Dear Younger (Nurse) Me

The song Dear Younger Me came on the radio as I was taxiing my kids to different events the other day. The artists of Mercy Me sing of the life lessons they now know and suppose writing a letter to their younger selves. Ultimately, one realizes this knowledge is only gained from living it. Nevertheless, it did get me thinking about what I might have to offer, from a nursing perspective of 25 years, to those less veteran than me. Here’s my:

Top 7 Things I Wish I’d Known About Nursing Sooner Rather than Later
You’ve Got to Embrace the Process

There are important things in knowing your role as a nurse – state practice acts, institution-specific nursing policies and procedures and specialty organization practice standards but, starting with the Nursing Process is the key to success. I know, I’m taking you back in time to Nursing 101 but the process of Assessing your patient, creating a Plan, Implementing that plan then Evaluating your patient’s response to it, is the golden standard. This cyclical process places the patient in the center of your care, promotes interdisciplinary teamwork and allows for greater autonomy. This is a solid foundation from which to build so embrace the process!!!

NursingProcess

It’s your Nurse-Patient Relationship! Don’t Let Others Define It!

Well-meaning colleagues to the ones crispier than day old KFC can lead you astray in signing off patients to your care. Comments like “She’s a troll”, “He’s a drug seeker”, “That patient’s daughter is a control freak” or the good old “Good luck with this one” can lead you down a dangerous path of bad decisions with equally bad outcomes. Sometimes you’ll get exactly what the prior shift advertised. Often, though, your fresh face is an opportunity for a fresh start. Use the given information obtained prior to walking into the room as a guide and not a determinant of how you’ll deliver care. I’ve come to “specialize” in these “problem” patients and find my experience in recovering relationships highly rewarding.  These interactions move me toward more open and better thinking; these moments provide me meaning to nursing as being more than just a job. Own your relationships — they are yours!

Don’t be Afraid to Share Some of Yourself

It’s been said, “Patients don’t care how much you know until they know how much you care!” This is very true in my practice. To this end, I am open about my 40 year history of Type I IDDM and time served on the other side as a patient. I’ve learned more in this experience than I did in nursing school. Sharing evens out the playing field and allows for an empathetic approach to care. My “weakness” becomes a strength in establishing effective nurse-patient relations. Go ahead – throw fear out the window and share!

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Donuts and Diabetes: a constant battle
Go to Patient Funerals

Patients come to us at their most fragile, vulnerable and helpless moments. We often know things no one else (including spouses) knows. The hours we spend at patients’ bedsides can make you feel like nurse-banker-priest-friend. Many patients move toward recovery. Inherently though, we will lose our battle against illness and some of our patient will die. I’ve cried many tears at the death beds of patients I’ve grown to love. Several years ago, I started going to the funerals of these patients. Here, I’ve learned how one-dimensional my experience of tubes, procedures and machines of my patients was. Funerals allowed insight into the WHO of my patients. It provided me a means to conclude our patient-nurse relationship and allowed me to move forward in establishing new ones. This is not easy but nursing never has been — go to funerals!

Become a Physician’s Nurse

I know, nursing heresy right? But answer me this, Don’t you want to be the nurse the medical team turns to when hell is in the hand basket? Better yet, don’t you want to be the nurse a physician chooses for their family member or themselves when in need of care? My four “C” attributes of a physician’s nurse are Candor, Compassion, Commitment and Collaboration. In other words, nurses that:

  • Assert themselves in patient care
  • Care about what they do
  • Apply themselves to their work
  • Recognize teamwork makes the dreamwork

These nurses gain respect and appreciation. This gives nursing a voice in all aspects, moments and environments of care. If you love autonomy being a physician’s nurse is the pathway to freeing yourself.

Give Your “Gifts” Beyond Hospital Walls

Volunteering your nursing care to homeless clinics, disaster organizations or on medical mission trips can renew your nursing soul. Burnout quickly comes when we lose insight into why we do what we do. You most likely didn’t become a nurse to make millions of dollars. Instead, the need of someone else led you to choose our profession. Volunteering reconnects you to this. You’ll likely work harder in this endeavor than in your daily grind but reconnecting to purpose and mission is invaluable and sustaining. Give your gifts!

