Crazy times.
Survival is the mission now in this COVID pandemic.
And nurses are right in the middle of it.
Nurses’ presence with patients at their most vulnerable times has never been so public.
Nurses’ role in service to humanity has never been so loud in the media.
And more broadly in one way or another, this pandemic is changing everything.
An Opportunity for Nursing?
As you know, thinking about nursing and caring — what it is, what it is not, and the importance of how we talk about it with nurses and others— has been a constant for me.
Ever since I experienced reality shock as a new grad when my peers and bosses told me straight up that the role and job adjustments I was questioning as part of the healthcare system were things that I would just have to accept.
In a national news interview last week with a nurse from Michigan, I heard the nurse grapple with the horror of what she and others were experiencing and how nurses were being portrayed. She said, “We are important to patients, we’re being hyped-up even as martyrs. The reality is we’re just trying to keep these really sick patients alive and be there for them in these scary times”.
Nursing is a complex discipline. Our disciplinary domain is far and wide, and rarely understood by those outside of nursing, and not well articulated by those within nursing.
Is this an opportunity for what nurses do to be better understood?
Remember Suzanne Gordon’s warning and advice to nursing,
- As long as nursing allows the public and institutions to define us by focusing on who we are, rather than what we know and do, we will continue to be sub-valued in the political and public relations struggle.
- Nursing suffers from the virtue script — that nurses are motivated by selfless and noble acts. This view trivializes our knowledge, skills and contributions in attending to humanity, and trivializes our use of science, research, policy, operations, etc.
- The only way to reverse our hazy professional image is for nurses, especially nurse leaders, to articulate clearly and often that nurses save lives, keep people safe and save money with impactful descriptions; making it apparent that nursing is the backbone of healthcare
Given the high level of attention this pandemic has put on nursing, this is an opportunity to describe and translate what nurses do so others can visualize and articulate it in their conversations.
Disciplinary Distinctions of what Nursing Does and Does Not Do.
Let’s start with the distinctions between nursing and medicine. This is an important topic as the public and many in medicine automatically assume that nursing is singularly an extension of medicine.
Let’s start with Nightingale. She does the best job in defining the distinctions in terms that are understood today better than ever, but are not talked about.
“It is often thought that medicine is the curative process. It is no such thing.”
The function of medicine and surgery is to remove obstructions of normal bodily functions.
“Surgery removes the bullet out of the limb, which is an obstruction to cure, but nature heals the wound.”
“So it is with medicine; the function of an organ becomes obstructed; medicine, so far as we know, assists nature to remove the obstruction, but does nothing more.”
“Neither can do anything but remove obstructions; neither can cure; nature alone cures.”
“And what nursing has to do in either case, is to put the patient in the best condition for nature to act upon him.” pp 74-75
These are such powerful words and wholly understood and accepted within wellness science. Wellness science is more of a symbiotic partner with nursing than acute medicine.
Nursing assists patients to return to wellness by providing them with information, comfort, safety and self-care resources— physical, emotional, social, spiritual, etc.
And yes, we are active participants in medical processes by providing observations/assessments, safety practices, medications and treatments, etc
Granted … All of this needs action/behavior-oriented translation for the public.
For now, listen to this distinction from Kathleen Sitzman. It’s mindful attentiveness and knowledgable, conscious caring that is central in nursing science. Nursing is not hugs and tear wiping.
Sitzman (2001) discovered that patients felt high level caring when nurses
- paid focused and in-the-moment attention to them through mirroring, eye-contact, verbal validation of their concerns;
- not through the display of personal warmth and touch and high-level friendliness (similar to virtue-script)
- It was the exchange of mindfulness, immediacy, attention and presence that brought a sense of comfort and healing towards wellness for patients.
Lastly, for today, let’s turn to Suzanne Gordon words from her poem, “Just a Nurse”
Use these words with your voice in everyday conversations.
- Nurses make the difference between life and death
- Nurses have educated eyes that prevent medical errors, injuries and other catastrophes
- Nurses make the difference between healing, coping and despair through active presence
- Nurses educate patients and families about how to return to and maintain health/wellness
- Nurse researches produce data and knowledge that help nurses and doctors give better, safer, and more effective care
- Professors who educate future generations of nurses through the use of nursing and caring science
- Nurse scientists who manage and monitor patients who are involved in cutting edge experimental research
- Geriatric nurse practitioners who make the difference between a patient staying in their home and a patient going to a nursing home
- Palliative care nurses who makes the difference between a patient dying in agony and dying in comfort and with dignity
- School nurses who keeps kids healthy and in school so they can learn
Thank you to all nurses for your knowledge, skills, strength
and clarity of purpose.
We need you today and always.
image courtesy of cottonbro, pexels.com