Nurse’s Day 2017

Today is May 6th, the beginning of Nurses Week in North America which ends on May 12th, the birthday of Florence Nightingale, and, since 1974, is celebrated as International Nurses Day.

1963 Prize giving @ Royal Surrey County Hospital, Guildford

Though I will not be buying any Hallmark cards for my nursing chums, I am thinking of my comrades and sisters who are my fellow nurses. Those friends we made, bonded in student years with the sharing of patients as we changed ward rotations; the remembrance of patients who were dear, beloved, or cantankerous, those we recall as much by attitude and character as by disease, those births celebrated and deaths honored. Then there were the working years before reentry to university bringing new adult companions, both student and teacher. Now, in this final quarter of life, I have found a sisterhood of nurse writers and poets. Some still work at the bedside of, or in the clinics with, patients – others teach, and all of us remain nurses within our communities and families. We write of the past, distant and immediate, bringing disease and care into the present.

Nurse Poets reading in Charleston 2016, Veneta Mason, Cortney Davis, Muriel Murch and Jeanne Bryner

 

We are lucky to have found each other and are grateful for the collectors among us: Cortney, Judy and now Jeanne who gather up our words, harvest them to reseed the bare virgin soil of tender young hearts. We write from different geographies of the Americans and the world. Jeannie Bryner from Ohio, Cortney Davis from Connecticut, Venenta Masson from Washington DC, Judy Schaefer from Pensilvania, Madeleine Mysko from Maryland, Patsy Harman from West Virginia.

Before I left California, I took from my bookcase the written work of my nursing friends. It is an impressive display of non-academic writing from professional women and men, and grows each year.

Within my bookcase

In 2018 Kent State University will publish another anthology of nurse writing, ‘This Blessed Field.’ Within this anthology are stories from young nurses, our stories, sharing our innocence with the new nurses of today helping to guide and comfort those following in our footsteps with the light we shine for them.

Each year on May 12th a church service is held in Westminster Abbey in London and at St. Margaret’s Church at East Willow in Hampshire. Wikipedia tells me that during the service, a symbolic lamp is taken from the Nurses’ Chapel in the Abbey and handed from one nurse to another, thence to the Dean, who places it on the High Altar to signifies the passing of knowledge from one nurse to another.
I will be in London that day and will go to the Abbey.

Norfolk bound

Thanks to Nikki Morris, director of Norfolk’s Big C Cancer Charity, The Bell Lap and I are heading to Norfolk this week. It will be wonderful to be speaking to nurses, carers and other health care providers in the afternoon and then reading and in discussion at Kett’s books in the evening.

Events
2016

Muriel Murch High Res 4

Muriel Murch photo by Beatrice Murch

Muriel Murch, Author of The Bell Lap
Wednesday 7 September 5:00 pm

 

 

All of us age and change – and we all watch while those we care about go through their own life changes.

Muriel Murch’s new book The Bell Lap (Taylor and Francis) shares human stories of caring and being cared for that will ring true for all of us – and the bigger medical issues such as living longer vs ending well are timely debate for those in the medical profession.

Tickets £3, refundable against the purchase of any book.

Kett’s Books is delighted to be donating profits from the sale of this book to the Big C, Norfolk’s Cancer Charity.

BELL LAP

The Bell Lap Stories for Compassionate Nursing Care

Glasgow Bound

Beatrice presenting her book at the Feria del Libro in Buenos Aires

Beatrice presenting her book at the Feria del Libro in Buenos Aires

Taking a night train tonight from London to Glasgow. A new adventure for The Bell Lap and I as we go to the Royal College of Nursing Congress and Exhibition 2016Wisepress is featuring The Bell Lap at 11.20 am through noon on Tuesday June 21 (stand number A9). I have no idea what to expect – a big convention hall and masses and masses of people wandering about. Hopefully some folks will have tired feet and want to sit down and listen to a story or two. Thinking of Beatrice when she presented her book on the A-line subway in Buenos Aires in 2014.

