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Abstract

Paloma, the protagonist of this story, is a 47-year-old nurse who decided to leave her job after 23 years serving at a public hospital in Madrid. She gave a new turn to her career devoting herself to natural therapies. This change was motivated by the dissatisfaction and frustration caused by the tasks she accomplished in her former job, which she felt were very different from what she had in mind when she first chose to be a nurse. 

Introduction

     This article describes the experience of Paloma, a nurse who, at 43, decided to leave the hospital where she had been working since she finished her studies to devote herself to the field of natural therapies.
     I thought of interviewing Paloma not only because she was a friend of mine and thus would be happy to collaborate with me, but also because I was curious about the reasons that made her quit a stable job that -from my point of view- was quite compatible with her family life, which was always her priority. She sometimes complained about her job, that she didn't like it because it wasn't really "nursing". I had always thought, however, that it had its compensations and that her complaints were more a statement of intent than a real problem.
     The main cause that triggered this decision was the constant dissatisfaction produced by the job she was doing which, for different reasons, she kept until, as she said, she felt that 'she was called to do more'.
     Through this article we can follow the process that made her think about leaving the hospital, the crisis that led her to do so and the reflections that led to that. Her faith and the support of a missionary community and of her family were the main elements that caused her to finally make up her mind, convinced that she was going to find what she had always wished for her professional life.
     Writing this biographic article, rather than a mere drill to learn how to do an in-depth interview, transcribe and analyse it, has been a most enriching experience for me at both a professional and personal level. I have been able to attest that listening carefully, putting yourself in somebody else's shoes and reflecting upon their lives helps you understand them better. In practice, this would translate into a type of caring based on their real needs and not on stereotyped, poorly reasoned responses. It has, too, made me realise that a great difference can exist between a person's feelings and how an observer perceives them, as well as how, on many occasions, we flippantly cast judgment on other people's business. In this particular case where, due to my friendship with the interviewee, I had the opportunity to closely follow the whole process of change, I had to make great efforts not to let my opinion prevail over her own feelings and reasons. Sometimes I thought that many of the things she said were not true; at other times, that maybe fantasy made her remember the facts differently from how they really happened. But in the end, after listening carefully I come to the conclusion that, while perhaps not all of it was totally authentic, that was the way she perceived and felt about her life and I didn't have sufficient elements to judge what she expressed because under the same circumstance two similar people can act in a very different way.
     More and more frequently we nurses are becoming aware of the need to investigate in order to act on the basis of scientific evidence. Our lack of time, the lack of facilities in and motivation by institutions along with the scant knowledge of existing methods prevent research from developing in a desirable manner.
     The development of qualitative methodology in nursing is even poorer than that of quantitative methodology, to judge from some analyses conducted on the level of production in this area.¹ This methodology, however, is clearly fundamental and indispensable in a profession like nursing whose aim is to give adequate response to people's problems from a holistic point of view.²

References

1. Richart Martínez M. Estado de la producción científica de la enfermería española. Index de Enfermería 2002; 38: 15-18.
2. Alonso Coello P, Ezquerro Rodríguez O, et al. Enfermería basada en la evidencia. Material didáctico. Difusión Avances de Enfermería. 2004: 47-58.

Biographical narration

The origin of the vocation. I don't remember feeling that I wanted to be a nurse ever since I was a little girl. The decision really came in high school and it led me to a field that I did like, which was relating to others. I was clear about what nursing was: providing care for the patient, spending time with the person who needs you. My father, who wanted me to be a lawyer, was willing to let me study medicine, because he thought being a nurse was a lower category. I remember saying to him, "I don't want to be a doctor because doctors aren't with the patients. Doctors come in, diagnose and operate, but they don't get to know people, they don't spend time with people". And that was my main vocation. It was actually a vocation of being with and helping people.

First memories. This is how I remember my first years in nursing school. It seems like a movie now. The interns would help us so we could finish our work sooner and, when the weather was good, we could go out on the terrace with the patients and play the guitar and sing with them. I remember those as very happy moments. And if I knew that there was an old man who didn't have any visitors, I'd go up after school and shave him, and that kind of things. I remember that the hospital seemed more like a field hospital, because we had nothing, but there was a lot of love and companionship.

