Patrice Rancour, MS, RN, PMHCNS-BC has spent more than 35 years in the healthcare field. She has practiced at the bedside, taught in the classroom, and run a private practice as a consultant. A undergraduate and postgraduate of Ohio State University, Rancour is also a Certified Advanced Care Planning Facilitator and a Second Degree Reiki Therapist. She is widely published in textbooks and medical journals and has given numerous conference and symposium presentations. Visit her website.
Read Lee Ambrose's reviews of Tales From the Pager Chronicles & The Pager Chronicles, Volume Two
Interviewed by Lee Ambrose
Posted on 02/06/2011
Tell us how you came to be first a registered nurse, and then the various other roles you've fulfilled along your path. Did you always want to be a nurse or did that choice come to you somewhere later in your education? Did you always see yourself working in less traditional nursing roles? Or were you exposed to them and found that they fulfilled a higher purpose that you hadn't yet known you were searching?
Back in my formative years, there weren't too many career options open for women. I found health and science courses interesting in high school so decided at that point in time to pursue nursing. I often wonder what I might have chosen if the current opportunities that women have now were available then.
Personally, as I look back, I've been able to choose many different roles within nursing: in education, writing, consulting, advance practice, private practice. I believe it has been the variety that has kept me stimulated and has allowed each form of practice to inform the others. I have also been extremely lucky to have been surrounded with numerous entrepreneurial opportunities and remarkably self-empowered older women mentors from a variety of different backgrounds. They provided a richness which stimulated my practice.
In addition, working in an academic environment that fosters inter-disciplinary connections creates hybrids of practice, which can be very creative. Personally, I have always felt a little suspect of those folks who have ten-year plans for their career goals. I often start off on a path which I believe is going to deliver me somewhere specific, and before I know it, I have been detoured from where I thought I was going, to arrive somewhere else quite unexpectedly. (My therapist friends call it synchronous; my spiritual friends call it providential!) From where I sit perched now in my career, I can watch the inevitability of my career path and see that all unfolded as it needed to for my growth and development, despite—and perhaps, especially because of—the more painful parts of the journey.
In your first book you state that a quote from a conference was the impetus for the book. Would you share that quote and how/why it compelled you to write the book?
I keep looking for the conference quote to which you are referring, and am embarrassed to say I can't find it. One quote I do remember is from Grayce Sills who kindly wrote the foreword to the first book. I was taking a clinical course from her in graduate school, and at one point, she bluntly put it to us that it was now time to stop reading what others had to say, and to start doing the writing ourselves. I guess that stuck with me at some level—especially as a women's issue at that time—and I've never forgotten that. (Word to the wise to teachers: Be careful of the language you use, as your students are paying attention, despite what you think!)
Do you journal regularly? And if so, does your journaling include snippets of your days on the job and/or your patients and their impact on you? I am asking if you already had a stockpile of patients and experiences from which to draw for the first book or if you only started to gather them after you decided to write it?
I am struck by the power of words. Language is the clinical tool I use to motivate, reframe, transform and empower others in their own personal work. I have often used writing as a means of working with patients facing major illness. In fact, I've published many clinical papers on such a practice. I frequently work through my own personal therapeutic impasses using writing to understand the meaning of whatever suffering I am personally experiencing.
So, while I would say that I didn't stockpile snippets of cases to use for later, my penchant for writing about my experiences with patients emerged as I continued to be flooded by the impact of working with people at their threshold events. And of course the work that I was doing at the time was mostly concerned with the threshold between life and death.
As a nurse myself, I have often said "I could (should) write a book." Were those words that you echoed throughout your career as well?
I have been dismayed about the way the media overlooks the role of the nurse as a healer in our culture. Medical dramas like House reinforce the inappropriate worship of medical doctors in this culture. Other similar dramas focus so much attention on all the sex happening between the hospital workers, I often wonder who is caring for the patients. I keep hoping someone would tell the stories of the patients and of the seemingly invisible nurses who care for them 24 hours a day.
Over the years, I have primarily written for professional clinical journals, been invited to write book chapters, that sort of thing. The idea to write a creative, narrative non-fiction account about my work was something I became pregnant with over time. Snippets, as you say, would come to me, but I was lost as to how to develop the snippets into a cohesive whole. The idea of using the pager as a literary device to propel the story line finally helped me to knit together a narrative that created connections between seemingly disparate people. The connector became myself, and the way our interactions affected not only the patients, but also how they affected me.
And that's when Grayce's refrain came back to haunt me as well. The other comment I would make is that as a voracious reader myself, I love the way a writer can turn a phrase, contrive to make me smell a rainstorm long before it's dousing the page, dazzle me with the liquid velvet of a summer night, create tension so wily that a muscle in my cheek starts twitching. Well, who wouldn't want a piece of that herself?
Do you have a favorite story from the first book? Book two? If so, which ones are they and why are they your favorites?
