Interview with Barbara Bauer, History 150 Spring 2020, Conducted by Rachel Brandon, March 12, 2020.
Brief Bio:
I chose to interview Barbara Bauer. I got into contact with her because I was interested in the idea of interviewing a nurse who had experiences with immigrants, and my mom helped connect me to this nurse through a chain of contacting people from the Netflix show Pandemic. Barbara graduated from Marquette University in 1972. The army paid for the last 2 years of her school, and she ended up on active duty 9 years working all different areas of nursing from ER, Med-Surg, Clinics, Head Nurse, she took a graduate course & the last 2 years worked as an OB-GYN Nurse Clinician (now Nurse Practitioner). She also did volunteer work for 2 years mostly outside of nursing but did spend 3 months in Thailand working with the Khmer refugees. Then she took a refresher course and worked at a tiny hospital in eastern Washington. She said they were only 24 beds if you counted the cribs, but they were the only ER in a 50 mile radius so there were some interesting times. Then she did 2 more years of volunteer work in Guatemala. She saw patients in the clinic and did sick calls in villages. She said the best part was teaching health promoters for the villages connected to the parish. She later moved back to Tucson & tried to do volunteer work with Agency work but finally decided that she needed a real job. She went to work at the VA again and got to do all kinds of nursing. She spent her last 10 years working as Senior Clinical Officer which is House supervisor off tours. She then retired and traveled a while. Then she moved back to Tucson again, and discovered the Alitas last March when they were getting 80 or more refugees a day. So around the age of 70 she was still in the nursing field!
Transcript:
Rachel:
So the first question is, in your nursing career, have you had any experience with an undocumented patient that you were aware of?
Barb
Yeah, several. The one that I basically remember was that quite a while ago, like a long time ago, I gotten back from Guatemala and I was working at an agency at one of the hospitals here in Tucson and they had a young man in the hospital that had been picked up at the border. Very, very ill. And I had him for just a couple of shifts, I think, but the interesting thing was really trying to figure out what was wrong. And I suggested to the doctor, he looks like he has typhoid. And sure enough, he did. All right. And there’s a difference between undocumented people that have just crossed the border and are trying to get through without presenting themselves at Border Patrol getting picked up by border patrol in those claiming asylum because those claiming asylum actually have a legal right to be here.
Rachel
Yeah.
All right. So the second question is, do you think US immigration policies have had an impact on people receiving medical care? If so, have you seen specific examples of this?
Barb
Yeah, it was policies direct effect on patient care. One of the policies when it picks up people or processes people, apparently there is a law that says any prescriptions that people have have to be taken away and replaced with drugs from the United States and actual prescription. What we’ve found is a lot of times is HIV meds and people’s medications have been taken away by policy, and not replaced.
Rachel
Yeah.
Barb
And sometimes they have been replaced. That would be one incident of how it affects patient care. Like, apparently by law, Border Patrol agents have to stay with somebody they have taken into custody. We have one mother that was taken to the hospital for delivery, and an armed Border Patrol guard was in the labor room with him.
Rachel
Oh,that would be a little intense.
Barb
Yeah, it’s sort of like, okay, who do you think is gonna run away? Mom or Baby? But you know, yeah, you would think there could be some thought put to how these laws are put into effect.
Rachel
Yeah.
Barb
It could be outside the labor zone because then, outside the room. I don’t know why that happened. But it’s interpretations and also time following their procedures, they’re US laws, but it’s not for me.
Rachel
Yeah, no, definitely not. I agree.
Alright, so the next question is how do you handle like tense and difficult situations like those as a nurse?
Barb
Talking, I seem … I mean after the fact or or during the time, anytime you just try to be as calm as possible, try to figure out where you’re going to go with this need who you need to talk to how can you make the situation a little bit better and defuse it if the residual stays with you a lot of times in these really tense kind of environment. And I found that I have some friends that are very close. It’s very helpful talking to them. I talked to my sister and they say, you help me now you’re going to have to tell the story to somebody else. So you can get some relief, because stories can be so horrendous. That people need support. All kinds of people gain support, even if you just we don’t really try to elicit their history, because because we’re not with them long enough to do much about it and we don’t have a situation here because our people like going throughout the states to make that family and friends and going to those people are caring, really tough situations. And they need their family support too.
Rachel
Yeah, very true.
