My Firsts... as a Nurse in the U.S.

I came to America with just a Red Cross work experience. I taught first aid, responded to disasters, and did some fundraising. But my excellent n0-holds-barred clinical experience as a student nurse in military hospitals had provided me with more than what any US-trained student nurse had ever experienced, then and now. So, I embraced my foray into the United States, with unbridled enthusiasm and with great expectations and anticipation.

The bright lights of New York City beckoned. Across 8509 miles and 20 hours of the turbulent plane ride. As a 23-year-old, the world was my oyster. It was the promise of a fantastic adventure that had sustained me through five years of nursing school. I was more than ready for my many firsts.


First Hospital

In January 1983, there were twenty of us young nurses who came on our first plane ride across the continents. We were the first big wave of recruits to descend on Roosevelt Island, a waterfront community situated in the East River of New York City between Manhattan and Queens.

The brochure for Bird S. Coler Hospital in Roosevelt Island looked much more impressive than the hospital itself. Coler Hospital is/was one of two chronic care hospitals specializing in rehabilitative care (the other one is Goldwater Hospital) located on the island.

It proved to be a great first hospital because it was not a jarring first exposure to the American hospital system; it was a slow and easy transition to independence for this Manila city girl who had ventured outside the safe haven of my native land under the protection of family and the comforts of home.

My first unit was the Intensive Care Unit, but it really was more of a step-down unit for acute episodes that needed more care, and some patients had to be transferred to other acute hospitals when we could not provide any more services.

The breathtaking view of Manhattan across the East River and the expansive grounds of the hospital made up for the not-so state of art facility. The winter months brought in the magical Currier and Ives display. And the Fall foliage reigned supreme with its riot of color that framed the hospital building like a Monet. In the spring and summer months, we lunched on the hospital grounds surrounded by the lush gardens and the flowering magnolia and cherry blossoms trees, with river breeze on our faces.

We occasionally waved at the passing sailboats and even threw some kisses at the bare-chested men on those boats, emboldened by the fact that we would never see them again.





First Tram Ride

In our first month, we were housed in a dorm near the hospital. The Nursing department had given us a week to settle in before our Orientation. Our group of 12 ventured out on our second day. Our destination: Manhattan. The rest of the nurses were still in bed crying out for their families in the Philippines.

Our group was luckier; we were single and unencumbered by sentimentalities. That’s what we told each other in the morning, although we had muffled our cries in the pillows as we wept for our mommies.

The Roosevelt Island tram was scary and exhilarating at the same time. We dared not take the bus that would have taken us circuitously to Queens just so we can take the underground subway train into Manhattan. Anyway, the tram was the direct way to reach the place we'd just seen in the movies.

So off we went to explore. I asked the security officer for directions, then also asked if he had a map. He looked bewildered by my request, then turned around and grabbed a "mop" from a passing housekeeper. That was my first lesson to mind my accent and my pronunciation. We quickly learned that there was a huge difference between "bag" and "bug". We were now being "Americanized".

With the cable car suspended and swaying 250 feet up in the air, like the newbies that we were, we whooped excitedly and unashamedly as the east side of the midtown Manhattan skyline came nearer. The sun was setting down and we were bathed in the glorious colors of orange and red. The Queensboro bridge was the backdrop in this post-card perfect scene. It was a magnificent welcome to our new home.

Then we were in the middle of 59th Street, with too many cars, and too many people rushing off everywhere and the impressive (and expensive) Bloomingdale's store in front of us. The city was vibrant and humming with activity; the City that Never Sleeps. We had arrived!





First Patient

I called her "Sessa"; a 75-year-old Hispanic woman who had been in the unit for years for chronic renal failure and thrice-weekly peritoneal dialysis.

In my group, I was the first nurse to volunteer to learn the complicated bedside procedure using the Tenckhoff catheter. Pretty soon, I was an expert on dialysates, instill time, and dwell times. I was bold and fearless. It helped that our nephrologist was the very cute Dr. C. We had great memories of his different colored Lacoste polo shirts with the matching briefs that we have spied when he bent down to talk to Sessa.

Sessa was cantankerous and expected me to speak to her in Spanish. I struggled with my pidgin Spanish (even though I had four years of instruction in school). She turned out to actually speak good English, and I passed her test because I did not cower and break into tears. I treated her as my grandmother, and always had a hug and a kiss for her.

First Patient Death

Sessa was my first patient death. Just before we came on shift, she suffered a cardiac arrest in the unit and passed away. We just spent six months together and I never even had a chance to say goodbye. Two other nurses (who she had proclaimed as her other favorites) assisted me as we washed her uremic skin and combed her gray-matted hair. There was no relative coming to claim her body, but we wanted her to look her best.

As I cleaned the gel from the defibrillator paddles off her fragile chest, the finality of the moment gripped us all, and soon all three of us were crying. The head nurse offered to take over, but we refused, controlled our emotions, and resumed giving Sessa her last bed bath, our final respects.


First Leadership Experience

Our bunch of RNs, BSN-prepared novices took over the reins from the LPNs who used to be in charge of the units. Suddenly, here we were, naive and timid, suddenly being groomed to run the unit. Within two years, I was appointed as the day head nurse in an in-patient unit, with a staff of eight RNs and twelve nurses' aides.

