Olden Days of Nursing: A Pioneer of the Past Spurs Others Forward
by Guest Blogger: Cynthia Freund
I talked with Marianna the other day about the book I’m writing (more about that later). She referred me to a post on her blog from a couple of months ago, a post describing the olden days of nursing. She added that she had some very positive responses to that post—and then she put the question to me, “Would you be interested in writing something about the olden days for my Blog?” I obviously fit the age criterion.
I read the post of August 4, 2020, Olden Days of Nursing: Dialysis, about a nurse working in the days when kidney dialysis first became available, the beginning of the 1960s. I know Marianna was asking me to write something about my own early experiences in nursing, and I may do that yet. But this particular post made me think of a dear friend who died a year ago, one-month shy of her 95th birthday. She, too, started one of the early kidney dialysis units, but this time at the Veteran’s Administration Hospital in Durham, North Carolina.
In this millennial year of the nurse, I want to pay tribute to Audrey Booth, both a typical and unusual nurse—a pioneer in many ways.
From the dust bowl of Nebraska, Audrey, a curly-haired blonde, climbed on a horse twice her height to ride to-and-from a one-room country schoolhouse and onto become the Associate Dean at the University of North Carolina (UNC) at Chapel Hill.
The interval between that Nebraska farm and UNC took her to Case Western Reserve in Cleveland, Ohio, where she earned a master’s degree in nursing. She became an expert in the care of polio patients during the height of the epidemic in the 50s, including caring for kids in iron lungs. That expertise brought her to Hawaii and Guam, and also transported her back to the mainland and the University of North Carolina (UNC). After the polio epidemic, she focused on kidney disease and, in the 60s became a leader in opening the new hemodialysis unit at the VA hospital in Durham—one of the very early dialysis units in the US.
Looking for new hurdles to jump, she joined a small select group planning the nurse practitioner program at UNC. And then, when the North Carolina Area Health Education Center Program started in the mid-70s, Audrey became the Director of Statewide Nursing Activities. (AHECs, as they are called, were designed to be centers of education and innovation, serving as magnets to attract health professionals to rural and underserved areas.) She became an Associate Dean in the School of Nursing in 1984—while continuing with all of her duties as AHEC Director.
Throughout her career, the essence of Audrey was as a leader, a role model and a mentor. She led and taught many nurses, usually just by example. She was not well-known nationally, but she was known by hundreds of nurses—and other health professionals—in North Carolina. Many of us attribute our professional success to her leadership and guidance.
And, as a matter of fact, it was Audrey who suggested to me that we interview the founders and influential promoters of the nurse practitioner movement in N.C. UNC started one of the very early family nurse practitioner programs. It was quite unique in its alliance with those starting a statewide AHEC Program and a Rural Health Program—a collaborative effort involving many. Audrey, and I, were involved in that pioneering effort. So, we conducted the interviews, but Audrey left the book-writing to me.
I am about to finish that book, titled: Nurse Practitioners in North Carolina: Their Beginnings in Story and Memoir.It will be in print in the spring of 2021—and will feature many other nursing stars of the olden days of nursing.
Audrey’s spurring me on to write this book is a perfect example of how Audrey led others—encouraging them to greater endeavors. Plain and simple: Audrey was an influencer, on a grand scale and with each individual. She was a mentor in the truest sense of that word. She was a strong voice for nursing and a strong model for women when women were still fighting for their due recognition. We indeed should celebrate all such nurses, just as the World Health Organization has done, declaring 2020 as the International Year of the Nurse and the Midwife.
Dean Emerita Cynthia Freund, MSN ’73, and Associate Dean Emerita Audrey Booth, MSN ’57, were awarded the highest honor of the North Carolina Nurses Association (NCNA) when they were inducted into the NCNA Hall of Fame on Thursday October 9, 2014. Nurses chosen for the Hall of Fame are recognized for their extensive history of nursing leadership and achievements in North Carolina.
Cynthia “Cindy” Freund, RN, PhD, worked for eight years with the newly developed Family Nurse Practitioner Program at the University of North Carolina at Chapel Hill in the early 70s. She then went to the University of Pennsylvania to start a joint program (MBA/PhD) between the School of Nursing and The Wharton School. She returned to UNC-CH and retired after serving 10 years as Dean of the School of Nursing. To her, retirement means “working without pay.” In her retirement, she worked on her book: Nurse Practitioners in North Carolina: Their Beginnings in Story and Memoir, to be published in Spring 2021.
Lorraine Starsky writes in the Pittsburgh Post-Gazette about three “extraordinary” Pittsburgh women who happened to be nurses. Each woman had provided services beyond the boundaries of the nursing role.
In this International Year of the Nurse and Midwife, Lorraine Starsky tells the story of three women who were trailblazers
LORRAINE STARSKY OCT 25, 2020 9:00 AM
In May 2019, long before COVID-19 became a worldwide pandemic, the World Health Assembly designated 2020 as the International Year of the Nurse and the Midwife.
The designation was, in part, to pay tribute to Florence Nightingale. Considered the founder of modern nursing, Nightingale was born on May 12, 1820, making 2020 the 200th year anniversary of her birth.
Nurses and midwives have had a long, rich history of safeguarding the health of people. Primarily they work without recognition and pass into history with their names unknown and their stories untold. In honor of the International Year of the Nurse and the Midwife, here are the remarkable stories of one midwife and two nurses who worked in the Pittsburgh area.
