Alphabet Challenge: P

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. 

P: Pediatric Unit

On one of the pediatric units at Babies Hospital in Columbia Presbyterian Medical Center in New York City, I contracted chicken pox. 

My roommate Gloria and I and six other students from St Peter’s School of Nursing in New Brunswick, NJ, spent three months at Babies Hospital where we did our pediatric rotation in 1960. We explored the city on our days off. While it was fun to be in NYC, I didn’t enjoy caring for sick kids. I couldn’t detach myself from their pain, sadness and the misery of their hospitalization. Give me healthy, happy kids every time. 

Toward the end of the rotation, I was dressing a toddler for discharge. I lingered in his room, playing with him just to hear his infectious laugh. 

It wasn’t until the parents had collected their son and left for home that the head nurse informed me the toddler was discharged because he had chicken pox. 

I never had chicken pox. After two weeks, I noted the first spot. The nurse in the infirmary diagnosed chicken pox and quarantined me. My classmates headed home since our rotation was over. I lived in New Jersey and couldn’t cross the state line with an infectious disease. 

The infirmary nurses treated the itch with Benadryl and calamine lotion but they couldn’t lessen the tedium of my confinement.  

Later on in my nursing career, I had to declare a specialty. I chose geriatrics.

Alphabet Challenge: B

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. 

B: Basement

My best friend, Carol, lived with her family in a basement apartment. Her parents were custodians of the four-story residential building near the corner of Summit Avenue and Mercer Street in Jersey City. I lived down the block. 

When we were in grammar school and I called on her to play, I had to walk down the three brick steps next to the apartment building. Facing a heavy door, I rang the bell. Carol would come to flip the locks and let me in. If Carol had to get ready, I usually told her I’d rather wait outside. Walking through the dark and damp basement to get to her apartment frightened me. I expected a stranger might be hiding in the shadowy corners of the basement waiting for me to walk by—and pounce! 

When I was older, I followed after Carol as she did her chores in the basement. Using the Dumbwaiters, Carol pulled at the ropes raising the box to reach each apartment. She rang a bell to alert the resident to place her garbage in the box. During this encounter, Carol and the tenant would exchange pleasantries, their voices echoing up and down the shaft. In the winter, Carol shoveled coal into the furnace. Throughout the year, she swept the basement floor regularly under the lone light bulbs hanging from the ceiling. 

In my teens, I spent more time visiting with Carol and her family (mother, father and older sister) in their cozy two-bedroom apartment. It was easy to forget that outside the front door, the basement stood in darkness. 

When Carol began dating, the slog from the front door to Carol’s apartment didn’t deter her suitors.  

After Carol and her sister married, their parents bought a single family home in southern New Jersey—for cash.

Alphabet Challenge: A

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. 

AAunt Anna’s Apartments

Aunt Anna lived in an apartment above a florist shop in Linden, New Jersey. She didn’t drive but she could walk along Wood Street where Mom and Pop stores lined the road. Once, inside a large Polish deli where ropes of sausage hung on hooks from the ceiling, Aunt Anna insisted on buying smoked garlic Kielbasa for me to bring home to my Polish mother. 

When she moved to Carteret, she lost the vibrant neighborhood. But she also lost the long staircase she had to climb up to the second floor, the traffic noise from the street and isolation from her neighbors.

What she gained was a sun-lit, ground level one-bedroom apartment, closer to her grandchildren and great grandchildren, a quiet neighborhood with a front porch she shared with a woman who lived next door—a new friend. 

Aunt Anna, my Italian father’s sister, was the second youngest and now the only sibling still alive among her five brothers and five sisters. When I last visited, she was in her late 80’s, twenty years older than I. We laughed together as if contemporaries. Opening the bottle of Chianti I had brought, we played Mob Hits CD’s and shared a bag of potato chips. My husband never could understand how I craved potato chips with fine wine. “It’s in the genes,” I would tell him. 

