Wonderland Book Club

QR bookclubLast Friday I discussed my book, Stories from the Tenth-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:

  1. 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.

  1. 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.)

  1. 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.

  1. 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.

  1. 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.

Besides the Q & A, I was happy to be able to drop some facts about nursing, such as nurses have been voted the most respected of professions for the past 18 years. And that the World Health Organization designated 2020 the Year of the nurse and midwife.

I was grateful for such an enthusiastic and supportive turnout.

 

 

 

 

 

https://wordpress.com/post/nursingstories.org/1635

 

https://www.dailywritingtips.com/say-no-to-your-darlings/

 

https://www.icn.ch/news/2020-international-year-nurse-and-midwife-catalyst-brighter-future-health-around-globe

 

https://www.nationalnursesunited.org/press/nurses-top-gallup-poll-most-trusted-profession-18th-consecutive-year

 

How Mindfulness Can Be an Act of Self-Care for Nurses

I recently came across a new, to me, Blog: Nightingale. A 2017 post by Teresa Brown describes her initial exposure and reservations about mindfulness—I am not giving away the ending. Given I had just spotlighted Julia Sarazine, a qualified mindfulness instructor, I decided to reblog Teresa’s essay.
The Nightingale website looks interesting and promising, however, I didn’t notice any recent activity. Sara Goldberg, founder of Nightingale, may have been busy with her new book: How to be a Patient: The Essential Guide to Navigating the World of Modern Medicine, which was recently released. I read her book and will review it in a future post.

Nightingale

Nurse Burnout Won’t go Away Until the Industry Changes. But in the Meantime, Mindfulness can Help Nurses Prioritize Their Well-Being.

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This past November I attended a workshop on nurse burnout at the Johnson Foundation at Wingspread in Racine, Wisconsin. Clinical nurses, administrators, and researchers came together for three days to discuss this pressing issue that is epidemic in nursing. One survey found that almost half of nurses are burned out, meaning they’re so overwhelmed by the job that they’ve lost the capacity to really care about it or their patients.

I tend to be suspicious of talk about mindfulness in health care because it seems to place the onus for change on individuals instead of the overall system.

Several of the workshop presenters discussed “Mindfulness” as a way to alleviate burnout. I tend to be suspicious of talk about mindfulness in health care because it seems to place the onus…

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Mindfulness: Julia Sarazine

I met Julia Sarazine this past June when I spoke to Rush University nurses in Chicago about my book: Stories from the Tenth-Floor Clinic: A Nurse Practitioner Remembers. We agreed on the need for nurses to tell their stories.

When I discovered Julia’s background in teaching mindfulness techniques to nurses in order to reduce symptoms of stress (see How PTSD Is Hurting Nursing) I asked if she would share her expertise and experience about how mindfulness can help reduce Burnout syndrome/Post Traumatic Stress Disorder (BOS/PTSD).

I’m honored that Julia agreed.

 

You’ve said that some experts feel that Burnout syndrome among nurses is a public health crisis. BOS has been affecting nurses for as long as I can remember. Why do you think this problem has been so insidious and tenacious?

Burnout syndrome is now receiving attention as demonstrated by The World Health Organization including it in the Revision of the International Classification of Diseases as an occupational phenomenon.

Levels of burnout are higher in professions that have high risk associated with them, such as a nurse administering medications and treatments that may have a significant impact on someone’s life. Also, nurses are usually the ones that hear and witness the patient and families suffering.  In most situations, nurses see people when they are worried about their health, in pain or being treated for a serious illness.  Over time, this constant exposure to suffering can take its toll on the ability to maintain our own health and wellness.

Moreover, the demands of the healthcare system continue to increase with technology and integration of electronic medical records.  As more patient care is being provided in the outpatient arena, patients are sicker and may require more care than in the past.

 

You left a hospital nursing position because you had symptoms of BOS, yet a few years later you returned to the same position you left. How did you find the fortitude to do that?

 Once a nurse, always a nurse definitely applies to my situation and decision to come back to the nursing profession.  I missed working with patients and the sense of accomplishment I received while helping others.  It is the same reason I was drawn to the nursing profession in the first place.  I know it has been over communicated, but being a nurse is truly a calling, not just a job. It was not an easy decision, but it felt right for me at the time as I changed how I handled stress and suffering.  I basically learned to take care of myself with mindfulness at work and how to transition to be fully present at home.

