Nurse of the Week Richard Onyait – “You Also Have a Purpose as Part of Humanity” (Part Two)

This is the second part of our interview with Nurse of the Week Richard Onyait, RN. Richard was an orthopedic clinician in Uganda (where a clinician is equivalent to a PA in the United States), when at age 32 he had to flee the country to protect himself and his family. He came to the US six years ago, determined to start a new life, and no less determined to continue caring for patients.

After arriving in Wisconsin to provide live-in care for a Madison resident, he used his first few paychecks to enroll in a CNA program. From there, he continued caring for his live-in patient while also working full-time in an assisted-living facility. Once he had saved enough, he enrolled in the BSN program at Herzing University-Madison, where he continued as a live-in caregiver while studying for his BSN. He graduated in December 2020, and is now working in the ED of a Madison hospital. Click here to see Part One of the DailyNurse interview with Richard.

DailyNurse: Now, you were an orthopedic clinician long before you enrolled in nursing school. So, during your four years at Herzing U-Madison, the classes must have covered a number of things that you already knew from experience and your original training. I’m just wondering, in addition to the value of earning your BSN and license, were there times when you thought, “I’m glad for myself that I’m studying this and learning this?”

Richard Onyait: Yes, there is a lot that I learned. I would like to say I had the basic template, but I needed to build on it. My prior training gave me the template, as it were, for nursing, anything in health care, physical therapy, as a physician, and so on.

I had to shift my thought process to a nursing perspective. Because during training, even during exams, I had the instinct to go for the physician’s options, which are not the nursing options, and I struggled with that. But eventually, I trained my mind to think and act exactly like a nurse. It’s part of the basic template of keeping the patient safe, professionalism, respect, integrity, compassion, empathy, beneficence, veracity. I just needed to put [those elements] in the right place and using them as a nurse.

DN: The pandemic started during your last year of school? How did that affect your senior year?

Richard: Well, it was an interesting one, because I was doing a mental health clinical, and they had to stop the in-person, clinical sessions. We were almost at the end of it, with maybe two or three weeks to the end of the clinical. And then we had to transition from in-person clinical to virtual clinicals.

Richard’s alma mater, Herzing University-Madison, Madison, WI.

My school created a program that still allowed us to do some clinical work, except it was virtual, which was a big shift. Because I love the interaction with my patients. It’s beyond just administering medication. It’s a relationship. There is something every patient has that is unique to them. Just like each of us, has something unique in us. And if you are able to interact with a patient, you can create a harmony or harness that inner being in them. And I missed that a lot during the virtual clinic. Because you are talking to a screen image, and you miss the human presence of the patient. In person, you can see their feelings, and they can feel your emotions too.

There is a therapeutic occurrence that communicates beyond just ‘I have your ciprofloxacin to help with the bacteria that’s affecting you.’ When you say those words, there is an inner being in you, that speaks to the silent inner being of that patient. And it creates healing. So this is something that I really appreciate during in-person clinicals.

DN: Can you recall one of your most meaningful interactions with a patient?

Richard: Oh, yeah. During my last internship rotation, about two months ago, I had a patient in the oncology unit who decided to leave against medical advice. She signed the form and was ready to leave my preceptor. I tried to talk to her and explain the ins and outs of leaving against medical advice, that you won’t be able to access this, you’re going to miss that. Still, she said that she was leaving.

DN: Why did she want so desperately to leave?

Richard: Well, she was frustrated. They were doing all these tests but couldn’t seem to figure out exactly what was going on with her. She felt like she just needed to GO. But she had many things going on with the cancer. She had respiratory issues.

So, I asked my preceptor, ‘Can I go in and give it another shot?’ And she said, ‘She’s all yours.’ I knocked at the door, thinking it was gonna take 10-15 minutes, but we talked for an hour. Somehow, she opened up about how she felt, and I shared some of my own personal experiences, telling her, ‘Hey, we’ve had a lot of difficult times, but you have come about five steps along your own journey. We don’t know how many steps are left ahead. But you can choose to take those five steps back and go back to square one, by leaving. And then you’ll have to start all over—if you’re lucky enough to start again—and you will start from zero. Or you can choose to build on the five steps you have already taken. Take one more, and hope that that is the last one and take the next one. And hope that is the last one and take the next one and just keep building on it. Because you don’t know how many more you have left to go. But we know that if you take the next one, it’s going to make it better. And the next one will make it better. And every day you take that step it keeps getting better, until you are at a point where you actually are good to go in a very good and stable situation.”

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DN: And did she stay, or did she go?

Richard: Eventually she still decided to leave. I escorted her to her car and everything. And I told her, ‘You know, if you can get back here, please do, because we need to take care of you and help you feel better.’

She went home and in two days, she had to call an ambulance to pick her up. She made it back to the same unit, and I was able to interact with her again. And one thing I remember her saying, is ‘The thing that brought me back was not the medication, but the words that you told me. That’s what gave me the strength and courage to come back and seek treatment.’ And she bought me a box of chocolates [and after some back-and-forth, the bemused Richard gratefully accepted it]. And she kept telling me, ‘just be the person that you are. What you say speaks to me in a special way. Pills can’t do that.’

DN: That’s why people trust nurses so much. When you need it most, their special combination of communication skills, empathy, and emotional IQ can lift you up. And so many patients must feel like that woman.

Richard: It happens everywhere. It happens in the ER, all the time. For instance, with patients who have been brought in after an overdose. The way the nurse interacts with them [can be healing] and remind them that their lives matter, they’re not just ‘drug overdose cases.’ We don’t always have a lot of time, for sure. But I always believe there is a silent talk that goes on between the nurse and the patient, even when you just offer somebody a pill. ‘Hey, I brought your Tylenol for the pain.’ The way you say and offer it can help heal the person as much as the pill itself.

“In life we all have a purpose for ourselves, but you also have a purpose as part of humanity. We have to do something special for each person, for the greater good of humanity. And for me, I find my purpose in caring for people whose lives are challenged by sickness, disease, disability. That’s where I fit in, in the jigsaw. I don’t fit anywhere else.”

DN: How is the COVID situation in Madison? Have they told you to expect when you start on Monday?