Dialysis Nurse on the High Seas

January 1, 1991 – Caribbean Sea

10-9-8-7-6-5-4-3-2-1-  HAPPY NEW YEAR!!! blared the loudspeaker.

Dialysis Cruise Ship 1991

Cruise Ship 1991

I shot out of bed and stood in the middle of the pitch black room with my heart racing. Where was I? What was happening? Oh yes. I signed up to work as a dialysis nurse on this nine story cruise ship for the week, and my payment was a free cruise. I went to bed early because I took a Dramamine tablet for my motion sickness. I drowsily climbed back into bed to sleep until my alarm clock awoke me at 5:30 a.m.

At 6 a.m. I joined my cabin mate, Laura, and Tess, two other dialysis nurses, in the dialysis room in the lowest level of the ship. The dialysis company had rolled on three dialysis recliners and three ancient dialysis machines along with gallons of dialysis fluid. In addition to the fee for their cruise, nine patients had each paid the company $1200 to dialyze them three times during this week-long cruise so they could see some places outside the USA. Once they left the USA, Medicare no longer paid for their life saving treatments. People with End Stage Renal Disease (ESRD) whose kidneys no longer cleaned their blood of toxins or removed fluids from their body needed 3-4 hours of dialysis three times weekly.

Our charge nurse, Ellen, divided us into two teams and assigned us to patients and times so we dialysed only while cruising at sea. Therefore when we were in ports, patients and nurses were free to go ashore and sightsee. The ship left Fort Lauderdale, Florida, then cruised to Key West, Jamaica, Grand Cayman, Cancun, Mexico and then returned to Florida on the seventh day.  I met the qualifications since I had now worked for three years on a large dialysis unit in the midwest.

This is my first cruise. The seas are rolling, so I am suffering from motion sickness. I was blessed in reading Psalm 107:28-31: He maketh the storm a calm, so that the waves thereof are still. Then are they glad because they are quiet; so He bringeth them unto their desired haven. Oh, that men would praise the Lord for His goodness, and for His wonderful works to the children of men!” Yes, the Lord is in charge of the seas and this ship. I thank Him for this opportunity to meet new people,  see new places, and relax in between dialysis sessions. Laura was on the ship last week also for Christmas and said it was so rough she had to go to the ship’s clinic to get a shot to stop her vomiting. She appears to have her sea legs now. Terra firma felt fantastic when Laura and I went ashore at the different ports! !

Key West Florida houses

Key West Florida houses

I climbed the rocks of Ocho Rios Falls in Jamaica in bare feet!

I climbed the rocks of Ocho Rios Falls in bare feet!

Parasailing in Grand Cayman

Parasailing in Grand Cayman

Pam with one of her patients using the old dialysis machine

Pam with one of her patients using the old dialysis machine

Laura showed me how to prime the old machines with saline and enter the amount of fluid to remove for each patient during their prescribed length of dialysis. They did not use the new computerized machines that I was familiar with because the rolling motion of the ship made the alarms go off too often. Our three patients arrived at 6:30 a.m. Our supervising dialysis doctor for this week was also a dialysis patient. I am not sure how ethical this was since he gave me his own orders for dialysis, but it was too late now to do anything about it. Dr. C. was a kind gentleman who also brought his wife and young children with him on the cruise. After he weighed in and we calculated the amount of fluid to remove over the next 3.5 hours, he asked me to take an extra half pound off so he could eat and drink more! I reluctantly entered the amount as he ordered me to do. I took a deep breath as the ship rolled and inserted two large needles into his fistula in his arm. We checked each patient’s blood pressure every 15 minutes and recorded it. Patients and staff chatted together in the small room as three hours slowly passed.

I checked Dr. C’s blood pressure, but it was too low at 70/50! I quickly put his recliner back so he was flat and stopped the machine from removing any more fluid from his body. “Dr C, I know you wanted to get extra fluid off, but I really want you to be with us on this cruise the entire week, so I am giving you 100 cc of intravenous fluid now (about 1/2 cup) to raise your blood pressure.” His face was pale. He didn’t argue with me. He completed the treatment and left with his blood pressure back up to his baseline of 110/80.

