Tuesday, May 28, 2013

Nursing and Ethics - a commentary by author Kate Genovese


KEEPING UP WITH THE CODE OF EITHICS IN NURSING

I recently read the article in the Boston Globe about the nurses, who cared for the terrorist, Dzhokhar Tsarnaev after setting off bombs at the finish line at the Boston Marathon; injuring hundreds and killing four innocent, beautiful people. An eight year old, just starting his life, two beautiful young women  in their twenties, and a young MIT security policeman, just starting his career and looking forward to so many more days of aprofession he chose and loved. All of them; their lives brought to an end abruptly because of a 19 year old Chesnian and his brother; young men who used our system and thought nothing of taking away lives and livelihoods of those injured.

As a registered nurse myself, I have taken care of hundreds, thousands of Americans and foreigners that have entered our country, legally and then who are not.


I didn’t much care. My job was to value their existence, dignify their place in this universe, and find worth in all people.

After 35 years of nursing I am not sure I could have followed the CODE OF NURSING ETHICS that I learned so many years ago in nursing school.

When I read the story of “Marie” and how she struggled with caring for the 19 year old Dzhokhar; being his bedside nurse; having to comfort him, medicate him to be free of pain and help heal his physical wounds, I wondered if I could have been so brave and followed Florence Nightingale’s practice of all people are equal and worthy of getting well.

Although a different scenario, I thought back to the early 1990’s when I worked the later shift at MASSACHUSETTS EYE AND EAR INFIRMARY. Being right next to the Charles Street jail, we often had a prisoner or two come our way for day surgery, or being sent to the Mass General for a burst appendix. I always took care of them in a sympathetic, caring way. Although they were prisoners, had done something against the law, I felt it was my responsibility to help them heal and keep them pain free; until I was faced with an emergency one evening.

My shift was to end at 6pm and I was anxious to get home, attend my ten year olds hockey game, but instead I found myself calling my husband telling him he was on duty for the rest of the night, a patient/prisoner from Charles Street jail was coming to us; he had badly beaten  up  one of the other inmates who was sent to Mass General, where his life was hanging by a string; the gentleman I was to care for after his eye surgery had beaten the other so badly that his kidneys had failed and he had severe internal bleeding.

As I read the story as what had happened, I suddenly felt no remorse for prisoner “Tommy”
That was the name I had given him.

I suddenly felt anger, hatred towards this guy for what he had done! Tommy was forty years old; no family, friends or significant other. I pictured this angry middle-aged man who blamed the system for everything that happened in his life.

Yes, I was projecting. But I couldn’t believe otherwise. The inmate he had injured was a 25 year old father and was being transferred to another facility west of Boston and had only another year to serve the Commonwealth of Massachusetts for a drug crime that hurt him more than anyone else.

So when “Tommy” was wheeled to me on his gurney into the recovery room, I was already going against the nursing Code Of Ethics in my head. I didn’t want to treat him with dignity or him having any value in this universe.

No, he certainly wasn’t a terrorist, what happened to me has no comparison to what happened on marathon Monday with those wonderful angels of mercy at Beth Israel and surrounding hospitals. What they had to deal with and face; being courageous themselves and hold their true feelings aside.

Because that is what we were taught to do; drilled into our heads in nursing school and in our own practices over the years; the worth of all people- no matter what the circumstance.
I remember getting report from the operating room nurse, all had gone well. He was stable. I looked at his hands, chained to the side rails and two guards standing next to him for hours.
I remember taking a break and calling my husband to see how my son Danny did in his hockey game. My husband asked about the patient. I told him it was difficult for me to be nice, kind after what he did to another person.

My husband had no response; he knew me and knew I would do the best I could for this man, because that is who I was and still am; a nurse, a professional that took an oath and a good standard of care  for all my patients.

And I am sure “Marie” had the same whirlwind of thoughts and emotions that I had over twenty years ago; only a little more intense.

It makes me wonder if this 19 year old held any of the values, ever, that we Americans hold and stand by. Did his brother influence him? Was he brainwashed?

We may never know. Nor did I ever find out what happened to my patient Tommy after I discharged him back to jail and their infirmary.

And the other inmate? He lived. He survived. He made it out of there and headed west of Boston to another facility months later.

Decisions to care, treat everyone equally helps us all grow on an emotional and spiritual level.
I question that even today. When I take care of a patient I know that is abusive to their family or lives a below-standard life. What, really, would God want me to do, expect of me?


Because it really isn’t about the other person, but about ourselves and what is right. There is a saying; just wake up in the morning and always, always, just do the next “right” thing for yourself and the universe, and God will see to it that things will just fall into place.


Many thanks to the wonderful nurses and support staff who had to deal with the injured, their families and attempt to try with God’s Blessings to do the next right thing and to help all of us continue to heal and help each other since the Boston Marathon.


Because of this, we have become a stronger Boston, a beloved Watertown and a country and profession I am proud of.



Kate Genovese RN

Author/THIRTY YEARS IN SEPTEMBER; A NURSES 
MEMOIR

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