Like the majority of high school students I didn’t have the vaguest idea of what I wanted to be “when I grow up”. Hell, I still don’t if we are being honest. I always envied those people that had gotten some sort of “calling”. Despite being a pessimistic, untrusting, conspiracy nut when it comes to the US Government, I actually contemplated going into the Air Force just to buy myself some time and earn some money toward college. I spoke with a couple recruiters who are eerily similar to car salesmen except it feels much more like a barter for your *soul and free thought.
Instead, I chose what seemed like an easy contingency plan. Nursing. Now at the time I was working as a PCA after school at the local nursing home. My parents value a strong work ethic and I was lucky enough (though I would never have thought so at the time) for them to teach me this. I knew I needed to do something when I graduated. I just didn’t know what. I was already in the medical field and it was alright, I mean, I knew that geriatrics wasn’t my thing, but I liked helping people and nursing could pay well while I worked on what I really wanted to do. Even better, there was a program 30 minutes from home that would allow me to receive my diploma in Practical Nursing in under 12 months. Yep, in under 12 months I could complete all my generals and assuming I passed my boards be a working LPN. I started two weeks after my high school graduation.
I have always been blessed to be one of those really annoying kids that could sit in class, pay attention, take a few notes I very seldom ever looked at again, and do great on the test. It didn’t always stick for long past that, but passing tests is all you need. And in the beginning it was all very simple. Mostly review of PCA role duties. How to give a bed bath properly. Making a bed with hospital corners. Taking a blood pressure, temperature, and a pulse. Basic stuff really. Eventually it got harder, but I kept up well and even made some good friends.
Then came clinicals. This is the point where you start going into various facilities and applying what you learn. I was nervous of course. Inside I’m a self conscious wreck with undiagnosed anxiety that turned my inner mind into one of those bitchy girls from Mean Girls. But I wasn’t nervous about it being too hard. After all, we were assigned one patient and were given the opportunity to go in the day before and read through their chart and study up. When you look at what nursing is really like this seems asinine and completely insufficient to actually prepare anyone. But that’s a whole other thing I’m not getting into.
Now I’m sure that there were many great learning experiences and such, but I want to share the three stories that stick out most in my mind. I want you to keep in mind this was 1997 which is nearly two decades ago (ugh, I’m feeling old now…). I would like to think that these sorts of things would NEVER happen today, but I believe I noted earlier that I’m a bit of a pessimist (though I prefer the term realist). You decide.
1. Bitch said what?! On the first day of clinicals at the local hospital I remember hearing two things from various nurses that stuck with me mostly because they pretty much sum up the feel of the way we were “welcomed” in nearly all of the institutes we visited. Granted, we were all nervous and a bit terrified so I’m sure there were plenty of nice staff that we just don’t recall because those sorts of things never stick with you when you’re in that type of mental state. I remember asking a nurse what my patient’s medication was for as I wasn’t able to determine why he was receiving it. Many times meds are used for things they were not originally designed for and I thought this may be the case (like antidepressants being used to help people quit smoking). The reply I received was, “Don’t you have an instructor? Why don’t you ask her. I have things to do.” Not much later I heard another nurse say, “Oh God! If that patient pulls that call light again I’m going to smother him with his pillow!”. As a young, impressionable student who had never heard any of the nursing home nurses speak this way, I was flabbergasted and it quickly left me with a long lasting impression of hospital nurses.
2. Who needs an interpreter… During my clinicals I was able to do a rotation through a local clinic. Again, I don’t remember most of it other than following one of the older physicians into an exam room. He looked at me, immediately dismissed me, and proceeded about his day as if I wasn’t even there. Upon entering the room I saw two young women, one on an exam table with a drape over her legs and an ultrasound machine near by. The second was sitting near her head. Both appeared nervous. The physician started talking to them about the images on the screen. No heartbeat. Not viable. Should pass. The second woman clearly stated that the patient didn’t speak english and started to translate as he was talking. He didn’t pause to take questions. He stood up and left the room as the patients eyes widened still not in full understanding of what was taking place. He did not at any time return to that room, but instead moved onto the next room and began scientifically explaining to me how in vitro fertilization worked and how it was done in the clinic without skipping a beat.
3. Anybody in there? In order to do a true OB and Pediatric orientation we had to travel about an hour away on two separate weekends. My first weekend was in OB and went well enough. I had the opportunity to help out a mother who was in a lot of pain and was very excited to come back for the pediatric rounds. The weekend arrived and I was assigned one of the two patients on the floor at the time. It was a small Hmong or Laotian boy a bit older than my girls but not yet a tween. He had terrible abdominal pain the last 2-3 days and the staff was in the process of trying to determine a cause. His mother was at his bedside throughout, but did not speak english. I assume the boy did, but he was so scared and in so much pain I never heard him say anything in the two days I worked with him. He had an older sibling who would come to visit and would translate on behalf of their mother. An interpreter was never otherwise present in person or via phone at any other time during those two days even when staff had direct questions for his mother. During that first day it was determined that he most likely had appendicitis and would need it removed. He was taken down for surgery without anyone actually speaking to him about it and no one explaining to his mother what was happening though they had her sign the surgical consent. Scared, I believe she contacted the other sibling who then showed up shortly after the boy had gone down.