 

What advice would you give to other nurses who have left nursing?

To leave the nursing profession is a very individual decision.  I believe all nurses are caregivers.  Where nurses are providing care may change and whom they are providing care to may also change.  For example, nurses may be taking care of their children, parents, family, friends or community members.  It may look different, such as volunteering for the food depository, listening to a friend discuss her new cancer diagnosis or asking the cashier at the grocery store how they are doing today.  Nurses are usually empathetic people and naturally take care of others throughout their lives.

 

There are terrible statistics about how many new nurse graduates leave the practice after a couple of years because of BOS. Among all the other tools out there to deal with this issue, what does mindfulness contribute?

 Mindfulness is not the magical wand that can solve all our problems and prevent burnout.  But it is a tool we can use to take care of ourselves so we can take care of others. I think all nursing students should be taught a few mindfulness skills when they begin nursing school.  If you can learn just a few simple skills to protect you while witnessing and feeling someone’s suffering, it can help prevent burnout and lower your stress levels.

 

What is your definition of mindfulness?

The mind naturally wanders from the present moment to the past or future. This is often referred to as autopilot.

  • Have you ever commuted to work and not remembered the drive or train ride?
  • Have you ever eaten something and not remembered tasting it?
  • Have you ever reacted to a situation and later regretted how you handled it?

These are all examples of mindlessness. In contrast, mindfulness focuses on being aware in the present.

There are multiple definitions of mindfulness, but the most commonly quoted is from Jon Kabat-Zinn: “Paying attention on purpose in the present moment, non- judgmentally.

 

How did you first learn about mindfulness?

Right after I left nursing, I was struggling with trying to process all of the deaths I witnessed. A friend recommended The Power of Now by Elkhart Tolle.  I read it and then began to meditate each morning. I found I was able to focus more and notice moments of joy in simple things such as a warm breeze on my face, a smile from a stranger and the taste from the first sip of coffee in the morning.

I continued to develop my own practice by taking mindfulness courses, attending silent retreats and eventually becoming a mindfulness instructor.  Mindfulness is never complete; everyone who practices is always learning and evolving through increased awareness.

 

How has mindfulness changed you?

Mindfulness allowed me to process all of the suffering I witnessed and absorbed while working at Cook County Hospital as a palliative care nurse practitioner.  During one of the mindfulness retreats, the teacher said, “ You don’t have to jump into the deep in of the pool, just dip your toe into the water as far as you can at this time.”  This was very helpful for me at the time because I was resistant to processing the deaths for fear I would drown in grief.  From this simple instruction, I was able to process each patient’s death by allowing myself to feeling the sadness and grief; then the grief lessened and I was able to wish the patient and family well.  I realized I was frozen in time, but the family and friends had moved on with their lives the best they could.

When I returned to my nurse practitioner position five years later, I used mindfulness to keep myself grounded in the moment so I could think critically and also not absorb all of the patient’s and family’s emotion.

Now I use mindfulness all day long to recognize when I am stressed and choose how to respond, enjoy pleasant moments more fully and to accept when I have feelings of sadness or grief while taking care of aging parents.

 

Please tell us about the success you have had in teaching mindfulness to the nurses at Rush University Medical Center.

 It is an amazing experience to be able to share the worst moments in my career and now teach how I processed the grief with mindfulness and continue to use it every day.

At Rush University Medical Center, we completed a study and determined that six months after nurses participated in a four-hour mindfulness and resilience workshop; they had reduced burnout and perceived levels of stress and increased mindfulness skills. We were thrilled with the results discovering that a short four-hour workshop can have an impact six months later.

 

 Please add anything else you think my Blog followers need to know about mindfulness.

 Here are some strategies and tips to incorporate into your daily life through informal practice, especially at work, where stress levels can be elevated. Just as a reminder, it is important also to practice informal mindfulness in times of minimal stress since it is easier to focus on being present and will make it more accessible during times of higher stress. Remember, it does not take any more time to be mindful.

