Brie Gowen

Savor the Essence of Life

Do You Know Who’s Nursing’s Worst Enemy?

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It’s no big secret that nursing is a challenging field. As if the ever-changing knowledge required to remain competent in the profession were not enough, factor in the inherent difficulties such as unrealistic staffing ratios and false perceptions from the community at large, and it’s near impossible to perform the job as is expected. 

So while striving to perserve required credentials, maintaining skill’s competency, and keeping up with continually changing and expanding technological advances, the professional nurse must also adhere to safe practice standards, ensuring the best possible care is delivered to his/her population. 

And that’s fine. I mean, we’re used to it anyway. Where things may get kinda slippery are keeping to such a high standard when short-staffed. But the hardest part is probably trying to reach the high bar that is set by the expectations of the patient population.

Indeed, nurses are not only expected to perform their job with skillful competency, without mistake, and in a timely manner, but also with a huge grin on their face. In fact, nothing ruffles the feathers of the general public more than a nurse who can’t seem to adhere to the Florence Nightingale, Angel of Healthcare perception. What I mean is, it’s just expected that nurses should perform their duties without complaint and with a happy smile. At all times. 

So is it the unrealistic expectation of the general public that makes nursing harder than it should be? Perhaps. What about stubborn, cocky physicians who belittle their nursing counterparts? Yep. That’s certainly a dinosaur I’d love to see fully extinct! How about unfair working conditions or a nonsupportive work environment? Is that the worst enemy of nursing at large? 

While all those things are terrible, they’re not the worst. It’s not even patient satisfaction surveys. And although this might disappoint some, it’s not even the large number of professionals who misspell HIPAA. (Of note, I don’t think this is a big deal whatsoever.)

I can recall my first nursing job. It was PCU, aka, Progressive Care Unit. It was a step down from ICU, which basically meant I worked my butt off. I had patients who likely should have gone straight to the ICU, but started with me instead. Most patients were one minute away from coding, but instead of having two patients, I had 4-5. It was awful! I mean, I loved it, but as a new nurse it was incredibly stressful. 

The great thing, though, was how much I learned. While I anxiously prayed my way to work, once there I hit the ground running and set-up an awesome foundation of knowledge for the rest of my career. Yet I only stayed there a year. I became certain it was the worst job ever. 

This fire of dissatisfaction was stoked by the company I kept. I worked night shift and several of my coworkers had passed go at burnout, and had completely submerged themselves in Bitter, Angry Nurseville. And they were determined to bring everyone else there to live. 

Looking back I see a job that to this day paid me better than any I’ve ever had, to include the largest sign-on bonus, best compensation package I’ve seen, and a rocking shift differential. We were paid frequently for continuing education, and had the joy of self-scheduling. Like, I only had to work a weekend every once in a blue moon. 

But at the time, I was sure my workplace was the pits. The bad mood, poor attitude, and “eat their young” mindset of those around me did their very best to poison my new nurse persona. They were serving up bad apples, and I naively fell into that barrel. And that was the worst. 

I saw it then, and I see it now. Do you know who’s the worst enemy of Nursing? Nurses. We are our own worst enemy. Sadly, poor attitudes of burned out professionals seek to infect the incoming newbies. Know-it-all nurses who are full of judgement but low on grace are negatively impacting those around them. 

Nurses are a strong breed. They have to be to survive nursing school, but that tough exterior is strengthened by necessity when they encounter the very real challenges of being responsible for the life of another while maintaining professionalism, integrity, and stellar, skillful performance without error. 

But sometimes that tough exterior actually becomes a hardened shell, one that lacks the compassion that led them into the field to begin with. The lack of help, grooming, and guidance from one’s peers can lead to burnout faster than anything. The inability of coworkers to be cohesive and willing to team-build can break a young (meaning green) nurse quickly, and it can even wear down the rest.

As nurses, when we forget what it was like to be the “new guy” we are not doing any favors for the field. When we lack grace and mercy for our peers we are actually enemies of the state, the state of nursing professionals. When we’ve lost sight of our compassion for not only patients, but also our brothers and sisters in arms, we become the worst enemy of nursing, for no one can more quickly tear down the field than someone on the inside. 

In our own unrealistic expectations of those within the fold, we can quickly put out the fire of even the most motivated of professionals. We eat our young and slowly smother everyone else. It’s a shame. And it’s something that only we can change. 

As a nurse we are taught to see the patient through eyes of compassion, to try and walk in their shoes, to see the good in all. Why is it so hard to extend this same gesture to our fellow professionals? It shouldn’t be. 

As nurses we must strive to not only provide the best care to those we serve, but also the best and most compassionate care to those we serve amongst. No one will save us if we do not at first save ourselves. 

