After moving from the US to Jerusalem, Nancy became a lactation consultant, but found the work lonely and the hours unpredictable. Getting her nursing degree has allowed her to care for mothers and babies while enjoying the teamwork of a hospital setting.
Tell us a little about your background…
I grew up in Huntington Woods, Michigan. Like everyone else I knew, I went straight to university following high school despite having no idea what I wanted to do with my life. I thought that I would get a general BA and then figure out what I wanted to do with my life and get an appropriate MA. I did know that natural sciences were out of the question as I had it in my mind that I did not have a head for science. I majored in Middle East Politics—I was in love with Israel after being there for six weeks as a teenager—and spent a semester of my junior year at the Hebrew University of Jerusalem. When I landed back in the US, I knew that I wanted to go back to live in Israel forever.
After graduation, in 1989, at 22, I moved on my own to Jerusalem. My parents were extremely supportive, although they weren’t very happy about it. They knew that I was planning on moving ever since I came back from spending a semester in Jerusalem (they were aware also that this is a risk parents take when they send their kids to Israel). They brought me up as a Zionist, believing that Jews should have their own nation, but we are very close and of course they did not want me to move so far away. As my father put it, “I think what you are doing is a good thing, but I wish it was someone else’s kid that was doing it.” While they were hoping this was just a stage, they have always been incredibly supportive and generous. I knew no matter what I did, they would be behind me. Of course we visit each other as much as we can, although it never seems enough.
Once in Jerusalem, I secured an internship in the Israeli parliament, the Knesset, but before it began, I started studying Judaism in an informal, English-speaking setting in the Old City and gave up the internship. After marrying, I began to study for an MA in Jewish studies with the intention of teaching in the type of program that I had studied in. The program was in Hebrew and very difficult for me. Meanwhile, I had my first two children, Maytal and Dovid.
I needed to write my thesis but all I wanted to do was mother my children. I didn’t want to leave them to sit in the library. I loved breastfeeding and became close to my La Leche League Leader who went on to study to become an IBCLC, an Internationally Board Certified Lactation Consultant. It was the first time that such a course was given in Israel. She got me excited about the course and instead of finishing my MA, I joined the lactation management course the next year. I loved it; I felt like I had found my calling. I gave birth to my third child, Rom, while studying, and just took him with me. I was 29 at the time.
It took me five years to finish all the requirements, sit for the boards, and become fully certified, at age 36, but I worked in the field during that time. Soon after I became board certified, I had my fourth child, Tehila. I worked part time and took my babies with me to work. It was very important to me to be with them. Unlike other Israelis who put their kids in daycare, I kept mine home with me until preschool at the age of three and then only put them in for half days. My fifth and final child, Tamar, was born two years later.
When did you start to think about making a change?
Until then, I had worked in various mother-baby rest homes. These “homes” are popular amongst the ultra-Orthodox women who aren’t ready to go back to their busy homes after birth. For various reasons, I did not want to work there anymore. I started building a private business as a lactation consultant, but the business side was very difficult for me. I was terrible at promoting myself and asking for money for my hard work. I wasn’t too upset about the lack of work because I had young children at home to take care of. I could leave them for a few hours at a time with my husband or a woman in my neighborhood. However, as the children grew, I found myself at home alone too often. I had too much time on my hands and can’t stand housework. Besides that, as the family grew, and grew up, so did the bills and I needed to start making money.
I began looking in earnest for steady work. Not just for the steady income but also for a staff to work with. I had been working on my own for a long time and missed the company of other people during the day, when most of my neighbors are away. I wanted to be part of a team. I also wanted to know if I was working the next day when I went to bed that night. I couldn’t get a hospital job as an LC without being a nurse. I looked into expanding my field, becoming a baby massage instructor, or a doula, for instance but I would still have to be a businesswoman.
A good friend of mine who studied with me for the boards, is also a registered nurse and a teacher in the Henreietta Soldz, Hadassah Hospital, Hebrew University, School of Nursing. Every time I voiced my frustration, she told me to come study nursing so I could work in maternity in the hospital. She always made it sound easy so I checked it out. Hebrew was no longer an issue but I was still sure that my mind couldn’t handle natural sciences.
The school offers an academic retraining program for people with a degree. The program is two and a half years long as opposed to the usual four and super time intensive with almost no vacations. I would hardly be home. I didn’t want to be away when my children came home from school.
