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The root cause of the nursing “shortage” is hospital greed

An essay in the Opinion Today section of the New York Times stated that the real cause of the nursing shortage is hospital greed.

It’s a bleed (nursing shortage) that began many years ago. The root cause? Hospital greed. It is the result of decades of mismanagement in a money—driven hospital system that prioritizes profit over patient safety. Far from a shortage, there’s never been more licensed nurses in America—they’re not being hired.

King, Lucy. “The Root Cause of the Nursing Crisis isn’t Covid.” The New York Times, 19 Jan. 2021.

My last post discussed the various obstacles that led to nurse burnout, which eventually caused nurses to leave the profession. I overlooked hospital greed. Paying more attention to the bottom line, many hospitals limit adequate nurse staffing.

California passed AB 394 in 1999 that established minimum registered nurse-to-patient ratios for hospitals. The final regulations were implemented on January 1, 2004. The law has improved patient care, lowered mortality, and improved nurse retention.

While no other state has passed a nurse-patient-ratio law, two Congresspersons, Jan Schakowsky (D-IL) and Sherrod Brown (D-OH), are introducing a new bill on the national level: Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act.

This bill will improve the health of patients by improving nursing care—establishing minimum registered nurse-to-patient ratios in hospitals, providing whistleblower protections to nurses who advocate on behalf of their patients, and investing in training and career development to retain hardworking nurses in the workforce. The pandemic has only magnified the need to support nurses in their work.

What excites me is that rather than states working on individual bills, this bill will direct behavioral change in all USA hospitals. I’ll be keeping an eye on its progression and giving support to its passage whenever I can. I hope you do, too.

Watch this powerful video that shows how insufficient hospital staffing undermines safe nursing practice.

We Know the Real Cause of the Crisis in Our Hospitals. It’s Greed.

click here to view 6 minute video

Nurses would like to set the record straight on the hospital staffing crisis. Video By Lucy King and Jonah M. Kesse

What does 2022 hold for Nursing?

The nursing profession has been riding a roller coaster these past two years as we lived with the pandemic.

In the beginning:

  • The World Health Organization designated 2020 the Year of the Nurse and Midwife spotlighting the profession internationally
  • Nurses were applauded by New Yorkers who stood on their balconies or hung out the windows of their high-rise apartments every evening at 7 pm to show appreciation for the care nurses gave the growing numbers of COVID patients
  • News coverage centered on the plight of the bedside nurse dealing with daily death and inadequate supplies along with the chronic nursing shortage
  • Stories surfaced in the media not only about nurses but written by nurses
  • Nurses were getting the attention they had long lacked and their contribution to the health of our population was being recognized

When the 7 pm applause from New York City residents faded, nurses still held the attention of the public into 2021. Media coverage showing nurses treating their acutely ill patients led many to seek nursing degrees.

It’s really quite reassuring, and one of the silver linings of this pandemic, that we have a new generation truly inspired to enter health care for altruistic reasons, (Dr. Neha Vapiwala) ‘Silver lining’ of 2020: Medical and nursing schools see increase in applicants, Today, December 22, 2020.

However, nursing schools continue to lack qualified instructors. Faculty is aging without replacements and classes are reduced. While there is an increase in applicants, many are turned away.

Last year, enrollment in baccalaureate and higher-level nursing degree programs increased, but colleges and universities (not including community college nursing programs) still turned away more than 80,000 qualified applicants due to shortages of faculty, clinical sites and other resources, according to the American Association of Colleges of Nursing. Yuki Noguchi, The US needs more nurses, but nursing schools don’t have enough slots. NPR Health, Inc., October 25, 2021.

We continue to see nurses leave the profession due to burnout, a persistent problem exacerbated by challenging working conditions. The industry standard of 12-hour work schedules may be more efficient for the hospitals than the nurses.