The boy was just getting ready to be wheeled into the OR when the sibling arrived and an obviously annoyed anesthesiologist took all of 2 minutes to describe to the sibling what would be happening and then pointedly told him he didn’t have time to wait for it to be translated and asked if there were any questions before wheeling him away as the sibling struggled to relay this to the mother. No kiss. No hug. No explanation to the little boy.
I was allowed to scrub up and come in to observe. The boy was terrified which was evident by his heart rate on the monitor if nothing else. No one spoke to him. No one bothered to explain what was going on. They simply slapped a mask on him and waited for him to go out. Then some one asked the other, “Is it a girl or a boy?” which was replied to, “who can tell with them anyway.” The surgeon entered and was kind and attempted to explain to me all that I was seeing on the monitor. During the procedure another gentleman holding a mask over his face, but not wearing a gown or shoe covers entered to speak to the anesthesiologist. But a minute later I witnessed him tap the boy twice in the middle of his forehead and say “Anybody in there? Do you feel this?” and then they both giggled.
It was determined that his appendix had ruptured about 2-3 days ago and mostly walled itself off, but the boy did have signs of peritonitis which meant he was a pretty sick boy! The next day I came on shift and it was evident that he was feeling lousy. He could hardly sit up in bed without vomiting or dry heaving which only exacerbated his pain. Not to mention he was a kid. He was terrified. The nurse on duty asked me about 30 minutes in if I had gotten him up to walk. I explained that he wasn’t feeling well and seemed to be in a lot of pain. It had been some time since he had any pain meds (his mother was not allowed to stay over so there was no one to advocate for him to receive night time medications) and told her I believed he needed these before we proceeded. She looked me in the eye and said, “Well, give them to him then.” I explained that they were an IV push med and I was not allowed to give these. She begrudgingly gave them and then told me to get him up to walk. I told her that I didn’t think he would be able to just then as he wasn’t able to sit up without vomiting. Again, she looked me in the eye and said, “Did you ever think it’s just his kind and he’s faking it?”. Blessedly she walked away not needing a reply.
By the time the end of the day came and we sat at our table to report off to the instructor (who had been pulled all day between the 10 of us) I was a wreck. Teary eyed, I explained to the group what I had seen. Our instructor was the sweetest, OLDEST, retired nurse that has ever lived, but bless her heart if I didn’t see steam pouring from her ears. I know that she spoke with someone regarding the incident, but I never learned more about it. Other than saying, “unexceptable” we never spoke more about it. In her defense, I did later that day fake a phone call from my family informing me that my grandmother had been hospitalized requiring me to leave, so had she planned to talk about it that day I never gave her the chance. I couldn’t bear to be there the next day. I had already decided that I was done with nursing. And I was for about 6+ months or so before I realized that I had to make money if I was going to afford to live on my own at college as I worked toward Plan B- not really sure what that would be yet…
Years later, it would all become fuel for being the kind of nurse I wish I had encountered when I was a student. It became my ideal of what a nurse was NOT. It has stuck with me over the years as I have continued to hear and see how nurses & providers around me have chosen to treat those that are “beneath” them financially, educationally, or culturally. I have heard people say, “They can’t even speaka the English, for God’s sakes!”. Really? I mean, REALLY?
I would like to say that I have gotten brave and that I speak up when I hear these injustices and set people straight. I would like to say that. I have found my own way most times. I remind people that refugees never wanted to come here, but a war in their country forced them to. I’ve asked people to think about what it would be like to live in fear of your daughters being raped in front of you, of you being raped in front of your sons and of them and your husband being killed or taken in front of you. Those are on the days I am feeling brave. On the days that I am not that bold I try to remind people that even if that family is “milking the system” their child never asked to be part of it and that child still needs care. I’m proud to have my tax dollars go to help a child who’s parents can’t or simply refuse to. I actually had a nurse tell me years later that it really made her think about things differently. On other days I say nothing and try to comfort myself with the thought that at least I didn’t agree. At least I didn’t condone. However, silence is just that.
Next: My first job & the home care experience…
*I have many family members that are veterans and do not think poorly of them and appreciate their service to our country. This is merely a commentary on the tactics of recruiters who apparently will lie to you and tell you whatever you want to hear in order to obtain you…