Professional Nursing, Battle-Borne

Original story posted on: May 7, 2020

On the news last night, two individuals, one an ICU nurse and the other an ED physician, shared their experiences by way of self-made video. 

“I never thought I’d treat an illness that could turn around and kill me,” the doctor said. (He must have missed freshman orientation.) The nurse recounted a death she was witness to, recalling patients dying alone – except for them, the nurses. They worried about what they might be bringing home to their families.

Yes, I may sound harsh toward the physician. But as a word of encouragement to the nurse, remember your heritage. Modern nursing was born in the context of the battles of the Crimean War, and in the heat of Civil War fighting in northern Virginia. We took an oath at our pinning ceremonies, an oath to selflessness and duty modeled by our mothers. Reading that oath again last night brought tears, expressions of pride, and sobriety at that to which we have committed our lives: our calling. Physicians, take note. Much of modern medicine likewise sprung from the devastation of those same places where professional nurses honed their skills: the South Pacific, Vietnam, and Korea. 

The founders of modern nursing, Florence Nightingale and Clara Barton – the latter not a formally trained nurse – are both examples of true courage, huge intellect, and powerful will. Both women looked at the plight of the poor and the effects of social inequality as public health battles to be fought and won. We now call these the “social determinants of health” (SDoH). To them, both well-born, public health was in crisis mode. Huge societal shifts came from their persistence.

Telemedicine is now a part of ICU practice. A robot is brought into the room, a physical assessment performed, and reports delivered to the physician to inform decision-making: a physical exam performed by a professional nurse. Medications and nutrition are administered by a professional nurse. Comfort to a dying patient and phone was taken into a room so that loved ones can say what needs to be said, are made possible with the care and compassion of a professional nurse.  

My first nursing experience was in 1991, in an ICU where we cared for AIDS patients, most with lungs ravaged by pneumocystis pneumonia. Medicine was limited. We knew so little. PPE was still years away. Old-school ventilators without filters belched out who knows what from their expiratory manifolds. It was the nursing care – the attention to skin integrity, aggressive pulmonary toilet, cleaning of stool and emesis, holding hands, while others recoiled from touching, that brought patients back from God or eased the trail to eternity. 

In our educations, we professional nurses learned that there is no defeat, regardless of the outcome, if we did what we were trained to do and what our callings led us to accomplish. It is in those sacred moments when we bear witness to a patient’s transition from one existence to the next that we are at our finest, as much as when we see someone who should not have lived walk out of the nursing unit: a new lease on life, because of a nurse. Miracles, both. It’s the job others find too hard. Some memories cut like a knife, yet our work is filled with a cherished sense of being in the right place at the right time.

Yes, professional nurses do this and much more. We carry these memories and accomplishments with us until our last day. We never stop being nurses.    

Marvin D Mitchell, RN, BSN, MBA

Marvin D. Mitchell, RN, BSN, MBA, is the director of case management and social work at San Gorgonio Memorial Hospital, east of Los Angeles. Building programs from the ground up has been his passion in every venue where case management is practiced. Mitchell is a member of the RACmonitor editorial board and makes frequent appearances on Monitor Mondays.

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