I snorkeled in Cozumel, Mexico.

I snorkeled in Cozumel, Mexico.

Laura shared with me that she was in her twenties, a new widow, and this was her first Christmas and New Year since her husband died. He was one of her dialysis patients who received a kidney transplant. But six weeks after they married, he had a complication and died suddenly. She said she couldn’t face being with her family and being pitied, so she chose to drown her sorrow in work on the cruise ship with total strangers. I prayed that she would know the wonderful comfort of the Lord Jesus Christ, “a man of sorrows, and acquainted with grief.” Isaiah 53:3 

Reflection – 2013

That was my first and last cruise due to the severe seasickness which plagued me. Even to this day, when I recall that long week, I still become nauseated! I truly thank God that they now have prescription medicine for severe nausea (Zofran) and also Sea Bands (acupressure bracelets). The Sea Bands work fairly well to prevent motion sickness when I am on a plane or train. But when rough weather is predicted, I take Zofran 30 minutes before my flight as it is much easier to prevent it rather than treat it after it occurs.

When I was in Israel in March, I gazed over the calm Mediterranean Sea and recalled the Apostle Paul’s shipwreck from the violent sea (Acts 27:14-44) and Jonah’s tempestuous voyage when he was thrown overboard (Jonah 1:15). God sometimes takes us through great storms in our life to teach us to rest and trust Him in the midst of the storm. In John 16:33 Jesus said, These things I have spoken unto you, that in Me ye might have peace. In the world ye shall have tribulation: but be of good cheer; I have overcome the world.” I pray you will have a blessed New Year of looking unto Jesus and learning more of Him through the storms and the calm places in your life!

1024x768_bestfit - Copy (72)

The Mediterranean Sea when it is calm.

Advertisements

Jesus – Born in Bethlehem – Part II

“Now when Jesus was born in Bethlehem of Judea in the days of Herod, the king, behold, there came wise men from the east to Jerusalem, Saying, Where is He that is born King of the Jews? For we have seen His star in the east, and are come to worship Him.” Matthew:2:1-2

Bethlehem, Israel – March, 2013

25,000 people now reside in Bethlehem, Israel

25,000 people now reside in Bethlehem, Israel

Our tour group boarded our bus outside our hotel in Jerusalem and traveled 20 minutes to the city of Bethlehem which now has 25,000 residents. We drove past the huge cement wall built between Palestinian controlled Bethlehem and Jerusalem to prevent the Arab snipers from shooting them. At the checkpoint, the security guard waved us through after our driver told him we were American tourists. Our day to visit Bethlehem changed since President Obama was scheduled to visit here in three days. We parked in an underground garage and walked several blocks uphill to the Church of the Nativity, the traditional site where Jesus Christ was born in a cave. We passed Muslim women dressed head to toe in black, brown, or gray burkas.

Church of the Nativity

Church of the Nativity

Construction began in 326 A.D. on this oldest church in the Holy Land which is still in use. It is separated into three different sanctuaries of the Franciscan Catholics, Greek Orthodox, and Armenian Orthodox.

We entered through a four foot high door with a foot high wall at the bottom. Our guide told us they built it this short purposely as a deterrent to any enemies! "Mouse hole" entrance to Church of the Nativity!

“Mouse hole” entrance to Church of the Nativity!When an enemy entered all bent over, he couldn’t shoot anyone, but the person inside could knock him over or kill him easily.

Then we wandered from one sanctuary to the other. It was quite interesting to compare the different architectural styles, the Armenian one being the most ornate. We waited in line about 20 minutes to see the glass covered hole in the floor that is supposed to be the actual birthplace of Christ.

Traditional birthplace of Christ.

Traditional birthplace of Christ.

