I’m from starched white caps, white uniforms and polished white leather duty shoes…
I’m from giving AM care, PM back rubs and unwrinkled hospital sheets…
I’m from giving up my chair to a doctor at the nurses’ station…
I’m from paper charts and hand-written nurses’ notes to Electronic Medical Records…
I’m from smoking allowed at the nurses’ stations…
I’m from drawing up syringes of chemotherapy in the nurses’ kitchen before ventilated hoods and OSHA guidelines adopted…
I’m from “This is the way we’ve always done it,” to national nursing standard and patient effective Evidence-Based-Practice…
I’m from time-consuming deciphering and clarification of scribbled orders to prevent un-intended consequences…
I’m from initiating physician/nurse meetings to promote recognition of our common goal to bring a patient to their fullest health potential…
I’m from mentoring (with awkward feelings) a Russian-trained M.D. working as a nurses’ aide while learning English and preparing to take U.S. medical boards…
I’m from driving home after 11PM to 7AM shifts and not remembering if I stopped for traffic lights or stop signs…
I’m from calling the nurses’ station as soon as I got home to ask if my patient’s family made it to the hospital to say good-bye for the last time…
I’m from starched white caps, white uniforms and polished white leather duty shoes…
I started out this blog to draw attention to May 6-12 being National Nurses Week, and as I wrote a commemoration to my beloved profession it made me think of Florence Nightingale, the Englsh woman who in the mid-1800′s trained in London as a nurse and did so against her wealthy parents’ wishes: Nurses back then were considered to be either drunks, prostitutes, or both. Florence became known as “the Lady with the lamp” for her relentless efforts to obtain better nursing care and improve hygiene conditions for the wounded English soldiers fighting in the 1854-1856 Crimean War; 3,000 men died of their wounds during the war, but 17,000 died of infection. When I see what medical hygiene practice changes she made, I can see the first nursing research of “Evidence Based Practice”, which is today’s nursing standards of care.
At a time when women did not nurse soldiers, Miss Nightingale initiated a nursing program and then took three dozen women with her to Crimea where she saw the terrible conditions of the wounded men and and began to change the filthy state of the make-shift British-run hospitals. Her ethical practice, hygiene changes and diligent pursuasion with the doctors of that time eventually brought professionalism and respect to nursing. Now, 150 years later, national polls note that nurses are among the most respected and trusted professionals in our current time.
The week of May 6-12 is designated to celebrate the nursing profession: National Student Nurses Day on May 8th, and (world-wide) International Nurses Day on May 12, which purposely coinsides with Florence Nightingale’s birthday. However, as I googled the Florence Nightingale Pledge and her personal history, I came across the name of another strong advocate for the soldiers, and, before the war, nursing victims of cholera and yellow fever- Mrs. Mary Seacole, a Jamaican nurse and “doctoress” who was a contemporary of Miss Nightingale. However, she was refused permission by the London War Office and other military offices to volunteer in service to her own Jamaican-born soldiers fighting alongside the English troups. In her memoir she cited racism and Victorian attitudes. Undaunted, Mrs. Seacole went to Turkey at her own expense, setting up a boarding house for both Jamaican and English wounded soldiers, and even going to the Crimean front lines to nurse the fallen. Eventually she volunteered in evenings with Nightingale’s nurses, although Florence had been among those in London who had first refused her offer. Seacole became as well-known as Nightingale, but in a different capacity; she was a hands-on nurse, while Florence’s focus was as an organizer of nursing services and with the monetary means to do anything within her power. The grateful soldiers called Mary “the black Nightingale” and recognized her cheerful yellow dress and blue bonnet with red ribbons. Mary’s brilliant flame as the first advanced nurse practioner was brief, while the wealthy and well-appointed Florence went on to establish the first Training School for Nurses and was hailed over many years for her accomplishments in raising the standards of nursing practice. It was 100 years later, in the 1970′s, that Mrs. Seacole’s life work became a symbol for Black nurses, civil rights, and the women’s liberation movement.
