Nursing

This week I had the privilege of talking about Ebola virus disease (EVD) and my experiences in Sierra Leone with a bioethics class at Pacific Lutheran University. The students had covered ethical issues around EVD the previous week and some of them had read my blog. I presented a (relatively) brief PowerPoint and then had a question & answer session. Although I had been reluctant to talk publicly about some of the things I saw in the Ebola Treatment Unit, it did not seem to me that any of the students were uncomfortable with what I told them.

A number of the students asked questions about the welfare of the survivors after they had been discharged. I knew that there is a survivor program in Sierra Leone that helps people reintegrate into their communities but, since I spent nearly all of my time in the country working inside the ETU, I couldn't tell them much about the program.

I was very pleased that a couple of students asked about long-term health care goals for Sierra Leone; what is needed to prevent an epidemic like this from happening again? What happens when the aid workers leave? What sustainable health infrastructure will we leave behind?

I was particularly grateful for this opportunity because many of the people in the class are nursing students. I used the opportunity to ask the students to consider working in developing countries and was pleased that a couple of them seemed interested, even staying after class to discuss it with me.

When I speak to young people, as I will again in a few weeks, I encourage them to consider a career in health care and in nursing in particular. The nursing shortage in the U.S. is worsening. As baby boomers reach retirement age, our population is becoming older and there are more people with chronic conditions who require medical care. Nurses are getting older too. Over the last four decades, the age distribution of nurses in the U.S. has shifted to the right. More of us are older and approaching retirement age.



Age distribution of Registered Nurses in the U.S.
Health Resources and Services Administration, 2010

To satisfy the demand for nurses in the U.S., English-speaking nurses are aggressively recruited from countries with their own shortages of health care providers.

I decided to become a nurse after spending 10 months hitchhiking in Africa. I fell in love with the continent and its people and wanted a career that would allow me opportunities to return to Africa and work toward improving the health and living standards of Africans. Ultimately, I would like to teach nurses in Africa; something I was able to do in Tanzania and, to a lesser degree, in Sierra Leone last year.

Algeria, 1988

Nursing has provided me with endless opportunities for learning and a high degree of mobility. I've held licensure in four different states and two African counties. I've worked in acute care, critical care, and currently work in public health. I began my nursing career working neurology/neurosurgery and have held neuroscience nursing certification since 1995 (it will expire the end of this year). Over the years I've had countless nurses tell me, "I hate neuro!" I can understand the sentiment; neurological insults are devastating and leave people with life-altering deficits, but I loved working neuro. Caring for patients with neurological deficits can be challenging, but the goal is helping people achieve their highest level of functioning.

I spent most of my bedside career working in critical care and enjoyed caring for the most complicated patients I could find. I worked in units where we saw neurotrauma and multisystem trauma; people who had gunshot wounds, had fallen, or been in motor vehicle accidents. Critical care can be a highly stressful environment but, for me, it was exciting! (For what it's worth, I found working in emergency departments to be boring.)

I've also enjoyed my volunteer work, not just in Africa, but also in this country. I volunteered with a mobile medical clinic in the Lower 9^th Ward of New Orleans and St. Bernard Parish after Hurricane Katrina. I've volunteered in shelters and clinics in which most of the clients we saw were homeless. I loved listening to people tell their stories. I still volunteer at a clinic here in Tacoma.

There are, of course, a lot of negative aspects to nursing. It can be physically and emotionally demanding. Working in hospitals usually means having to work weekends. I spent too many years working nightshift. Taking care of sick people can be a dirty job. I've had to clean up almost every fluid and excrement that the human body produces.

Then there's the abuse; abuse from patients, abuse from patients' families, abuse from doctors, and, worst of all, abuse from other nurses (horizontal hostility or lateral violence). Health care providers are at high risk for being assaulted in the work place. I've been punched, slapped, kicked, bitten, spit on, and called every name in the book. Fortunately, I've never been seriously injured. Some of my colleagues weren't so lucky.

Nevertheless, I love being a nurse. It's a profession that allows me to put my Christian values of service and social justice into practice. Since graduating from nursing school in 1992, I've never had to worry about being unemployed. I enjoyed being at the bedside, but I'm very happy to be in public health now. I sometimes miss patient care, but volunteering allows me to do that.

It's definitely not for everyone but, if you're looking for a very rewarding career, please consider nursing.

 

My PowerPoint presentation:

 

Ebola virus disease: Ethical issues

Highline Community College
Associate Degree in Nursing
Class of 1992

Reference:

U.S. Department of Health and Human Services Health Resources and Services Administration. (2010). Findings from the 2008 National Sample Survey of Registered Nurses. http://bhpr.hrsa.gov/healthworkforce/rnsurveys/rnsurveyfinal.pdf.