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Marlee Crankshaw, R.N., holds patient Benjamin Warwick in Vanderbilt’s Neonatal Intensive Care Unit. (photo by Dana Johnson)
Reporter profile: Caring for others a true calling for Crankshaw
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Marlee Crankshaw, R.N., in front of a board of patient photos and thank you notes in the Neonatal Intensive Care Unit. (photo by Dana Johnson)
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Crankshaw and her extended family gather at the Madison home she shares with her husband, Robert. (photo by Dana Johnson)
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At a recent cookout, Crankshaw and her family pray before the meal. (photo by Dana Johnson)
Marlee Crankshaw, R.N., knows from first-hand experience that happily ever after rarely lasts forever.
When she graduated from high school she had a plan — get married, become a homemaker and have a bunch of children. For a time, the plan rolled smoothly along: Crankshaw married in 1971, had four children — Stephanie, Christopher, Jennifer and Katie — and was a stay-at-home mom.
Her idyllic life, however, soon took a detour.
“My husband was ill, very sick with diabetes,” recalled Crankshaw. “I kept hearing dialysis, blindness, losing limbs, kidney troubles and other bad things that let me know he might not be able to work in the future.
“I'd never been to college and I thought 'uh-oh, I'd better do something.' I could be left with four kids and no means of support.”
Nursing had always been in the back of her mind, so Crankshaw worked toward a two-year associate degree at Tennessee State University. “I remember thinking anyone can struggle through two years of something,” she said. “For me, the tunnel was so bright at the end, the time passed quickly.”
Crankshaw doesn't categorize her actions as forward thinking as much as propelled by fear.
“All I could think was — what was going to happen to us? What would I do? I loved being at home. I thought that was my mission in life, to be a homemaker, a mom, a wife. There wasn't anything better in life.”
Lucky for her, she believes people can have more than one calling.
Getting to Vanderbilt
Once Crankshaw graduated from Tennessee State University with an Associate Degree in Nursing in 1983, she landed a job immediately, but only stayed four weeks. After the hospital failed to open a pediatric unit, Crankshaw interviewed at Vanderbilt.
“I really avoided Vanderbilt,” she said. “When I was in nursing school I saw a flyer with preemies with tubes and wires and I thought — I'm not going there. I knew I wanted to work with kids, but I knew that the neonatal unit was not where I wanted to be.”
Twenty-five years later as the Nurse Manager for the Neonatal Intensive Care Unit and Newborn Services at the Monroe Carell Jr. Children's Hospital at Vanderbilt, Crankshaw couldn't see herself anywhere else.
“I was a new graduate and I wanted to work in pediatrics but there was nothing available. My first thought was that I'll just get my feet in the door and something else will open up. I came to the NICU, looked around, talked to the manager and I was stuck.
“I mean it's not just that it grabbed me; It grabs lots of people. I was mesmerized.
“When I walked around, I saw babies and they looked different from the brochures and flyers. They were real. They had fingers and toes and they moved. They are perfect. They're just tiny.”
Necessity may have led Crankshaw to Vanderbilt, but devotion, passion, affection and love keep her here.
After spending more than 10 years as a floor nurse, her aspirations grew. In 1995 she became the first staff nurse/case manager. Although a willing participant, she was a guinea pig for the pilot project, which would pilot would determine if a staff nurse could move into such a position without a master's degree. Crankshaw nailed it. She remained in that role until 2003.
While serving as case manager, her desire to learn more about health management and improving the quality of care in the NICU prompted her to enroll in Vanderbilt's School of Nursing program. In 2001 she received her Master of Science in Nursing, specializing in Health Systems Management.
This fall, at the age of 58, she began her coursework for a doctorate in nursing practice at Vanderbilt.
“I loved school and always liked to learn, and I didn't really realize it until I went back,” she said. “My master's degree opened doors for me that otherwise probably would not have been opened. I have so many ideas about models of care. I really like this kind of stuff.
