Authors

  1. Smith, Nikki Racquel DNP, APRN, FNP-BC, CNE

Abstract

A nurse and mother learns to be present, not perfect.

 

Article Content

Inever thought it could happen to me. I was an active-duty lieutenant colonel. I had managed departments with hundreds of employees and million-dollar budgets, made strategic decisions, been deployed to Iraq, seen combat, and treated patients in mass casualty situations. So how did I end up in a partial-hospitalization intensive outpatient program, diagnosed with moderate depression and anxiety with suicidal ideation? I had an amazing husband, three handsome boys, and a career doing what I loved. I was financially stable, with a supportive family and close friends. But there I was, sitting in group therapy sessions, thinking, "Surely I don't need to be here; there are other people worse off than me."

  
Figure. Illustration... - Click to enlarge in new windowFigure. Illustration by Janet Hamlin.

I hadn't gotten to this point overnight-there had been a cascade of events that I somehow ignored the effects of, until one October night I cried out for help. I woke up around 2 AM and asked my husband, "Would you be okay if I was no longer here? Would you be able to take care of our boys?"

 

He studied me. "What do you mean?" he asked. "Are you okay? What is this about?"

 

"I don't know," I said. But I did know that something was seriously wrong. In the back of my mind, I'd begun preparing for the worst. I had updated my living will, made sure beneficiaries had been named on my insurance policies. I did not have a plan, but there were increasingly intrusive thoughts. I saw myself committing suicide by different means, in vivid detail-the kinds of thoughts that I was too scared to mention to anyone.

 

I knew something was very wrong, and telling my husband was a first cry for help. He offered to take me to the hospital right away, but I refused.

 

"What would people think?" I said. "I'm a provider; I'm in a leadership position there. I know so many people. I cannot go to the hospital. I cannot go to the emergency room."

 

But something had to give. And how, I wondered, could I help my patients if I was a mess? I promised my husband that I would go in the morning, and at 6:30 AM, I called the behavioral health clinic. An hour later, I was at the clinic in my civilian clothes, not my military uniform, and soon after I was speaking to a therapist.

 

From that point on, I decided to be honest when I filled out the behavioral health screenings. I soon found that despite medication and bimonthly therapy sessions, I was continuing to have suicidal thoughts and was feeling engulfed by depression. I knew I needed more help, but I did not want to be away from my husband and boys. I agreed to attend an intensive outpatient program, opting for a civilian treatment program instead of one at the military clinic where I worked because I wanted a place where I could openly discuss my feelings without fear of judgment.

 

Over the course of the next three months, I felt the depression lifting as I dealt with life. I began to realize that I had never allowed myself to grieve the multiple losses of loved ones and other unexpected traumatic events that had occurred in recent years. I'd suddenly lost my father in 2018 while I was 38 weeks pregnant and didn't have a chance to say goodbye or attend his funeral. Two years later, at the beginning of the pandemic, I delivered my son at 32 weeks because of a placental abruption, and he stayed 12 days in the NICU. I lost my maternal grandfather 10 weeks later, followed by my father-in-law and paternal grandfather dying three months later within days of each other. And then there was the constant stress of working through the pandemic.

 

As part of my therapeutic process, I started to talk about the deaths of those that I loved, process them, and grieve. I finally had the chance to breathe, focus on me and my family, and face the emotions I had suppressed all those years. I told my therapist, "I can't put on this facade anymore." I was always the strong one, the one with the answers, the one people came to for advice and it was hard for me to be me. I had to stop pretending everything felt okay.

 

It forced me to take off the mask of toughness and resilience I'd been wearing all these years and really question who I was and who I wanted to be. I realized that it is okay to seek help. I can be a provider, mother, wife, friend, mentor, and all those things I desire without compromising my sanity. By seeking mental health, I finally gave myself permission to take care of myself and find my purpose. I had to learn to be present, not perfect.