1. Gerber, Lois MPH, BSN, RN

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MANY YEARS AGO, I was attending an orientation session for my new job as a public health nurse. I enjoyed dealing one-on-one with patients and their families, but I wondered if working in this busy health center would be as satisfying as my student community health experience.

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Fidgeting in my chair, I wondered which of the three supervisors I'd be working with. We all wanted to work with Mrs. R or Ms. P-but not Mrs. M.


Mrs. M was called the "relentless taskmaster" behind her back. Her erect posture and cropped gray hair emphasized an organized approach to her work and a no-nonsense attitude toward the nurses she supervised. Her crisp navy blue uniform and sturdy black shoes seemed unfashionable and out-of-date for a woman in her forties. I respected her but was wary of her clipped retorts and impatience with small talk.


I groaned inwardly when the manager announced that I was assigned to Mrs. M's team.


Starting the day with Mrs. M

When Mrs. M called me into her office several minutes later, my heart beat like a jackhammer. "Welcome to the team," she said. "By now you've learned that nurses treat the family as well as the patient. We must be friendly but professional. Often, new nurses focus on the social interaction instead of the family's health needs. It's an important nursing role." She sounded like everyone had described her: cool and a little harsh.


Mrs. M glanced at the calendar on her desk. "I'm going to make shared visits with you today. We'll visit the first client before lunch. Here's his chart. Write down what you plan to do and map out the route. Let's leave in 45 minutes."


Fortunately, my map and outline were complete when Mrs. M approached my cubicle. I grabbed my nursing bag, stocked with soap, paper towels, stethoscope, and other supplies.


"Can you drive?" she asked.


I took a deep breath before agreeing, embarrassed that my small car was dusty and my kids' toys were scattered across the back seat. Mrs. M didn't seem to notice; she sat down in the passenger seat and pulled a stack of patient records from her briefcase. When I asked for directions to the patient's home, she pointed to the city map on my dashboard. My stomach churned.


An unlikely poet

We arrived at the home of Mr. F, a burly 50-year-old biker with tattoo-covered arms who needed an I.M. injection of penicillin for primary syphilis. After I introduced myself, washed my hands, and took his vital signs, I drew up the medication in a syringe. My hands began to shake. I hoped Mrs. M didn't notice.


Mrs. M cleared her throat. "Talk with Mr. F about what you're doing and why," she said. "I'll sit here out of the way. If you need anything, ask."


Mr. F laughed. "You're new? It's okay."


I nodded.


"I write poems," Mr. F said, and recited a humorous ode to the nurses who'd cared for him. It made me laugh, and my trembling stopped.


After I gave Mr. F his injection, he told me he contracted syphilis from a woman who lived down the street. "I could've spread it to another lady," he confided. "I didn't tell the clinic worker, but I'm telling you."


"Who?" I asked in a soft tone.


He wrote down the woman's name and phone number and handed it to me. "Thanks," I said. "We'll check everyone you've had sex with. Syphilis spreads easily."


"There's no one else," he said. "Two women are two too many."


Mrs. M took my arm as we left the apartment. "You did very well," she said. "Besides teaching him about syphilis, you got the name of a contact that he wouldn't share yesterday at the clinic."


I smiled and breathed a sigh of relief.


With a wink and a smile

We returned to the health center minutes before noon. I grabbed my lunch bag, entered the boardroom, and set the brown sack on the polished oak table. Mrs. M followed me with a container of chicken Caesar salad. The other nurses had salads and pita wraps.


When I opened my sack and smelled peanut butter, I took a deep breath. I'd pulled the wrong bag from the refrigerator this morning-one of my kids had taken my tuna salad croissant and left me with peanut butter and jelly.


I eased the sandwich from the bag and slipped it under a napkin. Mrs. M must have seen it and asked, "Would you like to share my salad?"


"Thank you," I responded. "Would you like half of my sandwich?"


"Yes, I love peanut butter-lots of protein." Mrs. M smiled and winked at me, and my hesitancy about working with her dissolved. She might be demanding, but she was kind and insightful and willing to teach me all she knew about community health nursing. I smiled back and joined in the boardroom conversation.


Change of heart

As the day ended, I realized how wrong I'd been about Mrs. M. My initial perceptions of supervisory figures were often incorrect because of my own fears and insecurities. Mrs. M wasn't a relentless taskmaster but a serious professional nurse who wanted only the best for her patients and the nurses she supervised.


After a day of caring for a tattooed poet and working with Mrs. M, I felt like an official public health nurse.n