Happy New You!

January 1, 2015

I thank God that He made me a new creation when I received Jesus Christ as my personal Savior in 1971 (See Life Changing Letter).

Therefore, if any man be in Christ, he is a new creation; old things are passed away; behold, all things are become new.

II Corinthians 5:17

It is exciting to grow to know my dear Savior and best friend every day, and to continually learn about Him through all eternity as He reveals the riches of His grace to me!

And hath raised us up together, and made us sit together in heavenly places in Christ Jesus; That in the ages to come He might show the exceeding riches of His grace in His kindness toward us through Christ Jesus. Ephesians 2:6-7

The moment I received Jesus Christ as my Savior, I was seated positionally with Christ in heaven so now I can look DOWN from my heavenly position in Him. When I’m having a rough day at work and remember this, it helps me step back and get the big picture from God’s viewpoint in heaven. Then my little corner of the world doesn’t seem so big.

The other day, I was reading in Matthew 17:1-8 about the transfiguration of Jesus when they went up into “a high mountain”. This was likely Mount Hermon, which at 9232 feet is the highest mountain in Israel. It was spectacular when I saw it in 2013!

Mt. Hermon, the highest mountain in Israel at 9232 feet

Mt. Hermon, the highest mountain in Israel at 9232 feet

Matthew records that after Christ was transfigured before Peter, James, and John, they saw Him talking with Moses and Elijah. Perhaps Peter, James, and John were able to identify Moses and Elijah because Christ called them by their name.  How amazing that they were all having sweet fellowship even though they lived here on earth in different millennia! When the Father spoke and said, “This is my beloved Son, in whom I am well pleased; hear ye Him,” (verse 5) the three disciples were terrified and fell on their face! But Jesus tenderly touched them and said, “Arise, and be not afraid.” Then they lifted up their eyes and saw “JESUS ONLY.” Even though we will know other believers in heaven, all the focus will be on Jesus Christ, with no fear and perfect fellowship while we  worship and serve Him for all eternity! How gracious of God to give us this little “peek” into eternity to encourage us in the here and now. My tiny finite mind certainly has trouble comprehending “forever”.

In order to grow in His grace and keep me looking unto Jesus, I wanted to share a few things that God has given me in past years and presently that have helped me. For personal Bible study tools, I have been richly blessed at this web site: http://www.middletownbiblechurch.org  They have a wealth of free Bible studies. The 100 page study for New Believers is especially helpful which covers major Bible doctrines. Presently, I’m going through these notes again, but this time in Spanish to try and improve my language skills.

I also discovered Through the Bible (http://www.ttb.org/ ) with Dr. J. Vernon McGee who is now home with the Lord. They recorded all his sermons as he taught verse by verse through the entire Bible. I downloaded the app on my phone and tablet so I can listen to it while I’m driving or doing chores around the house!  These messages have been translated into 100+ languages so they are available worldwide. If you go to the archives, and then daily programs, you can choose to listen to whatever book of the Bible in the order you desire.

I also like http://www.prophecytoday.com/ with Dr. Jimmy DeYoung. During his Saturday 90 minute radio broadcast, he interviews various experts in Israel, Europe, and the USA and examines current world events in light of Bible prophecies. You can listen later to this broadcast at any time that is convenient for you. His daily devotionals, which he will email to you free, are also excellent as he writes about all the Bible prophecies.

A few of my favorite biographies and Bible study tools.

A few of my favorite biographies and Bible study tools.

I’ve also decided to start rereading the classic missionary biographies which were such a blessing to me as a new believer. Even though I’ve read them several times before, I always gain something more from them because I’m at a different stage in life than the last time I read them. I was delighted to find that they are now available on Kindle, and some of them are even free! So here is my list of favorite biographies: Isobel Kuhn-missionary to China, Hudson Taylor- founded the China Inland Mission, J. O. Fraser – missionary to China, Amy Carmichael – founded an orphanage in India, George Mueller – founded orphanages in England, Mary Slessor – missionary to Africa, Gladys Aylward – missionary to China, Zvi – a Polish boy who survived the Holocaust and then emigrated to Israel.

