Mary - Change Keeps Nursing Fresh

Mary -







My love for horses turned into a love for nursing. My father worked for a physician who raised horses and I would hang out with the horses and witness the physician’s caring attitude toward the animals. He was one of the most caring people I’d ever met. When I became old enough, he asked me to help him in his practice and I saw that he loved caring for people just as much. I decided to help people the way he did. Caring and compassion is what lead me to nursing, but variety is what keeps my interest.

I’m the kind of person who needs to be constantly challenged with new learning so I can continually develop my skills. So every few years I change my nursing focus. If I’m not learning, I get bored and then I’m not taking the best care of my patient. Every patient is different and brings his or her unique needs. I feel I can take on any nursing challenge with my knowledge and skills.

I also strive to earn patients’ trust by approaching their cases with a fresh, open mind and by conveying that their health is MY focus at this time. The patients are so appreciative and they show it in many different ways. I feel great inside when they say things like, “I really like how you’re caring for me.”

Some nurses hesitate to change from one area of nursing to another. Those are the nurses prone to burnout. They can tend to get stale and stagnant in one position. I think they feel trapped."Change doesn't hurt. It makes things better." Nurses need to pick up the student mindset and learn again and not be fearful of change because change means growth. It makes things better. We also need to be open to learning from each other. When nurses feel stale, yet have so much fear they won’t do anything about it, they become resentful towards others especially new nurses who come in with fresh attitudes and ideas.

Conversely, it’s interesting to watch how new nurses fresh out of school think they know it all. They could easily lose heart if there wasn’t a mentor nurse to encourage them. New nurses need to listen to those of us who have experience, because there is so much more to know and they’ll learn faster that way. But some insist on learning things on their own. They often flounder and sometimes even fail because of their lack of practical experience and unwillingness to ask questions. There’s really nothing I can do for those nurses. I can’t force them to accept the knowledge I’m willing to give.

Work environment is important to all nurses, and it is shaped from the top down. My current supervisor is an awesome person. She is my inspiration. She’s probably one of the most direct and outspoken people I’ve met in my career. She’s easy to talk with and she addresses our concerns immediately. Because I have a voice and am respected for my opinions, I find this to be one of the best jobs I’ve had. She understands that she needs to keep the staff happy on the job. Happy staffs make happy patients.

Speaking up and advocating are nurse care competencies and nurses need to find their voice and speak up for patient care. We are involved with patients more than any of the other health care providers. We have first-hand knowledge of how the patients’ case has evolved through the system. I’m not afraid to address things that I dislike or disapprove of with physicians or other staff members. I wish nurses would take it up with insurance companies who are dictating our patient care - not every patient can go home within two or three days after a surgery and insurance companies are demanding premature release.

Nurses are in a position to make change happen for our patients, for our profession and for the system.

Power Strategies: Resolve, Courage, Growth
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Lynn - Know when to Fold Them

Lynn -







I’ve taken a walk on a meandering career path. After I graduated from nursing school, I worked in a level-one trauma emergency room. The whole adrenaline-junkie atmosphere – I just loved it. But after three years of intensity, I got a little burnt out, so I switched over to a teaching hospital, also a level-one trauma center in the same city, and I tried operating room nursing for two years. By that time, I was so thoroughly burnt out that only five years after graduating from nursing school, I left my profession and for 18 years worked in the travel industry.

I knew I was a time bomb ticking when I faced that I was using a common coping strategy amongst nurses, especially emergency rooms nurses –“gallows” humor. This is where sometimes inappropriate emotional responses surface, almost like a defense mechanism. I wasn’t able to respond appropriately to sad situations or provide the kind of emotional support the patients’ and their families might need.

In retrospect, I was what I would call a party girl during my first stint as a nurse. I blew off steam by partying hard during my off hours. I was just too focused on having fun and not focused enough on the seriousness of being a nurse. It may have been my way to deal with the stress of working in a trauma center and the constant state of adrenaline.

I left nursing because I didn’t know how to cope, but I never stopped wanting to be a nurse. I maintained my nursing license throughout my 18 year diversion taking continuing education courses every few years. I’m glad I did because in the aftermath of September 11, with all the cutbacks in travel I was able to rejoin my original profession – as a prepared nurse.

Getting back into nursing after nearly two decades away has been an interesting and positive experience. I’m in a completely different environment now. It’s interesting because when I left, most of the nurses were my age. Well, now that I’m back, the majority of nurses are still my age. I’m with a very mature group of women –mostly women – and I like their values. I have so much to learn from them because they’ve been nurses now for twenty or thirty years.

The bottom line is, I work because I need to support myself and currently, I work in a clinic for MS patients. I find a lot of joy in my job - from my peers, my environment, and my patients – they call forth the nurse in me, offering comfort and counseling to people dealing with this dreadful disease in a loving form of caring.

There was a patient I talked to last week, a young mother with two little girls, six and eight years of age. She is losing strength, and she’s worried about not being able to see her daughters grow up. I just spent a few minutes with her and I said, “Let your daughters see your weaknesses..”."I find a lot of joy in my job - from my peers, my environment, and my patients - they call forth the nurse in me." Let your daughters learn how to care for you. And let them become the women that you want them to be when they grow up, whether or not you’re here to see that. And she was just so touched by that. I don’t know where that came from – my own soul, I suppose – but I was thinking about my sister who has daughters about the same age. What a nightmare to think that my sister wouldn’t be able to see her babies grow up. So I thought, what could I offer this woman? Let them be the women that you want them to be, that’s what came to my mind, and she was touched. That means so much to me, to just be able to reach out and make my patients find purpose for themselves and in their situation.

It's the giving of oneself. When you give out of experience, your own personal experience and how you care about people, it’s so meaningful for them and for you. You get back so much more than you could possibly give.

A flight attendant taught me a trick one time. I was watching a passenger in first class who was being difficult. I was flying on business, and the woman next to me was a deadheading flight attendant. So I asked her, “How on earth do you put up with people like that?” And she said, “I remind myself that I only have to be with them for a couple of hours, and somebody at the end of this flight has to live with them.” I find that attitude works in nursing as well. I can deal with anything for a few hours, because I don’t have to live with it 24/7.

You rally the people that you love, and the people who love you, whether it's your coworkers, your kids, your family, or your friends. Let them tell you how great you are. I have wonderful friends and a loving family. A friend of mine always says, “We have our nature family and our nurture family.” Fortunately, mine are both excellent. I have my cats. I relax a lot – I don’t party as much. I guess you could say I’m boring now, and it's very easy. I’m not in the adrenaline mode anymore.

Power Strategies: Making a Difference, Autonomy, Love
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Tamara - A Nurse Runs for the State Legislature and Wins

Tamara -







I have specialized in psych nursing since the early 90's, though when I was in nursing school, I never thought I would end up there. Psych nursing--working with mentally ill patients--is not about wearing scrubs with a stethoscope around your neck. It's partly about education: teaching patients about their medicines and how to manage their symptoms. And it's also about relating: I spend a lot of time helping angry patients calm down.

I got into the field when I needed a job--I had a new baby and my husband was out of the military and couldn't get a job. We needed health insurance, and I knew that state employees had good benefits. Western State hospital was advertising, so I got a job there, at first as a medical/surgical nurse, and later as a psych nurse, which I came to love.

After a while, I got involved in legislative issues through joining the nurses union. At first, I barely knew what a union was, and I was afraid to go to a union meeting because I didn't know anyone there. All I knew was jokes about Jimmy Hoffa. But I went anyway, and it was quite a revelation. I saw really strong women running the meeting and talking about important issues, so I was motivated to get involved. I was asked to do some lobbying at the legislature and getting nurses to testify before committees. I found out I liked doing that. At that time we were working on legislation to make it a felony to assault a health care worker, and we got it through.

I was asked to work full time for SEIU 1199, the main nurses' union in the state. I was the nurse organizer for all of the state employees--folks that worked at Western and Eastern State Hospitals, and at the Rainier school for the developmentally disabled, Fircrest. I was negotiating contracts with the head of DSHS."People need to get it that everyone needs to be covered." Some of the work was frustrating, because it seemed that the people making decisions didn't understand what happens at the bedside, where care is delivered. It's important that nurses be trusted in regard to treatment, which is a form of patient advocacy--doing what's best for patients. We weren't always seen that way, or understood. Some thought we were just working for our own self-interest, promoting better wages and benefits. It's true that we need employees who are satisfied with their work conditions if we want good care. The two things go hand in hand.

