The Life and Times of Florence Knitingale

Saturday, February 17, 2007

Saturday's Accomplishments

Mr. K is having a bunch of friends over tomorrow, to hang out in the shop and do such manly things as lend themselves to such a testosterone rich atmosphere. (Specifically, I believe that there is much burping, farting, and blatant adjusting and scratching of private parts, although I will never really know for certain, being that my collection of X chromosomes rather excludes me from membership in the rarified atmosphere of the club.) In preparation for this august event, and because I am a wonderful wife (or so I keep telling Mr. K...I'm hoping he falls for it) I agreed to do a tiny bit of cooking and baking. With that in mind, I spent the afternoon making my famous Meat and Potato Salad, specifically designed for those with Y chromosomes, and those who wish to hear their arteries slam shut at a great rate of speed. The recipe involves:

Take every single pot and pan you own out of the cupboard. Do the same with every spoon, fork, and knife. Proceed to get them filthy. Take all of the salad ingredients and spread them liberally over the counter. It is quite important to get them close enough to the edge that the floor might also benefit from this largesse. Stepping on them in stocking feet is a bonus. Spill pickle juice anyplace that really should not get sticky and that is hard to clean. Cut thumb on eggshell and try desperately not to bleed in salad. And so on. It's a fun recipe.

I also sat down finally and worked on the essay that I need to send with my application for nursing school. I've avoided this like the plague, largely because of my innate desire to write something somewhat unfriendly along the lines of "What in the hell else do you people WANT from me???? The recommendation of a sherpa in Mongolia? The signature of a 38-year old virgin? A thousand chocolate jimmies arranged in the shape of the school insignia and glued onto a field of olive pits? WHAT????" I'm told this is unlikely to cause the committee to swoon with joy at the thought of taking me into the program. Spoil sports. Anyway, I did finally finish it and Mr. K suggested that I put it here for your input. I will do so, with the understanding that you may ignore it at will. On the other hand, I welcome input. As long as it doesn't involve chocolate jimmies and olive pits. Do keep in mind, though, that it is a very different sort of writing for me in that it requires that I completely forget that I possess a sense of humor, that I pucker and press my lips firmly to the posterior portions of the committee members, and that the entire thing feels so sweetly manipulative that it makes me gag. I'm not good at "playing the game". Does it show? The following is the one page essay in its entirety. Feel free to tune out now if you like--I promise not to put anything remotely interesting or funny at the end of it. Certainly not in it.

Ms. K's Nauseating Essay
(This is a working title...I'm not married to it)
"A nurse friend once told me, long ago, that I should not even consider becoming a nurse unless I absolutely had to be one. I didn’t understand that initially. Now, however, after working as a CNA in nursing homes, a medical receptionist in various offices, a hospital volunteer, and a Medical Assistant in two very different, very busy clinics, I think I know what she meant. It was this: nursing is backbreaking, often heartbreaking work. It consists of long hours, mundane tasks, things that smell, messes beyond description, patients and families that are frightened and sometimes hostile as a result and, depending on the department, sustained levels of near-chaos that must become a livable status quo if the nurse is to survive it. The television image of a smiling, white-uniformed nurse tucking pillows beneath the head of a grateful, friendly patient has as much to do with real nursing as a folding chair has to do with a water balloon. Nursing is hard labor and the person who enters the field thinking anything else is setting his or herself up for burn-out. But nursing is also rewarding, interesting, and challenging in a way that builds the person who does it. My friend didn’t mean “don’t do it unless you’ll be on the bread line otherwise”. She meant “Don’t do it unless your soul insists on it. Don’t do it unless you know in every fiber of your being that this is where you belong and that it will be the hardest, best work you’ve ever done.”

It’s hard to come up with a single statement that answers the question of why I want to be a nurse. Truth to tell, I’ve always felt as if I was one at my core—some deep and unassailable place that has continually and relentlessly pulled me back to the medical profession where, once in it, I always feel that I’ve come home. Part of it, certainly, is the science of it. I’ve always loved the way the body works and the symbiosis of art and science that help lead to healing. I think I first started studying medical texts when I was about 10 years old and delighted in the way each piece of knowledge fit neatly in with another to create understanding. A bigger reason, however, is the people.

