I don’t want to stop growing.
She earned her BSN degree before emigrating from the Philippines to the United States. Wise advice from her grandmother helped her adjust to her new environment.
As a little girl, I took care of my siblings’ cuts and bruises. The medicine cabinet was my assignment. There was no question what would be when I grew up—a nurse! That was inculcated in my brain ever since I can remember.
I grew up in a relatively comfortable, close-knit and protective household with parents, grandparents, and siblings. We had househelps. During my teen and college years, I stayed in a dormitory operated by Roman Catholic nuns. My parents paid huge boarding fees in exchange for exclusivity, privilege, and security.
I graduated with a Bachelor of Science in Nursing degree in 1980 at the height of economic and political turmoil in the Philippines—and, at age 21, I joined the ranks of the unemployed. My country was under martial law for eight years, and unemployment was at its peak. To get work experience and further training in critical care, I volunteered my services at the newly opened Lung Center of the Philippines.
When I came home for the Christmas holiday, I boldly asked my grandmother to give me a gift of $75.
She asked, “What for?”
I said: “For exam fees. I want to go to America.”
She asked, “Did you ask your father?”
I replied, “He thinks I am too young to be on my own; he doesn’t want me to go.”
My grandmother, who was always a feminist, rolled her eyes and said, “No, you will go to America.”
A bold move
After I passed the Commission on Graduates of Foreign Nursing Schools Qualifying Exam, job offers from the United States flowed in. I chose a hospital in Chicago, and my baptism of fire commenced the moment I touched down at O’Hare International Airport. Greeted by a blizzard, I was shivering badly as I stood in line to deplane and board a bus to the terminal. I heard a flight attendant say, “I didn’t know we had a child on board.” With my 88-pound frame and ponytail, I looked like a 12-year-old, and the flight attendants assumed I had family waiting for me. Without asking, they hurriedly wrapped me in blankets and held my hand as they led me to a bus and instructed the driver to deliver me to my family.
At the terminal, I saw an HR representative from my new employer holding a placard with my name. After talking with the driver, he turned to me with a quizzical look and asked: “You’re a nurse? Are you sure you’re a nurse?”
My decision to come to America was fueled mainly by a desire to be financially independent, but it came with a price. The first three months were the loneliest. I lived alone in a single-room apartment, missed my family, and craved Filipino food. I longed for someone to talk to and wished that I didn’t have to speak English all the time, that I had a housemaid to cook and do other things for me, and that I had a driver to navigate those tricky wintry roads. I went through major culture shock!
Prior to my big move to the United States, I was confident that language and communication would not be a problem, given that English is my second language. (Visayan is my first. The Visayas or Visayan Islands, where I grew up, is one of three principal geographic regions of the Philippines. Luzon and Mindanao are the other two.) English was the medium of instruction in the Philippines, and it was mandatory at that time to speak English in private schools. It wasn’t enough. My spoken Filipino English didn’t pass the test in America, and I panicked. Every time the phone rang at the nurses station, I pretended I was busy. I could not put person and voice together. I had to see a face and moving lips to understand what was said, so I felt terror every time I answered the phone.
One day, the nurse manager learned my secret, and she announced, “Carmencita, today you don’t do anything but answer phone calls!”
“Oh, no! Can I do it tomorrow—please, please, please?”
Pleading with her didn’t work. Either I proved my command of the English language, or I would be sent home. For me, going home wasn’t a choice. That was tantamount to failure. I needed to prove to my father that my decision to come to America was right. So, no time for self-pity! I gave up reading Ludlum, Forsythe, and Michener. In between reviewing for the NCLEX exam and working full time, I immersed myself in every TV sitcom I could find—“Murphy Brown,” “The Golden Girls,” “Family Ties,” “The Wonder Years.” Those sitcoms introduced me to the American way of life and helped me understand the jokes. In due time, my English didn’t sound as if I had grown up during the Shakespearean period.
Shoulder of pork and ham
Who knew ordering food was going to be a problem? I was young and didn’t cook. Back home, someone else served the meals and washed the dishes. I had nothing to do with it. In America, I thrived on canned goods. On work days, I looked forward to eating hot meals at the hospital cafeteria—that is, until one day when I experienced terror. I asked for potato chips, and the lady at the counter, who had a very intimidating presence, handed me a bag of potato chips.
I thought she didn’t hear me right but said nothing. This went on several times because speaking up was difficult for me, and I didn’t have the nerve to question that intimidating lady. So I kept getting bags of potato chips while craving the “other potato chips,” the fried kind that were sliced into strips. If we had had Google back then, that would have solved my dilemma.
