A Parade of Gowns: A reflection by Michelle Spadoni, RN and Associate Professor at Lakehead University
In April, I was invited by Michelle Spadoni, RN and Associate Professor at Lakehead University, to give a workshop for the Provincial Nurses Education Interest Group AGM. Michelle introduced me by reading "A Parade of Gowns." This is a poem of mine that even I had never read publicly as it has felt risky, the poem being about mistakes in health care and sometimes the silences that follow. She chose it and went further by offering her own reflection on why that poem. Here is the poem followed by her comments.
A Parade of Gowns I was sitting in the waiting room Lakeshore Boulevard, in the silence of a Sunday. The only sound: air pushed through vents, pumped and repumped.
My friend’s mother had had a heart attack; half her heart, dead though she was still alive. Such a small heart left.
Another I knew went for surgery, Tuesday. General anaesthetic. Woke up shaven, in the care of her partner. These are stories.
A parade of women carried pillows through the hospital. Went home without their breasts.
On the surface things look fine, new breasts are offered. A buried instrument rusts out. An organ fills.
The instrument is detected and dug up like a time capsule. People run away from each other in shock. Don't tell your stories, they yell.
The effects are studied and displayed in a great art exhibition of our mistakes, lonelinesses, and the staff are thanked, at least that.
People have to keep working here walking the halls and no one knows how to talk about it. But the volunteers.
They our elders tend to ramble, they are free safe from suit, they know they are the keepers of the stories deposited in passing. When we tell them.
Ronna Bloom, Public Works, Pedlar Press, 2004
I read the poem "A Parade of Gowns" with my students when we are exploring what it means to be an ethical practitioner. Nursing is a profession that is rooted in human relationships, and subsequently moral responsibilities and obligations.
Your poem begins from a patient/family/friend perspective, in the waiting room, reminds me that hospital spaces are living spaces: you catch me off guard at first sitting in the waiting room in silence. As a nurse I am always so caught up in the doing…that inside my head it seems noisy -- for lack of words. Then you mention the sound: the air pushed through vents, pumped and repumped. It creates the sense of living spaces, of people, of life beginning and ending, starting again… You take us through the movement of human stories -- somewhere a mother has a heart attack…another leaves without a breast –– as nurses we are part of these moving stories, at any given time we pass through the lives of people…how?
How do we live out our obligations and responsibilities in these moments of suffering? Are we awake and present... are we just passing through? For surely if we are awake we are a part of it all…we see and thus hear and feel the "half of her heart dead…though she is still alive", we feel the pale warmth of a body shaven, and the shaken hand of the partner preparing to go home in this new reality, we feel the tremor in the arms of the woman who we helped position the pillow against the chest wall that now is raw and aches with the pressure of a drainage tube, we show her how to pin the drainage tube to her top, and position the pillow so she doesn't feel like her chest wall is falling open… and we wrap our arm securely around her good arm and waist so she does not topple over…. you see being present requires all of our senses-- it requires being awake to it all…your poem…awakens us…it calls us back… it reaches into me…and opens a space for it all- for the suffering, for the want to do good….to be good…and at the same time you reach the brokenness that exists in all of us….when things go wrong…human frailty…when we hurt…when we make mistakes… when we hurt one another ("run from each other") and "don't tell your stories…"
You just say it "on the surface things look fine, a buried instrument rusts out/ People run away from each other in shock. Don't tell your stories, they yell!" You found the words to speak of what as practitioners we must face, that sacred moral space. Your words reach into the silence, those words are a whisper –– buried instrument… run away –– the whisper rises above the noise and opens up what is so difficult to say. It physically catches me and I wonder what does it mean to be fully present… to be awake… for surely if we were awake we would turn to the suffering, and we would need one another, (patient, family, nurse, physician) to be totally present in the suffering…even the suffering we caused…we need one another…needing one another we speak our 'truths' with humility…hoping our words will reach the other… Your words tell a 'truth' people run away….don't tell your stories… and we are exposed… the brokenness…
PS-- as RNs we hold to a Code of Ethics, to a way of practicing and being 'good nurses', and when we make mistakes we have to report our mistakes immediately. Reporting has been associated with ideas of blame and shame, but I wonder if we look at reporting from a moral stance, if we can see reporting as an aspect of living well together, of being a community. Thus, as RNs when we make a mistake we talk with our physician colleagues, our managers/team leaders and we unpack what went terribly wrong, exploring what should be done next, keeping our focus on the patient. Your poem returns us to a moral space of responsibility, obligation, of our lives together, of human emotion and spiritual growth… that exists in moments of mistakes and things going terribly wrong. We know we must report, and we know at times it can make you feel 'alone' and stripped'-- it is all a part of 'suffering'… and this is preciously why we need one another (patient, family, nurse, physician, managers and so forth)...
Michelle Spadoni, DNP, RN, Associate Professor, Lakehead University