Getting the Message the Second Time Around

Amazing insights to aging by Twyla Tharp.

I read the book before. My husband had been impressed with dancer, choreographer, and author Twyla Tharp’s interview on the car radio and bought her book for me: Keep It Moving: Lessons for the Rest of Your Life. It was motivational and I breezed through it. Afterwards the book sat on our coffee table. I picked it up a few days ago and randomly opened to page 123 where Twyla talks of breaking a bone while she is teaching a group of children to dance. As she demonstrates a position, her foot collapses and she cracks the metatarsal bone in her toe.

Here’s what she says:

            “This was a fairly common, unremarkable incident really, except I was sixty-nine years old and this was the first major injury of my career. Until that moment, I’ve never done bodily harm to myself. Never twisted an ankle or torn a muscle or broken a bone. An impressive winning streak, only some of which I attribute to luck.

            Perhaps something like this has happened to you. Your moment probably looked different: your reached for a book on a high shelf and felt a sharp twinge in your back. You wrestled with a tightly screwed jar and, in defeat, asked stronger hands to open it. You hesitated before jumping down from a high stool at a restaurant, worried about the shock to your knees, then chose a safer route back to earth. If so, you appreciate the significance of that first moment when your body breaks its contract with you. You can no longer entertain the illusion that you are among the immortals, those who throw themselves delightedly after perfection with childlike intensity because they can. You begin to morph into a mere mortal.

            You may not have even realized you were under the illusion of being an immortal, but while mortality can appear at thirty, forty, or fifty, be assured it happens to us all sooner or later. It is the moment when you start to doubt whether you have control over your body after all. You resign yourself to aging.” (Emphasis mine)

Tharp, Twyla. Keep It Moving: Lessons for the Rest of Your Life. New York, Simon & Schuster, 2019.

            Now it may sound ridiculous, that at 80 I hadn’t resigned myself to aging. When I sustained a knee injury soon after my 80th birthday, I did what I am best at: denial. The first two weeks afterward, I somehow “forgot” the physician assistant at the urgent care told me to always wear the leg brace. I wasn’t going to let this injury limit me, so I walked around the house without it. Only when I went outside did I put it the brace on.

            When I finally saw the orthopedic surgeon, he pointed out the injury on the MRI: a torn anterior cruciate ligament and fully severed medial collateral ligament. Looking at my knee x-ray, he discussed the arthritic changes and osteopenic bones in my knee. He reminded me that I needed to wear the brace constantly except when sleeping. Leaving the office, my husband said, “That was good news, you’ll get better in six to eight weeks.” I didn’t hear that. I was too busy focusing on the degenerative changes in my leg. I had been so proud to race up a flight of stairs, avoid elevators when possible and walk all day while sightseeing in New York City. I was in denial that my body was aging.

I asked at the end of one of my recent posts: what will I learn from this injury? I didn’t realize what a profound question that was until I opened Twyla Tharp’s book for the second time. There on her pages were examples of other aging persons who use their years of experience to forge new paths toward quality of life. I, on the other hand, was hoping to keep the status quo.

 Twyla’s book is so different from the usual books and articles I read on “successful” aging that focus on scientific studies. Twyla mixes common sense, creative motivation, and lots of interesting anecdotal stories about famous folks, mostly in the arts, such as writers, dancers, painters, music composers, singers, musicians; some still alive, some long dead but all demonstrating a lesson that moves us to be better as we age. (I must confess my eyes glazed over the description of how the professional boxer and heavy weight champion, George Foreman, affected a comeback at 45 years old.)

What Twyla does best is to show how to circumvent the limitations of aging by abandoning old stereotypes. She says that “. . . chasing youth is a losing proposition.”  Forget the past, reinvent yourself. Keep reaching. Keep moving.

What did I learn? I learned that successful aging is not trying to keep constant the same level of ability. In using the wisdom we older folks have accrued, we can refine the path we take as we go forward on our aging journey. This journey is ours to define and enjoy.  

