During eight years of caregiving for a wife with ovarian cancer, there were many times when nurses served to help us get through the challenges of treatment, surgeries, chemotherapy and in the end, palliative care. I wrote the following essay about the value of nurses for the caregiving group that formed around us. Later it was published in The Right Kind of Pride, the book I wrote about our journey and for which this blog is named. 

With nurses doing so much work on the front lines and as first responders during the Coronavirus and Covid-19 epidemic, this bit of testimony is meant to encourage nurses everywhere, and to urge people to appreciate their training and work

Nurses, literally and figuratively

Tuesday, December 20, 2011, 5:30 PM

Two days after my wife’s surgery I woke early to head west and pick up our dog to go home and check on the house. Stepping onto the elevator I encountered two tired-looking nurses leaning on the back wall.

“Shift over?” I asked. “Yes,” one of them breathed, trying not to look too relieved.

“Well, I admire your work,” I told them. “Patients can be a pain in the butt, I’m sure.”

“You said it, not me!” one of them replied as they headed out the elevator and down the hallway, exchanging knowing glances.

No easy gig

Nursing is no easy gig, of course. Nothing in the medical profession really is.

They see so much, both literally and figuratively. Nursing is the most intimate of all professions. Even more so than being a doctor, in some ways. From inserting catheters to administering shots to washing patients who can’t wash, nurses see humanity up close and personal.

There are also broader dimensions. Families in crisis. Human frailty laid bare. The human condition. On those dynamics rest hopes of healing. That is why medicine exists, and nurses carry it out to the best of their abilities.

Of course, nurses deal with varied results and varied perceptions of their profession. Not having worked in the medical field, I do not entirely know what the environment is like. But some nurses I’ve met speak of doctors that do not treat them well, or show respect. Maybe the pecking order at some hospitals is harsh. Yet the good hospitals seem to celebrate every role from orderly to surgeons. And there really are some great hospitals in the area where we live. We can be grateful for that. And this is no paid testimonial.

But I’ll reiterate: When we think about who provides a great amount of care and recovery in medicine, we should never forget to thank the nurses, both men, and women. There was Allan, and Silvia, Rafaela, and Kathy. the list goes on. All with attributes that add up to good care.

Professional caregiving

Because nursing is basically professional caregiving, it is something to observe when you’ve been placed in the role of caregiver yourself.

The challenging part is that the tools have advanced but the needs have not changed. The records have gone digital. The ability to monitor patients is so sophisticated. Yet it is still the human responsibility of nurses to read those signs and pass them back along the chain for the doctors and surgeons to study. Front line. First responders. In tune. In touch. That’s the role of nurses.

It is a cosmopolitan profession. The nursing professionals in the four or five hospitals with which we have had experience are quite racially diverse. Hospitals seem to hire nurses to match the culture and backgrounds of their constituent populations. But not always.

Language is another important aspect of nursing. For example, at the network hospital where Linda had her surgery, the primary phone greeting is given in several Eastern European languages. Diversity is not some casual thing at a hospital. It really can mean life or death.

Communication

Style of communication is also important in nursing. Some nurses excel in this category, with a gift for compassion that is comforting and encouraging. Others are more business-like, and their attributes can be of tremendous value in many circumstances. Linda’s chemo nurse this time around was a focused woman whose competency and the organization was of great assurance. Success in chemotherapy treatment can depend on the nurse’s ability not only to administer the medicine but also to track and monitor patient response in real-time (daily response to treatment, blood counts and side effects and over the course of treatments (chemo tolerance and patient affect) these attenuations add up. Literally and figuratively.

Racing for life

Getting chemo really is like running a marathon; checking your vitals along the way, taking aid at the proper points and pacing your effort so you don’t falter. Chemo is a marathon.

But surgery is a sprint of sorts. Our surgeons fixed a hernia, did a colon resection and removed a 31mm cancer tumor in about 2.5 hours. That’s fast and brilliant work. You can worship athletes all you want. Medical doctors like these deserve real accolades.

