Guest post by Jennifer Payan RN, BSN, CCRN
When many of us decided to become nurses, we viewed ourselves using our hard-earned skills within the walls of our workplace. We envisioned inserting IVs and foleys, changing dressings, hanging IV medications, and diligently educating at the bedside. What we did not foresee was the “off the clock” time we would be tending to friends, family, and even strangers who are perfectly comfortable seeking our advice about their hemorrhoids or showing us their child’s strange rash that even a dermatologist would have to Google. It is amazing the trust and confidence that the initials “R.N.” give to those around you. For me, being “your friendly neighborhood nurse” has been both a blessing and a curse.
The downside of neighborhood nursing has been two-fold for me. For example, sometimes a lunch conversation with a friend takes a gruesome turn and becomes about her latest bout with the stomach flu – in detail. Although I have been known to down an entire Lean Cuisine outside my patient’s room while they are vomiting up something bloody that has a lower GI smell, I’d rather not discuss the disgusting during my leisurely lunch date. Another time, one of my older in-laws wanted to show me the earwax ball that had fallen out of her ear when she pulled out her hearing aid. She wanted to know if it looked “normal”. Truth be told, I think I’d choose a patient’s bloody barf over having to view a nasty ball of earwax in a pudding dish.
The second down side is the assumption that as a nurse, I know it all. There is the belief that I know, in depth, the treatment for the rarest of bleeding disorders that their Uncle Erwin has or whether Grammy may have a bad interaction if she takes ginkgo biloba and digoxin together. I’m a critical care nurse, not the Surgeon General! However, of all these perplexing questions, my nemesis remains the elusive “rash”. I believe my text in nursing school had about 2 pages dedicated to skin disorders, so I have no idea what I’m looking at. I’ve been shown rashes on babies’ butts and teenagers’ armpits. Mere acquaintances have revealed red bumps and patches to me on areas that require the unbuttoning of their pants. “Whoa!” I say, closing my eyes and turning away, “save that for someone who requires a co-pay!”
While I’ve been shown every laceration (“do you think it needs stitches?”) and angry bruise (“should we go in for an Xray?”), I do have to admit neighborhood nursing does bring its share of satisfaction. This is where the “blessing” part has come in. First of all, I feel very privileged to have the trust and respect of so many around me. I’ve bandaged up knees for the kids and applied steri-strips when needed. I’ve given injections of fertility medications to friends and neighbors and looked in their fussy babies’ ears with my otoscope. Just having someone give an educated opinion that may save them a 6 hour trip to the ER or who is able to stop some bleeding without dry heaving means a lot to people.
One morning, I was awakened at 2 am by a call from a frantic neighbor whose toddler had woken up with croup. She was terrified as I ran over with my stethoscope to assess him. We wrapped him up and took him outside into the cold air where he started breathing a bit easier. I helped her load him up in the car and she was able to calmly take him to the ER with the windows down and his stridor under control. There was also a time when I was dropping my daughter off at a friend’s house where I was met at the door by a pale and shaking dad with the phone in his ear with a 911 operator. “Help! Jen, Mason isn’t breathing!” I saw the young boy, blue, in his mother’s shaking arms and quickly grabbed him, put him on the floor, opened his airway and which allowed him to take a few gasping breaths. I found his pulse and started reassuring them that he was breathing on his own and appeared to have had a seizure. I heard his relieved father say to the 911 operator “There’s a nurse here now and she says he is OK.”
A few weeks after helping Mason, his family came by and gave me a necklace with an angel pendent. They couldn’t thank me enough for being such calm and reassuring presence when they felt so helpless, even though I felt I hadn’t really done much. So while my neighborhood nursing interventions may not compare to the high tech skills I have to use in critical care they fulfill my deepest love of my profession – giving comfort. I realize that while I love nursing at the bedside, my biggest impact as a nurse may just be hanging out in the cul-de-sac with my family and friends. Neighborhood nursing isn’t too bad of a gig after all.