When an Over-responsible Caregiver Learns a Life Lesson from a 5 Year Old

I have in recent weeks come up against my limits at times of what I can give to others and accomplish in the course of a day, and it hasn’t always been a graceful acceptance of those limits. I have instead resented them, and then learned the harder way to heed them and their inherent God-given wisdom rather than slam myself up against them to see if they will budge (they won’t, not much anyhow).

It can be a double-edged sword, this tremendous pride and meaning we caregivers find in being so good at seeing the needs of others and going to them with openness to help meet those needs. This characteristic is both its own reward and its own potential enemy – precisely because we are so good at it and there is always more need. When I find myself holding too tightly to my caregiver persona to be my personal motivator and satisfier, there always inevitably comes a point where I am hit with my finitude, and either become embittered or humbled by it. Which response I choose will set me on a trajectory one way or another.

Choosing to become embittered may initially make me seem stronger and tougher, but in the long haul my heart only grows empty and hard. Digging my heels into the role when I have in fact hit my limits has only led to resenting others, and ultimately judging myself rather than listening to myself when I feel my own needs emerge. I become more a shell of a caregiver than true substance.

Choosing humility frees my identity from the need to always be (perceived as) the strong one for others. It allows me to value myself in all my strengths and limitations, and gently voice rather than demand what it is I need. It allows me to rest, allows me to receive help, and most importantly allows me to love and receive love based on who we all are, not what we all do or need to do.

My 5 year old daughter showed me in one simple exchange how much I had lost sight of what’s most important in my perspective as a caregiver, and invited me back into the beauty of it.

“Mommy, what is a privilege?”

“Well, it’s something that you are so lucky to be able to do, something not everyone gets to do. It’s different from a responsibility, which is something you have to do.”

“So… a privilege is like how you get to be a Mommy to me and Kayla?”

She stopped me in my tracks and showed me the change of heart that I needed. She wasn’t looking at an incomplete checklist of all my responsibilities. She was looking at our relationship.

“Yes honey. It is a privilege to be a Mommy to you and Kayla. It is a privilege.”



Speaker Spotlight for 6th National Nursing Ethics Conference

I literally could not stop shaking when I received the email invitation to be the closing speaker for the 6th National Nursing Ethics Conference next year at UCLA. It is one of the most powerful and in-depth nursing conferences when we consider some of the core heart issues that nurses wrestle with as we are immersed in a profession that puts us face to face with such intimate suffering in this world.

To close out this conference with a 2019 theme of Vulnerability and Presence is no small task. I hope to do justice to the theme, but more importantly, to the courageous attendees who offer up their own vulnerability and presence in order to regularly care for others.

Leading up to the conference, the planning committee publishes various Speaker Spotlights so that people can hear the speakers’ thoughts about ethics and the importance of vulnerability. Carol Taylor interviewed me in late October, and I am happy to share my Speaker Spotlight here with you. Please consider joining us March 20-22, 2019 at the UCLA Luskin Conference Center.

The theme of this year’s conference is vulnerability and presence.  In what ways does this theme resonate with you?

I have had so many conversations with nurse colleagues, and so many internal dialogues, trying to work through the very raw and legitimate question of “How do I stay in such heartbreaking and heavy work over the long haul without shutting myself down?” As we prepared to be nurses, not many of our educators or preceptors talked about how hard, how challenging, how confusing vulnerability could be. There tends to be a quiet assumption that every nurse simply needs to find her/his own way with vulnerability. The majority of the preparation as a nurse was teaching critical thinking and technical skills – not so much in cultivating the power of presence. Yet I believe every nurse finds him/herself wrestling deeply with the issues of vulnerability and presence, the longer we spend with the sick, suffering and dying.   We have long needed a conference that brings us into rich, open, safe and shared conversations about vulnerability and presence as nurses. We need this for ourselves as much as we need it for our patients and their families.

You’ve been to this conference before.  What would you like to say to nurses who are thinking about  attending for the first time—or deciding about whether or not to return?

