Books

Four takes on nurses and paramedics

For some time now, I’ve been health proxy for my elderly parents. This has been an exhausting, complex, and sometimes grievous role. But these years of hospitals and decisions have lent moments of grace, too — and so many came from nurses. How grateful I’ve felt for the perfectly stuck IV needle, the explanation of “word salad” after a stroke, the sheet-as-litter hoists of my mother’s frail body, all that knowledge and vigilance transfigured into indispensable care.

I’m with Florence Nightingale. She believed nursing was “the finest of Fine Arts” and that a nurse shows as much devotion as the greatest painter or sculptor: “[F]or what is the having to do with dead canvas or dead marble, compared with . . . the living body, the temple of God’s spirit?”

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A visual-artist-turned-nurse-artist, aptly, quoted Nightingale in the excellent anthology “I Wasn’t Strong Like This When I Started Out: True Stories of Becoming a Nurse” (In Fact, 2013), edited by Lee Gutkind. It’s got 21 essays, and my favorites included one by a pediatric nurse aboard a Mercy Ships vessel; hers docked in Togo to tend the poorest of the poor. “I wanted to work at the end of the line,” writes Jennifer Binger. “I wanted my life to matter.” Others recall nursing school, an unforgettable HIV patient, and what it’s like to be a hospice nurse, “the midwife to the next life.”

You can’t cover nursing books without including Suzanne Gordon, one of the preeminent chroniclers of the profession. And so to “Nursing Against the Odds: How Health Care Cost Cutting, Media Stereotypes, and Medical Hubris Undermine Nurses and Patient Care” (Cornell University, 2005). As more baby boomers retire, “[a]ging patients beset with chronic illnesses are filling hospital beds, and there aren’t enough nurses to take care of them,” writes Gordon. This has been true for me, anecdotally, but to be more precise; as of 2012, nursing ranked fifth on the US list of professions projected to have job openings.

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Gordon also takes on media condescension (nurses are more often portrayed as practitioners of TLC than medical rigorousness) and the often-fraught doctor-nurse dynamic. In medical school, for instance, doctors are coached about interacting with patients but not nurses. And among umpteen quandaries, nurses must walk the fine line of when to call an off-duty doctor. “If you wake them up in the middle of the night and it’s not in the ballpark of what they want to be woken up about, they can be very abusive,” says one nurse.


Gordon also lays out the fascinating history of nursing, with the Catholic priest Vincent de Paul who, in 1617, first codified the connection between religion and health by establishing the order Daughters of Charity. Later came the European Protestant response, wherein laywomen became caregivers known as deaconesses (from the Greek “diakonia,” or those who serve.) Thus the origins of New England Deaconess Hospital, now Beth Israel Deaconess Medical Center.

Hospital settings are slow; first responders are fast (“diesel therapy” as EMTs call the speeding ambulance ride) and I’ve known both these in recent years. Kevin Grange’s fine, candid memoir “Lights & Sirens: The Education of a Paramedic” (Berkley, 2015) taught me that the jump from EMT to paramedic is like “transitioning from high school baseball to playing in the majors.” In many states, for instance, EMTs can’t “break the skin” (i.e. set up IV lines or do a tracheotomy). Grange is forthright about his rookie mistakes while training at UCLA: He’s so focused on stabilizing one injured person, he doesn’t notice there’s a second, for example. He longs to be the quintessential paramedic, like a taskmaster named Eddie Higgins: “[H]e possessed the critical thinking skills of an ER doctor, the compassion of a nurse, the leadership skills of a great coach, and a police officer’s expertise in scene management.”

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To pay for college and a PhD program, Joseph F. Clark worked as an EMT in New York City. “My Ambulance Education: Life & Death on the Streets of the City” (Firefly, 2009) is awfully good and plenty raw; a burn victim’s ragged breathing sounds like “freshly poured cola,” and some day’s run sheets are “a shopping list of grief,” full of gunshot victims, heart-attack sufferers, and suicides. One scene, in which the author crawls into a wrecked car to treat and calm the man trapped inside, thoroughly gripped me.

I was touched to learn that, when it’s all too much, Clark recharges by visiting the maternity ward to look at the babies — life’s beginning, rather than it’s terrible disruptions and ends. He also bestows serious gallows humor, a poetic sensibility, and a helpful glossary: AOB is “alcohol on breath,” and LOL is “little old lady.” I didn’t know whether to LOL or cry about that last one. But I know that many EMTs, nurses, and others in the caring professions will pull shifts this Friday, while we celebrate Christmas. So I celebrate them right now, right here.

Katharine Whittemore is a freelance writer based in Northampton. She can be reached at katharine.whittemore@comcast.net
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