I learned a lot in kindergarten, but unfortunately, and contrary to popular belief, I didn't learn everything. It felt like I learned a lot in nursing school, but it still wasn't enough. I have learned a lot in nursing, in my years thus far of being a nurse at the bedside. But most of all, I have learned exponentially more than I would have imagined in a year of open dialogue with nurses, from nursing students to seasoned nurses. Burnt-out nurses to those still full of naïve passion. These are some of the most valuable lessons I learned and applied in the past year.
Don't cry over spilled...
Poop. They say don't cry over spilled milk, but I have worked in NICUs and PICUs and I can tell you that a drop, an ounce, a whole frozen milksicle of hard-earned maternal breast milk is certainly worth crying over. I've learned to grip that stuff like the world's last Faberge egg, heart racing at the very thought of it slipping from my hands to the floor. The perfect details of someone's handiwork shattering around my Dansko clogs, the whole world in that instant painfully and resentfully aware of the negligent mistake I have made.
The explosive diarrhea that gets on your glove and through a misguided, poorly thought out, quick swipe of those flyaway hairs out of your face, gets firmly planted on the edge of your curls, causing you to drop the bed pan, splattering it all over the floor, your shoes, pants, the IV pole, and wall with a loud crash that brings even the laziest of coworkers running in your direction. That isn't worth a single tear, unless it is from an overabundance of laughter hours later over an aptly chosen mudslide at the bar around the corner with your coworkers when the shift is over.
I have learned that my day often, if not consistently, does not go as planned. It isn't worth my tears though, or even my disappointment. Learning to go with the flow has been a valuable lesson that has come closer and closer to home in the larger and busier units I have worked on. More so, watching the nurses who have burned out early vs. those with impressive staying power seems to be highly correlated with their ability to let things go without getting bent out of shape over it. So don't cry over the poop, the sputum, the dilaudid you just dropped on the floor... but never, ever, ever drop the breast milk!
What's gonna work? Teamwork!
This is the chorus of a theme song on a children's cartoon. Working in pediatrics, it seemed to always be playing in the background in all of the moments when I needed the reminder the most.
How am I ever going to make it through this assignment alone?
I would frantically whisper to myself early in the day.
And in that moment the cartoon gerbils, or munchkins, or whoever they are, would musically remind me of how.
I am never alone.
I can tell you a story, that I sat with a lonely patient on my lap, administering his meds one by one through his central line, IV syringe pump on the bed ahead of me. But I wouldn't be telling the full story unless I added that Molly brought the medications to me from the refrigerator and locked medication bin, going through the patient's medical profile and verifying one by one that each medication was correct, giving them to me lined up in order of administration time to ease my work of again verifying each medication against my patient's profile and then his arm band.
I would also have to tell you that Leigh had come in to remove the IV pump from the pole where it originally stood, leaving the IV line taught, at risk of snapping or coming undone. She detangled the many lines and cords to place them safely on the bed. I would need to mention the resident who checked in frequently, relieving me at one point when after hours of sitting I realized I could not hold my bladder another minute. She moved easily into my spot and he stroked her hair instead while I ran to the bathroom.
And I would have to mention Kathy, the nurse on the night shift who relieved me, agreeing to take my place with the patient in her lap, rocking him to sleep and tucking him into bed for the night.
I have learned that I am never, ever alone. In a code, I have had team members already helping out before I have even found my voice to yell for their assistance. The moment before I have become tired from compressions a resident or other nurse has tapped my shoulder and seamlessly taken over. When my patient has passed, and I have felt the sinking loneliness of failure, I have felt more supported and surrounded as each and every person has checked in, asking if I am okay. The charge nurse has sent me away for a deep breath and cold water on my face, and I have returned to a fellow nurse compiling my notes to ease to overwhelming task of documenting the precipitating events in time to accept my next patient.
Teamwork works, and it is often so natural in this environment that it goes unnoticed.
Rise, and shine, and give... the Glory, Glory
If that line doesn't start the chorus of the children's song in your head you must have spent less time in Sunday school than I did. But regardless, I have learned in nursing, and in life, the importance of giving the glory somewhere else.
"I don't believe in God."
You may say. To which I reply, not a problem! Just find another source. It could be a coworker, an old professor, or the Christmas cactus in your living room. Regardless, if you focus on the glory of what you do going to someone else you won't miss it if it isn't there. When you take the glory for yourself you start to expect it, and when it doesn't come your way you begin to lose your passion and drive. Those feelings of burn out may start to creep in, or even worse, you may begin to resent the patients, families, physicians, who once glorified the work you do and suddenly do not, or haven't for some times.
One of the issues I see in nursing, and I am as guilty as any other, is that we don't feel respected, so as a result we are desperate for recognition. There's a big difference between wanting recognition for the nursing profession and recognition for your self, as a nurse. Don't mess with the latter, its risky business and can lead you down a slippery slope.
So find where you will send all of your recognition, the your God, your gods, or your team, it doesn't matter. What matters instead, is that you learn to not find your worth in what you do based on the praise you receive for it.
Talk to Me
I have been so lucky in the past year to be thrust into dialogue with nurses around the world. I have a learned a lot from all of them, about our differences and similarities, new nurses versus the old the staples. But most of all, I have learned that as much as we like to talk to each other about what we do, we do not succeed in telling the world about it. And when we try, for some mysterious reason, it comes out like a laundry list of complaints and requests from martyrdom.
We aren't martyrs! We chose this profession, and it is time we start treating it like one. If the desire is for nursing to be seen and respected it is time to use our words and eloquently, confidently, to share what we do with society. Instead of complaining that doctors are portrayed in television, recognize that it is because physicians have written books and screenplays and placed their profession there sooner or more often than nurses have. Instead of crying that nurses are portrayed negatively, watch Wolf of Wall Street, Silence of the Lambs... We aren't the only ones portrayed negatively by characters or stories in film, we are just the group insecure enough to feel defined by it.
We nurses are desperate to be understood but fall short of fixing the problem, so pick your head up, stop whining about long shifts, sore feet, and stunted emotions that come from the work you have chosen to do. Instead, find a way to share the pride you have in what you do.
There is so much more than these three lessons, but I think this is a good place to start. I learned a lot from a year of being "just a nurse," I learned it all from you. So thank you, and keep up the good work.