Book tour in Chicago

Saturday, June 1, 2019

I am scheduling this post to publish on Wednesday, June 5, 2019. That day, I will be in Chicago talking about my book to the Advanced Practice Nurses at Rush University. I have three other venues scheduled before I head home on Monday. In between events, I will spend time with old friends. I’m having lunch with one woman that I haven’t seen in over 20 years!

Frank Lloyd Wright Home and Studio, Oak Park, Illinois

On Sunday, I will be reading at the Oak Park Library, Oak Park, Illinois. My daughter and 15-year-old grandson will have flown from Raleigh to join me. Afterwards, my daughter will show her son where she grew up. Maybe we’ll visit the Frank Lloyd Wright Home and Studio where, to get a change from nursing, I volunteered in the gift shop. I learned so much about Frank in particular and architecture in general. I always wondered if my involvement with the FLW Foundation had any influence on my daughter’s choice of a career—architecture.

So, think of me in the Windy City as you read this.

 

A Long Overdue Thank You

I had finally decided to clean out my office closet. I started with the stuffed cardboard Unknownfile box. The first thing I reached for was a frayed manila envelope. The stack of typed pages spilled out onto the floor. After I read the first two sheets—an early attempt at documenting my nursing life—I knew I was doomed to sit on that floor by the open closet door until I had scrutinized every page. One story especially held a surprise.

In the early 70s, after my husband completed his degree at the University of Chicago, we moved to the far south suburbs where housing costs fit our tight budget. My first job was at a community hospital. Soon after I started, I found out that my salary was the same as a new graduate nurse who had never even done a simple urinary catherization. I, on the other hand, was an experienced ICU nurse. I wrote a letter of complaint and while the Director of Nursing of the hospital commiserated with me, I wasn’t offered a raise. I quit.

I decided to apply for a job at a close-by nursing home in spite of the fact that I thought I was overqualified and working at a nursing home felt demeaning to my young arrogant self. I eventually learned differently.

I wrote about this experience in my memoir:

 

. . .I had worked in a nursing home—a well-run home

with low staff turnover—for a short period of time, but long enough

to savor the slow pace after being an intensive-care nurse for years

before. The residents bestowed many hugs and an occasional slobbery

kiss as I passed out medications on the evening shift.

I had forgotten that experience the day my academic advisor and

I talked about a master’s thesis. In 1979, like most of my classmates, I

wanted to study women—women of child-bearing age. Why did she

think she had to ask me again: “What group do you REALLY enjoy

caring for?” That’s when I remembered the hugs in the nursing home.

At the end of the version of the story about working in a nursing home that had sat in the manila envelope for over 15 years, there was an added comment about Eva Harrison that I hadn’t remembered writing.

Eva Harrison, the nursing home DON, had offered me a salary higher than the one I received from the hospital. She ran a warm and caring facility, valuing her staff and residents alike. I know she felt sad when I left after only six months but a new clinic opened. At the time, I believed that this new job was more prestigious than that of pill pusher in a nursing home.

What I had written was that I wished I had gone back to tell Eva Harrison that my time at her nursing home had so influenced me that when I graduated as a nurse practitioner a few years later, I had declared geriatrics my specialty. Working in a nursing home, Eva Harrison’s nursing home, set me on a career path that would both challenge and reward me.

Thanks, Eva.

Back to where it started: Chicago

I flew into cold, snowy Chicago last week to discuss my book at the main facility of Erie Family Health Centers. This felt like a dream as I stood behind the lectern gazing at the audience that, believe it or not, included a few familiar faces from some thirty years ago. I had been invited to read from my book: Stories from the Tenth-Floor Clinic: A Nurse Practitioner Remembers.I was discussing EFHC’s humble beginnings to this group of employees seated in the conference room on the third floor of an impressively designed modern building.

The main clinic that I remember was housed in a community center. Children’s laughter in the after-school program and the sound of the ball dribbling on an indoor basketball court easily penetrated the partitioned walls of the exam rooms. The dedicated staff experienced delayed pay days when revenue came up short. The clinic where I worked, a short walk from the main center, had mismatched chairs in the waiting area, second hand medical equipment, and roaches in the cabinets. In spite of the physical shortcomings, EFHC cared about the patients, the community, and its staff.

EFHC not only survived its humble roots but thrived and expanded. The non-profit organization now has 14 health centers, and more Advanced Practice Nurses (nurse practitioners and midwives) than doctors and is recognized as providing the highest quality of care by the US Department of Health and Human Services. The Chicago Tribune named EFHC as one of the top workplaces in 2018.

I am honored to be part of EFHC’s history.

