Off the Chart: A Nurse's Journey of Heart and Humor

By Jennifer Tipton

Off the Chart is an account of what goes on behind the scenes in health care. Jennifer Tipton takes readers through the nearly thirty-year journey of her nursing career, where they will experience the laughter, tears, hopes, and heartaches, all through the eyes of a nurse.

 

• Language: English
• Publisher: Palmetto Publishing
• Release date: Sep 15, 2022
• ISBN: 9798822905658

Jennifer Tipton

Off the Chart is Jennifer Tipton's first book, the inspiration of which came from some remarkable individuals who touched her life. In this book, she shares some of their stories and extraordinary experiences. Although the book takes place in So. California, Jennifer now lives in the Treasure Valley with her husband and their two Australian shepherds. In their spare time, they enjoy hiking, off roading, kayaking and white-water rafting. She believes that the greatest gift God gives us is one another, and for her, that includes her husband and the special people she has met and cared for throughout her life and career.

Book preview

CHAPTER 1

NURSING SCHOOL—

NOT FOR SISSIES

FIRST CAME THE PREREQUISITES, including algebra with ratio proportion equations longer than my arm! There was also microbiology, requiring us to identify some mysterious bacteria swimming on a slide that hosted a disease worse than death. And of course, there were anatomy and physiology, in which we watched in horror when a piece of the cadaver’s small intestine snapped off in the professor’s hand as she demonstrated the anatomy of the human digestive tract. We all agreed that the cadaver must have dated back to the days of Genghis Khan.

To all college attendees: Have you ever wondered why some professors take such delight in daring you to pass their course? That anatomy and physiology professor was one of those. Dr. Discouraging (as I will call her) would pinpoint a spot on a tiny slide during an exam while smirkingly instructing the class, Name that cell! She was truly evil, and she enjoyed it.

To all who are currently studying: Here’s a great strategy for success in these situations. Buddy up with the best student in the class! I met a gal in class who was taking anatomy and physiology for the fourth time because she said, It’s fun! (Said no one else ever.) After Dr. Discouraging suggested I drop the class because it was clear that I was struggling, I quickly befriended this gal for these reasons:

Don’t ever tell me I can’t do something!

I had two little boys depending on me to succeed .

My new friend enjoyed the class so much, and she made it fun for me too. She would make up songs to help herself study; her lyrics were so silly that I couldn’t help but retain the information. One such song to help learn the anatomy of the kidney was sung to the tune of I’m Henry the VIII, I am, but she changed the lyrics to I’m Henle the loop I am, I got married to the tubule next door. It worked. I carried twenty units that semester and ended up with a 4.0 GPA, earning me a spot on the dean’s list! I danced my way through the physical education requirement and learned to throw pottery for my humanities units.

When all the prerequisites were done, I entered the nursing program at Ventura College. It was a rough ride, with fewer than half of us making it through, but fortunately I was one of them. Unfortunately I encountered more than one nursing instructor with the I dare you to pass my class attitude. Thankfully there was one blond woman, a gentle-spirited nursing instructor from Santa Barbara, who was an exception to this. We were just in our first semester of nursing school when she confided, I just want you to love nursing as much as I do. Those words were so inspiring and carried me through the tougher days to come. I wish all instructors realized the power they hold to nurture a student’s potential rather than tear it down.

Nursing school consisted primarily of two parts: the lectures and the clinical rotations. A couple of extra classes accompanied these, like the one titled NS 10, which focused on medical terminology, and another called the Skills Lab, where we learned how to bathe a patient, change a bed, and administer injections, along with how to perform other vocational skills. Lectures took place in a classroom setting, while clinicals naturally took place in a clinical setting. Each semester the clinical rotation corresponded with the information provided in the lectures.

For instance, when we studied psychiatric nursing, the clinicals took place in a psychiatric hospital, and when we studied pediatrics, the clinicals took place in the pediatric ward of a hospital. My very first clinical rotation was with the gentle nursing instructor from Santa Barbara. The subject we were studying was geriatric nursing, so logically our clinicals took place in a convalescent home. Today’s nursing students are required to have their certified nursing assistant (CNA) license before they can apply for admission into a nursing program. We, however, did not have this requirement, and because I had never set foot in a nursing home, the experience was terrifying. Entering the nursing home, we first walked past a not-so-cheerful lady at the front desk; after that, all I could see were wheelchairs lined up along both sides of the halls. The countless wheelchairs each held an elderly individual. Many of these frail individuals were huddled over, chins on chests, with their eyes closed. They sat there motionless, just waiting for one of the staff to wheel them off to another location.

Along with the disconcerting scene, the smell could not be forgotten! The smell in that convalescent home could best be described as a subtle stench intermingled with whatever was being served for lunch that day.