All right, so the next question is, what is your opinion on undocumented people receiving treatment from public and private medical facilities? Is there a difference in should there be?
Barb
Ah, that’s a tough one because-
Rachel
Yeah. Yeah.
Barb
I mean, if you have a situation right now, even this closet coded, you don’t want people, untreated people in the population you need to get people treated, and then the intensity of their injuries or whatever. They have to be treated. Yeah, we would be just a totally I don’t know what would it be if we didn’t treat people that were obviously sick and needed care. The cost is a problem, and How you resolve that? I’m not exactly sure. I think they both, somehow, we should be able to come up to cover costs and there are differences. You know, some people come with absolutely nothing. Some people come from wealthier countries, they have passports, and they have funds available to help them cover medical costs. But I don’t know that anybody comes in that actually has insurance.
Rachel
Yeah. It’s rare.
Barb
So I guess the bottom line is, people have to be covered. They have to be helped, as best we can. And we’ve got to figure out how to cover that.
Rachel
Yeah.
All right, so my next question is what have your experiences been like working for? I think you say is it elitists or alitas as a nurse?
Barb
They have been wonderfully tremendous experiences. When I started working with them a year ago, we were still in the monastery, which was an old Benedictine Convent that had been bought because the nuns like to go, they were all elderly, and we moved back to the mother house and the buyer had to go through a lot of zoning changes and to do whatever he plans on doing to the buyer, right? But during the time he was there, he covered the utilities and a lot of good stuff and we were seeing-
N/A
[Incoming call made beeping noise]
Barb
One Easter that Easter, I think we had over 300 close to 400 patients or clients or whatever you have to do. [another beep] And we had over 400 volunteers working with Alitas, the meals we cooked with people. It was a tremendous experience. And again, the stories from the people, some of them are heartbreaking. Some of them were just amazing, and most of them are very new. Most of the people came in very dehydrated. They were working with getting a lot of foods and that was one thing we found out that we just knew that were not exactly fighting, but moms that were breastfeeding, if you hydrated the mothers and mothers, the babies did much better, just in your 48 to 72 hours they were with us. So you ended up really pushing into it. And I must say that the volunteers that I work with are really amazing people that we have several retired docs and that at the end are five days of work every week. And have amazing nurses, pharmacists, and the medical side of it. I just totally amazing.
Rachel
Yeah, that’s awesome. That’s really cool.
All right, the next question is what is the most rewarding part of your previous job and what was the most challenging?
Barb
Well, I retired about eight years aog now, in the last 10 years, I was working as a supervisor, hospital supervisor, senior clinical officer is ready to come to the VA. So you are really responsible for everything. And it’s, I guess one of the most … times I had was because your supervisor because you are going between all the crazy … in what’s going on and trying to adjust staffing and everything. A lot of times people were really having difficulty, get kinda lost in the shuffle and on time, I was able to spend an hour or more with a woman that had just lost her husband. While she was waiting for people to come from out of town, family, she worked from … they were from what is the outline? towns like an hour and a half, two hour drive away. So, I mean, instead of just not interested and be by yourself, I was able to spend that time I was afraid to do it. Probably the most challenging is trying to get staffing-
Rachel
Yeah.
Barb
And maintain a safe level of staffing. That was always one of the biggest difficulties and whatever situation that is most interesting I think because nursing is still mostly feminine. Although I could apply to anybody. I will take over at four o’clock at four o’clock. Well, I special clinic, clothes, … and those cases, typically recovery and then applications out. Occasionally there would be a patient that couldn’t go home. It didn’t require a cover on time, or the procedures lasted longer than it was supposed to or whatever. Now a lot of times we could put those patients in the in ED or an ICU, so they could be monitored and then sent home, but one time, there was no beds in the ED, there were no beds in the ICU. There was no staffing around. And I was talking to the nurse that was staying with the patient. And she said, I have to get my kids out of daycare. And the rooms for daycare were set in Arizona at that time anyway, as I understood it, I mean, first of all, your prices go up like every 10 minutes, you charge an extra horrendous amount. And if you don’t pick them up within the first hour, you can be charged with child abuse- and it would protect the agency too because sometimes, kids just left you know, yeah. And, you know, hopefully she could have called her or childcare agency and talk to him about it and told them the situation but it really became an issue with nurses and their family responsibility and the professional responsibilities and how to make those work. Well, we got it figured out, but it was like, that was tough.