“The baby comes first; that's what I love about this particular job,” Crankshaw said. “Everyone is learning about this new little human being and how to deliver the best of care. Here is this premature or critically ill newborn, and you depend on the good Lord, your decisions and the decisions of the entire health care team to ensure the baby receives excellent care.”
Crankshaw no longer works at the bedside, but remains a caregiver in a different role. In her nurse manager role, the recipients of her support and care have a different face.
“Now I come to work for the nurses who can help these families and babies,” she said. “That's why I became a manager. I give the nurses support. It's what they need. It's so emotional up here at times.
“That's why ultimately I'm back in school doing doctorate work. I can learn how to change the model of care. When I was going through school (in the '80s) they didn't tell you how to care for yourself. You learned how to care for the patient. There are so many demands on our lives. The nurses have to be of sound mind and body and be nurtured. If not, they cannot pass it on.”
Crankshaw enjoyed a close relationship with Children’s Hospital namesake and benefactor Monroe Carell Jr., who died in June. The two met 20 years ago at a Friends of Children’s Hospital luncheon at which Crankshaw was speaking.
She talked about the NICU needing a copy machine. Afterward, Carell introduced himself, and the next day he called her to ask what size copy machine the unit needed.
“After that I would send him cards and invite him to the NICU,” Crankshaw said. “Finally he took me up on it and then he just kept coming back. Sometimes he would bring other people, but mostly he would just come and hold the babies.
“He told me when he was raising money to build the hospital he would picture these babies.
“We just clicked,” Crankshaw said.
Caring for keeps
Books didn't teach Crankshaw how to care for people. Life experiences taught her that.
“Marlee is a very sincere person, one who is dedicated to her craft,” said Jeannie Temple, activities coordinator for Children's Hospital. “She is friendly. She cares. She cares about the patients and families on her unit. She cares about her staff.
“Not to say that all nurses are not dedicated to their craft, but her dedication and love for her patients stands out — it is one of her highest attributes.”
Temple should know. Twenty years ago, her daughter, Caroline, developed a special bond with Crankshaw during the eight months she lived in the NICU.
“She got excellent care from all of her nurses, but there was something special about Marlee. Caroline always responded to her with smiles and grins. And we all connected — I can't really say what it was.”
The relationship continued even after Caroline died in 1988, months after leaving the NICU. Crankshaw attended the funeral and stayed in touch with the family.
“She cared about us, too. It wasn't just our daughter. It was a natural transition to continue that friendship outside the NICU.”
Temple said Crankshaw spends 12-hour days at the hospital. When she is not here, her attention is devoted to her four children and 13 grandchildren.
“She is the most wonderful person that God has put on this Earth,” said Temple, catching her breath. “She is one of the few women that I don't mind saying 'I love you' to.”
Terrell Smith, director of Patient/Family Centered Care at Vanderbilt, has known Crankshaw for nearly 16 years. She vividly remembers their first encounter, where Crankshaw approached Smith, then the director of Patient Care Services, and laid out her goals for the future.
“She's bold,” Smith said. “She's creative. She committed. She's caring and compassionate. The way she thinks about these families and babies is beyond the clinical role. She is smart, both as a manager and as a clinician. Then you layer on the thoughtfulness, and she is the nurse you would want to take care of your baby.
“She is the person you would want to be your friend, the person you could trust with a secret, the person who can hold your confidence and who you can look up to,” Smith said.
An example of how Crankshaw works:
“Marlee is very committed to little babies looking like babies,” Smith said. “It is so easy for a baby who is so small, with tubes and wires all over the place not to look like the baby the parent was dreaming about.
“So, she encouraged people to donate clothes for premature babies. I even knitted a sweater. Marlee would take home baskets and baskets of clothes and wash them so the babies would look like babies to their moms and dads.”
After months of taking loads of laundry home she wrote a proposal to the Friends of Children's Hospital requesting a washer and dryer for the unit. Crankshaw asked Smith to review the report before turning it in.