I decided to look into other ways of making some money like teaching English privately, or working on line, to supplement my income but I didn’t connect to anything I was doing. Every once in a while, I’d get frustrated enough to start thinking about nursing school again. One day I was discussing things with another nurse friend, who said, that I could easily become a nurse and work for the health funds or hospitals. “Easily” she said. My baby was turning eight. I figured that it was time – perhaps.
That summer, on a visit to my family, I asked everyone what they thought. My parents and Aunts were very encouraging of the idea. Their encouragement is what made me make up my mind. When I got back from the US, I called the school.
To get into nursing school, I had to first have my BA from the University of Michigan approved by the Israeli ministry of education (because it is a non-Israeli university). Then I had to pass a Hebrew test and fill out a questionnaire designed to make sure that I was the right kind of person to be a nurse—questions like, describe a stressful event in your life and how you dealt with it. There was no test of knowledge. I did not have to be tested in English proficiency, but others were. I passed these exams on my 45th birthday, a Wednesday, and started school the following Sunday.
What is your next act?
I became a registered nurse in April of 2015, at the age of 47. I work as a nurse and lactation consultant in one of the maternity wards in Hadassah hospital, Ein Kerem, Jerusalem. My main responsibilities are the care of mothers and babies from two hours after birth until discharge. Our unit has a nursery for babies who need special care (but not NICU, or intensive care), including babies who are late preterm, undergoing photo therapy for jaundice, need to have their heart rates and oxygen levels monitored for any reason, or who just aren’t adapting well to life outside of the womb.
I spend some shifts taking care of those babies and admitting new babies (healthy full term) who were born just a few hours before. On other shifts, I am outside of the nursery, taking care of both the mothers and their babies who are well enough to be with them. These babies are often being monitored for low blood sugar or high bilirubin levels, or they may need antibiotics but are well enough to not need our constant supervision. The mothers are generally well. Some are recovering from a c-section and need to be treated as anyone does after major surgery, while starting to breastfeed and bond with their baby. Others are in pain from their stitches or have lost a lot of blood. Besides all that, I help them get breastfeeding off to a good start, answer lots of questions, give tons of encouragement, and deal with their nervous husbands…
I don’t know what it is like to work as a nurse outside of Israel but, from what I read, it seems quite similar. However, I think that the population that I work with is unique to Israel. First of all, most of my patients are Jewish, and many of them Orthodox Jews (both Jerusalem and surrounding suburbs are home to large Orthodox and ultra Orthodox communities). As with every nurse, the unique cultural considerations of your patients need to be addressed. Being an Orthodox Jew who grew up in a liberal Jewish home and related through marriage to a huge ultra Orthodox family, I have experience with people across the Jewish spectrum, which has helped me as a lactation consultant and continues to help as a nurse.
Being in Jerusalem also means a lot of Muslim patients. Anyone who works in a hospital in Israel knows how normal life is for Arabs and Jews who coexist peacefully in Israel. Besides many of the patients being a mix of Jewish, Muslim, and Christian Arab, many of the staff are as well—the doctors, nurses, aids, cleaners, cooks and every other sector of the hospital. Muslim nurses take care of Jewish patients just like I take care of Muslim patients. There are no politics or animosity. When an air raid siren goes off (like it did last summer when I was still working as a student nurse in ob-gyn) we’re all in it together. Just as when a staff member celebrates a nice event, we all celebrate together. You hope that the care and respect that you give your Arab patients will help to bring peace.
I love working with mothers and babies as I have for years. I am learning a ton as well as using and honing previous skills. I am working full time including nights and weekends. Working nights is more proof that I can do things that I previously wouldn’t have thought that I could do. It has taken a while to get used to being called a nurse and not having to correct people by saying that I am a student. For a while I felt like I was pretending.
I enjoy the camaraderie of the staff, being part of a group of women and connected to a world class institution. And of course there is a tremendous amount of satisfaction in being a nurse and helping women and babies during a potentially stressful time. When a woman thanks me and hugs me before leaving the hospital it feels great. The steady paycheck is awfully nice too.
How hard was it going back to Nursing School? What challenges did you encounter?
School was anything but easy but it was interesting. I not only managed all that natural science, I found it fascinating. I had a wonderful time the first year. Since it was an academic retraining, there were people there of all ages and backgrounds. I became very close to a woman in my program who was also American and my age, but my friends included Muslim men, Russian women, native Israelis of all ages and backgrounds. It was the strength of this group that got me through the second year.
