Where Nurses Bury Their Stories

As a nurse, she took children from their families and smuggled them in boxes and tool chests, placing them in a safe place until the end of the war. But she struggled with burnout. It was so emotionally draining.

I stumbled on Irena Sendler’s story while reading the book, Uncommon Character: Stories of Ordinary Men and Women Who Have Done the Extraordinary by Douglas Feavel, and I was struck by how she dealt with the emotional toll of her work — A struggle that so many of us face in healthcare.

The story begins in Warsaw, Poland and the German invasion had just swept through in 1939. Irena grew up in Warsaw and saw the formation of the Jewish Ghetto of 400,000 people confined in a 1.3 square mile area.

Irena worked in the Ghetto to manage rampant typhus due to the filthy conditions. She agonized as roughly 5,000 people died each month from typhus alone. Irena’s own father had died of typhus, and she often thought of him as she entered the ghetto to care for the community.

This persecuted community faced the ongoing threat of execution. When a large group of children was taken out by armed Nazis in 1942, it was likely that they would face death by Zykon B poison gas. So Irena chose to initiate a rescue plan that placed her life, and the life of her friends and family, in direct danger. She smuggled children out in suitcases, boxes, and tool chests. She brought a dog that was trained to bark when a Nazi uniform was near because the barking would cover any small noise the child might make.

Irena and her team rescued 2,500 children by the end of the war. She placed their names on slips of paper and placed them in jars, then buried the jars under a tree by a Nazi station. Irena kept careful records in those glass jars to ensure that the children could be returned to their families. The children were smuggled to willing Polish families who also supported the resistance.

In 1943, an informer reported on Irena’s activities, and she was imprisoned, tortured for information about the hidden children, and eventually sentenced to death. Thankfully, friends in the underground resistance movement were able to bribe the German guards who were tasked with executing Irena, and she was hidden anonymously even as her name was reported as a death in the concentration camp.

Faithful to her word, when the war ended Irena unearthed the jars of names and attempted to find the families of the hidden children. Sadly, all of their parents and most of their siblings were murdered at Treblinka death camp nearby. Yet the orphans were given information about their families and reconnected to their heritage through her careful records.

Irena, when she was asked to comment on her accomplishments, said “I still hear the cries of the babies and their mothers. …I am not a hero, I could have done more; this regret will follow me to my death.”[1]

Irena often counted the losses, but it took a student named Liz to help her — and the world around them — to count the survivors and realize the incredible benefit of her sacrifice. When Liz selected Irena’s life as the focus of her high school history project, she didn’t know that Irena was still alive, or that their project would lead to international recognition of Irena’s work and a nomination for the Nobel Peace Prize.

Irena’s story as an undercover nurse is such an inspiring example for nurses today. A lot of healthcare workers talk about how we only hear about mistakes and rarely hear about success stories. In part due to rigorous privacy regulations, we lack the closure of survivor stories.

Yes, we join improvement projects and look for ways to avoid the worst-case scenarios, but those solutions come at the cost of intensive study of our mistakes.

When do we hear about the patients who walk out of the hospital with a big grin on their faces?

I think this is something that oncology departments do well: Cancer patients have a ritual of ringing a bell when they leave at the end of treatment. Everyone gathers to clap and celebrate their victory. It is meaningful and memorable.

Irena saved names in jars and cancer units ring bells.

What is your ritual?

How can a contemporary nurse remember the good stories and treasure those successes in the midst of sacrifice and hardship?

Yes, we must maintain privacy. True, we cannot keep identifiable records of our patients. But there is no reason why we cannot keep our thoughts and feelings:

• “A father thanked me today for holding his son’s hand while he took his last breaths. His own flight was delayed, and he was grateful that his son was not alone.”
• “A mother told me she trusts me with her child. It meant a lot.”
• “My patient’s daughter said I have a calming presence. I was so stressed, it felt good to hear that someone felt sure of my skills.”
• “I got to see my patient walk out and climb into his car today while I waited for my ride. I wouldn’t be allowed to see his chart, so it was really encouraging to see him leaving alive and in good spirits.”

Whatever work you do, one way to push back the onslaught of burnout and feelings of helplessness is to treasure those beautiful moments that make time slow down for a moment and leave you feeling humbled and grateful to be there.

So think about how you can remember, and start keeping a journal of de-identified impressions, drop a penny in a jar, or add a patch to your quilt and cherish the good, the survivors, the jobs well done. Because there are a lot of unsung heroes who are never nominated for a Nobel Peace Prize, even though people’s lives were changed for the better when they showed up for work each day.

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[1] Feavel, Douglas (2016). Irena Sendler: Separated by Good or Evil. Uncommon Character: Stories of Ordinary Men and Women Who Have Done the Extraordinary, 3^rd ed. Aneko Press.