The key to nursing across three continents? Empathy

Abheena Jacob, BSN, RN, MEDSURG-BC, an award-winning night shift nurse in Pennsylvania Hospital’s Medical-Surgical unit, joined Penn Medicine in 2017. Her nursing experience spans over 18 years and three continents, beginning nearly 8,000 miles away in India. Here, she shares her career story.
 
I was born in India. When I was 15 years old, my grandma got sick, and I helped take care of her—bathing her, changing her bed linens, feeding her. That’s when I got the intuition that I should be a nurse. I wanted to take care of people who needed help.
I graduated from nursing school when I was 21, but in India, the hospitals at the time wouldn’t hire new graduates. You had to do volunteer work as a bedside nurse for one year without pay first to get experience. I would volunteer in the evening shift, and although training was rough, it turned out to be very helpful. We had to learn how to do everything for the patient: take X-rays, do bed baths, give medications, and speak with patients’ families. It made me feel like I could handle anything. To earn a living, I worked as a nursing tutor during the day. I was good at teaching. It was a great feeling to have people come to you with questions and be able to explain things to them. Both experiences would prove invaluable in my nursing career, as I developed my skills as a clinician and mentor.
During one of my volunteer nursing shifts, I took care of a young patient who was diagnosed with HIV/AIDS. He appeared to be very tired and would be asleep most days. One day, he opened his eyes when I was in his room, and he asked if I had food with me. He said he was hungry and didn’t feel like eating hospital food, and his family had not come to visit him. I learned that they didn’t accept him after knowing about his diagnosis—I think it was considered “taboo” in India at the time. I gave him my lunch and continued with my day. A few days later, the patient passed away. He left a note for me and other nurses that said, “Thank you.” This made me realize how much little gestures of kindness can influence others.
After those two years, I decided I wanted to work outside of India in an English-speaking country. I completed an English language test, went through a series of job interviews, and got approved for a visa in my next home: Ireland.
My first job in Ireland was at an assisted living facility for older adults where many patients had Alzheimer’s disease. Many were grandmas and grandpas, and they treated me—I was 23 years old—like one of their grandkids. They would share stories, teach me songs they loved like, “You Are My Sunshine,” and taught me Gaelic. I learned to say, “How are you?” and “Thank you,” in that language, which would make them all happy. 
I then moved on to a second job—I wanted to learn something new—and started working at a care facility in an acute brain injury unit. This was a very big change for me because I now took care of patients who had experienced traumatic incidents like motor vehicle accidents and overdoses. That was very hard, to see people go through that.
There was one patient who was a bit difficult to manage. He refused to have the nurses medicate him, screaming when he heard them walk into the room. After a month, the patient and I started developing a rapport just from me talking to him and having everyday conversations. He couldn’t see, but his hearing was very sharp, so I would describe what the weather was like each day. I would also play music he enjoyed, and even sang some of his favorite songs. He eventually let me take care of him without any challenges.
While working at the brain injury unit, I flew back home to India for my engagement ceremony and wedding. My husband had moved to Pennsylvania—his brother lived there—and I joined him after finishing my time in Ireland.
When I learned about Pennsylvania Hospital, I knew I wanted to work there. It would give me pride to say I work at the nation’s first hospital. I worked at another local hospital and applied to PAH in 2017 and was so eager to work. All staff are very warm and friendly. It felt like home from the start, and it still feels like home now. 
As I’ve learned throughout my many experiences, giving medication and learning all the new technology is important, but as I try to impart to our early-career nurses, nursing is much more than that—it’s feeling empathy for patients. You and your patient begin as strangers to each other, and you have to establish a rapport to help them through their care, even if it’s just by talking to them for a minute or two. 
For example, a patient at Pennsylvania Hospital once told me that it was his birthday. I wanted to celebrate and get him a treat, but the cafeteria and gift shop had closed for the night. Luckily, there were cookies in the break room, so I called over a few colleagues and we all sang happy birthday to him with a cookie. It was a small gesture, but he told us he would remember that forever. And so will I. That, to me, is what nursing is all about.
 
Penn Medicine employees: Did you have an unconventional path to health care or within Penn Medicine? Email [email protected] and tell us about your career journey.