Experiencing nursing from both sides

louise-walsh-jewish-home-for-the-agingFor Louise Walsh, Director of Nursing at the Los Angeles Jewish Home for the Aging in Reseda, Calif., nursing has always been at the center of her life. For this mother of two daughters, the ethical, moral and legal responsibilities of the profession have been foremost on her mind since her first job as a long-term care facility nursing assistant in 1974. Earning her RN degree in 1980, Walsh embarked on a life filled with the joys and sorrows that come with caring for the ill. She has worked in oncology units and spent nine years in the ICU at Northridge Hospital in Northridge, Calif., dealing with matters of life and death on a daily basis.

Yet it took a near-death experience for Walsh to gain a full appreciation of the true nature of her calling. In 1998, she was diagnosed with polycystic liver disease, and found herself wearing the same beeper she had seen on patients in the ICU. Her experiences as a patient and the treatment she received post-op allowed her to see nursing “from the other side of the bed rail,” as she puts it. “That gave me a greater sensitivity toward anybody who’s in a vulnerable health condition.” In a voice tinged with emotion, she recalls one particular night in 1999. “They were transporting a patient who had just suffered brain death to the operating room to procure the organs.” At that moment, the enormity of the situation hit home, and she remembers “going off to a private place and crying my eyes out.”

Doctors had difficulty finding a suitable liver for Walsh, and she ended up hospitalized at the University of California, Los Angeles, where she waited three excruciating weeks until an eleventh-hour transplant was arranged. It was during her post-operational convalescence that Walsh really got a taste of how patients view their own healthcare. Simple things, which she admits she herself did as a nurse, became aggravations as she lay in recovery. “One thing that really made me furious was the way hospital employees would walk by, pop their head in my room and toss old gloves or empty coffee cups into my trash can. I still get pissed when I think about it…my whole world had shrunk to that little cubicle, and I felt like that was my trash can! To this day, I respect the patients’ space.”

Other transgressions were more serious. She recalls the intense pain she felt when having a drain removed, and the dread she felt when the time came to remove another one. The bedside manner of the doctor and nurse left her cold. “They basically ignored me, talking about his weekend and other trivial stuff,” recalling that even as she cried in pain, they never once looked at her or asked if there was anything they could do to make her more comfortable. “I had fallen into that mindset where ‘you have to be a good patient,’ so I didn’t say anything. It was extremely impersonal and rude. I thought about how many times I had been in a patient’s room involved in personal chatter—so that experience really brought that home to me.”

It has been more than eight years since the transplant, and other than having to closely monitor her immune system, there is little outward sign of what Walsh went through. Today she is more physically active than ever, an avid hiker and jogger who participates in long-distance runs. Like all good teachers, she is able to synthesize her own life lessons into her work. “I’ve shared these personal examples as a staff developer, during training sessions,” she explains with a smile. “It really seems to raise the level of interest. I guess no matter how long you’ve been involved in this kind of work, you can never, ever overestimate the importance of compassion.”

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David Blumenkrantz

David Blumenkrantz’s professional experience includes an eight-year stint doing documentary work and freelancing in Africa, where he traveled extensively covering a wide variety of relief and development-related social issues. He ran a photography training course for Eritrean freedom fighters in Asmara, and spent more than two years running an information department for the Undugu Society of Kenya, an organization dedicated to improving the quality of life for street children and the urban poor. Upon his return to the United States in 1994, Blumenkrantz worked for the Los Angeles Times and various other publications as a freelance photojournalist. In 2004 he joined the journalism department faculty at California State University, Northridge, where he teaches documentary journalism and photojournalism.

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7 Responses to Experiencing nursing from both sides

  1. That trash can bit really affected me. What a HUGE point to make that oftentimes caregivers do not realize. Something as simple as this could be a rather large insult to a patient. Great advice for medical staff to read.

  2. I really enjoyed this article and it is something that caregivers often forget about. Nurses can tell all the stories in the world about being in the caregiving role but nobody really knows how the patients feel until you are a patient yourself. She has a great and although very sad, a very real perspective. Although I never hope on anyone to have to be a patient themselves, it seems as though she was able to gain insight that helped her in her own work that is invaluable.