Hannah Sandusky was born in 1827 to a Jewish family in Kovno, Lithuania. With no doctor in the village, Hannah was taught important skills by accompanying her midwife mother as she assisted with local births. She married Louis Sandusky, a window glazer, who came to Pittsburgh in 1860. Hannah and their son joined him 1861. She began working as a midwife, as well as providing care to the many impoverished residents of the Hill District — newly arriving Eastern European immigrants and Blacks from the South.
Her reputation drew the attention of a local doctor who called on her intermittently to assist him with difficult deliveries. He was very impressed by her skill and in appreciation for her help, he sent Sandusky and her son, who had an eye problem, to Germany to see an eye specialist. During the time that her son received treatment for his eye, Hannah attended a recognized school of midwifery.
With her son’s eye treatments completed and her midwifery education finished, Hannah returned to Pittsburgh with formal certification as a midwife, making her one of only a few women in the U.S. with that credential. She delivered 3,571 registered births, but there were, no doubt, many more births that went undocumented. Her passion for providing care did not always carry over to paperwork and The Birth Registration Act didn’t go into effect until 1870. Regardless of the exact number of deliveries; it is an impressive feat since she accomplished this while she raised her seven children.
Sandusky was very kind-hearted and was known for providing her services for free. In situations where a family was facing hardship, she also gave food, baby clothes, and blankets after a birth. She was affectionately known as Bubbe (Yiddish for grandmother) Hannah throughout the Hill District. She was 82 when she delivered her last baby and died at age 86 on November 15, 1913.
Her legacy lives on through the Bubbe Hannah Fund at The Midwife Center for Birth and Women’s Health at 2831 Penn Ave. Donations to the fund underwrite services for individuals experiencing barriers to quality health care. The Midwife Center overcame attempts to drive it out of existence, flourished with grassroots support, and expanded to become the nation’s largest free-standing birth center operated by midwives.
An exquisite, art quilt portrait of Bubbe Hannah hangs on the waiting room wall sweetly looking on the families awaiting the midwives’ services.
Like midwife Hannah Sandusky, public health nurse Anna Heldman spent the bulk of her nursing career in the Hill District.
Anna Barbara Heldman was born in Castle Shannon on January 15, 1873. Early on, she felt the call of nursing and found work as a practical nurse at Allegheny Hospital in 1893 despite the fact that she had no training or experience. When South Side Hospital established a Hospital Training School for Nurses, Heldman enrolled and was given a year’s worth of credit for her two years of practical nursing at Allegheny Hospital.
She was among the first graduating class of the South Side Hospital Training School for Nurses, receiving her diploma on April 8, 1897. About a year later, she volunteered to serve as a nurse in the Medical Department of the United States Army during the Spanish-American War. She served in Florida, Georgia, and Cuba. When she returned from her tour of duty, she worked briefly as a private duty nurse.
Heldman didn’t find private duty nursing challenging. In 1902 she learned about a new type of nursing referred to as community visiting nursing, the genesis of public health nursing. She was hired at the Columbian School and Settlement in the Hill District modeled after the Hull House in Chicago.
It evolved into the Irene Kaufmann Settlement. At this time Pittsburgh had very high rates of tuberculosis and typhoid, with the Hill District being a hot spot since it was crowded with the poorest of the poor — Blacks escaping the South and new immigrants.
Initially Heldman was discouraged, but she persisted. She already was fluent in German and that helped her master Yiddish, which was useful for nursing Jewish immigrants. She also learned Syrian, Lithuanian, Polish, and Italian, which gained her the trust and affection of the community. She became a recurring sight in the Hill District’s streets and alleys carrying her black nurse’s satchel. Soon people began referring to Anna as “Heldi.”
Her commitment included fighting for better housing conditions, stricter labor laws in the Hill’s cigar factories, better schools, workers’ compensation and the first legal aid service. She and her staff nursed well over 1,000 flu and pneumonia victims during the 1918 flu epidemic.
In addition, she initiated numerous public health programs that ultimately became city services, including a visiting nurses service, a prenatal nursing service, baby clinics and regular medical inspection of students in Pittsburgh’s schools.
The Hill District became Heldman’s family as she never married or had children. Because her dedication touched the lives of so many men, women and children in her 38 years of service as a public health nurse, she became known as the “Angel of the Hill District.”
As an expression of gratitude for her devotion to the Hill District, the city in 1939 renamed Overhill Street, Heldman Street, which still exists. When she died in March 1940 at 67, her body was brought to the Irene Kaufmann Settlement House. Thousands filed past her coffin to pay their respects to the indomitable woman they called the “Angel of the Hill District.”
Evelyn Paige Parke
Evelyn Page Parker was born January 8, 1921 in Pittsburgh. While she was a student at Westinghouse High School, she knew she wanted to become a nurse. However, in 1940 no schools of nursing in Pittsburgh would admit Black students to become Registered Nurses, so she left for Philadelphia. She enrolled at Mercy Douglass Hospital School for Nurses, which was the first nursing school in Philadelphia for Blacks.
While at Mercy Douglass she took a course at Philadelphia General Hospital, where she learned that Blacks were not permitted to eat in their cafeteria. She was not deterred and continued to go to the cafeteria. Eventually the cafeteria cooks let her eat.
