Marta Płaska 1929 - 2011

Marta Płaska née Zdanowska was born on 12th of January 1929 in Wojnowo, near Siedlce, Poland. Having numerous passions and interests, she was a kind and warm-hearted person who flexibly managed her work-life balance. Her personal life as a wife, mother and grandmother was a fulfilling one. Moreover, a top-results Poland Championships competitor in cross country and 800 metres track running, she was also successful at sports. She loved skiing and mountain hiking and always spent her leisure time in an active way. To relax, she was knitting and listening to her favourite Sandy Show songs. Her whole life she paid attention to professional development and made a great contribution to that of nursing in Poland. Marta Płaska received numerous decorations including: Polish Red Cross Medal (3rd class) and Order of Poland Reborn (5th Class). In the memories of her colleagues she has remained as a great friend and an unparalleled Ward Sister for the 21st Century. She passed away on 11th of September 2011 in Warsaw and was buried in the Bródnowski Cemetery.

During her education in Siedlce gymnasium she was a Scout; served as patrol leader and earned numerous activity badges, thus shaping her character. Together with her friends she would visit the local orphanage. The happiness, with which children welcomed every warm gesture and attention, brought her joy. Talking to them, she first-hand learned the power and influence of words. Her fondness of conversations and helping others influenced Marta’s decision to become a nurse. In 1948, accompanied by a friend she set out on a hundred-kilometre journey to Warsaw to enrol in a nursing school. It was not easy to navigate the post-world war II landscape of the capital city of Poland and find their way through its Praga district, to the Nursing School at the Transfiguration Hospital. The director of the school was Wanda Żurawska, a graduate of the Warsaw Nursing School and a Rockefeller Foundation fellow, who greatly cared for both education and edification of her students. She built up their sensitivity and openness to the needs of others. Schoolmistress doubted whether such a “poor thing” would cope at school. “I will, whatever it takes!” claimed Marta. She lived at the boarding house at 9 Zygmuntowska Street (Al. Solidarności today). Many of her school friends gave up after the first practical training, Marta stayed on and kept developing her skills. At that time, the school became nationalised and Sister Żurawska lost her position of the Schoolmistress, but remained a role model for the students. Marta received her degree from the new director, Irena Nieliwódzka. For Marta Płaska, patients were always first – most important. Seeing them recover was her greatest joy. She believed that a nurse who does not enjoy her work with patients, will never be a good professional, despite all the knowledge. Healing, she maintained, consists not only in a successful operation but also insightful observation and caring nursing. Marta claimed that knowledge, experience and attitude to patients must harmonize with each other. She did not stop after delivering her professional service, she liked talking to the sick, especially before surgeries when they needed it the most. She was patient, poised and treated every patient as an individual in dispelling their fears. Her sense of humour and warm voice were salves in themselves. With a smile she would say, she often administered a verbal Valium to the families waiting for their loved ones leave the operating theatre.

Exceptional scrub nurse

She believed nursing to be a special profession, for the chosen few, which gives a unique sense of satisfaction not to be met in other jobs. Having received her diploma in nursing she was appointed to work at the First Surgical Clinic of the Infant Jesus Hospital at Oczki street in Warsaw. She was working at a female ward where rooms where large and often housed more than a dozen patients at a time. After a few years there, at her own request she was transferred to the general surgery unit. A talented scrub nurse, Marta became a favourite of professor Nielubowicz. Her professional training and intuition were near perfect. She knew the procedure of each type of surgery as well as individual preferences of the surgeons and needed no words to understand them: she was handing in the right instruments without fail. She assisted in numerous difficult and specialised vascular surgery procedures on the arteries, the aorta and portal venous system – portacaval shunt. We estimate today that she took part in several thousand surgeries. Her willingness to learn and develop professionally was only topped by her striving for perfection. “Never stop learning” she would often say. She participated in clinical lectures and various kinds of professional training. Studying English, which she was using on her international trips, was her long-term commitment. In the early 1960s the Clinic’s staff were preparing for a kidney transplantation, only a few years after the procedure was pioneered by professor Murray’s team in Boston. Marta went to England to take part in a nine-month training at the London University Surgical Clinic where she assisted outstanding experts in vascular, ophtalmological, urological and gynaecological surgeries. She learnt to operate pumps, autoclaves and prepare surgical instruments and dressing materials. She received praising opinions from her supervisors. On her return to Poland she started to modernise the work of nurses and sharing her new-found experiences. As a first step, she replaced the old surgical sets with new, smaller and more handy ones: suited to a given type of surgery. She replaced heavy Schimmelbusch boxes with lighter sterilisation packages. Through research she proved that parchment is sterile longer than the standard paper used for packing surgical instruments. A real breakthrough was the introduction of professional surgical thread instead of the old linen thread which scrub nurses would need to reel and soak in spirit. She introduced numerous improvements; brought in specialised equipments such as drains, gloves and catheters but also masks and caps – earlier made of gauze by the nurses. 
In 1966 Marta Płaska assisted as scrub nurse in the first successful kidney transplantation in Poland. The first patient of this operation performed by professor Nielubowicz’s team was a 19-year-old Danusia: herself a student of nursing. As a result of a chronic condition she had her kidneys removed and was only kept alive through long and tedious dialyses. She had undergone around seventy such procedures and although gaunt and exhausted by the illness, she remained cheerful. The donor was another young woman with a head injury sustained in an accident. With the attorney’s approval, once the circulation stopped, doctors took the kidney. It was thoroughly rinsed with saline solution and carried to the other room in a sterile cloth. The operating team placed the kidney in the right iliac fossa of the recipient and performed first vascular and then ureteral anastomosis. The procedure was performed over exactly 57 minutes, 20 minutes later, after the anaesthesia wore off, the patient woke up. The kidney resumed its function. After the transplant the patient was placed in a separate, sterilised room because doctors were afraid of complications such as infections. There was no appropriate medication at the time and the patient was treated with imported medicine: Prednisone and Imuran. Thanks to the dedicated care of the whole team she was recovering quickly and was soon referred to reconvalescence at a sanatorium. Nevertheless, a few months later Danusia died of pancreatitis, even though her kidney was functioning properly. The procedure performed by prof. Nielubowicz’s team was a milestone in the development of Polish transplantology. Soon more transplants were performed even despite many problems encountered by the team. Immunological barrier was the main one: effective methods to reduce the ability to reject the new organ by the recipient’s organism needed to be found. The procedure of storing the removed organs was being researched. Other problems included the question of ethical and legal considerations, unregulated at the time.