Know Yourself Nurse

More to my previous point but I’d be remiss to not bring up burnout, compassion fatigue and secondary trauma. Current nursing literature identifies these as primary reasons nurses are leaving the profession. Recognizing early warning signs within ourselves and seeking care can take us from surviving to thriving in our work environs. Post-traumatic growth is possible but it takes action. The keys to success in knowing myself involve:

  • staying engaged in my work by seeking new knowledge, participating in shared governance and writing A Patient Nurse.
  • professional relationships – I seek mentors for myself and seek those I can mentor
  • seeking meaning in my work by asking what difference did I make today
  • learning from my mistakes and celebrating accomplishment

Now it’s your turn!

Where are you in your nursing career?

Newbies – What challenges are you finding most difficulty in overcoming?

Veterans – What lessons would you “send back” to yourself if you could?

I’d love to hear from you in the comments section below. Do you disagree with me on any of my point. Did I miss anything you’d like to add. Let’s get a dialogue going!!!

As always, thank you for reading A Patient Nurse! Please Share with a Nursing Friend!

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18 thoughts on “Dear Younger (Nurse) Me

  1. In 30 plus years as a nurse I realized everyone has a story. Finding out that story can be very humbling. The person who is non complaint in getting prescriptions filled maybe ready to be evicted from their home. Do we really expect people to pay $400 for a month supply of medication. Even if it keeps their stent open. The person who refuses to leave the ED maybe experiencing domestic violence at home and the ED is their safe haven . I’ be learned through the years to take the time to know the story it’s just as important as the history and physical. It’s not always about the care but the caring that makes a difference.
    Thank you Adam

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  2. Adam, I have been a nurse since 1964! I went through the diploma program at Jefferson and can’t say enough about the advantage of hands- on care from day one. Books are essential but not as important as the human touch. I am from the days of metal needles and bedpans and glass IV bottles, as well as the dreaded wards! Being in charge of 40 patients- always using the nursing process. After hospital work I did home infusion until retirement . This really tested my knowledge and ability to communicate with patients and doctors and made me stronger and more compassionate. Yes, I attended many funerals and became friends with some patients due to the long-term therapies. I have done some volunteer work and love what I am doing for your family now.

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  3. In addition to don’t let others influence your experience/relationship with patients, this also applies to colleagues, especially fellow nursing staff. Given the limited gateways to upward movement within the profession, nurses are plagued with battling for positions of respect, leadership and, often, popularity. Offer kindness and an open mind to even the the most snaggle-toothed newbie or oldie. Team work is dream work.

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  4. Nice post and great comments to, i personally believe until you give your own definition to nursing (that is take it personal), you really havent started nursing. Nursing to me is more like a lifestyle, the way we perceive nursing will influence our care. Thanks

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  5. I only have 13 years, ICU for the last 4. I still have so much to learn. I like what you say about labelling patients, I hate when other nurses do this. It is demeaning. I always try to remember that I have no right to judge others, I am there to care for them regardless of what put them there.

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  6. I loved every word of this! I NEEDED to read this right now. Being a practicing nurse for only a little over a month, I am thankful you shared your wisdom. I especially loved what you said about embracing the process and defining your own relationships with your patients. I have had a difficult adjustment, but things are starting to click slowly but surely. I think the most difficult thing for me right now is seeing the big picture- I get so focused on each task that I have a hard time prioritizing what is MOST important at this moments in care. Thanks for opening up such a great convo!

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  7. Advice to my younger self after thirty plus yrs stay at the bedside, management seemed like a good idea at the time. But after numerous management jobs I always found solace at the bedside which is why my sanity was maintained with part time staff jobs and that is where I ended my career at the bedside. Great post Adam

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    1. Pat – your comments mean so much to me and I give this one a big Me Too!!! Every time I tempted to go back to the dark side I remember all I have @ the bedside. Thanks Pat!

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