Nurse's Story: Susan - The Symphony

Susan -







I spent a lot of time as a hospice nurse. Expert hospice nurses know how to advocate for the dying patient. It doesn’t matter what my perception of dying is, or the family’s perception, it’s the dying person who needs to be able to go out the way they want to. As a hospice nurse I was like the conductor of a symphony. I needed to make sure everybody was on the same song. I couldn’t have some people playing the Star Spangled Banner and others playing songs by the Dixie Chicks and somebody else playing Kenny G. I would take up the baton and say, “Listen everybody. Here’s the song we’re playing. This is the person who has decided what the song will be.”

I’ve spent the last 15 years of my career in education. It’s the longest I’ve ever worked for one employer. I’m currently the associate dean for nursing at a community college. We are close to 200 nursing students, not counting the pre-nursing students. We base acceptance on grade point, I do the numbers and that is how I decide where to place the few that get in the program. We had 835 applications last year to fill less than 100 nursing student positions. So it’s a numbers game, and I love numbers.

I’ve been at this job for so long because I discovered it is where I need to be. I’m very good at it. People will say, Oh, you must love your job.” It’s not so much I love it, it’s just where I’m supposed to be because this is what I do well.

Patricia Benner wrote a book called Novice to Expert. She talks about how nursing maturation happens . It’s like a pebble dropped in the water with concentric circles going out from the point of entry. Novice nurses can only attend to that one spot in the middle, and it’s hard for them to see the greater parts that are out there. When I was a novice nurse, I didn’t know what I didn’t know. I saw one way of doing things and didn’t even think there could be a different way. I worked in an operating room where it was okay for doctors to literally throw things at me and to make sexual comments. It was like a dysfunctional marriage and I was a battered wife.

It was only after working in several different organizations and in various jobs that I learned how nurses should be treated and developed the confidence to stand up for myself and demand respect. We now know to educate our daughters to realize what civility looks like and how they should be respected at work and in life.

Sometimes students will say to me, “That clinical instructor was really mean. I don’t understand why she’s doing this. I listen to the student, then I ask them to flip to the shoes of the clinical instructor.”“I make a point of never answering any of their questions. I always ask another question. It helps to pull the inner strength out of them, by getting them to think and resolve their own issues.” I ask, “Why do you think she would do that. What do you think you should do about that?” I make a point of never answering any of their questions. I always ask another question. It helps to pull the inner strength out of them, by getting them to think and resolve their own issues. I feel it’s my job as an educator. It goes back to giving the student power. I believe many of the women coming into nursing have subservient personalities. They are co-dependent in some way. We say we want to empower nurses so they’ll be stronger, but we’re not finding strong women to come into nursing, some tend to be weak. They come to nursing to be cared for, not primarily to care for others.

If we find dysfunction in the nursing profession, we have to ask if it is the workplace’s responsibility or is it education’s responsibility or is it the nurse’s responsibility? On one hand, I think we can bring a person along and try our best to make them the nurse we want them to be, but they have to have something there to start with, some things that are innate. It’s like bringing a potential student to my door with a deficit in math skills and telling me I’ve got to fix it. It’s not always a matter of bringing them up to speed in math. Sometimes we have to go all the way back to elementary school and give them the positive math experiences that allow them to want to learn math. I can build on a math strength, but I can’t fix a math deficiency. The same holds true for personalities and learned behaviors.

As an educator, I tell students, “if you think nursing is all about holding and coddling your patients and all you do is take care of them, then you’re not in the right program. I tell them their job is to empower their patients to heal. And I empower the students. I give the students the right to fail, but if they make the wrong choice, they need to deal with the consequence. No matter what they are struggling through, I’ll be there to support them but I’m not going to take it over. I don’t allow faculty to embrace and care and take over when the going gets tough, because then they disempower students. We need to teach students to stand on their own two feet, so they feel powerful when they leave the school. We want to give the student the ability to conduct their own nursing symphony.

Power Strategies: Empowerment, Leadership, Strength
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Nurse's Story: Paula - Could I Really Help People?

Paula -







At the age of 16 I had stomach surgery. My ICU nurse, Terri, was wonderful. She inspired me to be a nurse. I admired what she did, but I wasn’t sure I could handle it. Could I really help people? Would the blood and body fluids bother me? The only way to find out was to try it. I worked as a nursing assistant the following summer and I loved it!

That summer, Noreen, my mentor, was terrific! She was the mother of one of my friends. When she was 40, she decided she wanted to be a nurse. She got her BSN and then started nursing in our small town. Her demeanor impressed me the most; how she was with me and the patients. She was good at listening, and her manner was soft and encouraging. She nurtured, supported and guided me. When I think of a professional, I still see her in my mind. She made me feel special because she allowed me to perform tests and took the time to help me learn and understand.

I worked in several areas of nursing, and met another influential person who saw my leadership qualities and convinced me to go into nursing administration.“I want the public to continue to put their trust in nurses to protect their loved ones, their bodies and their very being.” I took several administrative positions around the country and eventually ended up in my current job, in which I oversee licensing and discipline of nurses in our state and making sure nursing schools meet standards. The public needs to trust that when students graduate from a nursing school they have achieved a certain level of competence. It helps me to stay focused on my real desire, to effectively help people in their most vulnerable situations. What we do at the state ensures that patients can trust the nurse to help them when they can’t help themselves.

This job is rewarding because I have seen people completely change their way of practicing. We have a rehabilitative focus in our profession. If someone makes a mistake, we do what we can to help the nurse become a good, safe professional. I get to use problem solving skills to have an impact on nursing and people’s healthcare in general. Sometimes nurses don’t even recognize they have problems in their practice. Because patients put so much trust into nurses, I take my job very seriously. I want to keep the profession admirable. I want the public to continue to put their trust in nurses to protect their loved ones, their bodies and their very being.

As a regulatory body we struggle with the question of who is responsible to provide continuing competency. It’s important for nurses to continually learn new skills because of the constant changes in nursing. We all agree the growth needs to happen, but is it a personal responsibility or an employer responsibility? Should it happen every three years or every five years? Right now nurses renew their license every year, but what that really reflects is that someone paid the fee and stayed out of trouble last year.

Issues like continuing competency and others need to be addressed by the profession, and we need nurses to come forward and help find reasonable solutions. Unfortunately, nurses give so much in their jobs many don’t feel they have energy to devote to forming regulations or standing up for their beliefs. Many times nurses won’t step up, instead they wait to be invited. Rather than saying, “We need to be here,” and recognizing the power they have as nurses, they melt into the background. I try to empower nurses and encourage them to take up their own issues, rather than have the nursing commission go in and fight their battles. I would like to go out and say to every nurse, you need to be there. However, I might succeed in getting them there by rephrasing my plea to say, “I need you to be there. I want you” because that will better speak to the giving, nurturing, nature of the nurse.