 

Informal Mindfulness Practice:

STOP

STOP is a mindful technique that can be used in any situation to slow us down and reconnect with ourselves. It can be used before entering a patient’s room, sending an email, charting, speaking, or entering your home after work. The acronym STOP stands for:
• Stop whatever you are doing to pause for a moment
• Take a deep breath or two
• Observe any specific thoughts, emotions, or body sensations
• Proceed with more awareness

Two Feet, One Breath

This mindful technique can be used in times of stress to ground us and create a little space from the stressful situation being encountered.

With both feet firmly on the ground, while either standing or sitting:

  • Focus as much attention as possible on sensations in the sole of the left foot—perhaps pressure or sensations from contact with the sock or shoe.
  • Then shift attention to sensations in the sole of the right foot, with as much attention as possible.
  • Tune in to your breathing—just feeling the breath as it moves in and out.
  • Now, continue whatever you are doing in a more grounded and present manner.

Mindful Hand Washing

Use all the senses to bring awareness to the activity of washing the hands. Feel the temperature of the water and the sensations of the hands rubbing together, the smell of the soap, and the sound of the water running, and notice the bubbles forming from the soap. This awareness can be applied to any routine activity, such as brushing teeth, taking a shower, or typing an email.

 

Formal Mindfulness:

On-Line Mindfulness Workshop Opportunity:

TheMindfulness and Resilience 4- Hour Workshop has been shown to decrease stress and burnout symptoms and increase mindfulness skills 6 months after participating.

I am teaching it on Saturday, October 19thfrom 8 am – 12 pm CST.

For details:

https://www.sarazinemindfulness.com/corporate-mindfulness-programs

 

 

Julia Sarazine

Sarazine Mindfulness, LLC

www.sarazinemindfulness.com

How to Handle This Age Issue

The woman who was interviewing me asked my age. She was apologetic. “My boss wants me to get ages.”

I was ready for her.

“I am 76,” I said. “Not a problem to ask. I think it’s good that folks realize that older people can still be productive.”

“That’s one way to handle it,” she said, flatly.

Handle what, I wondered? But I didn’t ask just in case she would think I was being snarky and end our conversation. She was a columnist from a newspaper published in my old home town, calling to conduct an interview about me and my first book, a memoir.

Quite a few years ago, when I was dipping my toe into the writing life, I heard a local cookbook author being interviewed on a radio program. When the interviewer asked the author her age, she said, “I never tell my age. There are too many ageist readers out there.” I was floored. How would ageist beliefs disappear if those who are successful and of a certain age don’t sing their own praises? I wanted to reach into the radio and shake this woman. Since then I had been on a mission to tell my age. That was the way I was handling the age issue.

Once I stopped into a Weight Watcher’s storefront to get help in dropping the ten pounds that I have habitually lost and gained over the years. The helpful clerk was promoting the additional support one could find on the internet. “There is a Weight Watchers’ Blog,” she said, eyeing me before she continued. “Do you know what a Blog is?”

I immediately assumed she thought that I was too old to know what a Blog was. Since I had just recently set up my own Blog following advice on how to promote my future book, I huffed and puffed and said rather haughtily, that I have my own Blog, thank you, then turned and marched out the door. Only later did I recognize that was the wrong way to educate the clerk. Now she knew I was not only older but super sensitive. I should have just laughed and told her I had a Blog as if it were no big deal. Then she would be impressed by my age and my poise.

Since it is obvious that I am older, my new tack is to just be me and disregard any real or imagined mannerisms of others that are demeaning. While I don’t shy away from confrontation, and in some instances enjoy the battle, I would have to make an extra attempt to be cordial. Why call attention to my age? Let my actions and accomplishments speak for themselves. Yet another way to handle the age issue.

Now you can see that I am conflicted. Tell my age or not call attention to my age?

A week ago, a woman contacted me via email. She had seen my memoir on the publisher’s website. Could she talk with me about the indie publisher I had chosen? She finished her first memoir and now was exploring options. The memoir was about her grandmother who had sold alcohol during prohibition to support her family. The woman told me that she had written a few professional books and self-published a fiction story. We spent almost an hour discussing the pros and cons of self-publishing versus using my indie publisher.