There we were, led by the benevolent Ms. Santa Barbara like a small flock of geese in our goofy blue smocks (today’s nursing students also have much nicer uniforms), following her along in single file down the corridor to whatever lay ahead. It was under the wing of the very lovely and gentle-spirited nursing instructor that we felt a calling to persevere; we were, after all, nursing students. We were nursing students on our very first clinical quest, beginning our journey to save the world! And it was on that first day, as we stood there soaking (and smelling) it all in, that we first heard it. Barely audible, it was a faint cry for help. I heard it, and one of my classmates, Tessa, heard it. We looked at each other and immediately knew what we had to do. Like the superheroes we thought we were, we charged into the patient’s room where the feeble cries had come from, and there we saw it. Oh, the horror! There was poop everywhere. This same scenario repeated itself on the second day and again on the third day of our clinical initiation. But by day four, when we heard those cries for help, we simply looked at each other and said, I don’t hear anything. Do you? From that day forward, Tessa and I became the best of friends throughout the entire nursing program.

There was an authentic bond between the class because most of us felt like we lived and breathed nursing school every moment of every day. The experience consumed us, and sharing it brought us closer together. We watched as some of our classmates fell out, and while we were saddened for them, those who remained had to stay strong. We had to maintain a steady course of hard work and concentration to make it to the end. Some of us formed study groups and ate pizza…lots of pizza. After each final exam, we would rush to see our grades posted and shared the anxiety of wondering who had made it and who would be leaving us. Although the experience challenged us individually, we supported one another, and together we were fiercely committed.

A group of classmates and their instructor caught on the elevator

SOME OF THE INSTRUCTORS were intimidating. One such instructor was known as the Weeder because she weeded out the inferior students (those whom she thought to be inferior). I do appreciate the fact that she held lofty standards for her students because the ones who made it through would later become responsible for many lives.

Being responsible for others should undoubtedly demand a high level of accountability, but because of her malevolent reputation, on the first day of a clinical rotation with said Weeder, I felt like Larry, Moe, and Curly (the Three Stooges) all in one. I was so nervous that as I was preparing medications, I dropped them all on the medication book. In those days, we manually signed out the medications we were giving on a paper record as we dispensed (poured) them into small paper cups. As I fumbled and shook, Ms. Weeder stood next to me with her piercing gaze. One eyebrow raised, she announced in a most dignified tone, Look at you! You’ve contaminated the book! I froze in my spot and shivered with shame—until I realized, of course, that you can’t contaminate a book; she was just having fun with me. From that day on, the Weeder and I got along famously. In fact, at a college where the grading system was simply an S for satisfactory and a U for unsatisfactory, the all-powerful, intimidating Weeder woman graded me with all S’s with plus signs next to them. I was on my way!

One of the most wonderful and rewarding things about a career in nursing is the variety of pathways within the career itself. For instance, when I started out, I thought I wanted to practice in pediatrics, but I discovered that it wasn’t the right pathway for me. My pediatric rotation took a high emotional toll when I was assigned to the pediatric unit at a county hospital. At that time, this is where the less fortunate population was sent instead of the upscale private hospital. I saw there a small boy isolated because of a merciless disease, shut off in a room by himself—so frightened and alone. And there was a baby that cried all the time and refused to eat because she was suffering from a diagnosis called failure to thrive. This was because the baby girl was one of a set of twins, and the parents decided that they simply didn’t want two babies, so they chose to reject this baby girl and love only the other. It’s amazing what love (or the absence of it) can do. Perhaps because I had two young boys of my own, but I carried a knot in my stomach and cried throughout my entire pediatric rotation. I hold all pediatric nurses and those who work in the neonatal intensive care unit (NICU) in such high regard. It takes an incredibly gifted person to care for these tender young lives—thank you.

The county hospital offered a wonderful opportunity for learning. Many of the physicians at County were doing their residency training and, as a result, making it a great learning hospital. If nursing students happened to be within earshot as the experienced doctors and residents conferred, there was a great deal of information to be had! So, I tried to hang out without looking too obvious.

Throughout nursing school, each semester gave us a sample of what the many different fields of nursing had to offer. And it was certainly easy to get excited about each and every field when you were in the middle of studying it! In my first surgical rotation, I witnessed a C-section; it was beyond amazing! I thought then that surgery might be for me—until I witnessed an amputation. Upon hearing the sharp, shrill sound of the saw about to be deployed on the unconscious man’s leg, I found that it wasn’t so appealing anymore.

Psychiatric nursing is another distinctively unique field. Some of our classmates were assigned to an outpatient mental health center, while the rest of us were assigned to an all-men’s chronic ward at Camarillo State Hospital. I was in the latter group (lucky me). During our first few days at this clinical rotation, we all huddled together in the safe and secluded nurses’ station behind a securely locked door. There was a large glass window on one side from which we could observe the patients wandering about in the large day room. Here we remained until our instructor told us to come out and mingle! Although we tried to convince her that we could see things just fine from within the nurses’ station, she wasn’t having it.