To pull together and overcome the many challenges that exist in the field of healthcare we must first pull together as a team of nursing professionals. Only then will we be able to reach fully the goals we have for the nursing field. Only then will our efforts be worth anything substantial. 

United we are many, but divided we will certainly fall. Although it sounds cliche, sometimes the simplest answer is the best one. 

The field of nursing isn’t easy. We all know this too well. There are enough challenges we face without having to face unnecessary ones within our own ranks.

The next time you interact with a peer ask yourself if your behavior and words are ones that help build your fellow nurse, or if they in fact cut them down. If they’re anything beyond compassionate, constructive criticism that is aimed solely with a noble purpose then they are poison to the very thing you love. They are actually killing the field you claim to hold so dearly. 

And that attitude of unknowing self-destruction is the worst enemy of Nursing by far. 

A Nurse’s Story: How Can I Hate Something I Love So Much?

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Earlier last night I was watching a video that described the heart of nursing, and it perfectly depicted the calling to which I had surrendered my life. Because that’s what nursing is. It’s a decision to embark on a quest to touch lives, change lives, and save lives. It’s this crazy, strong desire to intercede on the behalf of others, and you find yourself sucked into the vortex of giving so much of yourself emotionally, mentally, and physically to positively impact the life of a complete stranger. You’re compelled, and you know no other way. 

But sometimes it really sucks. 

I watched that video, and I felt pride. I felt that famiar sense of pride that always surrounds me when I think about what I do for a living. I love what I do. But even as I watched this touching film and bristled under the emotions of gratification and fulfillment, I also felt a small twinge of guilt. 

I felt guilty because sometimes I hate it. 

When I cannot seem to fabricate the time needed to care for my patient in a manner that I find fundamental and safe, I hate being a nurse. 

When I mistakenly disappoint a patient’s family, or they misunderstand my intentions. When they then turn their emotional explosion over their helplessness to change the outcome of their loved one’s health onto me, I completely understand it. I really do. But hurtful words still hurt. And unrealistic expectations still stink. In those moments of undeserved verbal assault, I hate being a nurse. 

When cocky physicians speak down to me, or when those positioned above me in the hierarchy of healthcare treat me with disdain, I hate being a nurse. 

When I can’t seem to satisfy my patients, run faster, answer the call light quicker, hold my pee longer, or find a way to go without taking a break, I hate being a nurse. 

When I can’t seem to give enough pain medicine to the chronic pain patient, or sympathize more with the addict admitted with another overdose this month; when I can’t understand fully why the alcoholic continues to drink despite his cirrhosis, or why the noncompliant diabetic patient continues to let her blood sugar escalate out of control, I hate nursing. 

When the stress of my responsibilities threaten to overtake me, when the chaos of life and death situations seems too much to bear, or when I feel like I didn’t move fast enough, think quickly enough, or intervene as appropriately as I should, I hate being a nurse. 

When I fight unsuccessfully to keep someone from dying, and I walk to my car with the echoes of their distraught, crying families’ sobs ringing in my ears, I hate being a nurse. 

When there’s too much loss, too many unfair situations, and too much cruel pain, I hate being a nurse. 

But then I remember; I cannot help myself. I remember that I love it. 

I remember that I love the field, no matter the challenges. I remember that I love the calling, and whatever responsibilities that entails. 

I remember that I love the patients. Every. Single. One. And their families too. Especially their families. 

I remember that the problems I face, the frustrations I experience, the difficulties I come upon, they mean nothing when held up against the joy I hold over being a nurse. 

I watch things like the video I saw on YouTube, and that feeling of guilt for my minute emotion of hate becomes overshadowed by the mountain of love that rises up inside me. I hate it, but then, no, I love it. 

I love it. And that’s all that seems to matter. 

If These Walls Had Ears

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I quietly carried a neglected breakfast tray down the hall of my intensive care unit to dispose of in its proper location. Despite my best encouragement it had gone untouched by my patient, and as I passed another occupied room I heard soft, reverent words coming through the drawn curtain. 

“Father, we come to you now in desperate need…”

I kept walking swiftly past the whispered, urgent prayers of a visitor, and I was touched by the heartfelt petition I had been privy to overhearing. I heard a lot of things like that, but I knew I didn’t catch even half of them. And I thought in wonderment, for certainly not the first time, if only these walls had ears. 

  

Indeed, if only these walls had ears they would hear many an urgent prayer uttered. Prayers for healing, prayers for pain to be taken away, and certainly prayers to lessen the ache of a grieving heart. 

If only these walls had ears they would hear the tears, mournful cries of loss, racking sobs of helplessness, and shrieking wails of agony and pain. 

If only these walls had ears they would hear the urgent whispers of worried family, the angry words of distraught daughters, and the frustrated fuming of parents at the point of breaking. 