Over the past month I’ve been reviewing my professional portfolio. It’s an exercise where I asked myself, “What are my goals now and where am I going? What do I want to be and do?” I’m reformulating my goals, and as much as I love my job in licensing and regulation, I’m missing patient contact. So I’m looking to bolster my skills and talents, both managerially and administratively, but most importantly, I want to return to cardiac nursing. I’ll need to learn what’s happened in the last 10-15 years since I’ve left that area, but I’m excited to update and expand my knowledge.

I will be a nurse all my life. I was going through licensing records recently and looking at the ages of current licensed nurses. There were people 80 years old who still hold their licenses. Once you “get” nursing you never want to let it go, because it’s too hard to get. I heard one story about a man who paid his wife’s license even after she died. He said she worked too hard and it meant so much to her, that he believed she would want him to keep her license current. My message to nurses, current and future is, “Patients need you. People need you. Come in. Come back. Nursing is the most rewarding career you can have.”

Power Strategies: Encouragement, Accountability, Trust
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Nurse's Story: Margaret -A Certain Light

Margaret -








Actually, I always wanted to be a doctor but didn’t want to go through the twelve years of schooling that was required for it. I went for what I saw as the next best thing, which was to get my BSN. Although there are times when I wish I would have challenged myself to continue my schooling, I have no regrets about becoming a nurse. There have been many moments when I have watched what physicians do and it makes me glad that I chose nursing.

After doing floor nursing for a while, I went straight to the OR. As a child, I always knew that I wanted to see what the inside of the body looked like, so I had no trepidation about going into the OR. For the past five years, I’ve been doing open-heart surgery.

The number one thing people considering going into nursing need to know is not to take things personally. And number two – it’s always about others first. It’s a profession in which you handle other people’s lives and emotions. You get a whole personal perspective about them. You need to stay humble and open, take criticism constructively, always do self-assessment, and just hang in there.

It’s really the people that inspire me in my career. I truly love the variety of people that I can meet in one place doing one thing. It’s hard sometimes to explain what keeps me going, to be honest, because there’s a lot of grief and misery that we witness. But there are also many moments, for instance, when an 80-year-old gets up and goes home and continues to mow the lawn. That is rewarding enough.

Besides my sense of humor, I think what really saves me is my spirituality. You really can’t see everything from the human perspective; as far as I’m concerned, you have to see that what really gives us our humanity is our spiritual perspective. It helps in cases where things cannot be solved; where we just absolutely get stuck. You have to see life continuing and beautiful beyond the physical means that cannot be helped. The medical field cannot do anymore, so something needs to continue to beyond that.

Once in the lunchroom I told a story to my fellow co-workers about the books I’d read on life beyond death. In many instances, elderly people with Alzheimer’s or who were really sick seemed to be schizophrenic or going between several worlds, but every moment would come back and say hi to their daughter or son.“You have to see life continuing and beautiful beyond the physical means that cannot be helped.” I read a story that claimed sometimes these folks are actually looking for us, the family members, to give them permission to pass on. I had a co-worker who was going through this with her mother. We all suggested that maybe the mother was looking for her daughter’s permission to go. The mother had been suffering from a very long illness, teetering on the brink of death but not passing on.

Well, we had this lunchroom conversation on a Friday. The following Monday the co-worker came in to work, gave me a big hug and said thank you. Her mother had died on Sunday. She had talked to her mother, given her permission, and she had finally passed on after all those years.

Nurses are really a container for the grief of patients and their families. In many instances, when you get off your shift and go home, you are grieving. You take that home with you. In my case, you work on someone 13 hours a day in open-heart surgery and you do everything that you can, but they just don’t make it. They pass right in front of you. How can you not take that home to process? You go home, you cry. Maybe sit in a hot tub or run a hot bath. You sleep, and you just deal with it. When you’re ready, you can discuss it with your co-workers if you want. But everyone has a different way of handling grief.

People tell me I bring a certain light wherever I go. That to me is a great strength in nursing, especially to a highly stressed OR team or unit. There’s a certain aura that people carry with them and we all have our own. Mine is this light, and having the ability to make people laugh, too, because I’m so straightforward. I just tell it like it is, which people seem to find refreshing.

Like in any career, you get to the point to where you know when you’ve accumulated so much knowledge in certain areas and you are ready for a bigger challenge. You’d think open-heart surgery would be the greatest challenge, but I’m about to make a move over to critical care because I have a desire to work with a bigger picture. Whole systems – respiratory, metabolic, circulatory – along with the medications given, is a challenge for which I feel I am ready. I want to be able to put one, two, three and four together, and get a greater perspective. It’s time to move on, and I’m fortunate to be in a career that makes it possible for me to do that.

Power Strategies:
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Nurse's Story: Sharon - Witness a Case of Burnout - Saying No is Hard to Do

Sharon -







From first grade I knew I wanted to be a nurse, so imagine the toll it took on me to find myself burned out after 20 years from trying to cover the staff shortages by working 10 days in a row, sometimes 16 hours at a time or trying to herd 80 patients through exams a day. And to top it all off, when I couldn’t the impossible, I got replaced by someone younger they thought was faster!

My burnout came about because in every job I had, they worked me until I dropped. If I could work ten hours, they wanted me to work 12.“Nursing is a calling, if you don't answer it keeps calling.” If 12 works, then why not 16? If I could work five days, then they wanted me to work ten days in a row, and then when my skills weren’t as acute as they had been when I was working fewer hours, they replaced me with somebody younger and faster. I was working as hard as I could, yet I was a failure in their eyes.

I repeatedly said I needed more help and I was overwhelmed, but no relief came. I needed to work, so I moved to another hospital but the conditions were the same. They would tell me the budget was limited, yet they kept building new wings and getting new equipment. Nurse staffing was not a priority. So after enduring those circumstances as long as I could, I changed jobs and worked for a private practice and money wasn’t an issue to them. But one doctor I worked for wanted to see 80 patients a day. We had an MA, an LPN and I was the only RN, and he was angry because we couldn’t get that many patients in and out of his office in one day. He called me to task and asked, “Is there any way we can see more patients?” I said, “Only if they get naked in the waiting room.” He was furious with me. Shortly thereafter, he decided he could find somebody else, and that was fine with me.

I worked for awhile in a feminist clinic where even the doctors were women. During that time I felt I had power and people respected me for me and what I could do. I was empowered to say, “You know, I think this recovery room would work better if we did this,” and five women would say, “That’s a pretty good idea. Let’s try that.” If I had said that at the hospital, a doctor would have said, “We’ve always done it this way and that’s how we will continue to do it.” The feminist clinic had a teamwork atmosphere, without the competition that I found in the hospital. We all respected one another. We nurtured each other. We would go to lunch together every Saturday and share things about our lives.