I confess that during my student nursing days I don’t remember hearing of Mary Seacole; it was Florence Nightingale all the way. I am grateful to learn of her and to have been further enlightened of both these influential women as I began this May tribute to Nurses Week: the two leaders would be proud to have been the forefront of the educational advancements, specialty areas, and opportunities that nursing encompasses today. Congratulations to all the Registered Nurses, Liscensed Practical Nurses, and Certified Nursing Assistants devoting their education, skills, and compassion to those who receive their care.
March 19th is not only the day before Spring; it’s the day nurses are recognized for being certified, or specialists, in their field. Nursing starts out with a general knowledge of many diagnoses. In 1984, when I graduated as a nurse (GN), it was common to work in a medical-surgical area for at least one year while passing licensure as an RN and building on the learned base, gaining more experience. Specialty certification in a particular field was an option and has grown tremendously: pediatrics, cardiology, endocrinology (diabetes, thyroid), renal (kidney disease, to identify only a few. For example, the initials after the example RN, MA, CGRN, CNOR, mean this nurse is a licensed Registered Nurse, has graduate education achieving a Masters Degree, and has earned specialized training as a Certified Gastroenterology Registered Nurse and a Certified Operating-room Nurse. The yardstick to become certified in any medical specialty is high and set to establish a standard of care.
Certification in cancer nursing (OCN, or Oncology Certified Nurse) appealed to me within a few months after graduation and after an unexpected transfer to my hospital’s oncology unit. I found I loved this field of nursing and wanted to give the safest oncology care possible. Over the years I’ve worked with many excellent nurses who are not certified in their particular field: there are many valid and individual reasons why this may not be feasible. One reason is that aside from the time commitment to prepare, for example, the oncology certification’s initial sit-down test, the cost is over $200 and many employers will not reimburse. I was fortunate our hospital did reimburse with a passing grade and also a $0.50/hour raise, and my employers since have also encouraged certification with these incentives. The test is given every four years, and recertification is required each time to continue carrying the initials ONC (Oncology Certified Nurse) and all it implies. In recent years more and more recruitement managers are suggesting certification is preferred, but not required. And you can be sure patients & families notice any initials after a medical caregiver’s name and will ask what they stand for. I do, too.
The oncology nursing test involves multiple areas including comfort, coping with psychosocial, cultural and altered body issues, supportive care, sexuality, rehabilitation, pharmacologic and non-pharmacologic interventions, alterations in nutrition and elimination, immune-compromise, cardiopulmonary function, oncology emergencies, radiation, nursing care of the different types of cancer diagnosis, chemotherapy administration & possible side effects. It includes several other issues including health promotion and early detection, and professional performance. I know there’s a few I’ve forgotten here, either by poor memory or deliberatly wanting to forget, whatever the stressful topic. The Oncology Nursing Society (ONS) is based in Pittsburg, PA, and is a globally recognized ooncology educational organization: nurses from all the free countries of the world can take the test for certification. Every ONS educational magazine issue I receive has peer-reiewed articles written by OCN RN’s and from so many countries including Japan, England, Austrailia, Switzerland, etc.: cancer does not exclude any culture.
Today I’m congratulating nursing colleagues everywhere on their special achievement and celebrate this special day, March 19th. Anyone who isn’t a nurse, but reads this blog, may be surprised to see what’s behind the initials on their caregiver’s uniform.
Being retired for six months now, I’ve had only the rare medical question or two; no “real” patient care. I’ve missed the frequent contact and teaching, yet I’ve slipped into a different kind of busy as my husband and I fill our dance cards with comfortable pursuits and the complacency of good health. Of course I’m aware that we might not always have smooth-sailing for the rest of our time together: if I thought about it at all, in the back of my mind I’ve felt we’re each emotionally prepared for any emergency the other might encounter some day. However, that “some day” came to elderly friends of ours the other day and awakened me to the intense emotional turmoil an emergency can cause in the partner as well as the patient. Anxiety can play cruel tricks with our body and usual good memory.
