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INTRODUCTION
I believe that when a person becomes a nurse, they sign on for life. It doesn’t seem to matter for how long, or in what branch of nursing one works; there is a certain quality—a spirit, a depth of soul—which is unique to the nurse.
At the risk of causing the elite of nursing’s professional societies and academia to clench and grind their teeth, I also believe nursing is a calling, in that nurses possess an abundance of compassion—the wisdom born of the heart. Indeed, one of the basic rewards of nursing is the fulfillment which comes from the knowledge that one has made a positive, often profound, difference in another’s life.
Nursing is most certainly a world unto itself. Nurses are the nitty-gritty of “hands-on” people. Those who choose this profession are not the type who shrink from adversity; they are as frontline as frontline gets. Let’s face it—people don’t go through all those years of education and specialized training if they faint at the sight of blood, shrink from death, suffering, disease, overbearing doctors, and go squeamish at the thought of being smeared with various bodily fluids and solids.
What nurses witness and get involved with on a daily basis—death, birth, extreme despair, suffering, life-altering trauma, extreme joy, rage, disease—are phenomena most “normal” people experience only a few times during an entire lifetime. In the course of their typical workday, nurses deal with most—sometimes all—of those events.
The idea for this book came to me early one morning as I sat listening to a group of nurses swap “nurse stories.” These were the kind of true medical tales which enthralled nonmedical personnel (“normal” people) and kept them riveted to their seats. I had written two books about my own experiences in nursing—why not broaden the brush and add more colors to the palette? I would invite nurses from every branch of nursing to share themselves and their stories—allow normal people in behind the closed doors and let them walk around in the nurses’ shoes for a chapter or two.
Thinking in terms of This is gonna be a piece of cake! I took out ads in national nursing journals, newspaper classifieds, and the Web. So absolutely sure was I that I would receive an overwhelming response, I envisioned my local post office calling me to say that I needed a four-wheel-drive truck to pick up the hundreds of sacks of letters. I’d already decided to organize them by state and then by branch of nursing. Too, I calculated, it would probably require a full week just to download all the E-mail, let alone read and print it out.
Excuse me while I clear my throat and choke.
After three months, I had received a total of sixteen responses, not including those from my nurse friends whom I’d harangued on a daily basis. Eleven of the sixteen replies were from nurses claiming to be writing the same book. Of the remaining five, one upbraided me for “exploiting” the profession, one was from a physician wanting to know if he could get in on the act, two were legitimate, and one was from someone clearly not from anywhere on this planet or even California.
Time for new tactics. I sent copies of my ad to various nurse acquaintances asking them to post them in the nurses’ lounges of every unit, ward, and medical floor of every hospital, clinic, and nursing registry in their area. Soon it was reported to me that within twenty minutes to twenty-four hours of posting, the ad would be taken down by management, and the warning issued that any nurse who replied to “that ad” would be suspended.
Because I had a difficult time believing this, I personally took “that ad” around to my local hospitals. Surely something so benign as wanting to interview nurses about their experiences couldn’t be seen as a threat to management.
Again, give me a moment while I cough up a hair ball of naïveté.
The routine went something like this: I’d present myself to the director of nurses or one of the nurse managers, and as soon as they understood who I was and what I was trying to do, they would, one, start shaking their heads while they showed me the way out of the building; two (my favorite), tell me they did not want “their” nurses involved in any project which involved nurses discussing nursing, because it was “unethical” and in conflict with the interests of the administration and nursing in general; or three, laugh in my face and tell me to get real, get moving, and get lost before they called security. God forbid the spotlight of recognition should fall on nursing.
After a brief lapse into hopelessness, I pressed on only slightly daunted; I was a nurse on a mission, after all. I decided on the direct approach—armed with a phone and 103 phone numbers of “mover and shaker” nurses from Maine to Hawaii, Alaska to Key West, I began making calls. Once I had a nurse on the line (yes, it was rather like fishing), I would introduce myself, explain what I was trying to accomplish, and beg for interviews.
All were initially wary, a few hung up on me right off the bat, most listened politely until I was done, then employed the “Just Say No” method of refusal. After the first twenty-five calls and subsequent refusals, I got up the courage to start asking, “Why not?”
The most frequently given answer was: “I’m afraid.” Or: “I can’t afford to lose my job, and if the administration ever found out I spoke to you, I’d be fired immediately.”
I walked on my hands and did somersaults at that point to assure each nurse of complete confidentiality. I promised I wasn’t part of the CIA or a Neo-Nazi Nurse group trying to trap them into giving away secrets. Hell, they didn’t have to breathe a word about their views on nursing politics and healthcare—I wanted to know why they became nurses in the first place and have them talk from the heart about their daily world.
But still, the threat of being fired or having some stigma placed on them by management was strong enough to keep most nurses silent. In this volume there are stories from several who made me promise that I would not use their names anywhere in the book. To inject a note of amusement here: One nurse even insisted on having her interview in an out-of-the-way parking lot, then arrived by taxi disguised in a wig and sunglasses. So terrified was she of being seen by someone from hospital management that I had to interview her in the back of the cab as we drove from one end of Chicago to the other.
By the time all was said and done, I had spoken directly to or corresponded with approximately four hundred nurses from every state in the union about being interviewed for this book. Of that number, I was granted approximately one hundred interviews. And of those one hundred interviews, less than half were willing to follow through and allow their stories to be published.
At first I was shocked and dismayed by the fear I heard and saw, even though I understood where it came from. Other times, I was so frustrated by it that I wanted to divorce the whole profession. But every time I conducted an interview or transcribed a tape, I came away with the same feelings about nurses that I have held for them from the beginning—respect, awe, and love for this family of extraordinary human beings.
Nurses are incredible people working in an incredible profession. Theirs is the face of human compassion. They have all saved lives and eased the fears and suffering of their fellow women and men. There is not one who can ever be correctly referred to as “just a nurse.” Nurses are a far cry from the stereotypical images the media have been pushing on the American public since the profession began—the intellectually challenged, subservient inferior of the physician, or the oversexed slut in whites looking for a doctor to marry, or the pill-pushing, bedpan-wielding grunt, or the masculine, overweight, muscle-bound army nurse who wields her syringe like an M-14.
In this book alone, one of the contributors teaches ballet on the side, another is an attorney, another leads vision quests and teaches rock climbing, several have multiple master’s degrees and doctorates, several are paramedics, one is a professional comedienne, another a professional seamstress. There’s a weekend race car driver, a weekend blues singer, a substitute violinist for a professional orchestra, a professional pilot, a publisher, an award-winning artist, a cartoonist, an inventor of medical equipment, a carpenter, a farmer, a diving instructor—and on and on.
Today nurses everywhere are angry, frustrated, and horrified by what the insurance companies and the hospital corporations are doing in the name of greed to their profession and to their patients. I could fill the pages with statistics and facts that would chill the average reader (and potential patient) to the bone and fill the average nurse with even more rage and helplessness than she or he feels already. But I did not want this book to be about politics. Rather, I want it to be used as admission into the nurse’s world, to allow the reader to experience firsthand the soul of nurses as they go on about their business of caring.
In the following chapters you will hear the true voices of American healthcare. Compassionate healers and proven heroes—these are the nurses. Come, take a walk in their shoes.
—ECHO HERON
SAN FRANCISCO, MAY 1997