From Wards to Words and Back Again

It was 1995 when Between the Heartbeats Poetry and Prose for Nurses was first published by the University of Iowa State Press. Conceived and edited by Cortney Davis and Judy Schaefer, this was the first Anthology of Creative Writing by Nurses, gathered from around the world.

Heartbeats at Chapters Bookstore DC

Between the Heartbeats writers at Chapters Book Store, Washington DC, 1995

 For many nurses it was the first time our medical writing had been accepted for publication. That summer as many of us who could, maybe twenty out of fifty contributors, came to Chapters Book Store in Washington DC for our first ever reading. This coincided – not unintentionally – with the annual general convention of the American Nurses Association. The evening was exciting, scary and thrilling. Scary because we were reading our own work and thrilling because we were hearing the words and work of other nurses. All of us facing the same direction, our voices so different and yet so deeply in tune with each another. There was an audience, listening, applauding and asking questions. One man spoke up, “Wow, this is amazing. Can’t wait for when you present this to the ANA”. We were all silent before Cortney, in her calmest most diplomatic way, (her speciality) replied, “Actually we won’t be at the convention. They don’t want us and won’t let us present the book there.” Among the audience were nurses who would be at the convention. We were all stunned, silenced and sobered that those nurses for whom we wrote did not deem our words necessary or supportive of their work.

As nurse writers we came together for that weekend forming a tight union of sorts, loosely knit, tendrils of thought, vision, each of us seeing and transforming through words, our patients in the wards, clinics and communities we serve. Since those early years we have continued to write, sending each other our books, reviewing and commenting for each other, hosting nurses writers on the radio and spoke of our work to audiences wherever we could.

Coming together was always a chancy affair but we get our moments. Two years ago The Medical University of North Carolina held its first “Narrative Bridge Conference”. Five of us, Jeanne Bryner, Cortney Davis, Veneta Masson, Judy Schaefer and myself, made it there for the long weekend;. We were billed as “The Nurse Poets” and that is what we have become. Through the years more books of poetry, prose, creative non-fiction and novels have been written and published and within the ‘about the author’ description the word “Nurse” always leads. This is who we are, this is where we speak from, whenever and wherever we can.

It was Lisa Kerr from the MUSC school of nursing who again called us together this year. Lisa wrote asking if we could come, not only to speak to the faculty and students of the nursing school but that there could be an opportunity to perform as The Nurse Poets in the annual Piccolo Spoleto Arts Festival at the Dock Street Theatre. New books had been published, among them, Jeanne Bryner’s poetry Smoke, Cortney Davis’ When the Nurse Becomes a Patient, which won an American Journal of Nursing Book Award for 2015 and my 2016 The Bell Lap Stories for Compassionate Nursing Care were all hot off the press and we were eager to share our work. I was ending a roll-out with The Bell Lap, coming down from New York and a launch at the National Arts Club with the great cartoonist, and tonight – host – Roz Chast whose book about the final years of her parent’s lives Can’t we Talk about Something More Pleasant, remains a best seller.

A little help with the night before prep.

A little help with the night before prep.

It was – is – fun to be on the other side of the microphone. This was a first for Roz who is more used to being questioned about her work, and almost a first for me, being more used to asking those questions. With her questions and comments, memories surprised me and in the quickness of the moment words did not always take the long route – through my brain – as they rushed from my heart to my mouth. Maybe it was not the smartest thing to recall ‘my first leg,’ after Roz’s question about my failed operating room experiences. And so we learn. Beloved friends were there and I was more than grateful to see nurses in the audience, plus a doctor or two. Paul Gross and Dianne Guernsey who co-edit Pulse Magazine “Voices from the Heart of Medicine” came in on the train, Cousin Tom rode the bus from Cap Cod and nurse colleague Gerry Colburn traveled in from New Hampshire.

Tony and Peter and MAM

A Hug from Tony and Peter After it is all over.

It was a great evening and gave me the needed boost and courage to fly down to Charleston and join the band – not yet a rock band – The Nurse Poets.

