“A is for airway. Set up the suction.”

“Off to the patient, open to air…”

“I am doing this because…”

“Aware of the suffering caused by… I vow to…”

“In gratitude we offer this incense”

“Present moment, beautiful moment”

When I first started in Pediatric Intensive Care, my preceptor, Claudia, used to preface each action by saying out loud, “I am doing this because…” 

     This  not only helped the parents of our patients by providing them an explanation for the things that were happening in a room and helping to ease their fears, it also provided a self check for each of the actions that we were taking. I learned to say, “I am doing this because…” and, if I couldn’t fill in the “because”, I would reevaluate either my medication or whatever other action I was planning.

    The pattern of this statement, “ I am doing this because…”, is similar to the form of the mindfulness trainings that we recite in Buddhism. The pattern goes, “Aware of the suffering caused by… I am committed to…”. (the-5-mindfulness-trainings)[1]

  Recognizing and feeling how my action arises from awareness has helped me be more focused when performing tasks at work. It has also helped me be more aware of the skillfulness of the words that I am reciting when I am leading a meditation.     

     “In gratitude we offer this incense…May it be fragrant as earth herself. Reflecting careful efforts, whole hearted awareness, and the fruit of understanding slowly ripening.” (https://appliedbuddhism.org/en/studies/sutras/52-incense-offering).

      This is a piece of an incense offering  which we use in Buddhist rituals and in meditation practice.  I often recite all or part of this when I am performing tasks at work. 

     Saying this while I am doing something as simple as changing a diaper, or as complex as titrating an IV drip, helps bring my full attention to the moment, and realize that each of these actions can be an incense offering. 

    When I say “In gratitude”, I can feel it begin to generate a slight feeling of gratitude where before I might have felt only angry or sad or appalled. 

     It is not uncommon at all for me to say “I hate my life !!” In frustration during a hard day.

Just saying “In gratitude I offer this incense.” begins to generate a feeling of gratitude to sit beside my feeling of frustration or despair. When I remember to do this, it makes a difference to how I feel in the moment and how I feel at the end of a shift looking back. There also the added benefit that when things go well, saying “In gratitude I offer this incense…” helps me to pause a little and savor this happiness and not just take it for granted.

About the author

     I graduated from nursing school in 1984. I had been inspired to become a nurse while reading an article about the catholic workers community and clinic in Los Angeles. I left nursing after a few years. A large part of that was my inability to deal with stress. The other was the opportunity to  return to work on my families ranch and farm. It still feels strange to me to realize that the nurturing inherent in the culture of ranching actually led me to be attracted to nursing, but that is another story.

   When I returned to nursing about ten years later to work in a program for teenage children who had been born with fetal alcohol syndrome. 

     I soon found myself facing the same feelings of despair and anxiety that I had encountered before. I had begun attending a meditation group with a friend and was reading a book titled For a Future to be Possible where I encountered the following passage: 

“With just one drop of the water of compassion from the branch of the willow, spring returns to the dry earth.” 

When I read this line from a poem quoted by Thich Nhat Hanh, I could feel how tired I felt and how much I needed the “water of compassion” for myself. It was this desire that led me to meditation and mindfulness practice, and it’s effectiveness has led me to incorporate it into my daily life both in and outside of the intensive care unit.

[1] See also the Three Jewels and Five Mindfulness Trainings, adapted for Health Care Professionals, by Dr. Dzung Vo: https://keltymentalhealth.ca/blog/2023/03/ancient-wisdom-modern-health-care-professionals-three-jewels