Working for the union as an advocate for health care, I got to know my representatives in the state legislature. One of them was rude to me, and very patronizing toward women. Once I was having a discussion with him, and when we disagreed, he told me "That's not what you really think," as if he was patting me on the head. So I went home and told my husband: "I'm gonna run." He thought I was crazy, and it definitely wasn't like me because I'm personally conservative. I had to look at the internet to decide which party I was going to join, which one I could live with. I picked the Democratic side because I liked their platform. I began meeting with people that I knew in politics, and they said "Go for it," so I ran in 2000.

Here I was, a naïve candidate, never having run for public office, and I was up against a four-time incumbent. I lost. But I did pretty well: 48.3% against an incumbent. I decided to run again in 2004, and this time there was a vacant seat. I was tired of complaining about things that were wrong, so I did something about it. I ran again and I won.

What some people don't get is that everyone needs care. We're all patients. Health care is about meeting people where they're at and giving them the resources they need to maintain the highest level of wellness they can. We need to get everyone covered! Everyone needs to have a home, a medical home, where they can go to get preventative care and when they have medical problems. I don't think everyone understands the stress of not having health insurance. People need to get it: everyone needs to be covered.

Nurses have a unique role in advocating for patients. Survey after survey has shown that nursing and fire fighting are the most trusted professions. People trust nurses because they've had a nurturing experience with a nurse when they were vulnerable. I remember when I was 12 years old and had surgery on my feet. I was very afraid, but somehow the nurses made me feel better. They explained everything and reassured me. To me they were like guardian angels.

In high school I wrote a report on Florence Nightingale. I was amazed that was born into an aristocratic family, and yet she wanted to work in hospitals. It wasn't easy. When she tried to help the doctors, they told her to get out of their way. But things started changing gradually, like doctors learning the importance of washing their hands, and pretty soon there was a new profession: nursing. I'm inspired by strong women like Florence Nightingale.. My nursing instructors in college were all strong women. I liked how they spoke their mind, but in a kind way. I used their example. I can think of several situations where I trusted myself, spoke up, and actually saved a patient's life.

Another thing I've learned is that good nursing takes a person who has an deep awareness of her self. To help other people you sometimes have to check your own emotions at the door. I've taken care of sex offenders, murderers, people I just didn't like. I had to say to myself, "This is a human being who needs to be treated with respect and dignity, just like anyone else."

I'm convinced that nursing doesn't stop at the bedside, and that's why I've done so much advocacy work through the union and in the legislature. As nurses we have a responsibility to move the profession forward, as my nurse instructors always told me. And a big piece of that, to me, is educating society about health care, and what is needed to make the system work for people. Right now we have eight nurses in our state legislature. I think we're making a difference. Obviously, we need a national solution for health care, but we have to do what we can in the meantime. It's a great big puzzle, and we're fitting pieces in wherever we can.

Power Strategies: Influence, Achievement, Community
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Rosalind - A New Wrinkle in Nursing

Rosalind -







I told my counselor in high school, “I want to be a nurse.” She said, “Oh, you’re much too smart to be a nurse. You should be a teacher.” At the time I thought, “So do we want stupid nurses?” This made no sense to me. Teacher’s mistakes cause bad grades, nurse’s mistakes can cause people to die.

I was not deterred. I was accepted into both a university nursing program and a three-year nursing school. I chose the nursing school because that was what I always wanted to do. I had read books about dorm life and tunnels at the nursing schools, and I wanted to experience those things.

My education consisted of two days of class work and three days on a hospital floor every week, beginning in the second semester. During my senior year I was able to work as a charge nurse on night shift, and I worked for pay on the weekends and in the summer. So when I got out of school, the patient care experience I had during nursing school allowed me to go immediately to work as a charge nurse.

I’ve felt divinely guided to be a nurse. Nursing is what I’m intended to do. I know this because there were two times when I was going to drop out of school because I didn’t have money to pay for it. I ended up getting scholarships that I didn’t even apply for. In one instance, someone else applied for a scholarship for me. Another time, a lady who had died six months before I ran out of funds had set up a loan fund for student nurses who were in financial need. I was able to take advantage of those funds at just the right time.

I feel I’m gifted as a nurse because there are times when I walk into a patient’s room and I see things that aren’t physically there. Sometimes I see the hurt that’s underneath the pain. Sometimes I see things before anyone else does. I’m able to deal with difficult patients when everyone else throws up their hands and says, “I’m not dealing with them any more.”"You can't get rid of the wrinkles, but you can give fresh wrinkles." My gift for nursing allows me to critically think with very little information. I have a medical intuition. I don’t think it’s something that can be taught. One day I had a patient who was going down quickly. I called the doctor, but I was a float and the doctor didn’t know to trust my judgment. I was finally able to get a surgeon in and the patient’s life was saved. He had a leaking aneurysm – it didn’t rupture all at once, but if it had continued the way it was going, he would have died. One of the nurses asked, “What did you see?” I told her I didn’t exactly know. There was a subtle change in his color. There was a subtle change in his blood pressure. I had a strong feeling there was something very wrong. Good nurses intuitively critically think.

I have been a bedside nurse for 37 years, and I’ve always felt this is where God wants me to be. I tried being an assistant nurse manager and I worked for three years with the information technology unit developing an online documentation system. But my passion is bedside nursing so I returned to my purpose.

Nursing is difficult some days. It’s hard for me to watch patients refuse to take care of themselves and return again and again with the same problem. It’s also hard when someone is suffering and I can’t fix their pain. Whether it’s the patient or their family, there are times I can’t take the hurt away. I can only make them as comfortable as possible. Many times I sit with families and cry because there’s nothing else to do to comfort them. Nurse educators tell us we have to detach ourselves; we can’t be emotionally involved. I say they are wrong. I can attach long enough to care and provide comfort, and I don’t let it interfere with my ability to help the next person. Maybe crying with them is the best I can do.

There are nurses who talk about burnout, and you would think a person with 37 years in nursing might experience burnout. But it’s never happened to me. I think it’s because I don’t provide nursing care with my own strength. I do it by the strength of God. When I go to work in the morning, I pray, “God, use me today to be Your hands and Your feet and Your mouth to serve those people that I am privileged to serve today.”

Sure, there are days when I’m frustrated by a patient who is non-compliant or a family member who has been unreasonable. When I feel frustration, I go home and vent to my husband. He used to be a paramedic, so he understands what I’m talking about. He has learned not to try to solve the problem; just to listen to me. I vent, then I go back to God and say, “God, You care about these people more than I do. Give me Your love for them because I have to go back and see them tomorrow and I don’t have any love left.” And somehow, He gives me that love and I’m able to care for those people the next day. Most days when I go home, I feel like I’ve had an impact on somebody. It may be another nurse that I’ve inspired to care for herself by encouraging her to take her lunch break. Or it may be a patient or a visitor that I touched in some way.

I don’t get to mentor young nurses much because I float to different areas of the hospital but if I did I wound congratulate them on their graduation and in the same breath remind them they don’t know everything, and they never will. I’d tell them to be humble, be willing to ask questions when they don’t know what to do. I’ve been a nurse a very long time, and I still ask a lot of questions because there’s always something new I don’t fully understand.

I would also advise them to be ready to dive in and do something they’ve never done. Be the first to say, “Hey, I’ll help. I’ll do it.” Because that is the only way you’re really going to learn.

And finally, I would tell them not to take to heart the criticism that they might receive. Don’t take criticism to heart, but do take your job to heart. I might also tell them to look at their patients as someone that God has put in their path today to help in some way, and the help may be nothing more than giving them fresh wrinkles or a cup of cold water. You can’t get rid of the wrinkles, but you can give fresh wrinkles.

Fresh wrinkles can also get the patient to laugh. I will go into a patient’s room and say, “I want to get you up, because it’s good for you, and while you’re up I’ll change your bed and give you fresh wrinkles.” The wrinkles are the wrinkles in their bed – not their bodies! When the patient laughs, especially after surgery, they breathe deeper. The laughter releases endorphins, which promotes healing. Healing, whether emotionally or physically, is what I feel I’m called to do.

Power Strategies: Faith, Intuition, Humor
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Debra - You have to Respect Yourself for Others to Respect You

Debra -







I grew up around nurses because my parents owned a nursing home. Nursing has always intrigued and fascinated me, but I never thought I had what it took to be a nurse. So I got a bachelor’s degree in international business with the goal to take healthcare reform into the former Soviet Union. I discovered shortly after graduation that I didn’t like working in business. So I went back to work for my parents and got my associate’s degree in nursing. A consultant who came to work with my family’s business saw potential in me. She helped strengthen my resolve to follow my chosen path and succeed.

I’ve decided there are two kinds of nurses. There are nurses who perform the job and are talented and quite capable of the job, and to them, it’s a job. Then there are nurses who are passionate about nursing; driven to do it. Sometimes they have tried other directions in their life and are redirected to nursing because they discover that is what they are supposed to do. My passion is nursing because I want to make everything all right for the patient. I do it with my family and my friends. I’m a helper and I want to fix things. I’m learning not to sacrifice myself and my time because I do love to help someone else so much.