If only these walls had ears they would hear the concerned questions of an advocating nurse, the urgent and quick phone conversations of the staff striving to receive the answers and orders needed to intervene in the best way humanly possible. 

If only these walls had ears they would hear the proficiently articulated commands of the medical team as they fought fervently to save the woman dying in the bed. It would also hear the hushed prayers and weeping of her son in the hall. 

If only these walls had ears they would hear the dying husband tell his wife in a cracked, wavering voice, “it’s okay honey. I’m ready to go home now.”

If only these walls had ears they would hear the brother and sister outside their momma’s room trying to decide between their heaving tears whether she would have wanted to remain on the ventilator or not. 

If only these walls had ears they would hear the shaking voice of the young husband whisper emotionally to his revived wife, “I was afraid we had lost you.”

If only these walls had ears they would hear the huddle of family clinging to one another as they cried, “now he has no more pain.”

If only these walls had ears they would hear the young physician as he hesitantly broke the debilitating news to awaiting children that dad didn’t make it off the operating table. 

If only these walls had ears they would hear grateful exclamations of thanksgiving when a seemingly hopeless situation was resolved, when a life was saved, when a deadly disease was thwarted. 

They would hear plenty of, “help me Lord’s,” but just as many, “thank you Jesus!”

They would hear so much heartache, but also tinkling laughter and songs of praise. 

If only these walls had ears, they would hear things that shouldn’t be repeated, but also stories that deserved to be retold. They would hear loss, but also life. They would hear death, but also healing. They would hear grief, but renewal too. 

If only these walls had ears, you might blush at the stories they revealed. But you would also find new hope in mankind. 

And it’s true; every day I walk these halls I hear enough to last me a lifetime, and I hear a lifetime of lasting things. Yet I only hear a portion of what they have to say. 

Things Nurses See

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As a nurse in a surgical critical care unit I often have people comment things like, “wow, I bet that’s intense,” or even, “you must see some really cool stuff!” And I suppose I do. 

I get to see men and women recover after open heart surgery and people come off the ventilator that we thought may not. I see plenty of excitement, lots of trauma, and advances in medicine that would make your head spin. 

I get to see young men stand up and walk after a debilitating car wreck, or a woman proudly put on her lipstick and mascara a day after having a portion of her lung removed. I see the joy on a wife’s face when her husband finally wakes after anesthesia, and the excitement of a son as he videos his dad walking down the hall two days after his rib cage was pried open barbarically. 

I see happiness and miracles aplenty; I see healing and mended lives made new. It’s wonderful. 

But then there’s the other stuff, the things people may not think of when they try and guess what it is exactly that I do.  

I see families make tough decisions, like to finally take their loved one off the ventilator. I watch as my patient struggles to breathe through an ocean of inescapable mucous trapped in her failing lungs. 

I see daughters wince as dad’s chest heaves up and down laboriously, and I see the fear and helplessness in their eyes. 

I see them watch me expectedly and intensely as I push the medication I begged from the physician to try and ease mom’s tortured respirations, and I see my own self begging God to help me lessen my patient’s distress without being the definitive cause of her demise. 

I see children cry desperately as they hold the hand of a dying parent who cannot squeeze back their grasp, and I feel my own tears well up behind my eyes as I place myself in their grieving shoes. 

I watch along with loved ones as heaving breaths of the patient come further and farther in between, and I hold my breath with them as the heart rate slows, slower and slower, until it ceases. 

I see husbands kiss the dry, cracked lips of their dying wives, and feel that last breath on their tear-streaked face as they pass from this earth. 

I watch them collapse over the body in a mound of inconsolable grief. 

I see children left behind and newly made widows cling to one another in racking sobs, and I watch helplessly as I pray silently, Lord, give them peace as only you can. 

I watch myself try my best to console, hugging, patting, and saying, “you did the right thing,” or even, “there is no pain anymore,” but understanding that my well-intended, though stammering words of comfort can only do so much. 

As a nurse I see a lot of things, and many of those things I wish I did not have to see. There is life and restoration of health, but there is also death and grief. I see happy smiles and hear cheerful laughter, but I also see dashed hopes and painful wails that rip at your own aching heart. 

But then I see weary family as they leave the bedside of their departed love one stop to speak to me. I watch in awe as they envelope me in a tearful hug, thanking me for all the things I was sure I hadn’t done. 

I watch in shock but also gratitude as they try to smile for me, expressing how thankful they are that I made things more bearable for their family member at the end.

I see these things, and although they are painful, they are also a reminder of why I do what I do. They’re a breath of fresh air when I was afraid the wind had been sucked from my own sails in the midst of so much heartache and loss. 