The loss of illusion. Then I lost all that. I went to the Primero de Octubre Hospital and was working in the Neurosurgery ICU. Not for long, because I got married and then I asked to be transferred to the Ramón y Cajal Hospital. There, I was constantly moved around between different departments. I remembered I recovered a bit when I was in Plastic Surgery. I would have never dreamed of asking for a position like that, but because of working hours and other circumstances I wound up there. I had to leave that department and I ended up in the laboratory, the place least suited to my concept of what our profession is all about.
     I spent years volunteering to take blood samples so that I could at least say good morning to the person before sticking a needle into their arm. I think that played a very important role in my losing any illusion about hospital work. After a few years working in the lab I had the opportunity to take part in union action within the hospital. I was tired of the lab, I didn't see any prospects. I have always believed in great projects and as I get enthused easily and think that things and the world can change for the better, I joined the union.
     I ended up back in the lab sooner than I had thought, because I got disillusioned. And I didn't recover. For me, going back to the lab was a bit like returning to the punishment cell.

The doubt. From then on, during those last years I spent in the hospital I did think many times of asking for a transfer, but it never came about. I talked to the supervisors, and everyone said the same: "We have no time for anything, we're always running, there's not enough staff, no locums, we're overwhelmed". It wasn't that I was afraid of the volume of work, or night shifts, but I thought to myself, "If I'm not going to have enough time to provide nursing care as I think it should be done, I'd rather not see the patient, because otherwise I'll feel worse if I'm not able to treat them as I want to".
     The laboratory didn't provide any professional compensation for me, because I had to be on call, work on Sundays, night shifts. The atmosphere at work was not pleasant. I worked with a group of people who thought that the job was great precisely because we didn't have to see the patients, so I felt like a bit of a freak there. And I was always thinking that I had to get away, to ask for a transfer.

The quest. While I was going through all that, there were also a lot of changes taking place inside me, and also outside, in my family, and in my way of thinking too. I've always been a person with great spiritual concerns, but I have never included myself in a consolidated religious group. I've always been free, but I have always borne that quest in mind. The old question: "And all this, for what? There must be some other meaning to it".
     At that point, I began to wonder about another series of values, because what is always clear is that we want to be happy. And when you start realising that everything you have doesn't provide you with complete happiness, well, some people give up, but I certainly believed I'd be able to find it.

The pact. In that quest I tried to negotiate with God. I proposed it to Him quite seriously and I told Him that if we were still in time to do something worthwhile, I would take the leap as long as He would take it as well. I mean, I needed a confirmation that it was worthwhile because what I was suggesting would be very hard for me to do. I offered to go to the local parish priest and help in whatever was needed, anything I could do. I have never really liked that Church, as a matter of fact - the hierarchical Church. I also offered to walk the Camino de Santiago because I thought that would be an opportunity for coexistence, for silence, for what I consider the Camino is all about.
     And then suddenly after this proposal, right before my departure, I became pregnant with Paloma, which the doctors thought was impossible. I, of course, interpreted that as the answer. I took it as a genuine miracle in my life.
     And then circumstances combined in such a way that, through a friend, I got acquainted with a missionary community that, despite belonging to the Catholic Church, felt like fresh air to me. I went there quite reluctantly, but after three hours I felt at home, and I have kept that feeling over the years. And I started out on a road that at first offered more questions than answers.

The decision. And what began to happen at the hospital? Well, besides all I said before, the emptiness I felt was added to by a personal dissatisfaction. I said, "I really think I'm called to do much more". I saw I was wasting my talent or my abilities.
     Then, something very curious started to happen. After work, I would walk through the parking lot and get in my car, and it was like the phrase was awaiting me in there, inside the car. I would get into the car and remember St. John of the Cross, who said, "in the twilight of our lives we will be examined on love only". And I said to myself, "My God, I really am not doing what I have to".

