I Don’t Believe Florence Nightingale Did It This Way

 Each year the hospital that I work at has a Skills Fair. Its mandatory training for each department to update skills and have competencies documented. This year we are considering making it a bit more fun with a "Skill Olympics". It was 39 years ago when I competed in the nursing skill Olympics. I am not sure I am over it.

A few paragraphs about nursing school:

My classmates were adults ranging from their mid-twenties to their forties, which created a different vibe than a traditional college. My classmates took learning seriously. There were no dorms, no alcohol holidays, no Gumbys at T-Bones.  

There was class, studying, going home at the end of the day, and doing adult things. No one was rebelling or enjoying their first taste of freedom and autonomy. This was a group of people who had bills, mortgages, and adult responsibilities. The peer pressure was to succeed and not waste the opportunity to learn.

Embedded in my mind was the thought that I was responsible for another person’s life. The concept was daunting.  It didn’t help that the instructors frequently told us, “You can’t make mistakes, you are responsible for another person’s life!”

I learned the logic behind the skills in the classroom. I practiced my skills on a mannequin or a classmate in the lab and then applied them in real situations in the off-site clinical.  Mrs. Haney, the department director, said to the class, “You will be the best bedside nurses in the state.”  

I tested her prediction at the annual Skills Olympics held annually for every vocational technical institute in Minnesota. Each program sent their top students to represent the school in Minneapolis for a three-day competition. During the competition, all entrants would be evaluated on their skills in their chosen career path.

The nursing class had to demonstrate basic nursing skills in our lab, with all three instructors judging our performance. The winner of our class competition would then go to the Twin Cities to compete against all the other nursing schools. Having a winner at the state competition was a prestigious bragging right for the instructors.

Never having won anything more competitive than a classroom spelling contest, I was not optimistic entering the class competition. I was so certain of my failure that I didn’t even get nervous.  I completed the skills as if they were just another structured class demonstration or part of my daily clinical routine. Then I returned to my chair and waited to see which classmates would be picked.  After a brief instructors ' conclave in the office, Mrs. Haney announced that I was the student chosen to represent our class in nursing skills.

Another student, “Pretty Nurse,” was chosen to represent our class in a public speaking competition.  I was also “voluntold” (told I was volunteering) to compete in improvisational speaking to represent the technical institute. This was a one-time competition offered to students in any of the participating majors.

In the nursing skills competition, I would be required to wear my "whites," which included a nurse's cap, a white dress, white hosiery, and white nursing shoes. In short, our usual clinical uniform at the time. For the speech, I would wear dark slacks, a blouse, and the borrowed red blazer the school provided for such formal events.

The competition itself was scheduled for one day.  I would begin with the speaking competition, then, with little time to change into my nursing uniform, take a bus across the city to the satellite competition area. There, I would demonstrate my nursing skills in front of a panel of judges, consisting of nursing instructors from various schools across the state.

It was not just a skill Olympics for our nursing department. Each area of the technical institute was represented in the competition: the diesel mechanics, the motorcycle mechanics, the business office, and the chef training. It would be a full charter bus with the best and brightest of the Detroit Lakes Vocational Technical Institute driving to the Twin Cities.

The evening before the charter bus from Detroit Lakes was to go to Minneapolis, I prayed in my Chevrolet Buick for the twenty-mile drive to Wadena. Prayers were needed for that distance in what was currently the most reliable vehicle on the farm. I needed to buy the appropriate clothing for my competition. My current nursing uniforms were worn and lacked the crisp whiteness to create the aura of a professional nurse. Scrubs were not an option for nurses in the eighties; it was all-white uniforms only, and a dress if you were female. 

Fortunately, the JCPenney in Wadena had a small supply of nursing uniform dresses and white pantyhose. I found a new nursing dress in my size, which is unsurprising in an area where poverty and its accompanying obesity are common. Given my tendency to get ladders just by putting on pantyhose, I knew I had to pack an extra pair as a backup. I went to the hosiery rack and grabbed two packages of white extra-strength, tummy control support hose from the queen-sized section.

The students not competing had three days of regular classes. It meant an excused three-day holiday from courses for me. The day before the competition, the team traveled the four-hour trip to the Twin Cities. The next day was the competition, and the third day was breakfast with all participants, and then the bus ride back to Detroit Lakes.

