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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