Life Review?

Yesterday, I sat on the floor of my office skimming through one of my journals. The other 19 5-subject wide ruled notebooks with 200 sheets lay scattered on the floor around me. Okay, a couple were only 3-subject notebooks. The notebook on my lap spanned from May 2002 to May 2004. I had randomly pulled it from the heap. I didn’t intend to open it but when I did, I was back at the VA in Durham, North Carolina planning to retire early. My husband and I wanted to take a special vacation—Italy for five weeks—staying at a monastery in Venice and a villa in Tuscany. Would the VA give me the time off? Maybe it was best just to retire and enjoy this trip.

I began to journal in the ‘80s when my job proved so stressful that journaling seemed to help me cope. In the ‘90s I began to take myself seriously as a writer. Natalie Goldberg (Wild Mind) and Julia Cameron (The Artist’s Way) touted daily longhand writing to prime the creative pump. I never bought into daily journaling. Over the years there were large gaps between entries in my notebooks.

In the journal I wrote that I had given notice of retirement to the Chief Nurse. Then I wrote questions on the last page. Will we take the Italy trip? Will I continue to write? Tap into my creativity? See more of the grandkids? Finally, I asked: What will the future hold?

That was 18 years ago.

Yes, we did go on an unforgettable 5-week vacation to Italy staying at the Casa Vacanza Madonna delli’Orto in the Cannaregio neighborhood of Venice for a week and later, at the Villa Casa Pavon in Castigline d’Orcia in Tuscany. In a rented Ford station wagon we made day trips to Montalcino, Siena, Assisi and visited the dark, cool altars inside small chapels that dotted the winding roads, stopping along the way at local markets for groceries and wine.

I continued to write, eventually publishing a book about working as a NP in a clinic in Chicago. Most of the stories had already been documented in my journals. 

I took art classes in various media over the years.

Of course, I had discretionary time to enjoy the grandkids.

When I was done reading through the journal, the sun had set, and it was too late for my afternoon walk. However, I felt a sense of comfort in this reminiscent exercise. Or was it a nostalgia trip? Or, as Robert Butler first coined in 1963, did I experience a sort of life review?

Now as I am facing my upcoming 80th birthday, the last question on my journal page still remains: What will the future hold?  I can only hope life still holds many pleasant experiences.

And maybe a trip back to Italy.

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: X

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.

X: X-Ray Department

I believe the X-Ray/Radiology Department was in the basement of the National Institutes of Health Clinical Center where I was working but I’m not sure because I don’t remember going there on my own but usually following an entourage of white coats including the physician who was the head honcho studying a rare disease a couple of residents and a student or two and me the nurse practitioner taking up the rear happy to be part of this group and because I get to hear what the radiologist has to say when he points out the very subtle findings in the MRI or CAT scan or whatever x-ray the patient has had hoping

to identify if the disease being studied was causing the symptom that the patient was having so much so that he and his family came all this way from whatever state to get a diagnosis and they are upstairs in the waiting room on pins and needles hoping for clarification but I have been around this Institute long enough to know that most times there is no definitive answer and when the patient and his family hear that the diagnosis is inconclusive and look downhearted the primary investigator says that sometimes no diagnosis is better than a horrible one with no cure but that doesn’t make the patient or family feel better and I am sad for them because I know how much they wished to hear that their ailment had a name and a cure and they are disappointed to have traveled all the way to the NIH to get no answers however I still feel honored to be part of this research project although the part I play is rote but necessary in moving the research study along even if I don’t have a PhD in a research specialty nor am I one of the leading investigators in this important study I hope my nursing contribution has been helpful and I find out after I have given my notice and leave to follow my husband to another state because he has a new job that my position was filled by two nurse practitioners. 

Alphabet Challenge: U

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. 

U: University of Illinois at Chicago

I graduated from UIC, College of Nursing in 1981 with a master’s degree in Public Health Nursing. During my first semester, in the community assessment class, I was assigned to the Pilsen neighborhood with a fellow student. At the end of this course, we had to write a paper about the community and the health problems that we unearthed. 