Our Hebrew Christian guide, told us that in 1948 when the State of Israel began, Bethlehem had all Christian residents, but now there are only about 40 families remaining. The Muslims won’t hire them, so all the Christian young people are leaving.

We went to a gift shop that an Arab Christian started to support these remaining families. The believers carve nativity scenes out of olive wood which are very intricate. I treasure the one I purchased that portrays Mary and Joseph gazing at the Christ child in the cave. I also learned the typical manger was made of stone, unlike the wooden mangers usually portrayed in America.

My olive wood nativity scene carved by Christians in Bethlehem.

My olive wood nativity scene carved by Christians in Bethlehem.

Reflection – December, 2013

As I recalled my days in Labor and Delivery helping those babies into the world on Christmas morning in 1981, I couldn’t help but wonder if anyone assisted Mary during her labor other than Joseph? It simply states in Luke 2:7  And she brought forth her first-born Son, and wrapped Him in swaddling clothes, and laid Him in a manger. This is what the midwife or nurse would typically do who assisted the mother.  Midwives are mentioned in Exodus 1:15-22 who feared God and preserved the Hebrew male babies from Pharaoh’s wrath. “Therefore God dealt well with the midwives; and the people multiplied, and became very mighty.” I do not think God gave any details about Mary’s labor or delivery because He wanted all the emphasis upon Jesus Christ, the Savior of the world.Nazareth shepherd

The common shepherds were the first ones who learned of the Savior’s birth and came to worship Him, their Creator, who “took upon Him the form of a servant, and was made in the likeness of men; And, being found in fashion as a man, He humbled Himself and became obedient unto death, even the death of the cross.” Philippians 2:7-8. Emmanuel, God with us, who left heaven above, and came to earth to be my Savior. Born to die. Thank You, Lord Jesus, that You love me so much!

Charles Wesley captured this thought beautifully in the fourth verse of “Hark, the Herald Angels Sing”.

Mild He lays His glory by, Born that man no more may die,

Born to raise the sons of earth, Born to give them second birth.

Hark, the herald angels sing, Glory to the newborn King!

I pray you all may have a Christ centered celebration of the birth of our dear Savior!

Christmas Babies! Part I

A woman, when she is in travail, hath sorrow, because her hour is come; but as soon as she is delivered of the child, she remembereth no more the anguish, for joy that a man is born into the world. John 16:21

December 25, 1981 – 2 a.m. Labor & Delivery Staff Nurse

I glanced at the large white board in the nurse’s station which listed all the patients by name, stage of labor, and doctor. We still had six women in labor with four empty labor rooms. We had already done four deliveries since I was called in early at 9:30 p.m. to help the busy evening shift. I glanced at the fetal monitors which displayed each baby’s heart rate. All of a sudden, I saw one baby’s heart rate go dangerously low to 50 and stay there. The normal full-term baby’s heart rate was 120-160 beats per minute. Cathy, another nurse, stuck her head out the door of the woman’s room and yelled, “Call the doctor and nurse anesthetist, Pam! We have to do a stat C section (surgery). This baby is in trouble!”

The operating room technician, Teresa, ran to the prepared operating room (OR) while I called the two doctors. The nursing assistant helped Cathy wheel the huge bed down the hall to the O.R. Cathy had the mother lie on her left side to try and take the pressure of the baby’s body off her mother’s blood vessels.

Newborn Baby!

Newborn Baby!

We worked quickly. As soon as the anesthesiologist nodded that the mother was asleep, the resident doctor cut her abdomen and lifted the baby out of her womb. He  cut the cord that was wrapped tightly around the baby girl’s neck, and carried her to the warmer. Her own cord had choked her as she came down the birth canal. The baby girl let out a weak whimper.  I suctioned out her mouth and placed the oxygen mask over her small face. I dried her off quickly and she took several gasps of air! I silently prayed, “Dear Lord, Please touch this baby girl’s body that she may live.”  She let out a louder cry and the delivery room staff exhaled a sigh of relief. Her tiny body began to turn pink. The Neonatal ICU nurse wheeled the baby girl down the hallway to keep a close eye on her until she stabilized.

