Fifty years-a half-century (1957-2007)!! It is hard to imagine where those years went!!
Each April, I attend the Abington Memorial Hospital Dixon School of Nursing Alumni luncheon. The honored classes are those that graduated 25 and 50 years ago. Suddenly, this is my turn in the 50-year class!! Unbelievable!! The wonderful aspect of my nursing career is that after 3 years as a nurse in the hospital's emergency ward, I chose to become a visiting nurse and have been associated with home health and hospice care for the past 47 years.
The Early Years
One of the many lessons I learned from my mother was to save almost everything!! That is one reason why I now have many "memory books" filled with letters from patients, families, and staff as well as clippings of what I consider important milestones in my career. My first 50 years as a professional nurse have been wonderful. I share a few of the many experiences and memories that inspired me during my 47 years as a community/home health/hospice nurse, supervisor, administrator, and volunteer.
* For the first 12 years, I was a staff nurse. Many times, there were small children in the homes where I provided care to patients of all ages. Two of my favorite memories are the hand-drawn cards I received from the children I met in the patient's home. Both children drew their impressions of a nurse on the front of their notes. One child included my maiden name on her drawing (Figure 1). The other child addressed me as "nerssi." More than 40 year later, I remember the homes and the circumstances associated with both of these children. It was my hope that the children's early experiences with a nurse would influence their choice of a career. Through periodic contact with one of these families, I know that one of the children is a registered nurse.
* One of my first patients in 1961 was a baby boy born with Down's syndrome and numerous medical conditions. He and his family faced many challenges during the 40 years they kept in touch with me (Harris, 1995). Sometime ago, I received a picture of "Bob" at his 40th birthday party.
Letters to a Young Nurse
On many occasions, family members took the time to write personal thank-you notes to me or my supervisor. Fortunately, my supervisor gave me the originals or copies of these letters, which I included in my "memory books." The following excerpts are from 3 letters:
* "There is no possible way that I can express my appreciation for what you did for my mother, the happiness I know you brought her each visit. The care I could not give her and numerous little things she got to look forward to from you" (1961).
* "During my mother's last distressing months, Miss Dickert (author's maiden name) was a source of great comfort and kind understanding and brought a noticeable joy to her at a time when there was little joy to be had. The effect of her calm efficiency and her cheerful manner should, I believe, be commended, and that is the purpose of this little note" (1963).
* "Mother wanted me to send you a note that her irises are at the nicest right now and if you'd like to see them she would be happy for you to stop if you happened to be in the neighborhood" (1967). I did stop and see the irises!!
One reason I share these personal letters from my years as a staff nurse is to note that patients and families did not dwell on my professional skills as a nurse. Competent nursing care was, and is, an expectation!! Comments referenced the personal and caring aspects of the care process that were, and continue to be, vitally important in home health nursing.
These sample letters are not unique. Patients and families continued to share the same sentiments-that home health nurses exhibit care while caring-from 1977 to 1999, when I served as the executive director of Abington Memorial Hospital Home Care and Hospice. Thank-you letters that I received reflected that the nurses who provided professional services in the home cared about the patients and their families in addition to providing skilled care to the patient. Letters of commendation that I received for staff were posted on a "Thank You" board in the office. The letters were shared with the nurses, and copies were included in their personnel files. I encouraged every nurse (and encourage readers) to begin or continue to fill memory books so that in the future, you can reflect and be reminded of the important role you had in the lives of many individuals.
Unexpected Fringe Benefit
One of the challenges I met early in my career was where to eat lunch. This noontime oasis had to include good food at a reasonable price, a clean rest room, and a quiet environment, preferably with a booth where I could eat lunch before continuing my home visits.
In the 1960s, I provided care for the sick, made health promotion visits to mothers and newborns, staffed well baby clinics at community sites, and did camp nursing for several hours each day during summer months. Many of my responsibilities were concentrated in Hatboro, Pennsylvania. This small borough of 7,500 residents was founded in 1715. In 1777, General George Washington and his army passed through Hatboro as they pursued the British. The Revolutionary War Battle of Crooked Billet of May 1, 1778 was fought nearby. The town folks made hats during the war.
