Lessons from Mrs. Puchini: Walk the Line

From time to time, I will be writing stories about some of my teachers. They thought they were patients or clients, but I'm not sure who was more helpful to whom! In all of my stories, I am changing some of the following: their names, genders, ages, references to time period when we hung out together, and any potentially identifying information... just so you know...

Mrs. Puchini was a tiny elderly woman who always wore a housedress with a tiny white fringe of petticoat showing above her stick figure legs (Think flamingoes!) She loved to get up on a very tall ladder which was constructed during the year of her birth. As I approached her tiny little house, I walked along her side yard fence. Of course, since she and her family were small statured, so was the fence... 

Imagine my first sighting of Mrs. Puchini... Amid a little orchard of giant prune trees stood a lone rickety ladder, leaning up against one of the trees.  On the ladder's tallest step perched two little pink house shoes (slippers), with tiny white socks up to the ankles of these skinny little legs, topped off with a wisp of petticoat and a partial view of a pink housedress. Visually, 75% of her human form was apparently up in the middle of the prune tree, which was heavy with fruit. After I had rang her doorbell and knocked on the door for awhile, calling her name, the front door opened and Mrs. Puchini peered out with a big smile. She invited me inside. 

During our 30 minute visit, we eventually got to the discussion about her safety in her home, particularly dealing with her stove, her throw rugs (AKA flying carpets) and the importance of staying off stools and ladders (smooth segue!) Her big blue eyes grew wide and never flickered as she told me that she NEVER got on stools or ladders. She went so far as to put her hand on her tiny chest and assured me that she never would, now that I had asked her not to... Note the clinical and ethical dilemmas... 

For quite a number of years, Mrs. Puchini and I repeated this same conversation, every week or two. I never "confronted her"... I just helped take care of her, where she was, as she was... and tried not to let her know that I knew. That would have hurt her feelings. That would also have prevented me from being able to do the rest of my job. Every visit, she would hug me goodbye and wave from her doorway. Mrs. Puchini taught me a lot about respect, creativity, patience, compassion and a few tips on the strategy about how to walk that fine line between being a "healer" and being a guest. I continue to practice walking that fine line, every day. 

Years later, I heard that Mrs. Puchini had recently died peacefully in her sleep, in her own tiny little house. No ladders or stools were implicated.

My Work Space: The Intersection of Nursing, Law and Family Therapy

Welcome to my new blog. I intend to gather some useful sites and publications for you to use, conduct a few web-based research projects and generally create a tiny conversational bubble at the intersection of several different "planets." (Poor Pluto) My metaphorical "planets" are nursing, law and family therapy. I have to spend a little time on the background of how these places came together to create my work space. The story spans 32 years in 2 paragraphs. Feel free to skip it, too...

Starting out as a nursing student at UT Austin (Go, HORNS!), I became interested in the differences I started to see between who got better and who became a "frequent flyer" in the medical system, whether it be in the ICU or the psychiatric ward. Even in the ICU, I spent more time interacting with patients' families and helping sort out some of their tangles, often, as I tried to provide some continuity of care for our patients. 

Eventually, I went off into the community sector (wings!) and learned how scary it can be out there. If I was nervous about being outside the hospital setting, I can only imagine how frightening it must have felt for most of these vulnerable folks! Since most of my patients/clients were elderly, there were multiples of family dynamics (think giant kitty hairball!) to learn about and negotiate, every day. These patients and their family members were anxious to tell me their stories. I soon discovered that if I wanted them to let me in their home, check their incision, their blood pressure, their IV, their bandages, their lungs... I needed to listen, listen and listen...