Thursday, August 11, 2011

The Annals of Nursing- Junior Year Specialties Winter 1971-Maternal -Child Health

Maternal-Child Health is what I remember the school called it. It was our winter semester. And in that eight weeks, I never saw one child born. Students were many. Pregnant mothers few, for Hanover was a village and the Upper Valley was rural. Each student had been assigned to follow a "clinic mother". We met her at doctor's appointments and followed her progress.Had mine had her baby at the hospital,I would have been there to see it.

My clinic mother was a hippie, or as close to one as one could be in Hanover. She had different ideas about having her baby. She wanted home birth, and she wanted me to be there. "Do not even think about going if she calls you", my instructor warned. And my clinic mother did call me, and I did not go. I heard later that a local GP had gone out into the snow and delivered the baby.

I remember little of the rest of that semester other than distaste, and a terrible boredom. What I thought, could be more mind-numbing than post-partum? And it was during this time that my view on doctors began to change as well.

I was with a woman in labor and was stroking her hair, when an anesthesiologist snarled at me. "I am sure that's nice," he said, "Get out of my way". It has been 40 years, and I still hear it clearly.

A hospital is an Autocracy, not a Democracy, and the Doctor, always and ever, is the Autocrat. I hate autocrats. I hate the second class citizenship of nurses.( I have seen much to resent over 40 years.) And now with the misery of Maternal-Child Health over, I headed into my Operating Room Rotation. I was to spend time boxed in in a small room with medicine's Ultimate Autocrat- the Surgeon.

Ironic then ,that the surgeon I remember best was a civilized and gracious man. I would not see many like him in the future. His name was James Watson, and he was a thoracic surgeon. He was not young, nor was his scrub nurse of decades, a woman named Sue. I would see them at breakfast in the hospital cafeteria morning after morning. I am sure after all the years she had spent with him that she was as close as his wife, probably closer. She knew him inside and out. I was in his OR one morning when Dr Watson gently snapped at Sue. She had handed him the wrong instrument. She took it back from him. He turned away. And when he turned back, she handed it to him again. "That's better', Dr Watson said. Sue looked over at me and winked.

"You would be a natural in the OR", my instructor would say to me. She was gung-ho. A cheerleader. A procurer. She was wrong. I was not a natural for any specialty I saw in my junior year.

And now, bear with me, for I need to expand for a moment on the subject of surgeons. I remember the old joke I heard years ago at the VA hospital:

"Medical doctors know everything, but can't do anything. Surgeons do everything, but don't know anything. Pathologists know everything and do everything, but too late". Witty. And I remember a night at a big city hospital 1200 miles from Hanover. One of the surgical residents came to our ICU to look at a patient who was bleeding post cardiac surgery, She called the attending surgeon, who was not pleased. "Ah", the resident said to me, "The ABC's of Doctor ---. Accuse, blame, and criticize".

Add to this list the free-floating rage of a frustrated surgeon. It looks for a place to land. Scalpels fly. Aortas are ripped, scrub nurses are cut in the leg, or beneath the eye. A surgeon picks up an oxygen monitor and threatens to hit an ICU nurse over the head with it. A surgeon berates a nurse as a god-damned idiot for following another doctor's order for sedating the surgeon's patient. Everything is always someone else's fault. Even when friable tissue too fragile to have been sutured rips apart, it is the nurses' fault. They let the patient's blood pressure get too high. They-.

But enough. I feel I have made my point. Are all surgeons like this? No. But too many are.

I have no time now to take you with me to my Psychiatric Nursing Semester.
I will come back to it. For it was a milestone- the last specialty before the summer. The last time we would be juniors.

Our future was on the other side of August.

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