What we found was that any time after 12 hours, the medical errors that nurses were involved in started to escalate dramatically. And the reason that this was important is we found in our study that most nurses that were scheduled to work 12 hours really were there 13 or 14 hours. Linda Aiken, Conditions that are causing burnout among nurses were a problem before the pandemic, NPR, January 7, 2022.

 An additional problem for nurses is that they are pulled away from the bedside to do non-nursing tasks, such as patient status documentation. Sandy Summers, The Truth About Nursing, has suggested that nurses need secretaries or assistants to do this burdensome chore. To this, I can only add Amen.

Going forward into 2022 I am cautiously optimistic, given that the pandemic has demonstrated that nursing does make a positive difference in the health care of individuals and communities, we will begin to see corrections to the problems stated above.

I hope I’m right.

Art in My Life: Unfinished

As a child, I drew as I sat in the floral upholstered chair in front of our old 14-inch TV in the living room while I watched comedy shows like a popular sitcom, I married Joan.

I was encouraged by my freshman art teacher in high school to continue drawing. She told me to make sure to sign up for the art committee for the school yearbook. I did neither. 

I did draw several pictures for my Catholic nursing school yearbook: the Blessed Mother Mary, a student nurse holding rosary beads in one hand and a diploma in the other, and a caduceus.

When I went back in school to get my baccalaureate degree in nursing, I took two extracurricular courses: appreciation of art and clay molding. My clay dog was stolen in class as it was “drying out.”  While I admired the thief’s good taste in art, I never did another clay animal. 

When my two children were babies, I drew their sleeping faces. I kept notebooks filled with sketches as they grew. I took my first painting class—in oils. The class was held in a high school my children would both attend in a few years. We had a substitute. He was mostly silent except when we asked for help. Maybe he figured he would let our talent bloom rather than be stymied by instruction. I never went to the last class. I schlepped the 20 by 16 oil portrait of a nobleman though all our moves. His picture was from the cover of a magazine called American Artist, November 1965. I liked it. But I never finished it. 

Oils at that time proved too messy. I took a long hiatus while I worked full time as a nurse. Some time in my forties, when we lived in the DC area, I attended classes sponsored by the Smithsonian Institute. The instructors were impressive and talented. I was not. 

Soon after I retired, I took art classes at a Senior Center. The instructor played classical music while we students followed along by copying what he was painting. From his classes, I brought home partially completed canvases, mostly seascapes. I couldn’t keep up with the instructor, a former street artist in New Orleans, who put out ocean scenes with sea oats and seagulls gliding across blue skies. The hordes of passing tourists gobbled up his finished canvases. I had been planning to finish mine for years. But how many seascapes did I need? 

I have one good picture. It’s of apples. It took me a year to finish. The teacher, a man in his 80s, circulated among the students, individually giving instructions, or more often, sat beside us, took our brushes, and painted on our canvases while he told stories of his life in Budapest during WW II. Most times, I took the picture home with me and painted over his work. If he noticed, he never said anything. However, we all loved him. During class, as I waited for him to get around to me, I socialized among my fellow students. I took his classes for a year until he died. I didn’t finish another painting other than the apple painting, but I did make a lot of friends. 

I’ve never had a room of my own to paint in until five years ago when we moved to a town house. Now I have an office with a table on which I can leave a mess of art paraphernalia. My closet is filled with half-finished canvases, and blocks of various papers along with tubes of watercolor and acrylic paints plus pastels and charcoal, colored pencils, ink pens, many brushes, one standing and two table-top easels, and a portfolio carrier. I could give art lessons to a class of Kindergartners for a school year and still send them home with supplies over the summer break.   

I sit in my office finishing this essay. Outside my window, our neighbor’s crape myrtle wears its autumn coat of burnt orange leaves and brown berries. The bright sun makes diamonds of the leaves as they toss in the wind.

I decide that I’ll assemble my abundant painting supplies and capture the sight. This time I’ll complete the picture. 