Later in life she related the story, “Everyone started looking at me, thinking ‘What’s she doing here?’ But then, they started letting African American students eat there.”
Parker graduated in 1943 from Mercy-Douglas. She persisted in her efforts to promote equality for Blacks. Philadelphia General Hospital finally opened its nursing school and internship programs to Black students in 1945.
In the meantime, she pursued her nursing career in Philadelphia. She focused on public health nursing and was instrumental in helping to found the Community Nursing Services of Philadelphia in 1959. During this time, she married, had a son, and worked on her bachelors in Nursing from the University of Pennsylvania, which was awarded in 1961.
In the late 60s Parker returned to Pittsburgh and enrolled at the Graduate School of Public Health at Pitt. She finished her Master’s degree in Public Health in 1969 and became a faculty member at the University of Pittsburgh’s School of Nursing until 1981.
She then taught at Duquesne University’s School of Nursing until 1984 when she retired. She mentored students at both universities throughout her career. Even in retirement, her passion for nursing and social justice burned bright as she continued to help young Blacks pursue their dreams of a career in nursing.
Parker volunteered for many causes, from the local NAACP chapter, the AARP health committee, American Heart Association’s Sister to Sister Program and many cancer survivors’ groups. Probably closest to her heart was the Pittsburgh chapter of the National Black Nurses Association, which is called Pittsburgh Black Nurses in Action.
Evelyn remained a devoted member until her death in 2008. In her obituary, her son Tom Parker said “I think the challenges she faced just motivated her more.”
Today the Pittsburgh Black Nurses in Action carries on her legacy by offering support to prospective Black nursing students and addressing health disparities in the community. The Evelyn Paige Parker Scholarship is awarded annually.
Lorraine Starsky BSN, RN, retired in 2019 as a Public Health Nurse with the Allegheny County Health Department. She is working part time currently as a community health nurse consultant for Project Destiny. She can be reached at email@example.com
The World Health Organization designation of 2020 Year of the Nurse and Nurse Midwife has taken a back seat to the sensational political news alerts that fill our lives as if nothing else is important. This post is just a reminder that nurses still are on the front lines of COVID-19 and make a difference in our lives every day.
A deep thank you to my friend and fellow writer Michele Murdock who sent me the first Star Nurses publication, which documents the collaborative effort between the Washington Post and the American Nurses Association (ANA) to nominate six nurses from across Maryland, Virginia and the District of Columbia who “go above and beyond.”
Hopefully, we will have more collaboration between the ANA or other nursing organizations and news media in order to spotlight nurses who make a difference. What a great way to educate the public about what nurses really do. As you can see, the six nurses selected for the first Nightingale Awards practice in diverse settings and have varied backgrounds.
The Washington Post and the American Nurses Association Announce the 2020 STAR Nurses Award Winners
September 2, 2020 at 1:51 p.m. EDT
The Washington Post and the American Nurses Association (ANA) announced the winners of the 2020 Star Nurses Awards, recognizing registered nurses in the Washington, D.C. area with the Nightingale Award for excellence in their field. The six winners, who were nominated by patients and peers and were selected by the American Nurses Association and a panel of fellow RNs, are recognized for their achievements across a range of criteria including compassion and positive community impact. Below is the list of 2020 Nightingale Award Winners:
A veteran registered nurse on the Cardiovascular Intensive Care Unit at Winchester Medical Center, Lisa Dellinger is still passionate about her profession—and loves sharing her enthusiasm with new graduates.
Lisa Dellinger, RN
“I like admitting hearts,” admits Lisa Dellinger, a Cardiovascular Intensive Care Unit (CVICU) registered nurse (RN) at Winchester Medical Center in Winchester, Va. “We come together with procedural precision, and everyone knows their jobs without being told. That still lights a fire in me.”
Admitting a heart is the process of receiving a heart patient following surgery. These critically ill patients do not go to a recovery room. They come directly to the CVICU, where a team of healthcare providers ensures that all their lines and drips are accounted for and they are transferred safely.
“It’s like solving a puzzle,” Lisa added. “It’s a puzzle I can unravel, and I can keep my patients safe.”
From an early age, Lisa was always a problem solver. Although she dreamed of becoming a pediatrician, she knew she could not afford college. Instead, she joined the military and gained experience as a medical technician. It was during this time that she decided to become a nurse. “I realized that nurses get to spend more time with patients, so I knew I wanted to be a nurse,” she recalled.
Today, after 24 years in the field, Lisa is still passionate about nursing. In fact, she is most inspired when helping new graduates navigate the challenges of the profession.
“I love working with new grads. I love being able to pass on some of my knowledge—and hopefully some of my enthusiasm,” Lisa said. “I always tell new nurses that I would rather they ask me a hundred questions than do something to harm a patient.”
Lisa strives to teach new nurses what really matters. While she expects the nurses she mentors to be very attentive to the medical details of patient care, she thinks it is even more important that they get to know patients as people. Learning a patient’s personality can help nurses motivate them to get out of bed and get better, she explained.
“Ultimately, it’s our job to be our patients’ advocates—to be their voices,” Lisa concluded.
Lisa is a strong voice and an even stronger force. She is all heart.
As a pediatric oncology nurse researcher at Children’s National Hospital, Pamela S. Hinds, RN, Ph.D., FAAN, helps young patients find their voice and make sure it is heard.
