60th Nursing School Reunion or How Did We Get This Old?

. . . we take our leave after cake and coffee with tight throats, warm hugs, and moist eyes, to say our long good-byes.

WE

. . . sit at a long table facing multiple pieces of silverware, cloth napkins, sweet tea, and wine and lit by the wall sconces in the restaurant of a historic hotel in Cape May, New Jersey, delighting in the aromas of clam bisque, arugula salad, beef tenderloin and scallops.

. . . scan aging faces with familiar voices, exchanging pieces of our lives since our last reunion five years ago, attentive to each other’s tragedies and blessings.

. . . listen to the reunion organizer tell us stories sent by those not present, sad for their absence but joyful that the seven of us in advancing years made the trip, some in the company of daughters or friends.

. . . share the inner need to reconnect to the women with whom we have spent three years in our youth as we followed the call to care for others in sickness, childbirth, injury and at the end of life’s journey, transforming immature girls to strong, skilled nurses. 

. . . come back to where we started, in the company of our peers, with whom we lived in the nurses’ residence of Saint Peter’s Hospital School of Nursing and graduated 60 years ago, joining hands in a circle in the school gym singing the Kingston Trio song, Scotch and Soda, before we marched into the cathedral for the bishop to bless us as new nurses.

. . . grip the bonds that may have faded but did not weaken in camaraderie as we take our leave after cake and coffee with tight throats, warm hugs, and moist eyes, to say our long good-byes. 

Counting the Dead

How many will show at the 60th nursing reunion of St. Peter’s School of Nursing at Cape May, NJ?

Ruth and I are counting the dead. Ruth counts 13. I have 11. “We should count anyone who didn’t respond to the invitation as ‘dead’,” she jokes over the phone. I can’t help but laugh. Maybe I’m laughing off the somberness of such a task. 

We are putting together a directory of Saint Peter’s School of Nursing, in New Brunswick, NJ, class of ’62 to pass out to the attendees at our reunion next week in Cape May. It’s bizarre that Ruth and I don’t share an accurate list of our fellow classmates who have passed away in the last 60 years!

I have three lists of information in front of me. Ruth, Joan, and Alice had split up the directory from the last reunion in 2017. They attempted to contact everyone who wasn’t on the dead list. I volunteered to collate the results. Ruth and I are trying to sort out those who responded versus those who didn’t versus those whose addresses are unknown versus those that we are sure are dead. I had phoned a few of my classmates to verify the information I was given, and to be honest, to reminisce. Many had moved in the last five years to be nearer to family. Many stopped driving. I heard of their illnesses and of the illnesses of husbands, if husbands were still alive, death of grandchildren and grown children. With each phone call, I heard the warm voice of an old friend. 

I don’t remember how many women were originally accepted to Saint Peter’s School of Nursing. No men, married, or God-forbid, pregnant women were welcome. Forty-four young, mostly Catholic women completed the program. We spent three years living together in the “nurses’ residence” under the eagle-eyes of around-the-clock housemothers. We graduated in our early twenties having bathed the dead, birthed the babies, assisted in surgeries, cared for toddlers, and the mentally ill. We were left in charge of a whole ward during the night shift until a nursing oversight organization told the three-year hospital programs (not just Saint Peter’s) that student nurses shouldn’t have that level of responsibility until after graduation, and then, of course, with pay.

The class of ‘62 has met every five years since the school closed in 1987 and the yearly reunions organized by Saint Peter’s Nursing School stopped. I had attended each reunion except for the time I was getting worked up for breast cancer in ’97 and the time when one of the then organizers rescheduled the reunion forgetting I would be in Ireland. I had volunteered to write our one and only newsletter which included the “save the date” that didn’t count after all. To be fair, that organizer moved the date so that I could travel to NJ from North Carolina the day after I got back from Ireland. As luck would have it, I caught a bug from my fellow travelers. I missed the 50th reunion.