Olden Days of Nursing: Navy Nurse

When I came across Navy Nurse: Memoir of a WWII Veteran, on Google, I said to myself: yes, finally a book about the olden days of nursing by a nurse who lived through the times. Helen Barry Siragusa was 98 when the book was published last year. A Navy nurse during World War II, she worked stateside in a Navy Hospital. Her remarkable memory and attention for detail is evident throughout her book. I bought the E-edition and read it on my computer over two evenings. 

Truth be told, I skimmed over the early pages of personal history about her grandparents and parents, and her life growing up in New Jersey—I wanted to get to the nursing stories. But I did stop to enjoy her recollections of visiting New York City as a teenager and dancing to the Big Bands of that time: Benny Goodman, Tommy Dorsey, and Glenn Miller. Siragusa saw Frank Sinatra singing his first solo, (not a pretty first impression) Polka Dots and Moonbeams, with Tommy Dorsey’s band. 

While Siragusa is 20 years older than I, her vivid accounts of her nursing career were very real to me: bed baths, back rubs and the camaraderie among the nurses. She describes a Striker frame, a bed that was used to prevent bed sores for patients who were immobile. I, also, recounted the Striker frame in my book. I believe that advancements in medicine and nursing during the early part of the 20th century moved at a slower pace than they do today. 

Again, I was blown away by Siragusa’s memory. She listed all the 33 patients on her ward B-11, the spinal injury ward at Saint Albans Naval Hospital, by name and history. There were 11 quadriplegics and 22 paraplegics. Of course, she would get to know these men since most would’ve remained on the ward long term. At the time, quads had a life expectancy of 2 years and paraplegics had 5 years. She witnessed the first car that was adapted for use by a quadriplegic.

Helen Barry Siragusa’s life as a nurse was cut short when she married and began raising her eight children. However, she was always a nurse. In her book she gives us her experience of the development and contribution of nursing during the early 20th century. All her nursing peers have since died. I am grateful to her for telling her nursing and patient stories that are enjoyable, educational, and poignant. 

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Navy Nurse: Memoir of a WW II Veteran

By Helen Barry Siragusa

From one of the few living World War II veterans comes this personal, inspiring, and remarkably detailed memoir. Helen Barry Siragusa takes us from her childhood in New Jersey during the Great Depression, through her career as a Navy nurse in a ward for paralyzed soldiers during and after World War II, to raising her eight children in Massachusetts, and finally to her home in Maine. Complemented by her beautiful photographs, her vivid storytelling reveals her as both an eternal optimist and a steely bearer of adversity. Death was her constant companion, and she was its counterpoint.

About Helen Barry Siragusa

AFTER GRADUATING from All Souls Nursing School in 1944, Helen Barry Siragusa was faced with a choice: be a nurse and a nun with the Sisters of Charity or join the Navy. She chose the Navy, changing her life and the lives of many others forever. For five of her eight Navy years, she cared for the most-injured soldiers of World War II at St. Albans Naval Hospital on Long Island. She worked in the paraplegic and quadriplegic ward, B-11, where the hope and perseverance of the injured boys and men stayed with her throughout her life. Along with her faith, these strengths carried her through many losses: the deaths of her beloved patients; the death of her Marine fiancé George, just months before their scheduled wedding; and the death of her husband and life-long companion Gus, the goofy and brilliant Navy flight surgeon who courted her at Marine Corps Air Station Cherry Point in North Carolina. Follow Helen on the remarkable journey from her New Jersey childhood during the Great Depression, through her Navy career, to raising her eight children in Massachusetts, and finally to her home in Maine. Helen’s vivid storytelling reveals her as both an eternal optimist and a steely bearer of adversity. One of the few living World War II veterans, Helen gives us this personal, inspiring, and sharply detailed memoir.

Writing with Humor

“It’s not what happens in your life but how you write about it.”

                                                —David Sedaris, Master Class: Storytelling and Humor

I watched David Sedaris talk on Master Class the other night. I got hooked right away when he said that everything is funny—eventually.

