Nurses as Healers: Good Work Environments

/ Carey S. Clark, PhD, RN, AHN-BC, RYT, FAAN / 2 Comments

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 research from www.mountainmiraclesmidwifery.com/, 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.

 

 

Nursing History and a Book

/ Jane K. Dickinson / 2 Comments

I was given a first-edition copy of Florence Nightingale’s book, Notes on Nursing, about a year-and-a-half ago. The book was in a glass case and slightly tattered from the looks of it. I was told I could do whatever I wanted with it – keep it, sell it, whatever.

I love old things. In fact, I have a copy of Elliott P. Joslin’s “Diabetic (sic) Manual for Doctor and Patient” that belonged to my great-great aunt and an old First Aid Handbook. But this one seemed different. I immediately felt it belonged in a place where nurses could enjoy it. I felt compelled to give it to my alma mater, University of Connecticut School of Nursing, because I know they have a collection of nursing artifacts and it would be well taken care of and displayed for nurses of generations to come.

This past Christmas I had the opportunity to hand off the cherished book to Thomas Long from the UCONN School of Nursing. He was actually excited that it wasn’t in perfect condition because that indicated that many hands had touched it and turned (and hopefully read) the pages. He asked how I came to own the book and where it had come from. Unfortunately I didn’t even know the story, so I couldn’t share it with him. I only knew that my friend’s mother had owned it.

Soon after I asked the friend who had given me the book and she told me the whole story:

My friend’s father’s sister was a Navy nurse during the 1940s. Soon after she was appointed the guardian of a boy who lost his parents. Later (I believe it was 1959) he purchased the Nightingale book for her (there is a letter with the book that shows the date and price of the purchase). This aunt lived with my friend’s parents the last several years of her life and when she died this book was found among her belongings. My friend’s mother kept it for the rest of her life.

If you are ever in Storrs, Connecticut, be sure to visit the School of Nursing at the University of Connecticut. There you will see the first-edition Notes on Nursing displayed as part of the Josephine Dolan Collection in the Widmer Wing of the Nursing Building. I look forward to seeing it there myself one day.

Courageous Conscience: Engaging in Politics with a Capital “P”

/ Adeline Falk-Rafael / 1 Comment

When I began thinking about a topic for this blog last fall, Canada was in the middle of a federal election and the upcoming U.S. presidential election was already making the news daily. I thought about the changes that have occurred in both our countries and globally since neoliberal ideas privileged “the market” over elected governments in the 1980s. Increasingly, policies reflect the interest of big business and the dictates of “the markets” rather than the electorate. And although both countries are arguably now plutocracies/oligarchies, both maintain a semblance of democracy through democratic structures and processes, such as elections. So what does this have to do with nurses and nursing?

The Nursing Manifesto itself answers that question. It is a call to action and one avenue for that action is engagement with political processes. I am reminded of an address Patricia Moccia gave at a conference in the late 1990s in which she used the term “citizen nurse” to remind us of the importance of bringing a nursing voice to the political table. With the percentage of eligible voters who actually vote near record lows – 54.87% in the 2012 presidential election and 61.1% in the 2011 Canadian federal election – one group could significantly shift results. In fact, in the recent 2015 Canadian federal election, the Liberal party made a concerted effort to get out the “youth vote.” The result was not only a change in governments, from Conservative to Liberal, but an increase in voter turnout to 68.3%. Imagine the possibilities if nurses mobilized to vote!

I’m not suggesting that all nurses will vote alike, any more than “the youth” in Canada did! But I am suggesting that increasing the number of nurses who vote has the potential to influence the outcome of an election. What we have in common is commitment to care for people, for promoting health, for social justice. Our work, then, as citizen nurses is to discover which party or candidate most closely aligns with our own values and become as involved as is right for each of us in supporting that party or candidate. It may involve running for office, contributing money, volunteering to work for a particular candidate, or simply but equally importantly, making an informed vote.

Voters, to my mind, are followers in the democratic process. Robert E. Kelley, who has studied followership for more than 30 years, initially characterized followers on 2 dimensions: active engagement and critical thinking. His 5 categories of followers included sheep and yes-people, neither of whom are critically engaged. As voters, sheep would wait for direction on how to vote, perhaps relying on family or community tradition (my family has always voted this way). A yes-person might be more actively involved with a candidate or party but simply accepts the “party-line” without question. Alienated followers, Kelley asserted, think critically but bring much negative energy with them. Voters in this category might spend that energy criticizing the candidates, parties, the system and either spoiling their ballot or loudly proclaiming their refusal to vote. Pragmatics, Kelley’s 4th category, align themselves with whoever is winning. As voters, they might watch the polls and vote with whoever is leading.

