Broken

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I work in the complex, convoluted, and often challenging American health care system.  I strive to provide the best care to my patients.  It is troubling to me when one of my loved ones enter this system, and are not met with those same standards.  Our health care system is broken.  Health care providers are expected to do more, with less, in the fastest amount of time possible. This hasty, fast-food approach to American health care is unhealthy, and unsustainable. We hear the nations cry of ‘health care for all’, but that doesn’t necessarily equate to good health care for all. It’s no wonder medical errors are the third leading cause of death in America today (Makary, and Daniel, 2016).

The piece I wrote below is my interpretation of the experience of a loved one struggling in this broken system.

 

The Broken Column, 1944 by Frida Kahlo

The Broken Column, 1944 by Frida Kahlo

I woke up today in pain.

I reached out to you,

You didn’t see.

I continued to have pain.

I reached out to you,

You didn’t hear.

I was scared by this pain.

I reached out to you,

You didn’t speak.

I still have pain!

I reached out to someone else.

They saw me, they heard me, they spoke to me.

I was broken.

I reached out to you again to let you know,

Your apathy was palpable.

Perhaps it is not me that is broken…

Makary, M.A., Daniel, M. (2016). Medical error-the third leading cause of death in the US. BMJ 353:i2139

A Thanksgiving Memory

This is my favorite Thanksgiving Memory.  I post it every Thanksgiving to remind me of how truly thankful I am for all the wonderful people in my life!!

Vintage Thanksgiving Postcard

Vintage Thanksgiving Postcard

Dear Nursing Administrator,

Today I witnessed an act, which for the first time, made me grateful to have worked Thanksgiving Day.  Before I explain, you need to understand a little background.

For the past month or so we have been caring for a nineteen year old-young man in room 419, who is slowly dying from lymphoma.  Over this past month I have never looked after, nor been involved in this patient’s care.  In fact, I didn’t even really pay attention.  Why?  I’m not sure.  As charge nurse I was up to date on his name, age, room number and diagnosis.  I knew his mom was a nurse and his father was a New York City Police Officer.  I knew that one or both parents never left his bedside.  I knew I found it extremely uncomfortable to participate in his case, what I didn’t know was why; I’m still not completely sure.  Maybe it was his age, maybe it was because his parents were always there, maybe it was because I identified with this family on some level and steeled myself from getting involved.  My apathy, or perhaps cowardice, found it helpful that their room was at the very end of our unit, so far removed from the nurse’s station, that their daily story played out on what seemed a far away stage.

Our unit is a twenty bed Cardiac Care Unit (CCU), not a hospice ward.  I’m used to dealing with critically ill, older patients in cardiac distress.  Even when those patient’s are terminally ill, I somehow rise to the occasion to support their crumbling family.  But this boy, what was he doing here?  What did I know of caring for a nineteen year old?  Apparently there are cardiac complications that come from bone marrow transplants which led this boy to our unit, and subsequently into our lives.

So while my head was buried in the sand for the past month, there were several amazing nurses consistently caring for this patient.  But today, Thanksgiving Day, I would soon come to find out just what I had been hiding from, because today I was assigned to care for this boy.

What had I been hiding from?  His family was lovely; two devoted parents sitting vigil in their hopes and tears.  His nurse mother was someone I could have easily seen myself working side by side with, and his NYPD dad, well, I must confess was a reminder of my own NYPD dad.  But this boy of nineteen was so ill.  His body reflected the disease that had stolen his youth and replaced it with the frame of an old man’s.  Swaddled in blankets to fend off the cold, his face was the only piece of flesh I could see; though his eyes were pale and hollowed, a spark, still dimly lit, reflected back, and a smile slow danced across his lips from time to time.

Room 419 was where this family would spend their last Thanksgiving together.  No fancy table, no turkey, nothing to remind them of the holiday unfolding on most American tables that day.  No, this room was the exact opposite.  The only reminder of the outside world I could gather was the pile of soda cans collecting on the window sill.