This conference is extraordinary to me in the courage and hope with which it tackles some of the deepest internal challenges we face as nurses, as human beings. It gives such intentional space for open acknowledgement and exploration of the issues that we so often do not have time to talk through with colleagues in the midst of such busy work days, but experiences we carry with us all the time. We grieve, hope, and vision together in this conference for the preservation and advancement of the true heart of nursing, and that is a truly sacred experience of community.

You’re a practicing nurse.  What are some of the everyday ethical challenges you encounter and can you describe what helps you stay centered so that you can advocate effectively for patients, families, your colleagues and yourself?

I work in a pediatric intensive care unit, where so many parents understandably hold on to so much hope that modern medicine can keep their critically ill child with them for as long as possible. We see many children placed on life support with debatable quality of life. We see children who are abused and yet family members want “everything done” when they appear to only have a lifetime of suffering or minimal engagement with the world ahead. As I am constantly revisiting what helps me stay centered, a few key factors come to mind: 1.) It serves me better to take more time asking questions of families and colleagues and listening carefully before I allow myself to jump to conclusions about an ethically challenging case. This has often helped me filter out voices of people who do not actually know the real situation, and helped me build greater empathy for those most closely involved in the decision-making.  2.) I am learning the value of the very hard work of communicating my own concerns to patients’ families and to colleagues in ethical dilemmas, rather than staying silent. I try to do this with a constant posture of humility and openness to hear the other perspectives, but it helps me resolve some of my own ethical tension when I give myself permission to speak up in a way that is clear but not antagonistic.  3.) I recognize that I cannot avoid ethical dilemmas or grief if I want to be a nurse, so this is not an expectation I hold of myself or of the profession. I try to pursue love, wisdom, humility and compassion above all as I learn to navigate the gray areas together with all of my amazing colleagues.

All nurses are reporting heavy caseloads and multiple demands on their time, energy and expertise. If we believe that we owe every human we encounter the gift of our compassionate and healing presence, how can we keep ourselves energized and focused?  Do you have secrets to share?

I am growing increasingly convinced that it is through entering into what seems to be the hardest things that we ultimately find ourselves more energized and focused than if we avoided them. Avoiding them simply leaves me feeling muddled and weighed down. If I am honest, I can easily use all my nursing “tasks” as a reason for me to shy away from pulling up a chair next to a grieving or “angry” family member, because the tasks will always be there. Quite frankly, performing the tasks come more naturally than opening myself up to hard conversations, to vulnerability and presence with a stranger. But every time I have chosen to spend even just 5-10 minutes listening closely to a family member, I find myself with such a deeper understanding of why we all are where we are with the patient’s care, and how it seems we ought to proceed. It helps me focus and prioritize my tasks better because I understand better what is important to the patient and family, not just to me.

Please join me for my Closing “Creating Safe Spaces for Vulnerability and Presence” at NNEC 2019.

Questions, please email Janine Mariz Burog at JBurog@mednet.ucla.edu

TED-Ed Lesson for TEDxTalk “How Grief Can Enable Nurses to Endure” is now available!

For all nurse educators, managers, leaders, bookclub facilitators, or bedside nurses looking for a guided way to talk about work-related grief with other nurses:

I have created a new TED-Ed lesson based on my original TEDxTalk, “How Grief Can Enable Nurses to Endure.” It includes some introductory prompts allowing for people to share about their work-related grief experiences as well as their perspectives towards grief. The lesson then provides additional insights and references to other authors who have addressed grief and self-care in less traditional ways. Finally, the lesson concludes with closing discussion prompts to help participants consider how they can begin reframing their perspective towards work-related grief in nursing.

Participants do not currently need a TED-Ed account to participate in the discussion, as my desire is to reduce all barriers for voices to be heard in this conversation.

Please share this lesson with nurses, nurse leaders, managers, administrators and educators. It is my deep conviction that these conversations need to happen for the betterment and well-being of nurses who regularly encounter suffering, death and dying, and all the accompanying emotions.