My last nursing job was at a long-term care facility. I liked working with the seniors because they appreciate the tiniest things I would do for them. But after working there for a short time, I started getting calls at 3 a.m. “The day shift nurse can’t come in. Can you do her shift as well as your 3-11 shift tomorrow?” I would explain to them that I wouldn’t have time to sleep, but then they would ask if I could work an extra half shift. They would ask over and over again and I was not good at saying no. I felt if I didn’t work when they asked me to, there would be repercussions. If I didn’t play along, I wouldn’t get pay raises or promotions. I soon realized that even though I did what they asked, I still didn’t get the pay raises or promotions. I felt unappreciated. That’s when I left nursing to open the bed and breakfast.

Running a bed and breakfast is very much like nursing. My husband would tell people, “Sharon gets to give lots of TLC, nourish people’s bodies, and change beds, the only thing she doesn’t have to do is bathe them.” I say nursing is a calling, if you don't answer it keeps calling, so I found this way to heal. To me the bed and breakfast is as spiritual as nursing. I believe everybody who stayed came to bring me a gift or to receive a gift. People told me incredible stories from their hearts and souls. I felt I made a difference just by listening. I even nurtured my housekeepers. I listened to their problems and helped them in any way I could. I encouraged them to move on to better jobs, because I saw more potential in them than they could see in themselves. I helped them build confidence. I think nursing gave me the gift to help people feel good. The empathy I developed throughout my nursing career has made me a better host, mother and friend.

I always felt there was a spiritual aspect to nursing. My job was to make patients comfortable and help them heal. Sometimes I knew I said the right thing at the right moment, and that would fulfill me. I remember a non-English speaking patient I cared for. I didn’t speak Spanish, but in the back of a nurse book I had was a list of a few Spanish phrases, so I grabbed the book and made an attempt to communicate with him. I had enough information to ask him if he was in pain, where the pain was, and if I could give him something to ease the pain. He had been laying there suffering for quite awhile, and the nurses hadn’t picked up on his discomfort – or they were too busy to care. I know I made a difference for him that day.

I loved nursing when I was able to really care for the patients, but most of the time competing and conflicting pressures got in the way. I believe that cost me on a spiritual level. I’m sure it attributed to my burnout. I try to keep my sense of humor, and posted a quote from Dear Abbey to keep myself laughing:

We the Willing
Led by the Unknowing
Are doing the Impossible
For the Ungrateful.

We have done So Much
With So Little
For So Long
We are now Qualified
To do Anything
With Nothing.

Anonymous

I can’t find the cutting I had posted so I googled it for my story. Most likely, Abby printed a nurse altered version. I would think most nurses would be adverse to using the ungrateful line, for fear others might interpret it as referring to the patients instead of management. I don't believe any of my patients were ever ungrateful. I was willing to tolerate the conditions in order to have the opportunity to give them the best care I could, the care they deserved. Many times I went to work exhausted fearful if I didn't go to work that day, that my replacement wouldn't be as caring or tender with them as I would.

I was a hospital patient recently and found it interesting how nursing has changed in the 10 years since I left the profession. I saw a difference between the young nurses and the older nurses. The young nurses are technologically-oriented. They came in, looked at the computer, read all the dials, made their notes on the computer and then left. I felt like I was a piece of equipment when they were in the room. The real nurses, who tended to be older, came in, asked me how I was doing, and then looked at the machines and entered data.

I had one really bad night when I was in a lot of pain. The next day I was supposed to have a chest x-ray. The charge nurse called x-ray and asked them to bring up the portable x-ray machine, but they refused and said I had to go to x-ray. I explained to her that I didn’t want to go to the x-ray department, because they kept me there forever and I have to have the oxygen on underneath the mask. The mask gets hot and after awhile, I can’t breathe. She decided to take me to x-ray herself. It took a long time and she could see that I was having a hard time. She reached over and held me and comforted me. That made a big difference for me. I was so happy to have a real nurse caring for me.

I no longer have the bed and breakfast, and my recent hospital experience inspired me to return to nursing. I may return in an educational capacity. I know I’ll be able to find a niche somewhere, and I’m motivated and excited to care for people again.

Power Strategies: Dedication, Loyalty, Service
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Nurse's Story: Carolyn - I Never Imagined I Would End Up Here

Carolyn -







I began my career as a dental assistant, but it wasn’t a good fit for me. After all that, I found looking into people’s mouths unappealing. What’s ironic is I don’t mind looking inside people’s bodies – just not their mouths. I have more of a sense of accomplishment working in surgery than I did when I was working on teeth.

I chose nursing for the people contact. When I was in nursing school this poor lady was getting ready for a colonoscopy and she had to drink the stuff to clean out her intestines. She was sitting on the little commode and I kept getting her warm blankets. She said, “Oh, this is so nice.” We were laughing and joking and she said, “I guess if I was going to have to have someone with me while I was doing this I would want you to be the one.” I was glad to make her uncomfortable experience a little more pleasant. Another lady had a radial neck procedure and she started coughing and the tube was coming out and it made me sick to my stomach. I was over in her sink gagging and thinking, oh, my gosh, I’m going to vomit! I can’t be a nurse if this happens! The lady started laughing and by the time we were all done we were both laughing. I said, “I’m so sorry,” and she started laughing. She said, “I would have done the same thing.”

Everybody has vulnerabilities and if I’m able to identify where the patients are coming from and let them know that I’m not perfect either, then I can relate to them better.

I am so fortunate to be working with the open heart surgery team. It was really a fluke that I came here, and it wasn’t something I thought I wanted to do. I worked as a technician in surgery while I went back to school for my nursing degree. After college I worked on the floor for awhile, thinking eventually I would work as an OR nurse. While working on the floor I also worked occasional evenings in open heart surgery, so I got some cross training.

Things change fast in the workforce. They were begging for nurses when I first went into nursing school, but after I graduated and spent a few months on the floor, suddenly there was a reduction-in-force in the OR. Because I had the open heart experience, they said I could either go to open heart or find a job elsewhere. I didn’t think I wanted to work in open heart, but I also didn’t want to search for another job. As it turned out, the move to open heart was the best thing that could have happened to me.

Working in this department wasn’t always rosy. One of the surgeons was very difficult and all of the nurses were afraid of him.“Everybody has vulnerabilities and if I’m able to identify where the patients are coming from and let them know that I’m not perfect either, then I can relate to them better.” Nobody wanted to speak up about how hard it was to work in the environment he created, because we watched him fire someone who talked back to him. But things have changed and the environment is great now. We’re doing this thing called med teams where everybody listens to each other and takes responsibility to check and double check things. As nurses we’ve always done that, but we’ve never done it with the doctors. Now it’s okay to say to the doctor, “I’d like to double check that. Are you sure that’s what you meant? Can you please clarify that?” Instead of just going along with what they say.

Open heart surgery is something I never would have imagined myself doing. I am amazed by the heart muscle. Sometimes I look at a patient’s heart and think, “I can’t believe we just did all that stuff to this guy’s heart and it’s still beating.” It’s fascinating! It’s also hard work, but at the end of the day when my shift is over, I like to play hard too.