Four of us had made it and it was grand to be together. Jeanne had driven for two days from Ohio. Cortney flew from Connecticut, Veneta from Washington DC and I from London, via New York. At breakfast we celebrated with coffee and grits. We quickly shared our stories, families, the agonies of book promotions and knowing as all women of a certain age do, that we will continue to balance these lives until illness, infirmity or death claim us.

At noon, under Lisa’s guidance, we spoke at MUSC nursing school for more faculty than students but how eager they all were, how they knew the importance of story, the lives led before and beyond the illness of the patient. Then an afternoon break before being driven past the Emanuel Church where flowers are still laid out daily in remembrance of last years tragedy to an early supper of fine southern food. (Where oh where do I get the real recipe for Green Fried Tomatoes?)

Then we walked to the Dock Street Theater where the audience was already gathering for our evening performance. The theatre is nestled in a small courtyard, intimate and perfect for poetry readings. The seats filled quickly and chairs were added along-side the cloisters until there was standing room only. We sat, warm but not hot, under the evening sky. Our time was tight, and so were we. Introductions by Barbara, the organizer of the festival. then Lisa, organizer of us and then, following each other in alphabetical order, we were on. Each of us brought our full-to-overflowing hearts to the mics and poured out our words. Jeanne watching family, Cortney and Veneta their clinics, and I from the wards and communities before returning to nursing school with an excerpt from The Bell Lap.

Veneta Masson, Cortney Davis, Muriel Murch, Jeanne Bryner

Veneta Masson, Cortney Davis, Muriel Murch, Jeanne Bryner

The audience rose to applaud these words that came from our hearts and our memories. Why did they love us so? We were good 🙂 yes but was it just the words, or was it the knowledge that with these words they know we have seen them, as people before patients. We have marked and held them in our hearts and returned them to themselves, thus received and healed, if not cured. Giving this audience an understanding that as these words have come from the wards to them they may also return to the new young nurses of today.

Jeanne, Miriam from L.A., Venetta and Muriel

Jeanne, Miriam (The next generation), Veneta and Muriel enjoy the reception for The Nurse Poets.

Permission to Touch: ¿Permiso?

We laugh when AARP first shows up in our mail box on our fiftieth birthday. But over the years we come to read more articles until devouring the magazine from cover to cover. This April’s bulletin issue features Jessica Migala’s article High-Tech Ways to Stay Healthy which looks at the new world of medical app options for both patients and doctors.

In Stuck in the Past: Why are Doctors still using the Stethoscope and Manila Folder? Michael R. Splinter, Executive Chairman, Applied Materials, Inc., asks ‘Why Physicians haven’t adopted more modern Technology?’ He suggests that physicians should get rid of the Stethoscope and the Manila Folder. But I would ask him, along with Medscape Editor, Dr. Eric Topol and others, in the interest of good physicianship, for want of a better word, to hold steady and reconsider, first the sturdy stethoscope with all its uses and then, memory.

Mike Newall’s 2007 film Love in the Time of Cholera opens in the year 1880. Early in the film, Fermine Urbino, having rejected her suitor Florentino Ariza, suddenly, mysteriously falls sick. Her anguished father calls for the young doctor, Juvenal Urbino, who hurries to the bedside of his friend’s daughter. A lady’s maid hovers nervously in the background. Approaching the bed Dr. Urbino takes in Fermine’s glistening, feverish forehead. His hand reaches down to check her pulse. Then, bending low over the bed, and in haste for a rapid diagnosis (and screen drama), rips open Ferimine’s bodice to reveal her breasts, which rise, quivering under such an assault. Putting his ear close to her heart he leans low to hear its rapid, beating pulse while struggling to contain his emotions. But we all know what is going on and – because the film is a little slow and predictable, and most viewers have read the book – what will happen.

We may miss these dramatic bodice ripping moments but it is an undeniable fact that the invention of the stethoscope in the early 1800s made diagnosis of certain illnesses better, and faster.

In 1816, while studying medicine in Paris under Dupuytren and Jean-Nicholas Corvisart-Desmarets, René Laennec began to experiment with ways in which to hear the body better. His first instrument was a plain wooden monaural tube.