Then lunchtime arrived, and with it came Emma, one of our nurses, (off duty that day), with a large bag in her arms, and a six-pack of soda in her hand, heading for room 419.  As I went to greet her with a confused expression on my face, and a ,”What are you doing here on your day off?”  She told me she was here to bring 419’s family Thanksgiving dinner before she was due to catch a train to her own Thanksgiving dinner.  You see, while I was flying under the radar where this family was concerned, Emma was flying high; high on her morals, her faith, and her uncompromising dedication of what it means to be a nurse.  There was no way she could sit down for her own Thanksgiving meal, without first and foremost providing one for this family she had grown so close to.  What a special moment to witness.

Thanksgiving is such an American holiday.  We all take pride in our heritage, our sophisticated menu’s, our high-end wine lists, alternately, we take such a twisted approach on sharing a meal with family we might not want to be sitting next to.

Ironically, Emma is not at all American, she is Filipino.  But somehow, she, more than any American I know was able to take this holiday, and provide one family with the gift of thanks, when they probably felt too weak to feel anything but the life of their core slipping away.  I know this family was truly thankful for this one gift, this one meal, that this one very special nurse provided for them on what would be their last Thanksgiving as a complete family.

Vintage Thanksgiving Poem

I was thankful to have had the opportunity to witness grace in action.Several days later the boy in room 419 was granted his wish to go home to die.  His parents complied, and forty-five minutes after being laid to rest in his own bed, that nineteen year old boy died on his own terms, in his own way.

I will never forget this Thanksgiving as long as I live.  I am nominating Emma for the highest award we give to nurses in our hospital; The Daisy Award.  I’m sure every Thanksgiving I will be reminded of this family and be truly grateful for all the wonderful people in my own life.

Sincerely,

Jean

I wrote that letter over ten years ago, and I have never forgotten the family from room 419, or the nurse who made their last days bearable.  They make me thankful every year for the life I have, and the family I live it with.

Since that time I have become a mother myself.  Losing a child, any age, is unfathomable to me; it was my understanding he was their only son.

So on this Thanksgiving Day, don’t sweat the small stuff.  Who cares if the Turkey’s a little dry, or the company’s a little wet.  Be thankful to be together with your family and friends.

I know I’ll be!

Happy Thanksgiving Everyone!!

thanksgiving vintage postcard

Halloween Traditions

Vintage Halloween Cover

Yikes I can’t believe it’s been two years since my last Halloween post, I feel like I’m in the confessional.  Halloween has always been my favorite time of the year.  Maybe because I’m a fall baby, or love dressing up, or perhaps it could be all that great free candy, but no matter what, I always feel so nostalgic during this time of the year.  When I was younger I used to make Halloween costumes with my best friend and we’d go around the neighborhood or to parties always trying to out do our previous costume.  My mom always made a huge pot of meatballs and spaghetti on Halloween, and after a fun night of trick-or-treating, my six siblings and I would come inside to a warm house that smelled of tradition and family.  I relished those moments every year.

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I’m the one on the right, clearly a homemade costume!

That's me in the baseball costume with my little brother.

That’s me in the baseball costume with my little brother.

When I moved to my first apartment in New York City, one of the first parties I ever threw was a Halloween party.  It was awesome, and everyone dressed up, and spilled out into the streets in their costumes.  But after that party, Halloween seemed to go into hibernation for awhile.  I didn’t throw, or go to any parties, I didn’t dress up for years it seemed.  Was I becoming a Halloween scrooge?  I hoped not.

Walk like an Egyptian.

Walk like an Egyptian.

But like all good things that come around again, I met my husband, and we started a family.  My oldest son was born in the fall, like me, and I couldn’t wait to dress him up for his first Halloween.  Secretly, I couldn’t wait to dress up again myself, and he was just a great excuse.  We spent our first Halloween back in my old neighborhood with my parents and my family.  Halloween was back online, and that pot of meatballs and spaghetti was back on the stove…I was home again.