We adapted very well, and for my part, I felt that the nurses' aides welcomed us and treated us as family. We only needed the flimsiest of excuses to have a party. Our shared food bonded us. We feasted on Caribbean jerk chicken, Indian samosa, American hot dogs, Italian lasagna, and of course, Filipino food (adobo, pancit, lumpia). The "lechon" was a big hit among the hospital staff.

I had great nursing supervisors, but I learned more about leadership from two nurses' aides: Elena and Mrs. H. They showed me how to lead with humility, love, and respect by giving me their perspective on how to win the other staff over. They did not dazzle with an alphabet soup of degrees and certifications, but they possessed the wisdom of being the matriarchs of their families. and an innate understanding of emotional intelligence and common sense.

Elena and Mrs. H told me what I needed to hear, not what would have pleased me. From them, I learned how to mean what I say and say what I mean without being mean. They taught me how to listen, to really listen with my heart.



First Snow

I remember it like it was only yesterday. My first snow happened in my second month in America.

We have moved to a new apartment off Roosevelt Island. I was standing at the bus stop near the hospital shivering in the cold winter air. Fully bundled up, thick wool coat, scarf, and ear muffs. Then, the white fluffy crystals came down from the sky. There is something magical, and cleansing with the first snow. I raised my face up to the heavens, uttered a simple "Thank you" to God, opened my mouth, and caught the snowflakes on my tongue. Sweet!

The next day, the hospital grounds were blanketed in six inches of a winter wonderland. My friend and I looked at each other, and by mutual agreement, veered off the path to the bus stop. We went to the side of the hospital where the ground was unmarred by footsteps. Virgin snow, and no one around to laugh at us. We quickly laid down on the ground and made snow angels; arms and legs outstretched and flapped them up and down in and out. We giggled as the disturbed snow swirled around us.

Our shared bliss was suddenly interrupted by muted laughter. Not to worry, they were just two other friends who had the same idea. Soon, there were four of us, Filipina nurses on the snow-covered grounds. Good that there were no patients to witness this.

It was two decades later when I did the snow angel again. In my backyard with our dog Brownie on top of my chest, peering in curiosity at me as I lay down on the snowy ground. Sweet!





First Doctor Crush

Dr. L was a brown-eyed blond doctor who moon-lighted every weekend in my unit. With his Nordic good looks, he probably had a girlfriend in every hospital he worked at, but he was the first ever non-Filipino male who tickled my fancy. My other friends said that he was a snob with a God complex, but for some reason, he was always nice to me.

One day, I was waiting for my turn at the cafeteria and pointed out the french fries to the cafeteria worker. From behind me, Dr. L chuckled and said, “I like french fries, too”. Who’d think that such a simple sentence would make me stammer and render me blubbering like a fool?

Then, as bad timing as it can get, Dr. L’s pager beeped. A code arrest in one of the skilled nursing units. Romance (and lunch) interrupted. He looked at the soda can that I was holding, and with a sheepish smile of apology took it from me, sipped from it, returned the soda can, and said, “Thank you.”

Woah! What else can I do but give the soda can back to him, and said “Take it”. I don’t know how I should have handled it like a more sophisticated woman would do, but his gesture was a sensual action that I was too naive and uncomfortable to respond to. I thought, “Dalagang pilipina ako!”, a typical conservative Filipina. I was overwhelmed.

Truth be told, a tiny wild part of me swooned. But, in all my innocence and probably due to my unfamiliarity with modern courtship, I convinced myself the blatant flirting was disrespectful. I gave him the cold shoulder the next time we met in the unit.

The internet search yielded a recent picture of Dr. L. He’s now a hematologist in the Bronx. He still sports the same round-rimmed glasses, older but still has a boyish charm that had captivated me all those years ago.




First Save

The evening head nurse screamed at me one day for failing to oversee a nurse who was taking care of a patient who fell and sustained a hip fracture at noon time. In all our confusion, the patient did not receive any pain medication, until the evening shift came. The primary nurse was busy passing medications for the rest of the unit, and I was too caught up in preparing the incident report and the transfer papers for the acute hospital in Queens.

I started to protest, but then I realized that I had command responsibility. I was hurt, but I accepted the censure. My inexperience was showing, and it took my more experienced peer just a few minutes what I failed to see. We failed the patient; the guilt kept me up that night.

The next morning, I was rounding with this head nurse (she had done a 16-hour shift) when I heard a gurgling sound. The elderly patient's color was still good, but she was gagging. I looked at her mouth and saw a big mucous plug at the back of her throat. With a gloved hand, I reached in, and scraped the thick plug off the roof of her palate. And the gurgling stopped.

The evening head nurse patted my back and said, "You just saved a life." I went back to check on the patient. She was resting comfortably; she had dementia and probably had no idea what just happened, but I squeezed her hand and whispered, "I'm glad I was around when you needed help. Thank you."

The incident sparked an interest in me to try emergency nursing, where saving lives happened every day.



There were many firsts...

My four years at Coler had given me much more in terms of my growth as a nurse and as a person. It did not matter that it was a small hospital tucked away on a small island. I loved the hospital and its warm-hearted quaint community of staff and patients... my first hospital.

It was the start of an incredible journey in a foreign land, away from family and childhood friends. I was young, adventurous, and full of dreams. Suddenly independent, suddenly an adult. And I was surrounded by my new friends and the patients that I cared very much about.

Sadly, I lost contact with my nursing friends; we went onto different paths and we don't see each other anymore. Some of my patients had long been gone, and the hospital had changed and merged with the other hospital but the fond memories are forever locked in my heart.












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