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When
You’re 94 by Thomas Weaver
You
won’t find anyone — dean, professor, or student — in UVM’s
Rowell Building who doesn’t have direct experience with the nursing
shortage, ideas for addressing it, or anticipation of what it might mean
for the career ahead. It is the issue of the hour, shaping the research
and teaching, and driving a number of new initiatives at the university’s
College of Nursing and Health Sciences. Selling
a Profession There
is some good reason for that. Though nursing has largely shed the misperceptions
sown by cheap-laugh sitcom caricatures, inaccurate images still exist.
Lost on many — the intellectual challenge of the field, the range
of job opportunities, the reality that many nurses make good salaries
and love their jobs, and the truth that men can be nurses, too. Yet, on
the positive side of the perception coin, nursing annually ranks as one
of America’s most trusted professions. Dean
Betty Rambur admits that her early impression of nurses, even as she started
to consider nursing as a career, fit into a tidy couplet — “they
wore white and worked nights.” Rambur has worn white in her 24-year
career, but these days she is more likely to be in a stylish business
suit working long days as she oversees the schools of Nursing and Allied
Health, consolidated into one college this summer. She leads a school
that has in the past several years added a major scholarship program to
address Vermont’s nursing shortage and notched near 75 percent increases
in both applications and enrollments. More
nurses entering the field at UVM is good news, of course. But Rambur and
her faculty colleagues approach their work as educators with the knowledge
that more nursing graduates will mean little if they aren’t prepared
for the rigors of a tough job at a tough time. “One
of our challenges is to prepare graduates to work in complex, fast-paced
environments,” Rambur says. “At the same time, nurses must retain
the closeness to patients and compassion that’s really at the heart
of healing.” Field
Lessons Microphone
in hand, Scollins stands before a semi-circle of clients, leading a word
game designed to stimulate both fun and memory. The participants range
from Dubie, a one-time New York Times foreign correspondent who suggests
“Aphrodite” for a girl’s name beginning with the letter
A, to those who miss turns because they are sound asleep. Scollins’
innate patience and caring are at work as she interacts with Matt, who
is anxious he will miss his ride home and mentions his concern repeatedly.
Finally, Matt stands and announces, “I’ve got to catch a train
going north.” Scollins is quickly at the man’s side, rubbing
his back, encouraging him to stay, assuring him his ride will be here
after lunch. And
Matt does settle back into the game, timidly offering scraps of memory
from his life in northern California as he searches for words. A city
beginning with S. “Is
San Francisco too far away?” A city
beginning with E. “Have
you heard of Eureka? My uncle built the hotel there… this is wonderful…
it makes me remember all of the things…” It
would be a shame having Anne Scollins serve people in need of little more
than a tall latte. But working in a Philadelphia coffee shop paid the
bills after Scollins graduated from Haverford College with a degree in
social work she wasn’t sure how best to use. When her father, Dr.
