How many times do we as nurses find ourselves teetering on the edge of wrong and right? How do we find that perfect balance of in-between, the shade of grey between moral and immoral, ethical or unethical in our practice? Nursing is an occupation where we must battle against our own human nature day after day. For some of us it's quite life changing, we learn to anticipate another's needs, the boisterous learn to be silent, the shy to advocate. We are told to push away our own selfish desires of spending extensive time with the injured or lost, to prevent us becoming over involved, overstepping the boundaries of propriety. We learn we must treat the cruel and violent with respect and understanding no matter what their crimes may be, even if they are a paedophile or murderer. It must be asked then how many other occupations are forced to lock their heart up so tightly? To remain respectful, tolerant, polite, advocating, gentle, and attentive, overall providing the holistic, non-judgemental care that is expected of our profession, no matter the situation?
The answer is not many. To be so involved in another's well being, caring for them in such a personal intimate manner is such a rare privilege and knowing as a nurse you are accepting the responsibility to advocate is a blessing. However this also can be heart wrenching when you come up against clashing values, violence or the nurse's own internal turmoil.
We can all relate to certain instances in our career, the moments that have touched us, the times we have felt torn and left the shift in tears. A part of nursing includes a sacrifice of ones own core values, to learn an ethic framework for a profession that may not match with our own morals.
Many instances rise to mind, can you remember the time you were presented with a personal gift or card of money in gratitude by a small aged lady smelling of rose powder. Her eyes are a faded blue; wrinkles deepen, as her eyes crinkle in her smile. She is so thankful you have been by her bedside, holding her hand, massaging soothing balm into the soles of her old feet, whilst keeping up a happy banter over the past couple of days. You were her nurse, you supported and cared for her, she appreciates this, she's going home and she wants you to know. She wants you to remember the bond you shared with her, to not forget her, she has so little family in her life now. You stand there and smile, but your mind is shaken, a nurse should not accept an expensive present and certainly not money from a patient. What will you do? You don't want to hurt her feelings, you have the choice to refuse, you can offer to give it to the nurses at the station too or will you break the rules and accept?
What about the young teenage girl? The one with long dirty blonde hair, big green eyes and a giggling laugh, she's sitting in the bed tear stains down her cheeks, she's fifteen and pregnant. Her boyfriend has left her and her parents don't feel she is mature enough to be a mother, she has been admitted for an abortion. The girl wants to keep the baby she tells you, she feels bad for killing it. You ask her why she doesn't tell her parents this. A shrug and the eye contact is broken, the youth nursing her stomach as if an answer would come to her. Finally there's the whisper that Pa can't afford it. Heartbroken you don't know what to say...what can you say? It is obvious you shall not be able to change anything. Should you try to convince the family to keep the baby anyway, even if it may grow up in poverty? Destroy this young ladies chance of schooling and fitting in? Do you even agree with abortion? Your God agree? Maybe abortion is fine in your mind, but still looking at that immature young girl you can see her pain, it's real and no matter how stupid or foolish she may have been at the time, you will find yourself wanting to make the pain go away. We're human, a creature of emotion and morals. Yet as a nurse we are forced to squash them away and follow rules of appropriateness that often are not our own.
Last we should consider those moments of abuse, feeling scared as a grown intoxicated man swears and gestures at us, demands better service, stronger drugs. He towers over you and you can smell the grog on his breath, the scent of smoke in his skin and clothes. He is angry and irrational; he threatens to report you to the hospital and have your license stripped away. Some nurses shall pointedly express to him that his behaviour is not appropriate and if this continues security shall be rung, others will do their best to placate, offering blankets whilst apologizing for the wait. However sometimes as assertive or accommodating as one may try to be, there are people that will not be fazed and the ante will be upped. A shove or demeaning words they will spill from his mouth, you will feel belittled, angry or tearful, and resentment will fill your heart. Security shall come in and sit with the man, other nurses will try to take over the interactions with him to give you a break if you are lucky, but it will still be you accountable for his care, you writing out his pathways, speaking with the doctor and struggling to smile whenever his family go past. You can't get angry, you can't tell him exactly what you think and the loss of justice pains you somewhere deep inside.
When people think of nursing, they think of Florence Nightingale, a caring woman, gentle, devoted and sacrificial. They have this expectation of a nurse to be perfect, to be sweet and kind and never show a negative emotion. It's an unrealistic stereotype, as humans we have our own morals and value systems; we have the strong and gentle personalities and an ethical framework to follow. This framework being a code of conduct that controls how we're supposed to act at all times. Does it control us at all times? The correct answer would be yes, the truthful answer no.
Those moments of grey they fill our work life, how many hugs have been shared with our patients? How many stories of advice and sharing of beliefs? Bets can be made that periods of friendship have sparked with patients, that we can remember twenty years later. In experience it's certain all of us have witnessed the foolish nurse crushing on someone they should not. That nurse going and collecting a lonely elderly gent's mail for him as he has no friends or family, of the one sharing her religion, checking a family member's temperature or selling some beauty device from a magazine.
Is this wrong? Probably, but it also shows we are all human. We make mistakes or get lost in the mass of shades that are expected of us to understand. To be a nurse one has to learn how to meld their own morals with the ones we're trained to perform, to act in public as one does at work for the integrity of the profession. So many expectations are on our shoulders.
However to be a nurse is also amazing, we get to see the most vulnerable time of a person's life. We get to be by their side as they slip away to their maker. We get to comfort those grieving, reassure the scared, ease pain and discomfort, be teachers and confidants of the greatest secrets in these people's lives.
Nurses don't see themselves as perfect. But to some....we truly are.