Kelley’s final category is that of effective or “star” followers who are actively engaged critical thinkers with a “courageous conscience” to stand up against illegality and injustice. I think this category of followership exemplifies what being a citizen nurse is about.

A License to Hide?

/ Lisa Sundean, PhD, MHA, RN / 10 Comments

When I graduated with my BSN many years ago, I was filled with pride; pride for having completed a rigorous course of study and pride for having passed the most anxiety-producing exam I had ever taken – the NCLEX. I remember my professors saying that myRN professional signature should always include my licensed title and degree; RN, BSN. RN – the holy grail of credentials for those who take the challenge of nursing education and dare to confront the NCLEX. They said all other denominations of nursing come after the RN. So, I became Lisa J. Sundean, RN, BSN and now I am Lisa J. Sundean, RN, MSN, MHA and soon-to-be Lisa J. Sundean, RN, PhD. Aside from my name, what is the constant in this lineage of credentialing ancestry? You got it – RN. Registered Nurse. Hello, I am Lisa and I am a Registered Nurse. In that you can trust according to annual public polls. RN is the only designation that allows me to practice as a nurse. No other credential allows me to practice legally except the RN license.

According to the American Nurses Credentialing Center (ANCC), the proper way to display licensure and credentials is by highest degree earned followed by licensure, state designations, awards/honors, and others (ANCC, 2013). So apparently, I need to tweak the order of my signature. I will consider it. But note, RN is still clearly in the signature. Some would argue that APRN can substitute for RN, but not according to ANCC. I’m not going to argue that point. I will leave that for the APRNs. What matters is that RN is displayed somewhere in the alphabet soup of acronyms.

Several years ago, I was volunteering for a local hospital fundraising organization. While recruiting sponsors for the flagship fundraising event as co-president of the organization, I was signing letters directed toward potential sponsors and donors. Of course, my signature was Lisa J. Sundean, RN, BSN (I didn’t have the MSN, MHA yet). The hired event planner took issue with my credentials saying it would be confusing for sponsors and donors. Naturally, I argued with him and I kept the signature intact. I argued that if people knew a nurse was asking for support they would feel more confident about giving. Revenue for that event increased by more than 100% over the prior year (yes, you read correctly!). Okay, maybe my signature was not the only reason, but nurses do have credibility. For sponsors and donors, knowing a nurse was leading the fundraising effort probably helped.

Not so many years ago, I was finishing my Master’s degree program. The capstone project had me combing through hospital websites and board directories looking for RNs serving on hospital boards. I’d heard of certain hospitals that had RNs on their boards but I was challenged to locate them in the board directories. I was perplexed that very few hospitals listed nurses on boards with their RN titles. The reasons for this are complicated, but in talking about it with a particular hospital CEO and RN, I was told that as nurses move up the career ladder to more senior level executive positions, they sometime drop the RN title because it can become an impediment to further career advancement. Pause. Think about that for a moment. The very licensing credentialing that allows nurses to practice, to deliver educated care to people in need, to advocate as educated and licensed professionals becomes an impediment to personal/professional development…(sigh).

Recently I have noticed that some nurses from academia and other work settings have retired the RN title in favor of using state designations and certifications. It may be obvious to those of us who are familiar with the constellation of initials that these people are, in fact, RNs with superlative credentials. However, the general population, who apparently trust nurses inherently, have no idea how to decode these initials. They wonder, “Is this person a nurse, a professional bill collector, a doctor of neuroscience, a professional health director, or a certified entrepreneur of noetic perspectives?” In all of the high level credentialing that nurses accumulate, the only letters that really stand out to the general population are RN – Registered Nurse.

At a time when nursing is entering its “golden age” as Donna Shalala declared so emphatically in 2010 at the release of the Institute of Medicine report, The Future of Nursing; Leading Change, Advancing Health (Robert Wood Johnson Foundation, 2015), some nurses choose to hide their licensing credential. At a time when we need nurse representation and participation at so many levels for healthcare transformation, some choose to stow the RN away. It is concerning that some feel the need to hide their professional identity to advance and have influence in leadership positions.

