I lived through it: teaching through telling tales

1 September 2013

Wintec nurse educator JACKIE McHAFFIE shares a tale or two about the role of storytelling in teaching nursing.

A hush went through the lecture theatre ...

As an educator, I frequently question my purpose in the great game plan of nursing. I have forty years of nursing experience in the profession. I became an educator to make a difference and inspire future generations of nurses with passion for the profession of nursing.

Such noble thoughts were racing through my head as I gazed out at the 180 neophyte student nurses in the lecture theatre waiting eagerly for the word on the history of nursing as a profession. They had the timeline ‘from before to now’ on the screen above me. How do I make them want to listen and interact with the subject when the majority of them were not even born before the 1980s?

Being of Māori and Irish descent, I draw upon my heritage to assist me in telling a personal story. I lived through some of this history, so who better to explain it to them than someone who lived through it? This would make me a relic from the past, so to speak.

Story telling is an ancient technique used to educate, and therefore, empower, as well as to provide life lessons and hope. With the invention of writing and print, stories became books. The telling of stories to nurses who have no experience makes the reality seem closer for them.

For example, when a question about “death and how do you deal with it?” rises from the lecture theatre it prompts me to share an oft-told tale of my own first experience:

There I was with four months experience under my belt when my fellow student nurse and I went into wash and prepare the body of the deceased person for the relatives who were on their way in from home to see their dearly departed. This was the first time for the both of us. Coming from a religious and spiritual background, we both entered the room with reverence and no knowledge of what could happen. No one prepared us for the scientific fact that the lung space had filled with air so when we turned the body onto the left side, the inevitable WOOSH sound echoed from the deceased. My colleague flew down the five flights of stairs before someone caught her to explain. Me, I lost the power of speech and could only stammer and stutter out the words “b-b-b body WOOSH” and “not dead”.

To this day, I have never let someone attend a dead body without mentioning the fact that when one dies nothing works anymore, so every space will fill with air if it can. These words of advice have now become known as the ‘Gospel according to Jackie’. Through sharing my stories, the students tend to relish them as one of their own and are more likely to remember the story’s lesson longer.

We encourage students to use professional language but to use it with caution. I illustrate this by sharing the tale of the young girl quietly telling her best friend how the elderly neighbour had died. Encouraged by her educator mum from an early age to use the correct terminology, the daughter says “she died of an unstable vagina” . As the neighbour was in her nineties, I hasten to add it was actually “a case of an unstable angina”.

Stories where we are the heroine always appeal to me, but I learned early on in my career that learning also comes from the good, the bad, and the ugly. It is the combination of all three that will guide student nurses in their learning. The awareness helps them to form a visual picture.

Frequently students ask “how did you feel back then?” Which is my cue for another story, ‘My first injection’:

Picture the nervous young student having checked and rechecked all her equipment and then walking to the bedside with her fellow student (I was a first year while she was a third year).

The elderly gentleman was happy for me to do the injection. He said we all have to learn sometime, so it might as well be him I practised on. I went through the ritual of preparing the site and then prepared to insert the needle. In the back of my mind, I said the following words to myself: “be firm, don’t hold back, Jack, you need to breach the epidermial layer to reach the muscle”.

In went the needle and bounced off the bone back to me. Forty years later, I can still feel the crunch like nails scrapping on a blackboard. The patient was not built like a muscle-bound beach guard. Rather, he was a thin elderly gentleman.

Thank goodness for my colleague who quietly whispered “just do it with a different needle and insert it again, just not so far this time”. The patient then thanked me for my gentle technique. I just nodded and smiled because, in a rare moment for me, the power to communicate escaped me.

The images from my stories may provide a note of caution or help to overcome fear, until the students have their own stories to tell that reflect on their own developing nursing practice. Whether spontaneous or planned, each story is a learning opportunity for students to further develop their scaffolding for nursing practice, knowledge, and experience. Storytelling is not new to nursing, with Pamela Wood analysing in 2009 a group of 16 kiwi nursing stories published between 1910–1914, which she refers to as backblock nurses’ stories.

As nurses, we have a long tradition of folk tales, stories and narratives explaining what it is that we as nurses do. I will continue to tell my stories and hope this inspires others to include a piece of their history in their work for others to learn from. In the words of an Irish quote: "May you have the hindsight to know where you’ve been the foresight to know where you’re going and the insight to know when you’re going too far."