Exercise!

Exercise!

To help my physical body, my sister recently told me about Mary Ann Wilson, RN who has developed an excellent chair exercise program. In some parts of the USA, her TV program is broadcast on PBS which is  called “Sit and Be Fit.” http://www.sitandbefit.org/ I found her on You Tube and felt fabulous after I did some of her exercises! She has a series for office workers that is broken down into 5 minute segments that you can do at your desk. As you have probably discovered if you have a computer/desk job, this position is not kind to your body! She also has special exercise routines for those with arthritis, diabetes, osteoporosis, prevention of DVT in airplanes, and vestibular exercises to improve balance. As we all age, balance decreases and the risk of dangerous falls increases. So you may want to tell your older patients about this resource and try out the exercises yourself!

Eat Healthy Foods!

Eat Healthy Foods!

I also recently read in the Nutrition Action Health Letter about the healthiest vegetables, fruits, and grains. They gave each a score for their nutrients and fiber content. So here are the top 5 in each category:

Vegetables: Kale (1392), Spinach (968), Collard greens (737), Swiss chard (717), Turnip greens (714)

Fruits: Guava (575), Watermelon (314), Kiwi (201), Papaya (189), Grapefruit (141)

Grains: Quinoa (73), Amaranth (66), Buckwheat (64), Bulgur (60), Barley (59)

So Happy New You! Please feel free to share your favorite Christian biographies with me at pamela.aprn@gmail.com

For my new readers, you may enjoy reading my post last year where I tell about working as a dialysis nurse on a cruise ship over the New Year holiday. Oh, how my stomach rolled! 😦

Babe of Bethlehem

“Now when Jesus was born in Bethlehem of Judea in the days of Herod, the king, behold, there came wise men from the east to Jerusalem, Saying, Where is He that is born King of the Jews? For we have seen His star in the east, and are come to worship Him.” Matthew:2:1-2

Bethlehem, Israel – March, 2013

25,000 people now reside in Bethlehem, Israel

25,000 people now reside in Bethlehem, Israel

Our tour group boarded our bus outside our hotel in Jerusalem and traveled 20 minutes to the city of Bethlehem which now has 25,000 residents. We drove past the huge cement wall built between Palestinian controlled Bethlehem and Jerusalem to prevent the Arab snipers from shooting them. At the checkpoint, the security guard waved us through after our driver told him we were American tourists. Our day to visit Bethlehem changed since President Obama was scheduled to visit here in three days. We parked in an underground garage and walked several blocks uphill to the Church of the Nativity, the traditional site where Jesus Christ was born in a cave. We passed Muslim women dressed head to toe in black, brown, or gray burkas.

Church of the Nativity

Church of the Nativity

Construction began in 326 A.D. on this oldest church in the Holy Land which is still in use. It is separated into three different sanctuaries of the Franciscan Catholics, Greek Orthodox, and Armenian Orthodox.

"Mouse hole" entrance to Church of the Nativity!

The tiny entrance to the Church of the Nativity prevented intruders!

We entered through a four foot high door with a foot high wall at the bottom. Our guide told us they built it this short purposely as a deterrent to any enemies! When an enemy entered all bent over, he couldn’t shoot anyone, but the person inside could knock him over or kill him easily.

Then we wandered from one sanctuary to the other. It was quite interesting to compare the different architectural styles, the Armenian one being the most ornate. We waited in line about 20 minutes to see the glass covered hole in the floor that is supposed to be the actual birthplace of Christ.

Traditional birthplace of Christ.

Traditional birthplace of Christ.

Our Hebrew Christian guide, told us that in 1948 when the State of Israel began, Bethlehem had all Christian residents, but now there are only about 40 families remaining. The Muslims won’t hire them, so all the Christian young people are leaving.

We went to a gift shop that an Arab Christian started to support these remaining families. The believers carve nativity scenes out of olive wood which are very intricate. I treasure the one I purchased that portrays Mary and Joseph gazing at the Christ child in the cave. I also learned the typical manger was made of stone, unlike the wooden mangers usually portrayed in America.