Pamela S. Hinds, PhD, RN, FAAN
Sometimes they want a back rub. They might want to chat about their fingernails. Most of all, they want to be heard. They are young cancer patients. And they have a strong advocate in Pamela S. Hinds, RN, Ph.D., FAAN, a nurse researcher at Children’s National Hospital.
Pamela performs pediatric oncology research that enhances patient outcomes and improves nursing practices. Over the course of her long career, she has had many emotional experiences with young patients and has really learned to listen to them.
“There are so many children whose faces and stories stay with me,” Pamela said. She recalled one young woman who had acute lymphocytic leukemia and experienced several recurrences requiring multiple bone marrow transplants. “I would end each day with a few quiet moments with her. It would soothe her so much when I would just rub her back,” she remembered.
Pamela also recollected a teen girl with a rebellious spirit and an extremely aggressive form of cancer. The girl tried desperately to find something positive. “She would say to me, let’s talk about the one part of my body that’s normal: my fingernails. So we would talk about her fingernails,” Pamela recalled.
For Pamela, the diverse stories of the many children she has treated are what motivates her research. As the principal investigator for a number of federally funded grants, Pamela can amplify children’s voices to help them get better, more compassionate care.
“For many years, we didn’t ask children questions,” noted Pamela. “We never asked them what it was like to be receiving cancer treatment. We just delivered the treatment.”
Pamela and her team created a comprehensive set of questions to help care providers talk to—and understand—seriously ill children. The questions are now available for use across the country via the National Cancer Institute of the United States.
Speaking of the emotional challenges of her field, Pamela admits, “It’s very painful. But I believe in the power of love. And I see love every day—the love of a parent for a child, and a child for a parent, and also of staff to children and children to staff. That’s an amazing thing.”
As a school nurse, Viktoria Holley-Trimmer is responsible for the health and safety of every student in her building.
Viktoria Holley-Trimmer, MS, RN
You have to start somewhere. Good days start with a nutritious breakfast. Good students must first be healthy students. Viktoria Holley-Trimmer is making sure that students in the District of Columbia start healthy and stay healthy—as a D.C. public school Registered Nurse.*
“I always tell people that I didn’t choose nursing. Nursing chose me,” says Viktoria of how she came to the profession. During the nursing shortage of the 1980s, Viktoria was offered a full scholarship to attend nursing school. She took it, and she has never looked back.
At Francis Scott Key Elementary School in D.C., Viktoria is helping young people achieve their best possible health, so they can thrive as students. “The day in the life of a school nurse includes something new every day,” she said. “Kids are just so amazing.”
From bandaging scraped knees to coaching scared kindergartners to helping kids manage serious long-term illnesses, Viktoria is responsible for the health and safety of every student in her building. She also does regular education sessions with the children, teaching everything from proper hand washing technique to healthy eating habits.
A big part of school nursing is taking care of the broader community. And Viktoria is certainly committed to strengthening her community. Every year, Children’s National Hospital holds a cereal drive to provide breakfast options to underserved children during the summer months. Viktoria is one of the leading contributors.
“Last year, I collected more than 11,000 servings of cereal for children in D.C.,” said Viktoria . “I talked to the parents and the teachers and rallied them to the point where they brought me cases of cereal.”
Even with schools shut down due to the Coronavirus crisis, Viktoria is continuing to care for her community. She is currently working as a contact tracer for D.C., fighting the community spread of the virus one phone call at a time.
From her cereal drive efforts to her day-to-day work in the school, Viktoria is ensuring that children in the District know that someone cares—that someone is committed to giving them a strong start.
Cherissa Jackson is the Chief Medical Executive at AMVETS (American Veterans), a registered nurse, a veteran and a proud post-traumatic stress disorder (PTSD) survivor.
Cherissa Jackson, RN
Cherissa Jackson has covered a lot of ground. She traveled thousands of miles to complete her tours in Iraq and Afghanistan. Back at home, she has logged hundreds of miles running—in an attempt to outrun her post-traumatic stress disorder (PTSD). As the Chief Medical Executive at AMVETS (American Veterans), Cherissa is using her skills as a registered nurse and her personal experience with PTSD to help other veterans recover.
As a single mom to twin daughters, a veteran, a nurse and a leader, Cherissa has overcome some major obstacles—but none has compared to PTSD. Cherissa served 23½ years in the U.S. Air Force, many of them as a nurse. She served as a battlefield clinician in Iraq in 2005 and 2006 and in Afghanistan in 2011.
“I treated soldiers for PTSD. I knew the signs,” Cherissa recalled. “When I started experiencing some of those same symptoms, I hid in silence for five years.”
When her daughters left for college, Cherissa stopped hiding. “I had a PTSD break. I knew I had to get help,” she explained.
Years later, Cherissa has learned how to manage her PTSD. She uses a tried-and-true regimen of faith, meditation and exercise to keep her disorder at bay. Exercise is key. She said, “I tell people all the time that when I run, I sweat like crazy. That’s me purging those bad thoughts and feelings. That is me getting rid of what I experienced in Iraq and Afghanistan.”
Cherissa has shared her struggles with PTSD in several national magazines, and she wrote a best-selling memoir, “At Peace, Not in Pieces” about her experiences. “I strive to inspire others not to live in silence,” she said. “There is a way to be functional and not be ashamed to admit you have PTSD.”
