In 1997, after finishing school, I set off with my brother to visit nursing schools, in England. At first, I had no plans to leave Ireland, I was just attempting to satisfy my school that I was filling out all the right applications and that I was serious about nursing. After all, at 18 and male, with no immediate family in healthcare, perhaps I was an unlikely student for a nursing course.
I think it was August 1997, the results came out. I had to get my family to go and collect them. I was at work, in a hospital operating room, as an assistant. I remember leaning on the pillar, talking to my mam on the phone. Yes, she could open the envelope and tell me if I had done well enough to get what I wanted. Forgive my memory, but in almost 12 years, I am sure that I am glossing over some of the exact details. I do remember that my brother was the one that ended up calling Liverpool, England to see if I had the required results for entry into their nursing program. Thankfully I had!
I remember turning to my, then colleagues and grinning, telling them that I was going to nursing school in England. Somebody asked me, who was I going to go with, and who did I know over there already. My answer, no one! I am going to be a nurse! After all, I didn't know anyone when I started my job here, and now all of you are surrounding me, eager to know if I will be a nurse or not.
My dad and I set off for Liverpool. It is amazing how much stuff you can get into one of those black cabs when you have to. I was setting up a life for myself, overseas, away from the familiarity and comfort of home. I was nervous, excited, scared, and thrilled. What would be in store for me?
In those first four years of nursing school, I worried and fretted and wondered if I'd ever make it through. Thanks to my class, the tutors, the college staff and most importantly the unending support of my family I did it! I graduated as an RN in June 2001. I finally had a piece of paper that made me a nurse! At that time, the focus of my worries changed - now that I am a nurse, what sort of nurse would I be?
While in nursing school, I started to do clinicals and see hospital life. I started to feel what it was like to be part of a team and care for those at times of crisis and ill health. This was not my only education. My family, especially my mam, encouraged me to be well-rounded and gather as much experience and education as I could. I think my mam was concerned that once I was done with school, I would have no time for a social life, for friends or for broadening my horizons. She may have been slightly wrong about that. Never the less, it was with this in mind that I decided to learn to scuba dive and look for a summer job. These are 2 things that played a large part in my future of transcultural nursing that I was yet to experience.
Summer 1998, my first summer. What would I do? To me, there were 2 choices; go home and resume family life or look for something related to nursing that might broaden my experience. I picked up a school paper, just to see what was being offered. I remember seeing an ad for summer camp. A place in the mountains, a chance to help kids and adults with special needs have a summer vacation. A chance for their families to have a rest from complicated care. It sounded good. There was one small issue!
"Mam, I found a summer job...."
"O.K, what is it?"
"It's a special need summer camp, it will help my nursing and broaden my skills......"
"O.k, what's the catch?"
My mam was and always will be very astute when it comes to me. She knew there was more to this, seemingly innocent summer job. I didn't really think it was such a big deal. I had already been away from home for, approximately 9 months. I was arranging to be home in September before, I would have to leave home again and return to nursing school. Ok, there was the issue of the camp being in the Catskill Mountains, in upstate New York. In my defense, I had the opinion that if I was away from home, I was just not there. It did not matter if I was down the street in Dublin, or across the Atlantic in another country. I knew my family would be there for me. And, they proved me right! My mam was probably shocked and amazed, but I told her, she had encouraged me, so I had to go!
That summer, I went to the Catskill Mountains. I worked hard and then had some time to travel. I fell in love with the country and a certain individual. To this day, people still believe that my partner is the reason that I chose to come back to the USA. Sorry, to say this is not the case! Sure he's important, but he has not and never will stop me doing what I need to do. In fact, truth be told, he supports me, nearly as much as my mam. I could have said "more", but really over 10 years with him, can't equal the first 18 of life with mam!
June 2001, I am a nurse! I have my degree in my hand. Now, what do I do?
I didn't know what to do at first. So I spent one more summer in the USA, working at camp. That was my 3rd summer as a counselor and the staff wanted to see me return as a nurse one day. Maybe? I just wasn't ready for that yet.
I returned home to Dublin. I needed to see my family and show them that I had made it as a nurse. My mam, unfortunately, was unable to be at my graduation, so I needed her to see the pictures and the degree and me. I felt like it had been a lifetime since we had spent any time together. She did too!
My very first nursing job was per diem in Dublin. I found an agency that would accept newly graduated nurses and let them try different areas. Those few shifts in Dublin also taught me many things. Dublin is and always will be, my home. It was not the place that I was going to work. Nurses in Dublin made me feel bad! I don't think it was intentional. I was an English trained nurse that had come back to work in Dublin. A black sheep, come to fit back into the fold of Irish trained nurses and nurses that really wanted to be in Ireland. I realized I wanted more. I had seemingly outgrown the nursing jobs of Ireland and needed to reach out to find challenges and experience that I would not get living and working in my hometown. Does that sound biblical? It was how I felt. So I moved on.