This early stethoscope belonged to Laennec (Science Museum, London).

This early stethoscope belonged to Laennec (Science Museum, London).

By 1851 it had evolved to a binaural instrument with flexible tubing. He named his instrument the stethoscope from the Greek words Stethos (chest) and Skopos (examination). Laennecs’ new invention was far more accurate in hearing heart and lung sounds than the old method demonstrated in Love in the Time of Cholera. But it had its detractors. Christopher McManus writes in his Right Hand, Left Hand, that Thomas Watson MD, was known for not only using his new stethoscope but sitting and watching the patient and saying he found the stethoscope ‘more of a hindrance than a help and that although he could not do without it, he did without it as much as he could.’

A young Scottish physician, John Forbes, moved to London in 1840 while his old friend James Clark was the young Queen Victoria’s physician. Queen Victoria loved all things Scottish and was fascinated with modern medicine. So it was not surprising that in 1841 she chose this studious doctor for her family and the Royal Household. Scottish physician or not, Forbes brought with him the new French instrument, the stethoscope.

Not until almost a hundred years later, in the 1940s, did Rappaport and Spraugue design the stethoscope with two sides, one for the respiratory system and the other for the cardiovascular system which remains the basic design used today.

The most basic work horse stethoscope used today.

The most basic work horse stethoscope used today.

What the Stethoscope does now, beyond listening to the regular or irregular trills and lub-dubs of the heart, and searching through the dull silence or fretful peristalsis of the abdomen for the calm gurglings of a bubbling stream, is to permit the physician to bend low, in homage to the body. His other hand may search to feel for a pulse away from the apex beat, ‘the Watson Pulse,’ of the heart’s aortic pounding, catching the dance of the two partnered beats. Maybe his fingers brush the abdomen before he takes courage and palpates the flesh, quadrant by quadrant.

In Argentina it is customary to ask permission, ¿Permiso? before crossing the threshold and entering a home. Today the physician needs an excuse to touch the body and the stethoscope gives that permission and allows the patient to accept this touch. Then he can slip the scope into his pocket and bending closer again percuss the lungs, tapping and listening over and around each lobe that embraces the heart.

As nurses we have permission to touch the patient, and time to be intimate. Washing, turning and tending the body are among our arts. They hold their place as skills alongside checking monitors and charting observations. Touch can comfort and bring safety, relaxation, even healing, and healing can pave the way to curing. Maybe nurses used touch more when we moved from bed to bed in the large open wards of long ago where patients saw and connected with the suffering of one another and were helped by that sharing. In our efforts to incorporate ‘individuality’ and privatization into every aspect of our lives, illness has become shuttered away in lonely single and semi-private rooms, where patients lie secreted and alone.

In Buenos Aires, I have had occasion to see a few physicians over the years I have visited. Nothing big, just mindful checking in and up. The office of Doctor Garavaglia, the General Practitioner, is typical of them all. His big desk faces out from the back wall and the two chairs sitting comfortably in front of it are inviting rather than intimidating. There are two bookcases holding literature as well as medical texts and a screen in the corner to give privacy for undressing and the examination couch if the patient should need it.

In each office, the visits begin with conversation, discussion about our mutual families, for that is but courtesy. Before Doctor Garavaglia asks what brought me to him, what he can do for me, he pulls out a card – no bigger than the old Kardex cards we once used. My name is written on the top, my passport and phone numbers also. And there, in cryptic hand, go a few notes. But then he puts down his pen, and listens as I talk, occasionally nudging me this way or that. For as he listens and watches me, how I talk is as meaningful to him as what I say. I speak of our daughter and he reaches into a drawer, pulls out her card and glances at it. In a moment he has her relevant history in his recall, which he – naturally – shares with me. When, a year later, I return he pulls my card from the same drawer. ‘Ah yes, I remember’ updates are made on the card, then it is put aside. ‘¿Cómo estás? Estas bien, verdad?’ He means it. It is good to see you. And we talk once more.

