An aerial view of my dream life looks like me taking a deep breath and appreciating the life I have right now. I have a confession. My name is Amanda Limberg and at some point over the past decade, I started glorifying busyness. I am a registered nurse, a mom to four amazing daughters, a military wife, and a nurse practitioner student. The facade of self-worth's correlation to how busy you are was conceived at some point in my 30's. At nearly 40 I have started to reflect on this and realized that being in a hurry all of the time is not what my dream life looks like at all. Watching my daughters swing with their heads thrown back in laughter for five more minutes is absolutely worth missing the mark on bedtime. I have traded my 4.0 GPA for a slightly lower number served with a side of fort building. The idea of just making it through this tough week, this tough semester, or this deployment cycle and then having fun is ludicrous. The truth of the matter is that swinging with your head thrown back, building forts out of every blanket in the linen closet, or whatever the thing is that you are just too busy for is precisely what makes the tough times a lot more manageable. My dream life looks like me perfecting the art of slowing down and appreciating the life that I already have.

"It doesn't cost anything to pay attention!" During my childhood, this was a statement often heard from my father. He was not only wise but also motivated. My father became a parent while he himself was still a teenager. He had a dream to one day become a pilot, but that dream would have to be put on hold in order to put groceries on the table. He worked as a bag boy at the local grocery store. He was a hard worker, and always paid attention to the expectations of people two and three positions above him. His hard work and dedication did not go unnoticed. He was promoted and then promoted again. From 1981-1984 he had worked his way up from bag boy to the assistant store manager. In 1984 he was offered a job with Frito Lay that would allow him to start his days before the sun came up, and then attend flight school in the afternoon. During his flight lessons, he would listen closely to his instructor, hung around the airport in his free time to absorb any available knowledge, and studied hard in his time off. Once he had enough training hours he started paying attention to available flying jobs. He flew skydivers and business day trips continuing to pay attention to different paths to getting a full-time flying job. In 1998, 16 years after he started working towards his goal he accepted a job with a multibillion-dollar corporation flying privately owned jets. He never stopped paying attention to his surroundings, never stopped believing that he could, and showed up every day to work hard. I am proud of all he has accomplished and proud to call him dad.

During my youth, I distinctly remember wishing that our family lived in a nicer house, had a nicer car, and could afford other luxuries that everyone around me seemed to have. I was the product of teenage pregnancy, and my parents worked hard for the things we had. The value of a dollar is something that I was taught to appreciate for as long as I can remember. Hard work, trustworthiness, dependability, and integrity were consistently focused on attributes during my childhood. As an adult, I am so very thankful that I grew up the way I did. Experiences that I once considered hardships shaped me into the individual that I am today. I became an emergency department nurse in 2004. One great thing about the emergency department is that the healthcare team does not know your ability to pay, medical insurance status, or socioeconomic status. Unfortunately, that means that oftentimes patients are prescribed medications and referred to specialists that they can not afford. The environment where I was raised gives me a unique perspective that allows me to recognize these situations and intervene. Recognizing that the eye drops a patient was prescribed cost $800 and notifying the medical provider that the patient has voluntarily disclosed that they do not have health insurance has enabled me to set the patient up for success in following discharge instructions after leaving the facility. Having the provider either change the prescription to an equally effective and more cost-effective option or having the prescriber order the first dose to be given in the emergency department so that the bottle that would otherwise be thrown away can be sent home with the patient does not come as naturally to my colleagues who grew up in better-served communities. The subtle cues of mistrust in the healthcare system can be easily missed by someone who did not grow up around those ideas. The ability to assess and appreciate a patient's cultural beliefs enables the healthcare provider to build a relationship where a realistic and holistic plan of care can be created with the input and agreement of the patient. As I enter my final year of graduate school this fall to become a dual board-certified nurse practitioner, I am excited to continue this practice as the provider instead of the nurse. Looking back on what I aspired for during my youth, I can not help but be thankful for unanswered prayers. True wealth is found in the relationships that we can form because of our experiences in adversity.

“When I was a boy and I would see scary things in the news, my mother would say to me, ‘Look for the helpers. You will always find people who are helping.’ To this day, especially in times of ‘disaster,’ I remember my mother’s words, and I am always comforted by realizing that there are still so many helpers — so many caring people in this world.” – Mr. Rogers, Fred I was 19 years old when the September 11th attacks occurred. I remember watching those search and rescue parties sift through the rubble. I distinctly remember being in nursing school, and though I was not yet a helper, I was training to be one. Years later when concerns of Ebola reaching America arose, I was there, on the front lines training other healthcare professionals in proper personal protective equipment that thankfully we never needed to use in real life. When COVID-19 was first announced, I had been an emergency department nurse for 15 years and my first instinct was to familiarize myself with the transmission of other coronaviruses like severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS) because there was more data available. Using this data, I was able to educate my patients using the evidence-based research that was available at the time. Sitting with a patient and listening to their fears was often the best intervention for their chest pain and shortness of breath. At the beginning of the pandemic when panic was more contagious than the virus, people just wanted to be heard. Returning to a patient’s room for them to ask me to repeat what I had just told them while holding up their smartphone with family members anxiously awaiting an update would sometimes make me have to turn my face to adjust a piece of equipment just so I could secretly blink away my tears. I did a lot of technical things that might make me sound important to a non-medical person during the pandemic, but I honestly believe that the most important thing that I did was communicate with my patients and their loved ones. I did not take away all their fear, though I would like to think I decreased it. I did not cure anything. I just pulled up a chair, held their hand, and listened. I never tell anyone that they are going to be fine, I learned that lesson long ago, but I like to think that my patients know that I will do everything within the realm of possibility to ensure that their mind, body, and spirit will be genuinely cared for while I am their nurse. I am fairly sure that is the stuff Mr. Rogers was talking about.

I am a mom, military wife, foster parent, ER nurse, student, sister, and aunt, but what is the title for someone whose family died by suicide? I will never forget the morning that my father called me to tell me that my amazing, adventurous, gorgeous, and carefree aunt had taken her life. She was the “cool aunt” that let me drive years before I had a driver’s license. She loved to travel, had a good job, and loved her daughter fiercely. There must be some mistake. Obviously, she was murdered. The police must be mistaken. Women never shoot themselves; that is what men do, right? If she were suicidal, we would have known. You cannot do anything in this family without everybody knowing about it. There is no way! Not our family! Not my aunt! Those thoughts, some of which I said out loud, swirled in my brain as hot tears streamed down my face. My father did his best to answer my questions with the information that he had at the time. For the second time in my 13-year long nursing career, I called into work, then I packed a bag, and started the drive from Montgomery, Alabama to Greenville, South Carolina. I spent the next four hours in the car alone. Memories of my aunt rotated through my mind like a poorly organized PowerPoint presentation. I could not believe what was happening. A conversation that I was not supposed to overhear as a child replayed in my mind. My aunt had been sexually assaulted as a child. The assaults were never discussed, and to my knowledge, never addressed with a mental health professional. The following year my husband and I became foster parents. I vowed to honor my aunt by addressing childhood trauma in the children placed in my care. I created a home where there are no secrets. Mental health counseling is no different than going to the dentist. There is no such thing as a forbidden topic. I hope that in doing this, I can prevent the suffering that my aunt endured.