Every preschooler has contemplated the question, “What do you want to be when you grow up?”

When I was a little girl, I dreamed of becoming a nurse.

I could picture it perfectly. The starched white uniform. The perky cap. The stethoscope. I took tender care of my dolls when they were sick. I read every book I could find about famous nurses like Florence Nightingale and Clara Barton. I worked as a candy striper throughout high school.

Somewhere along the way—maybe after all those trips to the library—my dream changed. Today, rather than providing care at the bedside, it is my privilege to share the words of those who do—the men and women who minister to the sick and the injured.This is their story.

From the beginning to the end
Nurses are the nucleus of the medical industry. From the first breath of a tiny newborn to the last sigh of an aged adult, nurses use their skills and training to offer comfort, care and compassion. Their roles are varied, and the opportunities are boundless.

Nurses fly in helicopters to assist with trauma. They work in medical offices caring for well and sick patients. Some travel around the world bringing skills to those most in need. Others are employed in businesses to help maintain the health of the workforce.

For many years, females have dominated nursing; however, there are growing opportunities for male nurses.

“Men can be just as caring as women,” says Ricardo Cosares, R.N., a long-term-care nurse in the Palmer-Hinson Care Unit at FirstHealth Richmond Memorial Hospital. “Nurses learn new things every day. It is an exciting career. There is a lot of job security, and you can go anywhere. Need is universal. Helping the sick and healthy is a continuous process. It’s a great profession.”

Lori Hoepner, R.N., a pediatric nurse at FirstHealth Richmond Memorial Hospital, has six years of experience in pediatric nursing.

With so many options available, how does a nurse decide which area to pursue? “I don’t really think that you choose nursing,” says Lori Hoepner, R.N., FirstHealth Richmond Memorial Hospital. “It chooses you. I know in my heart that I am a pediatric nurse, because it’s where I’m supposed to be. It’s hard to put into words. I enjoy children, but it’s more than that. For me, nursing is a passion.”

In health systems throughout the Unites States, nurses comprise the largest percentage of employees—assisting patients from labor and delivery to long-term care and hospice services.

Labor & Delivery
Nancy Diggs, R.N., always knew she wanted to help people. Today, she assists mothers and babies in the Labor & Delivery Unit at Richmond Memorial Hospital.

“It takes a special kind of person to succeed in nursing,” says Diggs. “You need to really want to do it. There is a lot more involved than simply treating and assisting patients. We actually support the whole family. There are a lot of little details that make a real difference, and they aren’t all medical. Finding a meal tray after a long labor or offering encouragement to a worried grandparent are just as important in many cases as the actual medical treatment for the patient.”

Nancy Diggs, R.N., is a nurse on the Labor & Delivery Unit at FirstHealth Richmond Memorial Hospital.

Diggs, a 19-year nursing veteran, has worked as a Labor & Delivery nurse for 15 years. “There is not a ‘typical’ day in our department,” she says. “You never know what to expect. It’s sort of an organized chaos. I like the excitement.”

In addition to providing care at the time of delivery, Diggs also teaches childbirth classes several times a year. “The classes help patients become more aware of the process,” she says. “They gain a basic knowledge of what will be happening and learn some of the terminology used during the delivery.”

When a mother presents to the hospital in labor, the nursing staff is her primary contact. Nurses manage her care—assessing her status and incorporating standing orders from the physicians, often right up to the time of delivery.

“We form a strong connection with our patients,” says Diggs. “We offer a lot of one-on-one support. New mothers feel vulnerable; it is unknown territory for them. They trust us to help them through it. It is a blessing to be invited to be there at the beginning of a new family. Each one is a special, joyous occasion.”

Children are people, too
Managing children in the hospital presents unique challenges. At Richmond Memorial, children are typically treated for acute illnesses or injuries such as respiratory problems, chronic diseases, including diabetes, and recovery from minor surgeries. “There is no such thing as a typical day in our department,” Hoepner says. “Children are people, too. But you always have to remember that they are not little adults.”