My phone rang; it was a friend telling me his wife was having a severe nosebleed. She was on coumadin plus another blood thinner. They had applied pressure on her nose for over fifeteen minutes, but still bleeding from both nostrils without slowing down. Telling him to call 911, I went to their home to wait with them; at 80+ anything can happen. As I walked in two neighbors arrived. This turned out to be a “more is better” scenario, because, while I held pressure on Mrs. M’s nose, her husband, very anxious at this point, became short of breath and felt like he was going to faint. As the emergency personnel arrived they quicklyly assessed the situation and decided the husband needed to go to the ER first (!): he needed oxygen and was in worse shape now than his wife. Extra gauze and more pressure seemed to at least have stabilized her bleeding. As Mr.M was leaving I asked both patients where their emergency phone numbers were so I could call their son, who was at work. Under ordinary circumstances this vital couple looked after one another, independent of outside help, but under this stress their anxiety levels were so high, being worried not only for themselves but also their partner, that neither one could remember anyone’s phone number or the location of their telephone list, or even an area telephone book that we could find. Off they each went to the hospital, and valuable time had been wasted because there was no prepared emergency information readily available. Their home was extremely neat, everything in it’s place, but where was the phone book?? As each patient was enroute to the ER, the neighbors and I found a telephone roll. Of course all I got was an answering machine as I tried one of their children after the other. Within a few minutes a son called back, very concerned, and would follow through with his parents. By late afternoon both were stabilized in the ER and discharged, so it ended well.
However, my lesson from this event reminded me how quickly an emergency can shatter what we think we “know”, and telephone numbers seem the first to fly out of our memory bank. Once home again, I banged out an emergency contact list, our individual medications and allergies, our PCP and pharmacy phone numbers, and what hospital we would want to be taken to (the emergency attendant had asked this question). I will update the lists as needed, especially medications. Also included in this emergency envelope, placed prominently by our phone, is the name of the bank we use so our son can access the box where we keep important papers he might need if neither of us are able to make decisions for the other. He has the key, but he’s busy with a young family and work- why should he have to depend on his own memory while dealing with our emergency?
I’m putting this out so you can get your own medical information together in one easily accessible place. I hope you don’t ever have to use it, but I’m just sayin’; in case.
How quickly the days go by. Slow down; not so fast! That’s the thought that passes through my mind at the start of each day in the already four months since I retired. Then follows a moment of deep appreciation that every day I have the choice to stay home if that’s my preference; no 8:00AM priority to check-into-work, no appointments that can’t be changed to just about anytime. I am retired from “have to”.
And it’s true what other retirees had told me, that there aren’t enough hours in the day to accomplish all that I’d like. Every day I make sure I have at least two mental and physical projects so my brain doesn’t turn to mush, or that I god-forbid become a couch potato and have to resort to sweat pants to accommodate my waist. The Internet web sites provide a wealth of brain food, like “Words with Friends”, and the nursing continuing-education credits required to keep my RN license current. Much as I would like, my fingers tapping the computer keyboard don’t qualify as physical activity, and so I make myself do a few minutes of simple yoga moves or lifting hand weights now and then throughout the day. Some days I exercise my taste buds with a no-sugar-added frozen yogurt banana split at Ice Cream World. I’m only human. In my blog onbeinganurse:Retired,Parts One and Two, I told you that my husband and I had joined a gym. Guess what? A month later he wimped out on me. Well, okay, in all honesty he did develop a (temporary) sciatica. This diagnosis was enough to put a big smile on his face when the doctor told him to rest his leg. The suggestion wasn’t to rest his leg forever, but it gave him a dignified excuse to gratefully forgo a last effort for great abs. So it’s the Silver & Fit program for me at the for-women-only Curves facility.
