I had the opportunity to attend a nurse recognition dinner last night in honor of a fellow co-worker, Nancy Kelleher, who was accepting the Essence of Nursing Award. This award is given to a nurse who epitomizes the values of a great nurse.
Nancy works in care coordination, which means she helps patients navigate the course of their hospitalizations and facilitate the discharge process. Some patients go home while others go to a rehabilitation center, hospice, or home with services. She's pivotal in helping patients get to where they truly want to be - home. I only had the chance to work with her for a year, but I will always remember how helpful she was guiding me as a new nurse by asking all the right questions about barriers to discharge. I will also never forget a moment we shared together in the room of a patient who was CMO (comfort measures only), which means you no longer continue interventions to keep someone alive but, rather, keep them comfortable to ease them through the dying process with as little pain and distress as possible. This patient had been on the floor for months and was dying - we always thought he would go faster than he when he did but to our surprise, we'd always come back the next day to find out he was still on the floor. It wasn't until a few days after Nancy stepped into the room with me and grabbed this patient's hand, stroked his hair, and expressed her best wishes for him that he passed. This moment was emotional for us both because in his long months in the hospital, no one had ever come in to visit.
Work gets busy, stressful, and chaotic for us all. At some point or the other, we just want to pull our hair out and walk out of the office. Many times we need a mental health day, but events like last night really help to remind nurses what it means to be a nurse, why they chose this profession, and also gives us the encouragement and appropriate thanks to continue doing the work we do. A lot of people and patients always ask me, "Why don't you become a doctor?" I know it takes a very smart person to be a doctor, but it takes a very particular type of person to be a nurse, and a good nurse, at that. I wouldn't trade the work I do to do any other job. The dinner last night confirmed that all the night shifts barely staying awake at four in the morning, stressing over your patient with acute GVHD for the duration of your twelve hour shift, and the heartache from patient's deteriorating is all, in the end, appreciated.
This event also made me reflect and remember what my values are a nurse. A year and a half out, I've learned a lot but also still have endless amounts to learn. These are a few pillars of my practice.
Science. Know your anatomy and physiology. When you go into an assignment knowing how a disease progresses through the body, you feel much more confident about the type of care you can give for that patient. Every patient and disease comes with their own set of specific interventions, and the more you familiarize yourself with certain conditions the more you'll be able to predict what that patient will need. Reading and understanding the disease will also help you anticipate complications and emergencies that you can prepare for and catch early on to treat. I still find myself looking up acronyms of conditions I'd never heard about before (I swear people make up their own acronyms all the time), and that's okay. Even for illnesses that I've studied a thousand times in nursing school - it's really okay, and it's safer for the patient, too (I will never ever remember they kidneys and what happens once you get to hose tubules . .)! The nurses I look up to are constantly assessing their patient and understanding things in the context of their current health problems and health history, whether they're just laying in bed or walking on the floor. It's part of getting a well-r0unded picture of what's really going on in the context of that individual that makes patients so unique. You know all their nuances because you're at their bedside the whole day - and that information can really serve as gold when talking about things like medication compliance, understanding health materials, and helping the medical team make decisions that will work for that patient.
Heart. I've always said nursing is just as much a personality as it is a profession. If you don't care about people, you can't be here. The best nurses are experts at navigating tender patient situations through careful understanding and appropriate responding in a way that is meaningful, and ultimately, efficient for a patient. In other words, you communicate in a way that gets through to the patient, in a way that works for them, in a way that lets them know that you care. Whether it's a person who's actively dying, a trauma, someone who has a bad prognosis, or something totally unrelated to medicine, it's important to understand what's going on in a situation and how to respond to it. Not everyone can do this.
Being a team player. I hate when nurse's see a call bell going off right next to where they're sitting and just stare at it. With that being said, it's simple. Help out. If you have free time, ask if someone else needs help. And if it clearly looks like they do, don't ask - just do. With all the commotion going on in a hospital, you never know just what the simple act of emptying a foley or giving PRN pain meds will do to ease a coworker's day. Get to know unit staff including housekeeping, the secretary, pharmacist, and doctors. You'll need them.
Don't just stay on your floor. Get out there. Nursing is way more fun when you're off the unit and have time to hang with coworkers in a new environment. I don't mean get wasted (although a few drinks never hurt anybody!), but go to conferences, dinners, and talks that allow you to see the people work with in a different light and educate you about the world of nursing in general. It's necessary for me to stay updated with current events and to not have my head in the clouds, solely focused on my one unit in my one hospital. Nursing has come such a long way since Nightingale. To know the profession is to push it forward, too.
You'll always be a novice. I truly believe that twenty years from now, I'll still feel like a new nurse. I say this because I'll always have something new to learn. Be humbled by the people you encounter and the new cases you take on, as they are reminders of all the potential you have, how much smarter you can be, how much better you can handle a patient scenario, and how much more prepared you'll be going into the next case to make sure someone's stay in the hospital is as comfortable as you can. Sometimes I still do the NCLEX questions of the day to jog my memory about foundational concepts I learned back in nursing school. They remind me that there are other fields out there outside of my comfort zone in hematology/oncology/bone marrow transplant. And I'll never know all of them.