Nursing

If you ask any wide-eyed, green, wet-behind-the-ears nursing student why they want to be a nurse, she will likely get a dreamy look on her face and immediately say something like she "Just wants to help people!"  Help ease suffering; heal the broken; bind-up the wounded; Encourage the down-trodden.  Educate the ignorant. We all essentially wanted to save the world while wearing comfortable scrubs and sensible shoes. 


I remember saying those same words.  Having that same vision; that burning mission....that sense of higher purpose.  I remember getting misty thinking about all the good I could do in the world.  All the hands I could hold.....all the love I could share.   Florence Nightingale in shining, crisp white. 


And then the reality of nursing hit me full force.  The understaffing.  The never having enough help and never feeling quite sure you are doing the right thing, but not having time to second guess either.  The IV sticks you didn't get on the first try.  The moment when you first realized that the world of nursing was more about hanging IV's, passing meds, and charting for hours than it is about offering comfort or healing anything.   It was about being able to assess a situation quickly and take action, almost on automatic pilot, listening to your developing sense of "nurse intuition" .....and it was about getting it right.  Because you don't get a second chance when a life hangs in the balance.


It was not glamorous to change bed linens for the third time on your 12 hour shift because your patient has diarrhea.  Again.    It's not glamorous to clean vomit off your shoes.  It is not glamorous to fish a pair of dentures out of a full emesis basin.  It is not glamorous to administer enemas, insert Foley catheters, shave private parts, shove an NG tube down someone's nose while they fight and curse at you so you can administer charcoal to absorb the poison they swallowed in a failed attempt to kill themselves.  It is not glamorous to come in to work when it is dark and leave 12-14 hours later when it is still dark......only to come back to work in 10 hours and do it all over again.   It is not glamorous to suction secretions from someone's tracheotomy or to change adult diapers full of adult poop.  It's not glamorous to take out the trash, to empty the Foley bags, to see maggots in a wound when you change the dressing on an amputated stump, or wade through ankle-deep trash in the hoarder-house of your home-care patient.


None of these images are what you think of when you think of nursing.  It's certainly not what I had in mind when I applied for nursing school.  There have been hours of the drudgery of paperwork, hours of cleaning up all sorts of bodily fluids, hours of gritting your teeth and taking the verbal abuse of patients and family members who just don't appreciate your time and effort.  And there have been moments of sheer and total terror.  Moments when your patient is talking to you and then slumps over at the bedside and becomes nonresponsive.  Times when you pull the cord to call the code and the adrenaline kicks in and your training takes over because you are too shaken to think straight.  There are moments when you teach and teach and teach your heart out.....and they still don't get it.  There are veins that roll or blow and just disappear and are impossible to stick. 


There are times when you have to leave one patient who is dying of cancer to go see another patient who is struggling for each breath due to emphysema and then leave that patient to see a patient who is facing amputation of a second leg and then you leave that patient to see another patient struggling with another catastrophic disease.  And you catch glimpses.......glimpses of yourself in their suffering.  Glimpses of your possible future.  Glimpses of your family members.  Glimpses of life choices that led to ruin.  Glimpses of suffering.  Glimpses of pain.  And sometimes, glimpses of hope. 


I've been present for countless baby deliveries.  And I cried at every. single. one of them.   (Yes, nurses cry....we usually try to hide it, but we do).   The miracle of a new life....the hope! The possibilities!  The newness!  The first face-to-face meeting of the baby and mother and the overwhelming sense of love at first sight! 


I've also been present at deaths.   I've worked Hospice when my job was to go to the home and try to offer comfort measures to ease the transition and make the death pronouncement.  Sometimes, I was there when the patient passed and sometimes I got there after the fact. My job was to bathe and prepare the bodies.....and to comfort the family and loved ones.


I have held the frail, thin-skinned, vein-lined hands of so many precious elderly patients.....offering a smile, a prayer if indicated, a few words of encouragement and care.   I make it a point to look into their eyes....eyes often dimmed by time and disease.....but eyes that have seen a life-time and really lived.....and I have seen so much there. 


I started off by saying that nurses want to "take care of people".....but somewhere along the way, we really gain so much more than we give.  We learn, feel, see, and hear such diverse slices of the human experience from day to day......and I've come to realize that this is a gift that few other professions allow. 


I work mostly as an administrative nurse now....not as much hands-on care these days.  I supervise the nurses who do.....I try to mentor and teach them what it means to really care.  And I try to make a difference for them.   I still interact with the patients, but mostly on the phone....intervening when there is a problem or a need or when I need to assist them in arranging their care.  I still go out and see patients from time to time.  I never want to lose that part of my profession.  It still thrills my heart to hold a hand and look into someone's eyes and know I've done something to help them. 


I got a message this morning from one of my former co-workers that one of my long-term home care patients - a man that I cared for regularly over a 3-4 year period......had passed away.   My initial reaction was shock and then sadness......but it was quickly followed by the knowledge that it was a relief for him.  The 3-4 years I'd known him were riddled with hospitalizations for exacerbations of his disease processes that caused him great pain and caused him great suffering.  He always had a smile for me though....he called me his "Manda-Baby" and would ask for me by that name when he called our office.  When he knew I was scheduled to come see him, he would turn off his oxygen, light up some incense and spray air-freshener so that he could pretend that he hadn't just smoked before I got there.  He wasn't fooling anybody.  Nothing smells as guilty as cigarette-smoke and patchouli-scented incense....but it was a game we played.  He knew that I knew that he knew that I knew......but he didn't want another lecture about how smoking was bad for him.  He made his choices and he chose to continue smoking, even though it was very slowly killing him.   He was gruff and rough around the edges and had lived a hard life.  He didn't have much, but once, when he went to the farmer's market and bought himself some fresh corn, that sweet man saved an ear of corn just for me.  That ear of corn meant the world to me....it meant that I had made a difference in his life....enough that he would think of me and want to share something with me...even an ear of corn. 


I had moved away from the town where he lives.  I moved to another state and took another job and hadn't seen him in more than 7-8 months......but this morning, the news of his death still broke my heart.  And I cried.   That's what it's like to be a nurse.  At least it is for me.....It's giving and giving and giving......but getting so much more in return.  It might be a lot messier than I bargained for....and a lot less glamorous and a lot more tedious at times......but it's always worth it.  I'm still proud to be a nurse.