Thursday, July 24, 2008

How Can You Bear to Be a Nurse?

I was recently at a conference where Mary Mallison's classic 1987 piece, from the American Journal of Nursing, was presented. I had forgotten how wonderful it is. This probably won't have a lot of meaning for those who aren't in nursing, but for nurses it is so meaningful.

How Can You Bear to Be a Nurse?

How can you be a nurse? How can you bear the sight of blood?
Wait until you slide a catheter into a tiny vein just before it collapses. The flashback of blood you see will make you sing.

How can you be a nurse? How can you bear the sight, the embarrassment, of urine?
Wait until your new postpartum patient can't void, and her uterus is rising. Your persistent maneuvers finally work, making a catheter unnecessary. Urine then looks glorious.

How can you be a nurse? How can you bear to touch that alcoholic who hasn't had a bath in weeks?
Wait until you've repeatedly given ice lavages to that alcoholic and his esophageal varices have finally stopped bleeding. When he actually recovers enough to amble onto your unit to visit, dirt and all, you'll be happy enough to hug him.

How can you be a nurse? How can you bear to watch someone die?
Wait until you've worked for weeks helping a dying woman repair a decades-old conflict with her children, and at some point along the way you see the guilt fall from their shoulders and peace enter her eyes. Watching such a death can be an exaltation.

How can you be a nurse? How can you bear the sight and smell of feces?
Wait until you've been anxious about the diarrhea that nothing has stopped in an AIDS patient. Finally, your strategies work and you see and smell normal stool. You'll welcome that smell.

How can you be a nurse? How can you bear to watch children suffer?
Wait until you've rocked and soothed a suffering child into peaceful sleep, and you feel the child's relief washing over you like a blessing. Then you won't need to ask.

How can you be a nurse? How can you bear to look at searing trauma, at burned people?
Wait until you see healthy granulation tissue that has been given a chance because your sensitive nose detected an infection before it could take hold. That healing will look beautiful to you.

How can you be a nurse? How can you bear the stream of abusive words heaped on you by psychotic patients?
Wait until you've prodded and pulled a silent, withdrawn catatonic back over the lifeline, and she releases a string of expletives. Could Mozart sound better?

How can you be a nurse? How can you bear the sound of babies crying?
Wait until your combination of vigilance, bulldog advocacy, and gentle handling has given a preemie's lungs the time they needed to develop, and you hear his first lusty cry. You'll laugh out loud!

How can you be a nurse? How can you bear to care for frustrating, confused Alzheimer's patients?
Wait until you've devised a combination of strategies that provide exercise and permit safe wandering and you see a lift, almost a spring, in a patient's shuffling gait. You'll feel the lightness of Baryshnikov in your own step that day.

How can you be a nurse? So many of your patients are so old, so sick, these days. How can you bear the thought that, in the end, your care may make no difference?

Wait until you've used your hands and eyes and voice to dispel terror, to show a helpless person that his life is respected, that he has dignity. Your caring helps him care about himself. His helplessness forces you to think about the brevity of your own life. Then and there, you decide yet again to reject the pallid pastel life. No tepid sail across a protected cove for you. No easy answers. So you keep choosing to be a nurse. You have days of frustration, nights of despair, terrible angers. Your highs and lows are peaks and chasms, not hills and valleys. The defeats come more than often enough to keep you humble: the problems you can't untangle, the
lives that seep away too fast, the meanings that elude your understanding. But you keep working at it, learning from it, knowing the next peak lies ahead. And gradually you realize your palette is filling up with colors. You see more shades of meaning. You laugh more. You realize you are well on your way to creating a work of art, maybe even a masterpiece.
So that's why you've remained a nurse. To your surprise, your greatest work of art is turning out to be your own life.


Cat said...

Beautiful sentiments. Thanks for sharing that with us.

seanahan said...

It's a brilliant use of juxtaposition. Of course, it is written from the perspective of a veteran nurse. I'm sure the first time you have to do any of those things it is hard. Still, being a nurse must be a difficult job, mentally, physically, and emotionally, and this shows what exactly drives the nurse, the fact that you're helping people.

Kalleh said...

Thanks for those sentiments, Cat and Sean. I've been out of town recently and haven't had much time for my Blog. You are correct, Sean, that this had to be written by an experienced nurse. In fact, I suspect it could scare a new nurse somewhat.

It always amazes me how good writers can so beautifully capture feelings and situations. As I said, when this was presented, the group of experienced health care workers just sat there, stunned, at how wonderfully this described the practicing nurse. It's clearly why nurses stay in the profession, even though the pay is minimal. There is so much more to life and happiness than money.

kimly said...

In 1987 when I completed my LVN program, I recited this poem with my classmate, as a part of our ceremony. It still is a beautiful memory and all of those answers ring true 23 years later. I'm so thankful I was blessed to be a nurse.