Age 50 to 60.

Life is what we make it. Always has been, always will be.  Grandma Moses

Yikes! I’m getting old. As this chapter starts, I still have 15 years of Service to give to the sick. I look forward to it with gusto. As always being willing to add knowledge and become a specialists in a field that few nurses are interested in.

But first I will regress just a little. In 1979 I lost my beloved poodle, Gigi.  I had lost Fifi while living in Arizona. Now my Beautiful Silver Josephine was a lost little girl. She seemed to not understand why her best friend had left. She did indeed mourn and I often had to wipe the tears from her eyes.

It is often said that Nurses are hard and not capable of crying. Trust me that is absolutely a total untruth. Not just for my beloved poodles but often for many of my patients.

As my career progressed the DON called me into her office and asked me if I was interested in becoming an ET nurse. (Then it meant Enterstomal Therapist) Now referred to as a WOCN. I’m tempted to make you guess, but will say it stands for Wound, Ostomy, Continence Nurse. This is a clinical specialty of which there are less than 2000 worldwide. Well, why should I not accept the challenge?  The DON was willing to pay for the course, pay for an apartment in LA, so I would not have to commute and continue my salary while under instruction. If you think about it, it doesn’t get much better than that. What to do with my poodles. I was hosting an exchange student from Vastervick, Sweden for a year. He was reliable, could cook and when I talked to him about this situation, he was more than willing to keep the home fires burning in my absence. And the foreign exchange student leaders, lived only a block away. I of course came home on weekends. I missed Per Albin Jarnestrom as well as my poodles. He was a delightful young man. In the course of my hosting of foreign students I hosted a total of 10 from various countries. Off to USC School of Enterstomal Therapy for another adventure. It was a graduate course in 6 weeks. I was a basket case when I finally completed the course. I do not think I have ever had so much information stuffed in my mind in 6 weeks in my entire life. My instructor was the most caring individual I had met in a long time. She said, “No one fails my class”. Another few words of wisdom among many were always listen to your patients. They have words of wisdom that will assist you on your way to rehabilitate them.

When I returned with all this knowledge, my first patient was the father of one of the physicians on the hospital staff. He had colon cancer, an intestinal blockage and the surgical procedure was a loop ostomy. Not something I learned about during my education. I was beside myself wondering how to deal with this difficult situation. I said to myself. Carol, think it through. Consider all aspects of dealing with the situation. There was an incredible outflow of liquid intestinal substances spilling all over his abdomen as well as into the bed. I knew only one thing. I had to do something to preserve the dignity of this patient.  I thought the entire difficult situation through very carefully and came up with a plan and it worked with lots of effort and creative thought on my part. His physician son was indeed thankful for my efforts. I became very close to this entire family and as nurses never cry, I will tell you and I’m not ashamed to admit, I sat in the room with the family and cried with them while he was dieing. I did also attend his funeral. I think it is important to let your patients and their families know that you think they are special. And that is how I spent my life in this field of nursing. This is likely the most difficult aspect of nursing I have ever dealt with. Rehabilitation of ostomy patients takes a strong resolve and an occasional kick in the ass of those that are playing the poor me game. It was often not a pleasant situation but I had no choice but to move them onward and give them the strength to deal with this life style change. On a slightly humorous aspect in this patient care, I had one 72-year-old female patient ask me if she could still climb mountains.  I said “What kind of mountains”. She said, mountains, mountains. My answer to her was the only change in her life is the mode of exit.  As I attended another patient elsewhere his brother made an interesting remark. He said, Harry, think of it this way. It is just a different way to fart. I’m not gross. This is reality and the rate of intestinal cancer is increasing rapidly. I ask that anyone over the age of 50 consider having a colonoscopy.  It might save your life.

OK, enough of my ET stories. Wound care was another issue. Things had changed a great deal and my knowledge was not well received by any stretch of the imagination. It was a fight to educate the staff that my method of wound management resulted in healing 3 to 5 times faster than old antiquated methods.

I think I now need to take an interesting trip or two. With my retirement and the nice salary I was earning due to my clinical expertise, I decided to embark on some worldwide travels. I had already been on 2 Caribbean cruises, as well as a cruise that started out in Athens Greece. The Greek Islands and the Holy Land. While on active duty, I had also traveled to Italy with the Association of Operating Nurses.

