Humanity and Professionalism
I've been thinking a lot lately about my job.
So I've been precepting. I've been toying with going back to school. I've been a nurse day in and day out at work.
I've been having conversations with old nurses and new nurses and people who aren't nurses.
I've been thinking about how my stress level sometimes is a 20 on a scale of one to ten when I have a sick kid or when a kid turns blue and we're supposed to save his life.
And as a nurse you tell yourself or you make yourself think in your mind that you are solely responsible. And then you go home and you wonder what YOU could have done. You rarely focus on what the team could have done or what the doctors should have done but you wonder to yourself what you, yourself, as a nurse- should have done. Who you should have called what order you should have asked for. What was it that you should have picked up on?
And then, you precept nurses. And they look to you for advice. You, your humble self, for advice..and then you breed more nurses who haven't yet developed their own practice. And sometimes you agree with them and sometimes you dont, but your job isn't to really tell them what to do it's to raiset hem to be their own nurse the best that they can be -and to give them the knowledge they need to go on. And sometimes you can't stand the decisions you know they'll make, but you have to examine why..or sometimes you can't stand the attitude- but you can't be responsible for it. But in a way you take that on, too. And then you realize how much you really do LOVE your job and how much you put into it becuase there are kidsyou find you cannot just relinquish to their care for the day while you are supposd tos tand back and let them do the job. Because you find, and you realize- that you just want that kid to get the BEST - and you want to be sure that it happens. And maybe they are the best, maybe you think in some way you can do better, maybe you don't.
And then there's the mistake factor. are you responsible for their mistakes or are they responsible for their mistakes when they're with you or are you both responsible for their mistakes. And really -you notice as you yourself their preceptor that they're so young because they don't even think they CAN make mistakes...It reminds me of adolescence, the 'this hasn't happened to me so it won't happen to me scenario'. But Lord knows how many mistakes are made EVERY day in healthcare- and how many go unnoticed. And I would also like to state that I think it is naiive and self centered to think you haven't made a mistake and godlike of you to think that you WONT make a mistake. You will. You probably have.
And at the end of the day- its you. At the end of the day- its your checks and balances. In a world where you are not supposed to be human- whereyou aren't supposed to really cry or show emotion when a child dies...what do you do? In a world where you are supposed to maintain a professional boundary and take care of kids and families for a year or two of struggles, treatments, nights puking days crying...you aren't supposed to get attached when you hold them and tell them its going to be okay. It isn't human..
I guess I'm struggling with being a human and being a nurse. Because in so many ways we aren't supposed to be human. We aren't supposed to care, we aren't supposed to love kids that we see every day and try to save and have life and death conversations with. We aren't supposed to really grow to have anything but a professional relationship with families who come to us and cry on our shoulders and who TRUST us with EVERYTHING they have...who just need us sometimes. And we aren't supposed to mess up, either. If we mess up- its life and death sometimes. And if we mess up - we're less of a nurse. But we are only human.
And I guess I'm sick of people thinking we aren't human. I'm sick of people saying that I shouldn't cry when a child dies...because I'm supposed to have a professional boundary. I'm sick of people saying that its going to get easier with time when a kid I really care about ends up in the intensive care unit...or that when i see a baby turn blue for fifteen minutes it won't bother me anymore with time...And in the same breath say that 'its life' that it happened. You know what, you werne't there. You didn't see the kid turn blue you didn't hear the mother screaming and crying, you didn't have to push medicines that were going to paralyze him and you didn't have to watch them throw a tube down his throat. In the same way- you didn't experience what I did the day that I discharged that kid home and I knew I helped save his life even though it gave me a mental breakdown. The day that these things don't bother me, or the day I can't celebrate LIFe with my patients, I feel like, is the day i'm going to SUCK as a nurse. Because if it doesn't get to me then damnit- I have lost my heart. And I am human- and I shouldn't see some of the things I do. I shouldn't see some of the abused kids I do- I shouldn't see what terrible things humans can do..I shouldn't see little kids die as much as I do.
I love my job because I CAN put 110% in to it. I love it because I can care about it. I love it because I can make a puzzle with a 2 year old who can tell me that he's my friend even though I just gave him a shot in his belly. I love it because I can make kids feel better..and its not because I don't care. And I love my job because I can make a difference. I love my job because I can rock a baby to sleep and be doing something therapeutic. I love my job because I can talk to a teenager about how and why they are sick of the life they are living and how they want to end it and I can help them...because I've cared about them enough through the months I've been taking care of them to listen to them, to talk to them, and to take a few minutes between interventions to just ask how life is going. I love it. I love it because my job takes up approximately 50% of my week. And I don't want to do anything that I can't care about. I don't want to do something for that much time of my life that I can't FEEL and that I can't LOVE. I guess I only understand professionalism to a degree...I don't understand not being human. I don't understand a teenager telling me 'i love you...you're the best' and me not being able to say 'i love you too' when I've just been able to share a part of their lives with them that I connect with because to some extent I've been there...and I've been able to make a difference because of it...Those kids do have a special place in my heart. I love it because I have become GOOD at it.