It is the nurses however who are the trainers that get you back into shape after the taxing sprint of surgery or the exhausting marathon of chemo. With cancer sometimes you need both to be successful. Fast-twitch and slow twitch.

The range of human foible

That and a sense of perspective and humor helps. I was really glad the people at the nursing station had a sense of humor when after the first night at the hospital I trundled out of Lin- da’s room at 5:00 a.m. to visit the bathroom down the hall. No one looks dignified at that hour, and I felt a little like a college freshman in a “walk of shame” down the dormitory hall after an all-nighter. But no one said a word. They see weirder things every day. Lucky for me, a bald man seldom has bad hair days.

Nurses see it all, of course, the whole range of human foible. Being able to encourage patients with an occasional jest about the difficulties of recovery can break the ice and open channels in working through pain or other humbling issues such as finding ways to go to the bathroom when it is far from easy and convenient for the patient. All this basic stuff,. They have to know when and how to be light about it, and when not.

Startups and bending over backward

Nurses are the professionals who get it all going for people again, over and over. Week after week. Year after year. Think of all the focus and dedication it takes to be a nurse for 5, 10 or 25 years. And people do it.

The nurse who checked Linda out of the hospital has been working in the same phase of nursing for 25 years. She was immensely practical and detail-oriented, dispensing instructions so that we would know how to care for the surgical wounds and tend to bathroom matters the right way. That nurse fit her job.

A young nurse named Rafaela checked on Linda regularly during her week in the hospital. She seemed to appear like magic from around the curtain whenever there was a need in the room. That nurse excelled in care.

The first night after surgery, Linda’s nurse was a soft-spoken woman who struck up a conversation starting with a compliment about the fact that I was staying overnight with my wife. Perhaps it is not so common for people to stay over. The new Planetree model for health care offers a more humanistic approach to medicine and facilities, especially hospitals. Hospitals now provide comfortable couches that convert into beds so that family or supportive friends can stay overnight with a patient.

I can tell you that’s a huge improvement from the night spent next to her bed back in 2007 when the only available place to sleep next to her was something like a Medieval torture device. The vinyl recliner on which I slept formed a pronounced hump approximately the curve of a mature dolphin in mid-jump. It was not the most comfortable night of sleep in my life, punctuated as well by beeps and whistles and the bustle of nurses hustling in and out for blood pressure checks and temperature readings. They were just doing their job, yet I felt like it was a torturous night of sleep deprivation in a black site somewhere in Eastern Europe. I exaggerate, but when you’re tired the mind works overtime.

To her everlasting credit, my mother-in-law, who had done overnight duty on the dolphin chair the previous evening tried giving me fair warning without scaring me off completely. But let us say that it was one of the 3 worst nights of sleep in my life. The top 2 were surviving a bad bout of the flu and one very long night in the late 1980s with a prostate infection that made my lower abdomen feel like I’d swallowed an angry serpent. I don’t really want to list a Top 10. The memories are too painful.

But the dolphin chair simply had to do in that instance. Such are the duties of caregivers at times. It’s like God wants to humble you into sympathy for the patient. So I thank God for Planetree now.

Patience and patients

Still, as a caregiver, I lose patience in too many situations, grow irrationally embittered by circumstance or fall too quickly into self-pity or worse, anger or depression. What is the cure for those selfish emotions? Mostly, it’s gratitude. Step back and take a breath. Be a nurse to your own soul. Forgive your- self. Then get back to service.

Because it’s a miraculous little dynamic that when we fix our focus on serving others we wind up serving our own true best interests. That’s where we learn we are not alone in our challenges and our minds off our own problems.

People who through simple self-control and a modest demeanor exhibit such patience always amaze me. Admittedly I envy people like that, especially when failing to manage that level of self-control myself. Where do some people get such strength of character? Can it be learned? Are some people just natural caregivers?