During our conversation, we never mentioned age. Afterwards, looking over her website, I discovered that she was 82. I was impressed with her vitality, and enthusiasm to get her memoir published and promoted. Oh, to be so cavalier about one’s age! I now know how I will  handle this age issue.

Just ignore it.

 

decisionsright

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.

 

Meeting Nancy Panko

I was one of about thirty authors who attended the program, Authors in Your Backyard: A Celebration of Local Writers, held at my neighborhood library on a Sunday afternoon not too long ago. I arrived with copies of my book: Stories from the Tenth-Floor Clinic, and the syringes

Highlighter Syringes

to lure readers to my table. I didn’t know to bring a pretty colored cloth to cover my part of the table that I would share with another writer. Before the program started—a keynote address by a well-known mystery writer and five randomly selected readings—I roamed the room meeting the other authors.

At the very first table by the door, a woman about my age set up her books beside a poster publicizing her work. She had brought a table cover onto which she pinned a large sheet that announced: “Nancy Panko, author of Award Winning “Guiding Missal.” Her display could have been inside a book store. She had done this before.

While Nancy’s book was not about nursing, we soon discovered we were both nurses. She became a nurse in her late 30’s. She has been published 10 times in Chicken Soup for the Soul. Her 11thwill be in the next Christmas edition.

Nancy Panko epitomized the type of nurse I have long promoted. One who writes about her life as a nurse. Plus, she is an older woman. A great role model.

So, I asked her if I could spotlight her in my next post.

Here are two of her Chicken Soup stories and a link to her award-winning book: Guiding Missal.

Guiding Missal

Click here to order.

At the end of the stories, Nancy answers two of my questions:

Why do nurses need to publish their stories?

What has nursing done for you?

 

A Journey of Healing

On a sunny July day, my younger brother Terry was killed as he attempted to cut down a tree. He died instantly of traumatic head injury. In the blink of an eye, I no longer had a brother. He wouldn’t be in my life to tease me, give me advice, or to make me laugh. He was just gone, leaving a huge hole in all our hearts. The pain was unbearable.

As I grieved, I found I wanted to pay tribute to my brother’s life. At the age of 14, I announced to my parents that I wanted to be a nurse. As I grew up that goal got pushed aside, I got married and had children. I prayed that somehow I could find a way to go back to school to realize my dream of being a nurse. My husband and children were very supportive and we all prayed that God would show us the way…and he did.

I enrolled in nursing school, achieved good grades and made Dean’s List. In my Junior year, I began carpooling with Jeanne, one of the Intensive Care Unit (ICU) instructors. Driving fifty miles a day, we shared confidences and family stories. She became a mentor and a friend. I explained how Terry’s death affected my decision to return to school and how fragile I was just thinking about treating a traumatic head injury patient. She listened intently and seemed sympathetic.

The day before our senior year ICU clinical experience, Jeanne, my mentor and car pool friend, assigned me a traumatic head injury patient. I was in shock and disbelief. I prayed silently for help. I could not let my emotional, personal experience interfere with giving this patient the best care possible.

Upon entering the ICU, I learned that my patient was in surgery, having his second operation to relieve pressure from a blood clot on his brain. The doctors had given him little chance of survival. Terry had no chance at all, but this guy does, I thought. He’s still here, fighting for his life, and I’m going to do everything in my power to help him. I prayed for my patient and his family in the waiting room.

That afternoon and evening I studied the patient’s chart. His name was Sam, he was nineteen years old, the youngest child of a large close knit family and his accident was eerily similar to Terry’s. He worked for a tree-trimming company and while strapped in his safety harness perched in the tree to trim branches, he was hit in the head by a falling branch. He hung upside-down in the tree for nearly an hour before being extricated. He suffered a fractured skull with a large blood clot on his brain. A device was in place to relieve and measure the pressure inside his skull. A ventilator helped him breathe, he had arterial lines, IV’s and a urinary catheter. He had been given The Last Rites. Twice.

The next day, just after dawn, I saw Sam for the first time. His head was swathed in bandages, he was unresponsive and motionless. His tall frame completely filled the length of the bed, no sign of awareness in that young body.