What I have really discovered is that I want to be a nurse and a business woman at the same time. I am excited because my current job pulls on both sets of skills. I am drawn to it and I could dedicate every minute of every day to work. I’m learning boundaries. Even though I thoroughly enjoy my job, I have a young family so I put limits on the time I spend at work. If I don’t prioritize, I will just keep giving if I don’t have a system for cutting it off.

So, each day I write down my agenda, I’m vigilant about following it, and when it’s time to end my work day, I make sure I’m finished. This new system has worked out well and has made my life, and my family’s life, much better. In the last six months, since I started putting my family first, I am a much happier, complete person.

I’m blessed with a husband who believes in me, stands behind me and helps me see my real potential. My parents also help me see that I can do anything I want to do.."I don't ever want to settle in my career. I want to continually better myself." With their support and encouragement, I have proven myself in nursing, and I respect myself as a nurse. I work in an outpatient heart failure clinic and I have to be strong and confident for the patients. I have to be convincing with the patients to get them to do what they need to do for their quality of life. I’m the first to advocate for my patients, to stand up and say they need reduced cost medications or to get them into therapy treatments.

I’ve also established good relationships with most of the cardiologist so I’m able to tell them what I think the patient needs. My confidence in myself gains me respect and trust from the people around me.

I often enliven myself by listening to the song, Somewhere Over The Rainbow. I think, if bluebirds can fly over the rainbow, why can’t I? It gives me my power boost and gets me refocused. It regenerates my spirit and helps my fire burn inside.

I haven’t even made it halfway over my rainbow. I’m in a management position at 34 years old, and it’s only the beginning. I’ve got so many more things to do in my nursing life and in my personal life. I finally believe in myself. I don’t ever want to settle in my career. I want to continue to better myself. One of my college instructors inspired me to be the nurse I am today. She continually challenges herself, even though she is nearing retirement. She didn’t expect perfection from her students, but she did expect our best effort. She also didn’t expect anything she wasn’t willing to give herself. If I’m being honest, articulate and knowledgeable in what I do, then I’m being just like her, and I’m happy with that.


Power Strategies: Determination, Confidence, Advancement
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Dianna - Embrace the Change

Dianna -







Recently, I celebrated my 40th nursing reunion. It was absolutely wonderful. I started my diploma nursing program when I was barely eighteen, and graduated just a few weeks after my twenty-first birthday … I was so very young. And even though it has been forty years and many of us hadn’t seen each other at all in that time, we’re still good friends. After all those years!

One of my first jobs was at a dialysis center. This was back in the days before Medicare, so not everybody who needed dialysis was able to get it. There was a committee of physicians and community people who decided whether or not people would be accepted for dialysis. They essentially decided who lived and who died. I remember thinking, “Well, if you’re young and have a family, do you live? If you were a successful businessman, do you live?” Besides being confronted with the inequity of the situation, it I gained a lot of experience in dealing with patients who were dying, and extending myself to those patients and their families. Love and compassion are important for me.

I really am a people person, and I believe we must treat each other with love and respect. Hands-on caring is really important to me and I’ve always exhibited that, whether I’m working with staff or patients or administrators. But over the years, I’ve observed that love and respect doesn’t necessarily get extended by nurses to nurses. We tend to eat our young. As a new nurse you have to be strong, and you have to be really good at what you do. I always felt so successful and qualified in everything I did. But we really didn’t think that we should admit to needing help. We all had friends who helped us, and I had family that was supportive but we really didn’t expect that support at work, from our superiors.

There has been a lot of personal tragedy in my life. I lost a sister to breast cancer, and both my parents died as well. I went through a divorce, was downsized from my job, and later was diagnosed with breast cancer myself. As difficult as those experiences have been, some of them also presented me with opportunities. After going through treatment for cancer, I had the chance to attend a hospice conference on therapeutic touch. This is a type of energy work developed by a nurse in the 1970s. It’s all about healing and caring, and love and compassion for people, so it got back to that love and compassion I cherished when I started my nursing career. I decided to get a graduate certificate in Spirituality, Health and Medicine. It has really opened my mind to look at medicine in a very different, non-conventional way.

We’re pressured for time and the patients’ needs are urgent and therefore it is easy for nurses to forget about taking care of themselves and in some situations, even discouraged from taking care of ourselves. I was guilty of this and I consider myself one of the worst self-neglectors, the absolute worst. I didn’t take care of myself at all. I considered myself Super Woman – I could handle my sister dying, my parents illnesses and deaths, working full-time at a very demanding job, volunteering, church activities. I was convinced that I was Super Woman and could do it, I didn’t really realize that I believed I didn’t have a choice. It took time to realize that I really needed to take care of myself and so does every nurse.

Creating a healing environment for staff, wherever you work, is something to which I’m really committed. You treat people with dignity and respect; you’re honest and you deal with conflict openly and directly – deal with issues, not people. Behaviors may have to change, but that doesn’t make someone a good or bad person."The health care system is broken. That's not going to get fixed right away, so what do we do in the meantime? We can take care of each other." From there, you move on to caring competencies, which is where you develop a self-care plan that includes looking at spiritual, mental and social needs. I’ve given my staff an opportunity to create self-care plans. This is something I feel is important, because one year I had five nurses going through divorce at the same time. On the one hand, you can say keep it at home. But that’s silly. We’re a family at work; you can’t solve people’s problems but you can be sensitive. I’d much rather spend my time with my staff, listening to their stories and letting them be involved in decisions than sitting across the table with a grievance and the union.

You’re going to have to listen to people, but it’s not as easy as it sounds. Many people think it’s too touchy-feely. They don’t want to go there. There are a lot of pressures in health care, I’m not going to deny that. Being sensitive towards and taking time to be respectful of people and their lives is a priority at the bottom of the barrel. But think about it, it can’t be if you’re going to recruit and retain staff, you want them to have a supportive environment.

Administrators don’t want to pay for the training – that’s just crazy because we’re going to have to in order to have a healthy, educated nursing profession. The health care system is broken and it’s not going to get fixed right away, so what do we do in the meantime? We can take care of each other and do it better than we’ve done it in the past. When I think back, I have to admit I was an incredible workaholic. It’s just unbelievable when I think about it. I don’t even know how I did it. But I had to; it was part of my life.

Nursing is changing and new nurses don’t know the difference. We long-timers need to get over it and embrace the change. Find ways to take care of yourself, and be somewhat assertive in saying what you need. If you do, the patients will be cared for and nursing will thrive. With all the technology, nursing has to change. We must embrace the changes, because there’s not enough nurses. We need a way for nurses to take care of themselves and show that care to the patient – the caring aspect of why we are nurses.

Power Strategies: Empathy, Respect, Achievement
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Janet - I'm Happy I Decided to Continue Nursing

Janet -







My grandmother was a nurse in World War I and she told me her stories when I was young. I was in awe of the work she did. She graduated from nursing school in 1950 and immediately joined the Red Cross. She was sent to France where she nursed “her boys.” They didn’t have many nursing supplies to work with back then. I don’t even think they had penicillin; they used quinine and aspirin. Thank goodness for all the changes in science and technology – because in her day she used maggots to clean wounds!

She bequeathed her nursing pin and her bandage sheers to me and those precious items, along with a few black and white pictures of her and her boys, were my inspiration to become a nurse. Those gifts from my grandma are my most treasured, precious things I own. I’m a nurse because of Granny.

Now I have my own stories to tell, sans the maggots. One of my best nursing memories is of the time I helped a neighbor woman deliver a baby at home. Her husband ran over to my house yelling, “Come quick, she’s having the baby right now!” He had called 911, but the baby would not wait. I didn’t have to help much. I just held the baby’s head and turned the shoulders a little bit. Witnessing the birth of their baby and calming them down while they waited affirmed me as a caring nurse. I was proud to do my part.

The most emotionally difficult time I had providing care was to the mother of a patient who was dying of AIDS. He was there for a long time and she was with him every day. She stayed in the room and we talked while I was caring for him and I got to know both of them very well. One day it became clear to me that he was going to die on my shift. His mom was distraught and beside herself with grief. I comforted her as best I could and I encouraged her to get in bed with him and hold him. It seemed like the healing thing to do for both of them. After he died, she wrote me a beautiful letter. I still cry when I think of them.

I took some time off between 1999 and 2001. I was burned out, and diagnosed with cancer. During my recovery, I reflected on whether I wanted to return to nursing or try something else."I care for new nurses so they maintain their compassion to provide quality care to the patients." In the end, I decided to continue my nursing career. My calling is to help people. I’m very caring and nurturing and I’ve always known how important it is to me to choose a field where my longing to nurture would be used. Nursing is a natural fit for me. So, I decided to focus on outpatient recovery when I returned because the hours give me time to enjoy my life outside of work. I’m happy I decided to continue nursing.