Lately, I’ve been feeling preoccupied with the complexity of life, and I am also feeling less chipper. This is perhaps due to a restricted social life secondary to Covid. Not to mention the fact, I’m indeed getting older. So, when David Sedaris, sitting in a chair and looking directly at me from the TV screen, said that when we get older more and more “stuff” happens, “like you fall down.” Write about it. Of course, if I fall, I only hope I don’t break a leg. It would take a great effort to find humor in that scenario. 

I’ve written in the past about my confusion on how to handle getting older. Never mind that I’ve been a geriatric nurse practitioner most of my professional life. All I’ve learned about getting older seems useless when I apply it to myself. In fact, I wrote a post called:  How to handle this age issue in which I describe a scene where I had walked into a Weight Watchers’ storefront on a rainy day to sign up to lose the ten pounds that has ebbed and flowed across my midriff for the past twenty years. The sales lady, encouraging me to enroll in the program, mentioned that WW had helpful information on the internet. In fact, she authored an informative Blog. Then she hesitated, eyed me up and down, and asked if I knew what a Blog was? I immediately took offense thinking that she saw me as an older woman (of course I was) who, obviously, had to be ignorant of all technology. I pulled myself up stiffly and in a snooty voice told her I had my own Blog. I stormed out of the store.

At the end of my post, I mentioned that I regretted I had reacted so poorly. There could have been a teachable moment for the sales lady had I casually told her about my Blog. And laughed at the thought that I was computer illiterate just because I was older.

David Sedaris wouldn’t have been so understanding and forgiving. He wouldn’t look for teachable moments. He wouldn’t have taken umbrage either. He would’ve let the story play out—knowing the scene will become humorous—later. He thinks it’s fascinating to show peoples’ prejudices. Plus, it’s important to add the author’s own fallibilities.

Will David Sedaris’ suggestions be helpful in tweaking my attitude toward my own aging? Will showing the humor in the inevitable and enjoying the irony in what life hands me make me a better writer? And help me better handle this age issue?

E.R. Nurses: True Stories from America’s Greatest Unsung Heroes

E.R. Nurses: True Stories from America’s Greatest Unsung Heroes by James Pattersong and Matt Eversmann, Little, Brown & Company, 2021l

I bought E.R. Nurses: True Stories from America’s Greatest Unsung Heroes at my local independent bookstore. The book isn’t an easy read. I wanted to skip over the tales that involved babies and children. But I didn’t. I honor each author’s experience because he/she is willing to share these stories with me and expose their vulnerabilities. 

Real nurses write real stories about what they do on “routine” days. The stories are mostly short, from two to seven pages. Most of them twist my gut and bring me close to tears. The stories are a testimony to what nurses must overcome to help their patients. 

E.R Nurses. is a bare bones book. No preface, foreword, introduction or prologue. Just chapter after chapter of unforgettable nursing stories written by unforgettable nurses. 

That’s all that is needed. 

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James Patterson has been criticized for co-authoring many of his books and for being more of a brand that focuses on making money than an artist who focuses on his craft.

He has had more than 114 New York Times bestselling novels and holds The New York Times record for most #1 New York Times bestsellers by a single author, a total of 67, which is also a Guinness World Record. 

His books have sold approximately 305 million copies worldwide. (Wikipedia)

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I’m happy that James Patterson has authored E.R. Nurses. His reputation as a best-selling author all but guarantees that a wide audience will learn what nurses really do. 

Book review: Rewarding, heartbreaking stories of E.R. nurses

Mims Cushing

For the Jacksonville Florida Times-Union USA TODAY NETWORK

October 24, 2021

We clapped for them, we cheered for them, we banged pots and pans for them, we cried happy tears and sad. And now we can read about them. They were the first responders during COVID-19. But much of this book does not deal with the nurses who dealt with that. It’s about the nurses who go about their job as emergency nurses. They too deserve clapping. And the authors have dealt with, perhaps 100, day shift, night shift and flight nurses.