 

Retired Nurse Practitioner & Author Marianna Crane presents her memoir,
Stories from the Tenth-Floor Clinic
On February 20, Marianna Crane, retired Erie nurse and author, met with our nursing staff to discuss her memoir, “Stories from the Tenth-Floor Clinic,” which movingly recounts her experiences as a nurse caring for the underserved elderly at Erie in the 1980’s.
We had a full room, a great discussion about the nursing profession, and over $300 were raised for Erie’s patients through the sale of her book!
Please join us in continuing to support Crane’s work! Keep up with her on her blog and website, Nursing Stories.
Buy the Book!
Proceeds from the sale of Crane’s memoir go towards providing quality care for Erie’s patients.
Crane with Dawn Sanks, Director of Health Center Operations at Erie West Town
Crane with Dr. Lee Francis, President and CEO
A full room!
Erie Family Health Center | 312.666.3494 (city) | 847.666.3494 (suburbs) | www.eriefamilyhealth.org

The Building as Character

 

Countdown to Publication Date: One Week

I have three readings scheduled at local books stores in the next few weeks. I will send out an e-vite tomorrow. It’s both a stressful and exciting time. I have to remind myself to “have fun.”

The latest review of my book: Chicago Writers Association, Windy City Reviews:

Stories From The Tenth Floor Clinic. Marianna Crane. Berkeley, CA: She Writes Press, November 6, 2018, Trade Paperback and E-book, 212 pages. 

Reviewed by Deb Lecos. 

Marianna Crane has written an important memoir detailing the complex needs of an aging population and how a humane society should shift its thinking about what is “conscious-care” when people reach a certain level of fragility. The reader journeys along with Marianna while her beliefs change as a nurse practitioner, running a senior clinic within a Chicago-based, subsidized-housing building. 

As a nurse practitioner specializing in gerontology at the Veteran’s Administration, Marianna is governed by strict parameters. When a job change takes her to a senior clinic within a CHA building, she faces an environment quite different from where she trained, and is forced to adapt so she can help those under her care. Many of her patients are alone, disconnected from family, and easy prey for those intent on stealing their meager incomes. Continuing to live independently can be difficult when a patient’s health moves swiftly downhill and there are no friends or relatives to assist in decision-making. Residents of the building have come to rely on the clinic and its support staff to ensure they have social interaction, food in the refrigerator, and a fan when the heat becomes dangerously high. 

After work, Marianna’s home life is fraught with similar issues, as a complicated relationship with her mother has reached an unsustainable level of dysfunction. Her mother has become increasingly combative, and her disinclination to engage therapeutically requires Marianna to devise a solution that is respectful to her husband and two teenage children, while ensuring her mother has a safe place to land. Utilizing the new approach that she’s been reluctantly taking with her patients affords Marianna necessary skills to handle this emotionally-challenging situation. 

With chapters unfolding in story form, the reader glimpses the lives of vulnerable people. We learn what happens when the frail are shuttled into the corners of society without enough support. Filling that gap in care are Mattie and Mary, who work under the direction of Ms. Crane and are devoted to building humane over-sight relationships with the residents. Mattie and Mary compel Marianna to redefine her role in the clinic community by introducing her to Angelika, a woman choosing to die in her apartment instead of going to a hospital. Angelika has refused a diagnosis of the ailment ending her life. After losing the battle of Angelika’s resistance to leave her home, Marianna allows herself to adjust to the 

needs of those she is intent on helping. She comes to understand that sometimes care means respecting the wishes of a dying woman and not requiring her to take a final breath in the hospital, even if doing so breaks a dozen rules in the process. 

The stories Ms. Crane starkly and, at times, graphically illustrates occurred in the 1980’s. Similar events are continuing to unfold today in subsidized housing and homes all across the country. Difficulties the aging and poor experience in navigating ill-health and death within a system built for the well-off and healthy have worsened in the time since the author encountered these experiences. The VA, health clinics, and senior care programs are still underfunded and mismanaged, exacerbating the condition of buildings and staffing needs. 

There are no concrete solutions to the problems we face in determining how to care for a growing low-income, aging population. It is my fervent wish as a reader of this memoir that we do so with an ability to change our thinking, much as Marianna Crane convinced herself to do. Convenient, easily-enacted answers to the complex struggles of the elderly, many of whom are not connected to functional families, will not be successful. As Marianna came to her own epiphanies on how to be of assistance, so must our national community. This is a relational issue and it deserves a relationally-creative response, one that is centered on humane and caring treatment for all ill, infirmed, and end-stage-aged people. 

The Perks of Serving on the Board

 

I have served on the Family Patient Advisory Council at my local hospital in Raleigh, North Carolina since it’s inception a little over two years ago. I became the first Chair and now I am the Senior Chair.

This last week, the hospital funded my travel to Chicago to attend the Patient Experience Conference 2018 where the Chief Nursing Officer, Manager of Service Excellence, also a nurse, and I gave a presentation: Operationalizing Patient Advisory Council: Going Beyond the Boundaries.

 

I felt privileged to discuss the successes and challenges of our group and pleased, as a retired nurse, that I am using my background in health care services to facilitate change. In this case, to promote and improve the patient experience.

 

Patient Experience

Patient experience encompasses the range of interactions that patients have with the health care system, including their care from health plans, and from doctors, nurses, and staff in hospitals, physician practices, and other health care facilities. As an integral component of health care quality, patient experience includes several aspects of health care delivery that patients value highly when they seek and receive care, such as getting timely appointments, easy access to information, and good communication with health care providers.