My olive wood nativity scene carved by Christians in Bethlehem.

My olive wood nativity scene carved by Christians in Bethlehem.

Reflection – December, 2014

As I recall my days in Labor and Delivery helping those babies into the world on Christmas morning in 1981, I couldn’t help but wonder if anyone assisted Mary during her labor other than Joseph? It simply states in Luke 2:7  And she brought forth her first-born Son, and wrapped Him in swaddling clothes, and laid Him in a manger. This is what the midwife or nurse would typically do who assisted the mother.  Midwives are mentioned in Exodus 1:15-22 who feared God and preserved the Hebrew male babies from Pharaoh’s wrath. “Therefore God dealt well with the midwives; and the people multiplied, and became very mighty.” I do not think God gave any details about Mary’s labor or delivery because He wanted all the emphasis upon Jesus Christ, the Savior of the world.

Shepherds of Bethlehem.

Shepherds of Bethlehem.

The common shepherds were the first ones who learned of the Savior’s birth and came to worship Him, their Creator, who “took upon Him the form of a servant, and was made in the likeness of men; And, being found in fashion as a man, He humbled Himself and became obedient unto death, even the death of the cross.” Philippians 2:7-8. Emmanuel, God with us, who left heaven above, and came to earth to be my Savior. Born to die. Thank You, Lord Jesus, that You love me so much!

Charles Wesley captured this thought beautifully in the fourth verse of “Hark, the Herald Angels Sing”.

Mild He lays His glory by, Born that man no more may die,

Born to raise the sons of earth, Born to give them second birth.

Hark, the herald angels sing, Glory to the newborn King!

I pray you all may have a Christ centered celebration of the birth of our dear Savior!

Christmas Babies!

December 25, 1981 – 2 a.m. Labor & Delivery Staff Nurse

I finished my night shift orientation in September and am feeling much more comfortable in my skills as I don’t have to think so hard about every little thing! Since it is my first Christmas in Labor & Delivery, I am required to work and they designated me as charge nurse since the Assistant Nurse Manager is off tonight.

I glanced at the large white board in the nurse’s station which listed all the patients by name, stage of labor, and doctor. We still had six women in labor with four empty labor rooms. We had already done four deliveries since I was called in early at 9:30 p.m. to help the busy evening shift. I glanced at the fetal monitors which displayed each baby’s heart rate. All of a sudden, I saw one baby’s heart rate go dangerously low to 50 and stay there. The normal full-term baby’s heart rate was 120-160 beats per minute. Cathy, another nurse, stuck her head out the door of the woman’s room and yelled, “Call the doctor and nurse anesthetist, Pam! We have to do a stat C section (surgery). This baby is in trouble!”

The operating room technician, Teresa, ran to the prepared operating room (OR) while I called the two doctors. The nursing assistant helped Cathy wheel the huge bed down the hall to the O.R. Cathy had the mother lie on her left side to try and take the pressure of the baby’s body off her mother’s blood vessels.

Newborn Baby!

Newborn Baby!

We worked quickly. As soon as the anesthesiologist nodded that the mother was asleep, the resident doctor cut her abdomen and lifted the baby out of her womb. He  cut the cord that was wrapped tightly around the baby girl’s neck, and carried her to the warmer. Her own cord had choked her as she came down the birth canal. The baby girl let out a weak whimper.  I suctioned out her mouth and placed the oxygen mask over her small face. I dried her off quickly and she took several gasps of air! I silently prayed, “Dear Lord, Please touch this baby girl’s body that she may live.”  She let out a louder cry and the delivery room staff exhaled a sigh of relief. Her tiny body began to turn pink. The Neonatal ICU nurse wheeled the baby girl down the hallway to keep a close eye on her until she stabilized.

I returned to my other patient, Marie, and checked her progress internally. She was ready to start pushing the baby out. She was totally exhausted after 16 hours of painful labor. After an hour of pushing, I saw a patch of the baby’s black hair peak out! We wheeled Marie in her bed down the hall to the delivery room, helped her transfer to the narrow delivery bed, placed her heels in the steel stirrups, and her hands on the steel handles. I had her husband, John, sit on a stool beside her.