By December 2001, I was back in England looking to work in the health care system that I had been trained in. I had a good idea that emergency room nursing was the job for me. In my degree, I had also completed a UK specialist practitioner qualification in oncology. So armed with this and my degree and my travel to the US, I applied for an ER job close to where I had trained. At first, I got per diem there too, but then I found an ER, willing to take a new nurse, willing to learn. I was asked if ER was a suitable place for me. I responded with, I can face new challenges. I spent 4 years conquering the basics so that now I have my piece of paper that means that I can start learning in the real world. Being a student nurse is one thing, being an RN is quite different.
I spent 3 years in that ER and am grateful to all the staff, patients and ems personnel that started me on my path to nursing.
My love of travel had also grown. I had traveled most of Europe with my brothers for vacation, I had flown transatlantic for my summer job, I needed to see more and do more. Once again, I found an add in a magazine! Travel nursing, see the world. How could I resist? I didn't!
A lecture hall in Manchester was the start of what turned into a long, long process. It would take 3 years to get my permanent resident card and end up in the States as a nurse. I was determined. There was so much experience out there, just waiting for me.
I could not possibly sit around and just wait. I am impatient! I need to feel like I'm doing something. I made new friends in the process of getting my US paperwork in order. It was them that offered me one more experience that I could not turn down!
"Mam, you know that I'm working on my US paperwork...."
"Well, people that I have met, doing the same, say that it's very easy to get an Australian visa and get into nursing over there"
"Oh, I see...."
October 2004, hello Sydney, Australia, Brian is here to nurse! Just outside Sydney and then an aboriginal community off the coast of Queensland were the places that I worked. Those experiences alone could take up another small book. The only problem with those jobs was REALLY being alone. By now, I was working for my US paperwork and developing a relationship with my partner. It was a difficult time to be halfway around the world, and a day apart. While my family was welcoming the New Year 2005, I was going to bed on January 1st, 2005 and my partner was getting ready for New Year's Eve celebration to begin. This was one of the loneliest times of my life. I compare this to death and dying of a close relation. I was truly alone. I survived, I learned, I grew.
When I returned to England in the summer of 2005, I was getting nearer and nearer to having my paperwork in order to be a US nurse. I had always wanted to see California and I could not imagine starting my nursing anywhere else. So I did.
California, October 2005. New challenges and new situations. For the 1st time, my partner and I could be closer then we had been. He traveled from New York to live with me in Anaheim. And I started work in one of the many local medical centers. A hospital that catered for tourists from Disney, prisoners from the OC jail and people from the local communities. I realized early on that I have no knowledge of Spanish, but that did not really stop me! So my triage took a little longer and I had to ask for some more help to communicate with my patients. I still was able to be a nurse and continue to learn. Once again I have a debt of gratitude to those staff and colleagues and patients that accepted me as a nurse and help me grow in the US healthcare system. I even remember defending the US health care system to an Italian patient.
"No, this is not Europe and that is not what happens here"
From California to New York. A long distance. Although, in case you ever wanted to know, you can drive that distance, with 2 drivers, in as little as 47 hours. This, however, I can not recommend!
I came to New York to finally work as a nurse in the summer camp that I first worked at, in the summer of 1998. In fact, they paid for my license and offered me so much help, I felt like family. The only bad part about that was that it took forever and a day to finally get my New York license.
After that first summer of nursing in the Catskill mountains, I need a winter job, so I came to work in Rochester. Now that is a city that you can learn a lot from. I worked at a regional trauma center and felt that I was continuing to grow and learn as a nurse. It was here that I also started to work as an EMT. I felt that I needed a new challenge, to reach out and help the people of my community. That truly was an education! There too, I made new friends and gathered colleagues that were able to help me work in a community that I previously knew so little about.
May 2008, tragedy struck! My partner lost his dad. By this time, I had fit into a second family. The adoptive American family that loves me, nearly as much as I love them. I have too many experiences, as part of this family to fit into this small space. Suffice it to say, I belong to an Irish and now an American family, thanks to my partner and his family. I was at home in Dublin and my partner called me.
That was one of my most difficult journeys. I had gone to Dublin, after 3 years to wish my mama happy birthday. I stood in our Dublin kitchen and heard the pain and the sadness in my partner's voice. He had lost his dad. Again, thanks to my mam's support and understanding, I left Dublin, on her birthday, to fly back to my adoptive US family. As a nurse, you strive to do everything you can for your patients. As a partner and son-in-law, you stand helpless in the face of death. Sure I understand pulmonary embolisms after surgery. I just can't explain what it feels like to lose someone that close. Even now, writing this, tears well up in my eyes and I feel their loss. I am powerless. What can be done?
Challenges are not things that I move away from. Critical thinking comes with nursing. Problems need solutions. There were many options considered in those following months. In the end, the best solution was to move in with Mom and sister-in-law. So what about my nursing?
I will always be a nurse. I can find a job anywhere. Any place, country, time. I am a nurse. So at the moment I per diem in 3 rather different hospitals. I can experience a variety of communities and give back to one that has been my partners home for many years.
I also decided that I wanted to do more with the emergency medical services. So I am in school to be a paramedic. I finish in June and then I will be able to work pre-hospital as well as a hospital.
So this is my transcultural nursing experience, so far. I have only been a nurse seven, nearly eight years. I have so much more to learn. Every experience, good or bad is an opportunity to grow. Sharing experiences helps others grow. Long may it continue!