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My husband and I eventually moved into a house of our own, in a neighborhood with tree lined driveways, and friendly faces.  My husband and I made new friends, in particular one couple who love Halloween as much as I do. They have been inviting us to their annual Halloween party for the past three years, and dressing up has never been more fun, especially since I’ve dragged my husband into it.

80's Rock!! 2013

80’s Rock!! 2013

Meet Morticia and Gomez 2014

Meet Morticia and Gomez 2014

Richard Simmons and Olivia Newton John 2015

Richard Simmons and Olivia Newton John 2015

My mom brings her big pot of meatballs and spaghetti to my house now, and my siblings come with their children to trick-or-treat around the neighborhood with their cousins.  I only hope that when they come home from trick-or-treating, and enter their warm house, with the smells of comfort and family, they relish these moments as much as I do.

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From this years Trump Family: Wishing everyone a safe and Happy Halloween!

Donald and Melania Trump 2016

Donald and Melania Trump 2016

 

happy-halloween-witch-4

 

 

#LogiVSS Very Short Story Challenge

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     So the other day I posted a link to Tara Lazar’s website about a very short story challenge sponsored by Logitech on my other blog.  The idea was to write a short story on twitter in 8 lines or less.  I wasn’t exactly sure how to write a story that short and have it make sense.  After a bit of research, I realized that this type of writing is a bit of an art form.  On twitter, there are so many entries where people manage to write their stories in only one line, that would be 140 characters or less for those of you unfamiliar to twitter like myself.

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     Now, considering I didn’t have a twitter account, and knew nothing about it, not only did I have to figure out how to write a story in eight lines or less, I also had to figure out how to set up a twitter account.  To my surprise it wasn’t as difficult as I thought it would be, and after a bit of reading and a great introductory video by David A. Cox  I was on my way.  I created my twitter account using my nightingale tales blog name, and created my twitter handle (that’s lingo for my @I.D.), and successfully entered the Logitech challenge.  I even managed to write my story in 6 lines; not quite the 140 character story, but I now have something to strive for.  It’s a little addicting trying to complete a story in 140 characters.

Here is my entry.  Let me know what you think.

vultures-2

The Volt

 

“Is she dead Nurse?”

I look up at them with disgust, their vulturous stares bearing down on me.

My eyelids lower, nodding once.

The room stinks of their intemperate breath as they exhale in unison.

The Volt cling their talons deep into the edge of their Chippendale perches, lying in wait as the executor readies himself beside the lukewarm carcass.

A prescient silence spreads smoothly over the committee, followed by bilious projectiles of vehement objections.

I retreat for the exit, my back aligned with the door.

I will never have to work again.

Veterans Day: A Tribute to Military Nurses

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     The last time I posted for Veterans Day, I wrote about the special relationship between the nurse and the soldier’s they care for.  But today, on this Veterans Day, I wanted to recognize all the nurses who have courageously gone to the battlefield, risked their own lives, and in some cases lost their lives.  I wanted to delve into the history of the military nurse, their duties, bravery, and unyielding dedication they show to the soldiers in their care.

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Florence Nightingale attending the wounded of the Crimean War.

     Florence Nightingale is the most famous military nurse in history.  Although not a commissioned soldier, her experiences during the Crimean War helped to pave the way, for what would be in America, The Army Nurse Corps.  Florence Nightingale’s presence during wartime led to important changes in hygiene, and sanitary conditions in the hospital wards at the front lines.  Those changes were brought back to Great Britain, and America, and had a global impact on hospital care both on the battlefield, and at home.

     Since that time women have traditionally served in times of war, but mostly in volunteer corps, not as officers.  During the Revolutionary War the Congressional resolution of July, 27, 1775 allowed one nurse for every ten patients in Continental hospitals.  Nurses were paid two dollars per month a salary that increased to eight dollars per month by 1777.  Nurses were in great demand on the battle field to care for the sick and wounded soldiers, and in 1778 George Washington ordered his commanders to hire as many nurses as possible.  Nurses traveling with the army were at risk for injury as well as disease.

