Giving Nurses A Voice

This week we’re celebrating National Nurses Week by taking time to thank nurses for their commitment and dedication to the healthcare industry. In a time where nursing salaries are fractions of what professional athletes make, it is important we acknowledge their countless hours of grinding around the clock for the sake and safety of others.

This week, we gave nurses an opportunity to speak their minds. Here’s what they had to say:

Some Wanted To Talk About Improvements
“Today we had a mandatory meeting about what it takes to practice as a nurse safely. One of the big points that we touched on was the concept of teamwork and how that relates to our relationship with patients. There was a lot of talk about how in order to provide the best possible care for a patient, there needs to be teamwork or a group of collaborative minds that can work on uncommon and challenging situations—and that’s absolutely, positively, 100% true. You almost have to be philosophical about it in a sense; with shift changes occurring regularly, it’s never just you and a patient. You have to be willing to take a step back and say ‘you know what? I’m one of several people that contributed to the care-taking of this patient.’ It’s easy to get bogged down by the little things, but nursing really is a team effort, and I sometimes forget that myself.

Also, another component of nursing—one that I feel goes unnoticed by many staffers in my particular unit—is that we need to have a system in place that provides a sense confidence and empowerment amongst every member of our unit. I’ve seen some of my fellow coworkers get down on themselves over a certain patient scenario with no one to fall back on; I’ve even personally been in that situation, and it can be really tough. As a nurse, you’re somewhat desensitized to a lot of things, but that doesn’t mean you’re totally oblivious to what’s happening around you. Having someone like a preceptor to fall back on for reassurance and to be an advocate for you speaks volumes for what you’re doing. I talk to my friends from college all the time about their hospitals: what it’s like, how the doctors treat them, so on and so forth. Their answers always vary depending on the facility and unit they work in, but we all agree that support and constructive feedback is one element our programs could afford to enhance going forward.

But at the end of the day it’s still a job; the long hours we often work, can complicate our personal lives, leaving us physically and mentally drained. My body and brain begins to run on autopilot and it can easily bleed into what little time I have away from work. Luckily for me, my wife knows this is all part of the job, but there are definitely days where a little regularity in my schedule would be appreciated.

However with that being said, this is the life I signed up for. I wholeheartedly knew what being a nurse entailed: The crazy hours, the intense work environment, and the unpredictability. But I’d do it all over again. If you could provide a sense of comfort to a complete stranger during their darkest times, wouldn’t you want to help? It’s that sense of responsibility that drove me to nursing and it’s what keeps me loving my job.”

While Others Wanted To Address Culture 
“Bernice Buresh wrote a whole book about the Nurse's voice: From Silence to Voice: What Nurses Know and Must Communicate to the Public. There is so much nurses know about personal health, family health, and community health, but because we focus on hospital nursing more than any other kind, all other nursing voices are lost.

Last night I watched the new CW show Containment, and noticed immediately the erasure of nurses within the first half-hour of the first episode. Somehow there are no public health nurses inside the Cordon Sanitaire; there are no off-shift RNs, no LVNs, no Nurse Practitioners, no Public Health Nurses. This happens in TV shows because no one knows what Nurses do, really. Since Suzanne Gordon wrote Nursing Against the Odds: How Health Care Cost-Cutting, Media Stereotypes, and Medical Hubris Undermine Nursing and Patient Care (2005), things have only gotten worse. Not it's not just a doctor's world, it's a politician's world that a nurse has to navigate.

So my thing I would like to be heard is: It's all very well to ask about a difficult patient (but we can't talk about them, because HIPAA laws prevent us from disclosing Personal Health Information that way, which is good) or a long shift (which, without a discussion of how nursing is viewed and paid for is really just whining), but it's better to bring up what we know. Things like: Why you want to wash your hands before and after you cook, or eat, or go to the bathroom, or how to childproof or elder-proof a living space [it's more than electric plug caps and handrails]. Why safe public transit is essential to good public health [it's more than not being beaten up on the bus]. How Nurses take care of you, your family, and the community, and you don't even know it.

I get it; stories about difficult patients or long shifts have all the tang of gossip. But that "difficult patient" may be someone who, until their first hospitalization at age 79 for surgery, has never been in a hospital, never had anesthesia, and never slept away from home with 24-hour noise and light and strangers. Yet we have the nerve to call them "difficult"? I've been a patient in the hospitals I've worked in: we're noisy and busy and it's overwhelming and disorienting, and that's from someone who knew the place intimately and could do a lot of their own care themselves. What about for people who don't have that advantage? Who don't know who's going to take care of them in hospital, or once they get home?

With enough staffing, those people can be kept safe and well cared for through their whole stay, and be sent home to good home care and home follow-up. But that's not a story, because that removes the "difficult" label from the patient, and puts it on the system that fails them. With enough staffing, shifts are not "too long" every single day. With enough attention paid to what nurses know and can do, communities can be healthy. And no-one wants to talk about that in terms of Nurses' voices.”

And Others Wanted To Talk About Lessons Learned
“A cantankerous patient was asking for all sorts of unnecessary things while I was busy with my other ICU patient. She was berating everyone who came into her room. I decided to swallow my pride and irritation, ignore more pressing priorities, and get my patient that second cup of coffee she wanted. The correct answer in nursing school would have been to deal with more acute issues first. I stayed gracious and her whole demeanor changed. She just wanted to know that someone cared and she wasn't going to be ignored. She didn't have any more petty requests for the rest of the day, and even her vital signs improved. The applicable lesson for my story is first of all not to let pride dictate your priorities. Although we are taught to tend to the sickest patient first, flexibility allows nurses to get more work done in the long term. By acknowledging patient needs right away, even if the request is frivolous, nurses can start a shift with good patient rapport.

Nursing school may also deal with hunches. Often, these are simply assessments that reveal data a nurse doesn't know how to use yet. I have fewer vague feelings and suspicions now that I'm an anesthetist, though of course I usually have more monitors and objective data at my disposal. I worked on a telemetry floor and a PA removed the patient's pacer wires after heart surgery. Afterwards, the patient felt sick and nauseated. I told the PA something was wrong and kept calling up the chain of command, because the only thing that changed before the patient started feeling lousy was the pacer wire removal. Sure enough, the patient needed emergency surgery for cardiac tamponade--blood filled the pericardium when the PA pulled the wires, which would have killed the patient in a few more minutes. The key with hunches is to eliminate impossible choices and examine improbable ones.”

---

At some point in time, we’ve all been emotionally touched by the ways of a professional nurse, and often times it may feel as though the profession is undervalued within the realm of the healthcare industry. The contributions and sacrifices made by nurses on a daily basis are truly immeasurable. On behalf of everyone at Magnatag, we’d like to thank them for their dedication to the healthcare industry.