Many things happened. When things happen, they happen at the same time, so that you have to make a choice. Everything pushes you.
     One night, when I was on call, I came down to Casualty and there was a poor old man who was alone, dying on a stretcher. I thought it was horrible and I looked for the nurses but none of them was available because they had so much work to do. So I went up and told my colleagues that I was going back down because the old man was dying. They told me that if I wanted to act the nun, go ahead, but that I was there to work on biochemistry. I felt really bad. Everything was becoming more and more evident to me.
     Then I started getting dizzy spells and went on sick leave. What I really thought was difficult to explain to the doctors. I thought that the real cause of the dizzy spells was my life itself, which had no direction and was spinning around, there was a hole inside and I was falling into it - it was more that, and not my inner ear.
     It was then when I took the chance and went on a 10-day silent retreat. At first, when I was there I wanted to leave, get away, because it's very hard to get inside one's self. We're not used to listening to our inner voice. It was on those days when I really started to ask myself what my life existed for, and I did it with unprecedented seriousness. I did want to get an answer instead of just rambling. The answer was, I understood, that I had to work through words. I saw that very clearly. On top of it, surprisingly enough, that went back to what my father had wanted me to do - he wanted me to be a lawyer for, he said, I had a great capacity for transmitting, for defending. And yes, I had always missed that, the dialogue, being with other people, as I said before. So when I got back home after those ten days, I had already made up my mind.

Francisco's support. Driving back home I couldn't stop mulling over how I was going to tell my husband. It all seemed so crazy and foolish! And I said to him, "I've made a decision. I'm leaving the hospital; I quit". Even while I was saying it I was thinking to myself, "Oh well, I'm saying it, but I'm not really going to quit. How could I possibly quit?" It just seemed impossible to me. He said, "If you quit, we'll have to cut back on our lifestyle but what really matters is that you're happy, because if you're not, neither our children nor I will be either. So if you have to leave the hospital, just leave it."

The farewell. When I look back I realise that my colleagues' attitudes when I said good-bye after so many years made a deep impact on me.
     It was funny because the first question was always the same - did I have an ace up my sleeve? But once I explained to them that there was nothing but the need to regain my freedom in life. well, the question changed: "Why on earth would you leave this job? You have a permanent post here!".
     Does the fact of having a permanent post mean that you needn't question anything else in your life? Apparently yes, you have a permanent post and therefore you must keep it until you're 65 and never stop giving thanks for having it. And I told them, "Yeah, but now I've found out that it's not that I've got a job for life, it's that Social Security has got me for life".
     When they heard this they stared at me as if I were some kind of weirdo. And I don't blame them, for I was explaining things from my own experience, which doesn't have to be the same for everybody else. So the next thing they said was, "What about your pension?".
     I agree that one mustn't live life foolishly, but my feeling was that I wasn't going to let my life be conditioned by a retirement pension. Who can promise me that I'm not going to die tomorrow?.
     When I took my papers to the HR department, the clerk, who was an acquaintance of mine, told me, "Did you know that if you're caring for a handicapped person you are entitled to a one-year leave of absence?" My brother-in-law has a mental disability and lives at home with us, so I asked for the leave. But the funny thing about it is that I spent the whole year suffering from anxiety precisely because of that. It was as if, afterwards, when the business wasn't going well, or there was a crisis, or whatever, I could hear a little voice telling me, "Come on, you can always go back to the hospital". And I really didn't even want to hear that little voice!
     One can never say that something is not going to happen, because you never know the twists and turns life is going to take, but it would take something really, really terrible and unexpected for me to go back to the hospital. I would do quite a lot of things before that, anything. Actually, going back to the hospital would be the very last thing I would ever do! It's as if I've developed a phobia to the working system they follow at the hospital.

The prospects. I had none, no job prospects. At first you get some ideas running through your mind, such as "I can set up a nursing practice", things based on what you can do, right? But no, I knew that was not the right idea. I think in those first moments I didn't develop any plan of action, it was more just getting predisposed. "I must empty myself first", like a good clean-out. First I had to get rid of ties, obligations and preoccupations, and then whatever was to come to my life would come. And indeed that's how it happened.