Michael Scollins, a UVM professor of pharmacology, underwent quadruple
bypass surgery in 1997, Anne got a glimpse of the power of nursing. “When
my dad was sick, I saw just how incredible the nurses working with him
were,” she says. “They were the faces we recognized. The nurses
would breeze in and they were just so comfortable and comforting. I really
think that affected me, though I didn’t realize it at the time.” Scollins’ parents are both physicians (her mother, Dr. Mary Scollins, is a clinical assistant professor in neurology at UVM) and she initially thought they might urge her to try medical school instead. “My parents really supported my decision to go back to school for nursing. They realized my tendency is to want to be with people. I want to be right in there.” Handling
Lives in Crises The
challenge for nursing faculty is to develop students’ ability to
maintain the spirit of compassion in the face of stressful situations
and an ever-evolving array of machinery and procedures. “I
tell the students that, yes, you need to be able to control the machinery
so it can do what you want it to do,” Whitney says. “But let’s
look at the patient, see what response the patient is having, and never
lose sight of the fact that these are human beings whose lives are in
crisis.” Associate
Professor Jeanine Carr worked as a hospital nurse through the nursing
shortage of the late 1980s and knows the difficulties. “It’s
frustrating when you just can’t give the level of care that you want
to give,” she says. “You come home at night thinking about all
of the things you weren’t able to do because you were just too busy.” Carr
says that before stepping into the demands of such a setting the most
important skill a new nurse must acquire is “to have a questioning,
inquisitive way about you — not just going with the flow, but always
questioning what is going on with the patient.” Even
a stressed nurse is going to have significant time working closely with
patients. “Bathing, helping someone go to the bathroom, nurses are
involved in very intimate ways with patients that can open up space for
a conversation about a concern a patient might not otherwise talk about,”
Carr says. Real
Worlds Collide In
light of that, it’s significant to note that a growing number of
UVM nursing undergraduates (about one-quarter of last year’s sophomore
class) are non-traditional-age students, card-carrying members of the
real world. They bring the advantages of diverse life experience and maturity
to their UVM study. They also often carry the responsibilities of families,
jobs, and mortgages, along with the weight of those textbooks in their
backpacks. Christina
Remillard, UVM junior, is among the “non-trads.” She’s
taken the long way through college with years off for her three children,
ages 7, 5, and 2. In her mid-twenties, Remillard is focused on graduation
in another year and the seller’s market that is the bright side of
any professional shortage. A good job, often a solid salary, and the attraction
of a helping profession is what draws many non-traditional students to
nursing these days. As
she takes a break from her clinical rotation in Fletcher Allen’s
post-operative ward, Remillard exudes a calm energy, a fast engine idling.
When she wraps up her hospital shift and coursework in Burlington for
the afternoon, she’ll go home to a husband and three kids in St.
Albans, a Brownie-Girl Scout meeting (she’s the troop leader), and
three papers due the next day. What’s more, she and her husband are
about to take on a co-parenting role with a terminally ill three-year-old. As
Remillard spins out the story of her life and her day, it’s clear
that she’s been through a lot and is unafraid to take on more, an
attribute that should serve her well professionally. She sees parallels
between the challenges of parenting and nursing, including the need to
think fast and be adaptable to new situations. “When
you have kids you just learn as you go,” she says. Asked what area
of nursing she hopes to pursue, Remillard doesn’t pause. “I
want pediatrics.” Burnout
Proofing Jeanine
Carr suggests self-advocacy is essential to a nurse’s well-being
and fending off the occupational hazard of burnout. “Traditionally,
nurses have not spoken up much,” she says. “We try to help students
learn assertiveness skills, so they can effect positive change for themselves,
for their patients, and for the work environment.” Self-care —
mental, emotional, and physical — are essential, Carr adds. To take
care of sick people, a nurse must be well. Stuart
Whitney agrees, and he knows the stresses both as faculty member and as
a practicing nurse working per diem in the post-operative ward at Fletcher
Allen. He sees realities and rewards and aims to give students an accurate
picture of their future careers. “When people concentrate too much on the negative side of nursing, they do get burned out because they’re not recharging themselves,” Whitney says. “If I deal with a combative patient all day long, I can go, ‘God, what am I doing?’ But if one patient comes up and says, ‘Thank you,’ all that bad stuff that I just dealt with is erased. I realize this is why I’m here. I did make a difference.” |
As
America’s median age tracks ever upward, there’s another line
we should be concerned with on the Great Graph of Being and it’s
down-bound. It’s the measure of the percentage of nurses available
to fill the myriad roles demanded in the field today. Those two lines
— our advancing age and nursing’s thinning numbers — are
on a collision course. When they meet, you or I just might be lying in
a hospital bed pressing a red button to summon an over-stretched nurse.
Both
need for and evidence of compassion are on vivid display at Project Independence,
a Middlebury-based adult day care for the elderly. A month before graduation,
UVM nursing student Anne Scollins spends the better part of two days a
week here as she completes the sixth clinical rotation of her undergraduate
experience. 
Perhaps
more than any other undergraduate major, nursing presents challenges that
run counter to the suggestion that college is not “the real world.”
Often, these students juggle trials of both the real and the college kind
— for instance, the death of a patient in the morning and a biochemistry
mid-term in the afternoon.