A tribute to nursing, by a physician

Nurses General Nursing

Published

Suggested Title| "My Nurse Mentors"

|Author| Joshua Grossman, M.D., F.A.C.P.

|Affiliation| Clinical Assistant Professor of Psychiatry and Internal Medicine: The James H. Quillen College of Medicine: East Tennessee State University

|Voice mail| 423 929 7576

|University e-mail| [email protected]

|Personal e-mail| [email protected]

A physician colleague sent me this tribute he wrote to the nurses who took him under their wings when he was a medical student and then an intern, many years ago. I thought other nurses would enjoy reading it. Feel free to write "Dr Josh" with your thoughts at the e-mail addresses provided above.

My professor of English Literature at the Johns Hopkins University endorsed, "The mark of a genius is humility." While I am certainly no genius I would like to respectfully submit this tribute to my nurse-mentors who took their time to train me in both the art and science of the practice of medicine. These are but a few. Memory fades with the years. My journaling should have been more conscientious. Here are a few of those wonderful nursing caregivers that I can recall and now would like to honor.

In my junior year of medical school I had to learn and did learn to start intravenous fluid lines. When I mastered getting the needle into the vein in one smooth, swift minimally painful stick I still could not tear tape so I could not easily secure the needle in place. I suggested to my intern that I carry scissors and I was haughtily told in a sneering, condescending tone of voice, "No doctor carries scissors. You have just got to learn to tear tape or you can not be a doctor!"

Well, for sure I wanted to be a doctor so I strained and struggled until finally a nurse made the time to teach me the following, "Hold the tape between the thumbs and forefingers of each hand; then put your knuckles together; then put your thumbs on your knuckles, and then separate your wrists!"

And that was it. Instantly I became an expert. I trotted about happily volunteering to start additional intravenous fluid lines confident in my newfound ability to tear tape. Nothing could have been simpler. It is my shame that I do not recall her name, but her method of tearing tape remains with me to this day. And now, in this writing, I thank her. I thought of her respectfully and I thanked her each and every time I tore tape.

In my senior year of medical school I was admitting a patient with upper gastrointestinal bleeding. The intravenous line with normal saline was established. Blood was drawn for type and cross match. The nasogastric (N.G.) tube was in place revealing that the bleeding had stopped. As the nurse and I were smoothly working as a team admitting the patient a Roman Catholic Priest entered the room. I was dumfounded. I turned to the nurse and as I began to voice my dismay she firmly took my arm and started for the hallway. I realized that my arm was going out of the room and if I wanted to keep my arm I had better follow it and follow her.

In the hallway she gently but firmly explained that, "In the care of any and all seriously sick patients, including but not limited to Roman Catholic patients it is correct and appropriate to provide the sacrament known then as the last rites or extreme unction now known as the sacrament of the sick or equivalent in the event of any acute illness that might unpredictably further deteriorate and progress to the demise of the patient!"

Not being Roman Catholic myself and not having any instruction in spirituality in my medical school years, I listened carefully and learned much. Through my years I have always inquired if my patients or their families or significant others want a visit by clergy. When the answer is, "Yes doctor," I have telephoned priests, and/or ministers, and/or rabbis personally and directly and I have documented these telephone calls to clergy in the chronological record of medical care of my patients. In time I have endeavored to educate my marginally literate hospital ancillary personnel who have written in ink in the chronological records of patient care thus, "Priest visited and gave the patient the last rights (sic)!"

In time I have become more acquainted with the process and I have accepted the role of Padre` Perez (wearing both wig and medieval large cross) that provided me the opportunity to administer the last rites on stage, that I chanted (and can still chant even now) in classical Latin accompanied by a bassoon for Don Quixote de la Mancha in our fifteen performances of our Jonesborough Repertory Theater performance of "Man of La Mancha!"

Nevertheless, giving credit where credit is due, my initial understanding of the importance of clerical visitation of critically ill and potentially critically ill patients came from a dedicated, educated, kind, gracious nurse. Again I take this opportunity to thank her and again I apologize respectfully to her for not even remembering her name.

In my internship, I was privileged to meet and learn from the best of the best of my nursing mentors. She was a married Asian American with a pre-school child. Her dedication was such that she chose to leave her family each afternoon to work the evening shift of our emergency room. And that is where I was fortunate to meet her. I do remember her name but I withhold it out of respect to protect for her privacy and confidentiality. Her chosen "abbreviation and/or anglicanization" of her name was, "Mitzi." It was the name she went by. It was the name we used in the hustle and bustle of our emergency room. We knew her by no other name. She was the best of the best.