Am I still a nurse? The opportunities are rare now: a sea-sick voyager on a rocking, whale-watching tourist boat, some minor questions from friends and family. However, determined to maintain my nursing identity, I’ve steered myself toward a few questions of my own as I read in my nursing journals about the rising number of nurses leaving hospitals to do non-acute care or even for non-nursing positions. They site reasons like age… stress… physical safety… dissatisfaction with the nursing environment…and a BIG one; management often not making an effort to retain a qualified, seasoned nurse- an Oldie, sure, but a Goodie. During the last four years of my own nursing career I had just the opposite experience: my manager and clinical director went to bat for me, already a Senior Citizen of 66 when I interviewed for the position. They continued to offer support and/or solutions to any concerns I had, like my afore-mentioned nemesis, electronic charting. So my own question is, who will be there to take care of the Baby Boomers that are beginning the healthcare journey? The possibilities that many in their number will need nursing care are very real, particularly with statistics revealing a national increase of obesity and its’ complications, like diabetes, cardiac and kidney disease, and orthopedic problems. I’m still a nurse as I research and write an article about retaining older nurses to help fill the deepening shortage gap. I’m still a nurse as I write about patients once in my care; their courage, their humor, the way they and their families coped, or didn’t cope. Sometimes, remembering a joke a patient told me or a funny story about their day, I record the moment, laughing with them all over again.
These stories are for me, still a nurse.
Four weeks ago, on July 27, I retired from 34 years of nursing. I love my profession and, thanks to the patience of my husband and three growing children, took great pride in becoming a nurse; beginning as an aid, then a Licenced Practical Nurse and then a Registered Nurse, certified in oncology. On this last day, anticipating personal sadness and tears as I shredded my work folder of daily patient schedules and reference papers, I found myself going through the voluminous folder without a twinge and tearless. It felt to me that it was “time” to let go. During the morning and afternoon the staff had filtered in and out of my location with congratulatory good-byes and hugs, surprising me with a luncheon smorgasbord, balloons and a beautifully decorated farewell cake. I was both pleased and humbled to be the focus of their attention. There were several of my “regular” patients on my schedule and I had an opportunity to tell them what a privilege it’s been to help provide their care. Having cared for my final patient, I closed up my computer’s Electronic Medical Records (EMR) system, the Nemesis of my struggle with electronic charting . That’s when I felt a “tug” at my heart-strings: could I really be feeling I was going to miss the EMR, the worst nightmare of my last four years in nursing practice? It was surprisingly disturbing to shut down my ID number and password for the last time. This was not one of the nostalgic moments I had prepared myself for: I actually felt like I was saying good-bye to the computer as if to a colleague. Weird.
Day 7 post-retirement; issues which concern me:
(1) Having an undefined amount of available time has made me giddy. These first few days being home I have a case of “flight of ideas”; moving from one project to another just because “I can”, yet not completing any of them.
(2) Words with Friends and Daily Challenge social web sites have become addictive for me, as well as these TV sites; The View, The Ellen DeGeneres Show, Chopped, House Hunters, Hoarding, Say Yes to the Dress, and Paula Dean’s “Best Dishes to You”. I love Paula’s laugh and her Southern accent (but she uses waaaay too much butter!). No wonder I’m not getting anything done around here.
(3) My husband has his own TV, but does he ever turn off ESPN ?
(4) Oh, good: I’m still a nurse; the other day I taught my husband how to draw up his insulin and inject himself. He did very well and I told him so. Then he endeared himself to my ’nurse side’ by asking if I’d observe him again the next day, just for reinforcement. Why, sure! Grasping at straws here.
(5) After only one week of retirement I can see that my weekly dance card is in danger of filling up quickly: a library volunteer day, a Senior Citizen Silver Sneakers exercise program, and the inevitable doctor appointments, squashing the myth that retired people have more time for leisurely mornings to just watch the Today Show and The View.
(6) Personal maintenance at my age takes a lot of time every morning: instill dry eye lubricating drops, inhale calcium nasal spray to keep my bones strong, pluck overnight “rouge” chin hairs, swallow a myriad of prescriptions to prevent or cause this-or-that, and pull on thigh-high Jobst support stockings without sacrificing the tendons in both arms.
