In the Shadow of Miss Nightingale

In January 1981, as a result of spending a week in the hospital for a severe case of scarlet fever, I decided I wanted to be a nurse. I was 16, a junior in high school in Apache, Oklahoma. All I knew of scarlet fever was that it made Laura Ingalls Wilder’s sister go blind. Thanks to the nurses at Grady County Memorial Hospital in Chickasha, Oklahoma I made it through that horrible week.

I can’t recall any of the nurses’ names who took care of me, but I can recall their actions and how they made me feel. I knew I wanted to be like them, smart, caring, decisive, warm, healing. They seemed like angels, only more. They knew best what would make me heal and feel better even if I didn’t want to hear it.

Those were my first nursing mentors. I’ve had so many more since then. I can think of no better time than National Nurses Day to remember a couple of them.

When the attendant wheeled me into my hospital room that January day in 1981, a student nurse stood at the bedside ready to help me into bed. Her teacher entered the room right behind me and asked the student to try to start my IV. I didn’t really know what an IV was and was so sick I couldn’t really follow the student as she tried to explain to me what she was about to do. Her first attempt failed. I cried. She apologized. Her instructor asked her if she wanted to try again. I’ll never forget what happened next. The student declined. She told her instructor she knew she couldn’t start my IV because her skills weren’t up to the task of starting an IV on someone as dehydrated as I was. She told her instructor that since I was so sick and scared she thought it would be better for me to have someone else get the IV started and get my fluids and antibiotics going. The instructor nodded, left the room, and then came back in a few minutes later with another nurse. The student held my hand and talked quietly to me while the staff nurse expertly started my IV and got my fluids and medication going. At that moment, I didn’t recognize what had just happened.

Looking back years later, I realized the nursing professor wanted to see if the student would recognize the needs of the patient and respond only to the needs of the patient. I’d say she passed that test.

After a zig-zaggy road full of dead ends, I finally entered a practical nursing program at Tennessee Technology Center in Harriman, Tennessee in October 1993. I was 29, a little beaten down by life, but trying to get myself together. I’d been on the waiting list for nursing school for two years and had started to think I’d never get in.

Classroom-only studies filled the first few weeks of the program, then clinicals started. The day finally came when I had to give my first intramuscular injection. My patient for that shift was a surgical patient in her mid-thirties. I went to her room to perform my first assessment of the morning and could immediately tell she was in pain. I did a quick set of vital signs and checked her incision. When the patient confirmed she would, in fact, appreciate a shot of her prescribed narcotic I left the room to find my instructor, Alma Johnson, RN, to help with the injection. Mrs. Johnson joined me in the medication room where I presented her with the patient’s medication order sheet. The staff nurse who worked at the hospital obtained the medication from the narcotics cabinet for us. I had already assembled my supplies, syringe, two needles, two alcohol swabs, a cotton ball, and a Band Aid. No matter how hard I tried, I couldn’t stop shaking.

With trembling hands, I picked up the vial of medication and the syringe. I looked at the syringe, looked at the vial, looked at the syringe again. Mrs. Johnson leaned over and whispered to me, “Miss Shackelford, you’ll need to uncap your needle in order to draw up the medication.” If the staff nurse in the medication room with us heard, she gave no indication. Mrs. Johnson smiled at me, encouraging me to continue.

Something clicked into place in that instant. Even though I was scared out of my mind to stick a one and a half inch needle into a live human being, I took a deep breath, compartmentalized my fear, and realized every moment I stalled was another moment that woman would spend in pain. I realized this was all about that patient in pain, not about me being scared.

Mrs. Johnson stood quietly beside me, her hand resting very gently on my shoulder, as I confirmed the dosing on the medication order sheet, confirmed the medication by reading the label on the vial, then drew up the dose into the syringe. I presented the order sheet, vial, and syringe to Mrs. Johnson to check. She reviewed them and said nothing, just met my eyes with a smile and a nod. She walked beside me to the patient’s room, stood beside me while I identified the patient, located the landmarks for the ventral gluteal site and gave the patient her injection with steady hands.

When we walked out of the room, Mrs. Johnson turned to me and smiled.

“Well done,” she said. I knew she referred to more than just my injection technique. It was the first time I felt like a nurse. Not that I gave the injection, but that I did something that helped another human being cope with her illness.

At graduation in September 1994 I told Mrs. Johnson that I wouldn’t have made it through nursing school without her kindness and what she taught me that day. I wasn’t kidding. She’d taught me the most important lesson of nursing school with only two short sentences and her gentle presence. It’s a lesson I carry with me still.

Many nurses since then have inspired me in many different ways, but these women stand out as some of the most important in starting me on the path I continue walking today.

Happy Nurses Day!


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