Our first project during this rotation was to choose one of these gentlemen to write a report about. Initially it was extremely uncomfortable to interact with the mental health patients, but then I befriended a young man who suffered from paranoid schizophrenia. His family had him admitted to the chronic ward because they could not manage him at home. The patients in the chronic ward would spend the rest of their lives there; they would never be discharged to return home. Schizophrenia usually affects young men in their early twenties, just like my new friend. He was a quiet and withdrawn young man, but we managed to communicate. I discovered that before he became ill, he had loved to play the guitar, and although he still had his guitar, it had no strings. I asked the staff if I could buy him the strings for his guitar.

The staff informed me that I could, but he couldn’t know where they came from; that was fine with me as long as he could have them. After his guitar had been newly strung, he played for us while we all sat around him listening. And then nursing students and psych patients alike all began to sing along as my friend played. It was truly awe-inspiring to witness this. These men struggling with chronic mental health issues could remember every single word to their favorite songs, despite their illnesses. The experience was proof that music can genuinely transcend all boundaries; there simply are no limitations to the joy it brings. Music truly is the universal language.

There was yet another patient during our psych rotation who won my heart. He was quite large and very gangly, a gentleman named Henry. Henry was not one to be reckoned with, and that posed a big problem the day my most treasured white Oakley sunglasses went missing. We searched high and low for my Oakleys only to discover that they were on Henry’s face. I spotted Henry having a grand time, sporting my beloved sunglasses as he danced about the unit. He thoroughly entertained himself as he danced and laughed boastfully about his fresh new look. Although I didn’t get the sunglasses back, the joy they brought Henry was worth it!

Classmates at the Camarillo State Hospital Campus 1987

THE CLINICAL INSTRUCTOR FOR our rotation at Camarillo State Hospital was a very warm woman by the name of Millie Biddle. Millie was a short, round woman whose eyes twinkled when she smiled. Millie was also very insightful. She once said to me, You would take them [the patients] all home with you if you could, wouldn’t you? The thought had never occurred to me, but I suppose she was right. After overcoming my fears, I saw each of these men as the sons, brothers, and husbands that they were. Abandoned by their families and placed in a facility, all because of an illness they did not choose. Admittedly I did feel a genuine sense of compassion for them, and while I probably would not have taken them home, the very insightful Millie was indeed onto something.

It was years later that I came to realize I suffer from what I call the Dudley Do-Right syndrome. In case you’re not familiar, Dudley Do-Right first appeared as a cartoon in 1961 on the Rocky and Bullwinkle show. He was a royal Canadian mounted policeman, a true hero of the Mounties! Whenever the dastardly villain Snidely Whiplash would tie the ever-innocent heroine Nell Fenwick to the railroad tracks, Dudley would always burst in shouting, "I’ll save you!" And he always did.

Forever helpful Do-Right saving Nell from the dastardly Snidely Whiplash

THEREFORE, THE DUDLEY DO-RIGHT syndrome was the desire to save anyone that I could—and some that I could not. Being in the medical field is a calling, and I believe most of us share a passion for helping others. One hospital I worked at called it having a servant’s heart. We are born with it.

There was a lot for me to learn from Millie Biddle, not just about psychiatric nursing but also about myself. One day she was talking to the class about the different ways in which we each manage stress, and she used me as an example…uh-oh. Millie told the class that because our clinicals began at 7:30 a.m., it did not mean to come flying into the parking lot with your hair on fire and music blaring at 7:32 a.m. (like yours truly). She went on to say that some people (like yours truly again) drive fast, are usually running late, and listen to very loud music as a control mechanism when under stress. Maybe…

But she said these things with love and my best interest at heart. Years later I had the privilege to be there for her at the end of her days. But that story comes later.

Camarillo State Mental Hospital had housed as many as 7,266 patients in 1954, and by 1966 those numbers had drastically dropped to 871. The psychiatric hospital for both developmentally disabled and mentally ill patients known as Cam permanently closed its doors in 1997. It has always been a mystery where the remaining patients went; some say they were transferred to other facilities, and there are also those who believe many of the patients were set free on the streets due to the lack of funding.

Camarillo State Hospital opened 1936 and closed 1997. Many claim it was haunted, some believe the building remains haunted today.

There are rumors that it inspired the Eagles song Hotel California

(although I read the band denies it)

THE CAMPUS HAS SINCE been redeveloped as the California State University Channel Islands—where, coincidentally, they offer an excellent nursing program!

The most difficult semester of the nursing program at Ventura College was the cardiopulmonary portion. The lectures and clinicals were with the notorious Weeder woman herself—it was a double dose of terrifying.