James Patterson and Matt Eversmann have come up with a book about the lives of hard-working men and women who work in emergency rooms in the United States. The authors have captured the essence and drama of their stories.

The nurses’ stories are sometimes heartbreaking and sometimes frightening, but all offer a close-up view as to what it takes to be a nurse. The night shifts are particularly difficult, even hard to read about.

Of course the outcomes are often painful, especially when children have to see their father or mother slowly ebb away. The nurses take solace in the fact that sometimes something wonderful happens as when a father takes off his rosary and places it around his son’s neck before being wheeled off to surgery. A nurse suggested that he do that. A few days later, the father dies, but his son will always remember that gesture.

It’s particularly frustrating when a patient is being particularly difficult when a nurse has just seen something tragic. A 7-year-old had fallen out of treehouse and was in cardiac arrest and the nurses worked on him for 54 minutes — as someone else made a petty request. During one night shift, a nurse is nearly strangled, with a choke hold by a severely mentally ill man.

No two days are the same. “Sometimes [one of the teaching nurses tells new nurses], “you get to be a part of a miracle. Other times no matter how well you do your job, it just doesn’t work out. People are going to live, and people are going to die. You have no control. You just do your job.”

One of the nurses wishes that people impatiently waiting for help in an ER would realize that, if they are not being treated, it means someone else is in worse condition than they are: “If we don’t get to you right away, it means you’re stable. If you’re waiting, that’s a good thing. It’s when we all rush in and jump on you that you should worry.”

Give this book to someone who is thinking of being a nurse or is one already. Read it yourself and bang pots and pans all over again, in your heart.

Mims Cushing lives in Ponte Vedra Beach and has written three books. 

Public Health Nursing Needs Recognition

The COVID-19 pandemic has pushed the field of public health into the spotlight. Yet nurses, who often work most closely with the community, have somehow remained largely in the background. (Stories from the Field) 

In the following article: Stories from the Field, public health nurses Susan Blue and Maureen Cava capture the essence of public health nursing. The six podcasts they developed showcase actual public health nurses telling their stories in order to recruit nurses and educate the general public. Canadian public health nursing shares a similar goal with their American counterparts: . . . putting energy and rescores into disease prevention instead of waiting until people get sick to spring into action. As a public health nurse, that means reaching the entire population to maintain and improve people’s health and quality of life. (Susan Blue)

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University of Toronto

September 30, 2021

Stories from the Field: Podcast on public health nursing launched with U of T support 

by Rebecca Biason

Susan Blue and Maureen Cava, both retired public health nurses, created the Stories from the Field podcast to shine a light on the important role public health nursing plays in the health-care system. 

The COVID-19 pandemic has pushed the field of public health into the spotlight. Yet nurses, who often work most closely with the community, have somehow remained largely in the background.

It’s an oversight Susan Blue, an alumna of the University of Toronto’s Lawrence S. Bloomberg Faculty of Nursing, and Maureen Cava, who was cross-appointed to the faculty and taught community health nursing, are hoping to rectify.

Both retired public health nurses, the pair decided to create a podcast called Stories from the Field to amplify nursing voices and help students and the wider public learn more about what public health nurses do – perhaps even consider it as a career. 

Stories from the Field’s six episodes (takes) listeners on a journey across Ontario as co-hosts Blue and Cava speak with public health nurses about everything from harm reduction and the opioid crisis to nursing leadership and the COVID-19 pandemic.

“I’ve worked in public health for almost 40 years, and I still get asked what hospital I work in,” (emphasis mine) says Cava, who is also the former president of the Ontario Association of Public Health Nursing Leaders. 

“We are passionate about public health and committed to ensuring the public, as well as other nurses, know what public health nursing means.”