My husband and I have jet skis and I can get rid of a whole week’s worth of tension by getting on the jet ski and going fast and twirling around in the water. The jet skis and my dog are both great stress relievers. So is a TGI Friday with the girls. My release comes from fun and exhilaration and by diverting my focus from work to play. I think you have to feel good about yourself in order to feel good for others and to help others. I feel good about my work, and my play, and I really love helping people.

Power Strategies: Engagement, Courage, Diversion
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Nurse's Story: Linda - The Intention to Comfort

Linda -







The core of being a nurse is, to me, the intention to comfort and bring healing. It can be physical, spiritual or emotional, but with that intention you can literally change a person’s life in one shift. As I walk in from the parking lot to my job each day I think to myself, what is it that I want to get out of my day today? And I answer, I want to be joyful; I want to bring healing and comfort to whomever I come in contact with.

As a person who sees the cup half full instead of half empty, I created a daily commitment. I focus on finding the good deeds that people do every day and recognize those. I find two people each day to acknowledge the work they do or the way they do it. The surprised looks of appreciation are an incredible reward of joy for me.

In my current role as care coordinator, I make daily rounds with the medical team which consists of an attending, residents, interns and medical students. I had noticed that a young medical student seemed particularly shy and overwhelmed during rounds.“I want to be joyful; I want to bring healing and comfort to whomever I come in contact with.” This often invites more questions and there seemed to be a harshness from some of the senior teaching staff toward her. One particular morning, I could just see that this young woman was really struggling with this pressure. So, after she finished presenting her patient I said, “I just loved the way that you advocated for that family when you were giving your report this morning. It really tells me that you consider communicating with families a priority.” She burst into tears and said, “ You are the first person who has told me I was doing a good job.”

From that point on, every time she was reporting on a patient, she’d catch my eye and I’d give a nod of affirmation to her. The next year she was chosen to be part of the Residency Program. The first time she was assigned to my team as a resident, she gave me a hug and said she wished she had written to me to let me know that I made a difference in her life. The morning that I told her she was doing a good job, she was questioning her ability to become a physician. But I had helped her to see that she was doing the right thing and continue. For me, it was just a sincere observation and a comment given so willingly. But for her – it was life changing.

Nursing is one of the most rewarding career fields you can choose. As a nurse, you are involved in the most intimate experiences in your patients’ lives as you witness everything between birth and death. It is a courageous profession. It takes courage to walk into a room where you know that someone has just been diagnosed with a life- altering condition, and to meet them wherever they are at that moment, whether it’s to sit and cry with them or help them plan how they’re going to live. It is to be the privileged witness as they take their last breath.

I was blessed to work in pediatric hospice. It was the most challenging and meaningful work that I have ever done. One night I’d been at a house until about 8:00 p.m. with a child who was actively dying. The on-call nurse was going to make a visit after I left when the family felt like they needed support. I got a call about 2:00 a.m. that the on-call nurse was on her way out there and her car broke down. The family needed her right away because the child was dying. I agreed to go back out, but in the dark of the night I got lost and was not there when their daughter died. I could tell it was disappointing for them when they didn’t have the support they had counted on.

At the parents’ request, I went in and bathed the child. When I walked in the door, the mother was sitting in a rocking chair in another room just rocking, back and forth, back and forth, and she could not even look at me. She was just incredibly angry. They had other children, and they wanted to make sure that the body was taken before the siblings were awake. I finished bathing her and contacted the funeral home. They came out and at the family’s request, I carried her out to the vehicle. I could have gone back home at that point, but my work was not complete. My credo to always comfort had not been accomplished.

And so, I went in and sat at the feet of this grieving mother and waited. I waited until her rocking got slower and slower and she finally started to cry. As she started to sob, she let me take her in my arms and comfort her. There’s something about waiting in silence at the feet of a grieving mother. You can't do anything until she begins to let go. But it was my intention that compelled me to go to her and wait, patiently, until she could accept the open arms of comfort.

Power Strategies: Service, Empathy, Love
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Nurse's Story: Kathleen - The Nursing General

Kathleen -







I want to elevate nursing in the eyes of the entire United States of America, and hopefully the world. I want to change the way people look at our profession forever. There are more nurses in the United States than soldiers in the military. What an incredible power! What an undaunted force we would be if we had one voice, if we could only unite.

I held many jobs before I came into nursing. I was an executive administrator for a chamber of commerce, an administrative analyst for a corporation in Los Angeles, a seventh grade school teacher and I made old radio commercials on an AM station in New York. When I got into nursing at the age of 38, I thought it was more difficult than being president of the United States. It is physically, emotionally, psychologically and spiritually taxing. I’m spun around so much every day I don’t even know where my car is when it’s time to go home. Because so much happens during the day, I’m a cacophony of emotions that I can’t sort out.

I have written several books about nursing and I speak to many nursing groups. My goal with the books and speeches is to help nurses raise their collective and individual self-esteem. Nurses need to understand the problems they face in the workplace.“I want to change the way people look at our profession forever.” For example, there is the dysfunctional physician-nurse relationship. Nurses don’t realize there is a power difference, and until that is understood, it can’t be fixed. When a physician asks, “Where is the chart?” We say “Oh, I’ll get that for you.” We begin our phone calls to the doctors with, “I’m sorry to bother you,” as a child walking into a room would to a parent. We need to get adult communication going between the nurses and the physicians, and give nurses examples of how it has been done. It takes so much courage for nurses to talk with physicians on an adult level.

Last December, I quit my job as the manager of a 57-bed orthopedic unit. I was working 70 hours a week. I was stuck. I was a victim and I was a martyr. I couldn’t get out of it, partly because I loved what I did so much. Every nurse feels that conundrum. They love what they do, so they don’t leave. After giving up my manager job, I sat down and wrote a book for three months. Then I returned to work as a staff nurse and I found myself unconsciously falling back into the subservient behavior. I have to consciously stand up for myself and not allow the doctors to order me around like a child.

Nurses don’t want to acknowledge their subservience. It’s quite a daunting task to take this entire culture and this entire profession and try to help it. In organizational psychology there is the one half of one percent rule. That is the momentum needed to move an organization. I figured that one half of one percent of nurses in America amounts to 40,000 nurses. I’ve already spoken to 10,000. I only have 30,000 to go and the wheels will be in motion! Culture changes happen at glacial speed, in really small increments. But when nurses walk back onto the floor after hearing what I have to say, they aren’t able to act the way they have in the past. It’s impossible. I just love it!

It’s really all about empowerment for nurses. When I was a manager, I got my charge nurses together for a retreat. During the retreat they came up with a philosophy for our floor. It was only seven sentences long. We presented it to the staff and said, “You have three choices. You may edit it, sign it, or leave the department.” Every person signed it and now they are living it. Because it’s in writing and everyone agreed to it, people remind each other. It made an enormous difference in how the nurses behave and how they treat each other.