I feel a particular affection for the characters in several stories from Tales from the Pager Chronicles. In "Betsy and Elizabeth", we meet a young woman who is embarking on cancer treatment, but who is also someone who has a dissociative identity disorder, unbeknownst to the nurses caring for her. The emergence of her alter ego (a part of her personality that has survival value, I might add) presents challenges that are larger than either of those conditions alone.
"Sleeping Beauty Awakens" introduces us to the unfortunate young man who thinks he is waking from a simple knee surgery only to learn that a below-the-knee amputation has been necessary due to unforeseen complications. The issues here have to do with his youth, the loss of the illusion of control one has over one's future, and the sensitivity of introducing the events that have transpired while he has been in a coma during the past month. Helping someone come to terms with a catastrophic change in his body, of which he is not aware, is a daunting challenge.
In The Pager Chronicles, Volume II, a number of characters spring to mind. In "Where's Jack?" the story hinges upon the ability of the nurse to try to track down a cancer patient whose schizophrenia puts him at risk for problems that other cancer patients don't experience. His aberrant behavior may be understood within psychiatric/mental health circles, but in non-behavioral health settings, such as oncology, this person can often get lost in the complexity of treatment settings with no ability to advocate on behalf of himself. Jack's background of psychotic self-mutilation makes him vulnerable in a system known for its fragmentation. The two methods to control aberrant behavior in this country are the health (read "sickness") care system and the criminal justice system. Once one moves past the boundaries of treatment, the only other option for social control of aberrant behavior is the legal system. Helping such patients navigate the inherent maze puts us in touch with our own fears about our own vulnerabilities.
Finishing the book with "One Door Opens" helped me to circle back round to the fundamental truth inherent in each of these collected stories: that the basic human condition often has the capacity to bring out the most noble in us, even when it does not appear to us to be so. I felt it was my job to bear witness by giving these people a voice, and by so doing, I suppose it helped me find my own.
How did telling these stories change the people about whom you wrote (and their families)? How did it change you?
I'm not sure that telling these stories changed any of the people I wrote about. If they did, I have yet to hear about it. I think writing about one's work does force one to immerse one's self deeper into the greater meaning of things. Experiences become less clinical, more existential, less about individual suffering than about the universal suffering of humanity. Writing about peoples' transcendence of their suffering gives my own life a broader context, helps me see where I might (or sometimes, might not) be fitting into the whole of things. In workshops, I often mention that helping people find meaning in their suffering redeems it. I think writing about such tender experiences helps the writer grow emotionally, spiritually and psychologically. In the genre of the wounded healer, writing about humanity's woundedness is a healing all to itself.
For me the confluence between writing and healing arrives at the nexus of the word healing, which means "to make whole." I believe that through writing, unconscious experience is held up, examined, meaning is made, and the experience is restored to the wholeness of the examined life. In this way, writing about those parts of our selves and our experiences that might have been lost to us returns us to our true selves in such a way that wholeness is possible. And thus, healing.
In The Pager Chronicles (one and two) the reader gets the sense that your days are filled with multi-tasking, running here and there, giving freely of yourself. Your job seems like one that is capable of draining the body, mind and soul of all positive energy if allowed. How do you renew yourself throughout the day? What do you do after hours to find the necessary peace and renewal to return day after day? From where do you get the strength to go on when it seems as though there is nothing left to give and your challenges have not yet been met?
What a grand question! And yes, you are so right. If one is not paying attention, this kind of work can bite you right back in the hind-quarters. But that is the saving grace of using writing intentionally as a healing modality. There are programs out there even now—Ohio State University's STAR (Stress, Trauma and Resilience) Program (pdf) that are investigating and developing intervention programs designed to mitigate the effects of compassion fatigue, an occupational hazard of health care workers. As I've mentioned before, it is wrong to believe that those of us who care for people who are suffering aren't affected by it. It is also true, as one writer put it, that such fatigue isn't always the result of caring too much, but of caring too little.
Personally, I have found that I need to mix my work so that I am not at any given time doing just one thing. For example, while my private practice is committed to working with people facing life-threatening illness, I also work "upstream" in a university faculty/staff wellness program, delivering worksite health promotion programs. (The reason for this choice: it makes no sense to wait until people get broken, and then to fix them. Better to give them the resources they need to stay well in the first place.) I provide program consultation and conference presentation work in addition to my writing projects. This kind of gumbo makes for a more energized and diversified work life.
Will you continue to write more "Pager Chronicles?"
The third volume is already underway. However, this one reaches way back into my past as a newly-graduated nurse who becomes the director of nurses of a ninety-nine bed mental health facility up in the mountains east of San Diego back in the mid-1970's. (My staff members were primarily local goat ranchers so perhaps you can see where this might be going. Or maybe not!) I am coupling those "Tales from the Hilltop" with "Tales from a Private Practice," describing, in a most reverential way, how clients suffering from various forms of abuse, were able to transcend their personal tragedies and make themselves whole again.