The stranghe disease. At the age of 25 I spent a whole year on a sick leave for an illness the hospital could never diagnose. They treated it as hyperthyroidism but I know, and I know it for sure, that it was not hyperthyroidism. I would take like 25 pills daily. I was so limited by this condition that that I had to go back to my mother's. Francisco and I went to my mother's house because I couldn't be left alone, I had no strength, my muscles were wasted. When my mother saw that almost a year had passed and I was drooling, it really was like that, she said, "I'm going to see a naturalist doctor. There must be some doctor who won't prescribe any more pills, who'll take you off all that drug stuff, and who's a real doctor, because we're not going to any quack." And she found one.
     During a guided relaxation session, a visualisation I did later on when I was working at Fuente de Salud [the therapy centre where she worked after the hospital], I went back over the year I was 25, I remembered it exactly and I realised that that man, in only one month, had cured me exclusively by means of cleansing. He told me, "You're poisoned, child. The first thing we have to do is get you detoxified." That meant a fruit diet, controlled fasting, a bit of vitamin A and that was it. And within a month I started recovering amazingly.
     That experience taught me that we have a lot of resources against illness that normally remain unexploited, in other words, it was my first contact with natural therapies. I think that is why when, later on, all those doors opened before me as possible choices, I didn't have to wonder if this was a valid one, I just accepted quite naturally that it was.

The new professional specialty. A few days, ten, maybe twelve, after quitting my job at the hospital, I got a phone call from the therapist who was treating me with reflexotherapy and she said to me, "Remember I told you that a friend and I were thinking of setting up a therapy centre? Well, we've done it, and I think it's really crazy, I don't know if we can handle it! We know how to give massages but we're stuck with a pile of legal papers and don't know how to deal with it. As you have some previous experience with labour issues it would be great if you could give us a hand now that you have time to spare."
     I listened to what they were doing and immediately thought they just had gone cuckoo. You could tell the company was already broke before it even had a single client!.
     Nevertheless I saw a possibility within all that chaos, and it was that, in a place like that, I could have the time I didn't have in the hospital to interact with people.
     Well, that's how I saw it; I wasn't 100% certain but it was like an open door. One thing I knew for sure, though: I would certainly not stay at home, that was not my cup of tea. I hadn't quit the hospital just to be a housewife, which I think is great, but was not my vocation. And as it was related with healing, despite the fact that their view was a bit strange to me, I said, "Let's try it". From the very beginning I was greatly motivated, because I was convinced that everything I had done must be of some good and that must lead somewhere.
     During the first year I basically did management, accounting and organised that chaos and we slowly began to recover. After the first year I devoted myself to what I really felt like - my vocation. I studied and learnt, and I still keep doing so, about the natural techniques which would be my first tools. Since then, thanks to my academic background and experience at the hospital and with the help of the new techniques I am learning, I have worked as a practitioner. It is precisely due to the training I received that I can see the connection between what I learnt as a youngster and what I am gradually discovering now. And that gives me the great satisfaction of knowing that what I do really works. That the people coming to my practice, often disappointed by more traditional techniques or simply looking right from the start for therapies that don't involve taking drugs, get good results. And that is really gratifying.
     I now know, of course, that I don't heal anybody, but that it is people tho cure themselves when they want to, I just accompany them on their way. Now I really feel that, through my work, I can help people to be happier, and that also makes me very happy at a professional level. The most unpleasant part is the business side.
     My spiritual career hasn't stopped either, I keep going forward. Right now I am studying the first course of a Theology degree, because at some point, when I think it is the right moment, I also speak about spirituality. I don't impose my ideas on anybody, nor do I limit them to a specific creed, but I do try to put the person in contact, as far as possible, with that superior self which I firmly believe exists. Well, because it is my conviction that that is the ultimate healing, and without that you may get closer, sometimes not so close, but you never quite reach the goal.

The final reflection. I now think it has all been for the best because if I had stayed in Plastic Surgery, I would probably still be there changing dressings. And that would have been fine, but then again the experience wouldn't have been as enriching as this has been for me. I've done a lot of inner work with these things. I've come to see how those colleagues, if I can call them that, were a necessary presence in my life in order for me to go away and find my true path. I'm sure this is my path. I am not sure that this is where I will be the rest of my life because who knows what will happen tomorrow? I don't know for how long I will live, how much this enterprise is going to last, but I do know that the next thing will be for the better. If six months from now I have to close my business, I will. I'm not afraid, that has been a great benefit for me. I am totally convinced that there are many things I can do well, which many people will appreciate because they need them, so I don't have to worry about that.
     I think everything is in its right place, it's how it is and it's fine. And I feel that these years have been, perhaps, the best in my life.

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