Day 31 post-retirement:
It’s been a month and, just like other retirees told me, there aren’t enough hours in the day. Or there could be if I re-organized a couple non-priorities. I do miss being a caregiver, though. Maybe I can satisfy this personal need by volunteering a few hours a week at the residential care facility very near us. Before I went to nursing school I was an aid at a nursing home, and loved talking to the residents about their past. Stay tuned to onbeinganurse:A nurse one day…the next day NOT; part three of three.
On Friday, July 27, 2012 at 4:30 PM I hang up my stethoscope. Well, not literally; in fact I haven’t seen my own stethoscope for a few months- I’ve had to borrow one of the generic stethoscopes from around the office. This retirement thing is huge. When I wrote my first blog I talked about how this life-change was looming ahead for me in another year or two: I asked myself then who I would “be” if I wasn’t practicing nursing anymore: it’s been my identity for 34 years. On one hand I know it’s time for me to move over for a younger, smarter, bachelor-prepared Nightengale (gender not excluding males, of course). On the other hand, I’ve got the skills to continue, but not the physical stanima or patience anymore. I love the patients, but I don’t deal with the mental stress as well as I used to. Between the electronic charting and the packed schedule and the people discovered to have urgent need when they were only scheduled for bloodwork, my nursing days were numbered. Still, I wavered, vascilating between should-I and no-not-yet, lessening my hours with a job-sharing partner so that physically I could stay and keep my mind stimulated by a profession I love.
Life happens, though, and last Fall I fractured my foot. No surgery, but six months in an immobilizer boot meant shifting my assignment out of the exam room and hands-on care, and the other nurses picking up my duties while I picked up some of theirs, like taking some triage calls and teaching new patients about their chemotherapy medications. Just as I got sprung from the boot, I started spilling coffee -and most anything- down the front of my shirt; an MRI showed that two of four tendons had evidently divorced each other and counseling was not an option. I’m right-handed and for patient care and/or supplies I have to reach up or to the side many times a day, which had become pretty awkward-appearing to my watchful patients. Plus, coffee stains on a white lab coat don’t relay a professional appearance. I couldn’t keep up with the laundry.
So it was time to abdicate from my self-ensconced throne. Handing in my letter six weeks ago made retirement pretty near, but not immediate: It’s the actual walking out the door this Friday, handing in my hopefully un-stained lab coat with my embroidered name and credentials, when realty will set in and my identity changes. Oh, to be sure, like the Girl Scouts, I’ve been preparing. My husband and I started volunteering weekly at our library, bringing back memories of my grade school librarian, Miss Lathrope, and the Dewey Decimal System. We joined a gym and do the Program for Old Geezers (my name for it; see my blog from July 6, 2012). I plan to be on Words with Friends less and write more. So you can see that I’m not going to vegetate, at least not yet.
Stay tuned for Parts Two and Three: a couple of the issues I see ahead are a husband who’s been retired for twelve years and enjoyed his alone-time while I’m at work, and, to add to that, now we’ll have a Budget. Oh, boy.
This week my husband and I joined a gym. Our insurance pays for a one year membership and we have use of all the equipment; we can go as often as we want. Gung ho, we went to check the place out and talk to a representative who tailors Senior Citizen programs: I call it the old Geezers’ program. The 40-ish trainer told us a bit about her background, asked us each a few questions about our health, history and current, and then showed my husband the treadmill & how to use it. We left him plodding along, focused on the picture icons across the treadmill’s dashboard. I only hoped he wouldn’t adjust the program that our trainer had already adjusted for his age and inactivity, unless you call activity bending from his TV chair to reach into his hide-a-way for a snack a few times each evening.
