One thing I’ve noticed about nurses since I became a nurse, is once you are a nurse, you are always a nurse in one way or another. You become so unconsciously enculturated with the quirks of nursing, they are impossible to ignore. This became even more evident to me when I was working one of my jobs as a research assistant in an Alzheimer’s care facility and met Martha, Mar for short.

I approached Mar like I do with anyone else. I never know how memory impaired my patients are before I meet them nor do I know the extent of their other physical limitations, so all I can do is sit and talk with them to gather information. I asked Mar if I could pull up a chair and talk to her about our research study; she obliged. I started talking about the study and Mar interrupted, “Now, wait a minute…wait just a minute… are you a nurse?”

“Yes, yes I am,” I said with a smile.

“Well, I’m a nurse too,” Mar said with a twinkle in her eye.

I couldn’t help, but be a little excited that I knew we would speak similar languages. I asked Mar what her background was in nursing. Her face lit up.

“I worked in the New York City hospital ER for 30 years. But, I’ve worked in the surgical ICU too; I always had multiple jobs like most of us.”

I told Mar I also worked in the surgical ICU. She then said again, “Oh, you’re a nurse?”

This is when I realized the extent of Mar’s memory loss. So, I just played along and reminded her that I was, in fact, a nurse. Although her comments were disjointed due to her dementia, they were all relevant. “You can’t be lazy and be a nurse. My biggest pet peeve was people just sitting around doing nothing.” I concurred.

Mar told me so many stories that day; we talked for almost two hours. She exclaimed she always wanted to be a nurse. When her mother was sick in the hospital, Mar would stay with her as much as possible. After school, she would take the bus to the hospital and be by her mother’s side even though she wasn’t old enough to be there alone. The nurses who cared for her mother would sneak her in and let her stay. Mar asked them to teach her the trade and she became very active in her mother’s care back before regulations were so strict (this was in the late 1950’s). Mar attended nursing school in the 1960’s. She told me she was the only African-American female in her class, which was difficult, but nothing could stop her passion.

Most of her other stories were from her time in the ER. She was a charge nurse for awhile and came across as someone with a rough exterior that protected her heart of gold (like so many nurses). She told me about a patient who frequented the ER due to domestic violence. The patient was too embarrassed to tell anyone and too co-dependent to break up with her abusive boyfriend. One final time when the patient came into the ER with another injury, Mar told her she was going to help her after the patient finally admitted she was ready to leave her partner. After the patient was discharged, Mar drove to the patient’s house, helped her pack, and let the patient live with her until she could recover.

On hard days in the ER, Mar liked to take her breaks in the nursery and talk to the babies. One of the docs who noticed her asked, “Mar, what exactly do you even say to the babies? They don’t understand you, ya know?”

“You don’t know if they understand me. I tell them everything,” she said. “I ask them how they are, what they need, I tell them about the weather, and about the beautiful things happening in the world. I remind them of their possibilities and encourage them to aspire to every hope and dream they will ever have.” Tears welled in my eyes.

“In nursing and in life there is always love to give. You never know how you will affect someone, but that shouldn’t determine whether you give it or don’t.”

“Fair point, Mar, I couldn’t agree more.” I said.

Later I found out that Mar was never married and never had any children. In fact, she was cared for by a state appointed guardian and had been since her memory decline. She was now in her 80’s and running the show in the Alzheimer’s facility, much like she probably did when she worked in New York City. And although Mar does not have any direct family caring for her, the nurses in the nursing home are helping Mar just as she helped others in her career. I’m fairly certain she wouldn’t want it any other way.

Of note, I frequently meet nurses who are unmarried and do not have kids, but still give epic amounts of love to anyone in need. I find this fascinating and I’m not certain of why the pattern exists. However, I do know, that with both of my jobs (in the ICU and extended care facilities) I get to see many people full circle. And every choice you make as a nurse, every ounce of love and hope you give, can affect someone later in his or her life, even when you don’t see it. This is one of the most beautiful and unique aspects of our career. In Mar’s case, once you are a nurse, you are always a nurse, even if you don’t recognize it yourself; likewise once you are a nurse, you have the power to change lives, even if you don’t recognize it yourself.