While I was on leave, I realized the act of nursing is what makes me feel good as a person, and that’s why I do it. I help someone and they appreciate it. I like to do follow-up phone calls after patients have surgery and go home and I feel good when the patient remembers me. I even have patients write letters to my managers saying beautiful, lovely things about me and it’s very heartwarming.

While on leave I was finally able to stop long enough to ask myself why a nurturing person like me would feel so burned out. I inventoried what I didn’t like about my situation and I realized the reasons were the politics of the organization, not feeling professionally respected by the doctors and the administration, and because some co-workers would backstab and be mean to each other. I decided I want to work with people who believe we need to stand up for ourselves and each other. I returned to work with this new resolve and in my new job I found that the culture was different, and I now work with an encouraging and supportive team.

People shouldn’t go into nursing unless they are compassionate and want to support patients and their loved ones through tough times. I deal with life and death issues daily, and if I can’t provide encouragement and nurture the patient, then I shouldn’t be a nurse. I also like to take new nurses under my wing, because I had caring nurses who did that for me. I want to educate them and show them how to do things the right way, instead of making them struggle to figure things out for themselves. I care for new nurses so they maintain their compassion to provide quality care to the patients. If we can’t nurture our own, how can we expect them to be positive, feel good about their work and remain capable of caring for the patients?

Power Strategies: Clarity, Compassion, Excellence
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Dawn - Changing Careers at the Age of 50

Dawn -







My education is in finance, and it took me 15 years to get my degree. Ever since I graduated from college, I have worked for the Division of Child Support for the State of Washington as a support enforcement officer. Nobody ever says, “When I grow up, I want to be a support enforcement officer,” but it’s really a great job and I’ve enjoyed it every step of the way. Why would I leave it? I have simply decided that I want to become a nurse.

My grandmother was a nurse. She was in her 50s, when she became an LPN. She was able to meet the challenges of learning new skills and beginning her nursing career in her middle age, so I’m sure I can do the same.

I’ve always been interested in medicine. When I was in high school I was a candy striper. But, I didn’t like being around sick people, so I decided not to pursue a medical education at that time. As I’ve matured and have raised my children, I’ve developed more empathy. Also, a few life circumstances have helped lead me to the decision to become a nurse.

First, my nephew was born with about seven massive heart defects. While he was in cardio intensive care he had one-on-one nursing."Where there's life, there's hope." I worried he would die because he was so sick. I was so impressed with the nursing staff that took care of him around the clock while he was in the hospital. I was struck by the fact that you can’t give up; where there’s life, there’s hope. He survived all that and now he’s 19.

Time went on, and I continued to search for what I wanted to do when I grew up. I wasn’t sure I was in the right profession, even though I really liked my job. One day I was reading an article about a set of triplets from Africa being adopted by a couple in Chicago. The story talked about a nurse who had cared for the babies in the orphanage and how she saved their lives during a natural disaster. I had a strong visceral reaction to that story and there was a voice in my head telling me to be a nurse. So I’m finally listening!

In my current job, people tell me they believe I’m meant for greater things and expect me to move to higher leadership roles. There are few people who know my current plans, and I think they’ll be shocked when I tell them, “I’m going to go to nursing school.”

I’ve already begun to take the prerequisites to enter nursing school and with each course, I feel more certain that I am doing the right thing. Although the courses have been hard, I’m never discouraged. The more I talk with other nurses or talk with the college advisors, the more I know that I really, really want to be a nurse. Nurses say being in my 50s is not an issue.

I plan to get my RN degree so I can work directly with patients. I really love babies, so I would like to go into pediatric nursing. I hadn’t thought about being a surgical nurse until I had a surgery myself, and now I think I could go into surgery as well. I’m pretty open to where my interests might lead me and where the need might be the greatest.

I believe the skills I have developed in my current job will apply in nursing. I am committed to finding resources for my current clients at Support Enforcement, who are facing seemingly insurmountable life problems. They may have issues I can’t do anything about, but I always try to help point them in the right direction where they can get some help. I just can’t stand the thought of brushing somebody off – there are plenty of people who will do that. As a nurse, I will be a deep well of resource for my patients and will help them in every way I can.

Another parallel between the work I do now and the work I foresee for myself in nursing is that my clients in the child support system, especially when they first come in, are usually in emotional distress because their partner just left or they’re in the middle of a divorce and they have to deal with this ugly thing called child support. I have to be able to understand people who are emotional wrecks and I need to not pass judgment. I know nurses must do this as well. One thing I’ve learned is there is always another side to the story. I’ll listen to whatever a person is telling me, and I know for that person it is true, but I’m kind of like Paul Harvey…I’ll wait for the rest of the story.

I can’t wait to experience the rest of my story. I feel a call to nursing in my heart, and I’m excited to continue my new journey.

Postscript: On September 9, 2006, Dawn sent the following message:

Dear Terry - I was accepted into the Nursing Program at Pierce College Puyallup and will start in January 2007. I’m very excited - this is the beginning of a whole new chapter to my life. Thank you so much for your support and for the opportunity, as coincidental as it was, to talk with you and Terry Kluh. It helped when it came time to write my personal statement for the application.

Power Strategies: Achievement, Passion, Making a Difference
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Terry - Make a Difference...with Dignity, Kindness, Respect, and All of My Heart and Soul

Terry -







Recently a manager position opened at the hospital and many people assumed I would apply for it because I’m branching out within the organization. I’ve been charge nursing and have joined some committees that are more management focused. There is a part of me that likes all that, but I’m not really interested in management because I would have to leave my true calling; patient care.

I don’t want to be in an office answering emails and acting as a go-between for administration and nurses. I really admire people who do it, but in 26 years my reasons for choosing nursing haven’t changed. Working with patients is extremely satisfying. The patients inspire me to be the nurse I am. They are really the only reason I’m here.

I feel I’m successful when I make a"The patients inspire me to be the nurse I am. They are really the only reason I'm here." difference each day in some small way and do it with dignity, kindness, respect, and all of my heart and soul. My priority is the person I’m caring for and I make sure they get quality and safe care, with a smile. Anybody can put in an IV, but a successful nurse makes the patient feel cared for while they’re doing it.

I’ve worked with cynical, burned out nurses. It’s unfortunate they have become that way. I think it happens because of politics and personalities – things can get very interesting, especially when you have groups of women working together. So many of them are trying to find power, but there is a vast difference between true power and ego power. Ego power is destructive. True power blossoms and grows everybody around you.

I try to conquer the ego powers with acceptance and kindness. I’ve been called a Pollyanna, and I’ve decided I can live with that. It’s challenging to take a positive attitude when I encounter people who want to hurt me, but it’s also helped me grow personally. I think my response has earned me respect. They leave me alone because they can’t drag me down.

I wasn’t able to respond with kindness when I was young and new to nursing. I was more vulnerable and, you know, nurses really do eat their young. I would like to see that change. It’s better than it was, but it seems to be fear based. Experienced nurses think someone fresh out of school won’t give the patients quality care and truly new nurses need to earn their trust. But, I have a different way to help them feel confident.

I like to take new nurses under my wing; embrace them and let them know they can look to me for guidance. I say, “I’m here for you. You come to me and I will help you. Ask me any question you can think of.”

I remember how it was when I started nursing, so I want to help new nurses experience a positive beginning. I was scared when I started my first job, but I didn’t let it show. I acted competent, and that got me through. I think all new nurses are in the same boat. It takes time to work through the orientation phase and trust yourself to really know what you’re doing. You’re faced with something new all the time. New nurses worry what people might think less of them if they say “I don’t know how to do this.” To this day, I’m not afraid to ask questions of anyone or say “I need your help” or “I don’t know how to do that.” Nobody ever knows everything, all of us are continually learning.

I personally found it difficult to show up for my patients when I was facing a personal crisis. It was so overwhelming I could hardly see myself, but I still stood by the patient and said, “Hi, my name’s Terry and I’m going to be your nurse today.” Inside, I was thinking, “I’m about ready to die, but you go ahead, tell me everything.” I got through that personal challenge and now can better empathize with my co-workers because I know first hand what a challenge it is for nurses, and all care providers, to contain their personal lives and reactions and put their focus on the patient.