While he was contemplating being an Olympic challenger by next year, Paula (not her real name) took me to the medicine ball area. I eyed the row of bright orange balls, ranging in weight from 4 lbs to 14 lbs, relieved when my preceptor chose a wimpy 4-pounder for me. In short order I was repeating her example to swing the ball side to side from shoulder height to the opposite knee, ten times and repeat it on the other side for ten, than repeat for another set of ten. Fortunately Paula was doing the counting, because I was needing to concentrate on looking as good as I could to other gym members I had begun to notice, none of whom looked to be over 35 or anywhere near my totally stretched-out yoga pants’ size. Seniors were not the norm in this gym. Or, if I’m the “before”, were these the “after” Seniors? I swung that ball with more enthusiasm.
In the next 30 minutes Paula directed me through three pieces of equipment designed to perform magic and strengthen the core and leg muscles of an over-weight woman who has no metabolism left to speak of. As I progressed through the various machines, I changed my focus from hoping to look like I’ve been using a gym ‘forever’; now I just didn’t want to FAINT in front of all these physically fit people.
When my time was up (and after all those reps on all those different machines I had been afraid my time really was up) Paula had me switch with Richard on the treadmill and she took him toward the balance balls. Good luck with that, I thought, as I watched her match him up with a ball nearly the radius of his waistline. Examining the treadmill’s dashboard, I pushed a couple buttons that showed me the recommended cardio rate based on my age. The problem was, I don’t admit to 69 and, when the machine asked me to put in my age, I had entered what I hope my body will be after a few sessions and said “50″; that was a good year as I remember. Is that asking too much? Yes, because a strange sound began to emanate from the treadmill’s base and the walkway began to elevate as if one of Mt. Everest’s peaks. In another bewildered moment I was climbing without benefit of additional oxygen and my heart rate was on its’ way to exceed any range acceptable for a 69 year old. Not to mention my legs hadn’t moved this fast since I was twenty and chasing a toddler. Quickly I got my wits together and pushed on a few more buttons: the darn thing grinded to a crawl, pulling my legs towards the rear as I hung on to the bar- and my balance- with all my might. Ah ha- the “stop” button! and regained my footing without calamity. That was a close one. I glanced to my left at a man who was already on that treadmill when we had arrived an hour before and, judging by the sweat rings on his shirt, had not slowed down his frenetic pace one iota. Not a chance that he would have even noticed if I fell off right next to him. On my treadmill’s dashboard I carefully re-addressed the question of my age; this time I entered the truth and nothing but the truth.
And in another few minutes here came Paula and Richard. We had completed our first session without embarassing ourselves! Now that we had gone through a session, Paula wanted to know our goals. I said balance and strengthening. My portly husband was next.
He replied with a perfectly straight face, “I’d like to see my abs one more time.”
After 52 years, he still cracks me up.
In 1909 the daughter of a Civil War veteran and widower wanted to honor her Dad for having raised her and her five siblings alone after his wife died in childbirth. Sonora Smart Dodd, of Spokane, Washington, had heard a sermon about Mother’s Day and felt that fathers earned the same respect. One year later, in June of 1910, the town mayor declared the first Father’s Day: June was chosen because it was the month of Smart’s birthday. In 1966 President Lyndon Johnson made a proclamation to honor fathers on the third Sunday in June, and President Richard Nixon in 1972 signed the public law that made it an annual celebration.
Not such a celebrated day as for Mom, however. Father’s Day falls 4th behind gift and card-giving on Christmas and Mother’s Day, and then after Mother’s day itself. Let’s face it; we all know there’s no great urgency to secure a restaurant reservation in advance of Dad’s day as there is for Mom. Does the term “under-appreciated” come to mind? For the most part, the 70.1 million fathers across the nation are deeply involved in their children’s lives, balancing work and family, chauffeuring to school and outside activities and sharing household chores. Career decisions and ecomomy determine whether a parent stays at home with the child, and in 2012 the “stay-at-home” Dads number 167,000 (up from 143,000 in 2006) while the partner leaves the home to work. Many couples have been able to job-share, or a willing grandparent steps up to the plate, thus eliminating the need and expense of facility day care. Sometimes there’s not a partner and it’s all on his shoulders. And, unfortunately, on the other side of the coin there are fathers who avoid any responsibility and choose not to be in the picture at all.