They’re the confirmation, these things I see, that I am exactly where I need to be. That even when I see the unseeable, I also can see God’s hand working through me. 

The Truth About Your Critical Care Nurse

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I stood at the bedside of a critically ill patient, conversing with a colleague. We discussed the numerous IV Vasopressors on-board, and what options were available to optimize heart function while maintaining kidney function. 

It was a dance; single, smooth steps to hopefully maneuver the dance floor as gracefully as possible without tripping over any toes. 

“Will I ever be as smart as you guys?!”

I turned in surprise at the question from a nurse orienting on our unit, and I felt a slight blush rise up my cheeks. I also felt a strange sense come over me, as if I were an imposter standing at the bedside. 

Certainly she didn’t mean me!

After eleven years transversing through the complicated arena known as intensive care I had to admit it had gotten easier. I no longer feared coming on shift for example. But still…  

I still had a lot to learn. And so many days I felt as if I would never catch up to an ever-changing, always evolving field. 

It was a dance. Some days I led, but other days I followed. Many shifts ended with me feeling like the most graceful performer on stage. Yet others ended with me licking my wounds where I had fallen clumsily. 

And someone had asked if they’d ever be as smart as me?!

Sure, some days I felt incredibly wise. But other days ended with me certain I was a blundering dunderhead. 

I flew triumphantly through some code situations, while others concluded with me wanting to bang my head up against the wall for what I could of, should of, would of done better if given a second chance. 

Some shifts I emerged from the building feeling like a game-changer, a life-saver, a calculated risk-taker. Then other times I slinked slowly off the unit surrounded by a cloud of defeat, an aura of loss, and a feeling of uncertainty for my abilities competing with a certainty that I had chosen the wrong career. 

Sometimes I knew all the answers it seemed, but more often than not I still had questions. Lots of questions. And I knew without a doubt that I couldn’t do what I did without the assistance of those around me. 

“Will I ever be as smart as you guys?” She had asked. 

I honestly hoped she’d be smarter. Certainly smarter than I felt on even my most brilliant of days. 

The fact was I didn’t feel special, or above and beyond. I felt capable, but often times incapable. I felt sufficient in my duties, but honestly, often times I felt terribly insufficient to perform the weighty task assigned me. When handling something as lofty as life and death, many times I felt very, very small. 

I stood at the bedside of the critically ill patient, watching multiple monitors, titrating cardiac drips, and I was hopeful. Not all the patients that came through my area pulled through, but many did. And though I felt small, in essence God had placed me in the midst of something very big. My responsibility was huge. Perhaps I was doing okay. 

Maybe I didn’t always feel like the smartest, the best, the most efficient, but I was where I needed to be. I did what I needed to do. I did the best I knew how. Of that I was sure, and maybe that was what she saw. 

What Would Life Be Like Without Nurses?

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Once upon a time I accepted a patient assignment just to discover that one fella would be discharging home that morning. That’s pretty typical, and I dove in head first to help make the process go smoothly for this man whose biggest concern was going home to cuddle his dog. 

The physician described to him a new blood thinner he would be going home with, and as the doctor left the room I cornered him in the hall. 

“Do you have any samples in your office?” I asked. 

I explained the cost of this medication was high, but the physician felt certain the patient’s insurance would be adequate to cover it. I wasn’t so sure, and before he had time to leave my unit I had called the man’s pharmacy and verified that indeed his insurance would deny coverage. 

That’s the thing; I thought about stuff like that. So while it was my responsibility to make sure the patient understood how to take this new medicine and possible side effects or drug interactions, it also fell on my shoulders to make sure that when he left my floor he could actually fill the medication, and affordably. 

Then there was the matter of a new little problem with a thing you might have heard of called Diabetes. There would be new discharge medications for oral, diabetic medicine, but also for sliding scale insulin coverage. 

These were very good medicines to treat his elevated blood sugar, but I would be the one who happened to ask the patient, “do you have a glucometer at home?” or even, “have you ever administered insulin before?”

The answer would be “no.”

The fact is nurses play an integral role in patient care from the moment a sick individual enters the door, during their hospitlization, and throughout the discharge process. I work with some of the most compassionate, skilled physicians I have ever encountered, but they are also some of the busiest. The patient load under a doctor’s care is huge, and many important aspects will only be noticed by the bedside nurse. That’s just a fact. 

The nurse is the one who insures a patient isn’t being set up for failure at discharge, making certain educational needs are met, medications are affordable, needed equipment is in place, social work needs are implemented, a safe environment is in place, and if a discharge home is appropriate overall. 

What would the life for a patient look like if these needs were not met? Would you see readmission rates soaring? What about mortality rates following discharge?