When she joined AMVETS in 2019, Cherissa began running the organization’s HEAL program. HEAL, which stands for healthcare, evaluation, advocacy and legislation, aims to reduce veteran suicide, unemployment, homelessness and hopelessness by providing vital resources.
In addition to her work with HEAL, Cherissa is concentrated on elevating the issues that women veterans face. She created the Women Veteran Journey Map, an online tool that illustrates the unique experiences of women service members.
Cherissa may have suffered in silence for far too long, but she is sharing her journey with PTSD and advocating for other veterans now. She’s covered a lot of miles, and she is determined to leave markers to help those who follow.
In addition to teaching, Jonas Nguh, Ph.D., RN, a professor of nursing at Walden University, is deeply committed to serving marginalized communities—and inspiring his students to do the same.
Jonas Nguh, PhD, RN
When Jonas’s phone rang in the wee hours of the morning, he was startled. The voice on the other end of the line was frantic, screaming, “Thank you, thank you!” Jonas Nguh, Ph.D., a registered nurse and professor of nursing at Walden University, inspires these reactions from his students.
The caller went on to explain that she was one of Jonas’s former students and that she had just passed her board exam to become a registered nurse. “She told me I was one of the only people who never gave up on her and that kept her going,” Jonas recalled. “She called me before she even called her husband!”
“It’s just amazing to me that I can use my abilities to improve the lives of others, whether that is the people in my community, my students or people around the world,” Jonas added. “I love working with people and for people.”
It is that genuine love of people that brought Jonas to nursing and that makes him such an accomplished educator. The youngest of five children, Jonas grew up in an impoverished community in Cameroon. He has three older sisters who are all nurses.
“I think I was born into nursing,” he said with a smile. “Now I get to prepare the next generation of health care providers.”
In addition to teaching, Jonas is deeply committed to serving marginalized communities—and inspiring his students to do the same. Jonas does several mission trips every year with his students or his faith community.
In 2010, following the catastrophic earthquake in Haiti, Jonas facilitated a hand washing initiative. Jonas and his students visited D.C. area hotels and collected the complimentary bars of soap left behind after guests checked out. They found a vendor to disinfect and repackage the soap. The class then delivered the soap to communities in Haiti where hygiene products were scarce.
“Sanitation is the first basic element to prevent infection,” Jonas said. “I’ve always been committed to looking for the little things that can help. This was practical and feasible, and it helped.”
Jonas is proof positive that little things quickly become big things in capable hands. Jonas is not just competent; he is gifted. And he is always willing to share his gift. “This is a calling, not a job,” he concluded of the nursing profession. “It’s a mission. It’s the whole purpose of my existence.”
Sarah Rose, a registered nurse unit supervisor at Inova Alexandria Hospital, is committed to listening—and really hearing—patients and frontline nurses.
Sarah Rose, RN
Sarah Rose is a good listener. As a registered nurse unit supervisor at Inova Alexandria Hospital, Sarah makes sure that patients’ voices are heard and respected. She also ensures that the nurses who work at patients’ bedsides have a voice in shaping health-care policies and practices.
As a child, Sarah wanted to be a veterinarian. She loved animals, so it seemed like an obvious career choice. Her parents had other ideas. One summer, they convinced Sarah to volunteer at a local hospital. She was able to directly interact with nurses and patients on a daily basis. A new nurse was born.
“I always had a calling to help others, and this junior volunteer program allowed me to see how much nurses were helping,” Sarah recalled. “That started me down the path to become a nurse.”
When Sarah joined the staff at Inova Alexandria, it didn’t take long for her patients and co-workers to recognize her aptitude for caring. She received the hospital’s Nursing Excellence award in 2015, 2016 and 2019.
Most recently, Sarah was recognized for her efforts to promote shared governance. Shared governance empowers nurses at the bedside to work with leadership to formulate policies and to express concerns drawn from their day-to-day interactions with patients.
After just two years as a staff nurse with Inova Alexandria, Sarah was promoted to unit supervisor in October 2016. Her unit provides step-down care for patients with serious cardiac issues.
“I strive to lead by example,” Sarah says of her role as supervisor. “I want to show new nurses that we can take the time to make personal connections with patients—to use the patients’ names and engage in small talk. Those simple connections make a big difference.”
Even when faced with difficult patients, Sarah remains dedicated to listening first. “It’s not just about letting them speak and then not hearing what they are saying,” she said. “You have to acknowledge what they are feeling. You acknowledge their concerns and then you explain what you’re able to do to help with the best possible outcome.”
Sarah listens. She pays attention. And she connects. By really hearing her patients and her staff, Sarah Rose is helping improve lives and enhance her profession. Sarah’s hearing promotes healing.
We are excited to announce a series of web discussions “Overdue Reckoning on Racism in Nursing” starting on September 12th, and every week through October 10th! This initiative is in part an outgrowth of our 2018 Nursing Activism Think Tank and inspired by recent spotlights on the killing of Black Americans by police, and the inequitable devastation for people of color caused by the COVID-19 pandemic.
Racism in nursing has persisted far too long, sustained in large part by our collective failure to acknowledge the contributions and experiences of nurses of color. The intention of each session is to bring the voices of BILNOC (Black, Indigenous, Latinx and other Nurses Of Color) to the center, to explore from that center the persistence of racism in nursing, and to inspire/form actions to finally reckon with racism in nursing.