We learned about the very center of it all: the core component to maintaining human life, the human heart. It is the pump that is essential for providing blood to every organ and every cell, from the brain to the toes. The human heart also maintains a close relationship with the lungs; it pumps the unoxygenated blood into the lungs, where the oxygenated blood is then returned to the heart to be pumped to the rest of the body. If something goes wrong with the heart or the lungs, it commonly affects the other. The human body is quite remarkable in that way. In its complexity, our bodies are intricately designed so that systems work together. In the cardiopulmonary system, the fluids and electrolytes (potassium, calcium, magnesium) play a huge role in how the heart and lungs function. Although the semester was indeed the most difficult module for me, this is where I would discover my field of choice—but because of some unforeseen obstacles, it almost never happened.

We each have our preferred method of study; some learn best by hearing the material, some by seeing it, and some by the hands-on method. I discovered many years later when training new nurses that the See one, do one, teach one method is extremely effective for most when it comes to learning a new skill.

When in nursing school, my study habits to prepare for a final were to make a pot of coffee, sit at the kitchen table, and intensely review my notes until the very last minute. And I emphasize…the very last minute.

As was customary for me, I was preparing for the cardiopulmonary final exam and flew out the door just minutes before the exam was scheduled to begin. As I sped toward the college, the song on the radio was Twilight Zone, by Golden Earring (great driving song, by the way), but regrettably on this particular day, I think that the universe was trying to tell me something. When I briskly entered the classroom, the exam was already underway. What was going on? I had made it on time, although barely. As the song said, I felt like I was stepping into the twilight zone. It was then that I remembered our class for the final exam had been scheduled to start a half hour earlier than usual. As Weeder shot me a sideways glare, I realized I had just under a half hour to successfully complete the final exam if I wanted to remain in the program. No pressure there.

In the world of nursing exams, which includes the biggest kahuna of them all, the state board exam, there are usually two right answers, and you must choose the better of the two. In this case, it was to my advantage not to have had the luxury of time to overthink each question. Instead, I was forced to focus intently on each question, choose what stood out as the better answer, and move on without hesitation. It was with this approach, and by the grace of God, that I passed.

The completion of nursing school happened one semester and one final exam at a time. These steps were necessary before taking the state board exam and finally receiving registered nurse licensure. There were some who, without first completing the program, took a chance and challenged the state board exam to obtain their license. These individuals were usually already licensed vocational nurses (LVNs). In some states, an LVN is called an LPN (licensed practical nurse).

For one to obtain an LVN/LPN license, they must only complete a one-year program versus the two-year requirement for an RN. Because many LVN/LPNs have had years of clinical experience, some are quite successful at passing the state board exam with the knowledge that they’ve accumulated from on-the-job experience.

To pass the state board exam, we were expected to comprehend some of the most complex content imaginable. The study of fluids and electrolytes made our heads spin, and the Krebs Cycle (which explains the process of cellular respiration at the molecular level) caused even the best students to cower. Remarkably much of this difficult and detailed material is necessary to practice nursing in the real world.

The difference between nursing school and the real world is that in nursing school, the instructor asks a question, and you are expected to regurgitate all the appropriate and related information. In the real world, you’re not expected to know everything; you’ve just got to know what your resources are.

Accompanying the demanding cerebral challenges were many other valuable lessons to be learned in nursing school. While I was completing a clinical rotation at a modest little country hospital, the patient to whom I was assigned had received news of a dreadful diagnosis, and although her doctors had a treatment plan, her prognosis was undeniably poor. Overcome with sorrow and a sense of hopelessness, the despondent woman had changed out of her hospital gown and into the street clothes she had come in wearing. The woman had conceded to her fate and was determined to leave the hospital against medical advice. The nursing instructor suggested that I go into the room and talk to her.

The tiny woman sat on the edge of the bed; I took my place in the chair next to the bed, feeling so uncomfortable. It was incredibly awkward. I didn’t have any idea what to say to her. The nursing instructor stood in the doorway and motioned for me to come out and speak with her. She asked me why I was sitting so far away from the patient. I didn’t have any answer for her. Maybe because I was raised by family members who weren’t huggers or touchy folk by any means, I was taught not to invade anyone’s personal space. But after the instructor kindly persuaded me to consider a different approach to the awkward situation, I discovered an effective way to help with the uneasiness we both felt. I reentered the room and sat next to the lonely little lady; I put my arm around her and just let her cry. I learned then that sometimes no words or interventions are needed because sometimes, a nurse’s job is to just be present.

Regrettably not all nursing instructors taught or remotely mirrored compassion; there was one such heartless instructor in my final semester. She was a large, loud woman; I’ll call her Big Ella. We were in our final semester of nursing school, and only a fraction of the class that had started the nursing program together remained.

We were all exhausted and also elated to have come this far and be so close to completion! The state