Thoughts on being a nurse after 20 years.

I’ll tell you the truth; I haven’t always liked my profession.  I quit college to get married in the ‘80s, and then I had a child soon thereafter. If I hadn’t made those choices at such a young age, I probably would have ended up doing something else. But in my early 20’s, I found myself divorced with a toddler. I had so little imagination, I thought I was looking forward to a life of either blue-collar work or poverty. I had three choices…go on welfare and become a statistic, find a back-breaking factory job that would pay the bills (which would have eventually been outsourced anyway), or take some classes at the local community college that would help me give my son a middle-class (ie. “better”) life.  I couldn’t picture myself doing either #1 or #2, so I went to nursing school.

In the early days, I defined myself by what I did for a living. I was young and I thought that “ER nurse” was the coolest answer I could give to the question, “what do you do?”  I collected initials behind my name and prided myself on being the fastest, smartest, most efficient and skillful ER nurse that I could be. When tragedy struck, such as the drowning of two little boys, brothers, in an unsupervised pool with an unlocked gate, or when the sole survivor in a car crash that claimed the lives of seven people was a four-year-old girl asking, “Where’s my mommy and daddy?”, I distanced myself emotionally from the human aspect of the job. I believe that to cry would show weakness, and furthermore, if I let these things bother me, how could I function? Besides, I was more focused on living the life of a young, cute, self-destructive ER nurse, just like on TV. Partying with my ER buddies on my nights off, chasing cute guys, making up for all the fun I thought I had missed out on because I married young.  I thought any young woman would love to have my life, because it was anything but boring. But I didn’t know who I was or what I was doing.

After just a few years, I found my life in ruins. (Another blog post for another time). My father had just died too, the person that I most wanted to make proud.  I left nursing for a little while, and a shift happened (again, another blog post, or several, for another time). I returned to nursing, but I never returned to the ER.  I was not the same young woman. I was beginning to know myself, and hitting rock bottom had humbled me enough that I had a new empathy for my fellow human being. I came back with a renewed sense of purpose. I wanted to make a difference.

Since then, there have been times that I’ve wanted to leave the profession. Sometimes “doing my job” involves carrying out orders that I know are not in the best interests of my patient, even though they are perfectly acceptable from the perspective of medical practice standards. In these times, I have felt like I am just a cog in the wheel of the big, bad machine. That is not what I want to be. I want to make a difference, remember?  At other times, I connect with a patient on such a deep level that I feel that fate must have put me there in that place, at that time. These are the times when I have felt that I have a gift to bring to my patients.

When I am titrating the Pitocin, interpreting the fetal monitor strip, or handing the doctor an amnihook, I am not doing anything special for my patient.  In fact, sometimes I do those things against my better judgment because it is my job.  If I weren’t doing those things, some other nurse would be there doing them. It’s the things I do that aren’t really in my job description that I feel are my greatest contributions to the nursing profession.

tired nurse

I am currently on a travel assignment, and I’ve been having a hard time with homesickness and questioning my motivation for doing this assignment, as well as whether I want to keep nursing at the bedside when it’s over. Last week, I had a patient that really touched me and gave me a reason to keep going.  My interaction with her was the catalyst for this blog post. She was (is) an immigrant from one of the lesser-known African nations, having come to the United States sixteen years ago to escape the misogynistic control of the society there. She came to the U.S. at the age of 23, met a nice man, got married, became a Jehovah’s Witness, and eventually had a son, who is now four years old.

Because of her spirituality, she refused blood products and an MRI to rule out the suspected placental accreta, which earned her the unofficial label of “difficult patient.”  Due to these and other risk factors, she had undergone a cesarean despite the fact that her baby had died in utero. She had nicknamed her baby Jack-Jack, and his loss was devastating, especially since her age (nearly 40) and her medical issues made having another baby nearly an impossibility.

Her husband left her in the evening to go home and care for their young son, leaving her alone. It was one of those uncommon nights where I actually had some free time, which was good because she called me into her room and told me she needed me to sit with her. She said she needed a woman to talk to. I’m glad she was specific. I’m good at meeting my patients’ physical needs, but I’m not always good at reading the emotional needs of a person that I just met, despite how hard I try.  I ended up spending a total of about four hours sitting and talking with her that night.

She talked about her faith. She told me the story of having been raped by an uncle in Africa and becoming pregnant at the age of 14.  Despite the trauma, she wanted to keep her baby. Her family took her to the doctor for what they told her was prenatal care, and they gave her something they told her was a vitamin.  It was a sedative, and when she woke up, she had undergone an abortion against her will.

She told me about the traumatic birth of her other son four years ago, here at this very hospital, and the extended hospital stay afterward, and how because of it and her experience in Africa, she held a lot of mistrust and bitterness toward the health care system. She told me how the doctors, residents, and nurses at her first hospital stay treated her like she was stupid and wouldn’t listen to her spiritual and physical concerns. She told me that she hadn’t believed them this time when they told her that her baby was dead, that she had demanded a second opinion, and that she had been rude and hard to deal with.

We talked about Jack-Jack’s soul. She said she knew that the baby she knew that moved and kicked in her belly was still alive somewhere, but not here. Still, she wanted to say goodbye to his little body one last time, even though she had held it for hours that afternoon when it was still warm. She said she knew it was irrational, but would I please go get him for her?

I went down to the specimen refrigerator, where the body was awaiting transport to the morgue, and retrieved her baby’s cold, refrigerated body. I unwrapped it from the plastic bag that contained it, and redressed it in baby boy clothes and a handmade blanket. I placed Jack-Jack’s body in a bassinet and brought it back to her. We both cried.

What I did was probably against the rules. I don’t really know. And it certainly wasn’t in my job description. Any nurse would have assessed her incision and given her pain medication, but not every nurse would have given her the emotional support she needed that night. Not because I’m a special nurse, but because I just happened to have the time that night, and we just happened to connect on a deeper level. We connected not just as patient and nurse that night, but as women, and as mothers.

She thanked me for the “girl talk”, as she called it. She thanked me for bringing her baby’s body back to her. She thanked me for helping her get through the first night without him. But most importantly, she thanked me for restoring her faith and trust in the medical profession. Despite all that, I’m sure  she helped me more than I helped her.

I’m not the same lost, overachieving young nurse that I was twenty years ago.  I have heard it said, as the healer heals others, she also heals herself.  I don’t know about being a healer, but I’m certain that those patients whose lives I’ve touched the most profoundly have played the biggest part in my own soul healing.  There are times when I’m so busy taking care of everyone else’s needs that I don’t take care of myself, but I’ve learned to cut myself some slack. Nursing is a hard job, and I’m sure I’m not the only nurse who has ever questioned my career choice.  We are at times overworked, underappreciated, and stretched thin. There is something to be said for accepting and even appreciating the consequences of the choices you have made. That is what I want for my fellow nurses. Despite the challenges, I want you to see the potential you have for touching people’s lives, cut yourself some slack, break down the walls that you think are protecting you from being hurt, and be human. And I want you to love yourself for it.

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