Two Nurses Tell Their Stories in Literary Journals

Two nurses write about hospice services in literary journals. Great reads!

The Sun is one of two literary journals that I have unsuccessfully submitted to over the years. The other is the Bellevue Literary Review.

Close to 20 years ago, I drove to The Sun’s offices, parked in front of a single-family house on Roberson Street in Chapel Hill, and placed my submission, an essay doubled-spaced on hard copy, folded, and slipped into a legal-size envelope along with a cover letter and self-addressed-stamped-envelope, in the mailbox by the front door. I drove back to my home some five miles away and waited.

Imagine my pleasant surprise to find that each journal has recently published an essay by a nurse. And the topic is similar: hospice.

I can’t display sour grapes because I have long promoted nurses telling their stories. And since I have worked as a hospice nurse, I know that hospice care is poorly understood and underutilized.

Every Baby Needs to be Rocked by Barbara Woodmansee, The Sun, May 2022

Barbara Woodmansee is a hospice nurse who is stationed at a local hospital awaiting referrals from the staff. She has been told to keep a low profile. Her essay tells of seven hospice admissions. They give an overview of the types of patients hospice manages and the variety of services that the hospice program provides. Woodmansee shows how hospice intervention makes a difference in a patient’s last days along with the roadblocks she faces in providing care. She also tells us of a personal experience that inspired her to be a hospice nurse.

One of Woodmansee’s patients, Carrie, is a woman in her early 20s who developed COVID after delivering a heathy son. Her immune system has failed, and she has “multisystem organ failure; sepsis has debilitated her heart, kidneys, liver, and lungs to the degree that she has no reserve left to fight her infection.”

Woodmansee is present in the hospital room where the patient’s family gathers while life support is withdrawn. “Once the ventilator is removed, Carrie’s entire family stands at the bedside, each with a hand on her body—all except for her mother. Ann has taken Carrie’s infant son to the car. When her daughter dies, she is holding the baby.”

Woodmansee notes that “COVID has made me even more aware of my inability to support everyone affected by a patient’s death: the dying person, the family, and the staff who are trying so hard. One of the important gifts we (hospice nurses) give to families in hospice is our presence, but we have to move so much faster now, with so many new barriers between us, both physical and psychological. Worst of all, we’re getting used to it.”

With that, Woodmansee shows what nurses feel and the relentless circumstances they have had to deal with the COVID pandemic. Her essay also shows the personal investment a nurse makes to each of her/his patients.

On The Brink by Barbara West, Bellevue Literary Review, Issue 42, 2011 BLR Prize Winners.

Barbara West, an on-call hospice nurse, deals with an unclear after-hours emergency. She visits the double-wide trailer occupied by an elderly sister and brother. What she finds is the brother, slumped over in a wheelchair close to death while the caregiver/sister seems bent on ignoring reality.

After West attempts to lift the brother from the wheelchair to the bed, a loud sound emits from his body, and his breathing stops. She says, “If you work in hospice long enough, you’re bound to be accused of murder at some point. It could be over the phone, in a moment of passion from a guilt-ridden, out-of-state, family member. Or in person, simply because you’re the one at the door at that pivotal moment. Or maybe because you’re the white nurse with a Northern accent, the face of the American health care system that denied Daddy access to dialysis back in Oklahoma. For the first time in my career, I wondered if I might now have actually done what I’d previously only been accused of.”

West misses the interdisciplinary team that is available during usual working hours. Now on a Friday night, she alone must address all the issues other team members would. And it is when she notes their skills, the reader is made aware of the rich services a hospice program can deliver. But we also realize that, in the absence of other team members, nurses can assure that appropriate care is given.

The humor threaded through this story softens the sharp edges that West overcomes in steering the brother’s death to an acceptable closure. But the reader sees what discomfort West carries within her. She seeks reassurance from a coworker that she handled this case correctly. We learn that memories, both pleasant and uncomfortable, long remain with nurses when making judgements they must make on their own.

May we see more nurses writing their stories outside of nursing journals for the public to enjoy and be enlightened and to realize that nurses do make a difference.  

