Saturday, March 22, 2014

Nursing, Thirty-one Years Ago…





Nursing, thirty-one years ago…

Like a cliché, it seems only like yesterday. But one only has to look at the hands wrinkled by countless handwashings, it orientates me to the fact that “Man, I have been a nurse for a very long time”.

I am a nurse educator, so I welcome new nurses to the fold. I do not get threatened by the generation gap because I am energized by new knowledge and technology. It is an exciting time for a nurse today with advanced medicine, electronic documentation, and nurse empowerment.

But I do feel protective of the special gift that senior /seasoned nurses bring to the table. The experience of thirty-one years has not only made me stronger clinically but has also given me a better perspective of the impact of these nurses on the patients who will only benefit from knowledge earned through hard work and determination.

I truly support the tremendous contribution that the seasoned nurses have given to the profession, and they will play an important role in guiding the new nurses today to realize their full potential. Sadly, there is a sense of "entitlement" on both sides. There should be a better way to bridge the gap between generations. Patients do not really care what the nurse's highest academic degree is as long as they get compassionate care from the nurse.

Having learned from my mistakes, I respect myself even more today. Unencumbered by false modesty, I can proudly and humbly say that I am a damn good nurse, not because of any advanced degree but because I learned patient-centered care long before it became a buzzword.

Thirty-one years ago, I stepped into Coler Memorial Hospital on a cold January morning. Our group of young Filipino nurses newly flown to New York was culture-shocked. I thought that our patients spoke with difficult accents, all slang yet full of grammatical errors. I was convinced that the doctors misspelled their orders and were insulted when we questioned duplicate medications.

Our nursing supervisors towered over us with doubt written on their faces. They probably were wondering how these naïve, young women could stand up to the bossy LPNs who used to rule the roost. We were usurpers to the throne. We didn’t know any better and how dare we come to this place expecting to find our way into their nursing world.

But dared we did. We held our own, learned the slang, and worked our way to earn the respect. Not only by our supervisors but mostly by our patients who delighted in our enthusiasm and compassion. My supervisor Ms. Covington used to challenge me to go beyond my comfort zone. Somehow the patients who were abandoned in our care became our own grandparents. We held their hands and listened to their nostalgic remembrances of lives spent caring for their loved ones. We dried their tears just as we dried our own tears of loneliness for families left behind in the Philippines.

“You’re my favorite, Cerrudo.”, one of the chronic dialysis patients rewarded me with this one day. I quickly bragged to my friends about how I finally won over the most difficult patient in the unit. My friends did not even give me time to relish my victory; Sessa told them the same thing last week. I was Sessa’s favorite at that time because I had given her an extra ice cream.

My first unit was the Medical ICU. One part was the chronic ventilator unit where patients remained attached to ventilators; we became experts with trache care, suctioning, and communicating with our patients the best way we could.

Mr. Alston used to clench his jaw and blink his eyes three times if he wanted things done. One bedridden patient could only give a lop-sided smile if we positioned him right. Mrs. Richards frowned if we didn’t tuck her bedsheets right and gave us thumbs up when we did. Young Alli smiled at everything we did for her, as we wiped the drool on her neck, cleaned her trache, and brushed the tangles on her hair. I massaged the contracted feet of my ALS patient who continued to have a vibrant mind while his body wasted away.

The patients were our family… and every time one passed away, we cried with the rest of the staff. Most of the time, the nurses were the only ones who grieved their passing because the families had long abandoned them.

Two years later, I was promoted to a head nurse position in a general med-surg unit with 40 patients. I took my share of duties as part of functional nursing. There was usually one medication nurse who started and finished the day by giving meds with printed medication cards; from the back to the front of the unit where meds were given through gastrostomy tubes. Another nurse and I worked with a group of two nurses’ aides as we fed, bathed, exercised, and walked the patients. At 3 p.m., we started our narrative charting, our notes the same every day except for the vital signs and whether patients had bowel movements or not.


Thankfully, the technology and staffing got much better. The suction EKG bulbs were horrendous and left their distinct marks on our patients’ frail chests, the yucky gel too difficult to clean off. The manual mercury sphygmomanometer is now a thing of the past, now it’s just a button to push on the automatic cardiac monitor and we get veritable data of riches: BP, HR, oxygen saturation, MAP, endtidal CO2.

Gone are the medication cards, those 2-by-2 index cards with hand-written transcription of medication orders, and the dosage times written in black, green, and red. Gone are the Kardexes with nursing diagnoses that never changed. Gone are the hand-written doctor’s orders that were meant to confuse.

Back then, I was new, nervous, and unsure of my place in this world. Thirty-one years after I first stepped on American soil, I am still convinced that Nursing has given me valuable lessons along the way. That the rewards of nursing far exceed the material blessings. The compassion I have shown my patients was the greatest gift I could have given them.

And now, as a clinical adjunct professor and a clinical nurse specialist, I try to impress my students and nurses to remember why they chose this profession. I celebrate their need to explore new boundaries and to push the envelope but I remind them, as well as the seasoned nurses, to embrace their similarities and learn from each other.

When the patient needs a hand, it doesn’t matter if the hand that is offered is that of a baby boomer or a millennial. At the end of the day, the patients will remember a nurse who gave them the respect that they deserve.

Through the nurses I teach, I wish that a compassionate nurse lives on.









"My Firsts... as a Nurse in the US"- http://jcerrudocreations.blogspot.com/2012/03/my-firsts-as-nurse-in-us.html