Portrait of a Nurse

Depictions of nurses and of the relationship between nurses and doctors have been the subject of many films and books and stories.  Doctors are usually portrayed as leading and demanding, telling the nurses what to do.  Nurses are usually portrayed as carrying out the doctor’s orders, and occasionally talking back or standing up to them.  My mother and one of my favorite aunts were both nurses in the old mold, largely deferential to doctors, they wore uniform dresses of modest length and necklines, nursing graduation pins on their clean collars and little hats —but, my, has nursing evolved and changed!  Anyone who has been a resident physician or watched the many shows on TV about residents knows that competent and experienced nurses can teach, guide and even terrorize young and inexperienced junior doctors as well.

What a complex web we weave!

In today’s blog I want to draw you a portrait of a very special nurse and her very special role in the care and lives of children with eating disorders.  Her name is Sherrill Gandsey.

A few years after I established Kartini Clinic’s inpatient medical stabilization program at what was then Emanuel Children’s Hospital and is now Randall Children’s Hospital, the administration there announced that they would be assigning the various pediatric services a “nurse case manager” to work with the doctors.

Uh huh.  To manage us independent doctors, presumably, and “improve” care.  The impetus was the pressure insurance carriers were putting on hospitals to justify length of stay and accelerate discharge.  It was really about administrative money and control and we weren’t that enthusiastic.  But it wasn’t optional.

Then we met Sherrill.  Sherrill was and is a tall, energetic, meticulously dressed Texan, a devoted mother of two girls. As an R.N. she had held several roles as a floor nurse before accepting the position as a case manager.  She had to have her reservations about the eating disorder doctors…and the patients and their parents, known to be challenging. But her Southern graciousness never let her show it.  There were case managers who specialized in cancer, in heart disease and in neonatology, but Sherrill was to specialize in us.  What a stroke of good fortune it was, the day she walked onto the floor.

A quick study, it didn’t take Sherrill long to absorb our philosophy about parents not causing eating disorders and children not choosing to have them.  She could see that with her own eyes.  Far from being a mere agent of the hospital and liaison with the insurance, she became the go-to person for parents shell-shocked by their child’s admission to the hospital.  She calmed and consoled, she introduced families to the Ronald McDonald house, helped with transportation, mediated between ex spouses, firmly dealt with the kitchen and helped teach other nurses about our special kids.  The doctors made rounds every morning, but that left the rest of the day for parents to struggle silently with their issues and concerns.  Once Sherrill was on the job, they were no longer alone.

It was great.  And then she disappeared.

For seven long years she left our service and returned to the neonatal intensive care unit. We were shell-shocked at her transfer, but nobody asked us.

Then suddenly, like winning the lottery, she was reassigned to our service. And what a difference she has made.  She makes rounds with us every weekday, she gives parents her card and invites them to call her with any questions or concerns while their child is in the hospital. She stays up-to-date with our treatment approach,  she mediates tough conversations, she checks the food, she makes sure the doctors don’t mess up the daily orders.  Sherrill also attends our weekly team staffing and represents the interests of the parents and patients, greatly increasing their quality of care.

She’s back!  She’s on the team!  Let’s hear it for Sherrill and nurses like her who “give a damn” about children with eating disorders.  Boy, are they rare.