The directory is done and ready to be printed. Besides the dead, (the death count turned out to be 13), there are two who dropped off the face of the earth after graduation, some who have never bothered to attend a reunion but are still alive, and others who would attend except for their, or their husbands’, ill health. There are six who Ruth, Joan and Alice couldn’t contact, and we’ll keep them on the list until we hear otherwise. All in all, out of 29 who we believe to be alive and kicking, or limping, only eight will travel to Cape May this Sunday.

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.

Haunted Townhouse

Back in the 70s we rented a townhouse in Arlington, Virginia that was haunted. 

Now what made me remember this? Maybe because I, like many others, have been fixated on food while sequestered in my home over this past year due to the pandemic. Food and kitchens and houses. Now there’s a connection. Right? 

Back in the 70s, I was young and energetic and loved to cook and entertain—even though I had a toddler and worked part time in the recovery room at a local hospital. Some of my best creations came from that tiny kitchen in the townhouse. My husband and I often hosted dinner parties for the other young families who lived in our cul-de-sac. Once, inviting several couples, I made my husband’s favorite meal: Sauerbraten, sweet and sour red cabbage, potato dumplings and, from scratch, Black Forest Cake. Foodies out there will know that Sauerbraten marinates for five days and then is cooked long and slow and Black Forest Cake is a bear to make. Not to mention the challenge of that cramped kitchen. 

Back to the haunted townhouse. First, you have to know that we moved into a friend’s townhouse. Karl and his family outgrew their two-bedroom house and moved next door to a three-bedroom. He suggested we move into his vacated rental. We loved the idea of being close to our friends and having more room than our one-bedroom basement apartment, especially since I was expecting a second baby.  

Continue reading “Haunted Townhouse”

Glass Half-Full

Dominated by political turmoil and the COVID-19 Pandemic, this past year has been a roller coaster ride with few brief moments of slow travel interspersed with deep dives of fright and foreboding. The highs that I have enjoyed come in part from the increased attention given to nurses. I have long complained that the nursing profession has been mostly invisible to the public eye, media and policy making sectors. The increase in visibility and status of nurses in these turbulent times looks to me like a glass half-full. 

I celebrate all the recent recognition direct towards nurses. When have nurses spoken up in great numbers for their profession, their practice, their patients and for their contribution to the world-wide challenge to defeat of the COVID-19 Pandemic? When have nurses received so much positive media awareness? Been frequently appointed to expert panels along with physicians and other health care professionals? Interviewed prominently by the news media? Featured favorably on TV shows? 

How much of a coincidence was it that 2020 was designated by the World Health Organization as the Year of the Nurse and the Nurse Midwife? 

In reviewing my posts of the past year, I have pulled out the ones that show increased focus on the nursing profession. I enjoyed revisiting them and am hopeful that the positive attention showered on the nursing profession continues. 

Nurses Gain the Attention They Deserve

Impressive List of Nurse Experts

United Kingdom Nursing Students Work on the Front Lines of the Pandemic

The Power of Nurses

Nursing Students Provide Insights into the Pandemic Media In-Depth Look at Nurses

Heroic Symbol: A Nursehttps://nursingstories.org/2020/05/26/badass-nurse/

One of the memes circulating on the social media platform Reddit created from a photo of UNC Hospital emergency room nurse Grace Cindric taken by News & Observer photojournalist Robert Willett earlier this week.

What Would Flo Think?  

Why Does It Take a Pandemic to Recognize Nurses? 

Nurses Transform Lives

The Power of Nurses

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. 

Nursing Students Provide Insights into the Pandemic

The media mainly focuses on the nurses and doctors who are on the front lines of the COVID-19 pandemic. Rarely do we hear what nursing students are experiencing. 

Below is a repost from the Setonian, the official undergraduate newspaper of Seton Hall University.

**********************************

Seton Hall nursing students and faculty provide unique insights into pandemic

Posted By Alexander Krukar on Sep 16, 2020

Seton Hall students and faculty in the College of Nursing shared their stories and thoughts on being a future health care worker during the COVID-19 pandemic.