1984 I traveled through Norway, Sweden and Denmark. My 52^nd  birthday was celebrated in Stockholm with the family of my first exchange student. From there I traveled by train to Vastervick, Sweden to visit my 2^nd exchange student and his family. Traveling into Denmark I was fascinated by the terrain. It reminded me so much of east Nebraska that I suddenly realized why my Danish grandparents stopped in Nebraska to start life in the US. I visited the same church my grandmother had attended about 100 years before.

1985 a Grand European cruise, which visited 6 European capitals. 1986 a Pacific Crossing starting in New Zealand and ending in Los Angeles, making stops along the way. Mostly we were at sea for 12 days. These cruises are referred to a relocation cruises and they are not very expensive.

In between my travels, which were a large trip once a year, I actually did have a job and worked. My schedule was always busy and I carried a beeper 24/7, to meet the needs of my patient load. That would include going to work just about any hour of the day or night if required to solve a problem. Once while in Greece, I was informed by someone I had met that Americans are lazy. It was said they never learn a foreign language and no one speaks Greek except the Greeks. Well I decided to surprise a few of the shipboard individuals the next time I sailed with Royal Cruise Lines. I enrolled in a Greek language class. I really enjoyed those classes and to top it off, also learned how to prepare several Greek dishes. My Baklava was a hit. One student asked me for my recipe, as his mother was from Greece, but told me, my Baklava was better than hers.

Going to Athens to leave on the Grand European cruise, I decided I wanted to see just what a hospital looked like in a foreign country. So I whipped out my directory for ostomy and wound supplies and found the names and addresses of the reps in Athens for Hollister and Convatec.  I wrote a letter and sent it to them in English as well as in the Greek Language. I informed them my date of arrival and the name of the Hotel where I would be staying. A tiny, inexpensive hotel located at the foot of the Acropolis. I wasn’t in my room very long before I received a phone call from one of the reps, informing me I was scheduled to give a lecture at the University of Athens, medical center the following day.. Oh boy. What did I get myself into now? At least I had been smart enough to pack a lab coat to wear over my civilian clothes, so I would look professional.  To my surprise, physicians, registered nurses, as well as student physicians and nurses attended my lecture. Now my Greek was pretty good, but not good enough to give a lecture, so a drop dead gorgeous Greek surgeon translated for me.  My topic was “The role of an Enterstomal Therapist.” What I thought would be about a 30-minute situation, turned into 2 hours, due to the many questions the audience wanted to ask me. They were shocked to hear I carried a beeper 24/7 and wanted to know how much I was paid. Not wanting to give a dollar amount in a 3^rd World country, I informed them I was paid at the Administrative level.

I must admit I was shocked by the medical care I witnessed. No screens on the windows, and only one nurse on duty for the purpose of administration of medications. The patients were taken care of by family members. I found very little indication of patient care documentation and absolutely no such thing as a policy and procedure manual. Washing my hands even turned into a problem. No paper towels. Just the cloth towel that belonged to the patient. I decided to drip dry. I did visit a modern hospital that was air-conditioned and met the medical director Dr. Bisbee’s. He had founded the Greek National association for ostomy care. I also made a house call with one of the ostomy supply reps. I’ll not comment about that experience.

I was royally entertained in the evenings at nice restaurants. They are really party people and do not eat the evening meal until about 2200. Time to board my ship after an interesting and informative 3 days. When I returned I commented to my Greek teacher---

Nina, no offense to your country but I would not like to get sick in your country. She just laughed and said, “Neither would I”.

In 1987 I flew with a group and my travel agent to Kyoto, Japan to board “The Pearl of Scandinavia. We started in Kyoto, traveled south and ended this cruise in Hong Kong. We stopped in  Nagasaki, Japan then on to China, stopping in Dalian, and Qinhuangdao. From this stop we took a 3 ½ hour train ride to Beijing. This was a 3-day program. Returning to the ship we were greeted with a huge Welcome home from the ships crew, as well as the local natives. We pulled anchor and headed to Yantai, Qingdao, Shanghai, Xiamen, and finally Hong Kong. As I remember we had to anchor in the harbor in Shanghai, having lost our priority to the Queen of England.

In 1988 I traveled with a group for a 3 week shopping trip to Taiwan, Korea and Hong Kong.  Wow! Nothing like shopping in the Far East.

This brings me to a 5-year period in this Chapter. So I have decided again this Chapter needs to be divided into 2 parts. I’m not windy. I just did tons of things.

The pleasantest things in the world are pleasant thoughts; and the great art of life is to have as many of them as possible.   Michel de Montaigne.