When I give voice to the experience of nursing in my speeches, one of the points I make is that nurses do not have time to process what they’re feeling, and the lack of reflection causes people to be at work with unprocessed, unfiltered emotions and no idea how they are affected.

Last year I worked the floor around Christmas. I got to know one patient very well because I admitted her for surgery. I could tell you everything about her. The day after her surgery, Christmas Eve, I was the charge nurse and didn’t have her as a patient. I walked by her room and could see she was doing great. She was up with physical therapy walking the halls. She returned to her room and suddenly her nurse grabs me and says, “Come quick. Something’s wrong with my patient.” He was scared to death and wouldn’t even enter the room. I knew she was dead as soon as I arrived at her door. I could tell from ten feet away. So I tell the nurse to call the code. I start CPR and continue even when the code team comes. I was counting out loud and the ICU nurse turns to me and says, “What are you counting out loud for?” I answered, “I’m just trying to center myself.” “Well, count to yourself,” she says. Very mean, very angrily. I understood that she was very upset that we hadn’t brought the patient back and her anger had nothing to do with me. We all finally realized we couldn’t bring her back. The nurse who was attending to her falls apart. He had never had a patient die. So I’m the charge nurse and I have a dead patient, a nurse who is distraught, and three other patients to attend to. All this, with very few resources on the day before Christmas. I have trouble getting in touch with her family and have to continue to try to reach them throughout the day. Later that day I call the organ donation people and I say to the lady on the other end of the phone, “How are you doing?” She said, “Shitty.” I said, “I’m doing shitty, too. Tell me your story.” And she tells me the last two calls she received were a 13-year-old who skied into a tree at Snoqualmie Pass and another young child who was found dead by her mom that morning. She said, “I have more organs that I would ever want for Christmas Day.”

Suddenly I’m grieving my patient and I’ve picked up the deaths of these children. I swipe my badge, struggle to find my car and go home. Four days later I’m in the gym. I’m counting as I pump the barbell, and I fall apart.

The work of a nurse is the work of the heart and nowhere is it documented how much I care. No one documents the energy and thoughtfulness I put into my day. It’s just task, task, task and cover your ass charting. Thirteen pages of charting and nothing to represent what I actually did. I know nurses make a difference; I’ve seen it happen so many times. I honor this profession so much, and I grieve for the people that are leaving, and the people who are coming that don’t want it, so they don’t stay.

The next article I want to write is about the collapse of nursing; the extinction of the nursing profession. Why we are the next endangered species. You can say that nursing is dying because of the shortage or any other reason you want, but the truth is the nurse and patient no longer have any time with each other. The time together heals not just the patient, it also heals the nurse. Because nurses are stretched so thin and can’t focus their care on the patient, they feel like androids in a factory. Move patients in, move patients out. There’s no time and there’s no honor.

The goal of the next book I’m writing is to elevate nursing in the eyes of the entire population. There is so much anger and depression in nursing, most of it coming from learned helplessness and frustration. My future desire is to create a position called nursing general. The person in this position would be in charge of the nursing profession and would give 15 minute updates every week for all the nurses in the country. They would lead the troops and give nurses some voice, a way to speak up. With baby steps, I’m hopeful for positive changes for our profession. I’m only one person, but I’m dedicated to being a part of force.

Power Strategies: Influence, Leadership, Passion
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Nurse's Story: Chuck - Committed to Consumer Education and Advocacy

Chuck -







My nursing career began when I was in high school. I was in a health occupations class and was mentored by a nurse anesthetist in a veteran’s hospital. I worked with him three days each week, for two hours in the morning, throughout my junior and senior years of high school. It was a great experience and all the medical personnel encouraged me to continue my education in medicine. I was not a stellar student in school and am dyslexic, so I had never envisioned going to medical school.

I enjoyed playing football and was recruited at Southern Oregon State College. I went there to play football, but after a year decided to apply to nursing school at Good Samaritan in Portland. I started there in my sophomore year. But I don’t think I was quite ready for college. I dropped out, bartended and did some other odd jobs for awhile. When I was 22, I applied again to nursing school and wasn’t accepted. I reapplied and finally was accepted and this time finished my three-year diploma program.

Nursing jobs were scarce when I graduated in 1983. After working in a nursing home for awhile, I took a job in rehabilitation. I wasn’t sure that was what I wanted to do, but once I got into it, I fell in love with it. In 1989 I joined the Army Nursing Corps and was deployed in 1991 to Germany for Desert Storm.

That’s where I met another one of my mentors. She was the chief nurse when I was with the 396th Army Reserve Nurse Corps. She had served in Bosnia and was one of the first nurses ever to be a healthcare commander of a combat military unit.“I want the entire healthcare system to take responsibility for better consumerism.” At the time, those positions went to doctors only. She was a person of extreme integrity. She had a good sense of humor, but was also consistent and fair. She gave me insight into my own sense of integrity and modeled exemplary leadership behavior. She inspired me to follow her lead and become a person focused on a mission. She led by example, and I felt I could emulate how she worked. Because of what I learned from her, I will always “walk my talk.”

My master’s degree focused on organizational change and my goal is to obtain a position where I can influence consumer advocacy. Sadly, consumers are ignorant about the healthcare system and that puts them at risk. Many patients simply say, “Doctor, just tell me what to do.” This is not a good strategy for managing health. Patients need to know their options and what they can expect from their various choices. My role is to help educate consumers. I want the patients to know how to pick good providers and good hospitals. The entire healthcare system should take responsibility for better consumerism. This would require changes in the system.

I’ve recently applied for a director position with a nursing executive’s organization. I’m also on a task force that’s exploring reorganization of the health system quality assurance program. I want to do my part to improve healthcare quality, including patient safety and positive patient outcomes. I would like to see improvement in the way the regulations are set up. Right now, nurses are held to a minimum standard or a minimum competency. I would like to see the standard raised so instead of nurses being minimally qualified, they are expected to maintain practice excellence.

My current mission is helping nurses work toward a common goal, with that common goal being focused on the patients. It seems nurses work harder at fighting each other than they do at working together. If I succeed in obtaining a position where I can influence this area, one of my initiatives will be to create a “greater good” philosophy. I want to help nurses develop a more noble view of their profession. Nurses really make a difference when they help patients achieve their goals, and that’s why people go into the profession. With everything else happening in healthcare, nurses lose sight of why they chose their careers. I want to help them come together to say, “We have a common goal. We are all patient advocates. We are all promoting a holistic approach to healthcare.”

Power Strategies: Advocacy, Integrity, Leadership
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Nurse's Story: Susanne - Build Leadership in the Nursing Profession

Susanne -







My husband and I recently traveled to India. Four days into the trip, my husband was attacked by a bull. He sustained injuries and became a patient in an intensive care unit, one hundred kilometers away from the accident. Although my focus was totally on him, I couldn’t help but be impressed with the skills and competencies of the nurses. For what India appeared to lack in technology, they made up for in care and service. The nursing competencies and their attention to the patient and family were remarkable.