Nursing lights my heart when I hear thanks from patients. Occasionally a doctor will tell me I do a good job, and that can make my day, too, it’s just a small expression of appreciation, but it affirms my work. Because I know how well I respond, I try to pass those feelings on. I honor the people who pick up the trash and the laundry. I also honor our CNAs and secretaries. I can’t do my job without those people. I honor them and thank them and respect them and I’m glad they show up to do their jobs. I have to remember I’m not standing here alone and everyone needs to work as a team to get the job done. I’m grateful to be a part of the nursing profession, there are so many people I appreciate who have helped me along the way.

Power Strategies: Compassion, Dignity, Honor
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Nursing is Nourishing - A Serendipitous and Heartfelt Conversation

Dawn and Terry

“Terry was early and Dawn stayed late. This was an opportunity for a conversation between a nurse with 26 years of experience and a woman who just decided to enter into a nursing career. They talked about their thoughts, fears, and challenges. Dawn is the woman who just decided to change her career to nursing and had just applied to nursing school. Terry is the experienced nurse.” – Terry Taylor

Dawn:  I have a question about your feelings and observing people in pain; even being confronted with death.  How do you allow yourself to feel enough so you have that sense of being compassionate and empathetic without taking everything on and letting all of the grief and sadness wear you down?

Terry:  I believe it is a skill you develop after you’ve experienced it a few times.  Often, when someone does have a terrible experience and there is a death, there will be a debriefing with the people that were involved and you can get some support.  You might say, “This one’s just doing me in. I’m really having a hard time dealing with it and I got connected with this family and this patient and it’s almost like my own father has just died.”  

I see it as a chance to grow personally.  I have to realize that people who are going through tragedy need someone and, as an outside person, I can see the situation more clearly than those in the middle of it.  I have come to realize that this is what I do and what I do helps people.  Some stories will linger longer than others and when you feel sad you just have to work through it.  You will find that a lot of your co-workers will listen and help you with your own grief, and then you have to let it go.

Dawn:  I never really pictured the fact that you aren’t doing this alone.  Of course there are people around you experiencing the same circumstance.

Terry:  You’re never alone.  That’s one of the best things about nursing.  When I started working I felt a tremendous amount of responsibility to do everything well and right.  But even to this day I can go to one of my co-workers and say, “You know what? I need you.  Can you come help me with this?”

Dawn:  With all the sorrow and grief and trials and tribulations, how do you take care of yourself?

Terry:   I get burned out sometimes, and I get tired.  But there are a couple of things I do on a regular basis.  I try to get enough sleep and I take a nap every day when I get home from work.  I really guard that nap - it’s precious.  There are days when it doesn’t happen but they are few and far between.  I work 5:30 to 2:00 and then I go home and rest.  Some days when I wake up, I read.  I might read a spiritual book or some other book I’m enjoying.  I try to eat right and exercise and stay strong and be healthy.  I also try to keep things in perspective.  It’s easy to let a bad attitude take over, but that will destroy everything and make you miserable.

I have realized that I have an opportunity to touch lives in a really significant way and that a patient might walk away and have his or her life be different because of a moment they experienced while in my care.  I like that feeling – it’s very healing for me.

Nursing is nourishing.  There is taking care of other people and then there’s giving something to another person that just comes through you.  That kind of giving is above and beyond your knowledge.

Dawn:  In the body chakra system, the heart energy is transmitted through the hands.  So when you’re holding somebody’s arm and you’re touching them like that, your heart energy and their heart energy are connecting. Is it like that?

Terry:  Nursing is something that really has to come from your heart or you’re wasting your time.  I had a patient tell me the other day, “I just feel better that you were here with me today.  There are nurses and then there are nurses.  Some nurses really shouldn’t be nurses, and thank you.”

Dawn:  What would you tell somebody who, at almost age 50, is about to go to nursing school?  What is the most important piece of advice you would give?

Terry:  I would definitely say, do it.  I think you’ve got a lot of years left and there are so many areas where you can apply your nursing knowledge even if you’re not physically able to work with patients in a clinical setting.   There is such a need for nurses right now.  Your life experiences will be very beneficial.  There are things you will bring to nursing those young nurses fresh out of college haven’t developed yet.

Dawn:  Am I crazy for making this change?

Terry:  No, I really don’t think so.  I’ve seen other nurses around your age come right in and advance in their career very quickly.  You sound clear that you want to do this.  You may even find out down the road that what you are doing in your current job and the nursing will mesh at some point.  They’re always looking for depth in nurses to do bigger things and move on.  When you take experience like yours and then add the nursing, you become more valuable.

Working directly with patients is really the best way to understand the profession.  Then wherever else you go you will be able to reflect back on the basics of nursing.  The basic include an understanding of what it takes to care for people and how to make connections with people you don’t know in a very short period of time.  To let them know “I’m just here for you and we’re here to deal with what you’re going through right now.”  It’s also about understanding the pressures that nurses are up against with safety, quality, and accuracy.

Nurses need to be able to assess how much the patient wants to be connected.  Some patients are not interested in having you be involved in their life in any way.

Your assessment starts immediately when you meet someone, usually through the hellos and how are you and what’s the most important thing I can do for you today?  Those questions aren’t too personal, but still you’re getting something.  By asking a few questions I can find out if they need me to leave them alone or if they need me to make sure they are never alone.  Do they want their family involved or do they want me to buffer them from the family.  Being able to connect at a level that makes the patient comfortable, and helping the patient with whatever they want and need, renews my spirit.  When I leave work, sometimes I’m physically and emotionally drained from the day, but I also have a feeling of satisfaction that, I’ve made a difference, I got paid for it, and I did a good job.  That’s a good feeling.

I wish you all the best in your new career.
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Martha - Generate Knowledge for Nurses to Use

Martha -







My main focus has been on doing research. I had a master’s degree and was teaching beginning nurses, but I realized if I wished to stay teaching and doing research that I needed a Ph.D. Although my title is “Dr,” I am very proud of my RN designation.

I’ve always loved sciences. Nursing is mentioned as a caring profession, but it also is one that requires a great deal of background knowledge in scientific bases. What keeps people alive is not only that you care about them, but that you are capable of caring for their physiology.

When I worked bedside, I enjoyed my colleagues. I thought the unit I worked on was the best. My colleagues, though, used to tease me because I was forever trying to figure out how things work."You're going to have a lot of responsibility, but you're also going to have a lot of opportunities. Look for those oppportunities." Being terribly curious about how things interact, research is a good fit for me. If there’s anything I would have done differently, it’s that I would have gotten where I am a lot faster. Having a longer opportunity to be a scientist would have been better. Right now when we talk to some of our very bright, capable undergraduates, we should be saying to them, “Think about continuing on to get your Ph.D. right away.” We need people in for the long term, committed to their careers, generating knowledge for nurses to use. Too many of us get our masters and Ph.Ds late in our careers, when we’re already much older.

As a nurse, I am committed to advancing the knowledge of my field. I have done a lot of clinical work, and I realize there is so much we don’t know about how best to help people.

Whether you work in a hospital or a university, there’s going to be a power differential within the profession. It’s a result of the bureaucratic structure. There are people who have the responsibility for seeing that things happen, and to do that you need to have power. So if you’re a staff nurse, the supervisor has a responsibility for other things, so you might be asked to float to another unit, without an option of saying no. You can find that horribly stifling, or you can recognize it as a function of a complex organization trying to deliver care. I’ve chosen to be more focused on the latter.

With regards to the current state of our health care system, it feels like the opening line of a Charles Dickens novel. This is the best of times, and the worst of times. There are so many places to get very good care, but getting to the care is the hard part. I think we as nurses understate the difference we make. We should be able to say to patients, “You know, you’re in a hospital, and the fact that you’re going to get through the next 24 hours is because there’s going be nurses with you.” We need to speak up and be heard.

New nurses should know that their careers can be fun. I’d tell them, “You’re going to have a lot of responsibility, but you’re also going have a lot of opportunities throughout your career. Look for those opportunities.”

We experienced nurses need to greet them warmly and use the enthusiasm the newbies bring - appreciate the knowledge that they bring, help them out when necessary, and don’t scare them away with horror stories right off the bat.

Nurses who are maybe experiencing some burnout should support themselves by pivoting to a fresh place. It seems nurses wanting to change professions need something new and fresh. They don’t necessarily need to leave nursing. There are lots of other things to do and places to go. They’re bright. They’re capable. It really fills you with hope for the future of nursing just to know the kind of capable people that are out there.

Power Strategies: Intellect, Legacy, Achievement
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Ekene "Kennie" - Come to Work Happy and Ready to Help

Ekene “Kennie” -







My mother was one of the first nurses in her village in Nigeria. She was a wonderful caregiver. Everybody in the village wanted to be at home with my mother. When you were sick, she was the one to whom people were sent. Just thinking about her made me want to take care of people, and that’s what really drove me to become a nurse myself.