I returned to my other patient, Marie, and checked her progress internally. She was ready to start pushing the baby out. She was totally exhausted after 16 hours of painful labor. After an hour of pushing, I saw a patch of the baby’s black hair peak out! We wheeled Marie in her bed down the hall to the delivery room, helped her transfer to the narrow delivery bed, placed her heels in the steel stirrups, and her hands on the steel handles. I had her husband, John, sit on a stool beside her.

She gave several more pushes, but wasn’t making much progress. Dr. D. instructed, “Pam, give fundal pressure during the next contraction to help her out.”  I looked at Marie over my mask and warned, ” I’m afraid this is going to hurt you.” As I felt her large abdomen harden, I reached across her, grabbed the steel handle with both my hands, and pressed my forearm into her belly with all my strength. She screamed and I felt like screaming as my back went into a muscle spasm. At last the baby’s head popped out and his slippery body slid into Dr. D’s hands.

“Congratulations, Marie and John! You have a nice big healthy boy!” announced Dr. D. I pulled the string on the Apgar clock and wrote down the time — 3:03 a.m. Christmas morning.  Dr. D.  quickly suctioned the mucus out of the baby’s mouth with the blue rubber bulb syringe, and the baby let out a loud strong cry. Dr D placed two clamps on the umbilical cord and laid him on Marie’s abdomen so she could see him. “John, would you like to cut your son’s cord?” “Sure!” grinned John as he took the sterile scissors in his hand and snipped the cord.

Dr. D. carried the baby to the warmer and the Apgar timer buzzed at one minute. I gave him a score of 8 out of 10 which was excellent! His trunk, hands, and feet were still tinged blue. I suctioned the mucus out of his mouth again, wiped off his body with the soft, warm, cotton blanket and put a little hat on his head to keep him warm. The 5 minute Apgar time buzzed and I scored him 9 out of 10. His body was now pink, but his hands and feet were still slightly blue. I wrapped him tightly in another clean warm blanket and greeted him, “Merry Christmas, Timothy! Welcome to the world!” John watched his new son with amazement.

I carried Timothy over to Marie and placed him in her arms. All the fatigue vanished from her face as she gazed at him tenderly and kissed his forehead. After Dr. D. delivered her placenta and stitched her up, I put a warm blanket on her and wheeled mother and son to the recovery room.

The remaining hours flew by as we did two more Caesarian surgeries and two more normal deliveries. Eight babies were born that  Christmas night shift! I sat down twice for ten minutes during my ten hour shift. I was so happy to see the day shift staff walk into the nurse’s station at 7 a.m.! We gave them report, went to the locker room to change out of our blue scrubs into our street clothes, and walked wearily out the door into the bitterly cold Christmas morning sunshine.Christmas treeChristmas wreathChristmas morning

Reflection – 2013

My severe back pain continued, and I was diagnosed with two injured back muscles. My doctor ordered me to take a month leave of absence while I went to physical therapy to heal and strengthen my muscles. He said I was in poor shape physically and needed to exercise regularly if I wanted to continue to work in labor and delivery. So I joined the local indoor pool and began swimming four times a week. I happily discovered that swimming was also a great stress reliever and helped me sleep better!

The babies that were born that early morning will celebrate their 32nd birthday this Christmas and likely have children of their own by now. I wonder what kind of choices they have made in life? They share the same birthday that we celebrate the birth of Jesus Christ, King of Kings and Lord of Lords. I pray that each has chosen to receive Him as his/her personal Savior.

“For unto you is born this day in the city of David a Savior, who is Christ the Lord. And this shall be a sign unto you: Ye shall find the babe wrapped in swaddling clothes, lying in a manger.” Luke 2:11-12

Which Nursing School????

