I remember when I became a new nurse 21 years ago, and a friend asked me what I did at the hospital when I worked those long 12 hour night shifts. His thoughts were that the patients were asleep, so it was probably a job where you hung out and drank coffee, occasionally checking in on a patient. I remember walking him through what I usually did on a 12 hour 7pm- 7 am night shift, including most of the tasks and requirements of the job from receiving report at the start of the shift to giving report at the end of the shift. I made sure to include that if- when I got a break, it was usually around 2am or 3am when I was finally “caught up enough” to take some 20-30 minutes to nourish and hydrate myself.
As I thought of this telling of what nurses do some 20 years later, I wondered if I included what nurses are really charged with doing, which is supporting the healing of those we care for. Did I focus on all of the tasks and duties I would complete during that 12 hour shift, or did I also include the time spent rubbing backs, holding hands, saying prayers, educating, and supporting patients and their loved ones? Did I include the story about the time I had to call a deaf woman and tell her husband had passed after she left for the evening? Or the time when the family asked me to increase the morphine drip rate because “the doctor said she would be dead before the morning and we are ready for her to be gone”? What about the man with ALS being kept alive on a ventilator and feeding tube who lay lonely in his bed, unable to verbally communicate, and went for weeks at a time without a single visitor?
I believe that as nurses we need to educate the public not just on all of the technical skills we do each day to support patients’ receiving good medical care, but also on the healing aspects of our unique work as nurses: on how we were likely “called” to be a nurse because we want to make a difference, the skills we have developed that support us in creating caring-healing environments for patients, and the rewards of being able to support others through their healing process. I think we should be making it clear to the public as well that we are committed to our own health and healing, knowing that we can’t support others through health challenges if we are not also dealing with these challenges ourselves. And as nurses, we need to support one another in our own healing process, role-modeling what self-care and stress management look like in action.
A recent study showed that supporting nursing and creating “good nursing environments”, with adequate nurse staffing, leads to better long term patient outcomes, with fewer deaths one-month post surgery (http://mobile.reuters.com/article/idUSKCN0UZ2XL). It pays for hospitals to invest in having enough nurses, in treating those nurses well, and supporting nurses in what we have been called to do: create healing environments that support patients toward their greatest health potential. Healthcare facilities need to be moved to support nurses in managing their stress and enacting self-care in order to potentiate the healing of the patients these facilities serve. Good staffing is just the beginning of creating “good nursing environments”: nurses should be empowered to begin dialog with their employers regarding what a healthy and good work environment for nurses looks like in consideration of the healing work that nurses do.