Chapter 04: Working at MD Anderson as a Student Nurse

Chapter 04: Working at MD Anderson as a Student Nurse

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Description

Mr. Brewer begins this chapter explaining that he spent the clinical years of his RN training in Houston because the nursing program of Prairie View College there in 1968. He came to work at MD Anderson as a student nurse in 1970. He notes that there were no male RNs at that time and no male LVNs that he can recall. Mr. Brewer then provides a view of oncology nursing.

[The recorder is paused.]

Next, Mr. Brewer talks about the scope of responsibility of LVS at that time (comparing it to today). He talks about the model of team nursing under the registered nurses and notes that some of the models for organizing work were unique to MD Anderson.

Identifier

BrewerCC_01_20190516_C04

Publication Date

5-2-2019

City

Houston, Texas

Topics Covered

The Interview Subject's Story - Overview; Experiences Related to Gender, Race, Ethnicity; Joining MD Anderson; Personal Background; Overview; Professional Practice; The Professional at Work; MD Anderson Culture; Working Environment

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Disciplines

History of Science, Technology, and Medicine | Oncology | Oral History

Transcript

Tacey Ann Rosolowski, PhD:

Yeah, exactly. Yeah, exactly. So I noticed because you started at MD Anderson in 1970 and you didn’t graduate until 1972, so there’s an overlap there. So tell me about that overlap time.

Cecil C. Brewer, RN, BSN, MS:

Well, it goes back to—everything kind of rooted in my fifth grade, right, work. I had to work. I got married in 1969.

Tacey Ann Rosolowski, PhD:

Oh, okay, and your wife’s name?

Cecil C. Brewer, RN, BSN, MS:

Sandra. And we had a baby, and now I’m a—I have a family, and I’m in school.

Tacey Ann Rosolowski, PhD:

How did you meet her? What did she do?

Cecil C. Brewer, RN, BSN, MS:

Oh, we were high school friends and so we’re—

Tacey Ann Rosolowski, PhD:

What’s your child’s name, your baby’s name?

Cecil C. Brewer, RN, BSN, MS:

Keith.

Tacey Ann Rosolowski, PhD:

[Keith?], okay.

Cecil C. Brewer, RN, BSN, MS:

And we moved and so we were in Dallas and we moved to Houston because what—see, the way the program is structured, you spend your first two years on the—on your preclinical experiences. It’s called lower division nursing. You’re not taking nursing courses, you’re taking basic liberal arts and your science courses on campus and then you get accepted through a process to move into your clinical program or your upper division here in Houston. So Prairie View University is in Prairie View, Texas, and the nursing, pre-nursing is there.

Tacey Ann Rosolowski, PhD:

Got you.

Cecil C. Brewer, RN, BSN, MS:

But the actual nursing school is over here on Fannin. At that time, it wasn’t on Fannin, but it was—at the time, it was in the process of moving—had just moved to Houston in 1968, and I came... And I finished my lower division education at Prairie View in 1970. So I moved from preclinical to clinical in 1970 so that’s when I moved my family from Dallas—

Tacey Ann Rosolowski, PhD:

Down to Houston.

Cecil C. Brewer, RN, BSN, MS:

—to Houston in 1970. So work became not an option. It was never an option. (laughs) I applied for a position at MD Anderson, and since I had an LVN license, I had a dual role. I worked in whichever capacity was paying the most money at the time. So I went in as a student nurse because, at that time, MD Anderson didn’t have any male RNs.

Tacey Ann Rosolowski, PhD:

Hmm. Really, none?

Cecil C. Brewer, RN, BSN, MS:

This is 1970. And they had male orderlies, and no male LVNs that I can recall, so I became the odd man out, right?

Tacey Ann Rosolowski, PhD:

Yeah.

Cecil C. Brewer, RN, BSN, MS:

So—

Tacey Ann Rosolowski, PhD:

But you kind of like being that way, don’t you? (laughter)

Cecil C. Brewer, RN, BSN, MS:

Now, I came into the profession at a good time.

Tacey Ann Rosolowski, PhD:

You did, a trailblazer in your own way.

Cecil C. Brewer, RN, BSN, MS:

Uh-huh, right. And I—hired on as a student nurse because it paid more hourly salary than the LVN at that time. And during the summertime at the LVN role, well, allowed me to work more hours.

Tacey Ann Rosolowski, PhD:

Got you.

Cecil C. Brewer, RN, BSN, MS:

So I switched up between LVN and RN for the—from 19—when I was in school.

Tacey Ann Rosolowski, PhD:

Now, a lot of individuals who go into nursing say that they have trouble getting their heads around the prospect of oncology nursing. What was your attitude about that at the time?

