Cockroaches That Can Never Be Killed

During my clinical practice, while I was looking after an old man dying of pneumonia, I felt the weakness of life. Death is only a process that everybody has to pass through. It is merely a matter of time. In that process, I found that nursing was a process of companionship. Life does not involve just a single person, but many aspects. Giving support to the patient's family is also very important.

-Ching Ming-li

In a composition entitled "My Hope" that Ming-li wrote as a child, the first occupation she excluded from her future life was nursing. However, her parents thought that it would be much easier for her to find a job if she graduated from nursing school, so she arduously plodded along through her nursing school career. Now she says emotionally, "Looking back, I think it is really too early for a middle school graduate to make a choice for his or her future career."

When she first entered the nursing college, Ming-li was not too clear about what was going on. In the second year, she did not change her mind: she kept telling herself, "I don't like nursing." By the fourth year, she even considered dropping out of school. She found that several of her classmates had the same idea. Fortunately, one of the counselors heard of their problem and had a long talk with them. The counselor simply let the confused students talk about their feelings, and she analyzed for them the advantages and disadvantages of a nursing career. "Although she didn't tall us what the correct choice was, her guidance decreased our impulse to quit," said Ming-li.

At that time, one of Ming-li's close relatives was seriously ill, and she looked after him in the ICU. Seeing different tubes inserted in his body, she realized that a patient was actually a living person, not just a medical case. She also found that nursing was a lifetime career. She said, "Although I like nursing much better now, I still can't accept the working environment and the things nurses have to do."

In her fifth year at the college, her classmates used to encourage one another by comparing themselves to "cockroaches that can never be killed." Moreover, she was surprised to discover her strong vitality, revealed during the clinical practice which lasted that whole year. There are eight departments in which students have to complete their practice, about one month in each department, after which every student has to turn in a report. When her last report was turned in, Ming-li had a great sense of accomplishment.

Ming-li likes literature, and she had always wanted to study Chinese literature. "After five years in the nursing college, you really don't want to be a nurse?" Her mother's question has caused her a great deal of inner struggle. She thinks she should develop her own interests while she is still young, but she doesn't really want to part with nursing.

You Are Water

The contradiction in the process of nursing is that I like to get in touch with the patients, but I want to avoid their illnesses. During my clinical practice in the fourth year, I was looking after a dying patient afflicted with diabetes. The case was quite bloody, which was quite a shock for me. After that I took care of a breast cancer patient. Her condition was exactly like what was described in the textbook. All I could do was to be with her, make her comfortable and listen to her.

-Yang Chueh-hsuan

Chueh-hsuan also came to Eastern Taiwan at her parents' insistence that nursing was the most suitable job for girls. She thought that since she could not disobey them, she would rather choose a place far away from home-Hualien.

Facing the descriptions about birth, aging, illness and death in her textbooks, her reaction was: "It's so cruel, these phenomena are too abstract to comprehend." At that time, nursing was still far away from her.

Clinical practice in the fifth year came closer and closer to real bedside practice. In her contacts with the inhabitants in each community, and especially in looking after old people, Chueh-hsuan gradually affirmed herself. "In the hospital, there were too many things to do. All the patients needed help, but I felt that what I could do was very little. During my clinical practice at the Hsiulin public health center, I found I liked to be with lonely old people. We were eager to give them health education, only to find that what they really needed was our company and smiles."

Once in the hospital, she was looking after an old man who later became Ming-li's case during her practice in the community. One day, Chueh-hsuan invited Ming-li and some other classmates to visit him. She was surprised to find that he was a good painter. "As we were leaving, he gave each of us one of his paintings. From him, I experienced something outside our specialty."

The practice at the public health center made Chueh-hsuan realize that the purpose of nursing lies in going into the community. "A public health nurse looks after a whole family," she said. "In addition to the patient, we must give encouragement to other members of the family so that they can be psychologically prepared to take care of a chronic patient at home."

Although the students are only in clinical practice, patients and their family members always think they are omnipotent. In order to win their trust, the students have to resort to books to find answers to the questions raised by the patients. "Aside from the hospital, the library is another place we frequently go to. We have to prove our knowledge in front of the patients, and we also have to submit reports requested by our teachers."

"Sometimes we are afraid to ask our teachers questions, because if we ask one, they ask us ten more. We have to find the answers either from the library or from other information sources."

After pondering a moment, Chueh-hsuan continued frankly. "Just like Ming-li, I had the same impulse to drop out from school in the fourth year. But in the fifth year, I suddenly realized that I had begun to like nursing. For one thing, I had had actual experience in clinical practice; for another, I had become more mature intellectually. Ordinary high school students begin to consider which direction they should go only when they face college entrance examinations, but we nursing students encounter that problem three years earlier. So in the fourth year, many of us begin to wonder and hesitate. As a matter of fact, several classmates did drop out from school in the fourth year. However, ovce we entered the fifth year, we became more stable."

After graduation, Chueh-hsuan intends to work in Tzu Chi Hospital for two years. Why two years? "Nursing is a job of giving. During my clinical practice, I already had the feeling of being used up. I wanted to continue studying. Now that I am more familiar with nursing work, I have a stronger desire to accomplish my work independently."

Although clinical practice started in the second year, changing from a student to a specialized nurse still worries Chueh-hsuan. "I'm afraid. After all, there's a big difference between clinical practice and real bedside care. It will be a great challenge to adjust to the hospital environment in a short time." However, she remembers the words that her neurology teacher said to her during her clinical practice in a convalescent hospital: "You are water."

"Water never changes its nature no matter what container you put it in. I hope I will never change my nature no matter how people treat me."

More Than Just a Megaphone

Are nurses unfeeling? Actually we just don't speak out our real thoughts. Facing the dead, I have sublimated my thoughts. I regard death with an attitude of blessing. Emancipation from this world may be the best for many people.

-Yang Hsiu-yin

Hsiu-yin always thought she was too young to know what she really wanted when she entered nursing school. After studying three years in the nursing school, she entered the two-year nursing college.

In spite of the three years of nursing education she had already had, she still regarded clinical practice as her main source of pressure. In the classroom you face a dummy, but in real bedside care you face a real patient. "During my practice in the emergency room, I saw a patient talking to his family in the morning. That afternoon, he passed away. That made me feel that I had to appreciate every minute I had, because I didn't know whether I would still be alive tomorrow."

People can't imagine how nurses directly face birth, aging, sickness and death. There are 365 days in a year. If one patient passes away each day, that's 365 dead people in a year. "How should I face it? Should I make a hell out of my own life? I must adjust to these conditions, or else I will look cold and unfeeling. In fact, flowers still bloom and birds still fly. I periodically give myself space to let life return to its original meaning."

During her practice in the hospital, Hsiu-yin took care of a tongue cancer patient who couldn't speak. Sometimes he was awake and sometimes he was quite drowsy. Sometimes he would wet the bed. Hsiu-yin had to feed him every meal. After cleaning him, she would always hold his hand, trying to feel what else he needed. In the beginning, this whole-hearted work made Hsiu-yin feel very tired. One day, that patient gripped the young nurse's hand very tightly. She thought he needed something, so she asked him, "What else can I do for you, sir?" His wife said, "He just wants to say thank you." Hsiu-yin's weariness disappeared.

A patient's smile is her greatest sense of achievement. "Nurses face the patients directly. Sometimes we are more eager than the doctors to understand them. When patients and their families need support the most, we try to empathize with their feelings. However, many patients just treat a nurse like a megaphone-just something to pass the doctors' instructions on to them."