Let’s say my patient was also started on new cardiac meds for his heart rate and rhythm, because he was. But let’s also say that all his previous, cardiac home meds were continued at the same dosage. 

There’s a frequently misunderstood opinion by the layman that nurses simply give whatever medication is ordered by the physician, but this couldn’t be further from the truth. 

Your nurse is actually the one watching your vital signs and labs to make certain a particular medication is appropriate and safe. Your nurse is the one checking allergies, drug interactions, and questioning doctor’s orders as needed. 

Your nurse isn’t just a pill pusher; they’re your healthcare advocate. They’re making certain the medications ordered are needed, safe, and at the most appropriate dosage for your specific need. Then they’re relaying this to your physician.

What would life be like without nurses?

Would medication errors and drug interactions increase? I think so. 

Who would be present at all times to answer questions after the physician quickly rounds? 

Who would alleviate patient fears or offer emotional and spiritual support by holding the patient’s hand or praying with them when no family was present?

Who would remember to order a diet after a patient was NPO for a procedure that morning, or perhaps suggest that checking blood sugars might be a good idea for the diabetic patient on steroid therapy?

Who would notice the minute changes in mentation and suggest it might be the new medicine that is normally contraindicated in elderly patients?

Who would fight for pain medicines to be increased when they’re not working adequately, or call the doctor in the middle of the night when something didn’t look quite right?

Who would bring notice to abnormal lab results, acute changes on an EKG, or neurological decline before it became a bigger issue?

Who would do the little things that are actually big things to someone sick, like give baths, brush hair, or apply cream to a sore bottom?

When you think about it I’m not sure we could fathom a world without nursing, and while it honestly takes all members of the healthcare team working in conjunction to make patients better, the truth is a life without nurses wouldn’t be a quality life at all. 

That’s certainly how my patient felt when I held his Beta Blocker and got the dose readjusted, or when I helped him obtain free samples of a much-needed medication prior to discharge, while preauthorization was obtained for his insurance. I’m sure he also felt that way when he received education for administering insulin before going home with just a vial and some needles. 

One of my favorite things about being a nurse is when I am able to give my patient what they need to get better, when I am able to advocate, educate, and promote safe healing. I can’t imagine patient care without those things, and I don’t suppose my patients could either. 

 

Top Ten Reasons I Love Being a Nurse

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I know you probably hear me complain a pretty good bit about being a nurse, and shamefully I’ll admit that I do. Why? Because nursing is freaking tough. It’s stressful, mentally taxing, emotionally draining, and physically exhausting. The expectations for those in the field are often unrealistic, staffing ratios can be unfair, and the occupational risks are real. Then there’s the lack of appreciation for what we do, or even an absolute ignorance of the field. Remember The View?

But despite all the stress, despite the exhaustion, and regardless of the asinine instances that drive me absolutely bonkers, the fact remains that I love being a nurse. It’s true. I love it. 

Here’s my top ten reasons why. 

1. The knowledge. I think one of the coolest things about being a nurse is all the stuff crammed into my cranium. It’s insane. I know how to intervene to safe a live, and even secret ways to end one (insert evil laugh). The field is always changing, evolving, and progressing, and it’s pretty exciting to be along for the ride. I get a real satisfaction from knowing why something happens in the body and what I can do to help improve outcomes. Knowledge is power, and nursing know-how is the ultimate high. 

2. Being a part of healthcare. Medicine has come a long way over the years. Looking back at text books from the 1800s, and even just seeing how things have progressed since I became a nurse eleven years ago is mind-blowing. I’m honored to be a part of such progressive care, and I am proud to be a small but critical cog in the great machine of healthcare. 

3. Being a team member. Aside from being a part of the big picture of medicine, I am also honored to be a part of a smaller team in my immediate workplace. No one pulls together like a healthcare team intent on making a difference and saving a life. I’m consistently in awe at the fluid motion of my peers during a code, or even how perfectly all the parts come together to make a patient’s hospital stay a beneficial and pleasant one. From admission clerks, to housekeeping, to dietary workers, bedside nursing, physicians, and social work, all and more combine to make a person better than we found them. It’s amazing to watch and be a part of. 

4. I’m respected. Ok, a lot of times I’m not, and I know we all get upset over unfair treatment, but you have to admit, overall nursing is a highly respected profession. I am consistently thanked for being a nurse, and I believe that the population in general understand and respect the work nurses put out on a daily basis. And that makes me smile. 

5. People look to you for answers. Even if I sometimes get tired of so many questions, overall I must say I love it. I love being able to educate patients with that vast bank of knowledge I described. It empowers them to be more active in their care which makes both of our lives easier. Which also leads to…

6. I alleviate fear of the unknown. Being sick is scary, and I think my absolute favorite thing about being a nurse is helping to calm someone’s fears. By explaining what’s going on and what can be expected I make a huge impact on my patients’ emotional well-being and that of their family. I’ve used this the same in ICU as I did in Hospice care. Something about telling people what to expect makes the biggest difference in their experience, and it also makes me feel good. 

