My first job out of nursing school was on the telemetry floor of a small, community hospital. I spent six weeks training on the day shift, but I was hired for nights. The day nurses said that the night nurses would be very tough on me. What I saw during shift report did little to dispel my fears. Their reports were terse, often berating if I stopped them to ask too many questions. It didn’t occur to me at the time that maybe they were just tired. I only knew that in a short period of time I would be among them, on my own for the first time.

The night shift was, for the most part, Filipino. The “white” nurses (well, really, we were mostly pinkish) numbered three: Mary, with an impressive, and nowadays verboten, set of acrylic nails, and Sean, a young guy who longed to leave tele and go to the ER. If neither of them was on, I would spend the eight-hour shift listening to the other nurses chatting in Tagalog. My preceptor, Edna, was not very talkative. She’d give me my marching orders for the night and go off on her own assignment. I felt very alone.

The truth was that I was never alone. Those Filipinas would have sooner come to work naked than let me hurt a patient. I never realized just how closely they kept watch over me until one night a patient (someone else’s patient) developed pulmonary edema. Edna came over, grabbed me by the scruff of my neck and propelled me into the room. Sitting up on the bed, already surrounded by nurses, was a man sitting up at 90 degrees with a non-rebreather on. I could hear his ragged breaths from the hallway. It sounded like a coffee percolator. “This is what pulmonary edema looks like.” Edna said. She then proceeded to tell me what I should do or have available while we paged the doctor. Sit the patient straight up and get them on 100% O2. Start a second line (everyone on tele had at least one IV). Have lasix and morphine available. Start a foley. Get ready to transfer them to the ICU.

So it went. My first code, they handed me the clipboard. Little by little I was able to jump in and do a little more. Over the next year I became more proficient and we became friends and then family. Louie and Lynn became my Titas (aunts) and Edna became my Ate (big sister). We celebrated together: birthdays, holidays, someone leaving or having a baby. Every occasion was a reason for eating. Because, if you ever worked nights, you know food is important. On those rare, slow nights we would sit around and just talk about food. In between discussions of who made the best ponsit or lumpia, they’d start talking about their families and then where they grew up and that led to how, and why, they came to America.

One told me how she didn’t have indoor plumbing growing up. Another told how she and her husband got work visas to come over, but their young children couldn’t get visas for another 18 months. When she was finally reunited with her little ones, they cried to go back to their “real” mommy, who was Grandma. I learned that in the Philippines, only people with money went to the hospital, and if you needed medication, the doctor gave you a prescription and someone in the family had to go out to the drugstore and buy it. It gave me a whole new appreciation for what I have.

Since then, I’ve listened to the stories of nurses from Africa, Latin America, India or elsewhere talk about the issues in their home countries. Anything from lack of access to healthcare to not having enough supplies to not having enough nurses. Recently, I read on a blog where nurses would keep a pair of gloves outside each patient room. When they left that room, instead of throwing them away, they put them aside and would use again later on the same patient because there weren’t enough gloves to use a pair every time.

Staffing, access to health care, patient safety and advocacy. These aren’t just our issues, they’re worldwide. While I believe we need to work out our own problems first, I don’t think we should forget those nurses who work hard in other parts of the world, just like I’ll never forget my Titas and Ates, who helped shape me into a Real Nurse.