When did you realize you were meant to be a nurse? My first student experience was in a nursing home. The team leader confessed they had a patient who earned the title “Most Difficult” I chose her, thanks to my arrogance and innocence, because I thought I could reach her. Through her morning care she hollered and complained. When I didn’t rush her through her lunch, she began to talk about her life and the limited choices for a smart woman in the early 1900s. By the end of my clinical days, she called my name as I walked down the hall to leave. Sally B. didn’t just reach me; she touched my soul, and I still hear her haunting voice calling me to come back.
What do you think is the greatest part of being a nurse? Nurses bear the responsibility and privilege of entering the lives of patients and their families when they are in need and most vulnerable. The constant change in technology challenges, but it is learning to provide the best, personalized care in a corporate model that demands vigilance, commitment, and persistence. I remind myself of this every day.
How has the profession of nursing changed over the years? When I first started nursing, autonomy and clinical decision making advanced exponentially. To nursing’s detriment, litigation, the imposition of bureaucratically driven policies and procedures, and the layering of the health care team with yet another interface between the patient and the physician is undoing the autonomous growth bedside nurses enjoyed. Lack of autonomy will reduce bedside nurses to automatons.
You said you are changing careers. When you speak of nursing, your voice fills with awe. What has happened to make you want to leave?
It’s a symbolic, most basic illustration, but it depicts the root of why some nurses leave nursing. A group of nurses formed a committee, reviewed the literature, and revised a policy decreeing it was not harmful for nurses to wear nail polish as long as it was well maintained. The same nurses who celebrated this win refuse to shave, or don’t see the necessity of, shaving a male patient. Both things address personal hygiene. It’s just that simple.
Nurses now work in a world where initials in boxes on a paper taped to a patient’s door mean more than the documentation in the nurses’ notes detailing hour after hour when the nurse hasn’t left the patient’s bedside, not even for a bathroom break.
From an old feminist perspective, the clock is swinging backward. I worked through a time when MDs were held accountable for inappropriate work place touching and venting of anger at nurses. Â Because younger nurses don’t realize how older nurses fought for simple respect, they contribute to the devolution of professional boundaries.
Corporate health care mandates doing more with less. Decades ago we planned care before a patient arrived. In one instance, due to the emotionally complicated situation of one man, nurses volunteered to be primary caretakers throughout his hospital stay. The clergy and psych staff became involved. Everyone invested in the plan followed the man through his surgery, his stay in ICU, telemetry, and finally his discharge. When he returned, he told us we changed his life. A bitter, angry man was helped by a simple plan. How does insurance reimburse for that? How do staffing matrices account for that? Nursing organizations prattle on about “best practice.” Who defines that? The man whose life we changed, of course.
More often than not, I go home from my shift feeling I haven’t done enough. And thus, it’s time to go.
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