Our unseen mentors: Nurses don’t just care for patients, they create physicians.
“Behind every great woman... is another great woman.” - Kate Hodges
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It was my first month and I was certain that I had made the biggest mistake of my life. At some point during this unfamiliar journey of becoming a physician, family and friends had convinced me that I would be successful and I was foolish enough to believe them. Only 3 weeks into my residency, working in the Neonatal Intensive Care Unit (NICU) at one of the most renowned public hospitals in the nation, I had demonstrated how ill-equipped I was to achieve that outcome.
One of the reasons the NICU had been so challenging for me was that I had nothing to refer to from medical school. The NICU had its own language, and these patients were nothing like the patients I had encountered in my pediatrics rotation or my sub-internship during medical school. This space was unlike any other; we were caring for living miracles—fragile and tender miracles who seventy years ago would have had little to no chance of being here.
During my first rotation as a newly minted doctor, I learned that this place was different- medicine still prevailed as king but spiritual care was definitely queen. Rosaries, bibles, and evil eye protection bracelets abound with frequent visits from faith-based leaders. Everyone who entered the doors of this unit knew the sacredness of this space and treated it as such. We could take nothing for granted because our patients were too young to fear death and too small to fight for it. I was in constant fear.
On a Wednesday morning in my 3rd week of the rotation, under the dim lighting and the constant beeps of IV machines and ventilators, I finished pre-rounding. It was about 6:30 am and I sat in one of the comfy nursing chairs in the room to prepare for presenting my patients. I tried to memorize everything I could about these babies who had been entrusted in my care. They were the smallest and youngest in the hospital, ranging from 3-5 pounds and 12 hours old to the ripe old age of 2 months.
I was still recovering from the post-traumatic stress disorder that I developed on my first call ever, after the arrival of two of my current patients- 27-week-old twins. I remember that night (or should I say “nightmare”) vividly, standing side by side with my senior resident, each of us caring for our assigned twin. He was masterful while working on his twin and yelling out instructions to support me as I tried to care for mine. To this day, I’ve blacked out the details but remember fumbling through the resuscitation, awkwardly placing intravenous lines, and trying to figure out the right settings of ventilator support. Unbeknownst to anyone, I was silently pleading with God to take over and prevent me from killing this child.
I was so focused on memorizing my patient notes as I sat in that chair, that I never even noticed when one of the nurses came over and bent down, whispering in my ear, “Don’t worry, you’ll be fine.”
She was one of the head nurses and I was terrified of her. That day, she was caring for two of my patients and I had approached her during my pre-rounds to sweetly beg for a time that I could come back to examine the babies. NICU babies needed lots of rest to grow and their nurses were their bodyguards. They were in charge of protecting them from any excess stimulation and were determined to make sure no one would thwart that plan, not even their doctors. She hadn’t looked at me, but mentioned under her breath that she would be feeding the babies in 2 hours, so maybe I could try then. It wasn’t a promise, but I would take it. I scribbled the time on my notepad, thanked her profusely and skitted away.
Unfortunately, my fear of the NICU was all over my face at every moment, despite my attempts to hide my lack of confidence. Apparently, she had seen right through the facade. “I’m sorry, what?” I replied cautiously. She continued, “Don’t let them make you feel that you don’t belong here. You do.” Before I could even respond, she walked away.
I tried to make sense of her words and where they were coming from. I sat and thought about my experience thus far, rejoicing in the fact that I only had 9 days and 2 calls to go, before freedom from this place. After having a mini-celebration in my head, I started to uncover something that I hadn’t paid attention to earlier. There were many times that she and other Black nurses had saved me. Of course, I learned from my attending neonatologist and fellow residents, but the nurses were no less important in my training that month.
They would “suggest” a certain order for the patient that was not placed in the computer.
They would “ask” if I wanted to change the ventilator settings to a certain level, specifying the ideal settings.
They would come to “discuss” a possible plan for new symptoms that had developed in the baby and wanted to know if I agreed. Of course, I did.
I was the doctor on paper but the student in reality. They were the experts.
At that time, I was the only Black resident doctor in my intern class and one out of three Black residents (all of us women) in the entire program of 124 residents. Although I tried to remember I was a person and not a representative of the Black race, it was hard not to have that feeling. Honestly, I felt like I had embarrassed myself, them and the Black race.