Oh my gosh!
Rachel
Yeah, definitely.
All right. So my last question for you is, can you describe what your experiences abroad were like?
Barb
Well, in the 80s I was doing volunteer work, and the Khmer refugees from Cambodia were coming across the Khmer Rouge as undefeated their country was in a tremendous starvation. I mean, people were actually really, really starving to death, and I went to- I spent three months in Thailand at Caliban which turned out to be biggest and longest lasting camps, and we had work to do in stations at that time. There we were three of us was a doc and another LPN and myself and we go to different areas and give the shots and talk to people. We also covered an intensive feeding unit which was because they were starving in there, and we’re very… when the camp was first started in the fall, November. I was- I got there in January when they first got there.
We have world experts that had set the camp up. I mean, they were experts in all kinds of fields. And one of the things that was a rule, because no bottle, no pacifiers, no formula. Because previous to that there have been big episodes in Africa especially with formula and bottles because you can’t keep a clean and then they would get the free formula and then when they came afterwards, they couldn’t pay for it. And then they start diluting it. It was really, really awful thing for a long time. And so this was the procedure and then doing intensive feeding units with mostly family and staff too. If you felt the baby spike, just give him a little drop every couple seconds, you know. And you sat there and it was labor intensive. But it really isn’t. Right. I mean, they got better, for the most part. As soon as they got if they weren’t that far gone before they got to us. I don’t know that we added.
Then after that three month period or at the first group left the world experts, let’s say other groups came in big groups, people from big city hospitals here in the States and other way. And those rules just kind of went out the door after a little while and pacifiers and bottles and formul were right back because one unit with a pediatric unit, and I think they find the medicine they knew they weren’t in touch with the history. And the reason, I think for why those rules have been in place in the first place, and they reverted to their own training and their own experiences back in the states, which is very different than it is in a refugee camp. I don’t know that we had any big breakouts of diarrhea after that. But I do think it’s been interesting. I just read an article just recently, it was called the white savior syndrome, something like that.
And it talks about how the global north of whatever color providers, volunteers come into these situations, nurses comes into the situations. And we come with a background of knowledge and resources. And we don’t always listen to what the circumstances really are in those countries, and what we can provide and what we can’t provide. And in the end, the article basis of the article was to try to get people to open up when you’re doing this kind of work, and to just see where it’s going. But you’re in tune with your environment, and the culture of the people. And I worked for a year in Guatemala, two years in Guatemala after that, and it that … was amazing. I learned so much more than I probably did. Just being with the people when and how well they did. And again, it comes to a matter of resources and what you have and what you don’t have. At that time, we were still treating TB with structure myosin, and iron H pills. But we got tons of Iron H pills donated by us and we had to buy and you know, it was like, Okay, I’m working under the public health offices. That’s where the practice is covered from by working in a Catholic area, a parish. And there’s a lot of outlying villages that we have there. And then, and that’s what we covered. But they do get people that they found out that we had some myosin. This is the public health pattern, and they were really trying to treat people. But it was difficult. It was difficult to come by. So when people come out of the area, we come to the clinic and ask for the medication, a bunch, like, Oh, I can’t give it to them because I can’t buy for everybody. I mean, we can’t buy for everybody. And there are tough, really tough decisions like that.
Rachel
Yeah, that’s hard.
Barb
But overall it was really, really good experiences. And one of the best parts of it was that from these villages, outlying villages, we could bring the chosen representative to train as house promoters. And so then they would only train them. And then they would go back to their villages. That was a year long course that they took, and it was in conjunction with the program that was already in place, teaching health promoters throughout the whole country. It’s a really great nurse that was in charge of the programming for the country. And she visited us every once in a while and we’d have different programs. The geyser system was mostly guys, but there were a few women in the group that really learned and were really into bringing back to their villages teaching, education, about health and prescription I mean, in Guatemala at that time, you could buy from the pharmacy anything other than their products. So people were already buying drugs which they could afford, if they could afford them. And most of the time, if they bought iron biotics, they did not know if they actually needed them or not. And they would buy, you know, maybe two or three pills at a time and see if they felt better. They had to go by the door so our area was quite isolated. So we didn’t have the drug research. But that was in 84′ in the city and the capital, there was already a big problem with drug resistance like at that time myosin was pretty new drug. And already in the city, they were resistants to it because people could go and buy it, you know?