Caroline Pascasio, a sophomore nursing major, said her drive to become a nurse has remained steadfast in the face of the pandemic. She said she always knew she wanted to enter a field where she could help other people and feel as though she was having a direct impact on their lives.

“I remember when we were in the peak of COVID, I would always see on the news that they needed more nurses,” Pascasio said. “I wished I was just a few years older so I would have the proper training to help.”

The pandemic has also highlighted many stories from health care workers. Colleen Osbahr, a sophomore nursing major, worked in a hospital over the summer and said she experienced a situation like this firsthand. 

“One woman was working as a nurse, and her mother tested positive for COVID and was in the same hospital as her,” Osbahr said. “She was not allowed by regulations to go into her mother’s room, and unfortunately, her mother passed away.”

Oshbar said the pandemic has been stressful for nurses working in “understaffed” hospitals with limited resources.

“All nurses are putting the health of not only themselves, but also potentially their families, on the line for the benefit of the greater good,” she said. 

Dr. Katherine Connolly, a clinical assistant professor at Seton Hall, has been teaching nursing students amid the pandemic.

“I had the opportunity to work as a nurse practitioner in the hospital setting during the height of the COVID-19 crisis,” Connolly said. “I was very proud of the leadership and collegiality I observed given the uncertainty of the situation. I will never forget the deserted hallways decorated with beautiful cards of encouragement and thanks coming from school children or the loving support from the surrounding community.”

Some nursing students said they worry about adapting to the lasting changes that the coronavirus could leave on their field.

“This pandemic has definitely made me anxious because I know that our nursing curriculum will be different than anything it has ever been,” Pascasio said. “It’s just a little nerve-wracking because you don’t know what to expect. It’s not like you can ask an upperclassman because they’ve never done a clinical in the era of COVID.”

Connolly said she has heard many pandemic stories from her students.

“These students described feelings of helplessness as they were unable to assist COVID-19 patients due to shortages in PPE, which was reserved for doctors, nurses and respiratory therapists,” Connolly said. “As the supply of PPE improved—allowing many to move into the role of bedside provider—the task that most touched their hearts was assisting patients to FaceTime with family members at home, especially when the patient was not doing well.”

Alexander Krukar can be reached at alexander.krukar@student.shu.edu.

Overdue Reckoning on Racism in Nursing

Join me in attending this free series of timely web discussions: Overdue Reckoning on Racism in Nursing.

NurseManifest

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…

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Olden Days of Nursing: Dialysis

I still remember the teenager but not his name or how long he had been getting peritoneal dialysis (PD). I recall him walking between his parents down the long hospital corridor. He was going home to die. A father with small children had preempted the teenager’s spot on the dialysis unit. Restricting patients was necessary because supplies and personnel were in short supply at the time. Dr. Norman Lasker, head of the Renal Division made that decision unilaterally. 

I  had taken care of the teen when he came in for twice weekly treatments. His mother and father came with him bringing magazines with pictures of sweaty wrestlers, which I found repulsive. Not having any brothers, what did I know about teenage boys? However, we did have something in common: the new TV show, Batman. I would watch the show each week (no binge watching then) so when the teen came on the unit, we would have something to talk about. 

What happened to him after he was sent home? Hospice or palliative care hadn’t evolved, as yet. How did his parents manage? Did he wind up in a hospital at the end of his life? 

I called Carol Passarotti-Novembre. She and I worked on the same research floor: a 15-bed unit at Pollak Hospital in Jersey City. Carol was the first renal nurse in New Jersey, working alongside of Dr. Lasker in one of the first Dialysis Centers in the US in 1961. Only three other major Dialysis Centers existed then: Boston, Seattle and New York City. Dialysis nurses received on-the-job-training. 

Carol didn’t remember the teenager.

