2nd Place (2004)

How Nursing Enriches My Humanity
by
Barbara Britt, RN, MSN

It’s 8 PM.  Been here since 7 AM.  Just finally finished the residual paperwork (well, kind of) of a long, tiring clinic day. Today’s "to do" list is only about a quarter completed.  It’s good to know there are still goals for tomorrow!   Desk looks like I’m having a paper drive and I’m desperately hanging onto my favorite post-it that boldly states "a clean desk is the sign of a misguided career choice".  Have answered all the more urgent messages from parents, have faxed the chemo orders to the surgery pharmacy AND surgical admitting AND the operating room itself for tomorrow am (no redundancy in THIS place, nosiree!).   Looking forward to going home and getting some dinner, maybe managing to get to bed by 10 for 7 hours of sleep instead of the usual 5, but only if I can cut the drive to 45 minutes instead of an hour but the good news is that at this time of night  I can probably do it.  Open my email due to the compulsion of needing to know before I walk out the door if anything "important" has happened since I’ve been in clinic.  Big mistake but then I’m always making that same mistake.  Scroll through to see what’s really important for tonight.  And there it is, the reminder from KR to write our essays for the contest on "how nursing enhances my humanity".  I mean, get a grip!   Besides, it’s not as though she’s not set an impossibly high standard by winning the darn contest herself for the last two years.  Talk about intimidation.  As I contemplate whether or not to make the essay effort, I see that my dream of making it out of the parking lot before the attendant leaves is beginning to fade.

But I DID make a promise that I’d do one, so with absolutely no apologies about how long it is, here are my thought on this whole "enhancing my humanity" thing.  

Remember back to those first days of being a student nurse in clinical rotations?  The total paralyzing fear of realizing that someone expected you to go in and perform some new skill that seemed so very hazardous and you thought "how can I possibly do this, it is way too scary?"  Okay, so maybe I’m the only one who thought that.  But I do remember that despite my decision at the ripe old age of 7 to become a nurse, I really never fully comprehended what nursing was about even when I entered college.  I never even knew a nurse when I was growing up, except the nurses at my own doctor’s office who absolutely terrified me because they gave me shots. I knew that nurses took care of sick people and that seemed to be a pretty good idea at the time, but yes, basically I was clueless as to just what that would mean.  SO, it was somewhat of a shock to me as a junior in college to start that first clinical rotation and to meet and deal with PATIENTS!  And to recognize that patients usually started out as strangers.  And to know that  STRANGERS were one of my least-favorite life forms.  My anxieties as a student nurse frequently consumed me so that in the evaluation phase of every clinical course some mention would be made in that most personal of all session with your clinical instuctor about how I would really do much better if I found a way to deal with my anxiety. 

I stumbled through my first 3 clinical rotations trying to deal with the fear that welled up for me at the approach of each clinical day.  I did pretty well, all things considered, which is probably more of a tribute to my bone-deep core of stubbornness than anything else. There was that time, however, when I was so nervous on the first day of a new rotation that when I returned to my car at the end of the day, I discovered I’d left the key in the ignition, the radio on, and the windows down.  I know that many of those I work with now would have a very hard time believing that I was so insecure at every turn.  But not finishing was never an option.  I never even considered that nursing wasn’t my appropriate goal.  But I can remember that it was so hard for me to find the key to understanding what I was about, what nursing was about, in terms that could help me rise above my own fears.  I just wished that everything didn’t have to be so very hard.

My personal moment of enlightenment came on the first day of public health nursing when we all gathered in one classroom for the lecture portion of the day.  Our clinical instructors back at Cal State LA took the risk of revealing more of themselves than usual in helping us understand what we were about as students moving into this profession of nursing.  When we were all seated that first day, the instructors told us that they wanted us to listen closely to the record they were going to play.  We looked at each other, wondering what type of instructor-created bizarreness we were going to endure.  Then throughout the room came the music and words of Simon and Garfunkel’s "Bridge Over Troubled Water."  There was total silence in the room.  At the conclusion of the music, one instructor simply said "That’s your job.  Be the bridge".

That moment did it for me.  The potential was there for all these students to react with total ridicule of the mawkish sentiment that our instructors had shown, but that didn’t happen. The moment  was accepted as a passing of the baton between a group of skilled professionals and those that were seeking the same road.   I will be forever grateful that those nurses took the risk of sharing with us in that way.  In the words of the song I found for the very first time the link that was able to raise me above my anxieties, to find the larger picture in what nursing was all about for me. The connection was made between all my fears and all the fears of those I was trying to care for. All the anxieties didn’t go away, but I was able to start making sense of them.  It was my mastery of those fears that kept me in touch with what my patients were going through.  In later years I was finally able to see that nursing made me face my own personal demons: of pain, of inflicting pain, of uncertainty, of separations; of self-consciousness and shyness and fear of failure.   Every time I mastered a new fear, I was propelled on by knowing how this mastery would help those I cared for, that I couldn’t care effectively for those who were my patients unless I rose above those fears of mine.  I learned that it was time I started getting my act together.