Click here to access the lesson, and thank you in advance for contributing to this vital conversation!

what denying oneself is not

I’ve been spending a lot of time thinking and processing with certain people about some of my deeper heart issues that have been arising from my counseling sessions and from some of the current life situations I find myself in. Tonight, I feel that some clarity is finally starting to emerge from the vast swarm of thoughts and emotions and issues that I’ve been trying to sort out. And I think, no, I know, that God is doing something deep and profound in healing my heart in ways that I have needed for a long, long time. I think a great deal has to do with unlearning certain things about the denial of self that I used to label as “Christian,” “godly,” or “Biblical.” That is what this post will be about. What denying oneself is not. Hopefully, as I continue to process this under the authority of God’s Word, I can get a better sense in time of what true Biblical denial of self is.

Denying oneself is not being ignorant of one’s inner desires, passions, or preferences in the name of being God-centered or other-centered.  For example, consider the basic and common question of, “Where do you want to go for dinner?”  It is not somehow more godly to say, “Umm…I don’t know…wherever you want is fine” in comparison to “I would love to eat Afghan food right now.” Sometimes I think that we confuse dying to ourselves with losing ourselves and our God-given uniqueness completely. To apply this to a more important scenario beyond choosing a place to eat, I would say this also applies to how one feels about things such as large, loud conferences and ‘cold-contact’ evangelism. It took me so long, and so much deprogramming, to realize that not every godly and mature Christian ought to love and be passionate about those things. I am an introvert. I do enjoy conferences a great deal and have gained invaluable treasures for growth through conferences. But they make me very tired, and there is always a point during the conference where I deeply crave solitude. I don’t want to be in a loud crowd, 24-7. I don’t want to be jumping from session to workshop to small group to workshop to session. At some point, the introvert in me becomes completely saturated and I need to be away from conference activities and people so that I can actually take in on a deep heart level what God wants me to take in from the conference. I am an introvert. I am terrible with chit-chat, small talk, in-your-face conversations, i.e. cold-contact evangelism. I thrive on trusting, established friendships where I can share about my faith and my relationship with God in a way that is much more me. Generally speaking, outside of times when God, (not another person, mind you) has clearly asked me to step beyond my comfort zones in faith, I am doing everyone a disservice by trying to be something other than who God has made me.

Denying oneself is not a self-righteous disregard for healthy boundaries in oneself and in others. Between Mary and Martha, Mary set boundaries for herself by saying no to the chores, the busyness of hosting, the running herself ragged, so that she could say yes to sitting at her beloved Savior’s feet and receiving all that He had to impart to her. Jesus said that between the two sisters, Mary had chosen the better thing. Jesus Himself had boundaries. He moved on from town to town even though there were plenty more crowds clamoring for His attention, His touch, His miracles. He loved them without doubt; after all, He would eventually go to the cross for them. But He also set boundaries with them and said no to many requests from a deeper place of wisdom than most people could understand, much less accept.

Denying oneself is not a lack of self-care. There is something very wrong when we find ourselves saying, “I don’t have time to exercise because I’m involved with this non-profit organization and that church committee and this mothers’ group and that support group.” Denial of self does not necessarily mean that we completely disregard our own selves as persons just because we are so fixated on caring for other people. The apostle Paul asked for a little wine to soothe his stomach while he was in prison. He didn’t say, “Oh, heck, I’m already wasting away in prison. Give that wine to someone else.” I think at some point, I became a bit invisible to myself and I forgot that I too was actually a person who needed care and attention. As a result, I would ignore or invalidate internal red flags trying to warn me when my own spirit was being sorely neglected. Tonight, as I was going on a much-needed long run, I suddenly had a moment when I sensed the Lord just telling me how much I mattered to Him. That all this counseling and the active steps I’ve been taking towards better self-care has not been so much about me becoming overly self-indulgent, but it’s been about Him wanting me to finally understand that HE. LOVES. ME.  He knows me. I matter to Him too, just as much as everyone else that I’m seeking to serve. And He delights in me.

And so I believe this transforms how we then approach what it does mean to deny oneself for the sake of glorifying Christ and loving and serving others. That will require more musing and more time in the Word. And quite possibly a few more tears of both conviction as well as freedom. I am hopeful.