Patients are many, many things. They are all unique and they present with different issues in different ways. Every single one I’ve ever cared for has given me something of value, some learning that I hadn’t even realized I needed. For instance, I had a patient with leukemia who had been in remission for several years. She had suddenly begun to exhibit new symptoms, scary symptoms, and she had been sent for testing. Not four hours after the tests were completed, she called for the results which, naturally, we did not yet have. When I started to explain that to her, she became enraged. She called me names and accused me of not caring and wondered at high decibels how in the world we could provide such shoddy care. I sat there without saying anything until she was done and the entire time, my heart pounded. What could I say? How could I respond to what felt like such a vicious attack? It was that moment that I realized what I should have realized in the first place: I wasn’t listening. I had stopped listening as soon as I heard how angry she was because I was trying to think of a response. Once I realized that, I stopped thinking and listened. As soon as I did, I heard the fear underneath the anger. She was terrified, and understandably so. She wasn’t mad at me. She was mad at life, at fate, at her disease, and at whatever new thing was lurking in her body waiting to mess with her yet again. I listened until she was finished. Then I quietly and gently told her that I knew I could not possibly imagine what it must be like to be her, or how hard—beyond hard---it must be to wait for these results after she had received so many bad ones in the past. I told her I would call to get an ETA on the results, and that I would let her know as soon as I knew anything. I did those things, and we got through that little bit of it together. After that, I always kept this in mind: whatever a patient is dealing with, from leukemia to paper cuts and everything in between, may not be the most serious or the most important thing I have to deal with that day. But it is absolutely the most serious and important thing that patient is dealing with that day. And I always make sure to listen, and to remember that it is never personal.

Another memorable patient was a young man who came in every three months for an HIV test. He was a delightful man—smart, funny, interesting—but he refused outright to practice safe sex. He was gay, and he was utterly convinced that the disease was inevitable. He got tested only to try to avoid passing it on. I think it’s natural for those of us in the caregiving professions to want to “fix” everything. We want to help people, whether we say that out loud or not. But nothing I said made a difference. He was unfailingly polite and he listened to my carefully worded speeches about the importance of condom use and how easily he could save himself, but he always returned three months later with the exact same request, for the exact same reason. This was one of the hardest lessons I ever learned. “Helping people”, while an admirable goal, must be redefined for every patient. Help does not always look the way I think it might, or even the way I want it to. I wanted that patient to take care of himself. But the only help he wanted or would accept was a safe, non-judgmental place in which to be tested. I gave him that. I offered the rest. Sometimes, that’s all you can do.

I’ve cared for angry people, drug addicts, alcoholics, and people in utter denial. My rule of thumb is always the same: treat them with dignity and respect, listen, show them that I care, and offer all the help that I can, while acknowledging that they may want and accept far less. I’ve never had a job outside of medicine that has given me a fraction of the challenges or worked me anywhere near as hard as the ones I’ve had inside of it. I’ve also never had a job outside of medicine that brought me as much reward, as much learning, or as much satisfaction as even the most simplistic jobs I’ve had inside. For those reasons, it is as difficult to say what I want to do in nursing as it is to say why I want to do it. I want to nurse. Certainly I have areas of specific interest—I love working with cancer patients, so oncology may be the direction I go in. I also have a real passion for patient education and love working in women’s healthcare. I can see myself working in a clinic with women in underserved areas. But I also know how very much I don’t know. I am looking forward to my time as a student nurse so that I can see more of the possibilities. I want to see what other areas may grab my interest, but also what other areas I may find I have something to give to.

In the end, the answer is as complex as it is simple: I want to be a nurse because inside I feel that I already am, that my career path is as much a part of me as my brown eyes and the birthmark on my left foot. I am excited to continue the learning and to see what else I can give back. St Catherine of Sienna famously said “We need each other’s care, or we will suffer.” It is fortunate, indeed, that some of us need just as badly to provide that care."


  • At 6:35 PM, Anonymous Jill said…

    Well spoken, well written.

  • At 9:46 PM, Anonymous MonicaPDX said…

    Now that I've wiped my eyes, put my glasses back on so I can see, and swallowed the lump in my throat...

    If you were writing a proposal in coporate-speak, I could critique better. I'm really, really good at baffling with bullshit in that. I don't know medical-speak, alas. I don't know if nursing programs like their applicants to scatter technicalese, specify goals like a business plan, give examples of their accomplishments, or make points as to why they would fit in so well with the practice and methods of this particular institution.

    But I can tell a damned good piece of writing when I see it.

    It doesn't sound manipulative. ;) It rings true all the way. It's heartfelt, practical, caring, realistic, determined and dedicated. In short - ok, ok, at length - it sounds to me like just what a good nurse should be.