Lucinda Canty, Christina Nyirati and I (Peggy Chinn) have teamed up…
Sandy and Harry Summers review in their June 2020 The Truth About Nursing Blog a story that appeared in the Washington Post. I am always happy to see another example of the media covering nurses and nursing issues. And this time the authors talk about “what nurses actually do!”
However, it’s sad that it has taken a pandemic to call attention to the nursing profession.
The Summers, as usual, have done an exceptional job in their textual criticism of the essay.
Washington Postreport on nursing in Covid era offers unusually deep look at profession
A long April 2020 piece in thePosthad information from a diverse group of nurses. Of course, they were able to explain how itfeelsto be a nurse in the Covid-19 era—a common press theme now. But they also described the nature of the profession, what nurses actuallydofor patients, and nurses’ protests about inadequate PPE.
April 28, 2020 – Today the Washington Post had a good story by Dan Zak and Monica Hesse headlined “Nurses are trying to save us from the virus, and from ourselves.” That last part signals that this won’t be just a standard “nurse-hero” piece about how difficult it is to care for Covid-19 patients. Instead, the article manages to provide a surprisingly in-depth look at the nursing profession, from its historical roots to its key roles in patient surveillance and advocacy, including why many nurses are now protesting about shortages of personal protective equipment (PPE). One highlight of the piece is a capsule description of what direct care nurses do by Laurie Combe, the president of the National Association of School Nurses. Combe talks about the subtle but critical assessments and the vital psychosocial care nurses provide. The piece also discusses some of Florence Nightingale’s work to revolutionize care settings and improve survival rates in the 19th Century. And it describes nurses’ protest activities during the current pandemic, particularly efforts by members of National Nurses United to push for the federal government and hospitals to ensure that nurses have adequate PPE. One nurse protester mocks the “hero” narrative nurses often hear now as just “gaslighting” when it’s accompanied by a failure to provide them with PPE. These elements point to nurses’ key patient advocacy role, although the article does not make that link specifically. And the report is not perfect, as a few elements tend to support the incorrect notion that nurses are virtuous adjuncts of physicians, rather than autonomous professionals whose focus is serving patients. But overall the piece gives a vivid sense of what nursing is about and the situation of nurses trying to care for Covid-19 patients now. We thank those responsible.
Strong and smart
The Post report does start by discussing the demands of Covid care. It explains how hard it is to provide expert and empathetic care for 12 or more hours while wearing burdensome PPE in an under-resourced setting while “confronting the most frightening pandemic in 100 years.”
But then the piece backs up and asks what nurses really do. Apparently they are “the glue” and the “link between patient and doctor,” and their profession is consistently rated the “most honest and ethical” in Gallup surveys. Those descriptions are all somewhat problematic—the familiar polling point because it often masks a lack of true respect for nurses’ skills, and the earlier descriptions because they present nurses as adjuncts to physicians, which they are not. Nursing is an autonomous profession that exists to serve patients, not physicians. The reporters do say that nurses don’t want to be called heroes, but for the public to stay home and stay alive. And then they turn it over to a nurse expert, who picks up on the standard “most trusted” message the piece has just presented.
“But I don’t think that means people really understand what nurses do,” says Laurie Combe, president of the National Association of School Nurses. It’s a complex job, requiring knowledge of both biochemistry and psychology, in myriad environments. Nurses are helping your fourth-grader learn to track her insulin levels at school, and they are putting pressure on a gunshot wound at 2 a.m. while noting that the victim has no pulse. They are monitoring both your heart rate and your spirit. When they touch your arm, in what would appear to be a simple gesture of friendliness, they are also testing if you’re hot, swollen, dehydrated, tremoring. “I can observe what is on your bedside table that you’re reading — if I can talk with you about that, I can strengthen our connection to build trust,” says Combe, who has been a nurse in the Houston area for 45 years. “I can see who’s in your room visiting, what the interaction looks like, and see whether that’s a trusted person or not, so I know what I can talk about during that visit.”
This is one of the best capsule descriptions of nursing that we have seen in almost two decades of doing this work. Ten stars for Laurie Combe! She identifies the problem with the angel narrative, and then she addresses it, with a short, compelling description of how nurses help people in ways few even realize are happening.
The piece moves on to note that the coronavirus has changed what nurses do, as they may be working in unfamiliar units under extreme conditions without adequate PPE, “facilitating virtual goodbyes with dying family members” and “organizing protests against hospitals and the White House.” Some are running Covid testing sites, and the article profiles Brenda Lagares, who had been a “night nurse” in New York City before being recruiting to be a “sampling nurse” at a drive-through testing site in Bear Mountain, NY. She tests motorists after having “been given 15 minutes of training to potentially save their lives.” These descriptions do not convey a very full picture of nursing education or expertise. Fortunately, Lagares gets to explain what she does for patients even in the fast-paced and limited drive-through setting. She describes how, even encumbered by PPE, she can read patients’ emotional state (by examining their eyes) and provide reassurance (with explanation, encouragement, a wave and a thumbs up). The article also talks to another nurse at a test site, in Orlando, FL. Sasha DeCesare went to nursing school in Venezuela. DeCesare believes it’s great to be a nurse in the U.S. because (in the report’s words) “it’s a female-dominated profession, filled with strong and smart women.” But now she has worked 22 days straight, and sleeps in a hotel to protect her family from infection.