In order to get to know the neighborhood, my classmate and I walked the streets, looking at the housing and stopping in the stores. Mexican music played loudly from the shops while mothers, fathers, grandparents and lots of babies and children filled the sidewalks. I fell in love with the Mexican neighborhood. I brought home Piñatas, Mexican pastries and colorful vases. The vibrant sense of this Hispanic community impressed me.

There was another part of this geographical area: modest, detached homes and sidewalks swept clean by elderly Italian and Polish homeowners who soon would no longer be able to keep up their property. It was this population I would meet again in a few years after I became a gerontological nurse practitioner and took charge of a senior clinic on the westside of Chicago. UIC was the conduit for the welcome change of direction in my career. 

Alphabet Challenge: E

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. 

E: Eckhart Apartment

In the mid 80’s I worked in a clinic on the tenth floor of a subsidized building for the elderly on the west side of Chicago. The twenty-story apartment building proved to be a training ground for me: an inexperienced nurse practitioner and new to working with older people.  

I learned:

            that older folks were generally accepting and forgiving. That they enjoyed sex.   Some of them drank too much, hired prostitutes, carried guns in their purses, and chewed tobacco. Some sold their medicine for street drugs or money. Some were abusive and some were abused.

            that not all families wanted to care for their older members. That loneliness was the most pervasive condition among the group. I learned that family members, who suddenly showed up when someone was dying, might not be family. 

            how to plan a funeral, hand over firearms to the local police precinct, how to put folks in a nursing home, transfer them to an emergency room, and commit them to a psychiatric hospital.  

            to listen to a person’s story before I examined her. And that making a home visit told me more than I could ever learn from an office visit.

            that I didn’t need the support from a highly educated and professional staff but from people who were caring and didn’t walk away from a problem. And I learned that a sense of humor was a requirement when working with the elderly.

Olden Days of Nursing: A Pioneer of the Past Spurs Others Forward

Olden Days of Nursing: A Pioneer of the Past Spurs Others Forward

by Guest Blogger: Cynthia Freund

I talked with Marianna the other day about the book I’m writing (more about that later). She referred me to a post on her blog from a couple of months ago, a post describing the olden days of nursing. She added that she had some very positive responses to that post—and then she put the question to me, “Would you be interested in writing something about the olden days for my Blog?” I obviously fit the age criterion.

I read the post of August 4, 2020, Olden Days of Nursing: Dialysis, about a nurse working in the days when kidney dialysis first became available, the beginning of the 1960s. I know Marianna was asking me to write something about my own early experiences in nursing, and I may do that yet. But this particular post made me think of a dear friend who died a year ago, one-month shy of her 95th birthday. She, too, started one of the early kidney dialysis units, but this time at the Veteran’s Administration Hospital in Durham, North Carolina. 

In this millennial year of the nurse, I want to pay tribute to Audrey Booth, both a typical and unusual nurse—a pioneer in many ways.

From the dust bowl of Nebraska, Audrey, a curly-haired blonde, climbed on a horse twice her height to ride to-and-from a one-room country schoolhouse and onto become the Associate Dean at the University of North Carolina (UNC) at Chapel Hill. 

The interval between that Nebraska farm and UNC took her to Case Western Reserve in Cleveland, Ohio, where she earned a master’s degree in nursing. She became an expert in the care of polio patients during the height of the epidemic in the 50s, including caring for kids in iron lungs. That expertise brought her to Hawaii and Guam, and also transported her back to the mainland and the University of North Carolina (UNC). After the polio epidemic, she focused on kidney disease and, in the 60s became a leader in opening the new hemodialysis unit at the VA hospital in Durham—one of the very early dialysis units in the US.