    I think you've done good, sweetie. Go knock 'em dead. Er. Figuratively. ::major hugs::

  • At 1:20 AM, Anonymous angie Cox said…

    I could tell them that when I was worried, terrified even about Jeff no consultant ever had time for me , no doctor would explian .A few Interns took time out of fascination with Jeff's weird case . The nurses on the other hand not only cared for all his wants and needs they took time to try to re-assure me .I was frantic for information sometimes . One nurse had six very sick patients in a bay , buzzers went off all the time ,alarms , senile ones would scream and cry . Yet they walked with speed yet purpose to re-attach a drip at the same time chat about cricket or some other subject .I think you show every sign of being a fantastic nurse ,it's obviously something you want deeply as no-one would put themselves forward for such hard work otherwise.Your sense of humour will be much needed , it will need to be dark sometimes or the hurt will be too much . At the end of the day you won't have done any ordinary job but soothed the patients and the loved ones .It doesn't take long to realise you have a tremendously loving nature some is hidden behind humour . I guess it's hard to compete with the influx of foreign labour. My sister could tell you that there is nothing The N.H.S likes better than an agency nurse because she/he won't have the same holiday ,sick-pay rights .I guess that is true in the U.S .If you don't get the job Florence it won't be you it will be greed, short-sighted stupidity that is the reasoning. Luckily the nurses on Jeff's ward were South African or British born so spoke English .Most of the other staff hardly spoke any and towards the end of my sister's time in E.R an awful lot of Doctors hardly spoke a word or had accents hard to understand .They need people the patients will understand. I hope you get through this journey ,you shouldn't have had so much worry .

  • At 5:59 AM, Blogger Robin said…

    Well done...BRAVO!! I ADMIRE EVERYONE who goes into the nursing field, I believe there are some of us who are MADE for this job, believe me I'm not one of them. I nursed my kids and that's about all I could handle.
    It's people like you MsK who I WOULD want at my bedside...if nothing else but to make me laugh until I wet the bed!

  • At 6:50 AM, Blogger ambermoggie said…

    if they don't take you it will be their loss. Excellent essay and as always you had to make me giggle at a messy time didn't you? Chocolate on the keyboard once more(sigh) Do you think it would be going too far to lick the keys clean??

  • At 8:48 AM, Blogger Marianne said…

    Your essay very much has SOUL, I just cannot imagine any person not being touched to their marrow...and seeing that you would be the perfect choice for their program, if they're honest with themselves.
    Oh yeah...beautifully written too.

  • At 8:50 AM, Blogger Peg said…

    Now you have choked me up, Ms. K. I am a nurse - remember I had my 45th reunion last year - and you will be the kind of nurse needed by all of us. Caring, listening, thoughtful, understanding and, of course, armed with a good sense of humour.
    Humour in medicine is completely underated! I know, you have to try to sound serious for the essay, but please keep your sense of humour. Getting through any medical problem, even a paper cut, requires a good dose of humour. Why do you think I want 'watermelon tit bits? Good luck! You only live south of me, you know. I probably get a little bit cooler weather than you do, Ms. K., but I know about rain, fog, wind, and then glorious sunny days like today on the Wet West Coast!!

  • At 11:18 AM, Blogger Jo said…

    I can't possibly see how or why they won't take you on, you were born to be a nurse, I hope you make it x

  • At 11:31 AM, Anonymous Blogless Jude said…

    I am a retiring RN, after 32 years, and this is the 2nd time I am writing a comment to one of your blogs.
    Your letter touched me deeply, you truly understand the "essence" of nursing and at the same time have an inkling of what very hard work it is. Your letter is well-written, intelligent, organized and succinct.
    If I were on the board of the school or schools to which you are applying, I would say "we must have this one". Good luck.

  • At 11:37 AM, Blogger Lynn said…

    Good writing. It sounds like the you that we see here, more than you think.

    Once you get the nursing admissions people whipped into shape, would you mind taking a crack at Blogger? Their new improvement is anything *but*.

  • At 3:24 PM, Blogger Dianne said…

    I wish I were on that 'board'..I hope they can see what us here in Blogland are able to see..You are a Nurse!!..they just need to give you your certification! Good Luck Ms. K..A beautifully written essay..

  • At 5:21 PM, Anonymous Lilly said…

    If you were not to spend your life as as a nurse, you must spend it as a writer.

  • At 12:20 PM, Blogger Charity said…

    Very nicely said, Ms. K. :0)

  • At 8:54 PM, Blogger AlisonH said…

    Perfect. Totally perfect. I say that as both a writer myself and as a patient who has been on the receiving end of some of those IV lines, who has seen what the nurses go through.

    That committee couldn't possibly turn you down.


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