Nurse

A year ago today I posted to my hardly read blog about nursing. Apparently my feelings were universal as you, my readers, shared the post globally which to date has been read over a million times on this blog and even more by readers of the Huffington Post. In honor of this important milestone for my blog I have reposted a slightly edited version of the original post here. Tomorrow I will be back with my follow up of what I have learned in a year of being Just a Nurse.

In the first year of my career as a Registered Nurse I continued my education, wrapping up my Bachelor’s Degree in Nursing, not yet a requirement to work as an RN, but a well worth it continuation of a degree to make you a more well-rounded, and in my opinion, respected Nurse. One of the requirements for this degree was a course called “Professional Issues and Trends.” The course explored the profession of nursing, the barriers it is facing, and the way that we, as nurses, can change that. I learned many things in that course, but the most valuable lesson, the thing that has stuck with me the most was this.

A few days into the course, our Professor made one thing very clear; each and every one of us, from that moment on, needed to remove “Just a Nurse” from our vocabulary.

“Are you a Doctor?”

“No, I’m just a nurse.”

I have spent six years since trying to avoid that phrase. More so, I have worked to avoid that feeling. I work hard at what I do, but am often aware that my friends and family have no concept of what nursing really is. I don’t just bring you to your room at the doctor’s office, sit you on the table, and check your normal blood pressure, then go and get the Doctor. Instead, I am often in a room with a small child on a ventilator, multiple intravenous medications infusing through central lines keeping the vascular system constricted or dilated. I monitor blood gases and adjust ventilator settings accordingly. If the blood pressure goes too high I adjust the medications related to these values. I keep my patient adequately sedated and paralyzed, for their safety, without over medicating them. It is often my responsibility to determine this balance.

Recently, I had a nearly two year old patient who pulled his own breathing tube out in the early morning. We weren’t sure whether he would do ok without it so I monitored his respiratory status closely all morning. By mid-afternoon he seemed to be doing well enough. His sedation had worn off and he had no interest in spending another minute in bed. Concerned that he would harm himself moving around through multiple IV and arterial lines, plus a BiPap machine, and monitor leads, I decided to hold him. I was fortunate that day to only have the one patient since he still needed such close monitoring. He had no family present but needed close to a dozen IV medications over the next five hours. I collected them all and lined them on his bed. I pulled his syringe pump that would be used for the medications off of the IV pole and placed it on the bed in front of me. I lifted him out of bed and onto my lap, into my arms. For five hours we rocked and I held him close. He stared into my eyes, played with my hair with his one arm, tried to suck this thumb through IV sites and arm boards. I gave his medications one by one until the nurse who would relieve me for the oncoming shift came in.

I am not just a nurse. I am a nurse. Over the course of a 12 hour shift I can go from interpreting serial blood gases to comforting a sick child while continuing to monitor vital signs, respiratory status, and administer medications.

I am the eyes, hands, and feet of the physician. I am not their eye candy, or their inferior. I don’t stand up when they enter to room. I don’t follow their commands, we discuss the pathophysiology of the patient’s condition and together we make a plan. Often the things I suggest are the course of action we take, other times I learn something new I had not understood from this doctor. They don’t talk down to me, we discuss things together, as a team.

After a disagreement recently over a minor medical decision between myself and a doctor, a friend replied to me,

“No offense Kateri, but obviously we’re going with the doctor over the nurse for this one.”

“You’re just a nurse” they might as well have said, although I know that they did not.

I was surprised by how angry and affected I was. It felt as though the color left my face and the posture left my shoulders. Something inside of me sunk.

The following day I struggled to understand why I was still upset. Surely they had no idea what these words had meant to me, or how they felt. The intention had not been criticism or harm, I was making something out of nothing. Over lunch the following day, as I discussed my new job with my family, it became clear. My job is so much to me, and so much of it is misunderstood. And maybe this is no one’s fault but my own. Sure I’m a nurse… yup some days are sad… yeah, blood and poop don’t bother me. But that is all I say. I don’t tell you what I really do. And the media definitely doesn’t either.

Nurse friends, help me out here, maybe it’s time that we stop pretending we are less than we are, that we do less than we do.

I came across the following blurb this morning. I wrote it a few years ago for Nurse’s Day, and it rings as true today as it did then. I may not be a doctor, but I am a nurse. And if you are someone whose mind says “just a nurse” please, go ahead and ask the nurse you know best what it is that they do. I think you may be surprised.

I am a Nurse. I didn’t become a nurse because I couldn’t cut it in med school, or failed organic chemistry, but rather because I chose this. I work to maintain my patient’s dignity through intimate moments, difficult long term decisions, and heartbreaking situations. I share in the joy of newly born babies and miraculously cured diseases. I share in the heart break of a child taken too soon, a disease too powerful, a life changed forever. My patient is often an entire family. I assess and advocate. Sometimes I wipe bottoms, often I give meds, but that isn’t the extent of what I do. There are people above me, and people below. I work closely with both, without them, I could not do what I do well. I chose this profession and love almost every minute of it. I know I am not alone and I appreciate all of the nurses who work alongside me. Many of them have shaped me into the nurse I am. Someday I will shape others into the nurse they will be. This wasn’t my plan B, it was my plan A, and I would gladly choose it again.

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