Make a Difference Wherever You Are

I am a nurse, and I make a difference.  I don’t make a difference in the traditional sense of nurse-the comfort and fluffing and hand-holding.  It has been about 5 years since I have found myself out of the safety of bedside nursing & caring for patients who often confronted a potentially fatal cardiac illness but were recovering.  Today I serve the less desirable patient-the addict, the prisoner, the mentally ill.
Working at a prison was never on my radar.  I had the option in nursing school to do a rotation there, but I was scared.  I was scared of the K-9 units whose handler snarls, “Move over there and don’t look at the dog” as one navigates the cavernous halls, scared of the criminals, the pedophiles and murderers whose faces you might see on the evening news, and scared of being “locked in” which caused panic attacks during my psychiatric nursing rotation.  I was anxious about being on locked units, and even more about not being able to get out of it.  Psych nursing and correctional nursing were on my never to do list.
                But God sometimes has other plans.  Having spent the majority of my nursing career in critical care and obstetrics, I suddenly found myself exhausted as a nurse.  I was empty.  Needing to find a new focus that would hopefully breathe life into my vocation, I chose to take a position in a drug and alcohol rehab.  I was horrified upon learning that this specialty was considered psychiatric nursing and considered tendering my resignation.  Unfortunately, I thoroughly enjoyed this new adventure.  I watched how our patients would get physically well, even if their mental health and maladaptive behaviors continued.  Each behavior was a puzzle, a barrier to be overcome.
                I worked at the rehab for several years until my position was restructured. When that happened, I went even deeper into the marginalized community of drug and alcohol treatment and took a position at a methadone clinic.  Here the focus was not actually on abstinence but instead on harm prevention-to minimize the criminal aspect and the risk of diseases like HIV, hepatitis or sexually transmitted infections.  I admit, I was uncomfortable with it.  Patients often took benzodiazepines to obtain a “high,” that euphoric state that all addicts chase.  Patients overdosed in the parking lot.  They fought.  There was a security threat when a patient, released from the program for noncompliance, angrily said he would be back the next day with a gun.  Some patients chose not to bath.  Many lived at hotels or in their vans.  Often the patients would lie when it would be just as simple to tell the truth.  For many years, sometimes even now, their lifestyle was about getting what they needed, by any means necessary.  Changing so much of one’s identity can be a difficult, slow process.
                Fast forward several years, I was returning to the medical unit at the prison after seeing a new commitment who had been brought in by police after being treated at the hospital for injuries sustained in a drunk driving accident.  I waited at the door for the security officer to unlock the it so that I could enter our unit.  Eight men sat in the waiting room to be seen for sick call requests. I began to get anxious, knowing I only had a specific time frame to see each of the prior to the med pass.  Impatiently I buzzed the officer again to gain access to my unit. Finally the door was unlocked and I stepped across the threshold of the door, while hearing 3 male voices, in unison, greeting me, “Hi, Nurse Jaime!”  I was taken aback as I had only been working at the prison for a couple months and I had been cautious about giving my name to inmates.  When I looked their way, I was met by 3 wide cheesy grins of inmates in blue scrubs.  It took me a moment, that out of place, on the tip of my tongue kind of moment until recognized them as patients from the methadone clinic.  I stopped to say hello and jokingly asked why they hadn't listened to me when I told them to stay out of trouble.  They all laughed sheepishly as one by one they told me how I was their favorite nurse.  The older man, a man in his 60s with a gruff exterior who has been an addict for most of his life, and who had a reputation of being not only noncompliant but aggressive, laughed like a little boy.  The younger man, in his early 20’s who has a history of Crohn’s disease which he used to justify his addiction, looked just as happy.  The last gentleman, a man in his late 20s who was involved in a fatal crash, looked like he might hug me.  I stepped back to enforce a distance margin, but I did not step back from their hearts.
                One by one, these convicted men, these felons, these addicts, told me that I had made a difference.  I admit, I was puzzled and offered the lame excuse of just being a nurse and doing what nurses do.  The older man stopped me.  He stated, “You treat us like human beings.  No matter how pathetic we were or what we had done, you greeted us.  You called us gentleman.  You were pleasant.  You respected us.”
                Even typing this story, tears begin to fill my eyes.  These are men-men who made mistakes, men who are caught in the cycle of a chronic, progressive and often fatal disease called addiction.  I never treated them with great favor, but I also never looked down on them.  And that made a difference for them.
               Months later I was walking through the medical department and that same gruff older gentleman was sitting there having returned to jail.  He looked sad and shut down but, in my peripheral vision, I caught him watching my movements.  He was waiting to see if I still remembered him.  I called out to him, just a hello, and his face lit up.  Another time as I entered a housing block to attend to a patient who was having a panic attack, I glanced around the block at the guys lined up for haircuts and I recognized one.  I greeted him with a hello also and he lit up, waving. One evening I was on the women's housing block to complete physical assessments and a young woman practically skipped up to me.  "So this is where you went!" she exclaimed.  I was a friendly face that she recognized from treatment.  We chatted for only for a few moments, but she was pleased that I remembered her.  That she was memorable.

                When I studied nursing, I learned many procedures and protocols.  My competence of practice has been a source of pride over the years, but the ability to make a difference for these men and women humbles me.  I don’t remember learning this in school, but it has been imprinted on my heart: all patients deserve respect.  I practice nursing according to that, even in prison, the place where individuals are can be seen as disposable, worthless, and a waste of tax payer money.  And I am grateful to make a difference.


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