Coach gets it I think. Coach would hear where I was coming from. He has taught me so much about the fine line and the balance that we call the professional world. Professionalism sort of makes me laugh. I'm a professional and I get vomited on approximately once a week. I also clean up poop. I sort of have to chuckle about it.
Coach said once that people in the professional world, to watch them. One day we did together at the coffee shop. They stood a good foot apart. They walked erect. There was no leaning in to hear what the other was saying- there was a strict boundary there. I guess in my life I've learned that boundaries don't just keep other people out they just FENCE you IN. A life like that- you can live it- would it be worth it, who knows.
Bosses say when we start REALLY getting into a case we should step back. Otherwise, we'll get hurt. I suppose I can see an argument for professional longevity, but what is life without heart. A nurse is supposed to be there to care, not to keep up a boundary and say 'sorry I can't talk about this anymore'. I want to know about my 14 year old when they have a boyfriend because quite frankly it will effect their care. I don'tw ant to say 'sorry I can only talk about your cancer'. Its just so funny to me. It's so funny that in life and in 'professionalism' we set up rules on how to interact. Why can't we just live? Why can't we just be humans? Why does their have to be a code?
I guess I don't get it. I guess I'll work on it. I guess I'll talk to coach- he gets it. I get fried on thinking like this. Coach said once, "I ain't that smart" when he was referring to his colleagues. I knew what he meant, he's brilliant but he doesn't need that code. He also doesn't totally buck the system. He's an incredible person that coach of mine. I am lucky to know him and luckier to be inspired by him and luckiest to feel like I can walk in his footsteps to some extent.
It must be nice to inspire people every day- in your class, on your runs, in your everyday life. I find it hard to believe he did it by not caring. I admire that - because their was a code he broke there...becuase he's human. I admire that. Coach, you're wonderful.
So I've been precepting. I've been toying with going back to school. I've been a nurse day in and day out at work.
I've been having conversations with old nurses and new nurses and people who aren't nurses.
I've been thinking about how my stress level sometimes is a 20 on a scale of one to ten when I have a sick kid or when a kid turns blue and we're supposed to save his life.
And as a nurse you tell yourself or you make yourself think in your mind that you are solely responsible. And then you go home and you wonder what YOU could have done. You rarely focus on what the team could have done or what the doctors should have done but you wonder to yourself what you, yourself, as a nurse- should have done. Who you should have called what order you should have asked for. What was it that you should have picked up on?
And then, you precept nurses. And they look to you for advice. You, your humble self, for advice..and then you breed more nurses who haven't yet developed their own practice. And sometimes you agree with them and sometimes you dont, but your job isn't to really tell them what to do it's to raiset hem to be their own nurse the best that they can be -and to give them the knowledge they need to go on. And sometimes you can't stand the decisions you know they'll make, but you have to examine why..or sometimes you can't stand the attitude- but you can't be responsible for it. But in a way you take that on, too. And then you realize how much you really do LOVE your job and how much you put into it becuase there are kidsyou find you cannot just relinquish to their care for the day while you are supposd tos tand back and let them do the job. Because you find, and you realize- that you just want that kid to get the BEST - and you want to be sure that it happens. And maybe they are the best, maybe you think in some way you can do better, maybe you don't.
And then there's the mistake factor. are you responsible for their mistakes or are they responsible for their mistakes when they're with you or are you both responsible for their mistakes. And really -you notice as you yourself their preceptor that they're so young because they don't even think they CAN make mistakes...It reminds me of adolescence, the 'this hasn't happened to me so it won't happen to me scenario'. But Lord knows how many mistakes are made EVERY day in healthcare- and how many go unnoticed. And I would also like to state that I think it is naiive and self centered to think you haven't made a mistake and godlike of you to think that you WONT make a mistake. You will. You probably have.
And at the end of the day- its you. At the end of the day- its your checks and balances. In a world where you are not supposed to be human- whereyou aren't supposed to really cry or show emotion when a child dies...what do you do? In a world where you are supposed to maintain a professional boundary and take care of kids and families for a year or two of struggles, treatments, nights puking days crying...you aren't supposed to get attached when you hold them and tell them its going to be okay. It isn't human..