When a patient with acute florid left ventricular failure with pulmonary edema would arrive in our emergency room gasping for breath Mitzi would say, "Oxygen doctor?" We would answer, "Yes." Then Mitzi would give the oxygen and say, "Intravenous morphine doctor?" We would answer, "Yes." Then Mitzi would administer the intravenous morphine and so on and so forth.

Similarly with: diuretics, rotating tourniquets, the 12-lead electrocardiogram, and acute hospitalization. We had no intensive care unit but we had Mitzi and our patients did well. All of the staff physicians recognized the skills of Mitzi. If and when a patient would come in with ankle trauma the bone-and-joint specialists would endorse, "Have Mitzi look at the x-ray and then call me."

To the best of my knowledge and recollection, Mitzi was never honored or otherwise officially recognized by either our medical staff or our house staff. Mitzi was never given any awards, plaques, dinners out, letters of appreciation, letters of commendation and so on and so forth. Why not? Could it have been that the physicians, both attending staff and house staff were ashamed of admitting just how much they learned from Mitzi and just how much they depended on Mitzi?

And what became of Mitzi? Did she receive the outstanding care that she taught us to provide when she herself became unwell? Mitzi was hospitalized with unrelenting, never-ending, round-the-clock chest pain. In those dark ages, now decades ago, imaging was in its infancy. The chest x-rays were reported as negative. The laboratory data was unrevealing. I can still see and hear the chief-of-medicine, speaking in his deep voice and surrounded by his acolytes, waving his hand in the hallway outside her room and endorsing, "Aside from the small probability of malignancy..."

Matters came to a crisis when some well-meaning provider wrote on Mitzi's scut sheet (list of things to get done), "Get a psychiatry consult," that, in those days of stereotyping mental health professionals and stereotyping mental illness (has that changed?) deeply wounded Mitzi.

In those dark days before patient's rights, Mitzi was not supposed to see her scut sheet which was to be tossed (shredded?) and not to be, never ever to be, a permanent portion of her chronological record of medical care, but Mitzi, being perceptive, and knowing about scut sheets, albeit gravely ill, somehow did get to see her scut sheet.

Finally she demanded and got a medical oncology consultant who performed a needle biopsy of the inner lining of her chest and documented pathologically a spreading malignant cancer, primary site undetermined.

At last Mitzi, under a sentence of virtually certain death, now knowing the reason for her relentless chest pain, achieved a measure of peace. Was it the irony of her life that she who not only gave so much to the treatment and care of untold numbers of patients and trained untold numbers of interns when she was ill she was dealt with in a strange manner? Mitzi lives now in my memory. May she rest in peace and may her memory always be for a blessing.

Please accept my appreciation for my meager and imperfect endeavor to voice my humble and respectful appreciation of all of my nurse-mentors.

Thanks Mitzi!

God-bless!

God-speed!

God's Grace!

prmenrs, RN

4,565 Posts

Specializes in NICU, Infection Control.

All I can say is WOW!!

Zee_RN, BSN, RN

951 Posts

Specializes in Hospice, Critical Care.

I'm gonna cry.

gwenith, BSN, RN

3,755 Posts

Specializes in ICU.

A moving piece. Just wish a few more would take time out to do the same.

Gardengal

146 Posts

I am pleased to see such a thoughtful writing by a physician about nurses, and one nurse in particular. I wish that Mitzi did not have to go through what she did, and am thankful that we are paying more attention to pain and the reasons and subjective perceptions of it than we did in the past.

I can vividly picture the events described and thank the writer. I hope that this same or similar posts are being sent to physician sites as well as nursing. We know about the influence of nursing in our profession. I hope that other physicians and public are learning from this viewpoint as well.

Thank You Dr. Joshua Grossman, I will be contacting you personally.

Noney

564 Posts

Specializes in Critical Care.

Nice.

Hellllllo Nurse, BSN, RN

2 Articles; 3,563 Posts

Wonderful!

Thanks!

gypsyatheart

705 Posts

Specializes in Case Mgmt; Mat/Child, Critical Care.

That is beautiful ,very moving!

Wren

201 Posts

Specializes in Oncology, Hospice, Research.

This is great!

Another physician recently wrote a very moving piece in JAMA recently about learning from a nurse's compassion during the code of a child in the essay column, "A Piece of My Mind".

I don't recall the issue (sorry) but I know it was within the last month. If someone has it maybe they could post it here.

Good thread! :D

Nurse89

112 Posts

Very nice :)

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