7. I make a difference. I’m not bragging; I’m stating a fact. As a nurse I make a difference in the lives of my patients, and I can think of very few callings where you have the personal impact on people like you do in healthcare. You bring a baby to a mother’s arms for the first time or hold a grieving daughter as she cries at the passing of her father. You save lives, and you also make their passing from this life more comfortable. It’s a humbling experience, and it’s also a huge responsibility, but one I’m extremely proud to take part in. 

8. I take pain away. This isn’t just a reason Iove nursing, but also a reason people love nurses. We’re like little narcotic fairies, making pain-free wishes come true, and while that may occasionally make me feel like a drug dealer, over all I enjoy having the ability to make people smile, albeit drug induced. Wink, wink. 

9. Seeing people get better. In nursing you see some pretty brutal stuff, and the reality of death and dying can be crushing to a nurse’s spirit over time. So much sickness can be stifling, but then a story of hope and healing will emerge. And as you watch someone who you were sure would die, and maybe even briefly did, walk out your hospital doors (ok, roll per policy, but you know what I mean) it makes your heart soar. Seeing true stories of strength and survival spur a fire inside a nurse, and it helps our own hearts heal after seeing so much loss. 

10. Hearing thank you. I started out by stating that nursing is hard, and it is. Really hard. But it’s also rewarding, and when patients and families use the golden words “thank you” it’s an absolute treasure. It’s an encouraging affirmation that offers appreciation and cultivates a motivating environment. Above all it’s a friendly reminder to nursing staff that their efforts are valued, and it brightens my day. I don’t need a thank you to do my job, and honestly miss hearing that phrase quite frequently, but when I do it makes my job more enjoyable that it already is. 

Like I said earlier, nursing is tough. In fact it’s one of the toughest things I’ve ever encountered. I get stressed out, and sometimes I question my career choice. After an especially trying shift I may even beg God that I don’t have to go back. Some days I feel unappreciated, over-utilized, and under-paid. Other days the little stuff drives me crazy! Nursing is certainly not for the faint of heart. 

But all that seems to lose out in the end to my calling. My calling to be a nurse carries me through the bad days, and it helps to remind me of all the wonderful things that make me absolutely love what I do. 

20 Things Nurses Hate to Hear

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You ever have one of those days? You know the kind I’m talking about. It’s the one where from the moment you walk in the door you know it’s gonna be a shift from hell, and there’s not much you can do other than pull yourself up by your boot straps and hit the ground running. You put on your big girl panties, or big boy drawers, and suck it up, buttercup. 

In nursing bad days happen, bad things happen, and you just go with it. You pull together as a team and make the most out of a difficult situation. That’s what makes nurses awesome. Grace under fire. 

So when you ask the surgery team how the patient is doing that’s headed your way, and they say, “according to doc he’s the sickest patient in the hospital,” you wince, but then you put your gloves on and stand by. 

But still, despite the fact that nurses do what must be done to get the job performed well, there’s still certain phrases that a nurse hears, and they do not like at all. Some they may even hate to have someone utter. 

So, do any of these make you cringe?

1. “Your patient is a train wreck!”

2. “You’re charging today.”

3. “It’s your turn to get pulled.”

What about:

4. “Lab is on the line with a critical value.”

Or:

5. “We’re gonna be short-staffed today.”

Which isn’t cool if you also hear:

6. “You’re patient is a bit confused.” 

Come on, is there really such a thing as a bit when trying to keep someone from falling?

Or:

7. “He drinks about a six pack.” 

Which means at least half a case, right?

And sometimes:

8. “You have a patient family member on the line.” 

Ok, this isn’t always cringe-worthy, but when it is you know it.

Kinda like:

9. “His family is very involved.”

Or:

10. “Her family is a little needy.”

Yes, I’ll be honest. I’m probably that family member. 

But hopefully not this one:

11. “There’s some family drama going on.”

But all that is better than hearing this:

12. “There’s no family to speak of.”

Which makes it hard in some unfortunate cases when you hear:

13. “Yep, she’s a full code.”

Regardless, you never like to hear overhead:

14. “Code blue.”

Then there’s the ugh-worthy:

15. “You’ve got an admission coming from the ER.”

Which is only trumped by:

16. So and so “just called in sick.”

And you never want to hear a patient say:

17. “I have a really low pain tolerance.”

Cause that’s a challenge, right?

Especially if they add:

18. “I’m allergic to everything but Dilaudid.”