She gave several more pushes, but wasn’t making much progress. Dr. D. instructed, “Pam, give fundal pressure during the next contraction to help her out.”  I looked at Marie over my mask and warned, ” I’m afraid this is going to hurt you.” As I felt her large abdomen harden, I reached across her, grabbed the steel handle with both my hands, and pressed my forearm into her belly with all my strength. She screamed and I felt like screaming as my back went into a muscle spasm. At last the baby’s head popped out and his slippery body slid into Dr. D’s hands.

“Congratulations, Marie and John! You have a nice big healthy boy!” announced Dr. D. I pulled the string on the Apgar clock and wrote down the time — 3:03 a.m. Christmas morning.  Dr. D.  quickly suctioned the mucus out of the baby’s mouth with the blue rubber bulb syringe, and the baby let out a loud strong cry. Dr D placed two clamps on the umbilical cord and laid him on Marie’s abdomen so she could see him. “John, would you like to cut your son’s cord?” “Sure!” grinned John as he took the sterile scissors in his hand and snipped the cord.

Dr. D. carried the baby to the warmer and the Apgar timer buzzed at one minute. I gave him a score of 8 out of 10 which was excellent! His trunk, hands, and feet were still tinged blue. I suctioned the mucus out of his mouth again, wiped off his body with the soft, warm, cotton blanket and put a little hat on his head to keep him warm. The 5 minute Apgar time buzzed and I scored him 9 out of 10. His body was now pink, but his hands and feet were still slightly blue. I wrapped him tightly in another clean warm blanket and greeted him, “Merry Christmas, Timothy! Welcome to the world!” John watched his new son with amazement.

A woman, when she is in travail, hath sorrow, because her hour is come; but as soon as she is delivered of the child, she remembereth no more the anguish, for joy that a man is born into the world. John 16:21

I carried Timothy over to Marie and placed him in her arms. All the fatigue vanished from her face as she gazed at him tenderly and kissed his forehead. After Dr. D. delivered her placenta and stitched her up, I put a warm blanket on her and wheeled mother and son to the recovery room.

The remaining hours flew by as we did two more Caesarian surgeries and two more normal deliveries. Eight babies were born that  Christmas night shift! I sat down twice for ten minutes during my ten hour shift. I was so happy to see the day shift staff walk into the nurse’s station at 7 a.m.! We gave them report, went to the locker room to change out of our blue scrubs into our street clothes, and walked wearily out the door into the bitterly cold Christmas morning sunshine.Christmas morning

Reflection – 2014

My severe back pain continued, and I was diagnosed with two injured back muscles. My doctor ordered me to take a month leave of absence while I went to physical therapy to heal and strengthen my muscles. He said I was in poor shape physically and needed to exercise regularly if I wanted to continue to work in labor and delivery. So I joined the local indoor pool and began swimming four times a week. I happily discovered that swimming was also a great stress reliever and helped me sleep better!

The babies that were born that early morning will celebrate their 33rd birthday this Christmas and likely have children of their own by now. I wonder what kind of choices they have made in life? They share the same birthday that we celebrate the birth of Jesus Christ, King of Kings and Lord of Lords. I pray that each has chosen to receive Him as his/her personal Savior.

“For unto you is born this day in the city of David a Savior, who is Christ the Lord. And this shall be a sign unto you: Ye shall find the babe wrapped in swaddling clothes, lying in a manger.” Luke 2:11-12

All About Babies!

Labor & Delivery Nurse – Midwest USA, August, 1981

I have begun my orientation in Labor and Delivery which is 6 weeks on day shift and 2 weeks on night shift. This 1000 bed private hospital in the suburbs of the city seems much more professional and more advanced than the inner city hospital where I worked the past 4 years. I have had many individual classes taught by the various nurses, watched videos, and read medical journals and books about normal labor and delivery, high risk deliveries, and emergencies. They alternate classes with having me work with a different nurse preceptor weekly. Each nurse has a different teaching style and level of experience, so it has been a very thorough orientation for which I am thankful.