The United States is not the only country to honor fathers: Africa, Japan, Australia, New Zealand, Belgium, Germany, France and several others celebrate, most on a different date and time of year. Neckties are still the most popular gift: I would have thought it was bar-be-cue equipment. On June 17th this year, in our family there will be four generations of Dads’ standing around the grill. My husband is a Great-grandpa and our oldest grand-son is a new Dad to his 9 month old little girl. There’s usually a previously untold chronicle or two that comes out on these occasions, making Dick and I wonder how our kids “got away with it”, but it tickles them to confess at this late date.
Parenting today is so different from the 1950′s when I grew up. My father was a car salesman and worked all day, came home for supper and then went back to the dealership until 8 or 9 PM: I can count on one hand the occasions he came to any school events. Yet, I didn’t expect him to leave work- I understood that he was doing his best to support his family and that was the way it was in most families then. While my husband and I raised our three children in the ’60′s & 70′s he often worked seven days a week and still managed to be a baseball coach to their three different teams. Now our sons each are involved in their children’s activities and encourage their wives to pursue individual goals, as does our grandson, who shares with his wife in every aspect of their daughter’s care.
Let’s express our appreciation on a daily basis to all the fathers in our lives, and if we also give them a new tie on June 17th, so much the better.
May 7-11 is National Nurse Week and during May my nursing sub-specialty celebrates Oncology Nursing. There’s a big poster celebrating cancer nurses in the medical practice where I work and at last week’s staff meeting our managers contributed a delicious breakfast in our honor. It’s nice to feel special and appreciated.
A Gallup poll of the “most honest and ethical professions” has given nurses top ranking for the last 10 consecutive years and 12 of the last 13. Wow- a remarkable declaration, and to think I’m part that elite group. My children might beg to differ, based on what they’ve hinted as abandonment when they were adolescents during the years I went to nursing school. That was thirty years ago. I see so many changes in nursing, from not wearing our crisply starched white caps anymore (they didn’t get crisply starched very often and were found to carry germs from one room to another) to the many subspecialties of being a licensed caregiver. Just to name a few are labor & delivery, pediatric nursing to geriatric, medical-surgical, cardiac, dialysis, critical care, emergency, clinical trials (research), operation room nursing: there are many more. I was a medical-surgical nurse for six years then in 1984 was transferred to an oncology floor, or cancer care. It was not my first choice, but within a few weeks I felt this where I was ‘supposed’ to be. The next step was to become certified in this specialty. I know many excellent RN’s who are not certified in their specialty practice, but certification is national validation and recognition of proficiency. Over 35,000 nurses in the USA and internationally are certified in oncology nursing, which requires an initial 1000 hours of medical-surgical nursing and a course in the administration and side-effects of chemotherapy and recognizing potential metabolic emergencies related to cancer and/or treatment. Every four years a passing grade or equivalent of educational credits in cancer care is required to maintain national status as an Oncology Certified Nurse. Not every hospital administration or private practice will pay the $250 fee to register for the test, and this is an expense which has to be considered. In my experience, my employers have supported certification by reimbursing for a passing grade and also an hourly raise in salary.
Educational standards are continually being adjusted. A Bachelor’s in Science, or four-year degree, are the current preference, then a master’s degree for advanced nursing practice, such as nurse practitioner or clinical teaching to nursing students. Many nursing programs are now offering a doctorate in nursing.
Thirty years ago my husband took over the household so that I could become a nurse and pursue a personal dream. I’m so grateful to him and our children for their patience during those years of night classes and clinical hours, and for the opportunities and experiences nursing has given me. I still keep in contact with many patients, comparing family notes and current activities. My nursing friends and I feel a special bond. The time has flown by and before too long now I’ll be hanging up my stethoscope, exploring the new world of retirement. But I don’t think there is such a thing as retiring from being a caregiver, even if it’s from an observation view: I have lots of wonderful, amusing memories to write.
During National Nurses Week, and always, congratulations to all you nurses out there- be proud of your chosen profession!