  3. The only unfortunate part about this is that for nearly everyone, we do not really pay attention to the plight of others in life-altering or potentially life-ending situations until we find ourselves in the same proverbial boat. Early compassion and empathy for all.

    Great article — and thank goodness Louise Walsh seems to be doing well, and doing well for others.

  4. It’s sad that it took her becoming a patient to see how badly clinicians treat patients sometimes. I think hcps often become so jaded that they don’t care about their patients … they just care if they follow MD orders, don’t mess up & don’t kill the pt. “Early compassion and empathy for all” should be our mantra! Do we want our patients to have had a miserable experience because of our crappy care? If we don’t care, we should quit – & make room for new nurses who are eager to become great nurses.

  5. Vicki H

    What a great article and one that I have waited for at least 20 years. As a nurse of 25 years and a patient with a chronic illness for more than 40 years it was validating though sad to hear that someone else has seen what I have seen. I have had chronic kidney problems since I was a child and have had ESRD for 22+ years with 2 failed renal transplants and back on dialysis again for the past 3 years. I, too, have seen a lack of compassion and caring as to my comfort during many procedures performed by doctors and nurses. Recently I started giving presentations to any physician or nurse organization that will have me on my past experiences and the improved outcomes that can be achieved when patient and physician compromise together on a workable plan of care. Thank you Louise Walsh and David Blumenkrantz for this article!

  6. Shelly

    A little advice from my nursing instructor from many years ago: treat every patient like they are a member of your immediate family.

  7. sbf56a

    Back in 1990 i was 35 years old. and just had my 1 year anniversary at the hospital where i worked as a L.P.N. i had some unexplained bruising for some time did not think much about it. this one night working the 3-11 shift on a med-surg telemetry floor. for the past couple days had a nagging headache that would not let up no matter what i took. that evening i was walking to the cafeteria for dinner break and i was so short of breath walking there.but with rest got better while i ate. also noticed a small red pinpoint non raised rash on my arms and legs. but thought to myself will see my primary doctor the next day. at 22:30 while charting my whole left arm went limp on me and my left side of my moth started drooping. thought i was having a stroke. turned to the charge nurse who quickly had staff gather my purse put me in a wheelchair and taken to the e.r. they rushed me to a bed. in the exam room my headache was throbbing more and nausea set in and vomited. they took blood and my hemoglobin was 5.0 and platelets 5,000. typed and crossed for PRBC’S.asked which hematologist, infectious dx, neurologist i wanted. was sent for a ct brain. about 3 a.m. moved to neuro icu room. at 7 a.m. hematologist came in ordered a bone marrow bx. which came back TTP. started on plasmaphoresis treatments every day and high doses of predisone. she told me i almost died. well that got my attention and my family as well as my co-workers. i was in the hospital for a total of 3 weeks. this was the first times except 1 elective surgery in 1983 that i was on the other side of the bed rail. it is very humbling. the staff really took good care of me. alot of them i had worked with one time or another. you really get a sense what being a patient and being vunerable and scared is all about. at times when i was bored i was making my own bed bathing myself at the sink collecting my own trash because i wanted to help them out. and being a nurse it was just routine for me. posting my intake and output on the door. i did not want to bother the staff is i did not have too. my time then and since for different surgeries being a patient for the most part have been good and received good care from the hospital system where i was a employee. ( as a foot note the least invasive treatments did not help getting over the TTP. had a spleenectomy several months later which was successful my platelets run in the 300,000 to 400,000.) but as my doctor told me it lies dorment in your system and can come back. have to be mineful if i start to have unexplained bruising and pinpoint red places on my skin again to seek medical go the doctor. oddly enough many years later on the a med-surg floor i took care of a woman about my age who got TTP again 15 years after she delt with it and had had a spleenectomy. so all they could do at the time was put her back on steroids and getting plasmaphersis again. never found out how she made out only had her one night due to working in the hospital float pool. to this day that hemotologist did not know how i got it. and used my case as a case study at a conference of other doctors. so that is my journey as a person on the other side of the rails.