Probably those questions cheapen the issue. It is, of course, a complex combination of things that makes people good caregivers, or nurses, or doctors. Or perhaps it is simplicity that makes it possible. Be content. Learn to give. Don’t make life harder than it needs to be.

When it comes to institutional compassion, that is a goal much harder to achieve in some respects. The hospital where Linda had her surgery communicates its compassionate values in many ways. If I recall correctly, one of the messages posted on the wall reads, “We welcome all to this place of healing.” There’s definitely room for a religious message in there, but not an exclusive one. As it turns out, our nation is actually formed on a similar, inclusive ambiguity. So uniquely Ameri- can. Yet people seem to miss the subtlety in that. Want to turn it into an ideology not in keeping with the Constitution which guarantees freedom of religion and freedom from religion.

We are all equal souls. Nurses probably know that better than most. There’s nothing special about any of our functions. We all poop and pee. We all have a heartbeat. Breathe. Think. Cry out in pain. Laugh. Worry. Hope. Heal if possible. All part of the process. Such is humanity.

You know that cynical phrase, “some people are more equal than others…” Well, a nurse cannot afford to think like that. People notice if that sort of thinking creeps in.

When it’s your wife or your husband, your son or daughter, a close friend or even co-worker, you want the hospital and doctors and nurses taking care of them to do their very best to help them get well. It simply cannot matter whether someone is one race or the other, speaks Russian instead of English, or has no money to pay for the care they need.

Grace and blessings

I can tell you we have been the beneficiaries of such care, in ways that absolutely flabbergasted our ability to comprehend the many forces working behind the scenes to ensure our welfare. The least we can do in response to this grace and these blessings is what? Give back in any way we can. Pay attention to those taking care of us. Express our appreciation.

And guess what? Opportunities to reach outcome up more often than you might think. It is true that when you are in a position of most vulnerability, you are best able to share in the pain and challenges in other people’s lives.

Our nurse during Linda’s first night in recovery from surgery was so caring and attentive that conversation naturally flowed to the discussion of family and friends. It turns out our nurse was a single mom whose husband left her for another woman, leaving her to raise her two children alone. She was frustrated by how hard it was as a working mother–also attending graduate school–to meet someone, a man she could grow to love. She had nearly given up hope, she told us. Even the men on the Christian dating services turned out to be less than honorable.

It’s a story quite familiar to my wife who over the years has worked with dozens of families and single moms in her job as a preschool teacher. At one point after checking up on Linda, conversing while she worked, our nurse stopped and stood in the middle of the room, seeming to want to gather herself before moving on to other duties. We’d been talking about how she gave so much time to raise her kids, got them to rehearsals and practices and games. But how it was all worth it in the end because it keeps them busy even if it wears her out.

We talked of God and faith, too. She shared several of her favorite Bible passages with us. We told her we’d recently been in a bible course where we read the entire book in 90 days. “Oh, I don’t think I could do that,” she sighed.

“12 pages a day,” Linda assured her.

I admitted. “I didn’t keep up and had to hustle to finish.”

We encouraged her that all her work as a mom was worth it. That her children would turn out to be a blessing to her for her dedication. “Yes, I know,” she murmured. “But I have had to sacrifice a lot.”

Then she stood quietly in the middle of the room, seeming to contemplate her place in the universe. Standing in front of the privacy curtain and silhouetted by the light from the hallway behind her, our nurse stood and stared across the room, soaking up the relative stillness until she said quietly, “Well, God Bless you guys.”

It’s impossible to know the exact circumstances people face, or how they truly feel. Linda turned to me after our nurse had left and said, “She reminds me of so many single moms I’ve met, just “poured out” from having to do everything themselves. Wanting to be filled up spiritually.”

We met a veritable parade of nurses the following 5-6 days. All types of people and styles of care. Some were talkative. Others were focused and efficient. All played a brief yet important role in our lives. We can only hope that in some small way we give back to these people who daily give so much of themselves. Nurses literally and figuratively rule as far as we’re concerned.