Saturday, April 10, 2010

Confessions Of A Nurse

As a nurse in California, May has seen it all: the AIDS patient who pushed her to her limits, the wife who humiliated her husband on learning he had cancer, the Alzheimer’s victim who had no idea about the “thing” that was stuck under his fingernails, and the suffering hepatitis patient who refused to live.

It’s an experience perhaps no different from that of other nurses in the Philippines, but coping with it in a highly stressful situation is something else. “One has to have a genuine vocation for this line of work, otherwise one would not be able to cope,” she says.

"I used to go home at night, fall on the living room floor, tired as an abused mule, crying tears of self pity. My muscles ached like I was mauled, and there have been a few times when I just fell asleep on the floor, unable to drag myself to the bedroom,” she says.

(May, 38, agreed to be interviewed but asked that her real name not be published because of a confidentiality agreement she signed with the hospital).

Her first experiences were daunting. “After post-mortem care, I would see the dead person’s face everywhere I looked. Now, the memory just haunts me for a few hours,” she says.

“I still get attached to my patients and get emotional when one of those patients die. The first time [in the US] that I cried my eyes out was a few years ago. Death can be so draining on the nurse’s part, if we allow it. That is why it is sometimes
necessary to be emotionally detached.” That said, she still has to face seemingly endless challenges everyday.

May describes how she injected morphine into a patient who was on his death throes (“his father could not bear to see him suffer so much”), how she cleaned up the fingers of an Alzheimer’s patient whose nails were filled with poop, how she attended to a shackled hepatitis patient escorted by four heavily armed prison officers, how she administered 30ml of antibiotic into a patient’s bladder through her urethra while listening to her rage about being resuscitated.

She recalls how an AIDS patient pushed her to the edge. “He refused medication or took it depending on his moods. He changed his IVF rate, turned it off just because he thought he knew better, and because he knew how to deactivate the lockout
system. He argued about the time of his pain medication and denied I had given him any. He called often to remind me I was lying to him about his pain meds.

“He criticized me for not knowing how to do even the simplest things like taping his IV tubings. He was not happy with this, he was dissatisfied with that. Nothing was right. Every nurse he met was either lazy or stupid. To him, all the doctors were
against him and did not have any idea what they were doing. He said he was dying because we were not doing what we were supposed to do.

Then there’s the woman who cursed her husband after he had just been diagnosed with cancer, calling him useless and telling him “Why don’t you just die?”

Does her work affect her sanity somehow? She indirectly answers this by joking about her habit of locking their car three times and making sure that her clothes face a certain way and hang according to colors in her closet. She admits that some
nurses have had a nervous breakdown due to a heavy download and stressful conditions at work.

Still, it’s not all gloom and the good things about being a nurse in the US are more than enough to keep May and others going.

“In general, the doctors here value the input of nurses. It is not unusual to hear a doctor asking nurses their opinion about a possible procedure or test, a change in diet, an increase or decrease in pain medication doses.

“A lot of them treat nurses with respect, especially ICU nurses. You don’t have to offer your chair to the doctors. You can confidently tell them you will not carry out an order because in your nursing judgment it is not safe for a particular patient. In the Philippines, doctors are considered God; their word is law.”

She calls her American supervisors by their first name. She can disagree or protest if she thinks she is at a disadvantage. Back home, everybody is ma’am and sir. What she considers perks back home are the patient watchers.

“They do a lot of things and in government hospitals they are even trained to do nursing chores [like giving meds or suctioning] because the patient load is 40 patients per nurse in the Philippines. I think the present staffing ratio under
California law is 5-6 patients per nurse. Here in America, a nurse is called to do the simplest things like picking up a tissue paper that a patient dropped on the floor.”

May was in her second year of pre-med when her father told her he could not afford to send her to medical school. Her dad’s sister took over the financial responsibility on the condition that May took up nursing.

“It worked out for me because since I was a little girl, I’d always wanted to be a nurse. There was nothing more I wanted to be until I learned about Rachael Ray, Samantha Brown and Oprah Winfrey. They changed my whole perspective. Imagine being able to earn lots of money by simply talking, cooking and traveling. That must be heaven.”

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