Today Boston Healthcare for the Homeless celebrated Nursing Appreciation Week. We had an amazing lunch prepared by our constantly devoted kitchen staff. The lunch was followed by speakers. Unfortunately, I had to return to the floor to work, but I did get to hear a small part of one of the presentations when I came back down to summon a co worker to the unit.
Here's what I picked up:
Up on the projection screen was a picture of St. Francis of Assisi. The presenter, a nurse from one of the other BHCHP sites was speaking passionately and resolutely of the similarities between Francis and nurses.
As I looked around the crowd, trying to find Ashley so she could sign off narcotics with me I saw nurses of all ages and at all points in their careers nodding. Smiling.
"Nursing isn't an office job," the speaker was saying. "Sometimes it has to be. When you get into administration. But when you get down to it, nursing isn't about sitting at a desk. None of us were called to that. We couldn't chose anything other than nursing."
It was a brief segment of a larger talk and it inspired me while I stayed in the room of nurses, but as I returned to the floor alone I felt it began to resonate in a very different way. And I realized:
I rarely hear nurses talking about how they really feel about nursing.
It doesn't end at a simple lack of discussion, the absence of which could be attributed to an unstated understanding of a shared purpose. Surely astronauts in a shuttle don't review their mission statement every morning? But with nurses it goes beyond a lack of discussion. Sometimes it can become a complete denial of how special and important the field is.
Occasionally someone might ask, "why did you go into nursing?" and even then any zeal, emotion or passion (which was almost certainly involved in the decision) is often brushed over for a mild answer like "I always wanted to," or "Oh, it runs in the family."
Before anyone gets defensive, I'll admit exceptions. Especially when the group of people talking are particularly comfortable with one another.* Still I have found that nurses tend to downplay what they do, no matter what.
As a new nurse this aspect of the culture is learned through example, and passed on quickly.
In time a very casual, matter of fact - or worse, bitter, attitude about Nursing can replace the initial excitement and passion of a new nurse graduate. If we ran around all day talking about our calling and our love of healing people would think we were braggarts, or worse - crazy. That kind of language, the language we learned to speak when writing "Why I Want to be Nurse" essays becomes taboo. Instead, we try to talk about our shifts as if we're working a cubicle job. It's less grandiose. Less insane. Less dangerous.
The nursing sector of the blogosphere is substantially populated with LPNs and RNs offering pithy recaps of incompetent co workers or impossible patients. There's a lot to complain about when you spend enough of your days taking care of other people's problems. There's a lot to break your back, and even more to break your heart. But it's more interesting and less dangerous to be funny than to be ... anything else, and some blogger RNs excel at medical snark so readily that they can hardly be faulted for failing to embody the Nightingale Pledge "to abstain from whatever is deleterious and mischievous."
Unfortunately, this too is a form of downplaying what we do every day. It's a great coping mechanism to be sure, but it short changes the experience just a tad to never acknowledge that the job is more than a collection of witty anecdotes.
So how else to talk about nursing?
When I write entries about nursing in this blog I can tell you that I second guess myself with each sentence. I feel like I'm sounding too saccharine, too "Chicken Soup," and at times a bit too moral - driven. That's the "at best," scenario. At worst, I worry that I sound too self-serving, too proud, and too full of myself.
I've concluded that must be why most nurses don't talk about what we do with any degree of pride or realism. To actually discuss what happens on a day to day basis would surely be to implicate ourselves as more important than we are generally comfortable with people thinking we are. A good nurse is often a good nurse in part because he or she refuses to believe there isn't still room for improvement at the end of every day.
In nursing school our talk is the talk of vocation. We all talked about wanting to make a difference, wanting help people. We promised to always advocate for the patient. We promised to question convention, to look to evidence based practice to further standards of care. We wrote heart felt, tear jerking essays about why we didn't just want to get pinned but we needed to get pinned to fulfill our sense of purpose. A purpose still as young as our hearts were at the end of college, but a purpose that seemed pure and virtuous.
But that kind of talk fades out. And I am not entirely convinced it's because we suddenly wake up and realize that health care is a mess of HMOs and paperwork and burned out systems, although those things are certainly true. I'm more and more inclined to believe that we stop using the language of zeal and vocation because of modesty and embarrassment. Humility, which is so endearing in a great nurse, is also exactly what stands in the way of direct communication about what it is we do every single day at work.
Thankfully, because I work for Boston Healthcare for the Homeless that kind of talk isn't only resurrected during Nurses Week. At every chance they get, our administration reminds all of us, nurses, respite aides, kitchen, security, M.Ds, P.As, N.Ps, housekeeping and maintenance, coop students, and departments like finances, development, and H.R that what we're doing is good, and worth it, and that we're all in it together.
Still, the next time I hear two nurses talking about the job I would love to hear them tell one another, "Hey. It was a rough day, but you're still making a difference." And have the other answer, "Thanks. So are you."**
* One of the millions of reasons I love Boston Healthcare for the Homeless is that it seems every nurse I know has a very passionate story about why he or she is a nurse. Or about why he or she chose BHCHP. And we all share our stories freely. Really, I work in a strange and wonderful place.
** P.S: Entries like this are going to ruin my comedy career.