Sunday, April 21, 2019

Paul Obis RN - A Pioneering Nurse Influencer

Every young nurse graduates from training school with high minded dreams to heal the world, but after  a couple of years at the bedside the dream begins to fade as burnout sets in. No matter what you do to get around it, sooner or later, it's going to set in like the darkness of night.  An often times rigid and authoritarian hospital environment quashes outside the box thinking and  innovation. I was fortunate to attend school and work with a nurse that could see beyond the bedside and promote health and wellness on a more global scale. We were good friends even though our paths diverged as I stubbornly clung to bedside nursing and he moved on to a more grand vision.

Paul Obis entered nursing school a year after me. He was a slightly built young man with an engaging personality and shoulder length hair. The hair issue was a big deal in nursing school and addressed frequently at uniform inspections. Hair was thought to be a source of infection and everyone on the nursing staff had to keep their hair off the collar while working in the hospital. Paul opted out of the Brilliantine butch haircut for the  typical men in nursing coiffure and went with a pony tail to keep his locks off the collar. What worked for the girls worked for the guys.

Every student nurse has a shocking epiphany early on in nursing school, for me it was how much patients suffered. For Paul, it  was how terrible hospital food choices were for recovering  patients. In the early 1970s the ideal meal was a huge chunk of meat surrounded by something deep fried. The notion of "healthy food" was decades in the future. When someone heard that artificial ingredients and colors were a big component of their diet, the line of thinking was; those clever scientists are at it again. What will they think of next?

Nutition classes in the early 1970s nursing programs promoted notions that white bread was  just as nutritious as whole grain and the ideal protein source was a big chunk of animal flesh smothered in gravy. Paul was quick to note the malnourishment present in hospital patients as diets of the time did practically nothing to promote recovery. Vascular bypasses of one variety or another were the cutting edge procedures of the era. The sad part of this miraculous new surgery was the temporary nature of the complicated fix. Patients were returning to the hospital a few years down the road with their fancy grafts occluded by the very same atherosclerotic changes that afflicted their native anatomy.

The cholesterol theory relating saturated fats to vascular disease was in it's infancy, but this did not deter  Paul who began researching and promoting vegetarian diets as a boon to good health. Vegetarians were few and far between in the early 1970s and excluding meat from a diet was viewed in a freakish light. There was no internet or social media for folks to connect so Paul started writing a little 4 page newsletter with the proud title of Vegetarian Times.

Distribution was limited to the area around the immediate hospital on Chicago's North Side. By Vegetarian Times Issue No. 3 the newsletter circulated to areas that Paul could reach on his bright green  Schwinn Varsity bike. The VT footprint gradually grew to the point where I let Paul deliver them in my brand new Ford Pinto. Paul christened the little Runabout as  the Vegetarian Times Staff Car. A "LOVE ANIMALS -DON'T EAT THEM"  bumper sticker was proudly displayed which got me bemused looks in the Burger King parking lot. I was a blatant  carnivore and never really adopted the meatless life.

Vegetarian Times evolved into a full scale magazine and by 1990 Paul had a media blockbuster on his hands. He worked from an office in Oak Park with a staff of 25 producing the monthly magazine. When I saw the magazine for sale in the gift shop at the hospital where I worked in Pittsburgh, I came to realize the publication had journeyed full circle back to a hospital.
Yep, That's me endorsing VT. It's a good thing that
scrub nurse thing worked out. I was an awful model!

When we were young nurses it seemed as though time was giving us more and more. I now realize it can take everything away too. Sadly,  Paul died of Lewey Body dementia last June His memorial website of a life well lived is:

Saturday, April 6, 2019

A Vintage Operating Room Table

A classic Amsco O.R. Table. Turn one big wheel for elevation, the other for tilting
the head up or down. Grab the gear shift handles to activate breaks. Shift into first
gear and use the stirrups for gyne and urology procedures.
Old time operating rooms were furnished, not equipped like today's technological marvels. The focal point of just about any OR is the table because that's where the all the action happens. Vintage surgical platforms were crude, but effective pieces of furniture that could function without electricity. No complicated owner's manual  necessary. The adjustment wheels applied torque to gigantic screws that moved the table.

One of the design flaws was locating the position of the exposed screws with their inclined plane below the table.  Accessing the controls of a draped table required a trip down under for the circulating nurse. Circulating nurse was one of those new fangled terms and fools older than me called them "hustle nurses."  I was a frequent volunteer for this duty because I relished the serene environment  under a draped OR table while all that noise and fuss emanated from above.

During my under table sojourns it was all too easy to allow for some foolish daydreaming. Those big shining control wheels looked like they belonged on a yacht and sometimes I  imagined myself at the helm of a pleasure vessel on peaceful  Lake Michigan or driving a race car in the Indy 500.  A break from all the drama above always refreshed.

The exposed screws were also in a vulnerable spot when it came to collecting fluids from above. Blood would clot and dry on the surface of the adjustment screw so that subsequent rotations would produce a colorful rooster tail  of flying red flecks that reminded me of those spinning fireworks shooting sparks. The mini pieces of dried blood flying about would also refract the light from the big overheads creating a miniature light show that was a sight to behold

Surgeons had no direct control of patient positioning and were at the mercy of nursing and anesthesia to adjust the table. Positioning attempts were initiated immediately after the one...two...three... count  transferring the patient from a cart. Kindly surgeons like Dr. Slambow would always help lifting and transferring patients from the cart to table. Non verbal, cold as ice stares awaited less helpful surgeons who soon learned the up side of team work.

There were no specialty OR tables back in the days of one size fits all surgical platforms. Sand bags, rolled towels, airplane belt restraints padded with egg crate, and whatever else we could scrounge together made up our somewhat barbaric positioning armamentarium. (I just love that A...… word because it sounds like I might know what I'm talking about!) When we applied a restraint belt to a conscious patient the party line was always, "Since the table is so very narrow we use this for safety." There was no mention of the fact the belt helped keep them on the table if an abrupt anesthesia emergence occurred giving an alternative meaning to ambulatory surgery.