“As a public health nurse, you are taking a preventative approach to the health and wellbeing of the community at large, as well as individuals,” adds Blue, “It’s why we hope to see more nurses in the field.”

The podcast is proudly sponsored by the Lawrence S. Bloomberg Faculty of Nursing’s Verna Huffman Splane Fund, an endowed award named after Verna Splane, a public health nurse who graduated from U of T in 1939 and enjoyed an illustrious career in nursing and health care.

“Maureen and Susan have captured the essence of what makes public health nursing essential and have shone a much-needed light on the work of our public health nurses,” says Linda Johnston, dean of the Lawrence S. Bloomberg Faculty of Nursing. “This podcast will be an important tool for future nurses to see the breadth of expertise that this particular field of nursing has to offer.”

Writer Rebecca Biason recently spoke with Blue and Cava about the importance of giving nurses a voice and what they are hoping the podcast’s listeners will learn.

What is the role of the public health nurse?

Blue: To me, public health nursing means putting energy and resources into disease prevention instead of waiting until people get sick to spring into action. As a public health nurse, that means reaching the entire population to maintain and improve people’s health and quality of life.

The community is our client and that’s something I’m very passionate about. Keeping people out of hospitals can make a real difference in their health.

Cava: Public health nurses play a significant role in policy development – things like food security, basic income, housing and other social determinants of health. That kind of preventative upstream approach is what we focus on to ensure people are healthy, physically fit, have harm reduction strategies and have the resources they need so they don’t end up in emergency rooms or hospitalized for things that are preventable.

It makes sense to put money into prevention, but there has been a chronic lack of funding since we’ve been in the field. Public health gets a small piece of the pie to do an inordinate amount of work in preventing people from getting sick. It is why we are so committed to our work, as we see the value in public health nursing as an investment in the future of society.

What led to the creation of Stories from the Field?

Cava: Public health nursing is not well understood – by nurses, by politicians, by the public. When I was the president of the Ontario public health nursing leaders association, it was one of my goals to ensure people knew about what public health nurses do and the impact they have.

When I worked at Toronto Public Health, many of the student nurses I encountered had no idea about the scope and breadth of all that is involved as a public health nurse. It was such an eye-opening experience for them, as I hope this podcast will be for other nursing students.

Blue: Maureen and I met in 1990 working for the former North York Public Health Department (now Toronto Public Health). So, having known each for other for 30 years, it wasn’t a huge leap to consider embarking on this project together. We both share a drive to ensure public health nursing is understood and valued as a key part of the health care sector and wanting public health nursing to be brought to the forefront.

What were some of the unforeseen challenges in creating the podcast?

Blue: Well, we are novice podcast hosts. We had listened to a few podcasts, but certainly hadn’t developed one. Maureen came across a podcast camp offered through Ryerson University, and we thought it would be a good way to get some knowledge under our belts.

Cava: Following that camp, we thought, “Oh, for sure we could do this!” But it turns out we were a bit naive about the whole process. We had some initial challenges getting funding for the podcast, but eventually after speaking with Dean Johnston of the Lawrence S. Bloomberg Faculty of Nursing, her support and that of the Verna Huffman Splane fund helped get our project off the ground.

Blue: COVID threw a wrench into everything. We thought we would be recording in a studio together, but soon we were met with a steep learning curve of having to set-up equipment and software on our own. We were grateful to the producers at Vocal Fry Studios for assisting us along the way, but it was very tough in the beginning.

Cava: COVID also meant that many of our nursing colleagues who we planned to have as guests were working full tilt, and that took precedence over everything. We were lucky to be able to eventually meet and interview many experienced public health nurses to share their stories. It just goes to show how involved public health nurses are across the health-care spectrum.

Do you have a favourite episode?

Cava: For me, “Episode Three: Frontline in a Pandemic” stands out. It tells a captivating story about the early stages of the pandemic and the work nurses do behind the scenes to get those shots into arms. It shines a light on the role they had across Ontario in a way that hasn’t really been shown throughout the pandemic. Public health nurses were front and centre since the beginning of the pandemic and are continuing to lead in their roles as things are evolving.

