Kelowna Sunset

Nursing

I'm a nursing student, soon to be a fully qualified registered nurse. People often ask me why I am in nursing; when you are outnumbered 10 to 1 in a profession you are surely going to stick out like a sore thumb as a male nurse.

I recently presented a speech to over 300 nursing students during a nursing conference at Thompson Rivers University. I received startlingly positive feedback for giving a speech during the conference and I was very grateful for being able to share a glimpse of my thoughts to a large body of students who are aspiring to be great nurses. The following experience is a prime example of why I have chosen a career in nursing.

I was thinking last night how to summarize a truly exceptional experience to motivate and encourage the hard working students and soon to be graduates here in this room today. I quickly realized that I didn’t really need an exceptional experience full of grandeur to get a fairly simple point across. 

I recently cared for an elderly patient who was diagnosed with cancer and who was also at the time very sick and weak. I particularly remember this one client because I had the fortunate experience of reconnecting with her in another health care setting a few months later. She told me, most sincerely, that she would never forget my care because I was the first person to give her a proper bath and, word for word she said, “wash my bum.” 

For what is more personal than giving an extremely vulnerable person who may be facing the most difficult part of their life a bed bath. Though the act or skill of a completing a bed bath may be fairly simplistic in nature, the demeanor, caring nature, and overall presence of the nurse during the time of a bed bath is sincerely felt by the patient. The gratitude this patient showed me and the experience of making a small but meaningful difference in this patient’s life reassures me of my goals, career choice, and changing self concept.

I hope that you all will realize the essence of nursing practice and what nursing means to you as individuals. 

Thank you all, and good luck with your future careers in such a great profession.

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I wanted to share this speech, firstly, because this experience had an impact on my life that others could relate to, and secondly, to emphasize that nurses have the ability to make a difference in people's lives every day.

Unfortunately I occasionally see nurses who neglect the fact that the individual they are caring for is a human being with history, emotions, feelings, and a complex of experiences and connections within a community. This can be due to many reasons. The workload in the hospital is horrendous, 12 hour shifts mostly on your feet are tiresome, and working at night is hard on your body and overall psyche. In addition, health care mentality, floor moral, and cultural influences effect how we care for our patients. However, seeing a patient as just another name, body, or number moving in and out of the health care system is unethical and goes against patient centered care. I'm not saying that the majority of nurses are heartless care providers, this is far from the case, I'm making the point that being in health care is difficult and having the ability to keep perspective on being genuinely kind and caring can be strenuous under the current working conditions. When more nurses than ever are being burnt out, overworked, and under recognized,  there will undoubtedly be a negative effect on quality patient care. I also realize that as a nurse you can't spill your guts and give your all every day to every patient, this will surely end in burn-out and loss of perspective when coming to patient care. It all comes down to balance; you cannot be a perfect advocate and care provider for every client you encounter in the hospital, you can however act on beneficence and accomplish what is possible with the amount of time and resources provided. 

In order to resolve many of the issues in health care today, nurses must use leadership abilities and become true stewards of health (Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity-World Health Organization). Only through advocacy and  support for future change will positive effects take place in health care. This will not only act as a betterment for nurses, it will also ultimately be for the public good. When nurses have more time to care for their patients they will make less errors that could potentially lead to patient harm, build stronger trusting relationships, be more involved in discharge planning, and be able to better teach patients about their illnesses, medications, and treatments. All of these aspects will lead to greater patient satisfaction and quality of care. 

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On the same topic of patient care is the image of nurses. I want to make it clear that we are not simply caring persons whose qualifications lie on the amount of niceness we have. Most people do not realize what nurses do, and a nurses virtues often over shadow their experience and knowledge (Buresh & Gordon, 2006). Stereotypes perpetuate the idea that nurses are handmaidens for physicians and that we are health care providers who have little medical knowledge or impact on the patient's progression from being in the hospital to out in the community. The public is often unaware that nurses are a professional body of highly educated and skillful health care workers that keep people alive, rehabilitated, and re-integrated in our communities. 

