"Bugle Notes" - Nurse Appreciation Week

This week is “Nurse Appreciation Week” so I write this “Bugle Notes” to all nurses with heart-felt appreciation. As weird as it may seem, the first thing that came to my mind when I realized this was Nurses Week was my first day in my very first assignment at my very first military post only months after having graduated from the United States Military Academy at West Point in June 1977. I was a fresh new “Butter Bar” as a new Second Lieutenant is unapologetically referred to in the typical military vernacular. How all this relates to nurses will come out so bear with me!

I remember that first day as if it was yesterday. It was December 6, 1977, my wife Cathy and I had  arrived in Zweibruecken, Germany 3 days earlier. We had been married since June and I had only a few months of basic Signal Corps Officer training in Georgia under my belt. I was as naïve and nervous as you could be! My job was to be the Operations Officer for a Signal Communications Company in support of all US Army units operating in that region of Germany. I knew absolutely nothing about what that job entailed and needless to say how to do it! To really increase the anxiety level, I had 3 Non-commissioned Officers (NCO’S) working for me. I was now their “superior” officer. Each of these NCO’s had a minimum of 15 years and up to 20+ years in the Army and they knew their jobs! Even more anxiety producing was that they were all Vietnam veterans.

When one graduates from West Point it is very similar in a way to finishing medical school. In both instances you come away with a great amount of new knowledge and skills but the truth of the matter is that when it came to putting that knowledge into action in the “real world” we knew nothing, at least that is how I felt in both cases. I would bet the majority of you reading this felt the exact same way that very first day as an Intern. So, here I am, my first day as the “new Lieutenant” responsible for all the telecommunication, microwave, satellite and telephone communication operations of a 100+ person company supporting thousands of soldiers all over southwestern Germany and I know absolutely nothing, zero, zilch. However, and this is a big however, I at least knew that I knew nothing as compared to other new Lieutenants going through the same process who truly thought they knew everything and by God they were going to make sure you knew it, too! The equivalent of course in medicine is that one can start their first day as an Intern with the same approach – either recognizing you know nothing about how to really care for patients or pretending you know all there is to know. Only a fool would believe the latter but, like the Army, medicine is not immune to foolish thinking!

Being wise enough to know that I knew nothing and that these 3 NCO’s now working for me knew everything, I chose the correct approach, the humble approach, the “I know nothing will you please help me?” approach. I walked into the office where all 3 were sitting, each of them in their late 30’s to early 40’s and I just barely 22 and I said these words, “Hello, I am Lieutenant Andy Lamb, your new Operations Officer and I know absolutely nothing about what to do and how to do it. I need you to teach me all you know and I promise I will listen and learn from you. I cannot do this without your help.” From that moment, they immediately took me under their wings and taught me all I needed to know to do the job and much more. We became very close over the ensuing 18 months that I served in that position and I will always be grateful for their willingness to teach and support me. I was officially their “superior” officer, but in the eyes of most NCO’s, new Lieutenants are pretty much a pain in the rear unless they come in with the right attitude as I did. When a Lieutenant does that, those NCO’s will do everything in their power to teach, support and encourage him or her. That’s how a good NCO is and that’s why they are the “back bone” of the Army. Without them, nothing gets done and the mission fails.

Now to the whole point of this story! I grew to love those 3 senior NCO’s who cared for me and protected me. In the exact same way, I quickly grew to love the nurses during my Internal Medicine residency years, but especially those nurses whom I had the privilege to work with and learn from those first very precarious months when, again, I found myself in the position of knowing next to nothing about patient care. I will say again, only a fool would believe otherwise coming straight out of medical school. I took the exact same approach with the nurses on the floors, ICU and ED as I did those NCO’s. I needed them to tell me if I was doing something wrong or could maybe do something better. I WANTED them to tell me and I asked them to do so. How many times, especially during that first arduous year with no limitation on work hours or patient load, did a nurse save me from making a mistake and potentially harming a patient! Lovingly, patiently, compassionately, and professionally they cared for me and watched over me. They were as integral to my learning experience as any resident or attending when it came to learning what true compassionate and personal patient care looked like. I will always be grateful to those nurses. I will always remember how they cared for me on call nights when I was sick with fever and could barely stand but still had to cover the ICU. I will never forget the head ICU nurse look at me and say, “Dr. Lamb, you just go lay down in the call room here in the ICU and sleep. We will call you if we need you, promise.” And that is exactly what they did. I slept in the call room, they did not disturb me one time even though the unit had many sick patients. They took care of every patient and me as well. For this and many reasons more, I will unabashedly say, “I love nurses!” and I truly mean it. They were there for me and cared for me every time.

To all nurses who are on the “front lines” of medicine lovingly, compassionately, and competently caring for patients - you are the “back bone” of medicine and I thank you for who you are and all you do!  You are greatly appreciated, needed, and loved.

Andy Lamb, MD