Linda Pellico Delivers Keynote Tribute to Florence Nightingale
(Aug 2007)
Florence Nightingale Tribute
By Linda Honan Pellico
5/3/2007
Every generation rediscovers greatness... High school students find their way Shakespeare, educators to Dewey, politicians will find Jefferson and we nurses- well we look to Florence Nightingale.
Celebrated historical leaders continue to reach into future generations and speak to us and we choose what lessons we want to learn from the past so that we can enrich the future. We all come to the table to find something from earlier times that speaks to us in present time...we look for the attribute we either recognize in ourselves or aspire to and we hone in on it, eager to learn lessons from the wise sages. Those attributes that are unfamiliar or unpopular-well we simply scan, ignore or down play them and move on......I think that's human nature, and when discovering Florence so much can speak to us- there seems to be a vast array of personal or professional attributes that call seemingly -just to us- or not... Florence was a visionary, a feminist even before the term existed, a statistician, a researcher, a teacher, an administrator, a writer, an empathic care provider, a maverick, a passionate leader and much, much, more. Tonight, you have all been invited to this table because of your extraordinary ability to emulate some aspects of the first nursing leader born almost 200 years ago.
Think of it, we know Florence from pen and paper, no videotape exists of her, nor film, yes there are a few rare recordings of her voice but we really come to know her from ink and papyrus- that is how she stretches into the future and that is the power of the written word...Now I love words, and I love stories-- and of all the yarns I love most, well they're the ones about nursing. I'd like to spend a few moments drawing a parallel from the past to nursing today....a then and now comparison, sprinkled with some simple stories that tell of our work. I think it is a way to honor both Florence and you remarkable nurses.
What began with Florence creating pie charts at Scutari illustrating seasonal sources of patient mortality in the military field hospital has morphed into nurse researchers like Linda Aiken who demonstrate that short-staffing increases patient mortality. Talented nurse researchers now speckle the globe analyzing practice, education and policy but perhaps more importantly, I think Florence Nightingales legacy is seen in the day to day analysis of nurses who strive to understand best practices- nurses who stand by the bedside for one more minute, asking...what am I seeing....how is she reacting to the chemotherapy, what can I do to help this baby latch on...No, perhaps your story may not find its way into Health Affairs, JAMA or Nursing Research but I would argue that your exploration and inquiry into the patients experience is exactly what Florence had hoped for....research at the bedside- all of us observing, categorizing, examining, reflecting....
Florence was a mystic - one could argue that has morphed into chakras, Reiki, spirituality and holistic nursing. But it's also seen I think in those moments that we feel compelled to walk into room A first? What made us go there...what persuades us to order certain labs?? We are hearing and heeding something, perhaps it is simply that after years of nursing we have developed clinical wisdom and we have not taken the time to make what is implicit, explicit...Perhaps its something more...take my story... I walked into the room; it was the second cubicle from the end, the first thing I noticed were the blue plastic rosary beads tied around the railing. They looked so child like...you know the one's put together with kite string instead of silver chains. Delia was already intubated, on 100% O2 and barely sating at 90%. Her daughter sat in the Geri chair exhausted from maintaining a vigil at her bedside. It was then I noticed the blue plastic Madonna bottle and the smaller container with writing in old Roman style proclaiming Holy water from Knock, the other from Lourdes. Every divine intervention will be called upon- for tonight something will happen... I settle the daughter in a cot outside the Surgical ICU where she can sleep; I tell her I will wake her if anything changes. An hour later-close to 2am, I am back in the Delia's room but something is different, I feel it...it's as if there is a blanket of warmth over her bed....I have walked into something quite spiritual and I cannot ignore it. I quietly say, Delia is standing at the abyss- I will do my part tonight and I will accept all other assistance in helping her heal or not....by the morning, Delia's oxygen need is down by half- just 50% now with a sat in the 90's, she is moving, awake, looking at me with steely bright blue eyes, ...I reach over to her before I leave and put a bit of Loudes on the left side of her forehead, some from Knock on the right and I think to myself something wondrous happened tonight while the world was sleeping.... Perhaps, Florence's mysticism lives on in our understanding that science alone will not heal.
Florence cared for poor and indigent people as do we...200 years later- we have explored solar systems, can see, really see into the human body with remarkable technology but we have not solved the problems of hunger, homelessness or hopelessness...and we nurses are still the front line providers of care. One of my students told me the story of an RN on a maternity ward recently. The RN was busy with numerous laboring women, emergent C sections, nurses and physicians in training and add in the mix, complete novice nursing students. This RN, lets call her Mary, scanned the white board with the list of all patients and staff and asked my student, Suzie if she would mind just sitting with Monique, the patient in room 5 for a little while? "She's all alone right now and I think it would help her to just have someone in there with her." How could Suzie refuse- She stood in front of the door to room #5, knocked ever so gently on the sage green door and entered the room to find a girl on the bed -only her eyes moved in response to the knock.
"I'm just going to sit in here with you for a bit. Let me know if I can do something for you." "Are you having any pain?" Suzie asked. Eyes closed an imperceptible nod. "Suzie offers that sometimes a backrub helps. Would you like to try that?" Another small movement of the head that Suzie interprets as permission to act. As Suzie placed her hands on Monique's back, she noticed how smooth her skin was...as smooth as a child's. That's because of course -Monique is a child, a child of 16 in a delivery room, 5 months pregnant and laboring. A child with dark, bottomless, suffering eyes who is all alone in this sterile room without music or laughter. Suzie notices a tattoo on Monique's back that says Kibou and asks what does its mean? She whispers in a sigh, "Her name is to be Kibou." Monique clenches her hands and begins to breath fast. She begins kicking her feet....fighting the passage of Kibou. Labor lunges into high gear and Suzie even as a novice can feel the change and she runs across the hall for the nurse- the same nurse Mary who has orchestrated care, knowing sometimes good nursing is rationing out when patients will get her services and both return swiftly to room number 5- the room with no balloons, flowers or pink fuzzy slippers. Monique turns her head back and forth on the rumpled, sweaty pillows. Suzie holds the pink plastic basin as Monique silently retches from the empty depths of her belly, and the nurse Mary heads to the bottom of the bed-. "Push. Mary says- Don't fight, go with your body and soon it will all be over. Soon it will all be over." Soft words from the nurse as Monique cries, "I can't...I can't." Push, you can do this...
The sound of rushing waters and a muted thump on the bed. The nurse with a soft blanket scoops up the small form. Monique is now weeping for the loss of her tiny, tiny baby. Mary wraps the baby in a blanket and places a tiny cap on the baby's head. Monique holds out her arms for the tiny form. The nurse gently, lovingly lays the baby onto the mother's chest and simply, profoundly, touches foreheads with her, whispering ever so gently, "I am so sorry. I'm so sorry." Later that night, Suzie looks up the name Kibou and finds its definition is hope...and she weeps for the metaphor lost.
Where but in nursing could one almost daily witness both miracles and curses? I think it's what gives us our own unique culture, sense of humor, our understanding of how fleeting our mortality is and our optimism. We are not simply martyrs or ministering angels, nor masochists. We are nurses who use our intellect, compassion, senses, and power to understand and meet patients' needs. And in nursing, well we are never empty or alone- forwe have each other, this band of brothers and sisters who know what it means "to nurse". All of you are here tonight because you have set a shining example for nurses everywhere of what it is to provide compassion, commitment to patient care. You are the future leaders of nursing and you deal with hope, you deal with Kibou...
Story of Kibou was written by Pennilee Stephens West, first year Graduate entry nursing student at YSN