How ironic I found it when I realized that I had moved into pediatric oncology back in a time when most of our kids didn’t survive.  Here I was, one of the worst people ever in dealing with separations of any kind, and I had chosen a path that forced me to deal with the ultimate separation on a daily basis.  In the early days of RNs actually starting IV’s to give chemotherapy, this needle-phobic RN was able to stick that first little hand with that butterfly needle and learn that skill only because of the need to be the bridge for the patient and their parent between the unknown of the chemotherapy, the uncertainty of the outcome of the "stick" and the familiarity for them of having those tasks performed by someone they knew and trusted.  When I learned to perform bone marrow aspirates and biopsies, and to do lumbar punctures and administer intrathecal chemotherapy, the only thing that kept my own anxieties in check at learning these procedures was that I could make the experience better for the family by being the best I could be at this skill.  I was their bridge between fear, anxiety and the successful accomplishment of necessary steps of treatment.  Being their bridge and holding onto that image was my way of keeping my own anxieties in check until mastery of the task had occurred and my new self-confidence could assert itself.

I kept plugging away at my own issues as I continued on my journey through these many years of learning what it meant to be that bridge over troubled water for patients and families, but along the course of my quest, I started to learn that there are too many chasms to span, and some days my best efforts just aren’t enough. You know those days when it just seems like there’s not a soul in the whole hospital for whom you can make it right.  The times when despite everything you’ve tried, every plan falls apart?  When you’re so grumpy you’re like the proverbial bear with a thorn in its paw and you’re really trying not to be a grump but it just eludes your abilities and all you can do is keep moving forward, knowing that somehow it will eventually come around right again?  When those who work with you wouldn’t believe that you ever had a higher thought about anything?  When you are so proud that you’ve found a solution for a parent and the parent isn’t at all impressed with your solution?  When you hear someone taking credit for a plan that you worked hours to figure out for a family? I’ve discovered that for me those are the times when that image of being a bridge comes in mighty handy.  A bridge can be silently effective.  No one really needs to see it being built, it just needs to be there at the right time.   The foundations you lay down one day pave the way for the next hard day.  It doesn’t all have to be done at once.  It doesn’t matter if anyone knows you’re the builder of the bridge.  YOU know it, and with enough time and perspective, you finally come to realize that the self-knowledge is enough.

You know that saying about how when you reflect back on your life, you’re NEVER going to say to yourself "boy, am I glad I worked those longer hours"?    I’m here to tell you that the people who CAN’T say they’re glad for at least SOME of those hours chose the wrong career.  Because as tired as I am, as annoyed as I was the other night when my pager went off at 11 PM, as many times as I’ve had my purse on my shoulder, computer off, lights off, diet Coke for the road in hand and the phone has rung and I’ve stood there and said to myself "let it ring, let it ring, don’t answer it": as many times as all those conditions have existed, I am here to tell you that it is the very fact that I go back and answer the blasted phone that keeps me strongly rooted to the humanity all around me.  It’s my bridge to humanity that I can chose to go back and answer that phone, that I can make one more effort, and that finally if necessary I can leave the completion of my efforts to someone else.

I believe in life balance, of having work time and playtime, of spending time with family as the foundation of my non-work life, but I also believe that if you’re going to spend so much of your life "working," then that work best be something in which you can find personal meaning.  Working on being a bridge to help people through tough times has been my meaning, my touch with humanity, my acknowledgement that we’re all in this together and we’d best plan on helping each other out.  Some days I’m the bridge, other days I’m blessed to walk across the foundations laid by one of my colleagues. The sometimes secret, unspoken sharing with other nurses of the reality that through our actions we have made a positive difference in someone’s life is our own personal bridge to our shared humanity. The imagery is endless, but it works.  Nursing in all its permutations keeps us in touch with our world in ways that few others will be privileged to know.

The words of the song come to my mind in times of stress and they mean as much to me today as in that classroom 33 years ago.  "Sail on silver girl, sail on by.  Your time has come to rise, all your dreams are on their way.  See how they shine….  If you need a friend, I’m sailing right behind.  Like a bridge over troubled water, I will lay me down.  Like a bridge over troubled water, I will ease your mind".  

How many times have I known that if I hadn’t answered that last phone call instead of walking out the door, someone would have had a very troubled night?  A child would have been in more pain. A family would have spent long hours in the ED when just a couple of more calls meant that a direct admission was possible.  Those are good memories to hold to your heart when you finally walk past the empty guard stand in the parking lot and climb into the car to make your way home.   Those are my bridge moments.