I like the following quotes from the book "From Silence To Voice" that exemplifies the capabilities and importance of nurses (authors Bernice Buresh and Suzzane Gordon, a book about how nurses can give more voice and recognition to their profession).

"To speak with a voice of agency is to admit the incontrovertible fact that the 79-year old patient did not teach himself how to take his diabetes medication, that the 61-year old stroke patient did not read her own EKG, and that the demented man did not assess his own skin, discover the beginning of a decubitus ulcer, and act to prevent further skin breakdown. Most patient do not monitor and evaluate their own conditions themselves. When they are most vulnerable, they do not have the ability or the responsibility for preventing catastrophes or educating themselves about their conditions, treatments and medication regimens, Nor can patients always effectively negotiate the complexities of the system and advocate for themselves. This is what nurses do for them through their professional agency."

"Most people know they can't get into a hospital without a doctor. What they don't know is that they won't get out of one-at least not alive-without a nurse" (Nursing historian, Joan Lynaugh).  

"[If the voice and visibility of nurses were commensurate with the size and importance of the nursing profession] When faced with medical treatments or procedures, patients would do more than inquire about the details of the procedures and their physicians qualifications to perform them. They would seek information about the qualifications of the nurses who would care for them during and after their treatments. They would want to know the nurse to patient ratio on the hospital unit to which they were admitted. They would recognize that nurses are critical to outpatient surgery and the availability of nursing at such centers and about the extent and type of nursing services available to them in their homes or in other community settings."

When taking a closer look at what nurses actually do for people everyday, it is hard to believe that we are not more positively recognized in the media, journals, and the news. In fact we are virtually missing from news coverage (Buresh & Gordon, 2006). And therefore, if there is no major media influence on the projection of nurses the stereotypes, misconceptions, and overall understanding of nurses will remain unchanged. 

When the image of nursing remains stagnant it has multiple implications:

1) As the largest body of health care professionals, nurses have the ability to make dramatic change by being on health boards, involved in medical research, giving expert advice, involved in making new public and health care policies, etc. When nurses are not fully recognized by the public and/or other health care professionals their valuable ability to fully be part of these actions is limited  

2) The public will continue to undervalue nursing services. They will misunderstand that the nurse that takes care of them will keep them alive during their hospital stay because the nurse is the one that assesses their condition and vital signs, recognizes signs and symptoms of deterioration, has the ability to collaborate with other health care professionals, and follow out interventions or treatments that will reduce harm or even death. 

For example: A cardiac patient is having a heart attack and has crushing chest pain, the nurse walks into the patients room and immediately recognizes that the patient is indeed experiencing a decreased level of circulation of blood to cardiac tissue after identifying the location and type of pain the patient is experiencing, she/he already has an understanding of the patients condition and knows exactly what to do in this situation, the nurse quickly grabs a vitals monitor and a medication (nitroglycerin) that will increase blood flow to the heart, she/he further monitors the patient after the pain has subsided, she/he notifies the physician of the cardiac episode and receives orders for additional lab work and EKG readings, she/he process's the orders and documents what has happened. 

When a patient understands the implications of having a well educated and prudent nurse at their bedside doesn't this change how they will view their care during a hospital stay?


3) Nursing jobs will continue to be underpaid for the sheer responsibility that a nurse carries everyday they go to work. Working conditions will also remain the same. Without public support and uproar for having a safe patient to nurse-ratio in the hospital the prolongation of  the environment that nurses work in today will continue. 


These are only a few of the implications of a stagnant nursing image. 


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I hope that I have articulated the importance of nurses in our society or at least shed a sliver of light on the profession. 

I feel blessed to be in nursing and to have the ability in the future and now to help people and make a difference in individual’s lives, our communities, or even our world. I look forward to my future experiences in this field of work.

Gabe