Marta initiated the development of anaesthesiological nursing and postoperative care. Earlier it was ward nurses who would provide IVs during the operation. An assistant nurse was at the same time aiding an instrumenting nurse and an anaesthesiologist as well as – sometimes – prepare the necessary medicine. Anaesthesia was mostly based on ether which resulted in consciousness and memory loss, relieved the pain and caused relaxation of the muscles. It was administered by dripping onto a wireframe mask covered in gauze. Its pungent odour was unpleasant for the patient and irritated the respiratory tract. Fifteen minutes before the end of the operation an instrumenting nurse would order to notify the surgical ward that the patient needs to be taken in along with the instructions of the operating surgeon concerning further treatment. Marta Płaska dedicated Teresa Czerniejewska to serve as the first nurse of the new branch of anaesthetic nursing, thus marking its beginning. A modern Draeger anaesthetic machine was purchased; ether was gradually being replaced by safer halothane, invented by Raventos in 1956; and qualified anaesthesiologists were hired. Anaesthesiology started to take its modern form.

In July 1975 the Clinic managed by prof. Nielubowicz was moved into the newly-opened, biggest in Poland clinical hospital at Banacha street in Warsaw. The design and fit-out of the new general surgery unit was supervised by Marta and Alina Kowalska – an instrumenting nurse she chose. The hospital was equipped with a multipurpose surgery unit divided into three operating suites with fifteen modernly equipped operating rooms. It also housed a postoperative ward and intensive care unit with sixteen beds and a dialysis station. Operations performed at the hospital included general, neurosurgical, vascular and laryngological surgery, as well as kidney transplants. Patients were admitted nationwide and thanks to specialised care the effectiveness of treatment was growing.

Marta Płaska also specialised in sterilisation; she was getting her experience while training in clinics abroad. She was mostly interested in learning the work organisation of the central sterilisation units, operating the newest machines and methods of preparing medical instruments for disinfection and sterilisation. She put her experience to use while organising the first professional central sterilisation units: her knowledge proved to be invaluable. Banacha street hospital had the first central sterilisation unit in Poland. Surgical instruments were sterilised in modern autoclaves. As an expert she offered advice and training in sterilisation and disinfection. She taught her colleagues how to use disinfectants effectively. She also translated foreign language articles and equipment manuals.

International Awards: prestigious scholarships

In 1975 Marta went to Lund in Sweden. As a World Health Organisation scholarship holder she took part in a training at the University Hospital and became familiar with the organisation and equipment of the surgery, intensive care and central sterilisation units.

In 1977 she was nominated by the International Council of Nurses for a 3M Science Scholarship which she used to train in Helsinki at the Central University Hospital. The aim of the training was to get working familiarity with the practices of the instrumenting nurses in Finland. She was highly commended on her performance. As a winner of a competition she received a statuette – work of an Australian artist – symbolising life and health.

In 1979 she received an award in the competition organised by Instrumenting Nurses Scholarship Foundation and went to Edinburgh and Liverpool hospitals for training. It involved work organisation, equipment of central sterilisation unit, methods of transportation, preparation, sterilisation and disinfecting medical equipment. She got hands-on experience in the means of preventing hospital infections.

An exceptional ward nurse: a role model

Marta Płaska had exceptional leadership skills and she was climbing the career ladder fast. After two years of working at the operating ward professor Nielubowicz made her a ward sister. She was characterised by uncommon degree of diligence and dedication; and continuously developed her nursing skills striving for mastery. Full of charm, and always smiling she had an aura of warmth. Marta believed that a nurse should be an equal partner in the treatment team but it would not be possible without appropriate level of knowledge. She built a team of outstanding specialist nurses, kept supporting them and skilfully managed several dozens of people in an uncommonly trusting and kind atmosphere. In her hospital at Banacha street in Warsaw she hosted delegate nurses from Sweden, Finland and United States of America cooperating and sharing professional experiences throughout many years.