Currently, I’m a nurse manager at a veteran’s hospital. I’ve also worked bedside, in nursing homes and in a trauma center. My job gives me a voice with doctors and administration in the decisions being made about patient’s lives. I can make sure that patients are well cared for, things are done correctly, and my staff are doing their best to help the patients.

When you love what you do, it will show. You don’t need to broadcast it. When you are very caring and you love nursing, your patients will speak for you. People will come to you and say, “Thank you.” Come to work happy and ready to help. Nursing is all about helping, and the person you’re helping today might be the one who will speak up for you tomorrow. Soon you will find that that your boss might call you and seek your input. You’ll be surprised, but it’ll be because of your reputation.

I always tell nurses to remember they are licensed. There have been times when nurses have been credited for avoiding major errors. Doctors work really hard, some of them work 48 hours at a time without sleep, they’re only human beings. They’re bound to make mistakes. Nurses are trained to pick up on those mistakes and are trained to know what is right.

One of my roles is that of mentor to nursing students. The best moments of my life – other than the births of my children – is when I attend their graduations. I’m usually the one who’s crying and saying, “Oh boy, she made it.”

I thrive when new nurses come up to me and actually question me. I like that better than people who go about without questioning anything – those are the people who scare me, because you cannot know everything. Some people get very aggravated by those who ask a lot of questions, but I say they are the people who want to do well. I tell my staff, “Please try to mentor this person to evolve into a very confident, caring, compassionate nurse.”

New nurses do get burned out. When I talk to them, I do what I call a reality check. I tell them what nursing is all about. That it’s not going be a cushy job. It’s not about sitting at the computer all the time. It’s not about meeting and marrying a doctor. It doesn’t work that way anymore. The reality is, people will need your attention from the time you start your shift until you leave.

People will suck everything you’ve got out of you. They will aggravate you. Some will love you more than you want be loved. Some will appreciate you, and some will not appreciate anything you do, even when you’ve tried your best. You have to be ready for that. Think about all of this, and then say to yourself, “Is this what I want to do for a living?” You’re ready to be a nurse if you answer yes to all those scenarios.

There will be times when you will doubt yourself. What am I doing? Why am I in this career? We’re doing more things that are not in our job descriptions, but we’re faced with an industry where a nurse is expected to do everything. That’s why people get burned out. But if you love and embrace this profession, you will do well.

People have to understand, you cannot pay a nurse enough for what they do. A lot of people say, “You guys make a lot of money,” but considering what nurses do, and what they sacrifice day after day, as soon as they step into that job arena, you cannot compensate them fully with the salary they make."The person you're helping todaymight e the one who will speak up for you tomorrow." I am a manager. I can mandate people to stay past their shift, and I have done that. The nurse who is a single mom, struggling on her own, whose babysitter is calling every five minutes, threatening her that she’s going to call social services if she doesn’t come and pick up her kids, I’ve asked that nurse to stay. She doesn’t have friends she can call on to help. She knows she needs this job, and here I am mandating her to work, because I don’t have any other choice. It hurts me, and my hands are tied, because I’ve exhausted pretty much every other option. Maybe I mandated the other person two days in a row, and now it’s her turn. I’ve gone into my office and cried, but I still have to do it, for the sake of safety, for the sake of the patients. You are focused on making sure the patient gets optimal care.

So don’t do it because of the money. Go into nursing because you have the heart, and you are compassionate and loving, and you want to do well. Don’t do it because your mom and dad told you to. Make sure it’s something you want to do, because they’re not going to be there to hold your hand each time. It’s not going to be their lives - it’s going to be yours.

My dream is to work for the United Nations someday. I currently have a small nonprofit organization called Caring Hearts International (www.caringheartsinternational.org). We’re in the process of trying to build a free medical clinic and women’s center in the village of Azaraegeblu, Nigeria. I do a lot of volunteer work, both here and in Nigeria. I’m very well known in Nigeria for the things that I do. I support a lot of hospitals there. I’ve been teaching HIV/AIDS prevention, so I take a lot of condoms every time I visit. The customs folks, they open my suitcase and say, “Oh, the condom lady’s here.” I’ve heard that so much that it doesn’t bother me anymore. Then of course they want some, which makes me feel good, and I also give them pamphlets about different things, such as how to watch their blood pressure. Those are the kinds of things that make me feel good. I’m not going to change the world, but on my own small scale, I’m doing the best I can.

Power Strategies: Excellence, Commitment, Love
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Linda - When God Closes a Door...

Linda -







I've had some difficult times in my career. I had been a nurse leader in a facility for almost 18 years when I lost my job. That was a hard thing for me, in part because I didn't realize how much of me was invested in my job, even though I was a mother and a wife too. Losing that identity for a while was a real eye-opener for me because I loved being a nurse leader. I was depressed for awhile.

The bright side was that it helped me see how much I truly loved being a nurse leader, and how much support I had. I heard from nurses and physicians in my organization who didn't want me to leave. I had the backing of my organization: the Northwest Organization of Nurse Executives. I was amazed at all the support I got. For example, the nurses in my facility made a memory book for me, where people could write their thoughts. A friend who read it said, "Most people have to die before they hear these things about themselves!"

It took me about four months to find another job, because my husband and I didn't want to move. One of the things that helped was a plaque a friend gave me, which I still have in my office. It says, "When God closes a door, he opens a window." I found out that there are wonderful people everywhere, and eventually I actually enjoyed the change. I met wonderful new people and learned exciting new things. Life keeps changing anyway, no matter what you do.

For instance, when I was a young nurse we knew we would have to work night shifts before we got assigned to day shifts. We had to dig in and work overtime and extra shifts before we could ask for anything different. Nowadays, the young people want to work when they want. Some of them ask for day shifts and time off as soon as they start the job. In some ways it's good that they're assertive. But in a hospital someone has to cover shifts around the clock.

Another change is the entry of immigrant nurses into the United States, because of the labor shortage here. A few years ago I went to the Philippines and arranged for 6 nurses to come to our facility to fill our staffing needs."One of the supreme roles of nursing is being a patient advocate." More than just being new nurses, they were new residents of our country, and in the beginning, they needed a little more attention, like all people who come to this country. Their needs opened up an opportunity for our community to welcome and share with them, even helping set up households by providing food and furniture, because they weren't able to bring much with them. It was remarkable to see how our community supported the new co-workers.

At first there was perhaps a bit of adjustment in our facility, but now the immigrant nurses are very well liked. In fact, they're inspiring, because they are hardworking and they're very good caregivers.

One of the things I've noticed is that the nurses from the Philippines are not quite as assertive as our nurses, but they learn to ask the right questions on behalf of the patients. That's a skill and it's one of the tough ones to learn. We're working with physicians who have many years of education, but sometimes we have to ask them the tough questions, even though we have less education. I think that's one of the supreme roles of nursing: being a patient advocate.

Some people try to define what nursing is; they say that it's a science-based profession. They think the care-giving part isn't important because they can't quantify it. But patients will remember the tender loving care they receive. To me, nursing is a truly heartfelt profession.

Power Strategies: Community, Influence, Devotion
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Mary - Credentialed to Make Changes

Mary -







As a child, nursing was already very much a part of my life. My mother was director of a convalescent center, and from the age of five I’d spend half the day in kindergarten and the other half with her. During that time I learned what a marvel the human body is, and developed an appreciation for the preciousness of life that has stayed with me through my career.

After several years of traditional nursing work, I went into nurse education, a field where I have found my passion. I believe strongly in the ways education can change lives. As a faculty member at a community college, I help place student nurses in their clinical rotations. Clinical placement is crucial for producing nurses.

It’s remarkable to reach out and touch people and see them change. Education transforms people. It’s a lesson I learned for myself, but I also gleaned pieces of it from my mother. As a health care provider, she encouraged many people into nursing, furthering their education and seeing their own potential. She reached out and actually touched people, and she made a difference.

Just like my mother, I visualize potential and care deeply for the students I guide. Everyone has a unique story, so they all come from different starting points. Some come as single mothers seeking only a two-year degree. Some are nurses wanting to get a master’s degree. Whatever their story, I see their potential and I push them. It helps them, the patient, and the community.

I think that any education, any learning, empowers people. There’s such a human component to nursing, but yet there’s also an intellectual component. When you mold it all together, you reach people in a way that few actually can or have the opportunity to do. In that way, I think you are credentialed – and obligated – to make changes.

Everything in nursing requires a team approach,"It's remarkable to reach out and touch people and to actually see people change because they are transformed. Education transforms people." and, it’s the camaraderie that actually drives everything, not the leadership. Probably no one has more fun or enjoys herself more than I do. That’s really the truth. But I’m very serious about nursing. I’m very serious when I communicate what nursing is and the responsibilities and the power that nurses are given in the clinical setting.

