By Betsy Rosenblatt Rosso
In New Orleans, Louisiana in the late 80s, next to Tulane Medical Center, was the Veterans Administration hospital and Charity Hospital. While in junior high and high school, Greta Ellison would take the bus after school to Tulane, where her mother worked. Walking to the Medical Center, she would see patients and would-be patients with an array of injuries and ailments who were seeking medical care and other kinds of help as well. The need was vast, she observed. “It was utter chaos,” she said. “I had this extreme sadness and empathy at the same time, and I didn’t know what to do.”
When she was a senior in high school, a friend of Ellison’s was in an accident and was admitted to the intensive care unit at the charity hospital. She went to visit and was appalled by the patients lining the halls, and the hospital overrun with sick people. When she buzzed for admittance to the ICU, she was stunned by the angelic appearance, the poise, and the confidence of the nurse who welcomed her, gently but frankly explained the condition of her friend who she had come to visit, and guided her to his room. “I knew right then that I wanted to be a nurse,” Ellison recalled.
Ellison gave up a full college scholarship for volleyball when her competition schedule conflicted with clinical rotations in nursing school and her coach told her she had to choose. “I thought, ‘I can play sports on my own when I feel like it. I want to be a nurse.’”
Two decades later, Ellison carries with her a wealth of experience as a nurse, including time as an active duty Navy nurse, and a stint helping injured Sailors and Marines transition into stateside hospitals when they were medevac’d from the front lines, to her work as a combat casualty assistance visiting nurse for the Navy-Marine Corps Relief Society.
Ellison has always valued the opportunity to learn, never shying away from a tough task. “Sports gave me the guts to be challenged,” she explained. So, after starting her nursing career in pediatric and neonatal intensive care, where she learned to carefully reconstitute medications and calculate IV drips, Ellison transitioned to a floating ICU position. “If you were willing to do that and learn all the areas of nursing, you could make your own schedule,” she recalled, which was ideal at the point that Ellison was a young mom. “I did procedure nursing, radiology, cardiac catheterization lab, oncology, and orthopedics. It was the best thing I could ever have done. You have to be willing to ask questions and continue to learn.”
After September 11, 2001, Ellison decided to bring her nursing skills to the Navy. By then she was a single parent with four kids ages 3 to 11. “It was a difficult time,” she remembered. “I knew the Navy provided housing and insurance and I knew the military needed experienced nurses.” Ellison was assigned to Naval Hospital Twentynine Palms, California, a non-deployable duty station. “It’s considered an isolated duty station, in the middle of the desert, where Marines train before deployments, especially for Iraq and Afghanistan. I was able to work at that hospital and take care of active duty service members and dependents. It was the best decision for my children and myself. My kids were exposed to new people and places. Now, one of them is in the Marine Corps and one is in the Coast Guard.” Her first encounter with the Society was during her time at Twentynine Palms, when she had a major car expense and received help from the Society. “It was humbling but necessary,” she recalled. “They were totally supportive.”
During her four years in the Navy, Ellison met her husband, a Marine. The couple had a child together, and the blended family now has seven children. Still on active duty and because of concurrent conflicts in Iraq and Afghanistan, Ellison was required to deploy at the same time as her husband. “We had to sign a family care plan saying we would turn our children over to other family members. I decided I couldn’t do that to the kids. We had neighbors whose dads didn’t come home, so I decided to be a nurse outside of the military and continue to support my husband.” Ellison got work at military hospitals whenever she could as the family moved to Miramar, California, and then Jacksonville, North Carolina. Her husband retired in 2013 after 20 years, as a gunnery sergeant.
When the family moved to Camp Lejeune in 2009, Ellison did case management for the Navy hospital, facilitating the transition for injured service members who were medevac’d back to the U.S. The role was emotionally draining, as she communicated with other hospitals daily about critically injured Sailors and Marines, and heard frequent news about service members who didn’t make it. In an effort to find a less traumatic position, Ellison found a job with the Veterans Administration in Fayetteville, North Carolina. “I thought this would be a good idea because I could see them and guide them at a different point in their injuries.” Working at the VA did not turn out as Ellison had hoped, but she had kept in touch with NMCRS staff whom she had met doing hospital case management.
In 2013, Ellison was hired as a Society Visiting Nurse. Ellison was surprised to find the biggest challenge was not simply the medical or emotional needs of her clients, but navigating family dynamics of her clients’ loved ones. Typically wives, girlfriends (sometimes ex-girlfriends), mothers (or mothers-in-law) say they’re trying to help their Sailor or Marine recover, but actually they are just getting in the way, whether with misguided but good intentions, or an unconscious desire to assert control over a difficult situation.
In one case, the service member had been rendered virtually mute by a wife, mother, and mother-in-law who were outdoing each other trying to care for him but not allowing him to speak for himself or achieve any measure of independence. Ellison was receiving frequent calls from his family complaining about other members of his care team, and tensions were high. “I finally got everyone on the same page,” Ellison said. “I sent an email to the client, his wife, his mother, his mother-in-law, his counselor – everyone involved in his care. I said, I’m trying to help, and this is what I can and cannot do as a Society visiting nurse. I said, we’re all going to communicate on the same page because we’re working toward the same goal. I indicated that the client needs to speak for himself – and that I had received emails from everyone else but him. He’s a strong, capable man. Sure, he has medical issues, but we’re working on them. I want to see the strength and competence I know he had when he entered the military.”
Ellison was worried the family would be offended by her frank appraisal of the situation, but within a week the client asked for a home visit and Ellison was amazed at the transformation. “They set boundaries for their mothers, saying ‘this is what we need from you.’ They’re talking respectively to each other. He’s saying to his wife, ‘no, I’m talking right now,’ when she tries to answer for him. They’re hopeful for the future. They were so enmeshed in their problems that it really took someone who saw the whole family dynamic to say ‘this is what I see and what I feel would help.’” Telling the hard truth about a difficult situation was the catalyst for this service member to truly begin the road to independence and recovery.
“In a lot of cases, the caregiver renders the service member incompetent because they’re doing too much for him,” Ellison explained. “My goal, as the visiting nurse, is to assist the service member to own his or her own health and well being, to get them to the highest possible level of independence. Sometimes caregivers treat them like children, labeling them disabled, telling them they can’t do things on their own. We’re trying to support that Marine or Sailor so he or she can feel good about themself, to be competent and capable again.”
“When I started this job I researched communication and mental health so I could be as productive as possible when I was meeting with clients, and I learned about the strengths perspective approach. It makes complete sense, but many people don’t do it. Usually the first focus is on the problem. The strength perspective reminds you to ask what are you doing right now? What’s positive? You’re getting up in the morning and starting your day instead of sleeping until two o’clock in the afternoon. I start every interaction with my client by discussing strengths and looking at progress. Then I work on the other things and they don’t seem as huge.”
The strengths may seem small to someone who isn’t dealing with PTSD or TBI or serious physical disabilities, but they’re vitally important. “They might say, ‘I stopped before I reacted when someone pulled out in front of me in traffic or hit me with their shopping cart.’ They controlled their anger. They struggled with impulsivity and vigilance when they’re out in public, so their strength might be, ‘I didn’t get into a fight with this stranger. I stopped and realized it wasn’t worth it.’ They get really happy about stopping and thinking before reacting, and controlling their emotions in public.” Its baby steps – but you have to take it and go with it.
“They’re very proud when they can communicate and speak up for themselves and talk about the feelings they’ve buried. They say, ‘It really felt good to talk about what I was feeling, instead of secluding myself. I feel like I’ve come a long way.”