montessori-esque and kinesthetic, as the learning unfolds manually, hands on, and not solely by way of abstract whys and wherefores. After the students’ initial lab experience, they will practice – lots of practice, on the manikins and injection pads, and maybe oranges and hot dogs – and they will make the skill their own. Eventually, each student will provide a return demonstration (on a manikin), and only those students who perform the skill safely will be permitted to attempt a real injection on a real patient.

Frankly, that’s when the true challenge comes for the nursing instructor. Teaching shots in the lab is one thing; coaching students to give actual shots to people they’ve just met is quite another.

We’re teaching injections right now at my school of nursing, so all this stuff was in the back of mind when I was at Mass the other day and our assistant pastor reminded us that he’d only been ordained for a year. Thus, a little more than a year ago, Father would’ve still been in the seminary chapel, practicing the Eucharistic Canon as a transitional deacon, and anticipating his first real Mass on ordination day. It got me thinking: What an exciting and strange thing it must be to teach men to say MassDoubt-427x276. What an exalted privilege. And lots of fun to boot – probably one of the best parts of teaching future priests.

Sure, seminaries have to instruct men how to preach and teach, how to counsel and collaborate, and how to run a parish – the Code of Canon Law demands as much, and it’s what you’d expect. But lay people and deacons receive formation in such matters as well, and they often carry out those duties as a part of their ministries. What sets priestly formation apart, among other things, are those dimensions that are specifically geared to the “sacred power (sacra potestas)” conferred at ordination – which, for the priest, includes especially the power to confect the Eucharist. The power, that is, to make God.

For that’s what the word “confect” means – to put something together. In the case of the Mass, it’s the priest putting together bread and wine, along with his spoken words and intention, and, voila!, there’s God himself on the altar! It’s a miracle every time, regardless of how routine it might become for us – or even for the priest. And that’s where I was thinking the parallels between teaching nurses and teaching priests are particularly noteworthy.

I mean, I was already picking up on a correlation in the instruction arenaboth groups of educators guiding their respective students in the mechanics of future privileged duties, and delighting in their charges’ anticipation of the day they themselves would be able to fulfill those duties. Moreover, there are additional similarities with regards to the interior preparation naturally accompanying such practical instruction – instilling in our students the attitudes and dispositions that will facilitate a lifetime of service to the people entrusted to their care.

Finally, there’s also a parallel with regards to the day – for the nursing student, the first real shot; the priest, the first real Mass. No more pretending in the lab or seminary; no more dry runs and rehearsals. This is it – the time has come. The new priests will surely have rattled nerves considering what they’re about to undertake. Do seminary instructors have to coach their students at that point like I do mine? Urging them to project a confidence they don’t possess yet, relying instead on our confidence in them?

But that’s about it with regards to the analogies, I’m afraid, for there’s no comparing the actual tasks at hand. Giving a shot correctly and well – even the first time – is imperative for the recipient and the student nurse alike, and for obvious reasons. But saying Mass? Calling down the host of heaven, and traversing millennia 22bprhoadespopeJPII478to drag into the present Calvary’s awful paradox; holding up created matter, and commanding it to become the Creator himself – this is what the priest does, even that very first time he stumbles and falters his way through the Eucharistic Prayer.

And he’ll be doing it again and again, probably daily, and for the rest of his life. I know nurses can lose touch with the passion for care and service that drove them to nursing school in the first place, and we have to actively guard against that. Do priests have to do the same? Can they forget, in other words, their first love?

Pope John Paul II thought so, which is evident in his apostolic exhortation on priestly formation, Pastores Dabo Vobis. “Live the mystery that has been placed in your hands,” St. John Paul wrote, calling to mind the charge given priests in the Rite of Ordination, “when the offerings of the holy people for the eucharistic sacrifice are placed in his hands.” That mystery is the Lord Jesus himself, of course, who is the source and summit of the Christian life, and whom the priest is directed to enflesh in a particular and irreplaceable way through his life and ministry. The Pope continued:

For this to be so, there is need for great vigilance and lively awareness. Once again, the Rite of Ordination introduces these words with this recommendation: “Beware of what you will be doing.”

“Beware,” the Rite warns – these are dire matters indeed.

Please join me in praying for our priests. We all require the medicine God provides us through their hands; they, in turn, deserve our unflagging support and gratitude.

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A version of this story appeared on Catholic Exchange.

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