Nursing Blogs 2021 – #6 – Nursing Stories – Marianna Crane Profile

I am honored that my blog has won 6th place in the Top Nursing Blogs of 2021 sponsored by IntelyCare. This honor is an especially important recognition to me because the nursing community voted.

The prize is a feature profile on the IntelyCare Website. See below:

Marianna Crane is the author of Nursing Stories and the sixth place winner of our Top Nursing Blogs contest. She has been a nurse for over forty years and has practiced in a variety of settings including hospitals, clinics, home health, and hospice.

Marianna was one of the first people to become a gerontological nurse practitioner. Over the course her career, she developed a passion for home health care.

Marianna is retired from nursing. Her work is now focused on her writing, and her fellow nurses certainly benefit from and appreciate this gift!

Check out Marianna’s blog here and read on for a Q&A.

Maggie Kilgallon / Apr 11, 2022

Q&A

IntelyCare: What inspired you to start writing about nursing?

Marianna: “I have always wanted to be a writer. When I retired after a 40-year nursing career, I began to take writing more seriously. I attended writing classes, workshops, conferences, and joined a writing group. I write about what I know: nursing.

I started my blog, Nursingstories.org, in 2011 and eventually published a book, Stories from the Tenth-Floor Clinic: A Nurse Practitioner Remembers, in 2018.”

IntelyCare: What inspires you to continue writing a blog?

Marianna: “I believe that nurses are generally reluctant to call attention to themselves. My blog shows what nurses really do and how they make a difference. Under the umbrella of ‘Olden Days of Nursing,’ I spotlight nurses in my cohort to document the evolution and history of the profession.

The COVID pandemic has opened doors for the public to watch nurses in action and appreciate the contribution they make to health care. This is an unprecedented moment for nurses to take advantage of their popularity and visibility. We see more articles in the media about nurses and nursing practice than ever before. Recently, I have been re-blogging timely facts I have found on the internet or in the news media about nursing that would be of interest to my readers.

I try to include other topics in my blog such as writing, growing older, and confronting ageism, and my love of food. Lately, however, because of all the recent rich material about nursing, my posts center around nursing issues.”

IntelyCare: What advice would you give to other nursing professionals looking to start a blog of their own?

Marianna: “I encourage nurses to start their own blogs and write about their nursing practice. There are many free websites available. The time is ripe to show the challenges the profession faces. The public has seen how much of a difference nurses make to the improvement of health in our communities. There are many changes needed to improve our health care system in general, and nursing practice, in particular. The attention the nursing profession has received of late will only promote better outcomes for our patients if nurses continue to promote themselves. A blog is one way to do so.”

Check out the full list of Top Nursing Blogs here!

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

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

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

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

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

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

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

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

Health care today is changing

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

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

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

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

Today, we need a Nurse

Alphabet Challenge: W

I’ve signed onto The Blogging from A to Z April Challenge 2021.

The challenge is to blog the whole alphabet in April and write at least 100 words on a topic that corresponds to the letter of the day. 

Every day, excluding Sundays, I’m blogging about Places I Have Been. The last post will be on Friday, April 30 when I finally focus on the letter Z. 

W: West Catchment Area

When I started my job as a nurse practitioner in home care at a Veteran’s hospital outside of Chicago, I had the choice of taking care of patients in the north or west region. The north region was deemed a safer catchment area. The west region, which surrounded Oak Park where I lived, had pockets of crime caused by rampant gang and drug activity. I wanted to be closer to home and stop off for lunch if I was in the neighborhood. I didn’t think twice before choosing the west side. Maybe I thought I was invincible, a city girl used to the gritty streets and boarded up homes. 

I tried to keep my senses sharp and stay alert when I drove through the neighborhoods making my home visits. I kept my distance from the car in front of me in case I needed to make a quick U-turn. I avoided groups of young males loitering on the street corners and always locked the car doors. 

In the long run, it wasn’t just the neighborhood that proved unsafe. Any home I went into could hold danger regardless how dilapidated the outside environs. My close calls, and there were some, depended on the character of those with whom I interacted. 

Still, to this day, I keep my handbag on the floor of the car and out of sight.

