I'm writing this article as a response to recent portrayals of nursing on daytime television. Thank you in advance for reading, it means a lot to me and to nurses everywhere.
When I was a kid and someone asked me “what are you going to be when you grow up Stephanie?” I’d reply immediately and excitedly “A DOCTOR!”. I dressed up as a doctor for Halloween, I hung John’s Hopkins paraphernalia on my walls, and my parents gave me microscopes for Christmas instead of Barbie Dolls. As I got older I took every opportunity I could to shadow doctors, and volunteer in hospitals which is when my perspective completely changed. I was disappointed to see that doctors see each patient for mere minutes a day, and often don’t have the chance to really get to know them or their families. All too often I heard sick and dying people referred to as “the cancer patient” or “room 3” instead of by their names. I quickly realized that being a doctor was a tough and noble job that requires balancing the lives of dozens of patients at once, but I also realized it was not for me. Instead I observed another side of medicine in my time at the hospital. I saw professionals who were as skilled at handing out compassion as they were with handing out medications. That is why I became a nurse.
Nursing school was TOUGH! Nobody is "born" a nurse, nurses are created through blood sweat and tears (not to mention a few other unsavory bodily fluids). It took four years of physics, organic chemistry, biochemistry, anatomy, pathophysiology, pharmacology, and long days in the hospital but the toughest part came after. My friends and I quickly discovered that we had entered a completely thankless profession. We had just gone through four years of grueling curriculum to be treated like personal butlers, pillow fluffers, people that “wanted to be doctors, but just couldn’t cut it”, or worse- as objects (I promise you that nursing is a disgusting, completely unsexy job- sorry boys!).
Nurses and doctors have a set of skills that perfectly compliment one another, which I think is best explained through actual stories taken from my career:
The ICU team (consisting of a doctor, nurse, respiratory therapist, and a patient care technician) had been working all night to desperately save a woman’s life after she had a massive bleed in her brain, but we feared that we were fighting a loosing battle. We all had sweat pouring down our foreheads as we intubated, sedated, and coded her. We had been working for so long that our crash cart ran out of medications and I had to leave the room to go grab more. The physician asked me to give a medication through her IV as I was stepping out, and I pointed toward the vial of medication and said “it’s right there, just give it and I’ll be back in 30 seconds with the next dose”. He looked at me helplessly and said “but I don’t know how to”. Doctors prescribe the drugs and stand back to make sure everyone is doing what they need to do, but the nurse is the one that starts the IV, does the complicated calculations in his/her head, assembles syringes, draws up the medication, and pushes it in at the correct speed needed to help the patient. It takes years of training and a wealth of knowledge to be able to do this without killing or harming people. Adenosine gets pushed in as fast as humanly possible and is rapidly followed by a saline flush or else it does nothing to reset deadly heart arrhythmias, but if you do the same thing with sodium and you will cause irreparable brain damage- but why would I know that, after all I’m “just a nurse”.
Residents are doctors fresh out of school, with very little actual hands-on experience. A lot of what a nurse does is make sure that these residents are writing orders that are correct and safe. They’ve been doing this for a few months, and we have usually been around for a lot longer then that! The chief physician at a teaching hospital I once worked at told us at orientation “if a resident writes a dangerous order that leads to patient harm I will definitely reprimand him, but first I will come after the nurse that didn’t recognize and correct the error”. I have countless stories of this happening, but I won’t tell them because I respect physicians A LOT, and part of the training process is being novice for a bit. Mistakes happen, but be glad you have nurses on your side to catch and correct them!
Another one of my most memorable patients is unfortunately a story without a happy ending. He had been in the ICU for weeks, as sick as a person could possible get. Throughout the course of his hospital stay he required several emergency operations, often in the middle of the night. During the night, the physicians are not on the unit and it’s the nurses who closely monitor patients and call the shots. I checked my patient’s pupils, and measured the pressure in his brain. It quickly became apparent to me that he was going downhill fast. The physician rushed to the bedside as soon as he got my 911 page, and said to his wife “we need to take him to the OR immediately, his pupils are unequal and his ICP is climbing to 50. I think his VP shunt has become occluded. We will go in and try to clear up the blockage so that we can alleviate his hydrocephalus, but we may have to take the entire device out and replace it- ok?”. He then raced off to prepare the operating room, leaving me alone in the room to get him ready to be rushed downstairs. His wife was ghost white and wide-eyed. As I readied his multiple IV pumps, ventilator, and other life support machines for transport I re-explained what was happening until she felt that she understood what was about to happen to her husband. After I transferred his care to the skilled OR nurses, I sat with her for the rest of the night. It was a long night for everyone. She and I had many nights like this together, and unfortunately her husband ultimately passed away. I had become incredibly attached to her and the entire family already, but to top it off I learned that he had been a coworker of my father. My dad and I (along with a couple more of his nurses) attended the funeral together, even though I felt a little funny being there. We stood in the receiving line for the family, and when his wife spotted me and the other nurses she immediately got out of line and ran to us, falling into our arms sobbing. I was stunned that she had chosen to come to us instead of the long line of close friends and family, but I held on tight and cried with her. Throughout the day family members that we had never even met were coming up to us and doing the same. “We were all the way across the country, and it gave us so much comfort to know that every minute of everyday you were at his side when we couldn’t be” they said “we prayed for you constantly”. In the car on the way home from the funeral my father held my hand and may have even shed a quiet tear or two. I think it was the first time he really understood what nurses do. Physicians treat the disease or operate on a condition, nurses treat the whole patient and their families.
Beyond the incredibly technical aspects of our jobs, nurses live for the compassionate side of medicine. Only a person who has had to stay in the hospital knows how far a simple gesture goes. My coworkers and I would go out of our way to buy nice smelling body wash, shampoo and hair brushes. You have never seen a person’s face light up until you have given them the first satisfying bath, hair wash, and style that they have been able to get since surgery. Even if our patients are in a coma and don’t know that we are doing it, we still go out of our way to make sure they are cared for like family. It’s our job to not only give medicine, but to give dignity. Sometimes compassion is the best form of medicine.
I could go on and on, but I hope you get the point. Being a nurse isn’t a job, but an identity. Yes we are under appreciated and misunderstood, but we don’t do it for the recognition. We love our jobs. Chances are if you ask a nurse what the best and worst moments of their life have been, they will pull out at least one story that revolves around work because to us it’s deeply personal. Sadly people often belittle what we do, question our intelligence, or objectify us. Usually we turn the other cheek and carry on, but not today. Today 3.4 million nurses are raising their voices and demanding the respect that we have more than earned. #NursesUnite
How many specialists did you see before finding "The One"?