Nurses are often people with personal challenges in their own lives. It seems to give them a greater capacity to nurture. Even though the demands are huge and outstrip the compensation, they keep doing it, because it’s some kind of calling. It has to be. I can honestly say that you don’t see it in a physician. Often times there are physicians that go into medicine for altruistic reasons. But I think that there are equally as many that go in for the financial reward. Nurses just go in knowing that there is very little of that. That’s always been the situation, but they still do it.

Because of that, I have great hope for the future of nursing. I think that there still is that connection and I find that I really care about my students and they give a lot back to me. And I think that the patient gives a lot back, too. There is no other profession that comes so much from the inside. It’s very unique.

Power strategies: Influence, Leadership, Camaraderie
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Jane - Even before I was Nurse, I was a Nurse

Jane -







Who am I as a nurse? I’m an excellent nurse!  I grew up in a family of ten kids and I’m one of the oldest.  I was mothering and nursing from the time I was a preteen.  So it’s the essence of my being.   I’ve been a professional nurse for 33 years, so I’ve seen a lot of changes in the field.  I currently work in open heart surgery, but before that I worked in critical care.

When I started in nursing we had to wear white uniforms, hats and white nylons and white shoes."A latte, support hose, and the maturity to pace myself. That gives me strength!"  In 1976 when I moved from one hospital to another, I threw my hat in the garbage, figuratively and literally.  It was then that I learned nursing is not about what’s on your head, it’s what’s in your head.  When I first came out of nursing school, nurses were expected to do as they were told.  We were told not to try to figure things out, the physicians would do that.  

Now, nurses have increased knowledge and are a partner in the care of the patient.  The partnership is like a dance, everyone doing their own steps, but working and moving together.  That is very different from my early days in nursing, and it’s excellent to feel like you’re part of the team.  I feel respected for my knowledge and I feel nurses are starting to give respect to each other as well.

For many years, I went to work in the morning, worked all day and felt physically and emotionally drained by the end of my shift.  I would pick up a latte on the way home so I’d have energy to keep up with my young children.  Now I pace myself more, and I wear support hose!

A latte, support hose, and the maturity to pace myself.  That gives me strength!

Throughout my career I’ve seen a lot and I’ve changed a lot.  Who I am – my principles and my work ethic – that’s what drives me to excel as a nurse.  I bring quality and commitment to my job.  As a nurse, though, I’ve had to learn to compartmentalize.  

When I’m at work, I’m totally at work.  I’m completely there for the patients.  I show up.  I have learned to put all the steps together and work efficiently by forming good habits.  I learn to depend on my skills because they have become a habit.  When I’m off the clock, real life sets in.  

If I weren’t able to compartmentalize, I may not be able to put as much of myself into my career.  I think that happens with some nurses.  They have trouble compartmentalizing, and then they are not all there for their patients.

In my nursing career I had a wonderful mentor – my buddy Doris who is retired now.  I think everyone needs a mentor like Doris. She was fully committed to her patients.  I liked what I saw in her – her values.  She would always give me an honest answer and valuable feedback.  I felt comfortable with her.  I learned ways of dealing with both patients and colleagues through her.  If I needed to talk something out – bounce ideas off somebody, she was the one I would turn to.  I miss having that resource now that she is retired.

I’ve learned to treat patients the way I would want to be treated if I were a patient.  New nurses need to know - you have a job to do and with time you will be able to fit it all together and do it well.  You won’t be able to learn everything all at once, give it time .  Don’t do anything halfway – finish each job.  If you’re going to do it, do it right.  Find a mentor – everybody needs one.  Work as part of the team and be totally committed to each patient, and your career will reward you many times over.

Power Strategies:  Humor, Excellence, Focus
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Jan - The Blessing is the Privilege to Serve

Jan -







Burned out." "Depleted." That would describe me and most nurses from time-to-time. Some days after I'd given everything I had, I went home empty. Those days come and go, but there's another kind of burn-out, that has to do with boundaries. As a supervisor, or working in the education department, I would take work home in the evening and on the weekend. At one point I realized that even though I took the work home, I didn't do it. It just sat there.

That's a boundary issue. I thought I was the Lone Ranger, and if I didn't do it, it wouldn't get done. But I finally got it - the work will still be there. There's always something and I had to start thinking of myself and my health. I do the best I can given the time limits I have, then I go home and exercise, unwind, and do something for me.

I tell new nurses, "Figure out how to set limits for yourself. Recognize that the work will never be done and find a support network so you can hand off some of the responsibility." When I remember to remind myself, I'm fine. I can stop being the perfectionist and just do what I can.

Taking breaks is a life-saver for me. When I feel like my little basket is empty, and I'm physically and mentally exhausted, I need to get away.  Otherwise that emptiness can turn into depression.  I need a sizable chunk of time for my getaways, like two weeks. One day doesn't do it. For me, it takes five days to begin to unwind.

Change is a constant in this profession.  The new technology is great--all the advances with monitors and gadgets--but that makes it easier to ignore the patient, the human being. The machines can get in the way.

On the other hand, we have more opportunity to talk to the patients. We explain their plan of care. We tell them what will happen when they get home, how family members will be involved. In the past, we couldn't even tell them about their blood pressure. We'd say "You'll have to ask your doctor about that." Now patients have the right to know.

We also serve by being good listeners. I listen for the message beneath the surface and by watching body language.  A patient may be saying "I'm scared. I think I want to die, and I don't want to be alone."  I can sense that by his facial expression, or his gestures, or the way he looks out the window.

None of this came to me right away."There are moments beyond words, like just reaching out and touching someone's hand and seeing them smile. That's inspiration." It took years of experience, and classes, and the maturing process before I understood how to empathize with a patient. The time when I was a patient myself taught me more than anything. A few years ago I had an accident and crushed my elbow. As a nurse working with patients, I'd think "There now, we've put a cast on that fracture, and it'll be all better." But when it happened to me--that was an eye opener. I didn't really understand the pain, the fear, the change in life style--until I had that experience myself.

Serving people is my inspiration. The art of caring is the heart of nursing to me. Some days I may think to myself that I didn't accomplish anything. But when I tell another nurse "You did a great job with that" and see her face light up: that's my inspiration. And there are moments beyond words, like just reaching out and touching someone's hand, and seeing them smile. That's inspiration.

Power Strategies: Dignity, Resilience, Empathy
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Susan - I Created an Environment where Nurses Could Thrive

Susan -







When I was thinking about a career choice, I didn’t know if I wanted to be a mathematician or a nurse.  Because money for college was limited, my mom encouraged me to go to nursing school.  During graduate school, I became very interested in the women’s movement.  I was a strong activist and, along with some other nurses, we formed a group in the National Organization for Women called Nurses NOW.  We were convinced that many of the problems that faced nurses and the nursing profession were directly related to that fact that it is a profession comprised predominately of women.  We spoke out about these issues and were pretty open about our thoughts and feelings on the subject.  After I completed graduate school, it became clear to me that I would find it difficult to move up the management ladder in that particular city because of my strong convictions.  Hospital leaders could easily find the subject to be threatening.  Fortunately, I was able to land a job as Associate Director of Nursing in another state.  Within two years, I became the chief nurse, a position which I held for 16 years.  

In the mid 1980s, a new clinical nurse specialist joined our team.  As it turned out, she shared many of the same thoughts and feelings I had about women’s issues in nursing.  We began to talk about this with other nursing leaders in the organization.  We formed a Nursing Empowerment Committee which began to explore in depth the issues that nurses face.  We defined empowerment as “knowing and believing that one can influence others, effect change and ably carry out one’s role.”"Empowerment is not a gift...it has to come from within...it's our jobs as leaders and managers to create an environment where people can thrive."  We did a lot of research and reading on the subject.  Out of these conversations came the idea of an all day workshop that we developed and presented to the nursing staff at the hospital.  We taught nurses how to stand up for themselves and not be intimidated by overpowering physicians.  We talked with them about oppressed group behavior and how it caused the worst kind of nurse abuse, lateral violence or nurse to nurse abuse which often revealed itself as the “3Bs”, backstabbing, bickering and blaming. We worked with them to help build self-esteem.  I have to say that we were very fortunate to have the support of the CEO as we carried out this work.  We were able to transform the culture in the organization by openly dealing with controversial issues, enhancing self esteem and by building pride in the profession of nursing.

News of what we were doing began to spread and we were frequently asked to speak at other hospitals and professional meetings.  Often we would hear, “I would really like for you to come and speak in our organization, but can you use different language other than nurse abuse and empowerment and, please don’t talk about the oppressed group behavior.”  I would have to tell those people that we would not come unless we could speak to the issues directly.  I am convinced that we did make a difference for many nurses around the country over that five year period.