Cecil C. Brewer, RN, BSN, MS:

My attitude about the cancer patients was not—I didn’t have an issue with that because in my exposure as an LVN during my LVN training in Dallas, I was exposed to a tremendous number of patients who were being treated for cancer. And remember in 1968, the treatment for cancer was quite radical, and radiation treatments were quite radical. So a lot of my LVN training was geared for caring for those patients. And when I came to MD Anderson, the transition wasn’t very easy and challenging, interesting, and opportunistic. I didn’t know it was opportunistic at that time, that I was a trailblazer in oncology and would continue to be. I happened to be in the right place at the right time.

Tacey Ann Rosolowski, PhD:

Now, tell me about what you were doing and what your roles were when you first started and what those challenges were.

Cecil C. Brewer, RN, BSN, MS:

Okay. I have to take a quick (inaudible).

Tacey Ann Rosolowski, PhD:

Oh, absolutely. Let’s take a quick break here.

Cecil C. Brewer, RN, BSN, MS:

Okay. (break in audio)

Tacey Ann Rosolowski, PhD:

Okay. We are recording again after a brief break. So you were about to talk about the work that you were doing as an LVN when you first were hired here and then the challenges that—some of the challenges that you started to face and also, I have to say, what you loved about it. (laughter)

Cecil C. Brewer, RN, BSN, MS:

Well, when I started working in MD Anderson in 1970 as a student nurse, the practice of nursing was quite different than what it is today. Student nurses were given a lot of latitude as far as responsibility on the units because it was felt that through a professional student that our grade and our knowledgebase was much higher than, say, the LVNs. Because they were licensed vocational nurses, the training was one year, and the LVNs were working on the direction of the registered nurses. And since we were professional nursing students that our level of practice was higher than that of the LVN and that—you know, and that the LVNs basically should be reporting to us, not us reporting to the LVN. So technically, we were thrown into mana—leadership roles. We were expected to know about medications and their implications and their adverse impact on the patients and, etc. We were also expected to have a certain skill set in how to manage patients. We worked on the units as doing basic care, but also, we were moved into the responsibility of what we called team nursing. Team nursing is a duty that—a function of how a unit works. On a team, you might have a registered nurse, the LVN, and, say, two or three hospital aides or nursing assistants, and maybe a student. And the registered nurse is the leader and gives the—and provides the leadership, the directions, the problem solving, the resolution of issues, and the more complicated duties that go on with patients.

Tacey Ann Rosolowski, PhD:

Let me just interrupt you for a sec and ask if this autonomy that was given to student nurses, was that something that was happening as you discovered across the profession in many hospitals, or was that kind of the environment here at MD Anderson that there were those expectations?

Cecil C. Brewer, RN, BSN, MS:

I think MD Anderson, the expectations were quite different. I don’t think it was across the board because different institutions have different rules and regulation, beliefs, philosophies, liabilities, etc. I think the philosophy at Anderson, as I explained, was one of a level of professionalism and the amount of resource that we had around us so that we wouldn’t venture off into the depths of something we didn’t know how to manage. I think that was more of an MD Anderson culture. I had friends who worked at other hospitals as—doing student nurse jobs who didn’t have the experiences that I had. So Anderson was unique. Like, Anderson is unique because it’s oncology. It’s unique because of the type of services we provide to our patients, and I think just the way that Anderson approached the student nurses was unique. And so those experiences actually helped shape my skill set as a registered nurse because I will find myself maybe a tad ahead of my student peer group in school because I was being given options and experiences that they weren’t exposed to—being able to lead a team as a student nurse. And basically when I worked, I worked on the 3:00-11:00 shift, and that was—that’s the shift that has less resource around you because a lot of the resource in the hospital is very daytime oriented. You know your administrators, your doctors, your specialists, your supervisor, there’s a big concentration right there in—on—from let’s say, seven o’clock in the morning until five o’clock in the evening. But come five o’clock, it’s like everybody—

Tacey Ann Rosolowski, PhD:

Thins out.

Cecil C. Brewer, RN, BSN, MS:

—(overlapping dialogue; inaudible) desert around here. Well, it seems like though everybody is leaving, but they don’t, but there’s a very limited number of resources left on campus to care for the patient. And that’s what happened when—and then I worked 3:00 to 11:00, and if you—and then we’ve always told young practitioners, “If you really want to work and learn something and learn how to work independent and problem solve, work on the evening shift. You don’t have all these resources to pull from. You’ve got to make good choices, you’ve got to learn how to research, you’ve got to learn how to read, you’ve got to learn how to be independent in your thought process.” And that’s what working as a student in the evening allowed me to do. And I was able to learn how to give directions, learn how to lead a team in a very protected way, in a very—and so I thank MD Anderson for that in that I was able to do that as a student nurse.

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Chapter 04: Working at MD Anderson as a Student Nurse

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