I guess I'm struggling with being a human and being a nurse. Because in so many ways we aren't supposed to be human. We aren't supposed to care, we aren't supposed to love kids that we see every day and try to save and have life and death conversations with. We aren't supposed to really grow to have anything but a professional relationship with families who come to us and cry on our shoulders and who TRUST us with EVERYTHING they have...who just need us sometimes. And we aren't supposed to mess up, either. If we mess up- its life and death sometimes. And if we mess up - we're less of a nurse. But we are only human.
And I guess I'm sick of people thinking we aren't human. I'm sick of people saying that I shouldn't cry when a child dies...because I'm supposed to have a professional boundary. I'm sick of people saying that its going to get easier with time when a kid I really care about ends up in the intensive care unit...or that when i see a baby turn blue for fifteen minutes it won't bother me anymore with time...And in the same breath say that 'its life' that it happened. You know what, you werne't there. You didn't see the kid turn blue you didn't hear the mother screaming and crying, you didn't have to push medicines that were going to paralyze him and you didn't have to watch them throw a tube down his throat. In the same way- you didn't experience what I did the day that I discharged that kid home and I knew I helped save his life even though it gave me a mental breakdown. The day that these things don't bother me, or the day I can't celebrate LIFe with my patients, I feel like, is the day i'm going to SUCK as a nurse. Because if it doesn't get to me then damnit- I have lost my heart. And I am human- and I shouldn't see some of the things I do. I shouldn't see some of the abused kids I do- I shouldn't see what terrible things humans can do..I shouldn't see little kids die as much as I do.
I love my job because I CAN put 110% in to it. I love it because I can care about it. I love it because I can make a puzzle with a 2 year old who can tell me that he's my friend even though I just gave him a shot in his belly. I love it because I can make kids feel better..and its not because I don't care. And I love my job because I can make a difference. I love my job because I can rock a baby to sleep and be doing something therapeutic. I love my job because I can talk to a teenager about how and why they are sick of the life they are living and how they want to end it and I can help them...because I've cared about them enough through the months I've been taking care of them to listen to them, to talk to them, and to take a few minutes between interventions to just ask how life is going. I love it. I love it because my job takes up approximately 50% of my week. And I don't want to do anything that I can't care about. I don't want to do something for that much time of my life that I can't FEEL and that I can't LOVE. I guess I only understand professionalism to a degree...I don't understand not being human. I don't understand a teenager telling me 'i love you...you're the best' and me not being able to say 'i love you too' when I've just been able to share a part of their lives with them that I connect with because to some extent I've been there...and I've been able to make a difference because of it...Those kids do have a special place in my heart. I love it because I have become GOOD at it.
Coach gets it I think. Coach would hear where I was coming from. He has taught me so much about the fine line and the balance that we call the professional world. Professionalism sort of makes me laugh. I'm a professional and I get vomited on approximately once a week. I also clean up poop. I sort of have to chuckle about it.
Coach said once that people in the professional world, to watch them. One day we did together at the coffee shop. They stood a good foot apart. They walked erect. There was no leaning in to hear what the other was saying- there was a strict boundary there. I guess in my life I've learned that boundaries don't just keep other people out they just FENCE you IN. A life like that- you can live it- would it be worth it, who knows.
Bosses say when we start REALLY getting into a case we should step back. Otherwise, we'll get hurt. I suppose I can see an argument for professional longevity, but what is life without heart. A nurse is supposed to be there to care, not to keep up a boundary and say 'sorry I can't talk about this anymore'. I want to know about my 14 year old when they have a boyfriend because quite frankly it will effect their care. I don'tw ant to say 'sorry I can only talk about your cancer'. Its just so funny to me. It's so funny that in life and in 'professionalism' we set up rules on how to interact. Why can't we just live? Why can't we just be humans? Why does their have to be a code?
I guess I don't get it. I guess I'll work on it. I guess I'll talk to coach- he gets it. I get fried on thinking like this. Coach said once, "I ain't that smart" when he was referring to his colleagues. I knew what he meant, he's brilliant but he doesn't need that code. He also doesn't totally buck the system. He's an incredible person that coach of mine. I am lucky to know him and luckier to be inspired by him and luckiest to feel like I can walk in his footsteps to some extent.
It must be nice to inspire people every day- in your class, on your runs, in your everyday life. I find it hard to believe he did it by not caring. I admire that - because their was a code he broke there...becuase he's human. I admire that. Coach, you're wonderful.