Understanding patient experience is a key step in moving toward patient-centered care. By looking at various aspects of patient experience, one can assess the extent to which patients are receiving care that is respectful of and responsive to individual patient preferences, needs and values. Evaluating patient experience along with other components such as effectiveness and safety of care is essential to providing a complete picture of health care quality. – Agency for Healthcare Research and Quality

At the conference, not only did I learn about the patient experience movement and its growing numbers of supporters, I came away excited about the direction of health care.

After the conference, I met my friend Lois. Our friendship spans 40 years. We had one day of sleet and one day of sun in our quest to revisit old haunts and discover renovations to Chicago’s old buildings. At Navy Pier we asked a mother and daughter to take our picture. It turned out the daughter was starting nursing school with the intent to become a nurse practitioner. At this serendipitous meeting, Lois and I shared sage advice about the rewarding aspects of a nursing career.

Back home in temperate North Carolina, I look back at my time in Chicago and feel privileged to have attended the conference and had the added perk to have spent time with Lois.

Have you ever considered being on a Board?

I have choosen to reblog this post because I believe nurses bring invaluable skills and knowledge to various health care boards. I am currently serving on a board at Duke Raleigh Hospital in Raleigh, NC.
Next week I will be in Chicago at the Beryl Institute Patient Experience Conference along with the Chief Nursing Officer, and the Manager of Service Excellence to give a presentation about our Patient Advocacy Council. I will post updates from the conference and share more information about my board experience on future Posts.

NurseManifest

Here at the NurseManifest project, we have tended to emphasize grass roots, “on the street” kinds of activism to bring our deepest nursing values into everyday experience.  But manifesting nursing values needs to happen everywhere, and one of the spheres whereconference-table this is vitally important is in the Board Rooms, large and small.  Lisa Sundean, who is one of our NurseManifest bloggers, is embarking on her dissertation project to explore nurses on Boards, and in the interest of sharing her work wide and far, she has established website and blog – SundeanRN.org!  Her first blog post is now available, explaining why this is vitally important!  I highly recommend that you read her post: What do Boards Have to do with Nursing?  And if you have never considered serving in this capacity, think about it now!  We need to be manifesting nursing everywhere – at the bedside, the chairside…

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The Murder Building

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Originally posted on February 19, 2012 

 

When I visited a patient in my caseload that lived in an “unsafe” part of the city, I went in the morning. Right after the pimps and drug dealers had called it a night and before the shop keepers pulled up the bars over the store windows and the women came out to sweep the sidewalk litter into the streets.

One day Pearl, the social worker, asked to come with me to see a patient. She had a meeting in the morning so we left after lunch against my better judgment. If I were going to go to an iffy part of the city, this was the last place I would want to visit. The Chicago Tribune ran a story a few weeks previously about the “Murder Building.” I knew by the address it was next door to my patient’s apartment.

Everyone knows it simply as “the murder building.“

“They call it `the murder building` because people have been known to go into that building and not come out,“ said one young man standing on a nearby street. “You got to stay away from that place. Things go on in them halls you don`t want to see.“

What does that say about the neighborhood we drove through and the scattering of young men gathered on the stoops, some leaning against the parked cars, all seeming to be without a sense of purpose? I felt their eyes following us.

My patient lived on the second floor of a three story apartment building with his common law wife and various other relatives. The front door was locked and since there wasn’t a bell, I had to stand under the window and yell the patient’s name. The patient’s wife would come to the window before she sent one of the grandchildren down to let me in. This was before cell phones.

I dreaded leaving the safety of the car. Did any of the men think we carried drugs? I scooted out and quickly grabbed my nursing bag from the trunk along with a white bathroom scale. The patient was on tube feedings. It remained unclear if his wife was able to manage the procedure and give the feedings on schedule. I was monitoring his weight as evidence of success.

When Pearl and I completed our visit, we took quick, long steps to the car, avoiding eye contact with anyone near-by. As I stuffed my bag and scale into the trunk, I felt someone tap me on the shoulder. I waited for the command to hand over my nursing bag. Instead a soft voice asked, “Before you put that scale away, would you weigh me?”

I turned to see an older man with short gray whiskers on his chin and a pleasant smile. He moved aside as I slammed the trunk closed and carried the scale to the sidewalk. He took his shoes off and stepped on the scale. “I can’t see the numbers,” he said. I read them off to him, he stepped down, retrieved his shoes and said, “thank you.” Behind him stood a young man with dreadlocks. “Can I get weighed too?” He slipped out of his high tops. I called out his weight and he left with a “thank you.”

Behind him a line of men snaked along the sidewalk. Pearl emerged from the car and began joking with the men, young and old, as they waited their turn at the scale.

Back in the car, the scale packed away in the trunk, Pearl and I drove to the corner. As we pasted the Murder Building, ominous and frightening with smashed windows and debris scattered around its foundation, I realized a building doesn’t define a neighborhood.

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