She always eagerly shared her knowledge and experience with other colleagues. While she was professionally active and afterwards, as a retiree, she was involved in education of nurses. She trained numerous instrumenting nurses not just in the hospitals she worked at but throughout Poland as well. She was an unquestionable authority in surgical nursing and examiner for specialist courses which she prepared programmes for. It was her ambition to spread the cutting edge state of knowledge to all instrumenting nurses – especially those working in smaller hospitals. She encouraged her colleagues to organise bulletin boards with news from the world of medicine.

Marta’s exceptional organisational skills let her thrive in extreme conditions. Without hesitation she answered the call from the International Red Cross and in 1980 she took up a mission of organising operating rooms in the Kampong Cham Kampuchean hospital. It had been built in the 1960s as a gift of the Polish government for the Khmer nation and prince Sihanouk, and later devastated by the ruthless Khmer Rouge. Several buildings were completely destroyed; only pieces of medical equipment and instruments were left scattered. During the four-year Pol Pot regime around three million people were killed and further four maimed either physically or mentally. Only a handful of doctors remained in the whole country. Offering medical care was severely prohibited, the only allowed medicine being coconut milk. Polish team consisted of a surgeon, anaesthesiologist, four nurses and an engineer. They could not believe the local conditions. A province under their care counted one and a half million people whose needs were huge. The greatest problem was severe malnourishment of the surviving Khmer, pervasive intestinal worms, advanced tuberculosis, and tropical diseases: plague, cholera, malaria and Dengue fever. They had as many as three hundred patients a day; and operated on wounds old and fresh. Unknown earlier, postoperative care was introduced to the Khmer. The country was not yet stable and the fighting still continued in the jungle. Home visits with the patients were secured by the military, roads were destroyed and not passable, bridges were broken. Other great problems were permanent water shortages, power outages and tropical climate. In the course of three months, two operating rooms were set up, a treatment and an interview room, a laboratory and an X-ray unit. Marta was also responsible for training local staff. She took great care maintaining surgical instruments: keeping them sterile and ready to use was a big challenge. Patients were lining up to her to receive dressings: she had a knack for it. The Khmer language word she remembered as Hotna and understood as“martyred” defined her experience of the country. Hotna Kampuchea remained in her memories for a long time.

Activities in Polish Nurses Association (PNA)

From 1970 she was active in the Polish Nurses Association, served as a head of the Chapter and a Main Board Member for three terms. She participated in the National Assemblies of the PNA; founded the Section of Surgical Nurses at the PNA Main Board and was its president. It was her aim to raise professional qualifications and exchange views as well as professional knowledge among instrumenting nurses and thus improve patient care in surgery units. She represented the Polish section at international conferences in the Hague, Harrogate and Havana. As a president of the Committee for the Organisation and Technification of Work she visited Polish hospitals where she advised on and implemented modern solutions. Striving for the improvement of organisation and conditions of nurses’ work, she also increased the standards of patient care. It was especially important to her to prepare models of nurses’ work on every position within the health care system. Much of her effort was aimed at streamlining patient care. She organised exhibitions presenting the newest trends in hospital care equipment and was involved in Nurse Olympics. In 1978 she received the PNA Badge of Honour. She was the sole representative of the Polish Nurses Association at the Congress of International Council of Nurses (ICN) in Los Angeles in 1981. The Congress motto was “Healthcare: a Chance for Nursing”. Marta received a very warm welcome. She was introducing the Hungarian Nurses Association into the ICN and got a standing ovation for her speech as an inspiration to further development of instrumenting nurses. After the congress she toured the United States for a month and visited hospitals in Los Angeles, Chicago and Boston. She was mostly interested in the equipment of operating rooms, postoperative wards and intensive care units and had meeting with the leaders of American nursing such as Lillian E. Brown from University of California in Irvine; Mary MacDonald, nursing director of the Massachusetts General Hospital in Boston and Roxanne Spitzer from the University of Illinois Medical Center in Chicago.

Conclusions

Marta Płaska was the leader in surgical nursing and contributed significantly to its improvement. She introduced many innovative solutions in the work of nurses and initiated the development of anaesthesiological nursing and postoperative care. First professional central sterilisation units in Poland were created under her supervision. She trained numerous instrumenting nurses and was a role model for them. Actively involved in Polish Nurses Association, she was its recognised representative internationally. Professor Nielubowicz considered Marta Płaska to be equally responsible for the success of his Clinic and emphasised her great contribution in the early stages of the kidney transplantology. The improvements she implemented had an undeniable role in the development of Polish medicine.

Prepared by Grażyna Gierczak

Fig. Marta Płaska in the operating theatre

Fig. Marta Płaska in the American press

Fig. Marta Płaska with English nurses during her scholarships