Aunt Anna and I sipped our wine, sitting side by side on the sofa, listening to the Italian songs from my childhood. As the music played, nostalgia filled us with sadness for family members who had long since died. 

Living in North Carolina, I planned another trip to New Jersey in a couple of years. I never made that trip. Aunt Anna died suddenly. 

What would I have done differently knowing on that last visit I would never see her again? Wine and potato chips, Italian music and reliving memories—not a thing. 

I miss her. 

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.

 

IT DOESN’T LOOK LIKE MUCH

Last Saturday, toward the end of a daylong workshop, Carol Henderson, our leader, gave the last prompt. Where is home?

However, knowing we only had a few minutes left, I believe we seven women wanted to share our appreciation with Carol, and with Mamie Potter who hosted the event, before we left.

That prompt fell to the floor, unnoticed.

Afterward, maybe some of the others came back to visit the prompt and, like me, to mull over its meaning. I can hear Carol say, “It means what ever you think it means.”

I’m glad I didn’t write that day about “where is home.” I’m glad I didn’t hear anyone else’s take on it. I glad I didn’t write any cerebral philosophical theory that may have moved my pen knowing I was writing for an audience.

As thoughts of home drifted into my consciousness the following week, I found myself looking for a picture I had taken of an apartment where I had lived from the age of two to twenty-two.

Back in July, 2009, I visited Summit Avenue in Jersey City with my Aunt Anna. (I have already written about her.)

When we drove by, I attempted to take a picture. There just wasn’t a moment when a passing car didn’t obstruct the house. Because of heavy traffic I needed to keep moving. As usual, parking places were scarce. I gave up after circling the block four times.

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It doesn’t look like much. It’s the house on the right, 262—the middle apartment. The gate in front of the stairs was recently added. That gate would have limited the flow of social activity that took place on the concrete steps whenever the weather cooperated. Many of my memories of home when I was growing up happened on the front steps.

On the steps:

 I listened silently at age eight to the neighborhood women as they sat on the steps and talked of childbirth, raising their family and problems with their husbands.

little kids sat while I told spooky stories until the streetlights went on and we all had to go home.

the boy next door knelt on one knee and asked me to marry him when we both were in the third grade.

I walked shoeless from July to September.

my first date gave me my first kiss when I was sixteen.

I trekked on my way to my room to sleep in the mornings after working the night shift at the Jersey City Medical Center around the block.

my husband-to-be didn’t kiss me after our first date.

I know the steps aren’t a home, but they hold pleasant remembrances of growing up.That’s as close to a definition of where is home to me.

TRICK OR TREAT AT THE FRONT DOOR; HEARSE AT THE BACK

I have been pestering my classmates from nursing school (we are about to celebrate our fiftieth anniversary next month) to write their stories so I can post them on my blog. Maybe pestering is too mild a word. Regardless, I have succeeded. Two women have sent me stories.

The first comes from Joan Moore. 

This is her story when she worked for a Hospice in Central New Jersey in the late 1990’s.

THOUGHTFULNESS IN THE FACE OF GRIEF

Written by Joan Moore

One of the most important aspects of hospice nursing is that a nurse is available 24/7 for the patients. This means every nurse on the team is required to take a turn being “on call”.

I’d like to share one of my many on call experiences.

My weekend started quietly. It was a Saturday in October. Halloween. In that neighborhood when Halloween falls on a weekend, the kids start trick-or-treating in the early afternoon. I received my first call at twelve noon. Molly, a much-loved fifty-year-old with ovarian cancer that I had admitted two months previously, had just died. I offered my condolences and said I would be there in about twenty minutes.

I drove past many happy, costumed children on my way to the house. When I arrived, Molly’s brother-in-law was sitting on the front porch with a big bucket of candy for the neighborhood children. Inside, Molly looked very peaceful surrounded by her sister and three dear friends.

Hugs all around and emotional support. I explained what I needed to do to pronounce, per protocol, since it might seem silly to onlookers as I took a blood pressure and listened to lung and heart sounds on a person who just died. Then I called the doctor to inform her and the funeral director who told me he would probably arrive in an hour.

