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

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.

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