A hospital stay can be a scary prospect for a young child. The key to successful pediatric nursing is gaining the child’s trust. “It takes small steps,” Hoepner says. “You have to get on their level—literally down on your knees, eye to eye. Once you gain that trust, it’s surprising the difference it makes in providing bedside care.”

Pediatric nurses must be able to relate not only to their patients, but to the parents as well. “If parents don’t understand the process or what is expected at discharge, we’re going to see the child again,” says Hoepner. “We do a lot of in-depth teaching using written materials, videos and other audio-visual aids.”

Hoepner, who has six years of pediatric nursing experience, believes that nursing is a career in which you continually learn and grow. “You keep learning as you go,” she says. “It’s a challenging job, but as long as your heart is in it, you’ll be happy and successful.”

Medical/Surgical care
Many nurses begin their careers on the Medical/Surgical floors of a hospital or health system. Med/Surg nurses care for adults recovering from a variety of illnesses or injuries such as chest pain, pneumonia, surgery or dehydration from nausea and vomiting.

Keena Green, R.N., works on the Medical/Surgical floor at FirstHealth Montgomery Memorial Hospital.

They work closely with patients and physicians to ensure the best possible outcomes.

Keena Green, R.N., FirstHealth Montgomery Memorial Hospital, has spent more than 12 years as a hospital nurse. “Being a nurse has always been my dream from the time I was little,” she says. “I had lost loved ones as I was growing up. I couldn’t help. I wanted to become a nurse to not feel so helpless when someone is suffering.”

Green provides one-on-one care at the bedside, following through on orders, reviewing charts and test results and conferring with physicians regarding patient conditions. Like nurses in most other departments, she is responsible for administering needed medication, managing wound care, starting IVs and educating patients.

“With floor nursing, there is something new every day,” says Green. “We only see our patients for a short period of time. While they are in our care, they are getting better. They want to go home, and we have the opportunity to help them do that. It’s a good feeling.”

From hospital to home
Not all nursing care takes place in a hospital or medical office. In fact, one of the fastest-growing fields in medicine is Home Health. Patients today leave the hospital much earlier than they did five to 10 years ago, and Home Health nurses help ensure they continue to recover after discharge and help prevent unnecessary re-admissions to the hospital.

The goal of the Home Health nurse is to teach the patient and his or her caregivers how to care for the patient at home. The nurse’s range of skills includes IV infusion, wound care, diabetic teaching and medication management—just to name a few.

As a FirstHealth Home Health nurse, Lynn Agee, R.N., works with patients in their homes.

“Home Health offers a unique opportunity for nurses,” says Lynn Agee, R.N., FirstHealth Home Health. “Nurses practice independently and must have excellent assessment skills. Because the physician is counting on you to provide the most relevant and detailed information about the patient, it is very much a cooperative relationship—one that involves the nurse, the patient and the physician.”

A Home Health nurse faces unique challenges in a patient’s home. “You are dealing with patients and their families in their environment, not in the controlled setting of the hospital,” Agee says. “I love working in the community, and I feel I really make a difference in my patients’ lives. You build very special relationships with your patients and their families.”

And Home Health nursing is a dynamic field. “Every day is a challenge,” Agee says. “You never really know what lies ahead. You may walk in to find a patient in distress and have to act quickly. You may discover that the patient has been taking medications incorrectly because he can’t read or not taking them at all because he can’t afford them.

“We work as a team with our physical, occupational and speech therapists, wound specialists, social workers, nutritionists and Home Health aides to get the patient to the highest level of independence in the home, which is where the patient wants to be. That’s what makes this job so special: We are able to teach patients how to remain safely at home for as long as possible. It has been the most rewarding experience
of my nursing career.”

Managing chronic disease
Case management is a relatively new nursing function.