Since it was Halloween and children all around, the family told me to ask the director if he could please drive the hearse around the back of the house so as not to cause any commotion in the neighborhood. Conversation then revolved around Molly and good stories about her.

As I was about to render post-mortem care—washing and dressing the body—the body-language of the women told me that this was a task they wanted to do. They lovingly bathed Molly and dressed her. One laughingly remarked about Molly’s favorite sweater—it had silver threads running through it. She said, “I wonder what will happen when she’s cremated? Would she be all sparkly?”

The funeral director arrived and drove around the back of the house. Molly’s brother-in-law remained on the front porch giving out candy. It’s always difficult to watch as your loved one is taken out of the house for the last time.

I left, happy that my beeper never went off during this visit. I was available to listen and care. I wondered what the rest of my calls would be like. Turned out I was able to manage with only supportive phone calls and didn’t have to go out on any visits.

An epilogue to this—unbeknownst to me—one of the women was a nurse and a good friend of my supervisor. Monday when I went back to work she pulled me aside and told me that the family appreciated my silently watching over them while they rendered care. There is nothing more wonderful for a nurse to hear that you really helped.

 

Next week: Ruth Donoghue’s story: NAKED IN THE DELIVERY/LABOR ROOM

MOUNTAIN MAN: A NURSING STORY

I graduated from nursing school fifty years ago this month. I still remember this man.

The long, dark hall stretched out in front of me. It was eleven-thirty in the evening, close to the end of my shift. The thick soles of my Red Cross shoes silenced my step as I checked each room on the medical unit of St. Peter’s Hospital. The evening was hushed, almost mellow. Thoughts of impending freedom from the student role danced in my brain.In a couple of months I would be graduated, trading the blue and white striped dress with starched white bib and apron for an all-white uniform and getting a pay check.

A light tumbled out of a lone room at the end of the hall. I slipped inside. Only one of the two beds was occupied. A man lay still on his side, eyes closed, his chest barely moving. Even I, life-long city girl, could detect the earthy smell of the forest embedded in his body. I thought of him as the “Mountain Man.”

Three hours before, I had done the perfunctory PM care. Quietly, I reached into the bedside table, took out the stainless steel basin and filled it with warm water, wrapped the washcloth around my hand to make a mitt, and glided along the heavy creases of his weathered face. I washed his beefy limp hands. X-rays showed that no bones were broken when the tree fell on him. Carefully folding his left arm and leg over his body and with a couple of pushes, I shoved him over to his right side. The pillows wedged into his back and under his knees and arms kept him in place. He looked comfortable. With little experience to gauge the severity of damage, I wondered if Mountain Man would be alive when I came back the next evening.

The following day when I checked my patients, I was surprised to see him sitting up in bed. Over the next two evenings he steadily improved. He walked out of the hospital on his own four days later. But not before telling me what went through his mind during his illness. As he lay in a comatose state he thought he was dead. There came a warm glow about the room. A kind and gentle angel appeared and ministered to him, softly washing his face and hands, turning him to make him comfortable. He knew then that he would get better.

Graduation fell on a clear, cool day in early September. Three full years of nursing school were ending. The Bishop presided over the ceremony, which took place in a cathedral in downtown New Brunswick, New Jersey. I joined hands with the forty-four women of the class of ‘62.  Clad in crisp white dresses and winged caps, we swayed as we sang our class song, Scotch and Soda, in the drafty field house. The melancholy moment competed with a sense of new beginnings.

After the ceremony the evening mist circled around the crowd lingering outside the church. I searched for my parents. Mom wore her imitation mink and Dad had on his Sunday suit and a fedora hiding his thinning brown hair. A man standing silently to the side under the light of a street lamp caught my attention. His hands folded in front of him. A warm smile crossed his face. I stopped and stared. Mountain Man had come to see me graduate.