Some days, it is a bit overwhelming trying to absorb and remember all this new information. Every day I pray and ask God to teach me and give me wisdom in every situation. God has been encouraging me through these Bible verses:

“Not that we are sufficient of ourselves to think anything as of ourselves, but out sufficiency is of God.” 2 Corinthians 3:5

“I can do ALL things through Christ, who stengthens me. Philippians 4:13

“For the Lord gives wisdom.” Proverbs 2:6

I now understand why they never hire new graduates to work in labor and delivery. My background in medical-surgical nursing is certainly helpful when making split second decisions. Probably the biggest adjustment is taking care of two people at once (mother and baby) but only being able to see one of them until the baby is born.

fetal monitor2

External Monitoring of Baby’s Heart and Uterine Contractions

I passed my course in learning to read fetal monitor strips. I assess my assigned mother every 15 minutes and write my initials and all medications I give her on the paper of the fetal monitor strip. Each baby’s heart rate and the uterine contraction is transmitted electronically to the bank of 10 monitors at the nurse’s station. One of the technicians is assigned to sit and watch the monitors at all times. If they notice a baby in trouble, they immediately notify the assigned nurse. They rotate the techs during the shift since it is difficult to concentrate on the screens for more than an hour.

I am learning so many new skills such as applying the internal fetal monitor lead to the baby’s skull, and inserting the intrauterine catheter that measures the strength of the contractions. The internal exams are the most difficult to learn where I assess the stage of labor. With 2 fingers I feel how far the cervix is open (dilated), how thin it is (effaced), how far the baby’s head has descended. I check the mother first and then the experienced nurse rechecks to see if I’m correct. We go out in the hallway and I tell my preceptor my findings and she tells me hers so I can see if I’m correct. We only ask experienced mothers who don’t seem to mind double exams to help teach a new nurse like me.

After my assessment, I go out to the nurse’s station and write the findings on the 8 foot by 10 foot white board with an erasable marker. Beside each mother’s name is her doctor’s name, nurse’s name, her age, number of pregnancies she has had, time, and exam results. This way anyone can glance at the board and see how many patients we have in labor and what stage they are in. We all constantly help each other and are in and out of many mother’s rooms each shift. We all dread the days when all 10 rooms are filled! That means the next woman in labor has to go in the hallway on a stretcher. Thankfully, that doesn’t happen often! The most deliveries they have had in 24 hours in 28! They have 4000 births here annually.

I have learned how to circulate in a Caesarian section surgery, vaginal delivery, do Apgar scores of the baby at 1 minute and 5 minutes of birth, give pitocin to make the uterus contract harder, give intravenous pain medications, treat preeclampsia when the mother’s blood pressure goes dangerously high, and treat premature labor. I have not participated in an emergency C-section yet…

I have also worked in the recovery room where the mother stays for one hour after delivery. In the birthing rooms, the mother labors, delivers, and recovers all in the same room so I really get to practice all my new skills there. Every evening when I go home, I am so exhausted from so much new information! But next week I get to go back on night shift for the final two weeks of orientation. I think it will be fine once I become more sure of my assessment skills and get in a routine so I don’t have to think so hard about every little thing. Nothing is automatic yet like it was in  medical-surgical nursing. It’s rather unsettling to go from an expert level in diabetes back to a novice nurse in labor and delivery. But I know over time I will become comfortable in this setting like I did in diabetes and medical-surgical nursing.

Reflection – 2014

Over the years, the Lord has allowed me to work in a variety of areas of nursing. Sometimes I have had an excellent orientation and other times it has been “sink or swim” which is extremely stressful. My transition into labor and delivery was very thorough, but still stressful. It is always difficult to go from the expert level back to the novice level when you switch areas. That is probably one reason the labor and delivery nurses seldom left once they found their niche in nursing. Plus, most of them seemed to really enjoy it as did I. But it was probably the most physically demanding nursing I have ever done as I will describe in future posts. It took a huge toll on my body and health.

On the other hand, one of the joys of nursing is having the option of switching specialty areas for those who become easily bored like me!