Looking for new hurdles to jump, she joined a small select group planning the nurse practitioner program at UNC. And then, when the North Carolina Area Health Education Center Program started in the mid-70s, Audrey became the Director of Statewide Nursing Activities. (AHECs, as they are called, were designed to be centers of education and innovation, serving as magnets to attract health professionals to rural and underserved areas.) She became an Associate Dean in the School of Nursing in 1984—while continuing with all of her duties as AHEC Director. 

Throughout her career, the essence of Audrey was as a leader, a role model and a mentor. She led and taught many nurses, usually just by example. She was not well-known nationally, but she was known by hundreds of nurses—and other health professionals—in North Carolina. Many of us attribute our professional success to her leadership and guidance. 

And, as a matter of fact, it was Audrey who suggested to me that we interview the founders and influential promoters of the nurse practitioner movement in N.C. UNC started one of the very early family nurse practitioner programs. It was quite unique in its alliance with those starting a statewide AHEC Program and a Rural Health Program—a collaborative effort involving many. Audrey, and I, were involved in that pioneering effort. So, we conducted the interviews, but Audrey left the book-writing to me. 

I am about to finish that book, titled: Nurse Practitioners in North Carolina: Their Beginnings in Story and Memoir. It will be in print in the spring of 2021—and will feature many other nursing stars of the olden days of nursing.   

Audrey’s spurring me on to write this book is a perfect example of how Audrey led others—encouraging them to greater endeavors. Plain and simple: Audrey was an influencer, on a grand scale and with each individual. She was a mentor in the truest sense of that word. She was a strong voice for nursing and a strong model for women when women were still fighting for their due recognition. We indeed should celebrate all such nurses, just as the World Health Organization has done, declaring 2020 as the International Year of the Nurse and the Midwife.

Dean Emerita Cynthia Freund, MSN ’73, and Associate Dean Emerita Audrey Booth, MSN ’57, were awarded the highest honor of the North Carolina Nurses Association (NCNA) when they were inducted into the NCNA Hall of Fame on Thursday October 9, 2014. Nurses chosen for the Hall of Fame are recognized for their extensive history of nursing leadership and achievements in North Carolina.

Cynthia “Cindy” Freund, RN, PhD, worked for eight years with the newly developed Family Nurse Practitioner Program at the University of North Carolina at Chapel Hill in the early 70s. She then went to the University of Pennsylvania to start a joint program (MBA/PhD) between the School of Nursing and The Wharton School. She returned to UNC-CH and retired after serving 10 years as Dean of the School of Nursing. To her, retirement means “working without pay.” In her retirement, she worked on her book: Nurse Practitioners in North Carolina: Their Beginnings in Story and Memoir, to be published in Spring 2021.

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.

 

THE CHOICE

This was published in September 2018 in The Olli Writers Group Anthology

anthology 

On our first night in a hotel room in Estoril, Portugal, the thumping in my chest jolted me awake. Still groggy from jet lag, I tried to go back to sleep but the pounding demanded attention. I pressed my hand over my heart, feeling what seemed like a bird batting its wings to escape my ribcage.

Besides a touch of anxiety, I felt fine. No chest pain, no shortness of breath, no dizziness, no nausea. Then my bladder chimed in, upstaging my clinical observations.

Slowly, I rose and sat on the side of the bed, careful not to disturb my husband who was asleep beside me. Thinking I might pass out, I sat quietly waiting to topple. When that didn’t happen, I shuffled in the dark, feeling my way along the wall, to the tiny bathroom.

Successfully back in bed without tripping, falling, or fainting, I couldn’t help but let the jet lag overtake any further analysis.

The next morning, I awoke to the same sensation in my chest. More alert than the night before, I diagnosed the uneven heartbeat as atrial fibrillation. A geriatric nurse practitioner until my retirement three years ago, I had treated many patients with this condition—its occurrence increases with age. A fact I couldn’t ignore. A-Fib, as it’s called, isn’t life threatening and often stops on its own.

