True story. I wish I could intelligently describe to anyone what it is exactly I do at work. I just can not just yet. I call it the confidence of the ignorant. Part of what I do, (I think), is I read medical records and listen and look and investigate and read between the lines as to what exactly is wrong with the patient and then I try to interpret that into ICD 9 coding language, (which BTW, apparently, physicians don't understand, much less me), and then ask questions of the physician to see if I can help them translate symptoms into diagnostic code. There are many barriers to this process. First, physicians chart in symptoms. Always have and probably always will. Second, to a nurse, this makes complete and utter sense. I see the symptom and in my head I can connect that to a diagnosis. And so to me the medical record makes perfect sense. But not in the coding world. So I am a translator of sorts. And I don't as of yet speak the language fluently.
Take today for instance. Doctors are getting younger and younger. Most residents can not remember a day when cell phones, Apple, google, the Internet did not exist. When they chart it looks as if they are tweeting. They use acronyms I have never seen. So yesterday, when I read on a chart, patient currently in ALF, I thought what is that? So I googled it. ALF can (and the operative word here is can), mean acute liver failure. Now, not only did the patient not have physical symptoms of liver failure, not only was that NOT why they were in the hospital in the first place, they didn't meet diagnostic criteria either. Fortunately, for me and you, diagnosing is outside my scope of practice. The Board of Nursing does not give me permission to diagnosis. However, part of my job is translating and I really did need to know if that was a current working diagnosis on the patient. I don't know what exactly told me to wait and see. It certainly wasn't my very, very limited working knowledge on liver failure. And it certainly wasn't my my stellar competence at my job. I think it was the voice of God. And I mean that in all sincerity. So, today, when I read the chart, guess what it said? (And I am so grateful I didn't call a doctor out of the OR to clarify ALF.) Patient currently resides in ALF, commonly known as assisted living facility. One word changed that whole chart. I can only imagine how I would have explained to a busy physician why I desperately needed to know the patient's living arrangements. I guess I could have said I was putting my Christmas card list together and just wanted to share the love.
That little story will probably only strike you as humorous if you happen to work in health care. But I am sure we all could tell tales of I am so embarrassed I might die. And I am so grateful that I have been a nurse long enough and have enough grey and white hair and have made enough errors and had my pride wounded enough that I can finally laugh at myself. There was a time when I couldn't have. There was a time when I never would have shared that story. It is good to age.
"Getting old is part of getting past whatever illusion we have about ourselves. It is part of getting free." -Rich Mullins
I know I am not quite over "myself" yet. I hope I am not so naive as to think that people have not spotted some conceit, arrogance or false pride in me. I know it is there and that I am not humble enough to squelch it or even clever enough to hide it. A person can overcome it though, through prayer and service. But no amount of praying or fasting or serving will ever hold a candle to aging. It is the beauty of living. If we live long enough, we get old.
I was awful at being young. As a teenager I carried around complexes, had crushes that thankfully never flourished, (although at the time I thought I needed them), and I wrote really bad poetry. I still write bad poetry. Age hasn't helped that. My twenties were turbulent and ended very quietly. Finally at thirty, I no longer had to be "young and foolish"- I wasn't old yet, but I wasn't young either. And God who is always good through whatever age had graced me with joy, peace and even prosperity.
I think I wasted my youth by being too eccentric and far too concerned about what others thought. And pride consumed a great deal of my young and middle adulthood. And thankfully, "God being good still, is doing what He has always done best and what I will never be able to do, and that is to undo what I have done".
I think I am just beginning to realize as I age gratefully into the end of middle adulthood, that God lets us all struggle and succeed. It is true we all don't struggle and succeed the same, be everyone does both to some degree. And when we have done enough to create a false sense of pride and security, God allows us to age. We do things slower and are less driven. I still can embarrass myself, but I won't die from it and finally realize I am far more likely to die from natural causes or disease. And finally, I am beginning to see the wisdom in aging- we begin to become free of self-doubt, illusions about ourselves, irrational thoughts, false security, misguided perceptions, displaced love. And as we grow older, we begin to see exactly how free we are. We grow free. Free to finally love as we are meant to love. Free to really laugh. And most of all free to forgive. So, let me grow old.
All is grace and growing old is a grace,
Kathleen
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