The Angels of the Battlefield by William Ludwell Sheppard ushistory.org

     The Civil War brought the attention of Dorothea Dix to the forefront.  Though not a nurse herself, she was federally appointed as Superintendent of female nurses, and in charge of overseeing the entire nursing staff of the Union Army.  From 1861-1865 approximately 3300 nurses served in the Union Army for the grand salary of 12 dollars per month, and food rations.  Nurses during this time were at great risk for contracting contagious diseases, as well as the dangers of being on a battle field. Interestingly Louisa May Alcott, author of Little Women, served as a nurse under Dorothea Dix.

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WWI Nurse

     By 1898, under the request of the Surgeon General,  nurses were contracted for the Spanish-American War, and salaries were increased to 30 dollars per month and one food ration a day.  The Army, around this time, was more selective in the hiring of trained nurses, or graduate nurses approved by their nursing school directors.  These nurses were called contract nurses, and their training improved the quality of the military nurse.  The army later went on to establish the Army Nurse Corps in 1901 which organized nursing under the control of the army, and allotted for three-year terms.  At this time only 220 nurses were on active duty.

First 20 Navy Nurses Corps.

First 20 Navy Nurses Corps.

     In 1908 Congress established the first Navy Nurse Corps, though unofficially, nurses had been sailing on navy ships for nearly a century.

     In 1917, during WWI, nurses ranks had risen again to 12,186, and were stationed all over the world.  The Army opened its own school of nursing in 1918, but then closed it in 1931 due to budget cuts.

     In 1920 nurses in the military were given officer rank from 2nd lieutenant to major.

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     When the Japanese bombed Pearl Harbor on December 7, 1941 the nursing corps had dwindled back down to around 7000.  But with a reserve corps already established, and active recruiting, that number quickly went back up to over 12,000 within six months.  During WWII black nurses had begun to serve in large numbers, however their units remained segregated both at home and overseas.

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Liberated Nurses Feb 12, 1945

     In 1942 66 Army Nurses serving in the Philippines, became prisoners of war to the Japanese with the fall of Corregidor.  Just prior to the fall, 21 nurses escaped and made it safely to Australia by plane and submarine. Those that remained as POW’s did so for three years before they were liberated.  All received the Bronze Star Medal and a promotion of one grade.

Flight Nurses in Training 1943

Flight Nurses in Training 1943

First Navy flight Nurses 1945

First Navy flight Nurses 1945

     In 1943 the first class of Army Nurse Corps flight nurses graduated from the School of Air Evacuation, and basic training camps were established to train nurses for their military experience.

In November  of 1943 a plane carrying 13 nurses and 17 soldiers crash landed in Albania behind Nazi enemy lines.  All members of the plane survived, and after a nine week, 800 mile  journey, managed to escape enemy lines.  This story can be found in the book Albanian Escape, written by Army Nurse Agnes Jensen.

Nurses showing worn out heels after a sixty day hike out of enemy territory!

Nurses showing worn out heels after a sixty day hike out of enemy territory!

     In 1947 Nurses were given the opportunity to take a 56 week course in anesthesiology, and a 24 week course in operating room technique and management.

     In 1950 the Korean war begins, and nurses are sent to set up hospitals, and Mobile Army Surgical Hospitals (MASH)  units.

     By 1955 male nurses were authorized commission to serve in the U.S. Army Reserves for assignment to the Army Nurse Corps.

Operating Room, MASH unit Korea

Operating Room, MASH unit Korea

     1962 sees the first wave of nurses sent to Vietnam, and 1973 sees the last wave of nurses leaving Vietnam.  Nine nurses died in Vietnam during this time period.

Vietnam war memorial with nurse and wounded soldier.

