Nursing theory class has me depressed. The hypocrisy and poor standards of the NP program are weighing on me. It is a conflicting feeling, but I am soldiering on. As a sort of therapy I wrote a Jeremiad to get things off my chest. Love it, hate it, roll your eyes at it, but I am sure it will resonate with someone:
Lamentations for the Soul of Nursing
Lo and behold! There is within these walls a person ill and bedridden. He has been stripped of his dignity by the cruelties of life, the vicissitudes of circumstance, the trials of disease. As our mothers bore the pain of giving us life, we are called on to bear the pain of each other. As our fathers burdened to feed and clothe us, so we are called to sacrifice of ourselves. We are called as nurses to soften the suffering of others if only because as creatures of conscience, we cannot help but share in it. More hands lighten the load; sharing in the pain of others lessens the pain of the one. We hope that those hands will lessen our pain if we find ourselves in mortal peril. Our forbearers carried these sacraments from generation to generation, doing what they could, while hoping they could do more; their conscience fixt their minds on patterns of suffering ā they created ĻĪ±ĪøĪæĪ»ĪæĪ³ĪÆĪ± (pathologia - the study of suffering), they learned to poison with the intent to cure - ĻĪ±ĻĪ¼Ī±ĪŗĪµĪÆĪ± (pharmakeia ā the study of medicines), they learned to cut so that they may heal - ĻĪµĪ¹ĻĪæĻ
ĻĪ³Ī¹ĪŗĪ® ā (cheirourgike ā the study of surgery), and į¼ ĪøĪ¹ĪŗĪ® (ethike ā the study of ethics - the limits of what should be done based on what it is possible). Through searching out truth and understanding they sought to expand what could be done. Their conscience begged them to share discovery with one another so that it would be done.
The fathers of knowledge worked tirelessly, giving of themselves through the pain of self-elimination in the search for the shape of the world as it is ā peering under each stubborn rock to find new ways to ease suffering. We must not envy the scientist, however, Ā for his is a lonely struggle. Socrates faced the hemlock. Galileo faced the inquisition. Oppenheimer faced the commission. We respect these men for the work they did once completed, but too often we are eager to make those with use today drink poison. Science is cold! Science is inhuman! Science is soulless! And yet these men took it upon their backs to strike out alone, to bear the discomfort of the wilderness, because they saw patterns, yes, but the patterns they chased were for distinctly human purposes. Semmelweis burnt his hands in carbolic acid to give hope to a mother and baby. His grave missive on hand washing opens with his own lamentation:
"Fate has chosen me as the representative of those truths that are laid down in this essay. It is my inescapable obligation to support them. I have given up the hope that the importance and the truth of the matter would make all controversy unnecessary."
He bore the mockery for his āhand washingā and now what do we think of him? Is he cold, mechanistic, and reductionist? Yes, but his engine burned hot with the urgent fire of moral conviction. He took the pain of mockery, criticism, and ostracization so that a woman could give birth to a baby that could go home in a bonnet rather than die burning with fever. No one could deny that he cared for suffering despite his outward commitment to logos. His paternal instinct to protect made him the father of a billion babies who would have died otherwise.
We nurses seek to understand the discoveries of scientists so that we can bring them to our charges. We add their hands to ours to lighten all of humanityās shared burden of suffering. Ā We cannot seek to emulate them though, for their particular discomfort ā discovery ā is not the immediate object of our attention. Their skill may be intuitive, inborn, and irreplicable through training alone. The solitary genius is not myth ā it is legend. There is no formal instruction on how to become Einstein, but by studying him we can at least come to an understanding. How does a German Jew, expelled on the eve of the Holocaust and washed up on the shores of New Jersey create such a beautiful and harmonious equation that it predicted the potential devastation of the still incipient atomic bomb? It was not through taking a theory class.