It was a memorable experience and an incredible witness to their passion for their profession and holistic approach to care. The nurses valued family as an integral part and success to healing the patient. Embedded into their practice were the body, mind and spirit. The spiritual component transcended all beliefs.

In considering foreign nurses and their entry and practice to the U.S., I think of our care experience in India.“ feel drawn to making it different for nurses, by helping them to contribute more..” I believe the opportunity to exchange knowledge between the cultures is significant and beneficial. While I know and understand this, I would also be sad to bring them here, as I would not want to deny their own country the richness of their expertise.

These memories serve as reminders for why I went into nursing. I see my role as a vehicle to serve others, the patients, families, staff and physicians. As a healthcare leader and learner this is my mission and vision.

In the western world, I believe we have lost some of the momentum in nursing. The need for good role models, mentors, and coaches helps us nurture our profession, particularly new nurses, as well as our tenured nurses. Nurses deserve to be inspired, motivated, respected and honored. As a nursing leader, my desire is to build upon nursing professionalism to move it forward and prepare nurses for future leadership positions.

Nurses are great resources and we have the tools and knowledge to affect successful change and practice. I’ve realized first hand and through being there for others to support them, nurses’ knowledge is not always well-received or honored. I learned leaders need to listen. Nurses are problem-solvers and innovators, all in care and service to their patients and families. They need to be valued and recognized.

As a result I have developed a passion for leadership. There is a difference between being a manager and being a leader. Managers have the ability to operationalize day-to-day activities and leaders provide the bigger picture and vision. I feel drawn to making it different for nurses, by helping them to contribute more. I participated in leadership training, read leadership books, looked into research-evidence practices for leaders and continued moving forward in my education, which now finds me seeking a Ph.D.

Because of earlier experiences, I became determined to engage my staff collaboratively with my holistic and open-door approach. But, I realized people don’t automatically embrace change. Trust is a factor and must be acquired through building safe and real relationships.

I want people I work with to become accustomed to engaging in decision-making and to be willing to try something different. I had to recognize we need time to prove this method can be successful. Afterall, I’ve seen a lot of leaders come and go myself and they may not see the value in following my lead until I’ve proven myself.

After a year and many mistakes I began to earn their trust. Early on I mistakenly assumed everyone wanted to take part in decision-making. I think this is true, but they said their experiences of being excluded shut them down. Leadership is about coming alongside to learn, teach, collaborate and coach others into their work and ultimate satisfaction. Integrity and being present are important parts in developing relationships so that people feel they can contribute and make a difference.

After 30 years of nursing and learning, I have no regrets about my career choices. I am never bored and I always feel motivated. My career has led me to where I am today - continually learning, growing and stretching in all directions. I love what I do and at the end of the day I measure my impact. When my efforts make a difference, I feel extremely satisfied.

Power Strategies: Leadership, Inspiration, Relationshipsgo back to main page

Nurse's Story: Nancy - Not Everything that Counts can be Counted

Nancy -







When I was about eight years old, my sister fell and sustained a serious head injury. My mother immediately called the nurses who lived in our neighborhood. This nurse came on the scene and managed everything beautifully – calmed my mother down, put my sister in the car, transported her to the hospital, and kept in touch with my mother by phone to let her know what was happening so that my mother could stay with her other children.

For a relatively young child, that made a big impression on me. This nurse just seemed to know exactly what to do, but at the same time had such a calming influence on my mother. It wasn’t just that she cared for my sister. She was able to look at what was going on with the rest of my family, too. It was really inspirational to me to see that combination of intelligence and caring, but it would be years before I would be able to articulate why that was so. (IS THE CALMING INFLUENCE THE REASON WHY IT WAS SO INSPIRATIONAL?).

In college, I started out as a Music major. I’ve always loved music, and even to this day I still play (WHICH INSTRUMENT?) whenever I get the chance. At the time, I was juggling several part-time jobs while going to school, and it wasn’t working out very well. Eventually I got a job as a ward clerk in the local hospital to replace all the other jobs. That really was my first exposure to nursing as a practice, and I found it extremely enlightening.

The nurses’ work on that ward made the difference between life and death in many cases and provided people with comfort and dignity along the way.“I like to help people understand the impact of just their physical presence..” It was also the sixties, an era when many people were trying to do socially relevant work. What could be more socially relevant than using your brain to care for another human being’s health? My university was just starting a bachelor’s in Nursing program, and I ended up applying for it. So Nursing became my major, but I was able to get a minor in music, too.

I ended up going all the way to get my PhD, which I never would have imagined when I first began my studies. I have taught nurses, and now I advise them as the Dean of the School of Nursing at the University of Washington. Through the years, I have probably influenced thousands of nurses going into the field through my various roles. I like to help people understand the impact of just their physical presence. Imagine the comfort we can offer by simply being there as a patient goes through a difficult procedure or hears an unwelcomed diagnosis.

It was Albert Einstein who said, “Not everything that counts can be counted,” and I believe that applies to the care that nurses provide. As the health care system goes through changes in this country, some will be looking to quantify the work that nurses do, to turn it into billing codes. But how will physical presence be billed? What code will they give “being there” at the patient’s bedside to sustain them while they experience something that may be very difficult for them?

Nurses definitely have a professional purpose for being at the bedside. The work of nursing is knowledge work. And skilled nurses bring their knowledge and empathy together with boundaries. The people who provide nursing services are there because of their ability to make important decisions and judgments about people’s health, as opposed to simply being there to support other health professionals.

Throughout my career, I have changed the form of my instruction, but have essentially remained a teacher. And it’s a role I enjoy immensely. At the end of my deanship, I can foresee returning to the classroom to continue working with students and continue the research we’ve done. Grooming people is at the core of everything I do.

We are entering an era in which nurse practitioners will most likely be providing much of the primary-level care in the country, particularly in underserved areas. Our health care system can’t be sustained with the scarce numbers of professionals currently available, and who are anticipated to be available in the future. So we’re moving into an era of unbounded opportunity, and that’s a great period in history for us. I don’t think there’s any more question about whether or not nurses are necessary. Our contributions to healthcare are extremely well recognized. To imagine a world without nurses is very frightening indeed.

Power Strategies: Influence, Power, Teach
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Nurse's Story: Andrea - Between the "Ladies Home Journal" and the "Wall Street Journal"

Andrea -







I’m amazed I made it through nursing school. Never a cake walk, many students dropped out half way through the nursing program back in those days. Geriatric nursing weeded out students lacking stamina. We started work at 7:00 a.m., a lot earlier than other students, and were in a separate course track, isolated from others in our cohort. It was a residence program, so we took care of elderly patients -- people who needed to be fed, couldn’t respond, and needed lots of physical assistance. Half of my class dropped out. I wanted to prove I could stick it out. It was a matter of pride.