Pretty nurse and I were sharing a room at the Radisson.  Across the hall were our nursing instructors. Far away on another floor, the diesel and motorcycle mechanics were staying; other students from various programs were scattered on our floor. Our nursing instructors were responsible for managing our school’s participation and made all the arrangements. I suspected that there was a reason the mainly male and mainly loud partying students had reservations on another floor. Another floor to be separated from the female competitors.

 After years of negative school experiences, I didn't expect to succeed myself. It would be even worse now I carried the weight of representing my classmates and school. A childhood of being chosen last when teams were formed, this time I was the one picked first. Instead of being the default teammate, I was the first and only choice. The responsibility felt heavy, and I knew I would mess it up. I was doomed.

I had breakfast in the main conference room and then changed into my speaker's uniform, which included the required attire and the mandatory red blazer. In the conference room at the hotel, room dividers separated the waiting group from the speakers' competition area. A helpful volunteer handed me a book of "important quotes from historical figures" and told me to choose one quote upon which to improvise a five to seven-minute speech. If I had been given a random topic, I could improvise, but being required to use a book of quotes from little-known political figures was crippling for me.

Early in my life, I learned that if I jogged slowly while running laps in the gym, I would get passed by everyone running at full speed.  Running in a circle, the athletic kids would lap me repeatedly until, after several laps, I would be at the front of the line and finish early. The other students did five laps, and I did two. My motivation was the same for this competition: “Just get through it, and try to finish with the others, while doing as little as possible.”

I found an obscure Winston Churchill quote I can't recall and tried to rehearse the main point of a five-minute speech. Other rehearsing competitors surrounded me, practicing vocal intonations and hand gestures. The memories, sounds, and dread of high school came into my mind, and I was frozen. After completing my fifteen minutes of prep time, I delivered my five-minute speech, knowing I had flopped dismally.  I left the conference room area and returned to change into my nurse's whites.  “The bus is waiting,” someone yelled as I ran down the hallway.

I rushed into my hotel room and saw a young woman vacuuming the carpet. Now was not the time for modesty, so I quickly started tossing off my clothes while she worked. I grabbed my package of white extra-strong support hose and pulled it on. As I expected, the hosiery ran, with two large ladders forming from my ankle past my knees.  Fuck! My dress was knee-length, and there was no covering this; it was hideous.

At this point, I could hear people knocking on the door, yelling at me to hurry up. All was not yet lost; I had come prepared. I was proud of my foresight and preparation. I grabbed the second package, tore it open, and pulled the hose on. These only came up to my knees, a struggle requiring extraordinary effort. The tight, wide band of elastic meant to slim my abdomen gripped my knees and held firmly, refusing to move any higher. My legs were slammed together.

I glanced at the packaging on the bed; the label read Petite and Extra Support. “MOTHERFUCKER!” I screamed.  The housekeeper started moving quickly, watching me nervously out of the corner of her eye.

Some assholes had hidden a pair of petite-sized support pantyhose behind the larger queen-size pair. I grabbed the first two packages on the rack without looking. The asshole who performed this evil deed is probably still laughing over their prank.

I had no time to curse the asshole who did this to me; the knocking on the door and voices urging me to hurry were becoming frantic. I had to wear white stockings; competing and maintaining the nursing standard in the eighties was required. I couldn’t let my team down by not competing, and not being appropriately attired was a forfeit.

With superhuman strength, I could pull the elastic band upward over my knees; it clung onto my thighs like a suspension bridge.  I quickly threw my dress over my head, relieved that my dress hung just below my knees, concealing the tight elastic binding my upper thighs together.

Reaching into the dress pockets, I pulled upward on the pantyhose, stabilizing them just above my kneecaps. I stabbed the two bobby pins into my hair to secure my nursing cap, slipped into my shoes, and dashed out of the room.

As I ran toward the elevator, I could feel the support hose obeying gravity, sliding down toward my feet. I fought back as best as possible by shoving my hands into my pockets and pulling upward while navigating with my knees bound together in an impressive feat of elastic engineering. During my run/walk in the hall, I resembled a white pumpkin trying to move forward on bound feet through a riverbank of mud.