Debbie Timm Marcum, R.N., is a case-management nurse with FirstHealth of the Carolinas. Case managers work with patients with chronic health problems.

Like Home Health nurses, case managers must be able to work autonomously; however, their relationships with patients are much more long-term.

“We work with individuals who have chronic health problems like diabetes and congestive heart failure,” says Debbie Timm Marcum, R.N., case manager, FirstHealth of the Carolinas.

“Our link to a patient or family can be lifelong. We work hard to help them understand their disease and how to manage their symptoms.
We can help them judge when extra care is necessary and how to best access needed services.”

Case management involves teaching, monitoring and evaluating each individual. “The hospital is not conducive to learning,” Marcum says. “We reach out to patients and their families in their homes, where they feel comfortable. They absorb much more, and as a result, we can help them take steps to avoid future trips to the hospital for the same services.”

A home away from home
As individuals age, they often experience diminished capacities. They may be mentally or physically unable to care for themselves. Quality long-term-care facilities like the Palmer-Hinson Unit at Richmond Memorial Hospital provide a home away from home. The nursing staff often becomes a second family for these elderly adults.

Ric Cosares, R.N., is a long-term-care nurse in the Palmer-Hinson Care Unit at FirstHealth Richmond Memorial Hospital.

“We are advocates for the elderly,” says Cosares. “We speak for those who can’t speak for themselves.”

Cosares, who came to the United States in 2002, was born and educated in the Philippines. Prior to joining the Palmer-Hinson staff, he had no experience with long-term care.

“We don’t have long-term-care facilities in my community,” he says. “Families care for their elderly at home.

“I think long-term-care is a good idea. Many people work and can’t provide for their elderly family members. As nurses, we have the training to be sure they are comfortable and to manage their health problems. It is a very challenging, but rewarding, job.”

Death with dignity
“When I worked in Labor & Delivery, I got a chill every time a baby was born,” says Lydia Talbert, a certified hospice and palliative care nurse with FirstHealth Hospice & Palliative Care. “I never got tired of that feeling. As a Hospice nurse, I feel the same way when someone dies with dignity.”

What defines a dignified death? “It happens when a patient and family are as prepared as possible … when the individual is surrounded by family and loved ones … when the last breath is the next step in the journey rather than an ending,” says Talbert.

Lydia Talbert, R.N., is a certified hospice and palliative care nurse with FirstHealth Hospice & Palliative Care.

Hospice nurses work with patients who have been diagnosed with life-limiting illnesses (including cancer, end-stage heart failure, lung disease, stroke, Alzheimer’s and failure to thrive).

Although death is a natural part of life, patients and families facing the process experience a great deal of stress and uncertainty. The hospice nurse works within a team, using a holistic approach involving medical, spiritual and psychosocial methods.

Hospice care emphasizes symptom control and pain management. “We teach families what they need to watch for and what treatments they can use to comfort the patient,” Talbert says. “Sometimes that involves medicines or medical equipment. Other times, it might include massage or visualization. Although we can’t predict the time of death with certainty, we can help the family identify the signs.”

Like Home Health nurses and case managers, hospice nurses must be able to function with autonomy. “We have to be adaptable and able to change our routines quickly,” says Talbert. “It’s helpful to have some Home Health or ICU experience before pursuing hospice as a career. I think that most of us who have encountered the dying process desire to make death as natural as possible.”

Hospice nurses continue to work with families for up to 12 months following the death of a patient. “Death is not an ending,” says Talbert. “It’s one more step, and we work hard to help our families keep moving forward. We become very protective of them.”

Birth, death and everything in between
The role of the nurse is a pivotal part of every element of medicine. Throughout history, nurses have ministered with tender care to the sick, injured and dying. They use their skills and touch to heal with hearts and hands.

“Nursing requires dedication,” says Talbert. “The education is intense, but the satisfaction of knowing you have helped someone in need is the best reward.”