But that’s never as bad as:

19: “We have a mandatory meeting this week.”

Which is right along the lines of:

20. “Ahh, I’m also gonna need you to go ahead and come in on Sunday too.”

But we’re pretty used to that. 

Why Nursing Matters

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This morning I sipped good coffee and I read through my Facebook newsfeed. I came across several posts from a nursing group I had recently joined, and as I read the words of strangers, yet somehow not strangers, I realized I felt a familiar clinching of emotion in my throat. As I read another the building tears threatened to spill from the corners of my eyes. I swallowed an invisible lump, and I thought nursing matters. 

I’m a nurse, but I’m going to be completely honest with you right now. Sometimes I wish that I wasn’t. Some weary mornings as I gather up my stethoscope and trusty scrubs I think, I just can’t do this today. Some mornings I don’t feel it, and the fatigue from my own family obligations and personal circumstances make me certain I don’t have what it takes to enter the doors of my critical care unit. The idea of being completely responsible for another person’s life and the knowledge that I must be on point to prevent possible negative outcomes is absolutely daunting. 

Other days, severely long days, end and I think, I’m not cut out for this! After hours of off and on code blues, when the weight of the stress and responsibility crashes down on me after thirteen hours on my feet I wonder if I made the right decision when I decided to become a nurse. 

I remember when I first dreamed of becoming a nurse. It seems odd that it came with my mother’s tears, but as I watched proudly while she cried I thought perhaps I had found my calling too. She had just returned from an accident scene, an “off-duty” RN working fervently to stop the bleeding from an eleven year old girl’s complete leg amputation after a motor boat accident. As she described her efforts to locate the severed artery all while calmly reassuring and updating a frantic family around her, I watched her tears she finally gave permission to flow, and I thought, I want to be like her. I want to make a difference. 

Many weekends when I work I break away for lunch, and while in the cafeteria I will run into an older, male ER nurse. I’ll cheerfully say hello, and ask questions like, “y’all busy today?” He’ll answer in return jokingly and we’ll share friendly banter back and forth. What we don’t talk about is how he saved my mother’s life many years ago. A small, rural ER on a weekday night, and he was the top dog present. He was the nurse who gave my Momma life-giving oxygen in her lungs when she had none, and restarted her heart after it stopped. She has since passed away, but as I watch this guy on the weekends grabbing a soda and chips it doesn’t escape me that because of him I had twenty more years with my mother that I might not have had otherwise. 

I think recently when derogatory comments towards nursing made by hosts of the television show The View erupted in the media many people may have been confused by our reaction. Even Michelle Collins herself tweeted surprise that nurses seemed capable of the feelings we had about it. I think she might have even said we should “take a Valium and relax.” I think some people in the community thought nurses were overreacting, and while a great many supported us, still others just didn’t get it. 

The thing is nurses possess a passion that many can’t understand, and I suppose that’s okay. Yet that passion, that determination is what helps make nurses into the men and women they must be to perform the job they do day in and day out. It’s that passion that carries me to work on the days when I’m “not feeling it” or brings me back after a particularly difficult shift. 

The passion of nursing is what makes a woman pulled from a family picnic hold a gushing femoral artery closed until EMS arrives, or an ER nurse fiercely determined to give a young daughter back her momma for a couple of more decades. 

The cold hard fact is that nursing is hard, really hard, and it’s not just on national TV that nurses are persecuted. They are verbally, mentally, and physically abused on the front lines on a daily basis. The expectations put on them are extremely unrealistic most times, and the demeaning treatment from others is a crying shame. Yet nurses love what they do, and that passion to help others and make a difference drives them forward.  

Nursing matters, and most everyone will admit to being positively impacted by someone in its ranks. And as I read stories from fellow nursing professionals this morning I was reminded of that. I was reminded that we are strong, we are proud, and we make huge impacts on a daily basis with the lives we touch by simply “doing our job.”

I went ahead and I let the tears fall. I’m proud of my profession, and even though others may sometimes oppose me it will not change why I do what I do. Some people may never understand the passion or what it actually takes to be a nurse, but that’s okay. We’ll take care of them too. In the end, nursing matters, and I’m honored to be a part of something so noble as that. 

*Please feel free to share a personal story below in the comments of how nursing has positively impacted your life or your family. Let’s show nursing that it matters. 

5 Things They Don’t Teach You in Nursing School

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There’s a lot of information covered in nursing school. So much information, in fact, that it’s completely overwhelming. As a nursing student you feel as if your brain will burst with the weight of all the knowledge being quickly poured inside your skull. Yet in all that info there’s some things that slip through the cracks. 

I’ve often said that the “real world” of nursing is far removed from that presented in school. That’s just a fact. And being thrown into the refining fire that is actual patient care is the only true test of if you have what it takes to be more than just a nurse, but rather a really good nurse. 