On the bus across the city, I wiggled in my seat, discreetly trying to win the war against my pantyhose.  It was a doomed task from the start; there isn’t enough material in a pair of petite pantyhose to cover a plus-sized body. I must have looked like I was having a seizure as I spasmed and doubled over repeatedly, grunting and sweating, red-faced with effort. The bus had only a few passengers.  There I was at two hundred and fifty pounds, grunting and jerking at my underwear, and there was no hope that I would remain unseen.

The technical school where we competed was enormous compared to our small school. In the waiting area, I was with other competitors from across the state, all trying to outdo each other with their nursing knowledge. Two bragged about their skills in sliding-scale insulin management and specific gravity testing, showcasing the superiority of their class studies. I listened halfheartedly and remained quiet; my only concern was keeping my hands in my pockets and keeping a grip on my pantyhose. However, I did find it amusing that a pair of students from the metropolitan area were so proud of memorizing an insulin sliding scale.  The sliding scale is written as a medication order and varies little by provider; therefore, memorization of a sliding scale is meaningless.

When it was my turn to enter the classroom lab and compete, I was led into a large room filled with several “stations” for various nursing tasks. When I say "large,” I mean it looked like a football stadium, especially to a woman walking like a Mermaid on her tail. My thighs, covered in cellulite, were pressed together so tightly that they moved like Jello in a mold. I could only move my legs from the knees downward and had to keep my hands in my pockets to prevent my waistband from sliding below my hem.

The first station task was drawing medication into a syringe. Three judges observed me as I read the medication order.  I had to select the correct medication and dosage from various options and draw the appropriate amount into the syringe. After years of experience drawing up animal medication and recent practice with humans, I was confident and relaxed.  But each time I took a hand from my pocket, my pantyhose slipped. I could feel the cool air chilling the back of my knees as the pantyhose rolled down my thighs like a rope. This was a bit distracting.

Pick up a vial and feel the roll. Put down the vial, put a hand back in my dress pocket, and use the other hand to pick up another vial.  Somehow, I got the medication drawn up and was satisfied I had the correct medication and dosage as ordered. I looked like I had some disability requiring me to keep one hand in my dress pocket, grunt, and grimace.

The next station was a sterile dressing change. Once I had set up my sterile field and put on my sterile gloves, I knew I couldn't touch anything, or I would compromise the sterility. As I hobbled over, I made one last desperate attempt to pull my pantyhose up high enough to stay through the procedure. I tried to walk confidently with both hands in my pockets and pulling my pantyhose high enough to gain some distance on my thighs.

I managed to get through the dressing change quickly, maintaining the sterile field. It was the fastest dressing change I had ever completed, quite possibly the fastest the judges had ever witnessed. After I finished, I sighed with relief and pulled my pantyhose back up to my knees from mid-calf.

I could have quit or taken off the pantyhose and competed unfettered and inappropriately attired.  But I was committed and had already gone far enough; I had to keep plodding forward. In retrospect, if I had any self-confidence, I would have stopped and explained the situation to the three female judges and taken off the pantyhose.  We would have had a good laugh, and I could have continued competing. But the fear and intimidation were too great; the greater discomfort would have been letting slip my carefully placed mask of normalcy. I could not tell them that I was the impostor, just poor white trash.  In moments of panic, I reverted to my basic survival skills of staying quiet, acting like everything was okay, and getting through the moment.

My next task was to transfer a young volunteer in a role-playing scenario. I had a few minutes to review a quick nursing note about his physical limitations; he was acting as a patient paralyzed on his entire left side. My job was to take this tall man from lying flat on a hospital bed, sit him upright, and transfer him to the wheelchair beside the bed. I didn’t bother to attempt the complicated steps of a stand-and-pivot transfer. Frustrated and feeling the pantyhose roll, I lifted the young man from his bed and placed him in his wheelchair. I set up his foot pedals and announced that he was ready.

I finished the three physical parts of the competition.  The last assignment was to write a nursing note on each task. I could relax, sit down, and let the pantyhose make their break to freedom. Finished, I put down the pen, gave one more desperate tug, and left the competition area. 

Back on the bus and returning to the hotel, I opened the window despite the frigid Minnesota winter. Reaching down, I ripped off the pantyhose and tossed them out the window. Somewhere between St. Paul and Minneapolis, someone was unexpectedly gifted with a new pair of white support hose, only partially worn. I avoided eye contact with my fellow passengers; I was not going to explain why I had ripped off my underwear and thrown it out the window somewhere over the Mississippi River.