 

Of course, she wouldn’t since she had so many other patients. Some were on chronic PD, like the teenager. Patients came twice or three times a week, interspersed with emergency dialysis for acute problems like drug overdose, end stage renal failure, and post-surgical renal shutdown. For eight years, Carol was on call 24/7. Only once did she miss an on-call emergency. Another staff nurse from the research unit stepped in. The patient survived. 

Later on, Dr. Lasker was no longer the lone decider. Carol told me that a “board consisting of physicians, administrators, clergy and others reviewed potential patients to receive dialysis treatments.” She sat on this board. 

Carol ran the show at the Dialysis Center. The “Dialysis Center” was in reality four beds devoted to renal patients on the 15-bed unit. 

The procedure for PD was as follows:

After warming two-liter glass bottles of dialysis solution in the sink, Carol hung them from an IV pole. The fluid flowed into the peritoneal cavity and remained in the patient for 30 to 40 minutes. The bottles were taken down from the IV pole, inverted and placed on the floor so the fluid would drain back into the bottles, which took another 10 minutes. Repeat. The patients stayed overnight since each treatment lasted 36 hours. 

Carol managed up to four patients on Monday, Wednesday and Friday or Tuesday and Thursday. The day shift helped when we could. Evening and night nursing staff managed the PD during their shift. Carol discontinued the PD the following morning only to see the same patients come back the next day. 

Not surprisingly, Carol got to know her patients and their families well, as did all us nurses, since each patient came to the unit so frequently. 

One patient, Ellen, a slight Italian women with a large family, stopped breathing and became pulseless when I was in her room. I did what we were taught to do at that time. I slipped her on to the floor, struck her sternum with the side of my hand, breathed into her mouth and started chest compressions. The doctors on the unit came to assist me. We revived her. When she awoke, she told us she didn’t want to be resuscitated. We didn’t ask these questions in 1965. Happily, for me, when Ellen stopped breathing next, I wasn’t in the room. 

Carol had an uplifting story to share: 

“One of our patients was on PD for four years. Her local internist came to her home for each treatment, inserted the trocath [to make the pathway into the peritoneal cavity], and left. Her husband carried out each treatment. Even her little children helped with warming the bottles of dialysate. She switched to home hemodialysis for five years, then continued In-Center Hemodialysis for ten more years. At that point she received a cadaver kidney transplant, which lasted for a good number of years after.“ 

The following is from a speech Carol gave to nephrology nurses and technicians of North Jersey at Marriott Newark Hotel, Newark, NJ, May 6, 2011:  

“The role of the nurse has changed along with each modality of treatment, the changing needs of the patients and families, the advances in technology and the increasing demands for specialized education in nephrology.

. . . My knowledge of nephrology was ‘on the job’ everyday type of learning. I depended upon the physicians I worked with. . . .Working for the medical school had its advantages. The most important being able to be involved in research projects. e. g., vitamin studies, various solute clearance studies, cardiac output studies in the chronic PD patient and also, in developing the original cycler and starting home training programs for PD and hemodialysis.

 

(Carol was the first nurse to be included in a research study citation in the Annals of Internal Medicine.)

Today’s nephrology nurse is involved in direct patient care, teaching in all the fields: PD, hemodialysis, transplantation to the patients and their families as well as research and development. National and local organizations, such as American Association of Nephrology Nurses and Technicians were formed in order to ensure a high standard of education on both a local and national level and making nephrology nursing an accredited and recognized area of nursing. 

For me, the rapid growth and development in this area of medicine over the past 49 years, has been totally mind blowing, awesome, most exhilarating. The potential for future development is limitless!”

Carol married in 1968 and remained with the renal unit of the New Jersey College of Medicine and Dentistry Renal Division until mid 1969 when she left to have her first child. In 1971, she worked as a staff nurse in hemodialysis unit and later in the Hemodialysis Home Training unit at  Saint Barnabas Medical Center in Livingston, NJ. In 1976, she joined a Renal and Hypertension practice as both an office nurse and researcher in many drug studies. Carol worked  full-time, sometimes 50 hour weeks, before she retired in 2010 at the age of 70.  

