By Matt Skoufalos
Brenda Muchelli calls herself “a second-degree nurse.” Like many in the field, medicine wasn’t her first vocational choice – at least, not human medicine. Muchelli’s first degree was in zoology, and her first assignment was at the nonprofit Cape May County Park and Zoo in Cape May Court House, New Jersey.
“I went to college to be in the animal field,” she said. “I was a zookeeper, a vet tech; I was kind of considering vet school.”
“And then, in my mid-to-late 20s, my dad went into cardiac arrest at work on his 54th birthday,” Muchelli said. “I was his emergency contact. They called me at work and said, ‘Your dad stopped breathing.’ I blacked out.”
Muchelli’s father was transported to one local hospital, and then another, before he was stabilized. It took him a year to recover, but he’s since returned to work, and is “back to everything he’s done before,” she said. That experience made Muchelli reconsider her concentration in animal medicine; another one confirmed the impulse. While her grandmother was hospitalized during a bout with lung cancer, Muchelli was put off by the way her relative was treated by some of the staff into whose care she was entrusted.
“I said, ‘OK, that’s enough,” she recalled.
There were other reasons, too. Zoology was only allowing her to earn a $9 hourly wage, and after transitioning to a veterinary technician role, the pay rate didn’t improve much. Plus, working in an animal hospital meant occasionally euthanizing animals, which was emotionally taxing.
“I would cry like they were my own [pets],” Muchelli said. “With people, it’s a little bit easier; a lot of them understand what’s happening. Even if they don’t accept it, they understand.”
So, Muchelli went back to school. She enrolled in an accelerated nursing degree at Rutgers University in Camden, New Jersey. Within the course of an intense year, she had completed the program requirements, one of a small class of 30 new nurses.
“School was extremely stressful,” Muchelli said. “We weren’t allowed to work, so I had to take out a bigger loan. Four classes a week and 30 hours a week in the hospital … I lost my mind a little bit when I was going through that.”
“[But] we all had the same goal,” she said. “We wanted to get to where we could help people. We knew how important it was, so it should be that difficult. We just put our heads down and went through it.”
When it was all done, “the only place I wanted to go was the ICU,” Muchelli said. Upon graduation, she was hired by Cooper University Hospital, also in Camden: the very institution that had saved her father’s life. She’d completed a rotation in its ICU in the first three months of her schooling; as a member of the staff, she worked there for three years before transferring to the post-anesthesia unit.
“It’s still critical care, but a little bit happier,” Muchelli said. “You recover people from surgery, but a lot of them get better and go home. I kind of get the best of everything. Even though the stress level is there, it’s much less, and it’s not nearly as sad.”
Muchelli views patient advocacy as a major part of her responsibilities on the job. She related the story of a terminally ill patient who kept telling her caregivers that she wanted to go home and be comfortable instead of subjecting herself to additional tests, treatments or procedures.
“They wanted to do all these things for her,” Muchelli said. “I went in one morning and said, ‘She doesn’t want it. She wants to die in peace.’ The attending physician came up to me and thanked me for doing that. He looked at his fellow under him and said, ‘This is why you have nurses.’ ”
“I like feeling like I’m doing something to make these people feel human,” she said; “making them laugh when they feel like crap; making the doctors hear them when they don’t feel like they’re heard.”
Helping patients to feel understood, and helping her coworkers to advocate for their patients and themselves, is a very difficult and persistent challenge. Muchelli describes “a lot of extreme emotion involved,” and when people get overloaded, they shut down mentally. She also charts some expanded practice areas at her hospital, including stroke care and a partnership with MD Anderson Cancer Center, as evolving its ICU into “an everything ICU.”
“The typical patients we never had room for, so it was very taxing because they would all be comfort care,” Muchelli said. “It got to a point where my anxiety and stress was so bad because I was taking it home with me.”
To cope, she took up running. A former high school athlete, the exercise she once hated is now the best thing for her stress. Focus on breath and movement helps (as does the occasional glass of wine), but in general, Muchelli said she can work things out in her head when she’s running that don’t make sense when she’s sitting. And in the workplace, she’s come to rely on the camaraderie of her colleagues, who find themselves in similar circumstances often.
“A lot of stuff that’s traumatic or sad, we joke about it, and that’s normal,” Muchelli said. “It’s a way to do it every day. We pretty much debrief each other. I think the only people who get it are the ones involved.”
Just as her career goals have evolved from zoology to intensive care to post-anesthesia care, Muchelli believes she will advance her education further, with sights set on becoming a nurse practitioner or a nurse anesthetist. She’s consulting with nurses who’ve done either or both. But on whichever path her work takes her, Muchelli will remain committed to patient care and patient advocacy.
“I feel like everybody who helped my dad was so good to us before I even knew anything in the medical field,” she said. “I want to do that for the patients and their families too.”