Be the change you want to see in the world. ~ Ghandi

Wednesday, March 30, 2011


     For a week or two after Port-au-Prince was flattened by the Haiti earthquake, we were glued to the TV while the human drama of recovery from a disaster was played out live, unscripted, made possible by the sophisticated technology of TV and global communication. We saw the recovery crews pulling out the people or their remains, watched the reporters interview nurses overwhelmed by the sheer numbers of patients, watched as mobs of desperate people swarmed the trucks delivering food and water, which was at first dumped out the back of the truck as it moved along, barely in control. The images highlighted the heroic nature of relief work. This epic disaster now moves to a quieter phase as it takes its place alongside the stories of 9- 11, Katrina, the Tsunami, wars and other manmade or natural events of history.
     What was has been striking about all of these is the growing recognition of the role that nurses play in these events. At one hospital the CNN crew was referring to the workers as doctors, until the people delivering care came over to correct them. This has always been true about disaster publicity - the care is delivered by whomever happens to be there and more often than not it is a nurse.
     And so this is the background from which I discovered the writings of Nancy Harless. I was fortunate to receive an advance copy of her latest book, Nurses Beyond Borders, around the time of the earthquake. Like Ms. Harless, I have worked overseas and written about the experience. And like her, I have spent time trying to make sense of the experience, trying to explain it to others who I am not certain are really interested. Ms. Harless has worked in Mexico and also the Balkans during the recent war. Her previous books explore previous travels.
     Nursing Beyond Borders is an anthology. Two dozen nurses told their story about working in different parts of the globe. In some cases it was wartime - our own Viet Nam War or one of the civil wars of Africa. In other cases, the nurses may have been on a short-term mission trip or travelling. The stories are loosely organized into four categories - transition, shadows, humor, and looking back. There is no overarching "plot" nor is there any moralizing about the choices made by the nurse or the patients. As in the tradition of the best nursing "war stories" the clinical exemplars are just told, not a lot of frills or embellishments. and the reader is allowed to draw their own conclusions or ask their own questions. Ms. Harless wrote the introduction and a sort of study guide which is appended to the back    
     The introduction is probably the clearest statement about the phenomenon of becoming a Global Nurse, of any that has been written. I found myself wanting to cut-and-paste the whole thing into this review. I knew I was in for a treat when she wrote "....Sit back. Get comfortable...." and then a few sentences later followed it up with "..... And then get uncomfortable -very uncomfortable - so uneasy that you too, feel the call for action...." My reaction was, here is a person who gets it and knows from whence she speaks.
     There is a danger in describing overseas experiences, which is to romanticize the events, or the people who do this sort of thing, or their thinking. During a war, there will be periods of time that are boring, or where senselessly awful things happen for which there is no whitewash. Or we are led to think that the person telling the story has led a spotless personal life; or that the person never experienced fear and doubt during the experience, which is a particular failing of stories told by Christian Missionaries. It was something to which I was determined not fall victim in my own writing. Telling the real truth is something nurses pledge to each other at work and in their professional lives, and Ms. Harless deserves praise for that same commitment to truth she has continued in this work. These storytellers shared the aspects of global nursing that make it intense and very rewarding as well as a journey of personal discovery and service to humanity. Bravo.
     And so, I recommend this book to any nurse that is thinking of getting outside their personal bubble of comfort zone and out in to the big wide world. Get comfortable. Read… the get Uncomfortable… very uncomfortable……
Joe Niemczura RN, MSN: Nursing Instructor a the University of Hawaii University at Manoa, Honolulu, Hawaii. and author of “Hospital at the End of the World”