An Irish Tradition: Nursing

Compassion mixed with equal doses of technical competence and good humor has enabled Irish nurses to help generations of American patients.

Nurses were Ireland’s biggest export in the late 1980s when Anne Kelly finished her five years of training, first as a nurse and then as a midwife. “The job situation at home was bad and everyone was going somewhere else,” she recalls.

Kelly herself was recruited to come to New York City in 1987 from Kilconnell, Co. Galway, to work at Memorial Sloan-Kettering Cancer Center but it wasn’t her first time working outside Ireland.

Earlier, Kelly had spent 10 months as a midwife in Saudi Arabia, where one of her head nurses had worked a few years before. “It was a major experience for me, working with Irish, English and American nurses and doctors. I helped deliver a lot of babies there and studied Arabic to learn enough to communicate.”

Kelly credits her successes to her nursing studies at University Hospital, Galway, where the nuns were in charge. “Wherever we go, our training has stood to us,” she notes. “It’s in us to do the best we can for every patient. I think Irish nurses get on very well everywhere.

“The nuns were strict — insisting that our skirts were a certain length, for example — but they taught us from the very beginning that the patient is the most important person,” Kelly recalls. “‘Imagine that’s your family member there in the bed,’ the nuns always told us.

“So I always think, what if this was my relative? How would I feel?”

While Kelly insists “I’m no Mother Teresa,” she admits, “It’s always been in my head: How can I help the patient more? I think it’s in our DNA as Irish people to be kind, to go that extra mile,” Kelly continues, “and the patients feel it. They know we’re on their side. It may mean taking a few extra minutes to pick up on little things. Often, when you talk to a patient you hear worry in their voice and you try to find out what specifically is causing that concern.”

Without a doubt, Kelly makes it clear that nursing skills are number one, but to be able to reassure a fearful patient with a kind word – that’s the ideal combination.

“Illness can unravel the most organized, successful person, so to be able to help them to be calm and develop a positive attitude is invaluable,” Kelly notes.

“The patient is not just a number. Even when dealing with a huge volume of patients, we need to remember that.”

Strong, independent spirits
“Irish women tend to be very independent and like to take charge, so what better type of person to be a patient advocate?” asks Mary Anne Gallagher, Director for Patient Care Services at Beth Israel Medical Center in New York City.

With the right blend of humor, firmness and, yes, stubbornness, Irish nurses have the ability to engage the patient, she says. “They can cajole, encourage and get a patient to do the right thing, such as prompting post-operative patients to get out of bed and mitigate potential complications.”

Gallagher, whose grandparents emigrated from Creeslough, Donegal; Ballinalee, Longford, and Kenmare, Kerry, earned her Bachelor’s degree in nursing from Hunter College and Master’s in nursing from New York Uni-versity. Currently, she’s in the process of applying for Irish citizenship.

To demonstrate the independent nature of Irish women, Gallagher points to historic patterns of immigration. “Irish women were unusual in that, unlike most other immigrant groups, many of them emigrated on their own to America.” Indeed, one of Gallagher’s grandmothers came over by herself in 1916.

Gallagher remembers back when her supervisor went on recruiting trips to Ireland to interview Irish nurses, who were very much in demand in the States. “We knew the standard of training there was very high, so Irish nurses who came over were likely to pass their state licensing exams, and they were English speaking.”

Naturally, there were some adjustments to American ways of doing things, which were covered in training sessions. For example, she explains, the Irish nurses had to adapt to increased paperwork requirements “because we work in a more litigious country.”

In the Irish spirit of sociability, Gallagher also consulted with two fellow Irish-American nurses at Beth Israel on this topic and found that all three shared similar perspectives.
Cathy Sullivan, who holds a Master’s degree as a Family Nurse Practitioner, and is also a director of Patient Care Services, points out, “Independence and opportunities for education were big factors in Irish women entering a nursing career. Back in the early 1900s, nursing was considered well matched with Christ’s teachings, and Irish orders of nuns encouraged women to enter the healthcare industry,” Sullivan says. “Education for women was encouraged in this field.”

Another Beth Israel colleague, Catherine Coughlin, the emergency department’s  nurse manager, highlights the fact that “the nursing profession was respected by the Irish – nursing was not equally respected in all cultures.” In the past, she says, smart girls became nurses (or teachers) because those professions were considered acceptable for women.
Coughlin identifies two other factors that contributed to the popularity of nursing as a career choice: “Public service is part of the Irish culture, and a strong work ethic is instilled by parents and the church, and that got passed down in Irish American homes also,” she says.

Kind words
Anne Shea Flynn, who also earned her nursing degree from Hunter College, is a first-generation Irish American whose parents hailed from Port Magee, Kerry and Mountbellew, Galway. When she was considering career choices, it was her mother who inspired her to study nursing.

Flynn now works at St. Francis Hospital in suburban New York but during her years at Roosevelt Hospital in midtown Manhattan, she had the opportunity to interact with a number of nurses from Ireland who impressed her with their skills and attitude. “They were well trained, were kind and well spoken, had a good work ethic, and had a wonderful rapport with patients and doctors.”

While Flynn takes care of cardiac patients in a high-tech environment, she makes sure to put her warm Irish personality to work as well. “People come in for tests and because they’re going under anesthesia, they’re often nervous and worried,” she explains.

Flynn reassures them, choosing her words carefully, as the Irish instinctively understand the power of language and the distinctions between being sincere and patronizing.

“We’re going to take good care of you,” she promises, rather than just using a pat, overworked phrase like, “You’re going to be alright.”

Engaging styles
Maryellen O’Sullivan, whose grandparents came from Tipperary and Kerry, received her Bachelor’s degree in nursing from Wagner College and an advanced practice degree from NYU.

As a nurse leader at Memorial Sloan-Kettering Cancer Center’s Sidney Kimmel Center for Prostate and Urologic Cancers, O’Sullivan has five nurses on her staff who were trained in Ireland and also works with many nurses of Irish descent.

In comparing the approach of Irish nurses in greeting patients and doing assessments, O’Sullivan has observed that culturally, “they tend to have a softer, more engaging style and use some humor, which makes patients feel more at ease.”

Even the Irish accent can sometimes be a nice talking point that patients enjoy picking up on, she adds. “In a big institution, if you can humanize the experience and make personal connections, it’s very helpful.”

During the more than 25 years that O’Sullivan has been in nursing, she has seen the first wave of Irish nurses who arrived in the 1980s and a second wave in the last 10 years, as more return to the workforce after a break to raise children or do other things.

O’Sullivan reports that Irish nurses “have a strong history of being extremely well schooled and competent, very hard workers and exceptionally dependable.”

Technology has become much more of a presence in nursing today, O’Sullivan says, but the “key thing is meaningful use of technology, and while it can be a learning curve for some people, it doesn’t take away from their ability to do a nursing assessment or to develop an individual plan of care.”

No matter the specialty or sub-specialty, Irish nurses have demonstrated their abilities to bridge the Old and New worlds with grace, good humor and ability.