————————-

You’ve Got Mail

Screen Shot 2015-04-05 at 10.28.40 AM Earlier this year a report came out of Brigham Young University stating that ‘Loneliness and social isolation are just as much a threat to longevity as obesity.’ Republished in Science Daily it was then picked up by The Week on April 3. Thus is university research trickled into public consciousness. This ancient universal truth helps account for the modern obsession that we hold to e-mail, Facebook, Twitter and Instagram. These are all ways of staying connected within a real or virtual community that sometimes feels far way and out of reach.

In the days of long hospital stays, back in the early 1960’s, before rehabilitation centers and convalescent homes were big business, patients stayed in hospital until they were deemed ‘All right to go home.’ The tasks of daily living, such as being able eat, toilet, and digest alone and finally, in the last few days of ambulation, prepare and serve from the drinks trolley through the ward. In those years visiting hours were quite restricted. Patients and families could see each other only as the hospital hours, the family work schedules and public transportation allowed. It was often difficult to be at the bedside of a loved one through the days of a long illness. Cards and letters from the outside were very important.

Like other hospitals up and down the country, the post was delivered twice a day to The Royal Surrey County Hospital. It arrived at the front desk and was handed to the hospital porter on duty. Our head porter was named Frank and each morning Frank took the post and sort it into departments; Patients, Clinics, Matron and finally Nurses. Frank would put the different piles in his bag and, leaving the front desk in the hands of the lady telephone operator, set out on his rounds.

I suspect that this walk-about for Frank was as important to him as Matron’s morning rounds were to her, and, in their way, an essential part of the hospital running smoothly. Everyone looked forward to Frank’s arrival, a signal that maybe ‘you’ve got mail.’ Frank’s cheery face would be welcomed with a reciprocal smile everywhere he went. Frank went from Matron’s office to the Bursar’s, the departments, the nurses’ dining room, and then to each of the wards in turn, bearing cards and letters for the patients. In the wards, Frank would hand the post over to the Ward Sister who, depending on how busy she was, would begin to sort and give them out as soon as she could.

But Frank also had a fatherly interest in us nurses and, once we were no longer students but black-belted, silver-buckled Staff Nurses, he watched the patterns that formed in the letters we received. He seemed to know which letters bore serious intent, what passion was in the strong hand writing on the envelope. We would watch him too when he came to the wards. Sometimes he would pretend not to see us but he noticed weight loss and dark, hungry eyes. After he had handed over the patients’ letters to Sister on Victoria Ward he would look for me. If I was with a patient, he found a reason to wait. If I was by the morning coffee trolley he could come to me.

“Good Morning Frank. How are you today?”
“Well. Thank you Staff.”

My eyes would ask the question and his eyes would twinkle a response as, almost every day, he would pull his right hand slowly from his overall pocket and hand me a square white envelope, covered in airmail stamps. He never left these letters in the dinning room for other nurses to find and tease me with. The Royal Mail was then as fast as our young heart beats.

A Letter from abroad “Thank you Frank.” Did I blush? Maybe so, as I took the envelope from his hand into my deep uniform pocket. It rested patiently, beside scissors and tape, until I found a quiet moment to read alone.

I should have known then it was hopeless. I was supposed to be booking a flight to Malaya to work in the Leprosy Hospital of my friend Bushba’s uncle. Instead I was looking into Flights to North America.

Five months later I joined nurses from all over Ireland, England, Scotland and Scandinavia. We were that generation’s import of cheap labour. The next wave of immigrants from the old world to the new. That was fifty years ago.
This pattern of writing has stood us in good stead. Often we have been apart and whenever that happens we write to each other every day. Over the years The Royal Mail gave way to faxes and eventually to e-mails. There are bundles of letters in old boxes in the barn, files of faxes in trunks in the attic and years of emails stored on computer drives.

This week he flew away again as I stay behind to do what needs to be done. God willing I can join him before summer settles in. But until then we will take time to give and receive each other’s hearts and minds, sharing words together.