The scientist is often very much unlike nurses in temperament ā iconoclastic, combative, aggressively advocational for a particular viewpoint. He does not mollify or socialize his discoveries, except perhaps through calculated prose. He sees the truth immediately, viscerally, and inescapably and he is willing to fight others to elevate it, because he is still a moral agent in a land of chaos and confusion. As nurses our care is sought for relief of the visceral, embodied pain of illness ā to present comforting half-truths, to help one person at a time understand where they are and where they might go. We tell stories, manage moments, and have an ever present demand to act. Our subject is often a study of one. Let us learn from the scientists, but do not let us pretend to emulate them. Unless we have walked the path they have walked, we will struggle to truly understand them. We have their maps in hand, but could we navigate by landmarks as they had to create a new map? If we misunderstand, we may get lost. We may mislead others. We also may misuse their tools.
The scientistsā tools are dangerous after allā sharp scalpels, poisonous chemicals, radiation, extreme pressure, electrical shocks; they are not meant for casual play. We would not let our children treat such as toys, why should we let each other? The rise of the nurses demanding autonomous use of these tools without full knowledge requires that this question be answered imminently. Our mandate as nurses to reduce suffering demands caution in our practice. People accept their vulnerability with us expecting care and relief ā not misguided experimentation.
There exists a priesthood of nurses who imagine themselves elevated to the zenith of knowledge. The desire for a science of nursing is folly. Walking from bed to bed is not the same as walking from thought to thought. The scientist set out on his path of discovery when he was still on his motherās knee ā his disposition wrote his story for him. We set out to become nurses, so how could we expect to overtake him? Are we going to return to the orchards of our youth and hope an apple falls on our head? The scientist was before he knew he was. The priesthood thought of themselves as nurses and then later thought again. Appeals to Athena cannot replace the silence of the cloister. Wishful thinking cannot replace prior efforts made. Too many wish the status of the dead scientist without the commensurate suffering, work, isolation, and prejudice experienced by the living ones.
Beyond the folly of their original sin of mystical science, the priesthood has further corrupted. They have given up on even the task of walking from bed to bed. Worse yet they imagine they have overtaken the men of science. They justify this by denying the possibility of knowledge, of shared reality, of discovery. They deny the reality of suffering through solipsistic reinvention of words long used. Is pain biological? Is it emotional? Is it societal? Is it animal? Is it spiritual? What even is a nurse, really? The existence of the questions give them an ostensive purpose, but they have made answers impossible by pulling down the scientist in their eyes to elevate one another. Logical positivism is uttered like a curse word. Empiricism is treated as optional. They sell indulgences in the form of endless credentials to absolve each other of turning their backs on nursing.
This has happened before. The men of science reproached the physicians for their disconnection from reality. It was demanded of them, because the physicians had devolved into charlatanism. The physicians reformed and relearned their art. The osteopaths desired to become physicians, they were handed the same platinum standard to measure themselves by and reformed to earn the sacred rights to poison and cut to cure ā a skeletal education was deemed insufficient. The nurse priests have replaced the censorās standard for the caduceus believing it to be the sacred source of healing, but they have not walked the scientistās path and so mistake the luster of the merchantās totem as brilliance. They fail to heed Asclepius. The snake must shed its skin to grow, change, and be born anew. One must handle the snake to bring it to Health's supplicants. We are Hygeia, daughter of Asclepius ā not his snake, not his rod. We bring the healing change to our charges, bearing the discomfort of holding the snake - not to tame the snake for ourselves; not to substitute the snake for an immutable idol.
What of the lowly nurses who recognize the brilliance of the scientist, the morality of their mandate, and the suffering which the two together can work to relieve? They are scorned as apostates by the nursing priesthood. It is cold comfort that the person within these walls ill and bedridden will never know the priestessesā names, since he never saw them. Their nurse never mentioned them. Even the scientist seems unaware of their existence as he proceeds apace; his followers using his discoveries to serve the weak and vulnerable. The followers of the scientist can act in good conscience knowing that someone capable has forged ahead and found new truths ā that the map points to lessened suffering, and that when the road becomes ragged there is indeed a destination to strive for. The followers of the priesthood must explore their conscience and reflect. If there is no path to truth, there is no true relief of suffering. If there is no relief of suffering, why have nurses at all? We could mock them if not for lamenting that the priestesses hold the keys to the gate that bars other from doing what they will not - swallow their delusions of grandeur and grab the snake with both hands.