My knees were weak, but I knew every detail about his physical condition, medications, procedures and his monitors. In ICU, the details can mean the difference between life and death. I can do this, I said to myself. All my hard work to this point comes down to this day and this patient. I laid my hand on Sam’s arm. “Good Morning Sam. I’m your nurse for today, my name is Nancy.” I told him the day of the week, the date, the time, what the weather was like. I chattered on while gently caring for him. There was no response. After morning care and charting I took time to speak to his family.

Out in the waiting room, I approached a tired-looking woman and introduced myself to Sam’s mother. She told me all about Sam and the family. I asked her to join me in a plan to stimulate her son and, hopefully, lighten his coma. I asked her to bring in a radio to play his favorite music and family pictures to tape in easy-to-spot places around his cubicle. I shared my nursing care plan with her and she felt included. This plan was also a prayer. Sam’s mother had a glimmer of hope and was pleased that she could help.

Each day we carried out the plan. I talked to Sam and played his favorite music. While completing all my nursing duties, I told him about the leaves changing colors and about the apples and cider for sale along the roadside. His vital signs were stable, no signs of infection but there was no response. It was hard to see this young man remain so still.

One day, as I struggled to put one of his heavy, long legs into his pajama bottom, I said, “Sam, it would be great if you could help me. Can you lift your leg?”  His leg rose five inches off the bed. I tried to remain calm. “Thank you, Sam. Can you raise the other leg.” He did it!  He could hear and follow commands, he had bilateral lower extremity movement, still, he had not regained consciousness or opened his eyes.

The next morning, I was told that during the night Sam had started breathing against the ventilator. As I came into his cubicle, I put my hand in his and told him I was there for the day. Sam squeezed it! I grabbed his other hand and asked him to squeeze again. He obeyed. Both hands and arms working on command. Praise God! I encouraged Sam all day. By the afternoon, he was breathing totally on his own and no longer required the ventilator.

Still his eyes remained closed. As I worked with Sam the next day, he turned his head from side to side to follow my voice wherever I was. I brought his mother into ICU.   “Sam,” I said, as his face turned towards me, “Your mom is here.” A tear slid down his cheek. “Sam,” I repeated firmly, “your mom is here. Please open your eyes.” We watched him struggle to lift his eyelids. Finally, his eyes fluttered open, but he looked toward the sound of my voice. “Sam,” I said, walking around the side of the bed to stand behind his mother, “look at your mom.” Suddenly, recognition dawned in his eyes as he gazed at his mother’s face and began to sob. The staff and my instructor, Jeanne had gathered to watch this miracle unfold, they were all crying. I partially lowered the bed’s side rail for a long awaited mother and son embrace. I felt so blessed to be a part of this journey of healing.

Sam continued to improve rapidly and was soon discharged from ICU to the Rehabilitation Unit where he had to learn to walk, talk and perform all his activities of daily living. His mother was at his side every day.

In caring for Sam, I had dealt with my grief, loss, fears and emotions. I was able to do for Sam what I couldn’t do for my dear brother, Terry. Against all odds, Sam survived.

A few weeks later, while walking through the Rehab Unit, I heard someone call my name. It was Sam’s mother. We hugged, she was smiling. I saw a tall, handsome young man standing next to her. His formerly shaved head had grown a crew cut beginning to hide the many scars. I barely recognized him.

“Hi Sam, how are you?” I said. “Do you remember me?”

He cocked his head and spoke haltingly.  “Your voice sounds so familiar.”

The lump in my throat only allowed me to respond, “I was one of your nurses in ICU.”

His words came out haltingly, “You..are..Nancy..My..mom..told..me..all..about..you.”

Here was a true miracle standing before me. For two weeks, my life was intertwined with Sam’s as we each experienced joyful healing.

One day, while Jeanne and I were driving to school, I gathered the courage to ask her why she blindsided me by assigning me a traumatic head injury patient, when she knew my story. She explained that she believed in my nursing skills and even more so in my character. She wanted me to face my fear while she was there to watch over and support me. I was emotionally touched to feel her kindness.

A few months later, at my graduation, I received flowers from Sam’s family. The card said,” To our Angel!” On this journey of healing, I believe that both Sam and I had the divine blessing of someone watching over us.