“I took it home and my husband happened to read it — he came to me and said, “give her our washer and dryer.”
Hard choices
It has been said that Crankshaw is the “calm in the face of adversity.” She meets challenges with grace and determination both at home and at work.
“She comes to work every day and she is a top performer, even dealing with multiple issues,” said Smith. “Everybody has them — issues. But the beauty of Marlee is how she makes her choices. You can choose to be one way and pout and whine and bitch and moan, or you can choose to come to work and make a meaningful contribution. It's all a choice.”
Married 37 years, her husband, Robert Crankshaw, was diagnosed with diabetes soon after they wed. When she met “Shaw” as she calls him, he was “out on the town,” fresh from a hospital stay recovering from gunshot wounds sustained during a tour in Vietnam.
Over the years diabetes began to take its toll, costing the former Marine both his legs and one eye. Nearly blind and unable to care for himself, Crankshaw has balanced between two care-giving environments for some time.
Ten years ago the emotional, financial and physical strain hit hard. She was forced to take a medical leave of absence for depression. Today she is open about her experience and serves as a confidante to many others.
“I share my experience because I think it's important that people know you can recover,” Crankshaw said. “So many people are embarrassed to talk about depression because they fear others consider it a weakness or people are afraid they will be labeled. That's the problem.
“Back then I was embarrassed to talk about it. Depression is anger turned inward. You are mad at yourself, and if you don't let it out — it'll eat you up.
“I remember wishing I could have come back to work with a cast or something people could see. There are no visible scars with depression. But even with diabetes or cancer, people are ready to offer help. But when it's depression, people don't know what to do or what to say.”
Honoring service
Working through her own depression opened her eyes to other's pain, including her husband's. Seven years ago, she attended a Veteran's Day parade and witnessed the distress and loneliness of the military experience.
“There wasn't a good turnout for this parade,” Crankshaw remembered. “And I was embarrassed that we, the city, were not paying better attention. Then all of a sudden I felt embarrassed that I'd never paid attention. I had never been to a parade, and I was married to a military man.
“I had been dealing with the ravages of what Vietnam had left — a man who was bitter and angry. He did not feel honored when he returned, and I lived with that for years. I guess I just buried it, ignored it all. That's how I dealt with it.
“I feel like the kids and I were also casualties of war, not just him.”
Crankshaw has since discovered another passion — military families. This is especially evident at the hospital.
At any given time, about 8 percent of the NICU patient population is associated with the military. Many come from Fort Campbell, the closest military base to Vanderbilt. Many times, it is the mother who is left behind to care for a sick infant. Crankshaw makes sure these families do not feel alone. She also ensures that staff with deployed family members get additional support.
For years, the NICU staff has prayed for and celebrated with family of staff members on military missions. Information is posted on the last page of the NICU newsletter “Friday Update.”
The group goes as far as hosting a celebratory event for returning soldiers. It's a way the unit, often hailed as angels themselves, is able to applaud its heroes.
For Crankshaw's daughter, Katie Torbus, 27, her hero has been by her side all her life.
“I could go on and on and on about my mom,” gushes Torbus. “She is probably the most wonderful person you'd ever come across. There are two things she loves more than anything — her work and her family.
“God made her just a genuinely nice person,” said Torbus. “It's a part of who she is — loyal, trustworthy and so faithful. It's weird because it all sounds so unreal. But people love to work for her, with her, be around her.
“I used to tell her that she was the best mom in the world. You know growing up how you used to say that to your mom? Now being older, I still do. We all (siblings) wanted to do nursing at one point in our lives, because we wanted to be like her. I still strive to be like her.”
Torbus admits that she and her siblings make up excuses just to hang out with their mom. Crankshaw doesn't mind one bit. In fact, she lives for it.
“They are what keep me going,” Crankshaw said. “That's how I take care of me — being with my family, hanging out at home, going to ballgames, recitals, plays. Mingy (the name her grandkids call her) is ready and always present.”