Vietnam war memorial with nurse and wounded soldier.

     In October 1976 a B.S.N. was required for active duty in the Army Nurse Corps.

     1990 Nurses are deployed to support troops in Operation Dessert Shield/Dessert Storm

     September 11, 2001 America is attacked.

     2003 Operation Iraqi Freedom begins.

Flight Nurses Today

Flight Nurses Today

     Nurses on the battlefield, at the front lines, or in route to do their duties put their lives on the line, and as a result over 200 nurses have died in the line of duty.  The nurses presence during combat is indispensable.  Nurse soldiers, like all soldiers, sacrifice their time, their families, and sometimes their lives to protect the soldiers protecting our freedom.  Nurses on the battlefield have always, and will continue to be a voluntary job.  Nurses are not part of the draft, though shortly before the end of WWII there was a bill in congress to have nurses as part of the draft, but at the end of the war it was determined that enough nurses had volunteered that a draft was unnecessary for them.   Military nurses should be proud of their enduring history.  Great women bravely face the darkness of war, carrying with them only their knowledge, skills, and compassion, guided by the light from Florence Nightingale’s lantern.  That light continues to shine within the brave men and women of todays modern-day Army, Navy, Air Force and Marine Nurse Corps.

     I am proud to be a nurse.  I am grateful to all the nurses before me who had the courage to face danger, provide excellent nursing care to our wounded soldiers, and protect the freedoms we hold so dear.  I wish all the military nurse corps a peaceful Veterans Day, and a sincere thank-you from this civilian nurse.  You are all truly special for what you do.  And of course to ALL the Veterans and Active Duty Soldiers a HUGE Thank-you.

God Bless You All!

Halloweensie Winners

happy and sad pumpkin

Today on Susanna Leonard Hill’s website the winners were announced for the Halloweensie contest.  I was honored to have made the final 13 this year with my entry “The Haunting”.  Though I did not make the final cut, the fabulous entries, and their creative writers deserve to be recognized for their amazing Halloweensie stories.  Congratulations to all the winners, honorable mentions and everyone who had the courage to put their work out there (I know for me that is the hardest part)!  Now it’s on to the Holiday Contest…I can’t wait!!

P.S.  A big thank you to Susanna Leonard Hill, (and her helpers), for her time, hard work, and enthusiasm for hosting these fabulous writing contests!!

Halloweensie Contest

med_1221779230-1It’s that time of year again!!

Children’s author Susanna Leonard Hill is hosting her 5th annual Halloweensie writing contest.  This is my second crack at it.  I love everything about Halloween, but I especially love this writing contest.  There are always so many creative entries, so don’t just read mine, head over here to Susanna’s website to read all the fabulous entries!

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The Contest: write a 100 word Halloween story appropriate for children (title not included in the 100 words), using the words costume, dark, and haunt. Your story can be scary, funny or anything in between, poetry or prose, but it will only count for the contest if it includes those 3 words and is 100 words (you can go under, but not over!) Get it? Halloweensie – because it’s not very long and it’s for little people 🙂 (And yes, I know 100 words is short but that’s part of the fun and the challenge! We got over 130 fantastic entries last year so I know you can do it!) Also, you may use the words in any form – e.g. haunt, haunts, haunted, darkness, darkening, costumed, whathaveyou 🙂

Vintage Halloween CoverSo here is my entry:(exactly 100 words)

The Haunting

Tonight when children go to bed,
I’ll be that thing that they all dread.
I’ll creep into their darkened room,
A spirit from the grave exhumed.

For this is Halloween tonight,
When even darkness shakes with fright,
But I’ll be laughing with delight
When frightened children bolt upright!

What’s that in the children’s room?
A gang of youngsters in costume!
They’re waiting for me in the dark,
A clown, a monster,
…is that a shark?

Now it’s me who shakes with fright!
The children laughing with delight,
I bolt back to my burial site,
I won’t be haunting them tonight!

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