Chicken Soup for the Soul—Find Your Inner Strength, November 2014, 303

 

 

 

 

 

A Cast of Characters

It was the first week of September, a beautiful late summer evening that made you glad to be alive. I wanted to be outside, but I sat at the kitchen table studying for a biochemistry exam. George was relaxing, reading the newspaper. Our fourteen-year-old daughter was attending the first high school football game of the season and our seven-year-old son was in the front yard playing soccer with a friend. Suddenly, a blood-curdling scream outside had us jumping up and racing toward the sound. My gut churned hearing the agonizing howl of pain coming from our child.

George and I burst through the screen door running toward our boy who was lying on the ground screaming, “My leg, my leg.”

Rushing to his side, I cradled his head and told him to lie still and not move. Tears streamed down his face, as he reached toward his contorted leg.

“Call 911,” I said to my husband. I was sure his leg was broken.

At the first sound of sirens and sight of flashing lights, many neighbors flooded into the street. The ambulance and EMTs pulled into our driveway and promptly got to work. They splinted the lower half of Timmy’s body and moved him onto a stretcher.

A nurse neighbor approached me and offered to call the surgeon she worked with to meet us in the ER. Gratefully, we said yes. Timmy was loaded into the ambulance. We followed in the car.

The ride was a short one and the surgeon was waiting for us. Technicians whisked our frightened seven-year-old off to x-ray, George and I trailed alongside the litter, holding his hand.  Minutes later I stood next to the doctor as we looked at the films. “A spiral fracture of the femur is serious business.” I could see exactly what he meant. There were a good three inches between the ends of the broken bones.

I faced the doctor. “What does this mean as far as treatment and hospitalization?”

“He’ll need a pin in his leg then two weeks in traction. When the bones are aligned I’d put him in a hip spica cast.”

“What’s that?”

“It’s a little smaller than a full body cast, starting just under his rib cage extending to his toes on the fractured leg and to his knee on the uninjured one. A stabilizing bar will be attached as part of the cast to keep his legs in alignment.”

I felt weak in the knees and my mind was racing. I was in my first full year of nursing school twenty-six miles away. The only prayer I had of staying in school was to have Timmy transferred to an orthopedic specialist at the hospital in which I was doing my training. I could stay with him when I wasn’t in class and do my homework in his room and spend nights in the nurse’s residence. The surgeon respected my wishes and gave the order for the transfer.

That short term plan would suffice as long as he was hospitalized, but what would we do when he was discharged in that hip spica thing? George calmly reassured me we’d take one day at a time.

As soon as our parents heard what happened they said, “What do you need? And how soon do you need us to come.” We were relieved at their generous offer to help and set up a tentative schedule, to be firmed up as soon as we had a discharge date.

Two weeks later, we were given instructions for home care: two people had to turn him every two hours because he was no longer a featherweight little boy, but a large bulky plaster boy. At all costs, we could not jostle the metal skeletal pin apparatus protruding from the cast. We had to make sure he was adequately hydrated to help prevent blood clots due to his inactivity. He had cut-outs in the cast to allow for bodily functions using a bedpan and a urinal. We borrowed a mechanic’s creeper so we could place him on his stomach to play. Elevated on pillows to keep the metal apparatus from touching the floor, it was easy for him to pull himself around on the ball bearing casters while he maneuvered his little cars and army men. We alternated him between a sofa bed downstairs during the day and his own bed at night.

Our parents lived with us and cared for Timmy for three weeks. Everyone had the tutorial on how to care for the boy in the cast. George came home for long lunches to pitch in. However, weeks loomed ahead where we had no help.

When our wonderful neighbors heard there was a possibility I’d have to leave school to take care of Timmy, one, in particular, became a lifesaver setting up a schedule of volunteers to help during the work week. A nurse herself, Lynne was eager to assist. She was a Godsend. Words can never express how grateful we were for her help. She brought a red stake body wagon which was padded with many pillows so she could pull Timmy around the neighborhood on nice days. She set up a chaise lounge in the shade of the front porch with, you guessed it, lots of pillows, and Tim would color or read books.

For three weeks my neighbors covered Monday through Friday so I didn’t have to take a leave of absence from school. My heart burst with thankfulness for their sacrifice and kindness.

