“All Searching Together”: Reflective Writing and Nursing Research in a Magnet Hospital

For many of us, writing doesn’t often come as easily as we’d wish. The dream is that our fingers will tap dance across the keyboard and the words will race across the computer screen, sentence after flowing sentence forming well-ordered paragraphs and well-structured arguments—and every once in a while, after lots of practice, that might actually happen. But that’s not most people’s experience most of the time. Many factors can contribute to the difficulty of writing; for students whose grades depend, in part, on the papers they write, or for professionals whose advancement depends on publication, worry about the judgment of others and the fear of not meeting the standard may become paralyzing. Because some of the barriers to effective writing are emotional, reflective and creative writing techniques can be helpful even in an academic or scientific setting.

I recently had the pleasure of joining with two colleagues to provide a two-day writing retreat for a group of nurses and physical therapists at NYU Langone Medical Center Hospital for Joint Diseases. HJD is a Magnet hospital, a designation the American Nurses Credentialing Center awards to institutions that demonstrate qualities of nursing practice and patient care outcomes that attract and retain highly qualified professional nurses. Magnet hospitals are centers of nursing research, and a condition of maintaining Magnet status is that staff nurses conduct such research and publish the results. Dr. Donna M. Nickitas, a faculty colleague at Hunter-Bellevue School of Nursing and the executive officer of the CUNY Graduate Center’s Doctor of Philosophy in Nursing program, had previously worked with groups of nurses at HJD to help them develop manuscripts for publication. For this two-day retreat, she invited CHMP poet-in-residence Joy Jacobson and me to collaborate on a program that, in addition to her own thorough overview of producing research articles, would use artistic means to help participants get into the flow of writing.

Joy and I engaged the group in creative activities that we often use in our writing classes and workshops, including readings and reflective writing prompts that stimulate the imagination and rekindle clinicians’ passion for their research topics. We asked the writers to read aloud from their own work and from published poems and essays, not only for their content but also to help the writers become more comfortable hearing their own voices and being heard by others. And each day, as a way to relieve stress, quell anxiety, and center the group’s awareness in the creative present, Joy led a guided meditation that I accompanied on harmonium, a small reed organ with a keyboard and hand-operated bellows. All of us focused our attention on our breathing, loosened our grasp on thoughts about work and worries about writing, and vocalized in tune with the harmonium’s drone. And then we wrote.

On the second day of the retreat, we read a short excerpt from an essay called “Don’t Ever Forget Me” by Christopher Lance Coleman (the essay can be be found in an excellent anthology, I Wasn’t Strong Like This When I Started Out: True Stories of Becoming a Nurse, edited by Lee Gutkind). Now a professor at the University of Pennsylvania School of Nursing, Coleman was a nursing student at the beginning of the AIDS epidemic, when a lack of knowledge about how the disease was transmitted instilled fear in many health care providers. Coleman begins his essay with an account of being on duty one evening and hearing weak cries coming from behind a hospital door marked with a sign that said: “Patient Has AIDS. Do Not Enter.” Defying the sign—and the rules for nursing students, who were then forbidden to care for AIDS patients—Coleman entered and found a woman who had dropped her fork and was too weak to pick it up and feed herself. Coleman fed the woman and vowed to himself that no AIDS patient would ever again go hungry on his watch. He’s spent the past 30 years doing hospice work with HIV/AIDS patients and conducting research in HIV/AIDS prevention.

Coleman’s story had special meaning for one of the writing retreat participants, Patricia Lavin, MS, BSN, RN. Now the director of nursing quality and outcomes at HJD, Lavin worked at St. Vincent’s Hospital in Greenwich Village during the worst period of the AIDS crisis. In all, she spent more than a decade as an emergency room staff nurse and critical care nurse and also worked in nursing management. She writes: “St. Vincent’s was the epicenter of New York City’s AIDS epidemic. It housed the first and largest AIDS ward on the East Coast and is often referred to as the ‘ground zero’ of the AIDS epidemic. Thousands of people were treated for HIV/AIDS at St. Vincent’s and many died; many more passed through to visit sick partners, friends, and family members. Although there were other important AIDS wards and treatment centers in New York City, none took on the symbolic and cultural significance of St. Vincent’s.”

Here is Lavin’s response to Coleman’s essay, an account of a time when “we were all searching together”:

Marching with the Unknown

Staring into the faces of the emaciated and frightened men with fevers of unknown origin

Knowing that they wanted answers and no one had them

Fear etched into their faces, searching for any glimmer of hope from the figures in white who drifted in and out of their rooms and their lives

They were frightened

We were frightened

They stared with disbelief at the path of destruction this unknown illness brought

We, their caregivers, stared too at the ravages of the unknown disease

At the loss of all that they loved

At the unknown . . .

One patient taunted me—beckoning me to see what a nightmare he was trapped in

I was a new nurse and every day I came in and tried to be upbeat and happy

I focused on the positive, day after day, when I walked through the door to care for him

But he was dying

He was afraid

He was alone

No one knew why

No one could help

We were all lost, we were all searching together, and no one had answers in 1984

By 1988 I was working in Greenwich Village at the height of the epidemic

Now we had a name—AIDS

We knew that HIV was the cause

But it did not stop the ravaged bodies coming in through the Emergency Room doors

It did not stop the suffering, the pain and the fear

So much fear

So many questions still unanswered, how long could this go on for?

How many more would suffer?

Who else would die?

Your neighbor, your friend, your lover, your brother, your uncle, your father . . . ?

People praying,

People hoping,

People crying,

People suffering,

Agony and then courage, yes oh the courage and then action!

Marching in the streets in New York City and across the country

Demanding answers, demanding to be heard

Crowds of angry young men breaking down the doors in our Emergency Room lobby

Curtains and drapes being dragged off the windows,

Spray painted body forms painted on the sidewalk, painted in the lobby as reminders of their pain and of their dying bodies

When would it stop??

When would all the anguish turn into answers??

Death still came as the years turned into decades

It only marched slower now,

It took longer to come

But it still came . . .

–Jim Stubenrauch is a senior fellow at the Center for Health, Media & Policy
and teaches writing at the Hunter-Bellevue School of Nursing.