At the age of 50 I decided to reinvent my career.  I wanted to work for a health care organization that focused on keeping people healthy across the continuum of care, a place where I could use my leadership experience, management expertise and nursing background to be able to make a difference in health care for large numbers of people.  I had no idea where my vision would take me, but I set out to find out through the tried and t rue method of networking.  The position I found was Quality Director for a regional health care organization.  Although my salary was less and I had to move my family across the country, I have to say that it has been a refreshing change.  

In my current role, I work with other leaders and staff to find innovative ways to improve the quality of care we provide to patients. We also work to bring quality improvement activities to the local level, to engage staff so they feel that they’re really able to make a difference in their own work environment.  When people feel they have the ability to influence what occurs in their work environment, they have more ownership and pride in their work.

I went into management because I wanted to influence the ability of nurses to provide the best possible care to patients.  I feel that, as a leader, I have made more of a difference for many patients than I did when it was just me, individually, providing care to very few patients.  I’m proud to say that throughout my career, I have worked to create an environment where staff can truly make a difference for the patients they care for.  I have often heard leaders say, “We need to empower our staff.”  But empowerment is not a gift.  It has to come from within each of us and it’s our jobs as leaders and managers to create an environment where people can thrive.

Power Strategies:  Improve, Empower, Lead
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Lucille - Keep Adding Lenses

Lucille -







Executive nurse leaders are truly trying to balance the multiple demands and competing priorities in the whole universe of healthcare, for the ultimate good of the patient and staff. But the reality is the competing priorities are so large and so complex that it is very murky. It’s hard to see what it is one is doing, especially when one is in the trenches, so to speak. It’s not part of the educational process to be educated about how your administration functions. We learn our own roles, but we don’t learn the role of the other. So we deal with our allocation and we don’t see how it fits into the big picture.

The result is that we’re all living in what I’d call silos, not seeing or understanding the complexity of the decision-making by another person. We just look at the final decision and judge it. It’s very easy to make judgments that are sometimes incorrect. My view of the nurse executives I’ve worked with is that they work very hard to make the best decisions they can within the structure that exists for them.

It’s easy, when you’re four inches away from the patient – and I’ve been there – to make some judgment about them or the administration that may or may not be accurate.  That piece is separate from and yet intertwined with how to communicate across these silos in which we find ourselves. Touching the heart is something that takes time, and that is easy to put aside when you’re rushing and doing all of the things that need to get done. After all, a nurse’s role is to be with the patient on the sacred ground of that patient’s life.

Nursing involves both technical and thinking skills about the patient. But it also involves technical and thinking skills about processes and systems. That’s not as evident, nor is it something that we have time to do. And it’s not something that you do easily and consistently when you are learning the basic technical skills of nursing."Nursing involves the whole person of the patient, but it also involves the whole person of the nurse." The problem is, if you don’t progress to higher levels of learning in a formal way, you get stuck delivering good technique, but never get to the highest level of thinking. I’ve personally never known a nurse who would say, “I’m a bad nurse.” Being a good nurse is important to them. But there’s a difference between being a good nurse, and being at the highest possible level of thinking.

My comment to students is that to graduate from my program you must be technically proficient. That is absolutely necessary, but  not sufficient by itself. Sufficient means you also have to be able to simultaneously employ critical and reflective thinking skills.

One of my students commented that as she progressed from an LPN to an RN, her perspective changed because she had added knowledge, and information, and viewpoints. She found herself looking at familiar situations and seeing them from an entirely different lens. It’s the addition of those lenses that makes the highest functioning level of a nurse. The more lenses we can put on, the more ways we can see and hear things.

Nurses talk about having an intuitive feeling about patients.  Those who have been in practice and seen enough patients develop antenna that help them to recognize subtle changes –physical changes, communication changes, psychological changes.  But truly, picking up on subtleties requires a nurse who’s reflective, one who can say, “I’ve seen this before. I’ve heard this before. This doesn’t feel right.” It involves all the senses.  Nursing involves the whole person of the patient, but it also involves the whole person of the nurse.

I am passionate about nurses advancing their knowledge level and finding ways to make that possible.  That’s my passion in life.  I ask myself how I can start with the student at the very beginning level, and inspire them, and encourage them, and then keep them going?  It’s never ending.  We’re not the only profession in which it’s never ending, but it must be when you’re taking care of human needs. We do what we do for a variety of reasons and they’re all good, as long as it’s for the ultimate benefit of the patient.  That’s what most nurses would say:  “It’s for my patient.

Power Strategies:  Universality, Influence, Love
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Patricia - We Answer the Lingering Questions

Patricia -







Nursing is part of who I am, not just what I do. It's a calling. I retired last November and after being retired for only about four months, I decided to return to nursing part-time in a home healthcare office. I learned I'll be a happier person if I can continue to do nursing in some capacity. I knew I wanted to be a nurse from the time I was nine years old, and I never strayed from that vision of myself. I worked as a nurse's aide through high school because I wanted the background.

Later, when I was experienced enough to provide counseling to newly graduated nurses, I'd tell them it's good to get to know each patient in their care. Identify one thing you really like about that person. Even if there's something you don't like, focus on the part you can understand be empathetic about.

A lot of people fear the healthcare system. They're afraid of being taken out of their home. We try to support their having choices. I teach other nurses to give them things they can be in control of, and the barriers will go down. I did have patients who were tough to win over, but when I did, it was very special. I felt I was putting my whole heart into winning those souls over.

Some of the patients I've cared for in their homes have been hermits, people who don't like other people, don't want to be bothered. They want to be left alone. I've learned they may seem gruff and unfriendly at first, but I can win them over in a couple of visits. They begin to see that you're not there to hurt them, but that you genuinely care.

I had a lady who lived in the house her parents had lived in before her. She had never lived anywhere else and now she was very elderly, in her 80's. The house was in a rural area and had not been maintained. There was no indoor plumbing; you had to go outside to get water. There were lots and lots of cats. So this woman was a hermit, and though she didn't want anyone from the outside to come in, she was so sick she had to have help. I worked hard to earn her trust and respect, and eventually I got very fond of her.

It was a gift to be with that lady at her bedside when she was dying. It is a gift to be with a dying person and help them be as calm as they can be, or to fight it the whole way, whatever they want. They have to finish the journey by themselves, but you can be their companion as far as you can go.

Even in my administrative job, I continued to see patients periodically so I could keep that connection to the patient and what they really want. That's what nursing is all about. I'll keep that connection as long as I'm physically able.

I talk to young nurses about the question of choice. People are free to make their own choices even though we may not agree. We have to help them get the information they need and then let them make the choice. And not coerce them, or try to force them."The beauty of nursing is that our job isn't to cure everyone; our job is to support what they decide, no matter what it is." Quality of life versus quantity of life is a big debate. Once patients who are competent understand the choices, their decisions should be honored. Sometimes nurses are the ones who have to advocate for the patient's viewpoint. If they want to fight, fight, fight--great, we'll help them do everything possible. But if they want to be kept comfortable and go a less invasive way, then we should support that too. The beauty of nursing is that our job isn't to cure everyone, our job is to support what they decide, no matter what it is.

Many doctors do a great job of talking with the patients about their choices, but not every doctor does. So the nurses are the ones who answer the lingering questions after the doctor has left the room. Sometimes we can see that the patient doesn't understand the medical information, so we can clue the doctor in on that. Or the nurse can share educational information and go over it with them. If the nurse hears the family and patient discussing what to do, the nurse can remind them that they do have choices. It's much easier now than it was 20 years ago.

I think there's more of a partnership between nurses and doctors now. Most of the doctors I've worked with honor nurses as partners. I've had nothing but respect from most of them. Doctors want patients to have the information they need, and they are willing to spend time answering questions. But sometimes the patient is intimidated by the doctor's presence, and can't process the information quickly enough, so that's when the nurse can fill in the gaps.

There are exceptions among doctors. Some seem brusque and in a hurry, because they have time pressures, and they work long hours. I always try to let the doctor know what I'm thinking in a concise way. Sometimes I begin by asking the question: What do you think is going on with this patient, Dr. Jones? I say that I'm concerned and want to understand. I respect them, but I don't back down if it's something I think the patient needs. And they usually respect that. It doesn't take many contacts with a doctor before they figure out whether you're working in the patients' interest, or just trying to cover your own butt.

If you believe the doctor's instructions are not correct and are going to harm the patient, then you have no choice but to advocate for the patient and take it to the next level. But the best way is to work it out yourself by being direct and respectful. And don't take everything personally! The doctor is worried about the patient too, and you get on the receiving end of that at times. If you need to vent, go to a senior nurse or a mentor. You have to take care of yourself first, or you can't take care of anyone else.

Power Strategies:  Dignity, Compassion, Respect
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