On nursing
Every time I meet a new person, inevitably my work schedule comes up. Yes, I am a nurse. Yes, I work three days a week. Yes, I only work 36 hours/ week for full-time benefits. Yes, I work days & nights & weekends & holidays. Yes, sometimes it’s unbearable. Yes, sometimes it’s wonderful. That’s usually where the conversation stops, which is fine. However, recently I had an experience that made me think about nursing again, a little bit beyond the whacky schedule.
I was assigned a patient (and essentially assigned their large family) recently. She wasn’t doing well after surgery. The surgery she needed to survive, but it’s hard to say that this woman will ever get back to her baseline. So, I just dive in and do the work I’ve been taught. With some help from another nurse, I change dressings, I check her peripheral IV lines, I get rid of her central line, I hang new tubing for IVs and tube feeds, I label them, I clean the patient, change the sheets, give the medications, answer questions and explain my actions, all while slightly perspiring in a yellow gown I am to wear for contact precautions.
The patient doesn’t speak any English, and honestly, I think our cultures are so different our gestures don’t even communicate a whole lot. But something about patients like this—I love her. She is so utterly dependent on my care, and I have learned over the years how to provide that care. Hours away from those who love me most, I relish the opportunity to be needed and unabashedly care for and about someone.
Then, after several shifts working with this patient, the family gave me a Hallmark card that thanked me for my compassion and knowledge. I was deeply moved by this. I was just doing my job, like every day. I want to say—remember that night I was so tired that I was cranky and abrupt? When she would moan continuously and I could do nothing? And, the truth is that I didn’t save this patient. She didn’t end up getting better. Yet, I also know I have provided something priceless to this patient and to this family that goes beyond my hourly wage and benefits. Certainly, vise versa, my interactions with this patient and family have enriched my life and made it better.
I won an award last year for being compassionate, selected as the nurse to represent my entire small, wonderful, community hospital. I am deeply grateful for this award, but how can I possibly ever live up to such an award? I am not proud of every shift, every interaction, every situation. There are weeks where I never hit my stride. And yet, sometimes people would ask me how I could possibly be so patient. I don’t think I’m particularly patient, but here a couple of thoughts on why I love nursing (even when I am miserably tired/hungry/desperate to go home) and how I approach the work I do.
First, I truly believe all people are doing their best and thrive when they feel a sense of love and belonging (I’m definitely using Brené Brown language here, would highly recommend). People need love and belonging, and I believe when these needs are met, their best gets better. Not just patients, but their families, my coworkers, the doctors/ practioners, our nursing aides, the different therapists (PT/OT/speech), our supervisors, etc. Of course, our best is always going to fall short sometimes.
Assuming people are doing their best is simply a different way to approach life and conflict. Turns out, a patient may have a deeper need to feel love and belonging than to take their prescribed furosemide. And, I don’t assume people are trying to be unkind to me or the people around me, instead, I assume they are either unaware of their actions or something else in their life is eating away at their ability to make a genuine human connection. They are, after all, just doing their best.
Second, I was taught to approach nursing as a “sacred covenant” I have with my patients, a framework developed by one of my professors. Simply put, the sacred covenant is the promise (covenant) we have to our patients to do a good job, and the bond between the nurse and patients is special (sacred). Essentially, nursing is a spiritual practice for me. That does not mean it feels warm and fuzzy, because honestly, it doesn’t.
Nurses have so much power in the care of their patients, even, in fact, the power to save lives. A lot of the power is not glamorous; it’s timely med administration, maintaining machines that beep and beep and beep, dressing changes, cleaning bodies, people demanding more of you than you can (or even should) give, and being honest when you need help. Often, saving lives looks more like discontinuing unneeded catheters and performing regular dressing changes than it looks like CPR and IV epinephrine. Using the power I have as a nurse to do well by my patients gives me a sense of greater purpose and is deeply important to me.
A quick thought: sometimes I think people try to reduce nursing to something less than it is. Nursing is not fundamentally about patient satisfaction. Too much emphasis on that is going to lead to burnout, you cannot possibly make all people happy all the time. Nursing is not fundamentally about a paycheck. Of course, I wouldn’t do this work if I didn’t get paid, but still, something is happening in this interaction that is beyond money. Finally, nurses are not punching bags for the emotionally unwell or superhumans that can go without food and water. Our compassion and expertise demand we should receive the same respect and dignity we give to our patients every day, and for compassion to be sustainable there also must be reasonable boundaries. If our patients get served three meals during our shift, we can demand to have the time to go buy at least one for ourselves.
So what is nursing, then? It’s about the human connection you have with someone who is vulnerably under your care. It’s about all the scientifically based interventions we do every day to promote health and wellbeing, whether the patient is appreciative or not. It’s about taking care of the person to the best of your ability AT THAT MOMENT, no matter the outcome. And, maybe it is a superpower, too.
Life update:
I’m sitting in my room in Pittsburgh, putting off packing for a weeklong vacation to Montana to visit some college friends. Yesterday was my first full day back, and I thought, Pittsburgh is so empty! It’s strange to be back, but it’s so, so good. I’ll be in Pittsburgh all of August!
Heres what I wrote before I left:
My time in Boston is coming to an end. I’m ready to leave, but I’m also deeply grateful for the time I had here. I am grateful to my coworkers here, my managers here, the friends I’ve made, the soccer team I had a lot of fun playing with, the neighborhood bar I watched the USWNT games at, and my numerous roommates and neighbors. There are certain people here I could not have survived without. Traveling is like the ultimate test of FOMO (fear of missing out). I’m just on the edge of creating a life and routine here, and every new place you go means there is another place that you are not. And I’ll miss Bekah like crazy.
That being said—Boston—thank you! Next….
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I got to hang out with my parents in Pawtuckaway in NH and see them in their new Aliner/ glamping lifestyle! Very thankful I got to spend some quality time with them!
Thankful for each and every one of these people! For beach days in Gloucester, for friends visiting me in Boston, for Tuesday trivia at the Hong Kong, for a friend happy to go to a Boston Red Sox game with me (even though she was already going the next day), and for the endless hospitality from Danielle and her roommates Julie and Muneeb. Not pictured is my roommate Jaanvi, who kept me saner than she probably realized.
Holly & Travel Nursing 