The piece has some history. This starts with Nightingale’s work for soldiers in the 1850s Crimean War, which the article explains in some detail. It involved better hygiene, ventilation, nutrition, and fundraising. As the piece explains, “the death rate for admitted patients fell by more than half. [Nightingale] wasn’t only a caretaker. She was a revolutionary.” And she wrote Notes on Nursing, which “became a bible for modern care.” The piece quotes Barbra Mann Wall, director of the Eleanor Crowder Bjoring Center for Nursing Historical Inquiry at the University of Virginia, on the diversity of early nurses in the United States. (The piece might have noted that Mann Wall is herself a prominent UVA nursing professor with a PhD.) Apparently relying on Mann Wall, the piece describes the growth of nursing during and after the Civil War, as well as the development of nursing education from a two-year apprenticeship based mostly on skills — wound care, bedsores prevention — to a four-year program equally based on science. … Eventually, nursing would encompass a range of specialties and career paths; a nurse anesthetist might make $175,000 a year, while a nursing assistant might make $14 an hour.
Not surprisingly, the piece pauses at the 1918 flu pandemic. Apparently relying again on Mann Wall, it notes that the best treatment available then was “rest, hydration, hygiene — the pillars on which Nightingale had built her practice.” And it quotes then-health commissioner of Philadelphia Wilmer Krusen on what was needed in that epidemic, given that beds and physicians were in sufficient supply: “Nurses, more nurses and yet more nurses.” That is a timely comment today, when much of the early media on Covid-19 focused on beds and ventilators, ignoring the nurses who would be needed to care for the patients using that equipment.
And the article has a substantial amount of material on the protests, i.e., the patient advocacy. The reporters explain:
People keep saying that nurses are on the front lines, but they are actually behind enemylines, surrounded on all sides. They are trying to save us, and save us from ourselves. Nurses are protesting protesters, standing in their scrubs and masks to glare at “freedom-loving” citizens who spew insults as they rally for the economy to reopen. Nurses are taking to social media to convey the extremity of their situations: They talk about war zones, about titrating a dozen IV drips while troubleshooting fluky ventilators, all without reliable stockpiles of supplies.
The piece relies fairly heavily on Elizabeth Lalasz, a Chicago union steward for National Nurses United (NNU). Lalasz herself was out of the clinical setting for 18 days with Covid-19, which she says she got because of inadequate PPE; she calls the nurses “cannon fodder.” The report explains that Lalasz became a nurse in her 40s, after watching an oncology nurse caring for her dying father advocate successfully for him “against a phalanx of male superiors” to go home to die, 35 years ago. Presumably that means a group of physicians; of course, they were not “superiors,” but surely they had far more power, so that sounds like some impressive advocacy.
And Lalasz does some advocacy too, pointing to the dysfunctional U.S. health care system, which even before Covid-19 “left front-line workers feeling burned out, with high rates of attrition and suicide.” The reporters also talk to nurses at the California hospital that suspended 10 nurses for refusing to care for Covid-19 patients without an N95 mask. One of the suspended nurses, Jack Cline, explains why the surgical masks are inadequate, regardless of CDC guidelines saying otherwise. The piece also describes the recent White House protest by NNU members seeking more PPE for health workers—over 230,000 of whom have been infected with the virus, and 600 nurses have died from it. One protesting nurse was Charles Dalrymple, who spends hours caring for Covid-19 patients in negative-pressure rooms, in some cases helping them say goodbye to family through virtual means. He held a sign saying “20 SECONDS WON’T SCRUB THE BLOOD OFF YOUR HANDS,” with “HERO” in quotes. Why the quotes? Dalrymple said:
I feel that it’s being used to placate us — gaslighting this entire situation. A ‘we signed up for this’ kind of thing. But we didn’t. We didn’t sign up to go into a room without proper gear. . . . They can’t be throwing this word around just to make it seem like, ‘Oh, it’s okay that they’re dying. It’s because they’re heroes.’
Right. Nurses have always faced the virtuous-angel narrative, in which they get lip service but are expected to endure abuse and resource shortages without complaint. But now, the “hero” narrative seems to be functioning in a somewhat similar way for everyone on the Covid-19 front lines. If we call them heroes enough, and have the Blue Angels fly overhead to say thanks, then apparently it’s OK that we are still not giving them the PPE, tests, and other supplies they need.
On the whole, because of the detail about what nurses actually do, the material about the history of nursing, and the reporting on nursing advocacy—particularly the PPE protests—the piece is an unusually valuable one in the Covid-19 category. We thank those responsible.
The last day of Nurses Week ends today on Florence Nightingale’s Birthday: May 12.
Would Flo be surprised that a special day, May 6, had been dedicated to nurses in 1982, and in 1990, that day grew into a full week that ended on her birthday? Would she be pleased that the World Health Organization (WHO) has designated 2020 as “The Year of the Nurse and Midwife” in honor of her 200th birth anniversary? Would she be happy to learn that this 2020 designation is significant because WHO is promoting nursing education that will increase the numbers of nurses and midwives in order to strengthen Universal Health Coverage?
What would Flo think of the modern nurses’ role in this Pandemic? Would she be reminded how she, during the Crimean War, campaigned for better care of the sick and wounded soldiers and for a higher standard of hygiene, which saved countless lives? I bet she would be proud to see that nurses are still campaigning for better conditions for their patients. And that they are speaking out for safe working conditions for all health care workers.