There was a small restaurant in this town where I usually ate my lunch. Many of the local residents and employees in the town met for lunch. By 1 or 1:30 PM, many of the diners had eaten and I could occupy a booth. This was my lunchtime oasis.
Some months after I started to eat at the restaurant, one of the men, Charlie, who was a salesman with one of the local businesses, introduced himself and asked if he could join me. On a periodic basis, he and one of his friends joined me for lunch. One evening, after about a year of lunchtime conversations, I had a telephone call from Charlie to invite me to dinner. When questioned, he told me I had mentioned the town where I lived during a conversation. He called the telephone operator and was given my listed number. Although I would not discuss my personal life while at lunch, I did accept the dinner invitation. We married in 1969, and Charlie's friend who sometimes joined us for lunch served as his best man. We celebrated our 38th anniversary in February 2007.
In the early 1970s, we bought a home in Hatboro, eventually retired, and continue to live in the small town where we had met. The restaurant where we had met did not fare as well and no longer exists. It was sold several years ago, torn down, and replaced with a used-car lot.
The Administrative Years
My 22 years as an administrator of a certified and accredited home health agency with a hospice program provided me with the opportunity and privilege to
* be innovative and creative in planning and implementing new programs, for example, animal-assisted therapy (Harris & Levicoff, 2003), a nurse-managed health center (Harris, 1999), and a congregational/parish nurse program (Abbott, 2001)
* share ideas and opinions through publications and presentations in professional and lay settings
* participate in legislative and regulatory processes that made it possible for good things to happen for patients, nurses, and nursing at the state and national levels, for example, the enactment of legislation in Pennsylvania that authorizes nurses to pronounce death under certain circumstances (Harris, 1992)
* help shape the future of healthcare through participation on national, state, and local boards and committees
* surround myself with excellent role models and seek advice through networking with other professionals
* build on nursing's rich legacy from early nursing leaders at the national, state, and agency levels (Harris, 2005)
* serve as a mentor to students and staff
* view current healthcare systems as challenges
* enjoy personal and professional achievements
* choose to be involved, to be part of the action and solution
* develop international friendships with professional colleagues (Harris, 1997)
* be inspired by patients and families of all ages
* fill "memory books" with letters, notes, and pictures from patients, families, and staff
* write the Medicare and the Nurse column for Home Healthcare Nurse (HHN) for 12 years, from 1987 to 1999
* be associated with HHN since 1984 when my first article was published in the journal.
Current Opportunities
During the past 50 years, I have experienced personal and professional satisfaction as well as the lifetime honor of membership in a rewarding and respected profession. I continue to have the opportunity to serve as a volunteer on an inpatient hospice unit, as a congregational care nurse for my faith community, and as a board member with the southeastern Pennsylvania chapter of the Health Ministries Association and other health-related organizations.
Summary
In the 20th-anniversary issue of Home Healthcare Nurse (Harris, 2002), I shared my thoughts about Myers' (1930) article, "On the Advantages of Getting Into a Rut." N. Pauline Myers was a Perry County Public Health Nurse in Hazard, Kentucky. She shared the following thoughts in an article published in The Public Health Nurse:
When I was a very young nurse, the first tenet of my professional creed was "thou shalt not get into a rut." New places, new patients, new duties, and new routines were, I thought, essential to me. I felt that I needed the stimulation of strangeness to keep my enthusiasm to the pitch where I could do my best work. (p. 320)
Ms. Myers (1930) closed her article with the following insight:
Grown older and wiser, I see in my own smooth rut unimagined beauties [horizontal ellipsis]. So I say to each nurse in this work, make yourself a rut and stick to it. You'll find you are always having to extend the rut, that every day brings something of new interest, some tragedy, some joy that you must touch. You will find that eventually your rut will widen out and smooth down until you are traveling a long and golden highway straight into the hearts of your people. (p. 321)
Home health and hospice nurses from their earliest history, as portrayed in this issue by Karen Buehler-Wilkerson and also by Garey & Hott (1988), have traveled a long and golden highway straight into the hearts of their patients and families. Each of us, employed or retired, have many opportunities to extend the rut and continue to smooth the way for the many nurses who will follow us in the 21st century.
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