THOUGHTS ON NURSING
For years, a Littman 3M cardiology stethoscope was a vital part of my anatomy. It draped across the back of my neck like a docile snake and when it wasn’t there, I felt naked.
My stethoscope kept secrets in the night as I listened to hearts barely beating; the symphonies; changing pace from fast to slow with punctuated periods of apnea. I heard the seasoned sounds of death through weakened chests and watched as lips fluttered into a blue haze—trying to say goodbye.
I remember the way I’d lift a patient’s hair off their shoulders to place my stethoscope over skin and how everyone breathes differently—from groans to grunts, to soft and shallow breaths. Men’s faces giving way to a faint pink blush—their stories spun between their heart tones.
Father bought me my hunter green Littman stethoscope after I graduated from nursing school. I recall the comfortable fit of the ear tips, the high-level acoustics when I listened to my father’s lungs and the distinct lub-dub when I moved the single-sided diaphragm to his left upper chest.
Twenty years late, a stethoscope no longer hangs around my neck, but instead sits at home in a drawer, as I haven’t practiced direct patient care in six years, due to a rotator cuff injury. I’m now a health educator and researcher working with families and patients in crisis—answering their questions about a specific disease process, medications, and or procedures.
Part of the job encompasses ways to calm patients and families who are going through illness that has turned their life upside down. It takes a bit of getting used to—caring for patients and families without reaching for my Littman and obtaining a physical assessment. Instead, I listen to their health-related concerns, answer their questions, and research their specific requests or direct them to literature on health-related topics.
But all the while I assess them from their feet to their ankles and up to the top of their scalp looking for swelling, rashes, weakness, skin abnormalities, symmetric breathing, color, balance and coordination problems, and pallor. I watch for mental changes, weakness, and slurred speech. Like a detective, I listen to their stories which reveal who they are, what they’re feeling, and how I might be able to help them. And like a nurse, I watch their movements with an investigative eye.
I don’t do all the educating, as I’m also learning from patients and family members. They teach me survival skills on how to cope with catastrophic illness, death and dying, surviving overwhelming grief, pain and suffering, and how to keep one’s faith during difficult times. I listen to their stories of illness, frustration and anger; a man just learned that his wife has stage 4 cancer, a young girl’s brother was shot two days ago and may never walk again, a mother’s daughter was in a boating accident and is in a coma.
My transition as a nurse from direct patient care to a health educator for patients and families opened up a world of opportunities combining my MFA degree in creative nonfiction with my nursing expertise. But it also put a wall between patients and myself; rules as to what was expected of me and a role that included hands on nursing only during emergencies.
I often pass by the different wards, observing other healthcare workers’ comings and goings, casual dialogue between coworkers and physicians, the quick energy that surrounds all units. It’s the close allegiance between colleagues, the emergencies and codes, the teamwork, the inside jokes, and the intimacy between colleagues in a fast-paced environment that I sometimes miss.
These are the times that I remind myself of the definition of nursing by the International Council of Nursing: Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well, and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of the ill, disabled, and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient health systems management and education are also key nursing roles.
Six years into the new job and I don’t reach for my Littman any longer. It’s not buried for good at home, but used whenever a neighbor calls frantically in the middle of the night complaining of chest pain, or difficulty breathing. It’s a horseshoe around my neck whenever my friends, children, or grandchildren aren’t feeling well.
Though my stethoscope isn’t needed in my new position, it carries special memories that aren’t easily replaced or forgotten. It represents collegial closeness, the laughter, the usual disagreements and quick apologies, the personal conversations, like convent confessions held in a small, sacred break rooms—a unit’s culture embedded deeply in my heart, along with memories of friendship, sharing, and teamwork—a sisterhood of nurses.