“Trust in the Lord with all thine heart, and lean not unto thine own understanding. In all thy ways acknowledge Him and He shall direct thy paths.”  Proverbs 3:5-6

March, 1973, Midwest, USA – High School Senior

Ever since last year when the Lord gave me peace about becoming a nurse, I have struggled in deciding which nursing school to attend. I visited two small Christian colleges here in the Midwest that I really liked, but neither has a nursing program. So I would have to earn a bachelor’s degree in some other major and then continue on to get a two year associate degree in nursing. Six years total sounds way too long to be in school!

Where Should I Go?

Where Should I Go?

I left the Protestant Church where I grew up because the Bible was not taught verse-by-verse and I wasn’t growing in knowing the Lord better. My sister also left, which broke our parents’ hearts, especially Mom. We became members of a Bible church led by the Pastor who Linda met at the university her freshman year. A group of university students drive an hour every Sunday to attend. The pastor teaches a weekly Bible class on this university campus which is really growing!

They have a good nursing school at this university, so I decided to apply there as well as a three year hospital diploma nursing school in the same city. I have my interview tomorrow at the diploma school and will tour the University while I am in the city. The diploma students work many more hours of clinical in the hospital than the BSN students, but it is more difficult for them to obtain nursing leadership positions after graduation.

The next day I nervously entered the office of the Director of Admissions at the diploma hospital school of nursing. Mrs. L. greeted me warmly and gave me a tour of the nursing skills lab, classrooms, and dormitory. Afterward we sat down in her office and she asked, “So tell me why you would like to become a nurse?”  I replied, “I like science and I would like to help sick people get better. I enjoy learning new things, and I think it would be fascinating to learn all about the human body and how it works.”  She asked if I had applied to other schools, and I told her I was also considering the State University in the city here.

She advised, “After reviewing your high grade point average and ACT/SAT scores, I think you should go to the BSN program rather than our diploma program. Our program will probably be closing in the next few years, and I think you have real potential to go into management or research in nursing and earn your master’s degree or even a doctorate degree in nursing!” I thought to myself, “I am amazed that she thinks I have real potential to go far in my nursing career! I would just be satisfied to be a regular staff nurse, work a few years, marry a godly Christian man, quit work, have children, and be a stay-at-home Mom like my mother did.” I thanked her for her time and drove across the city to tour the State University.

I joined the walking tour led by a student that afternoon. This campus had as many students as my entire city where I grew up! It had over ten libraries, 30 dormitories, and countless classroom buildings. The 1000 bed University Hospital was about a block from the School of Nursing, so that would be convenient for clinical days. Despite all the buildings, it had green space and many beautiful trees, so it didn’t appear to be a concrete jungle. I am so used to living in the country, I hope I could adjust to living in a huge city.

State University

State University

When I returned home, I asked the Lord to make it clear to me which school I should attend, and He gave me perfect peace that He wanted me to attend the University. I registered and am so excited to start in the fall! It will be so wonderful to have fellowship with the other Christian students in the Bible class, and give the gospel to American students as well as the the international students who attend from every country in the world. In addition to the prerequisites for nursing, I’m looking forward to taking electives in a wide variety of areas since they offer so many majors.  The class catalog is fascinating to read.  I should also become very fit from walking all over the huge campus to my classes!

Reflection – 2013

The director of the diploma nursing program gave me excellent advice in steering me toward the BSN program at the University. As she predicted, the diploma school closed a few years later. After a 17 year hiatus from school, I made the plunge to return for my Master’s degree.

In God’s great sovereignty, He never gave me a husband or children. Little did I realize when I was in high-school that I would have a 40 year full time nursing career, but God knew all along!

One of my favorite hymns is:
Tis’ so sweet to trust in Jesus, Just to take Him at His word,
Just to rest upon His promise, Just to know, “Thus saith the Lord.”
Jesus, Jesus, how I trust Him! How I’ve proved Him o’er and o’er!
Jesus, Jesus, precious Jesus! O for grace to trust Him more.
-by Louisa M.R. Stead