Wonder women

(Modified version of a speech delivered at the recognition rites of the UP College of Nursing, June 19, 2017)

When we think of nurses and history we think of Florence Nightingale (1820-1910), a British woman who brought 38 other women with her to tend to wounded soldiers during the Crimean War and is acknowledged as having established the foundations for modern, professionalized nursing.

Nurse, educator, scientist

Fewer people, including nurses themselves, are aware that Nightingale was a feisty crusader for social causes, writing on every conceivable topic, to the extent that a collection of her writings, published some years back by the Wilfrid Laurier University Press, came to 16 volumes, with each volume dedicated to particular topics: society and politics, philosophy, education, public health, women and medicine, war and militarism, and two separate volumes on religions.

Besides being a nurse, Nightingale was a statistician, using the still young science of numbers to analyze social problems and identify their causes. Linking the high death rates in hospitals to infections, she became a fierce advocate for sanitation. In the 19th century, the germ theory was still being questioned by medical professionals, many of whom believed that illnesses were caused by miasmas, or what we call singaw ng lupa.

Many nursing schools still teach one of her most important contributions to public health, referred to as Nightingale’s environmental theory. First elucidated in her “Notes on Nursing for the Laboring Classes,” her theory came in the form of a definition of nursing as “an act of utilizing the environment of the patient to assist him in his recovery.” Nightingale believed that the recovery of a patient depended mainly on pure fresh air, pure water, effective drainage, cleanliness and light (especially direct sunlight).

Her Notes on Nursing date back to 1860 but they have become even more relevant in the 21st century, as the health professions forget the basics of health care. Besides sanitation, Nightingale also wrote about the importance of nutrition for the patients, warmth, attentiveness and a “quiet environment,” coming out of her experiences caring for soldiers with tetanus, where even the slightest noise could cause seizures. Today, we know that even in cases not involving tetanus, a quiet environment contributes to a person’s recovery.

We must push, as Nightingale did, for scientific approaches to problems, starting with sharp observation skills. Some years back one of my students told me his mother, a nurse in a government hospital, had acquired a reputation for being able to tell if a patient had taken for the worse, and was dying. I said I wouldn’t be surprised if we had many more of these nurses, especially the older ones, who have developed a clinical eye (and clinical nose, and clinical ear), able to tell when a crisis is emerging, or has been overcome, without too many fancy tests and equipment.

There is much to do in public health, outside of hospitals and institutions. I ask our nurses to lend their voices to more scientific, humane and effective approaches to the drug problem. Nightingale dared to defy conventional thinking in her time, and was able to use statistical evidence to support her causes.

Influencers

Nurses can be powerful, influencing the lives of families and communities. I suspect many of you have had nurses in your families, and that they inspired you to become nurses. There were none among my older relatives, but there were nurses who left their marks on many lives. I will cite one in particular—our school nurse, who kept the infirmary doors open not just to the sick but to anyone who needed social support. She later went on to teach nursing. . . and is with us today: your former dean and now professor emeritus Dr. Leticia Kuan.

In the years of martial law I had the privilege of working with nurses like the late Minda Luz Quesada, who would go to the police in the streets and in jails (when rallyists would be arrested), greeting them and trying to win them over. I continue to have the privilege of working with many nurses in public and community health, and others who are opening new horizons in exciting fields like genetic counseling and geriatric nursing. I have also had nurses taking graduate courses in medical anthropology, intent on improving nursing care by considering culture.

The modern Filipino nurse must fight old, as well as new, superstitions: the use of nonsense supplements, skin whiteners and all kinds of cure-alls. Our nurses must fight the over-reliance on expensive tests and technologies and tap into the rejuvenating power of listening, and being persistently kind.

Some years back, when my mother, who was 94 at that time, stopped eating and had to have an naso-gastric tube (NGT) inserted. I left the room knowing the struggle that was going to follow during the insertion of the tube. Outside, I could hear my mother protesting. Then I heard my son, who was about eight years old at that time and who had stayed at her side, consoling her: “Lola, lola, it will be all right.” I could hear my mother quieting down, and the tube was inserted.

I have tried very hard to make sure my children, especially my son, will be nurturers in a world that so lacks kindness, but I am certain he has been influenced, too, by the many nurses and caregiving personnel who have become part of our lives over the last seven years caring for my elderly parents, both of whom have dementia.

I used to tell my classes of health professionals that it’s so important to use the phrase “Kaya mo ito” with patients, but I think a better phrase to use, inspired by all the Florence Nightingales in our lives, is to say: “Kakayanin natin ito,” we will overcome, together.

Moving away from Florence Nightingale and her lamp, and thinking of all of the contributions nurses make, I beg your indulgence as I get a bit whimsical and draw from the movies to describe you.

Today I thank all the Wonder Women and Darnas who came before you in this noble profession, and I thank you, the batch of 2017, the new Wonder Women and Darnas, for having started to carry on the legacy of those who came ahead of you. (I am well aware of the few men who enter nursing, and I’m afraid I can’t use Wonder Men here because it sounds funny but that’s what you are: not just wonder men, but tunay na lalake for taking up a tough profession.)

Do remember the wise counsel of your chancellor, Dr. Carmencita Padilla, about being leaders and about how we have produced so many leaders for the world. May we hope perhaps some of you will become leaders for the Philippines?

Our country is in great crisis, but you can help us to weather the storm. Kayo pa. Kakayanin natin ito.

mtan@inquirer.com.ph