Changing Faces

nsgbksIn fall semester junior year, I changed my major at University of Maryland College Park from French- with a minor in Spanish—to nursing.  A roommate’s Anatomy & Physiology class taught by Sigmund Grollman, author of the required textbook, intrigued me.

The leap from studying a language that infiltrated my dreams to the complexities of medicine, pharmacology, microbiology, organic chemistry, psychology and nursing was huge. The abrupt change added a year to a four year curriculum. (Thank you, Mom and Dad).  Graduating with a BSN in ‘75, I continued employment at John’s Hopkins Hospital.  Here, I’d worked a nursing assistant on Brady III urology, named after Diamond Jim Brady, who endowed to The Hopkins after treatment for prostate disease. The ward was attended by a stellar group of physicians.  Equally stellar nurses, under the direction of a loving yet formidable charge nurse, stood to give doctors their seats, wore school nursing caps, white uniforms, white stockings and no-nonsense nursing shoes.
From N.G. (new grad) to R.N. after passing the boards, I was accepted as a nurse.  At times, nursing was a comfortable role; at others, there seemed a “disconnect” from classroom to hospital. Perhaps this was merely growth, yet we’d followed a new theoretical curriculum of biopsychosocial nursing. Our systems were intuitive, nutritive, affiliative, associative, eliminative, restorative (and a couple more) –as opposed to cardiovascular, respiratory, neurological, gastrointestinal, musculoskeletal, renal, psychiatric. It took time to mesh theory and practice. Some said we could “sympathize and empathize, but we couldn’t catheterize.”  Ultimately, I sensed a positive, holistic effect from my nursing education.

Over the years, patients have been addressed as “clients,” “Mr. X,” “Room 2413” and “the patient.” The label has changed in cycles for accuracy, privacy and dignity.
Nursing supervisors have been leaders, some old school, some new school, some characters, iconic, inspirational and dynamic, and some (rarely) abysmal.
The multidisciplinary team is interdependent on nursing staff, social workers, respiratory, speech, physical and occupational therapists, pharmacy, dieticians, clerical support, clergy, attending and a myriad of specialty physicians-to name a few.
Within nursing there is a bond and persona that prevails in and out of the work environment.  You are a cinch to pick out in a crowd, wherever you may be.
Nurses have a multitude of positions: staff nurse, nurse manager, wound care and infectious disease specialist, case manager, educator, hospice, home health or ambulatory care liason, and administrative roles-to name a very few.
Nurses have an unshakable reverence for the patient and their nursing license.
These forty years of medical-surgical nursing, CCU/ ICU, ED, PACU, pre-op, home health, field, workers’ compensation and hospital nurse case management have been a journey.

At each step, I’ve witnessed the best and worst of human behavior in the face of illness and loss, been generously and often unwittingly educated by my peers and my patients, and am forever impacted by a lifetime of patient and family interactions.
*In pathophysiology class, the professor lectured us on drug psychoses; as my sweet British female patient on a Pronestyl drip threatened to make “grunties” in bed, an alarm went off in my head, I understood and took action.
*When my comatose patient with underlying mushroom toxicity bolted up in bed, I was all ears for his stories of the tunnel and the light and St. Peter.
*In the Student Union, we quizzed each other on the origin, insertion, and action of muscles on flashcards; years later, I gaged the effect of traumatic injury on the young man in front of me in rehab.
*When the patient in bed 2 in ICU became pale, diaphoretic, converted to a bradyarrhythmia with complaint of nausea and chest pain, I scurried to support him, adjust his oxygenation, administer IV medications, run a 12 lead EKG, draw enzymes and ABGs; simultaneously, my comprehension of the underlying physiology became quite clear.
*In microbiology lab, we swabbed our own or classmate’s bodies to see what cultured; in my recumbent patient the vancomycin-resistant enterococcus raged.
*In the emergency department, all walks and stages of life jolt one’s consciousness:  victims of stroke and heart attack, acute respiratory infection, drowning, seizures and “pseudoseizures”, intoxication and overdose, child abuse, trauma, motor vehicle accidents, burns, foreign bodies and accidental injury. The presentations are as diverse and unforgettable as human beings.
*In the classroom we were educated to disease processes; in the hospital, the devastation of lack of disease management, poor choices and noncompliance stuns the patient, family and staff.

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Certain events and interactions in this life’s work have instilled convictions and irreverence, responses to the unpredictable individual patient experience.  I am permanently ALOC.  Nursing demands commitment and it’s changed me, my family and interpersonal relationships.  I’ve been a recipient of so many intangible gifts of nursing. I hope that my efforts have been meaningful, generating understanding, relief and hope.  I regret nothing.
As I change faces and embrace retirement from nursing, I say simply:

*Patients are forever in need of compassion, humanity and capable care.
*Hats off to today’s nurses. You are exceptional in an ever-evolving role with boundless expectations.
*We best serve the patient as a team.
*The passion we bring to each day makes a world of difference.

“Be Well” is my mantra.

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