After reflecting on Carol Passarotti-Novembre’s long career in nephrology, I ask the obvious question. How could the development of peritoneal and hemodialysis have progressed without the collegial partnership between nurses and physicians? 

Jersey Journal. Carol and Dr. Lasker are standing beside the first hemodialysis machine.

 

Ramblings on Expanding Nursing Practice

 

 

I asked Martha Barry who worked with me at the Erie Family Health Centers in the early 80s, to remind me if the Certified Nurse Midwives delivered babies.

 Here’s what she said:

The model for the Certified Nurse Midwives (CNM) when I arrived was outpatient care only. The CNM did all of the New OBs and sorted out the high-risk patients and cared for the other patients throughout their pregnancies, post-partum and follow-up gyn care. Prenatal care was intense case management. (We took) a lot of care and time to be sure no one fell through the cracks and got “lost to follow up.” Luckily, we could utilize the community health RNs to help find patients who did not show up for a visit. At the beginning, Medicaid was not widely available to all low-income pregnant women and especially not to non-citizens. The patients would be on a payment plan and would need to pay by “7-months” and it was a deal that included their prenatal, postnatal and delivery costs. I remember patients bringing their money stuffed in their bras to pay up at that 7-month mark. Deliveries were at Ravenswood Hospital. I wish I could remember the cost. The consulting OB physician would come to Erie for a few hours each week.

I also remember a few patients who worked at the live poultry plant and they said that although they had no health insurance, the boss would pay their delivery fees! 

I was preparing for my talk to the first class of AdvancingPractice, a one-year fellowship to develop quality care and nursing leadership at the clinic I had worked in over 30 years ago and written about in my book: Stories from the Tenth-Floor Clinic: A Nurse Practitioner Remembers.

I read Martha’s words to the group of eight APRN Fellows especially showing the generosity of the poultry plant employer. Then I told the Pigeon Lady story from my book that ends with a neighborhood funeral home director footing the bill for the wake and burial of one of our patients. He then turned around and donated that amount back to the clinic. (It’s complicated) I wanted to stress the interrelatedness of the surrounding community on the health care clinic. 

Part of my presentation was to discuss the historical context of the advancement of nurse practitioners and nurse midwives (collectively labeled Advanced Practice Registered Nurses, APRN).

One of the handouts for the class (Expanding Access to Primary Care: The Role of Nurse Practitioners, Physician Assistants, and Certified Nurse Midwives in the Health Center Workforce, National Association of Community Health Centers, September 2013) plunged me back to the time I and other new APRNs in the Chicago area were struggling to justify our right to practice to the full extent of our training.

How much had I forgotten—maybe wanted to forget. For example, back in 1957 the American Nurses Association developed a definition of nursing that would retard the advancement of nursing practice for decades: nurses were neither to diagnose nor prescribe. And some groups of nurses called us “little doctors” and didn’t support developing educational programs in nursing colleges.  

I hope the new Fellows I spoke to learned from my presentation something about the historical context of the role, the significance of the role in the community setting and the potential of the APRN career choice. 

I close with a quote from the NACHC fact sheet:

An expanded role for nursing is an idea deeply rooted in nursing’s past and from it, much can be learned for today. Indeed, nurses should take this historical opportunity to think creatively about recycling elements of past practice for today’s unique context—perhaps initiating state-of-the-art nurse-run clinics in rural and inner city areas; reaching others by telenursing; and collaborating with designers in technology firms to create Apps and other high tech solutions to bridge gaps that exist in healthcare today. To do so, they must first read and understand the impact of the historical antecedents, cornerstone documents, and legislative acts that contribute to the nursing profession’s rich history. 

 

Expanding Access to Primary Care: The Role of Nurse Practitioners, Physician Assistants, and Certified Nurse Midwives in the Health Center Workforce, National Association of Community Health Centers, September 2013, Page 9


 

 

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