The second year was mostly clinical rotations and the constant pressure to perform well in the eyes of instructors who seemed hell bent on making our lives miserable was outrageous. I often couldn’t remember why I had decided to do this. I also worked, as many second-year students do, as a nurse’s aid, in OB-GYN. I enjoyed the work but there were days that I didn’t come home from the hospital at all; I went from shift to shift and tried to catch a few hours of sleep before classes in the morning. It was exhausting but it was also strengthening. Who knew I had such energy! I came out of it feeling that I can do anything I set my mind to.
All along I had encouragement. The support of my classmates, my family, and my friends got me through. They were proud of me and cheered me on. Often, when I told people that I was studying to be a nurse, they would tell me that I’d make a great nurse. Comments like those helped expel the doubts. My best friend from forever had moved to Israel just a few years before and having her to talk to on the phone at the end of a long hard day or week was priceless. Her pride in me and what I was doing was so sincere.
Often strangers, such as patients I worked with in OB/GYN, seemed amazed that I could learn something new at my age. I never did understand what the big deal was. It’s not like our brains are shrinking in our forties. On the rare occasions that I asked, people explained to me that it’s not so much the studying that they expect to be hard at this age, but the change. Personally, I think that it was easier for me than for my younger classmates who were taking care of young children as well—and certainly I was smarter at 45 than I was at 18! For the staff in the school and the hospital, there was nothing surprising about an older woman becoming a nurse.
I could not have managed school and home life had my husband not begun working from home. He really made it possible. He became the main caregiver and did a wonderful job. On the rare occasions that I was home to take the younger girls to school in the morning, they complained that I didn’t do things like their father does. The older kids helped out as well, especially the third child who was often the oldest one at home.
My final clinical was in Obstetrics and Gynecology and it was there that my doubts finally vanished. When I first walked into the Maternity B ward in Hadassah Hospital, I felt like I had come home. That is where I work today.
I have to admit that I am extremely proud of myself and of my classmates. We did something pretty amazing.
What advice do you have for women thinking about becoming a nurse in midlife?
Every once in a while, a woman will tell me how she always wanted to be a nurse and I tell her my story. My message to her is that it is never too late. Recently, someone who dreams of being a nurse contacted me for more information. She said that I had inspired her. Personally, I think that once the kids are older, spending their days in school and their afternoons out with friends or at sports, is the perfect time to go back to school or pursue something new. I don’t regret not having done this earlier. Earlier was not the right time.
My advice to women who are thinking about becoming nurses in midlife is to go for it. You don’t need the science or a medical background; you’ll learn all that in nursing school. You need to have the right personality and the desire to be a compassionate caregiver with excellent communication skills while being a highly trained member of the health care team. The fact that a woman is older and has more life experience will only contribute to her understanding of the people that she is caring for. A wonderful thing about nursing is that there is so much a person can do with it. I knew from the beginning that I wanted to work in maternity since my passion and experience is working with mothers and their babies, but most people find their place while studying or even after. If I eventually have less energy than I do now—working shifts in a hospital requires more energy than I knew that I had—then I’ll get a job in a well-baby clinic in a nearby city. Another friend of mine found that she needed to be close to home (she is 48 and has 10 children) and not work on Shabbat and holidays in order for her family to function, so she found a job at a nearby health clinic with flexible hours. The possibilities are endless.
My favorite website as a new nurse is Medscape.
When I was a student, I loved AllNurses.
My main passion is still breastfeeding so I am active on Lactnet, which is a list-serve for lactation consultants as well as a local Israeli list-serve.
The only textbooks I liked enough to buy were Olds’ Maternal-Newborn Nursing & Women’s Health Across the Lifespan (which I bought the second to last edition of on Cheggs for $5) and Wong’s Nursing Care of Infants and Children. The bible of the course was Brunner & Suddarth’s Textbook of Medical-Surgical Nursing. I was very fortunate to be fluent in English as most of our texts were in English.
What’s next for you?
For now, I have so much to learn and strive for as a new nurse that I don’t think that I’ll take on anything else for a while. Perhaps one day I’ll learn to be a clinical instructor. I would like my students to have a positive experience.
Contact Nancy Chayn Fogelman by messaging her on Facebook.