Life Lessons from the Mouths of Patients

Although nursing school graduations happen two or three times in the span of a year these days, traditionally it is May or June that one thinks of as graduation time. So, right about now a slew of brand spankin’ new nurses are crossing over from classrooms and clinicals to the workaday world where careers are forged.

You new grads have likely been bombarded from every direction with advice on how to care, perform, be a team player and advance while simultaneously maintaining your sanity. The advice comes from instructors, colleagues and even family members without medical backgrounds. It’s similar to becoming a first-time parent—advice is being thrown at you left and right. Everyone means well but it can be overwhelming.

To add to that information overload, I’m going to offer a piece of advice of my own—but just one. My advice springs from a question regarding patient care that was asked of me by a good friend who is also a nurse. “Looking back, what would you have done differently?” she asked. Well, of course, there are many things. Hindsight has a way of allowing me to see the past more clearly and experience has a jarring way of bringing home the realization that I demonstrated a bunch of rookie behaviors. Those that I recall, though, were isolated instances unrelated to one another and would require many individual changes and, therefore, several nuggets of advice—and I’m keeping my promise of just one.

It is—ta da!—to get to know your patients. I mean really get to know your patients. Not just as ‘the gallbladder,’ ‘the fusion,’ ‘the triple bypass,’ and so on, but at least a little something about the person beyond the medical setting. Following this advice, by the way, will benefit you far more than it will the patient. You might assume I’m asking you to do this so that you can better skew your care to fit the patient and, yes, treating the ‘whole patient’ can result in better outcomes. But, that’s not where I’m going with this.

I have always been good at engaging patients in conversation and I’m not shy about asking questions. I have also asked patients for advice and opinions with a simple, “What do you think about that, Mr. Jones?” It sometimes astounds me that I vividly remember parts of so many conversations from years ago. I spent many years working with the medically indigent and it is humbling to recall the wise words and the personal stories of people who had so little and the lifelong impact they’ve had on me, a person of relative privilege.

In so many cases their words have stayed with me, shaping how I relate to others or to particular situations. There is a wealth of wisdom to be had in what we glean from our patients—wisdom that serves us well in our personal growth and in how we care for the patients in our charge. I treasure the life lessons I have learned from my patients. In many cases they have opened up my heart, increased my empathy for all others and slowed my quickness to judge. I owe them all a great deal.

I’m grateful for all I’ve learned but I know I could’ve done better and I regret that I didn’t. To restate my advice: as you teach your patients, allow them to teach you.

If you can pass along an example of a difference a patient made in your way of thinking or behaving, please do.

Will New TV Nursing Dramas Portray Nurses Accurately?

When it comes to medical dramas on TV, nurses haven’t been getting a lot of respect recently. Popular series such as House and Grey’s Anatomy mainly portray physicians. More often than not, nurses serve as secondary characters in these television series, and are seen lurking about on the fringes of the action. Small wonder, then, that despite the fact that nurses are highly skilled and saving lives every day, the general viewing public simply doesn’t get it. How could they, when they are being fed the wrong information?

But, hold onto your stethoscopes, nurses—hope may be on the horizon. The Center for Nursing Advocacy and, more recently, The Truth About Nursing, have long railed against the entertainment industry’s penchant for characterizing nurses inappropriately. The highly educated, highly skilled, life saving leader who is the real face of nursing has been nowhere in sight on TV—until now.

Two nurse-centric TV programs will begin airing in June. One, Nurse Jackie, debuts on June 8 on the pay cable channel, Showtime. It stars Edie Falco, of Carmela Soprano fame, as Nurse Jackie. She is an assertive, straightforward, plain talking, stand-up-for-her-staff kind of ER nurse who also is addicted to prescription painkillers. Showtime labels the show a comedy but the trailer I watched online was more drama than comedy. If I had my druthers I’d rather Jackie weren't wrestling with a drug problem, but television seems to feel that without a moral conundrum of some sort—in this case, having Jackie walk the line between saint and sinner—viewers won’t tune in. Whatever, let’s hope Nurse Jackie presents nurses in a more realistic light and focuses on the formidable clinical expertise that is the hallmark of the nursing profession. Showtime will make available to non-subscribers an online full-length episode of Nurse Jackie in early June, prior to its season premier on the for-pay network.

Then, on June 16, along comes Jada Pinkett Smith in TNT’s nod to nursing, HawthoRNe. Christina Hawthorne is the recently widowed Chief Nursing Officer at a busy Charlotte, North Carolina hospital. She is all about the patient and doesn’t mind overstepping her bounds to get whatever is needed, leaving doctors, administration and sometimes her own apathetic staff in her wake. Her cross to bear, for the sake of the aforementioned ongoing moral conundrum, is a rebellious teenaged daughter. Hawthorne suffers no fools and takes no prisoners—she is a formidable crusader for the cause.

NBC has also jumped into the fray with Mercy, a one-hour medical drama that focuses on three nurses and their lives inside the hospital and out. I liked the clips I watched. I couldn’t find a date for a season premier for Mercy so keep your antennae up. It will likely be in the fall lineup.

Hollywood has been solid in its stand that the public isn’t interested in shows about nurses, only doctors. That these shows have been developed at all is a huge step forward in the entertainment industry. Strong viewership is required for these programs to continue, so nurses need to tune in and we need to encourage others to do so. Do you plan to watch? I would be interested to hear what you think of these shows.

Should Nurses Have a Personal Mission Statement?

