When I went to nursing school, I never imagined there would come a time when I would be so privileged to give a "keynote" address. My expertise is more on narcotic keys and nurse's notes. But it happened. I was honored to address the graduating class at the College of Nursing at New York University during their pinning ceremonies. I asked my co-faculties for some suggestions for my speech. They told me to talk about what I know best, stories from my own life. So I looked inwards and shared with them this personal lived experience.
In late November of 2009, I took care of a 75-year-old Asian woman. She had a longstanding history of diabetes, CAD, HTN. Her health had started to decline earlier that year. She broke her wrist in a mechanical fall, and a wound failed to heal on the sole of her right foot after a debridement. Another fall led to a sub-dural hematoma, requiring surgical evacuation, after her foot amputation. The nearest hospital was two and half hours from her home, through rugged mountain roads. She did not have health insurance, and her immediate caregivers were only vaguely aware of the basics of infection control. She also had no advance directives, and she admitted to being incompliant with her diabetic meds, as she was trying to economize her meager resources. Later that year, she passed away due to complications of sepsis after a failed CPR. This grandmother of 10, who spoke little English, endured it all calmly and without complaint, even as she watched her life savings vanish in the last three months of her life to pay for health care. This woman was my mother.
I share this story not for sentimental reasons, but to reflect on the challenges that all nurses face today. The headlines constantly remind us of the ever-increasing uninsured population, the health care disparities, the lack of access to health care resources, gaps in practice and research, deficiencies in culturally competent care, the global graying of the population, geriatric syndromes, the astronomical cost of health care, and so much more. These issues make nurses, now more than ever, vital collaborators in health care delivery and reform, because in our jobs we become intimately aware of these things.
Of course, I didn't know I would have to deal with these challenges when I went to nursing school. I was barely 16-years old when I was accepted into the program. All I wanted was a college degree, and it didn't matter which one. Looking back after almost 25 years of nursing, I can say with great confidence and pride that sticking with nursing was the best decision I have ever made.
Men and women join the nursing profession for a variety of reasons. As a faculty member, I have the privilege of hearing students articulate the reasons why they choose to become a nurse. What is the underlying theme in their testimonies? They are committed to healing the sick and bringing compassion to the bedside and beyond. Generally speaking, nurses are not in it for the money.
When President Obama rallied the legislature to reform United States health care, he sought the advice of nurses. In his remarks on July 15, 2009, he said, "I know how important nurses are, and the nation does too. Nurses aren't in health care to get rich. Last I checked, they're in it to care for all of us, from the time they bring a new life into this world to the moment they ease the pain of those who pass from it. If it weren't for nurses, many Americans in underserved and rural areas would have no access to health care at all."1 In many ways, nurses are patients first and last line of defense.
As a nursing faculty member, I have the unique honor and obligation of ushering young and still malleable minds to become professional healers and agents of change in their profession. I explain to them that meeting the challenges of nursing is similar to peeling an onion. As graduates assume whatever life-saving careers they choose, they will assume responsibilities and meet challenges, peeling that onion until they are down where the tears are. But I don't mean tears of despair and helplessness, even if their first job is not exactly how they imagined it to be. I am thinking of tears of satisfaction firmly rooted in compassion. These are the quiet, deeply felt tears that I sometimes shed because I am glad I have nursed someone.
So, nurse, what are you in it for?