After receiving my bachelor’s degree, I joined the military with 12 other nursing graduates. Some of us didn’t even realize there was a war going on in Southeast Asia, but we quickly learned how to set up tent hospitals and fire a rifle and care for people with gunshot wounds. I also cared for people who had lost arms and legs in Vietnam. Fresh out of school, I suddenly had to behave as an adult. My idea of nursing was completely changed. I was really taking care of patients – not only caring for them, but also figuring out how to help them transition back to civilian life with major wounds.

I developed an affinity for orthopedics and rehabilitation through my Vietnam experience. And, I had the GI Bill to help me get to graduate school. I wanted to get my master’s, but wasn’t sure if I wanted to continue my nursing education and move up that track, or change my focus to a business track.

I remember the day I decided to go the MBA route. I was working at the hospital when a young teenager who had lost her leg in an automobile accident was being discharged.“I’m committed to sharing my knowledge and transferring my skills to others, so when I’m ready to fully retire, I know I’ve done my part to strengthen the nursing profession." Her family was presented with a huge bill as they were leaving the hospital. They were upset, and the teenager was distraught because she had cost them so much money. I kept thinking that all the rehab work I had done with this patient was going down the tubes. I took off my cap when my shift was over, put it in my locker and said, “I think I’m going for the MBA because I can’t deal with this cost issue.” That was in 1970. When I signed up for the course I still had my nurse’s uniform on. I received a lot of weird looks, like “What are you doing here?”

After passing the test to get into the MBA program, my quandary became how to get out of the MBA program. I found it difficult and different. It wasn’t like nursing at all. There were only ten other women in the class of more than 300 students, and I was the only nurse, so my orientation was very different from the other people in the class. The other students did not perceive the world through their feelings as I did. Everything we did was quantitative, not qualitative. Business and health care are two different worlds. It was hard to balance the two and I always said I’m halfway between the “Ladies Home Journal” and the “Wall Street Journal.”

After settling into the MBA program, I realized nursing really did prepare me for the business environment. One of the first things nurses are taught is to observe. In nursing school I was tested on my observation skills. I was told to walk into a room and out again and then asked how much water was in the vase? Where was the vase? What did the sheets look like? What did the patient look like? The point was to hone observation skills because I needed to know very quickly if the IV was still running, the oxygen was still on and if the patient was perspiring or looked uncomfortable. In business you use those same observation skills, you simply observe different things. You still look at the situation, assess it and decide what to do.

I retired from healthcare about ten years ago. At the time I thought I would work a little bit, and only when I really found something I wanted to do. I decided to work with health care organizations that needed to make system changes. Instead of working like a consultant, observing a system and then writing a paper to convey what needs to be changed, I work alongside a staff to teach them how to implement changes that have been recommended. I teach staff how to do things, and once they’ve learned it all, I walk away.

I’m pleased with the multi-dimensional path my nursing career has taken. In addition to consulting work, I work in a project that helps people without health insurance have access to health care. So I care for patients, for the community and for nurses. I use my nursing skills and my business skills. I’m now 62, and I don’t want to work as much as I used to. That’s why I feel strongly about orienting other people to do this work. I’m committed to sharing my knowledge and transferring my skills to others, so when I’m ready to fully retire, I know I’ve done my part to strengthen the nursing profession.

Power Strategies: Facilitation, Community, Diversity
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Nurse's Story: Janice - With One Voice

Janice -







There are two sides to nursing: the technical and the emotional. Both sides are equal in importance, and should be recognized for what they bring to patients. That’s a message I’ve always wanted to share with nurses, but wasn’t in a position to do it on a large scale.

After thinking about how I could best share my voice and vision for nursing, I decided to go back to school for a master’s degree in business. I knew that degree would lead to jobs in nurse management, which is how I thought I could have a voice in the future of the profession. I felt like that was where I could help nursing move forward and help nurses to have a voice. Sometimes nurses feel subservient, or that they’re not heard or they’re not powerful. I have fantasized about how powerful we could be if we could come together with one voice.

One of my most important contributions has been to keep one particular message alive, and that is that it’s critical to have nurses – not just physicians – involved in the decisions made about patients.“The nurse pulls all of the pieces together.” Nurses bring a different level of care. Where the physician comes in to diagnose and treat, the nurse manages the whole patient, checking in on the details of the care, the progress made, the social needs. The nurse pulls all of the pieces together. Voicing that message will help make a stronger health care team for patients and will help ensure nurses’ work is valued, which will make a difference in keeping and attracting quality people to the field.

I know it takes determination for nurses to stick with their work through the challenges they face. I have found that where nurses work – a hospital setting versus a clinic or other outpatient facility – may contribute to how hard it is to stay dedicated to the profession. For nurses, hospital work can be especially physically demanding. They may also end up feeling that their work is undervalued and that they don’t have enough time with patients. They may sometimes feel like they do more paperwork than they do patient care, and believe me, that’s not what keeps them coming back to work. Nurses come to work to care for patients and use their intellect – not to be stuck with reams of paperwork, or pushing pills. That does not fulfill their dreams or even their most basic goals.

My goal has been to ____________. There are people who have inspired me along my path, and one of them was the head nurse from the diploma program I completed many years ago. It was at a Catholic hospital, and that was at a time when many of the nurses were nuns. This woman – Sister Martha Joseph – is now in her nineties and lives in a nursing retirement home. I saw her recently and she said to me, “I work a shift. I sleep a shift. And sometimes I do crafts on one of the other shifts.” I thought to myself, how nice it is she still feels like nursing at ninety.

But I can understand her dedication, because it’s what I feel as well. It’s part of my being. No matter what job I do, I am a nurse. And I bring that to whatever I do. I just feel like I’m a nurse at my core. It’s rubbed off, too, my daughter is now studying to be a nurse, and she recently reconnected with an old friend from high school who is also a nurse. He wrote to her and said, “Nursing school is hard, but don’t be discouraged. Hang in there. It’s worth it in the end.” And my daughter said to me, “That’s the same advice you gave me, Mom.”

It’s important for nurses not to be discouraged about some of the barriers they’ll run into, because you run into them in every profession. Life never goes quite as smoothly as you think it’s going to go. “Don’t get too upset about the bumps in the road, but keep pursuing your dream. You are a voice for nursing in everything you say and do. Keep trying to make it better, if it’s not already what you want it to be.”

Power Strategy: Learning, Persistence, Solidarity
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Nurse's Story: Julie - Listen

Julie -







I feel I’ve been called to promote a higher standard of nursing care. It gives me great satisfaction to be an instructor in a nursing program where I can make an impact on future nurses, and provides meaning to my own life. I am also fortunate to have a clinical practice where I can make a difference in the lives of patients. The opportunities that nursing has given me, and the interactions I’ve had with people throughout my career, make me feel truly blessed.