I remembered that the day before, as my husband and I explored the neighborhood around the hotel, we had walked past a medical clinic. Through the large glass window, I saw several people sitting in a waiting room, some reading magazines, not unlike our clinics back home. I had no desire to seek help there. I didn’t speak the language, and who knew about medical practice in Portugal? Besides, I was counting on this event ending soon.

Getting ready for the day’s adventure, my husband slipped a sweater over his head as I laced my shoes. “By the way,” I said, trying to sound causal, “I’m having a little irregular heart beat. It’s nothing serious and I suspect it’ll end on its own. I just want you to know, that if by chance I pass out, get the tour director to call an ambulance and tell the medical folks what’s wrong with me—A-Fib.” Before my husband could become worried, I added, “I’m sure I’ll be fine.”

My husband of forty years trusted me, the knowledgeable nurse, to accurately assess my situation, and nodded. I figured he would be happy to be spared an interruption in our itinerary.

We rode the elevator down to the lobby, queued up with our tour group, and boarded the bus to Cabo de Roca. I grabbed a window seat. The vibrant, coastal city gave way to dry grasses clinging to rocky cliffs. I slid down in my seat and discretely put my fingers to my neck, checking my carotid pulse. The irregular rhythm ticked off around one hundred beats per minute. Not too rapid to worry me—yet.

After a couple of hours, the light blue sky became cloudless as we ascended into the thinning mountain air. Would the high altitude affect the rhythm of my heart? Would my pulse become so erratic that my blood stagnated, forming a clot that would migrate to my brain and spawn a stroke? My husband remained deep in his book. Or was he consciously ignoring me? The medical clinic near the hotel began to seem inviting, but very far away.

The bus turned into an empty parking lot. We arrived before other tourists. My husband was the only one who headed over to the one-story building that stood at the far end of the lot where one could obtain, for five euros, a certificate validating that one had stood at the westernmost point of continental Europe. The others headed to the bathrooms or the gift shop.

I stepped off the bus last. I felt something strange. Or, rather, I felt nothing. Had my heart stopped? No, it just felt that way with the fluttering finally gone. My chest was silent. My pulse was regular. The air smelled cool and crisp. Released from potential calamity, I dashed off to find my husband. No further health alarms marred the remainder of the trip.

When we returned to the States, my internist insisted I wear an Event Monitor: electrodes attached to my chest at one end, and at the other end to a plastic box that would hang around my neck for a month. When I noted any flip-flops from my heart, I was to depress the start button and the monitor would record the “event.”

One night during the first week, after I wrestled with the monitor to find a comfortable position in bed, I settled into sleep. My heart, booming loudly in my ears, jarred me awake. I pressed the record button. The monitor gave off a high-pitched sound and began taping. As instructed, I lay still. When the whining stopped, I stumbled into the kitchen to call the toll-free phone number.

The nurse talked me though the process of sending the recording across the phone lines. I hung up, relieved that she hadn’t told me to go directly to the hospital, as had happened with my friend, Norm, after his first submittal. “Get to the emergency room, NOW,” the nurse told him. The next day, a cardiologist installed a pacemaker in his chest.

I reassured my husband, who woke up during the taping and rushed after me, concern covering his face. We ambled back to bed—him to sleep and me to await any further malfunctioning of my heart.

Three weeks later, I mailed the monitor, wire, attachments, and unused batteries back to the company. I wouldn’t miss the nightly struggle to sleep with a rigid box digging into my ribs. Or the monitor’s beeping at inappropriate times during the day. Or most of all, the constant surveillance for any twitch in my chest.

The only two episodes I had during the month were not atrial fibrillation but sinus tachycardia: a regular, rapid heart rate, usually benign. Wearing the monitor for a month seemed too much of an inconvenience for such a paltry yield.

No doubt there will be other assaults to my aging body, mildly annoying or life threatening. The trick is to know the difference: whether to stay back and seek medical care or take a chance and get on the bus.

 

The Perks of Serving on the Board

 

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

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

 

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

 

Patient Experience

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

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

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

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

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

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