After six weeks in the cast, Timmy was admitted to the hospital to have the contraption removed and begin physical therapy to learn to walk all over again. I stayed in the nurses’ residence until he came home using a tiny walker. He was not allowed back to school until he could manage walking with crutches. When that goal was reached, George drove him to school in the morning and Lynne picked him up in the afternoon. Both the kids got home about the same time and Margie supervised her little brother until I got home at four PM. It was a team effort.

One afternoon in the first week of December, three months to the day after the accident, I came through the door to see my two beautiful children sitting at the table having an after school snack. “We have a surprise for you, Mom. Close your eyes.”

“Okay, they’re closed.”

Several seconds passed. “Open your eyes now.”

I opened my eyes to see both kids grinning from ear to ear. Timmy was standing unassisted and slowly walked toward me. I began to cry as he reached out his arms for the best hug ever.

Three years later, I graduated from nursing school, having made the Dean’s list six times. It humbles me to know my achievement would not have been possible without the kindness and sacrifice of family and friends to get us through a most difficult time.

Chicken Soup for the Soul—My Kind of America, August 2017, 240

 

Why do nurses need to publish our stories?

Nancy: As helpers, we know that there is more than one way to heal the body, mind, and soul. In writing fiction, we entertain while providing information and giving the reader a chance to escape reality – temporarily. Non-fiction can be instructive, informative, and educational in a private non-threatening way. Nurses on the job are creative, improvisational, and innovative, not only caregivers. Nurses are often underestimated but everyone knows that it is the nurse who is with the patient for 8 – 12 hours a day, not the doctors. The nurse is the patient advocate, she is the communicator of the patient’s condition while under her care, she is the liaison between the doctor and the patient. She is the glue that holds the entire hospital system together. If a nurse also has a penchant to write, those qualities come through onto the page.

 

What has nursing done for you?

Nancy: Nursing has enriched my life beyond measure. I returned to University 17 years after I studied the first time. At the age of 35, I was the oldest in my nursing class. It was the hardest 4 years of my life but I wouldn’t change it for anything. I graduated the spring before my 40th birthday and watched as my family cried when I walked across the stage to accept my diploma. Non-traditional students, that’s what they called us, are typically more motivated and focused in their studies and on each clinical rotation and that was true for me. As a well-educated nurse, my basic knowledge and ability to reason have never left me. Nursing is like the mafia, I can’t get out even in retirement because family and friends always ask my opinion on health-related issues. I’m always having to palpate bumps and lumps and looking at spots and rashes. My stock advice is usually, “I think you should see your doctor” or “put some calamine lotion on that poison ivy.”

Learning to Heal

I’ve long been a proponent of nurses writing their stories to educate the general public about what we really do. Here’s a book: Learning to Heal: Reflections on Nursing School in Poetry and Prosethat does that and more.

The essays, from seasoned nurses as well as recent grads and “respected elders,” are set in the United States and abroad and show the history, rigors, challenges, humor, and sadness that alternate during the nursing school experience. Not every author in this collection makes it to graduation.

The prerequisite of nursing—compassion, empathy, and psychological support—threads through the stories. The reader will learn the depth of the nurse-patient/family connection. This connection becomes ingrained in the nurses’ psyche as evidenced by Courtney Davis’ Wednesday’s Child. Her story mirrors my Baby in the Closet. She, too, wrote about a newborn with a deformity who was left to die in a linen closet. Courtney, like me, carried the fate of the baby along with unanswered questions for almost 50 years!

Never a specialty I wanted to practice, psychiatric nursing demands a special temperament.  Poetry especially captures the depths of human understanding needed to make a difference.

. . . Come to my group, my plea, as I knelt offering

filtered cigarettes as free admission tickets.

In an empty silence, we sat on single beds, arranged

in a square, in a room as cavernous as an airplane hangar.

What was my hurry? Most had lived there twenty years.

Hardly a word dropped into the atmosphere.

—Ward 24, Nancy Kerrigan

I associated with Geraldine Gorman’s Learning the Wisdom of Tea, who takes us though her education from a diploma nurse to a PhD. I, too, wondered where were the “(f)irst person accounts of interactions of patients and family . . .”  Where were the nursing stories? And I, too, questioned the authoritative methods of instructors in nursing academia. And I, too, felt fortunate to find a career path that allowed me to “practice outside the hospital.” My “wisdom of tea” began at the kitchen tables of my patients when I visited their homes as a guest, learning that I needed to obtain their cooperation in order to institute a treatment plan.