If you had the chance to reunite with a patient after 10 years to see the difference you had made to their life, would you do it?
This was an opportunity given to a mental health nurse, after Nursing Times helped facilitate an emotional reunion with a former patient last year.
Hope Virgo contacted us because she wanted to shine a light on the “massive contribution” a nurse had made to her recovery journey.
When Ms Virgo was 17, she was admitted to a mental health unit in Bristol with severe anorexia. She said the support of a particular nurse, Mandy Robinson, helped save her life and gave her the skills to stay well more than a decade later.
“It got me thinking about how often nurses see the longer-term impact of the care and support they provide”
When I met the pair, it was a real joy to see how excited they both were to meet again after so many years.
It got me thinking about how often nurses see the longer-term impact of the care and support they provide.
How often do you reunite with your patients? Is this something you would want to do?
I know that for Ms Robinson, this was a rare occasion but one that she thoroughly enjoyed.
In a video created by Nursing Times, Ms Robinson said: “As a nurse – and I’ve done this job for 30 years now – I think we rarely see the kind of longer-term outcomes of how people have done.”
She said it had been “lovely” to see Ms Virgo and to know that she had made “a little contribution” to who she was now.
In response, Ms Virgo assured Ms Robinson that she had in fact made a “massive contribution”.
Ms Virgo said: “I think quite often we don’t realise that, and obviously at the time we just take you all for granted, but all the stuff that you taught me in hospital I now use all of that stuff to help me stay well.”
Observing their interaction from behind the camera I could see what Ms Virgo’s words meant to her former nurse: she was completely made up and overwhelmed.
Together they looked back on Ms Virgo’s time as an inpatient and talked about how they used to go out on runs around the hospital.
Ms Virgo told how Ms Robinson had helped her to understand how to exercise in a positive way and that it did not have to be something that was “obsessional”.
“It is vital to look back and reflect on the positives and remind yourselves of the life-changing work you do for so many people”
After the story went online earlier this week, Ms Virgo posted a link on social media site Twitter and wrote: “If you ever doubt yourself as a nurse watch this and realise the long-term impact you are having.”
At a time when the nursing workforce is under severe – and escalating – pressure, it is vital to look back and reflect on the positives and remind yourselves of the life-changing work you do for so many people.
During International Year of the Nurse and Midwife it seems more than appropriate to be shouting about the difference you are all are making.
Last Friday I discussed my book, Stories from theTenth-Floor Clinic: A Nurse Practitioner Remembers at the Wonderland Book Club, which was held at a local independent bookstore. The audience was quite engaged and we shared discussions not only of my book but of the status of nurses, problems within the health care industry in general and in North Carolina in particular.
Here are some of the questions/comments:
How do you deal with the stress of caring for patients? Do you take these problems home with you?
Me: I have always taken home patient problems as evidenced by what I wrote in my journals. Journaling was a way I dealt with problems at work. The more difficult the patient issues, the more time I spent writing in my journal. A lot of the stories from the book have been documented in my journal. In fact, the last chapter, Playing Sheriff, was written before I found the journal from that time period. I was surprised to find the story closely paralleled the journal entry.
How brave you were to write about your mother. (I’ve had this comment before. The first time, I really didn’t understand what the person was talking about)
Me: It was difficult to write about my mother. We didn’t get along. It was especially disturbing that I was a gerontological specialist and couldn’t get along with my own elderly mother. But it was truth and I felt it was part of my story. (At another reading, I was asked what happened to my mother when she had a place of her own. I told how my mother found a boyfriend. Wish I had thought to add that to my response.)
How do you deal with writing about yourself? (Asked by someone who doesn’t write non-fiction)
Me: I look at this book as a story about someone I know. I tried to dissociate from myself so it was easier to be honest about my actions.
Who was your most memorable patient?
Me: Helen Stoltz. She lived in the apartment next door to the clinic. When I wasn’t busy, she would drop-in and sit a few minutes beside my desk and teach me about aging. Of course, she didn’t know that what’s she was doing. She talked about getting older and eventually dying, which showed me that older folks aren’t afraid of talking about death. She was ready to die. However, she was cheerful and upbeat and accepting of her life until her time came.
What was the most memorable line your wrote in your book?
Me: I didn’t write it but it came verbatim from my notes at the time. The funeral director told me how to go about purchasing a grave site for the Pigeon Lady: The Greeks are tight but the Catholics will give you a break. (page 96). I’m thankful that I wrote down what he said. He was such a character—embodied with Chicago smarts and a big heart.
What I didn’t say was that “I killed all my darlings.” Therefore, there are no “precious” sentences that have survived my editing, thank goodness.
This is from Suzanne Gordon’s Blog. Ms Gordon is a journalist and stanch supporter and promoter of all things nursing.
Recently she asked nurses to respond with their version of “Just a Nurse.” I am delighted to see their feedback. May nurses continue to tell the public what they do and how important their job is.
I would like to post all the ” Just a Nurse” submissions people have sent me. See below. What do you think? I think they are all great. Thank you so much, all of you.
I’m just a Pediatric Intensive Care Nurse. I just manage my patients’ drips to keep to their vital signs in a stable range. I just make sure their medications are safely administered. I just make sure the physician is informed of any small but meaningful change in their condition so we can work together to prevent…