Every business, profession and organization seems to have a mission statement. That’s a good thing—it’s always good to know where we’re going, how we’re going to get there and why we are going in the first place. I view that sort of mission statement as a big umbrella under which employees collectively operate. But, what about the individual employee? Should each one have a personal mission statement—a plan, a promise or a direction to strive for?

The question, ‘What is your personal [nursing] mission statement?’ was asked recently on an online nursing forum.

On the subject of mispronunciation of words a few months back, this same forum received over 500 responses. The mission statement question has, in the 15 days since it was posted, elicited a mere 11. I’m not sure how I would analyze the difference in the number of responses. Does it mean that nurses are just showing up and doing what needs to be done with no thought as to a greater purpose? I have no way of knowing. It can’t be that they are too exhausted at the end of the workday to bother with something as insignificant as expressing an opinion on a forum thread. If that were the case, there wouldn’t have been 500-plus responses regarding the mangling of our language.

There was a mixed bag of responses to the mission statement question. Some were thoughtful and sincere: ‘to make a difference in someone’s life every day,’ ‘to treat every patient the way I’d like to be treated,’ ‘to make the world a better place,’ ‘to make people feel better about their situation.’ Trite, yes, but also noble goals.

Others began with a snippy comeback: ‘welcome to the dark side,’ followed by LOL and, then, a positive statement.

Others were decidedly negative: ‘to get through the day without being physically assaulted by patients or family members,’ ‘ to cover my [behind] at all times because no one else is looking out for me.’

One seemed angry that the question was even asked. Overall, if I counted those that began with jaded statements but then mellowed out, there were eight positive responses. Only three came from the seriously disheartened (or so it seemed).

One respondent thanked the person who posted the question and opined that it is one we should all ask ourselves.

I agree. It should be easy enough to come up with one simple sentence we can silently chant like a mantra on a daily basis, especially in challenging situations—something to hang onto when we are at our wits’ end, to remind ourselves of something positive we’d like to accomplish.

What is your personal mission statement, if you have one? Please share it here.

In This Job Market, Interview Skills Make All the Difference

I don’t know how many student nurse readers of this blog there are, but I know there are at least a few. If you’re out there, I have some helpful advice to share with you.

The word is out that, in some parts of the country, newly graduated nurses are having a hard time finding jobs. Actually, there are jobs to be had but new grads’ dream jobs may be scarce. The recession is causing nurses who’re currently employed to stay put. For older nurses, retirement has been put on the back burner. Nurses, who just a few months ago were grousing about having to work extra shifts, are begging for overtime. Part-timers want to go full-time, per diem nurses want more hours. And, so it goes.

The bottom line for now is there is stiff competition for jobs. So, how can you gain the inside edge when trying to land one of these coveted positions?

I spoke with a couple hospital-based nurse recruiters and two nurse educators this week and this is the inside skinny. First, be a conscientious student and make good grades. When choosing elective rotations, remember that critical care and intensive care experience carries a lot of weight with those who do the hiring.

The main thing over which you have control is the interview. So, prepare, prepare, prepare!

Interviews at this time are far more formalized than ever. Appearance counts—a lot. A group of new students was preparing to go into the hospital for the first time and one of them asked the instructor what she should wear. The instructor said, ‘From this point forward, you should consider everyone you meet a future employer and you should wear nothing that looks anything other than professional.’ So, for the official interview, present with conservative dress, good eye contact, clear enunciation, friendly demeanor and, for goodness sake, no limp handshakes.

Interviewers are asking, ‘Why should I hire you over the 30 other new grads who’ve applied for this position?’ Be prepared to tell them. Think of the leadership projects you’ve worked on in school, make lists of the problem solving techniques you used, the conflict resolution techniques you employed—have all these skills at the forefront of your mind so that your accomplishments roll easily off your tongue when questioned. Toot your own horn. Promote yourself—albeit in a humble manner. Pair up with a friend and do mock interviews with one another. There’s something about verbalizing and hearing your own voice in a non-threatening situation that makes an actual interview easier.

In this job market, leave nothing to chance. Prepare—and good luck to all of you.

Did Anyone Notice National Nurses Week?

I get pumped up over National Nurses’ Week. No one is sending me gifts, treating me to a spa day or honoring me at a special dinner but I like that there are nurses who are being recognized with these gestures. I also like that there is a focus on and publicity for the nursing profession—not nearly enough, mind you, but more than usual. I hope a lot of people noticed.

I was pleasantly surprised to find an eight-page pullout section devoted to nursing in the Denver Post last week. All 15 of Colorado’s candidates for the 2009 Florence Nightingale Award were pictured and briefly profiled. Other articles in the section addressed the dilemma of too few nursing school instructors and clinical sites, that the recession has affected job availability for nurses but nurses will be in high demand as the economy stabilizes, and that bilingual skills increase a nurse’s employability in a soft economy.

Even Wall Street got in on the act, as Dorrie Fontaine, Dean of the University of Virginia Nursing School, was invited to ring the Closing Bell at NASDAQ, marking the close of trading on the final day of National Nurses’ Week.

Fontaine commented that the opportunity to bring attention to nursing and “the wonderful work we do at the University of Virginia,” is one of the biggest thrills in her 30-year nursing career.

In addition to spotlighting a nurse ringing the closing bell, NASDAQ also played a video celebrating nursing at its market site tower in Times Square on the world’s largest stationary video screen.

Kudos to NASDAQ and to the Denver Post!

Did you receive special gifts or were you treated to anything out of the ordinary? Were nurses in your area publicized in any way? Please share your National Nurses’ Week stories here.