One day, I’d had it! “Today is the day,” I told myself. “I will eat potato chips!” When that intimidating presence behind the counter handed me another bag of chips, I blurted out, “Why do you keep giving me this?” and pointed, “I want that!” The lady responded sweetly: “Honey, these are French fries, and those are potato chips. Which one you want?” Of course, the handsome resident physician behind me heard it all. At that moment, I wished the earth would swallow me whole.
I wrote to my grandmother and whined: “What the French got to do with it? Why can’t it be called what it is?” My grandmother wrote back, “When in Rome, do as the Romans do.” That was the end of my whining. For a long time, I didn’t return to the cafeteria or go to a restaurant because I didn’t want to go through another embarrassing moment. During those early days in America, I ate a lot of Spam—canned shoulder of pork and ham. My apologies to Hormel, the company that makes it—they even have a Spam Museum—but the thought of it now makes me nauseous.
Lost in translation
Working in a Level I trauma center hospital in Chicago, I found instructions in English and Spanish side by side in hospital hallways and elevators. Because I had taken Spanish courses in high school and college, I could read Spanish but couldn’t speak it very well. One day I was taking care of Mr. Gomez, who had sustained multiple injuries in a motor vehicle accident. He had been weaned off the ventilator and was in a Geri Chair that morning. He was aphasic, and articulation was an issue.
He blurted, “Mira, Mira, Mira.” I was excited that he had finally said something. I thought Mira was probably the name of a loved one, perhaps his wife. In my broken Spanish, I explained that Mira would come later in the day. Five minutes later, he started calling out for Mira again. This time I decided that maybe he thought my name was Mira, so I explained that my name is Carmencita, not Mira, and reoriented him to person, time, and place, like nurses do.
He was becoming frustrated, so I phoned his family and left a message that Mr. Gomez had started to talk and was asking for Mira. Could she come a little early? Perhaps seeing a familiar face would minimize his frustration and confusion. As I put the phone down, Mr. Gomez somehow managed to stand up and screamed MIRAAAA! As tears rolled down his face, urine dribbled down his legs. I realized then that he wanted to use the urinal. In Spanish, mira means “look.” He had been trying desperately to get my attention, and I had been completely lost in translation.
Again, I wrote to my confidante and whined, “I wish you had insisted much more seriously that I learn Spanish.” My grandmother wrote back: “Not knowing Spanish was not the problem. You need to learn how to listen.”
She got her point across. We hear mostly what we want to hear, not what the other person is trying to communicate. So I learned to listen and honed my communication skills.
But communication skills alone are not enough to be a good nurse. Nursing is hard work and requires a lot of patience, compassion, and dedication. Nurses also need strength, strong personal ethics, and intelligence to withstand the mental, physical, and emotional rigors of their profession.
Over the years, I have collected a treasure trove of nursing stories—39 years’ worth of stories that I share with nursing students. As the years went by, I wasn’t just surviving. I thrived, grew, and bloomed like a beautiful rose. (Forgive my hubris.) Looking back now, as I continue to scale my mountain, I can sing “Ain’t no mountain high enough” with Marvin Gaye and Tammi Terrell and “Don’t stop believin’” with Journey. The challenges I had as a young nurse in the United States did not deter me from doing what I love. I hitched my wagon to a star and made sure I did everything to achieve my American dream.
“Quo vadis Pinoy?”
Years later, referring to my big move to America, my father said, “Man should constantly look for something to solidify the meaning of his existence through his endeavors and aspirations.” Forty years ago, my high school principal asked the graduating class, “Quo vadis Pinoy?” “Where are you going, Pinoy?”
Pinoy is a demonym that refers to Filipinos. That question imprinted on my young mind and became a yardstick to measure how far I could go and how much I could achieve. My life now is a big leap from the life of that timid, rural kid from the Philippines who arrived in Chicago in a blizzard. Unlike many of my baby boomer peers, I don’t want to stop growing, and I don’t want to limit myself.
Anatole France said, “To accomplish great things, you must not only act, but also dream; not only plan, but also believe.” Obtaining a Doctor of Nursing Practice degree has clearly brought forth a new beginning for me, renewing my commitment to advance nursing education and disseminate evidence-based practice. At times, the effort and financial problems entailed in pursuing a doctorate seemed overwhelming, but the biggest challenge has been to take on a much larger leadership role to bring about the changes that truly make a difference to society.
With the knowledge I have acquired, along with my passion and dedication to issues that affect nursing education and the profession, I envision continuing my career path in academia. I will continue to develop and use my transformational leadership qualities in the hope that I can impact lives, advance the profession, and improve healthcare delivery processes for the next generation of nurses. RNL
Carmencita Abood, DNP, MBA, RN, CCRN, is a professor at Lone Star College-North Harris in Houston, Texas, USA.