A retired Registered Nurse and lifelong creative writer who is a forever believer in the power of words... and the sharing of the same.
Nurses have a language that is heard by all, including the hearing impaired, because it is a language of compassion, something one feels.
Note: This article was originally published March 4, 2002.
It was an assignment during Nursing 101; the date on the paper was March 17, 1995. The grade I received (A-) was not the best part; it was the inscription the professor wrote at the end. It read "Excellent job! I hope you always show this much compassion to your patients."
That profound statement moved me to become a better nurse. I made it my mission to become a patient advocate; I made it my second promise.
It all started back when I made my first promise, some thirty years before writing the paper; I was eleven years old. Having contracted a rate blood disorder (Idiopathic Thrombocytopenic Purpura, aka ITP), I was suddenly thrust from healthy child to sick, from home to hospital, from privacy to probing, from family to strangers, and I was scared. I had heard that hospitals had a funny smell, and that people who went to hospitals sometimes never came back.
My first night in the children's ward, the little girl across the hall died. I still recall the image of the gurney rolling down the hall with a blanket completely covering a small body, a crying mother overseeing the transport. That mother's first scream did not sound human, and it terrified me.
I was afraid to sleep. I missed my family; I wanted to go home. A nurse came in to comfort me. She told me it was okay to be a scared kid, that it was okay to cry, and I did. I also decided this was not the place I needed to be, that I would get better and go home, be with my friends and go back to school. It was my first experience with mind over matter, positivity and promise over negativity and fear. There were little other choices. I remember that I was too young to die, that there was a boy in my class at school that liked me. I had never been kissed. These were the thoughts of a very scared young girl.
Thank goodness for me, I was not born a follower, or a quitter. While my own parents cried daily and prepared for the worst (I was the second child to come down with ITP in our tightknit military community; the other boy, just sixteen, died shortly after I was discharged from the hospital), I was making deals with God. If spared, I promised to make good use of my life, that helping people and enriching the lives of others would be my primary and focused goal.
That mission started immediately after that promise. I remember venturing out into the hallway of the children's ward, bored to be constantly within the walls of my hospital room, or in the procedure rooms where I would receive multiple diagnostic tests, including two bone marrow extractions, one in the chest and another in the tailbone. I was awake for those procedures, and without anesthesia, and remember how many nurses it took to hold me still on the operating table while I screamed at the top of my lungs. My parents would later tell me that (that) sound horrified them while they sat in the waiting room just down the hall.
One morning, I had heard the constant cry of a baby/toddler and followed that sad sound. When I entered the room from which the cries came, I saw a baby standing up in a crib, holding a toy ukulele, tears streaming from the baby's eyes. I noticed the baby's fingertips were bleeding and ran to tell the nurse. The child, it turns out, was a hemophiliac, and someone had unknowingly given him an inappropriate for his condition. I was praised for my assessment! I was helping others! It was a feeling that helped me get out of my own funk.
Another memory is one where I had entered a wheelchair race, down the pediatric corridors, with a young boy who had been given little chance of recovery; that too may have planted the seed of compassionate nursing in me all those years ago. What I learned as a child in the hospital would help develop my skills as a nurse many years later, and for many years to come in every aspect of my own life.
It was not until I was in my late thirties that I would finally enter college for nursing and face my nursing 101 writing assignment. It was the weekend, and I had rented The Waterdance, a film directed by Neal Jiminez. It is about Jiminez's own experience with a spinal cord injury and his adjustments to five months of life in a rehabilitation center, filmed from the patient's point of view (and from disadvantaged positions). If I did not fully understand the word empathy, I did after watching that film; some just move you to change.
I learned that nothing can supersede a kind word, warm smile, or gentle touch, like those received from nurses. These qualities are most impressionable to those in need, those who have lost a part of themselves to ill health, those forced to seek help from total strangers in a profession diverse with multitudes of barriers. These barriers can be in the form of language, age, disabilities, mental challenges, tradition, religion, or social standards, all of which can alter the communication process, and more importantly, the healing process. The feeling of powerlessness, intrusive or invasive procedures, the invasion of space and privacy, coupled with the loss of one's own control over circumstances pertaining to the "self" is both dehumanizing and devastating, with only one solution... nurses.
Nurses have a language that is spoken everywhere, a language that is heard by all, including the hearing impaired, as it is a language of compassion, a language felt more than it can be seen or heard.
Some of my nursing instructors advised against attachment (to patients) and said nurses should remain objective, that attachment could lead to clouded assessments and burnout. I believed that nursing was about caring, dignity, and grace under pressure. I learned how important subjective assessments were, that what the patient was feeling was always more important than how it might be clinically interpreted. I proved, while a hospice nurse, you could be attached and let go all at the same time if you were truly a professional who understood the role.
I was enthralled with the teachings of the early pioneers of nursing. Still applicable today are Virginia Henderson's words (Excellence in Nursing, 1969); "The complete, mature or excellent nurse, however, is one who remains compassionate and sensitive to patients, who has not only thoroughly mastered nursing technical skills, but who uses (and has the opportunity to use) her emotional and technical responses in a unique design that suits the peculiar need of the person she serves and the situation in which she finds herself (or himself, as male nurses were finally entering what was once a female dominated profession). Compassionate care, without traces of enabling, is just one of the ways in which a nurse must guard against assuming any role other than that of a nurse; to understand who patients are and what is expected of us. Proven is the fact that rarely is competence a factor in the unmet needs of the patient, but rather their perception of insensitivity to their needs, or lack of respect (from caregivers) pertaining to the patient's point of view, or opinion; it is seen by patients as a lack of caring."
A 1993 article by Roberta Messner in the American Journal of Nursing, about what patients really want rings as true today as it did during my research for the paper: "Really listen to me. Ask me what I think. Don't dismiss my concerns. Don't treat me like a disease; treat me like a person. Talk to me, not at me. Respect my privacy. Don't keep me waiting. Don't tell me what to do without telling me how to do it. Keep me informed. Remember who I used to be. Let me know you care."
So it seems that what I learned as a child was what most patients wanted; the added personal touch, a smile, a kind word... simple caring. We commit a grave injustice if we act, even for a moment, as if the physical and mental states of being can be separated in the human body, mind, and spirit.
I would like to think that I modeled myself after experiencing good nursing role models as a child, and years later, as a nurse myself. I never forgot what I learned. Today, as a nurse educator (now retired), I empower others to learn more to perform better. And I trust that the deal I made with my maker remains a valid verbal contract to this day.
Wear A Mask... a retired nurse's plea.
Please help all those who are putting their lives on the line to help those afflicted with COVID-19 and other contagious diseases by protecting yourself and others by wearing a mask. When you get sick and need a doctor or nurse, you're going to wish you had, and that this pandemic did not cause a shortage of the same. We have lost healthcare providers and there has been a shortage of new professionals entering the field for decades now, unable to keep up with the demand.
When I was a nurse, the greatest danger was a needlestick injury (hence contracting a disease from an infected patient), or an attack by a psychiatric patient while providing care, but now the danger is airborne. These professionals are selfless. We wouldn't send our troops to the frontline without ammunition, right? The only ammunition healthcare providers have is PPE, so do your duty, read, research, and listen to those renowned in medicine and science, all data/fact driven, not conspiracy driven. When did frivolous gossip replace truth? Save a life today. Could you live with knowing you were the reason somebody else got sick and died, whether you knew them or not?