My commitment is to produce the best nurses, and make sure they not only have a strong skill set, caring behaviors as well. I think it’s imperative for nurses to have a conscience. I impress upon my students the value of learning good technique and their responsibility to maintain the high standards we teach.“I think it’s imperative for nurses to have a conscience.” When I see that light bulb turn on for them, I feel as though I have truly accomplished something. There are those individuals who are inspired by motivations other than healing and are less likely to uphold the standards of nursing. They tend not to care about developing good technique, either. So quality of care slips a notch and it’s because they think nobody’s watching, or they conclude no one else holds up the standard, so why should they?

One skill I especially emphasize teaching is communication, primarily listening and questioning. Nurses need to know how to listen well to their patients, to hear their stories, to be compassionate but also to detect evidence of discomfort, symptoms and other clues to the whole patient. But also because sometimes you can’t do anything else for a patient other than just listen.

In my clinical practice, I saw a gentleman who has experienced the gamut of back surgeries, and despite the large amount of narcotics he takes still has excruciating pain. I took time to just sit with him while he cried. Afterwards, he told me it was more important for him to have someone just listen than to have any other procedure done to him. It was clear he hadn’t felt heard by anyone up to that point; most likely the caregivers felt they had nothing more to offer him.

Communication is more than just listening and expressing compassion; it also requires asking the right questions. If you don’t, you may miss important clues about circumstances in patients’ lives that affect your ability to help them heal. As nurses, we need to be aware of those circumstances. I once discharged a patient with pain medications only to find out two days later that things weren’t going very well because this patient couldn’t afford the prescription. Had I persisted in my discharge planning a little deeper, I might have been able to get the prescription changed and the person wouldn’t have had to experience such prolonged discomfort.

Back pain is complex. I once saw a patient whose diagnosis was eventually ovarian cancer. That diagnosis came about as a result of asking the right questions about her symptoms and then thinking critically about the responses. I was able to rule out the back as a source of her pain and referred her on to a provider who then moved forward with the diagnosis. No time was lost in her case, but the consequences of not listening, of not questioning, are scary to contemplate. The worst thing that can happen is to miss an intervention, so the worst-case scenario is always in the back of my mind.

Nursing is just like any profession, filled with people who just want to do their jobs and who think on a day to day basis. They don’t want to think about the long-term effects of the way our country finances health care. They don’t want to get into management or the political debate of insurance versus care. They either have found an avenue of nursing that completely suits them or they are flying under the radar, just punching the clock, hoping no one will notice.

So we have to listen to each other, too; ask good questions to detect the symptoms of our own burnout individually and any slips in our professional standards. We not only have to advocate for the patients, but for nursing as a profession. There is a need for nurses who will speak out on public issues and open the door for change.

In looking at communication, we as nurses have to be aware of our own bias that we carry with us. I had a patient whose religious beliefs did not allow her to receive blood products. She was involved in a motor vehicle accident and broke both femurs. We took care of her nearly 50 days because her lab values were too low to safely proceed with surgery. Had she taken blood, she would have been out of the hospital in seven days. I had a really hard time reconciling my desires to heal her, to be efficient and to respect her beliefs. In the end, by being patient-focused and ignoring biases, a plan of care was developed. I tell my students that with all their knowledge and experience, one of the highest attributes of a good nurse is respect the patient’s beliefs.

Power Strategies: Connection, Curiosity, Order
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Nurse's Story: Maggie - A Certain Light

Maggie -







Actually, I always wanted to be a doctor but didn’t want to go through the twelve years of schooling that was required for it. I went for what I saw as the next best thing, which was to get my BSN. Although there are times when I wish I would have challenged myself to continue my schooling, I have no regrets about becoming a nurse. There have been many moments when I have watched what physicians do and it makes me glad that I chose nursing.

After doing floor nursing for a while, I went straight to the OR. As a child, I always knew that I wanted to see what the inside of the body looked like, so I had no trepidation about going into the OR. For the past five years, I’ve been doing open-heart surgery.

The number one thing people considering going into nursing need to know is not to take things personally. And number two – it’s always about others first. It’s a profession in which you handle other people’s lives and emotions. You get a whole personal perspective about them. You need to stay humble and open, take criticism constructively, always do self-assessment, and just hang in there.

It’s really the people that inspire me in my career. I truly love the variety of people that I can meet in one place doing one thing. It’s hard sometimes to explain what keeps me going, to be honest, because there’s a lot of grief and misery that we witness. But there are also many moments, for instance, when an 80-year-old gets up and goes home and continues to mow the lawn. That is rewarding enough.

Besides my sense of humor, I think what really saves me is my spirituality. You really can’t see everything from the human perspective; as far as I’m concerned, you have to see that what really gives us our humanity is our spiritual perspective. It helps in cases where things cannot be solved; where we just absolutely get stuck. You have to see life continuing and beautiful beyond the physical means that cannot be helped. The medical field cannot do anymore, so something needs to continue to beyond that.

Once in the lunchroom I told a story to my fellow co-workers about the books I’d read on life beyond death.“You have to see life continuing and beautiful beyond the physical means that cannot be helped.” In many instances, elderly people with Alzheimer’s or who were really sick seemed to be schizophrenic or going between several worlds, but every moment would come back and say hi to their daughter or son. I read a story that claimed sometimes these folks are actually looking for us, the family members, to give them permission to pass on. I had a co-worker who was going through this with her mother. We all suggested that maybe the mother was looking for her daughter’s permission to go. The mother had been suffering from a very long illness, teetering on the brink of death but not passing on.

Well, we had this lunchroom conversation on a Friday. The following Monday the co-worker came in to work, gave me a big hug and said thank you. Her mother had died on Sunday. She had talked to her mother, given her permission, and she had finally passed on after all those years.

Nurses are really a container for the grief of patients and their families. In many instances, when you get off your shift and go home, you are grieving. You take that home with you. In my case, you work on someone 13 hours a day in open-heart surgery and you do everything that you can, but they just don’t make it. They pass right in front of you. How can you not take that home to process? You go home, you cry. Maybe sit in a hot tub or run a hot bath. You sleep, and you just deal with it. When you’re ready, you can discuss it with your co-workers if you want. But everyone has a different way of handling grief.

People tell me I bring a certain light wherever I go. That to me is a great strength in nursing, especially to a highly stressed OR team or unit. There’s a certain aura that people carry with them and we all have our own. Mine is this light, and having the ability to make people laugh, too, because I’m so straightforward. I just tell it like it is, which people seem to find refreshing.

Like in any career, you get to the point to where you know when you’ve accumulated so much knowledge in certain areas and you are ready for a bigger challenge. You’d think open-heart surgery would be the greatest challenge, but I’m about to make a move over to critical care because I have a desire to work with a bigger picture. Whole systems – respiratory, metabolic, circulatory – along with the medications given, is a challenge for which I feel I am ready. I want to be able to put one, two, three and four together, and get a greater perspective. It’s time to move on, and I’m fortunate to be in a career that makes it possible for me to do that.

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