Country Music

I’m not writing my second book whose working title was to be “Home Visits.” The Pandemic has cast a spell on my brain, resulting in lethargy and an inability to focus on structuring another book. So, instead, I’ve decided to take each home visit story and submit it to a literary magazine for potential publication as a “stand-alone” essay. I plan to email one of the stories, Country Music, at the end of this week to an online journal. 

Country Music tells the story of three patients that I cared for when I worked as a nurse practitioner in a home care program at a Veterans Hospital outside of Chicago. They were at various stages of dying. In the late 80s, the hospice movement was just taking baby steps into the medical/nursing world. I was learning about dying and death from my patients and their caregivers. 

The locations of the three patients’ homes lined up perfectly for me to make the visits to them conveniently in the same day. This lasted for about three months. On the day of the story, a dreary, rainy day, I show the challenges I faced working with my three male patients and their wives (few women were enrolled in the VA health care system at that time), how each man played the hand he was dealt and how the women dealt their husband’s decline. 

One of the men loved country music. Talking with him about songs and artists, rekindled my interest in the genre. I found a great country western radio station on my government-issued compact car. The earthy, raw lyrics telling of common human emotions became my therapeutic passenger that accompanied me on my home visits. 

While I am editing this story for submission, I find myself checking into YouTube to listen to the familiar songs that supported me so many years ago. This is more fun than writing that second book. 

Home Visits Can Be Fraught With Danger

As I write my second book, which is about the home visits I have made over the years, I am resurrecting memories from my mind and the pages of my journals. Today’s post shows a time when I didn’t use common sense and how home visits can be fraught with danger. 

One day in early fall, on my drive back to the hospital after making all my scheduled home visits, I found myself passing by a patient’s apartment on the westside of Chicago. Since I was ahead of schedule, I decided to drop in, unannounced. I had the time. My patient had a caregiver: a tall, muscular man who always opened the door to the first-floor apartment wearing a long blond wig and thick make-up. Despite his flamboyant appearance, he gave competent care to his charge: a bed-bound, uncommunicative middle-aged man with multiple sclerosis. An exotic array of visitors wandered in and out of the apartment. My patient’s mother, strikingly average looking compared to the rest of the visitors, lived in rooms above her son’s and was often present when I came. However, this day I walked into an unlocked and empty apartment. Only my patient, lying in bed in the darkened bedroom, was present. 

Neither the caregiver, nor the patient’s mother, or anyone else familiar to me entered the apartment while I was there. However, as I finished with my evaluation, a man opened the unlocked apartment door. He wasn’t anyone I had seen before. My patient smiled at him knowingly.

The man removed his jacket and tossed it on the sofa. We introduced ourselves. His eyes moved down my body. Acutely aware of the precarious situation I was in—alone in that apartment with a strange man and unhelpful patient—a band tightened around my chest. 

“I’m just leaving,” I said as I promptly packed up my nursing bag. 

Safely back in my car, my breathing heavy and my hands shaking, I chastised myself for making this impulsive visit. No one back at the office knew where I was. It was a time before cell phones. What If something had happened to me?  I didn’t want to think of that. I never again made an unscheduled home visit. 

Sometime after that impromptu visit, at a nursing conference, I sat fixated as another home health nurse told a story about the time that she had made a scheduled visit. She rang her patient’s doorbell. He didn’t answer. It was later that she found out he had been murdered. And in hearing more detail, she discovered that the murderer had likely been in the house the exact time she was ringing the bell. Good thing the door wasn’t unlocked. 

Home visits can be fraught with danger. 

NURSES REALLY MAKE A DIFFERENCE

 

Betsy, a writer friend, emailed me the story she had read in our workshop since I had to miss the class. She knows I hang on every episode of her life in Ireland where her second child was born and she negotiated the daily vicissitudes of a different culture. In this episode she had left the hospital with her new baby girl. She happily accepted the offer to have a nurse visit her and the baby at home.

Her daughter is in college now but Betsy still remembers how helpful the nurse was—and knowledgeable and reassuring, which, in turn, made me remember the article I read not too long ago by David Bornstein, The Power of Nursing (NYT, May 16, 2012) about nurses who made regular home visits to at-risk pregnant women and continued these visits until their children reached the age of two. The program, Nurse-Family Partnership (NFP), conducted studies that demonstrated the visits improved both child and maternal health and financial self-sufficiency and provided a five to seven point boost to the I.Q of these children. Plus many more positive results.

