I was so confused after my first few days of work. I waited for months and flew across the world but there was a big problem. I didn’t like it. I just wanted to shout “just kidding!” and erase the past few months. Could I go back home, back to nursing in Rochester, and forget about all the adjusting I had done thus far? No, it’s not so simple?
My Nursing Identity
I am a nurse and that’s what I came to do. I know I’m good at it, and I feel passionate about it but those first shifts on the ward completely threw me. My entire identity as a nurse was tied to the way I learned to nurse in New York, the way my alma mater taught me to nurse and the way all my coworkers nurse. B Ward was not that way.
Let me tell you what it was like to nurse at Rochester General Hospital. I’ve cried over a patient because I couldn’t get him his pain medicine on time and I knew he really needed it. My tears literally fell in his hair as I stood behind him. I’ve felt accomplishment after a shift so crazy I never thought I’d make it out alive. I’ve proudly told new acquaintances that I’m a nurse and seen the way they admired my hard work. I’ve worked Christmas shifts with dying patients and shared gifts and cards together. I’ve felt the wheels in my brain smoking and I put critical pieces of information together and decide which nursing intervention needs to come first.
I missed that. I can picture busy, burned out nurses from across the country slapping me across the face for looking back and desiring what I had. We hated how busy we had to be in order to keep our heads over water. Our patients had a rainbow range of needs, and most of it wasn’t pretty. That pace left no time for a romanticized view of this vocation. And yet, I still loved it. It made me want to die and I cried the duration of my commute home more than once. But I was so proud of the work I got to do, the lives I got to touch and the compassion I still mustered up.
I missed communicating effortlessly with my patients. I missed the way I could assess their emotional needs and whether we would have a connection from our first interaction. I missed the way those annoying call bells reminded me I was needed.
On this ship, I work on B Ward, the home to plastic surgery, orthopedic surgery and Women’s Health. Compare this to my work in Rochester and it’s night and day.
Nursing on a Hospital Ship
Each patient has a mom or an auntie or a papa that must stay with them throughout their stay. These dedicated care givers do the majority of the child’s care. They comfort, they wipe and clean, they force feed nasty pain killers down throats.
Each ward has up to 4 crew members hired from Madagascar who help us translate (although not professional translators like I’m used to). They are also responsible for helping with linen changes, serving meals and convincing little mouths to open for Tylenol.
Then I show up. I’m a white-skinned girl from New York who can’t speak the language and has never worked with kids. Between the caregivers and the Malagasy day crew, what was there left for me to do? I felt useless. My workload had gone from 10 to 1 and this was not making me feel like a nurse. I felt like a highly trained giver of multi-vitamins. The spare time on the ward morphed from refreshing to imprisoning. There is no break room, no nursing station to escape to; no distractions from across the unit; no computers and no private rooms. You are in the ward with the patients the whole time with their faces staring up at you.
Evolving and Growing
I had to start the redefinition process of what nursing means to me to survive emotionally here. It starts as a perspective shift and evolves from there. I found that every aspect of nursing opposite from home had a silver lining. Those silver linings are what make nursing on the Africa Mercy so beautiful and enriching.
That extra time I hated? It’s a great time to play with the patients and be creative with new ways of overcoming language barriers. A few new words in their language will make a world of difference and they are ready and happy to be our teachers. The slower pace gives you the opportunity to give holistic care and compensate for the extra time it takes to actually understand what the problem going through a mama and a translator is. The lack of private rooms contributes to a beautiful village experience over the course of several weeks. You see patients with similar deformities notice they are not alone anymore. You see more experienced mamas explain to new admissions how different things work. It’s beautiful.
There were redeeming moments in those first few weeks that I held onto while I tried not to buy an early ticket home. It was a very gradual process, but my confusion settled. My calling to be a nurse and my motivation to do it well never changed. In fact, the ‘art of nursing’ was exactly the same on a ship in Madagascar as it was at home.
When I’m busy, but a patient has a complaint that makes no sense, I’m drawn to stop and listen, really listen, to figure out what they need.
When a patient is overwhelmed with emotion at a poor prognosis, I feel that squeeze on my heart that says, “This is not ok. This is not how it’s supposed to be.”
When a patient makes a comment revealing a misunderstanding, I don’t hesitate to give her knowledge that she deserves as the one living inside her own body.
That is the art of nursing, and it doesn’t matter where or who or how or when it’s done. Compassion and knowledge-sharing are deep within the DNA of nursing. I’m so grateful to carry that legacy anywhere I go.