Rachel
Yeah.
Barb
And so and then not take it or whatever. So in our area was trying to do is to supply the, the money, the drugs needed at a very low cost or no cost, but that it was really important to take the whole course if you need it to be on an antibiotic. And, and that was one of the other things that helps them We’re trying to educate people that know you don’t stop taking it just because you feel better. You’ve got to take the whole thing. Lots of challenges.
Rachel
Yeah, I’m sure.
That sounds like a really cool experience. That’s awesome that you got to do that.
Barb
Oh, it was. It was super, super challenging. And, you know, at times you just felt you were really just putting a bandaid on a super big wound. And that you’d be better off coming back to the states and looking to get things changed in the United States to help them. And then you got back here and it was like, Oh, I was better off in Guatemala Go back and forth. But yeah, it was good.
Rachel
Yeah, that’s really cool.
All right. Well, that’s all the questions that I have. For you, do you have any? Do you have any questions for me?
Barb
How is your course going?
Rachel
my coursework?
Barb
Yeah,
Rachel
it’s good. It’s been a really busy semester. Anatomy is hard.
Barb
That’s a tough one.
Rachel
Yeah, but I love it. We actually just got switched to- our spring break got extended and we’re probably gonna have to do some online classes at least until like April just because of the coronavirus stuff.
Barb
Right, are you staying home then?
Rachel
Yeah, mhm.
Barb
We’ll have to keep our fingers crossed that this doesn’t get much worse than that. It could very easily but
Rachel
yeah, for sure it’s scary.
Barb
It is. It is. I know. My mom told me that Back in 2018 2019, and actually when I was doing some ancestry work, and I was talking to her great grandmother had two adult children that died of that flu [Spanish flu in 1918]. And at that time, they did wakes from the home, the bodies stayed in the home. And she had to have her children laid out because of the Spanish flu virus.
Rachel
Oh, wow.
Barb
So, yeah, that was just like, oh my gosh. That’s what people went through. And hopefully, we won’t see that.
Rachel
Yeah. Hopefully not hoping that it starts to get under control a little bit.
Barb
Yeah. And thank goodness it’s not affecting young people too much. But I hate – oh well. Well, yeah, all we can do is hope for the best and wash hands!
Rachel
Yeah, for sure.
Research:
I researched the rise of the Khmer Rouge, or more formally known as the Communist Party of Kampuchea (CPK). I decided to research this group and historical time period because the nurse that I interviewed did work abroad here with the refugees impacted by this oppressive regime. This group had control of Cambodia from about 1975-1979. During this time they put in place many oppressive rules that repressed their citizens and murdered millions of people (Cambodia Tribunal Monitor). The country was essentially a large detention center and about two million people were killed during this time. This was obviously a major humanitarian crisis for many reasons which is why the nurse I interviewed, Barb, spent time here helping people.
References:
“Khmer Rouge History.” Cambodia Tribunal Monitor
https://www.cambodiatribunal.org/history/cambodian-history/khmer-rouge-history/
Post Interview:
I conducted this interview over the phone through my home phone. I recorded the interview using the Voice Memos app on my iPhone. I used google drive to transfer the audio file to my computer, and I used the otter transcription app to aid in the transcribing of my interview. I had to edit a fair amount because the initial interview time was over thirty minutes, so I wanted to cut that time down a bit. The file size was too large initially to post, so I cut some of the begining in end sections that were more of just formalities rather than important parts of the interview. I prepared a quiet space by waking up early that morning so it would be quieter. I also let my family know that I would be conducting an interview at that time so I would not have any interruptions, and I recorded the interview in my room where there is not much background noise. The only obstacle I encountered was trying to figure out how I would record the interview from my cell phone while still doing the interview over the phone, but I was able to solve that issue by calling her from a different phone at my house.
If I could do the interview over again I probably would have planned better options for recording because the audio was not the best quality. I feel like the interview flowed relatively well, but there were definitely parts where it could have gone smoother. It was harder to take the interview off script because I had sent Barb the questions ahead of time, so it was pretty set to those main topics. There were not too many divergences, but when there were it was because she was talking about a subject that she was very passionate about, so I think this was positive and contributed a lot to the conversation.