NFP, which has been around since the ‘70s is implemented in forty states, empirically proves what many of us already know: nurses REALLY make a difference. Training paraprofessionals to do the nurses’ job didn’t yield the same outcomes.

We nurses do make a unique contribution. No one else can fill our shoes.

THE WEIRDEST HOME VISIT

This originally appeared on 08/12/2012. The Weirdest Home Visit is one of many stories that didn’t make it into the first book. I am considering it for inclusion in my second book.

Nursing Stories

When I worked in the home care program at a VA hospital in Illinois, medical students sometimes came along with us nurse practitioners while we made our visits. I enjoyed showing them the reality of delivering care in the patient’s home—where we were guests—the subtle line between suggestion and decree, education and instruction, doing for the patient and letting the patient do for himself.

One afternoon, when I had a female medical student riding with me, I had trouble finding the house. In the day of no cell phones or GPS’s, I stopped at a gas station to call the patient’s wife. Was I being paranoid when she sounded like she was being deliberately unclear?

We finally drove down the well-manicured block in a rather upscale neighborhood. One house in the middle of the block was “protected” by a row of stately cypresses or if cypresses trees don’t grow in…

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Home Visits Can Be Fraught with Danger

 

One time, long ago, at a nursing conference, I sat fixated as a fellow nurse told a story about the time she rang the doorbell at her patient’s house, and he didn’t answer. It was later that she found out he had been murdered. And in hearing more detail, she discovered that the murderer had likely been in the house the exact time she was ringing the doorbell.

Home visits can be fraught with danger.

One time I visited a patient who wasn’t on my list for that day only because I was in the neighborhood and had the time. He was bed ridden and unable to speak. He had a caregiver, a tall, muscular man who wore a long blond wig and make-up but masculine clothes, such as jeans and a sweat shirt. He was attentive and capable and flamboyant. An exotic array of visitors wandered in and out of the apartment. My patient’s mother, strikingly average-looking compared to the rest of the visitors, lived in an apartment above her son’s and was often present when I came. However, this day, unannounced, I walked into an unlocked and darkened apartment. Only my patient, lying in bed, was present.

Neither the caregiver, nor the patient’s mother, or anyone else familiar to me entered the apartment while I was there. However, as I finished with my evaluation, a man opened the unlocked apartment door. He wasn’t anyone I had seen before. In fact, he was unimpressive in slacks and button-down shirt. My patient smiled at him knowingly. We introduced ourselves. His eyes moved down my body. Acutely aware of the precarious situation I was in—alone in that apartment with a strange man and unhelpful patient—a band tightened around my chest. I promptly packed up my nursing bag and left.

Safely back in my car, I chastised myself for making this impulsive visit. No one back at the office knew where I was. It was a time before cell phones. What If something had happened to me . . . .  I didn’t want to think of that. I never again made an unscheduled home visit.

As I work on my second book, which is about home visits, I contemplate my experiences. I want to include the various unsafe situations visiting nurses may find themselves. It’s not just the “iffy” neighborhoods that may hold danger.

For example, I have previously posted a story about a patient that might have been murdered by a family member. When I drove down the tree-lined street in a middle-class neighborhood to make a last follow-up visit to the widow, it never occurred to me that foul play, and not terminal cancer, could have caused my patient’s death.

There are other dangers to home visits, of course. One nurse I knew broke her leg while stepping on an uneven floor; another was attacked by the family dog. Environmental conditions, such as inclement weather, flooded roads and extreme temperatures, are a constant threat to home visits. Once my windshield wipers died on me as I drove on the highway in a snow storm.

Yes, home visits can be fraught with danger.

Murder Building

I am reviewing posts that I will consider for inclusion in my second book, which focuses on home visits I have made in Chicago, Washington DC, and Durham, NC. I came upon Murder Building that was originally posted on February 19, 2012. It’s a keeper.

CT-BIZ-VACANT-BUILDINGS-B_CTMAIN0501SR-d55be438

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 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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