Blue: “Episode Two: Harm Reduction Approaches to Opioid Use” is a favourite. Our guest Rhonda Lovell spoke from a personal perspective about being a young mum and how her interactions with public health nurses during that time in her life motivated her to consider this field of practice and move into public health nursing. She shared such great insights and knowledge.

What are you hoping students and the public will take away from this podcast?

Cava: It goes back to why we started the podcast. We want students to be inspired and think about public health as a career choice. We want them to hear from public health nurses who are passionate and excited about what they do, so that they can see the depth and variety of opportunities there are to work with people and communities. And if they do choose public health, or have chosen it already, I hope this also inspires them to advocate and to give back to the field.

Blue: It’s a career where nurses have considerable variety and can move to other areas of practice. Public health nursing offers lots of flexibility, learning and growth opportunities. For the general public, I think just hearing these human-interest stories will change their viewpoints about public health. Hopefully anyone, whether they are a nurse or not, can relate to this content and be informed.

Cava: These are true stories from the field. We hope students, nursing colleagues and those in other disciplines will listen and consider the impact of public health nursing.

My Fear of Trees

Today we had a fir tree cut down in the back of our house. Although it had grown so large that it would ultimately prevent us from opening the door to our screened-in porch, I felt guilty requesting that it be removed. 

I grew up in the city with few trees: one scrawny tree in a small plot of dirt encircled by cement in our cramped back yard; another one, which was no taller than my father, in the front of our apartment house and eventually disappeared from my old photos.  

While I didn’t grow up with trees, I respect them. Since a tree fell on our house during Hurricane Isabel in 2003, I feared them. 

Our house in Chapel Hill was nestled among a forest of looming oak trees. From the wall of windows in our living room with a cathedral ceiling, I would watch the oaks sway with the slightest bit of wind. Once I convinced my husband that we should go to a hotel when a hurricane was predicted. 

We eventually moved out of our “house in the forest.” I felt immediate relief that we weren’t threatened by a tree falling with every gust of wind. The lovely pine tree that is no longer at the edge of our home posed no threat. It was just in the wrong place. I hope it will forgive me. 

I did parley a story out of my fear of trees that I originally posted in my Blog on November 4, 2012. 

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The devastation Hurricane Sandy caused this past week on the east coast has reinforced my fear of trees. I have resurrected a column I wrote that appeared in the Chapel Hill News on June 27, 2007.

Living in the Forest with my Fear of Trees

A few years back, when my husband and I lived in DC, a tree slammed on top of a woman’s car as she drove home from work amid a thunderstorm and beheaded her. The woman was my age. I drove down the same street going to work. From then on, I felt in awe of trees. They were powerful and intimidating and untrustworthy.

We lived in subdivision with Bradford Pear trees lining the roads. One spring, as I looked out of my living room window, I watched a Japanese couple taking photos of each other under the white blossoms of the pear tree in front of my townhouse. Why weren’t they down in the tidal basin under the Cherry Blossoms?

Even lovely, modestly tall trees were not to be trusted. The following winter the beautiful Bradford Pear trees were covered with ice from an untimely storm that left us without electricity for five days. Before the ice could melt, the pear trees began to self-destruct. The frosty branches snapped off. One fell on a parked car and totaled it. Other branches lay scatted on sidewalks and roads like so many land mines. The homeowner’s association voted to replace the dangerous Bradford Pear trees the following spring at an additional cost to each homeowner. Before we had to dip into our pockets, my husband and I moved to North Carolina.

We fell in love with a frame home surrounded by large oaks. I failed to remember my tree phobia. But the trees didn’t let me forget their mischievous alter egos.