Now is the time to display the RN prominently along with other credentials. How else can we take credit for nurses’ roles in health, healthcare, and social justice? The public trusts us. Do we trust in the power of the RN? Let’s commit to leadership influence using the licensing credential that we worked so hard for; the licensing credential that we must hold to advance our nursing education, to provide bedside care, to be recognized as nurse leaders. The RN is not a license to hide. The RN credential is one to display proudly and be empowered by. If career advancement is at risk by our credentials, perhaps the alternative approach is to advocate for all that the RN stands for.

2016 is just days away. Now is nursing’s time. Be an RN. Happy New Year to all my colleagues.

 

References

American Nurses Credentialing Center. (2013). How to display your credentials. Retrieved from http://www.nursecredentialing.org/DisplayCredentials-Brochure.pdf

Robert Wood Johnson Foundation. (2015). Campaign for Action Five-Year Celebration Video. Retrieved from https://www.youtube.com/watch?v=SLM5zC7zmF4&feature=youtu.be

Spiritual consciousness and healing

/ dannywillis2015 / 9 Comments

This is my first time posting a blog and the experience has been both exciting and a little uncomfortable. I am moving out of my comfort zone, writing from my heart and soul. I’m thankful for the experience and hope to get better with time.  Here it goes!

As a young child, growing up in a rural village in the Pines region of Mississippi, and spending time with my mother’s side of the family in my beloved Louisiana, I was in love with the beauty of the infinite universe. I was very connected to the earth that I loved to play in and smell, the flowers I loved to smell and pick, the tomatoes, okra, onion, squash, peas and butterbeans that I loved to eat and that I helped my grandfather nurture and pick when they were ripe, the love and care of my father and mother and older brother, my ancestors, grandparents – both maternal and paternal – and great grandparents, great aunts and uncles and cousins and the infinite universe of goodness, simplicity, love, and beauty. The freedom and love of being a child of the infinite universe allowed me to sense into the universal rhythms of light and dark, activity and rest, stability and change, being and becoming, even though I didn’t have an advanced vocabulary for these things at that time. All of these experiences represented a universe where healing, love, and nurturing occurred. In the past few years, I have come to see these experiences as reflecting spiritual consciousness. I cherish being in touch with spiritual consciousness, and, thus, carefully tend to it patiently as a potentiality for nursing’s healing mission. Can the nurse working within spiritual consciousnes help other human beings experience healing and their own spiritual consciousness in order to transcend suffering of psychic, physical, social, existential, and emotional pain? I believe so.

Within the nursing context, I view spiritual consciousness as the unfolding of loving energy and various modalities of integrating nature and meaning whereby nurses facilitate healing. The nurse’s spiritual consciousness soothes worries and brings healing to others when they are in fear, pain, or suffering. Spiritual consciousness illuminates the universal need for humanization in nursing situations whereby dehumanizing circumstances deny or strip human beings of their dignity and humanity. Spiritual consciousness is the loving consciousness and healing energy that human beings tap into to restore harmony in times of disharmony.

Spiritual consciousness is evolved consciousness for nursing. It can be cultivated by nurses worldwide to facilitate healing. The nurse, in spiritual consciousness, being loving toward another during moments of the other’s suffering, brings healing energy to the situation. Spiritual consciousness is characterized by spaciousness and lightness. It provides a glimpse into the goodness and beauty of the universe, and the freedom not to get bogged down or trapped in mere physical and limiting aspects of being. I believe it is central to nursing’s healing mission. Thus, the notion of spiritual consciousness challenges each of us in nursing to experience this loving energy and to discuss it for better understanding the usefulness and limits of spiritual consciousness for facilitating healing. images

The human mind’s binding capacity can be warded off by shifting into spiritual consciousness. Spiritual consciousness does not include limited and bounded views such as hatred, sense of division, greed and power over others, malice, or separation between us, other human beings, earth, plants, animals, rocks, trees, rivers, stars, and the moon. In spiritual consciousness, we are all universal one.

As nurses gain experience sensing into their own spiritual consciousness, nursing will be better poised to meet its social mandate. Working from within spiritual consciousness, nurses are provided with multiple pathways for healings to occur. As nursing and society evolve, ideas related to spiritual consciousness and healing need further development.