Today I was asked by a patient whether I found this work hard. By “this work,” she was referring to the fact that I work as a nurse in an abortion clinic. She’s not the first patient that’s asked this question since I started working in the clinic this past September. I still struggle sometimes with how to answer. I’ve been writing and re-writing this post in my head for the past four months, trying to sort through the various emotions I’ve been processing as I settled into this new job.
For background: I mostly work in the recovery room, caring for people as they wake up from general anesthesia after their abortion. I’d say most of our patients are coming in between 6 and 16 weeks for their procedures…but not infrequently, we also care for patients coming in later in their pregnancies, up to 23 weeks. Many of these cases are for fetal anomalies. I also care for patients after local procedures—that is, for patients who opted to not use general anesthesia. Most of these patients are earlier gestation—between 6 and 10 weeks.
So…to answer the question:
In many ways, no, I don’t find it hard at all. In terms of the nursing care itself, it’s not super complicated. My patients are, for the most part, healthy people coming in for a normal out-patient procedure. While some folks have reactions to anesthesia, most people wake up fairly quickly…a bit groggy and often forgetful, but the point is, they wake up, often within 15 minutes of first falling asleep. This is not ICU or trauma or emergency nursing. I monitor their breathing and other vital signs, check for bleeding, assess their ability to safely get home. When they’re awake, I go over pain management and how to take their antibiotics and talk them through what to expect physically over the next few weeks.…most days, I get into a good rhythm and there are few, if any complications.
In other ways, yes, it’s a challenge. I struggle with how to balance the needs of the clinic flow with my own ethics and priorities as a nurse. I want to spend time with my patients, to offer space for them to share their stories and feel heard. I want them to not feel rushed in the recovery process…I want them to feel like they can take an hour, or more, if they need it, gathering the strength they need to walk out of the clinic and back to the rest of their lives. The reality is, I don’t have much time with my patients—maybe a half hour or 40 minutes for general anesthesia patients, 20 minutes for locals. Sometimes that’s enough, but sometimes, it’s not. I feel good knowing that I refer every patient to great organizations like Backline…but I became a nurse to be able to connect with the whole person in front of me, not just offer referrals and take blood pressures.
Is it hard? Is it heavy?
The days in which I care for women who are terminating a deeply desired pregnancy due to a fetal anomaly, yes, it feels hard. What could I possibly do for or say to a woman ending a pregnancy due to a fetal anomaly after rounds and rounds of IVF that might ease her pain?
The days in which I care for a patient who would be thrilled to parent another child but can’t afford the expense, yes, it’s heartbreaking. There are so many systemic issues of inequity at play in the lives of the patients who come to us…to see these same systemic issues play out over and over again feels frustrating.
When I care for someone who for their entire life never thought they’d have an abortion, but whose nausea and vomiting are so horrifically awful that they can’t stand another day of pregnancy…yes, those days feel heavy.
However, contrary to what some people might imagine an abortion clinic to feel like…I find myself laughing and smiling quite a bit at work. My patients are funny…and often draw on their sense of humor to help them through what can be a difficult and uncomfortable experience. We joke about weird family members, lame boyfriends, the crazy protesters outside, how cold the OR is, what they’re going to eat first when they get home, what ridonkulus TV show on Netflix they’re going to curl up and watch. We talk about the mundane as much as the profound, finding moments of warmth and connection in between the fog of anesthesia and the sinking in that this pregnancy—desired or not—is over. For every patient I see with tears of sadness and loss, there are also women who cry and laugh at the same time, sighing an incredible sigh of relief as they smile and reply “Thank God!” when I tell them they’re no longer pregnant.
The heaviness I might feel on any given day is often mitigated by the support of my co-workers, who are wonderful. But here is a truth, one that I don’t share with my patients: while it’s not always heavy work, being an abortion nurse is lonely work.
It’s not something you can generally talk about at a dinner party, or at that family reunion, or on the bus to the person who sits next to you and asks what you do when they notice your scrubs…at least not easily, for most of us. Not many people want to hear about the challenges of being a nurse in an abortion clinic. Add to that the fact that there’s no American Association of Abortion Nurses out there. There’s no network—either within other nursing organizations, or in a professional group designed just for us—for those of us doing this work around the country to come together and share our experiences. I know that there are abortion nurses in private clinics large and small, in hospitals, and in Planned Parenthoods across the country doing the same thing I am…and yet, because no professional nursing organization exists specifically for us, we are scattered like stars across the galaxy…able to glimpse each other from light years away, but generally unable to connect.
This past year has been notable for an increase in public storytelling around experiences of abortion. But that publicity is relegated mostly to those who had abortions, or, sometimes, those who provide the actual abortion. For the nurses, nursing assistants, and medical assistants who also provide much-needed and vital care, our experiences are still largely missing from this conversation. The only organizations that come close are Clinicians for Choice, geared for advanced practice clinicians who perform abortion care (which, as a nurse, I am not), or Nursing Students for Choice (which does fantastic work, but is still more geared towards students).
“Abortion providers are, by and large ostracized from the medical world just as much as abortion has become isolated from the rest of women’s reproductive health care, and this is where abortion and providers are vulnerable…This book left me with a feeling that cannot be squashed. That we are in this together. That we must rebuild a community of all those working in reproductive health and abortion care, not just for our own sakes, but to make this whole community safer and stronger.”
Now that I’m feeling more settled in my role, I find myself wanting to reach out to other nurses doing this work. I know, realistically, that many will make the decision to remain anonymous, heeding very real threats to their safety. I understand and respect that decision. But if you are a nurse willing to reach out, to connect, to share your story, and to potentially find yourself connected other fellow abortion nurses…well…I extend a warm and hearty invitation for you to be in touch. Let’s help take care of each other as we follow our calling to this vital work. The people we serve need us to take care of each other as much as they need us to take care of them.