In 2003, we came home from a wedding in California after Isabel blew in and out, delaying our arrival. As we steered the car up our driveway, a leafy bouquet lay over the top of our home. Luckily, the tree split in two so only half of the heavy eighty-foot oak crashed into the ceiling of our second-floor bedroom.

After we moved our bedroom down to the first floor, the sinister oaks, pines and dogwoods began closing in on me. I worried that one evening, while I sat out on the deck reading a novel, a mild-mannered maple would drop a branch on my head.

I suggested that we look for a condo in the city. Not enamored with the side effects of trees—raking leaves, cleaning gutters, and gathering fallen limbs from the driveway—my husband agreed to explore this. We trekked to each grand opening of a new condo building, and even bought two ten-dollar tickets to attend “Live in Downtown Day.”

Then late one afternoon in early spring, my husband and I sat out on the deck of our home. We sipped Merlot and discussed the merits of leaving our 2,000 square foot home for a cozy condo half that size loaded with a high monthly association fee. The tall oaks blocked the glare of the setting sun while the squirrels scampered up and down their trunks. Two hummingbirds buzzed over our heads, fighting over the rights of the feeder that hung from a branch of a birch tree.

Gradually, I began to realize that trees had a gentle side, too. I won’t deny when the winds pick up and the oaks sway overhead, I wish we had a root cellar to hide in but in the meantime, we’ll stay in our forest surround. And we’ll adopt a cat.

N.B. Seven years later we did move into a townhouse in Raleigh with limited trees. We never did adopt a cat. 

Photos of the Patients I wrote about in my book: Stories from the Tenth-Floor Clinic: A Nurse Practitioner Remembers

This past Saturday, I received a box in the mail filled with old photos. The nurse practitioner who took my place when I left the Senior Center sent this delightful surprise. “Rita Wisniewski” (I changed all names in my book except for my immediate family) said in her note that sending me the pictures of the patients we both took care of was “long overdue.” Rita had read my book but due to illness was unable to come to the various venues in Chicago where I promoted the book 2019. Between ill health and the pandemic, Rita had forgotten about contacting me. 

Rita read my book and recognized many of the patients I wrote about. Thanks to Rita, now I have pictures of those who appeared in my book. 

Molly, a wiry, eighty-year-old woman with an Irish brogue, lived next door to Ms. Henry. She often dropped into the clinic to socialize rather than to seek care. She didn’t take medication, and rarely complained of aches or pains.  P 103

Jerry Johnson, mildly retarded, wiggled between us, (on the dance floor) gyrating and twisting with abandon. It was a raucous moment that transcended age and ability.  (At a retirement party) P 117

Lilly Parks, a strikingly attractive woman in her seventies, stuffed her shawl down the front of her dress, and staggered about the dance floor on her matchstick legs as if she was going into labor. I had heard she kept a silver handgun in her sock but that evening she must have left it at home since her slim ankles were surrounded only by her rolled-down stockings. She waddled around in the center of the room clutching her belly to hoots from an enthusiastic audience (same retirement party) P 117

Stella Bukowski: (Sitting in a wheelchair) A dirty blond wig sat askew on her head. Only one leg, which was covered with a wrinkled cotton stocking, extended past the skirt of her housedress, and her foot was encased in a heavy black orthopedic shoe.  She reeked of a sharp ammonia smell. Urine? P 144

A picture of me that I have never seen before. However, I remember the poster, which was one of my favorites. I don’t remember where the picture was taken. The picture is too faded to read the citation on the bottom of the poster. Maybe one of you older nurses will recognize the poster and get back to me with the answer. 

Health care today is changing

Today we need someone who can help us manage our health care needs in the hospital, the home, the HMO, the school, the workplace, in long term care and in the community. 

Today we need a provider who can teach us how to stay physically and mentally healthy and how to prevent illness and disease. 

Today we need access to specialty practitioners who can provide expert heath care for individuals and their families. 

Today more than ever we need an advocate who can deliver quality cost-effective care throughout all the stages of our lives.

Today, we need a Nurse

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