The stories and poems in this anthology are varied, educational, entertaining, and poignant. Whether the reader is a nurse or not, all will learn that nursing has come a long way as Learning to Heal stories excellently show.

Computer Crash

I have been without my computer for four days so I didn’t work on today’s post. I didn’t have a computer to track any other posts that I could reblog. I didn’t want to scratch out a new post longhand. Maybe I could’ve been more aggressive or use my I Phone to pick up the slack in order to get a post out today, but I didn’t. This rant serves as an informal publication. I decided that not having access to my computer let me off the hook. Frankly, it was liberating. I enjoyed the forced separation from my constant sidekick. The computer is my portal to writing and without it I am free to pursue other activities—like shopping—even if I don’t come home with any purchases. When did I last have lunch by myself?

Not to be productive, to me, is paramount to being slothful. I am a writer and must write and/or complete one book promotional action every day. Well, how about I am also a person who enjoys a day off or a moment to enjoy myself without guilt. If my computer is not working how can I feel guilty not accomplishing my daily goals?

Sadly, my computer was up and running as of 6 pm yesterday. I didn’t rush to document this morning’s post. In fact, I put the writing off until now. I will be back to my routine soon.  In the meantime, I am holding on to this wonderful guilt-free break for as long as it lasts.

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

From Disengagement to Balance: The Journey to Positive Aging

 

Many of you reading this are not old enough to remember the disengagement theory. When I started out in gerontology in the 80s this was one of three theories of aging I learned about, and the most depressing.

The disengagement theory of aging states that “aging is an inevitable, mutual withdrawal or disengagement, resulting in decreased interaction between the aging person and others in the social system he belongs to”.[1]The theory claims that it is natural and acceptable for older adults to withdraw from society.[2]. . .

Disengagement theory was formulated by Cumming and Henry in 1961 in the book Growing Old, and it was the first theory of aging that social scientists developed.[5]Thus, this theory has historical significance in gerontology. Since then, it has faced strong criticism since the theory was proposed as innate, universal, and unidirectional.[6](Wikipedia)

Thank goodness there were two other theories that challenged disengagement theory: the activity theory and the continuity theory.

I mention the disengagement theory to show how negative attitudes surrounded the elderly from the inception of geriatrics as a medical specialty and how far we have come in understanding the aging process, which, of course, is not a-one-size-fits-all.

It’s been over 50 years since the disengagement theory first described aging. I am witness to the evolution of a more realistic description of the multifaceted components of growing old. I try to blog about uplifting examples of the latter stages of our lives.

Two weeks ago, I spoke about one of my favorite TV shows, Grace and Frankie,women in their 70s (at least when the show started), who are depicted in a positive light. Both are strong, independent, smart, creative and refuse to wear the stereotypical label of “old woman.” The show’s popularity delights me because I can envision an audience that not only enjoys the antics of the women but perhaps is learning that the inevitable losses of growing older are intertwined with pleasurable gains.

Then last week I re-blogged my friend Lois’ post about turning 77 after her husband’s recent death. Another positive take on aging even in the face of loss and grief. She closes her post with this observation: “I thank God for the countless blessings I experienced during this first birthday week of my solo life; there’s more fun to share . . .”

With this week’s post, I’m including a New York Times article about women in their 70s. Is it just me or have you also noticed that older women are getting more positive exposure?

Mary Pipher writes, “We (women in their 70s) can be kinder to ourselves as well as more honest and authentic. Our people-pleasing selves soften their voices and our true selves speak more loudly and more often. We don’t need to pretend to ourselves and others that we don’t have needs. We can say no to anything we don’t want to do. We can listen to our hearts and act in our own best interest. We are less angst-filled and more content, less driven and more able to live in the moment with all its lovely possibilities.” Mary Pipher, “The Joy of Being a Woman in Her 70s,”New York Times, 13 January. 2019: 10.

Pipher’s book, “Women Rowing North: Navigating Life’s Currents and Flourishing as We Age.” is now out in print. I intended to buy a copy.

 

 

 

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