There are many things you will learn in just that first year out, and actually that learning of new things will never end. There’s only so much they can present in an educational setting, and while there are a number of things you won’t learn until you’re on the job, these are a handful I find extremely significant. 

Those nursing professors are pure gold, and they try to impress the relevance of all facets of patient care, but here are five things you just can’t learn in nursing school. 

1. How to cry with your patient. 

You learn about sympathy, empathy, and emotional support, but until you sit with a 32 year old mother of young children who has just learned she has terminal cancer, you will never understand. 

Sometimes you cry right along with them, and other times your shoulder serves as a bucket for their plentiful tears. Either way, you won’t understand the significance of that moment until it happens. 

When a tough guy in his fifties, with no medical history, suddenly faces the reality that he has to have a major heart surgery that day you will let him squeeze your hand tightly as silent tears roll down his ruddy cheeks, and you will finally get it. 

You will finally learn that some days you don’t do something incredibly skillful and clinical, but instead you do something completely compassionate and wonderful. You cry with your patient. 

2. The importance of holding hands. 

In clinicals it’s so exciting to get your first IV, and nothing compares to sinking that nasogastric tube the seasoned nurse had trouble with. But I tell you this. Sometimes, often times, the most important things you do will go unseen. The thing most remembered by your patient will not be how you gave their medicines on time, or got a foley catheter in place without difficulty. No. What they will remember are the small things you might have thought were insignificant at the moment. 

When an elderly woman gets confused at dusk, and she becomes very frightened, your soft voice and caring touch will be the key to her comfort. The time you spent holding her hand as she drifts to sleep will mean more than any other intervention you could perform. 

In school they’ll use terms like “therapeutic touch,” but until you help lessen a young woman’s pain and anxiety after she loses a baby by simply holding her clinched hand while she unleashes her grief on your bent ear, you won’t fully understand just how important a simple thing like holding hands can be to a patient in need. 

3. How it feels when a patient dies. 

In school you will learn extensively about death and dying. They will try their very best to prepare you for the reality of healthcare, and this reality is that people die. You will know this. You’ll even think you understand. But then you will experience your first unexpected code. 

Even as emergency meds are being pushed, hard, fast compressions are being delivered, and crisp, perfunctory orders are given, you will feel almost separated from your own body. You’ll perform in a professional manner as you fight to save your patient’s life even as you hear their family crying loudly in the hall. You will work efficiently and instinctively, albeit likely nervously, until someone finally calls time of death. 

Later that night, well after hours of charting and a silent drive home, it will hit you like a ton of bricks. You might cry like a baby. However you react, you will grieve. You will question yourself and your actions. You may even question your profession choice. You will finally know what death and dying really means when you’re the nurse. 

Then you’ll get up the next morning to go fight another day. 

4. The joy of little things. 

In nursing school you will learn so many big things. You’ll learn big words and even bigger definitions. You’ll learn big medicines and big, big side effects. You’ll learn big laws that govern your practice and the big responsibilities that will become your own. 

Then you’ll experience the little things, and you’ll learn how big they are. 

Listening. Just listening. 

Washing a woman’s hair who has been in the hospital a while, and making her feel pretty. 

Laughing with your patient. Laughing loud and heartily. 

Feeding an elderly man whose hands shake too much to do it himself. 

Giving a bath to someone too weak to do it themselves. 

So many things that seem so insignificant and small, but that you learn are in reality totally huge. 

5. How to walk in someone else’s shoes. 

In school you learn about cultural diversity, mental illness, addiction, and all the different peculiarities that will make your patient a unique individual. But then you enter the real world of nursing, and you’re astounded by the people you meet.

You meet all kinds. All kinds. You’ll even encounter some of the meanest, rudest, most cruel types of people you’ve ever come across in your life. But you’ll also hopefully learn a very important truth; that being sick is hard work. 

Becoming ill, feeling helpless, and being forced to lay still in an uncomfortable hospital bed as tons of wires course across your body, a plentitide of tubes exit every orifice, and disturbingly loud and scary alarms sound relentlessly is awful. It’s just awful. And it tends to bring out the worst in people. 

If you can learn this, understand this, and allow it to guide your care of the patient then you’ll be on the right track. If you can sympathize with the addict and be patient with the mentally ill, combative patient, then you will start to understand. You will strive to walk in the shoes of the person who walked/rolled into your hospital. And only then can you really and truly help them. Only then can you make a difference. 

Nursing is a lifelong learning experience, and school is just the beginning. The bedside is where the real education starts, and then it just keeps on going. So don’t forget to pay attention. You might just learn something that will make you more than just a nurse, but rather a really good nurse.