Evolving As A Nurse

[PositiveEnergy]

“Hello, my name is Corey I’m your student nurse for the day.”

Remember how unnerved you felt the first time uttering those words to a patient?  Or, how you once peered longingly at the “floor nurses” who waltzed from room to room with such confidence, administering care that seemed so complex, mentally praying someday to be as poised, calm, and assured?  For some, those days might seem a gazillion years ago if you are a seasoned nurse, or like yesterday if you are still a novice, just beginning your career; a nurse (or student) with yet many firsts ahead. 

First experiences will forever remain embedded in the nadirs of your mind, like how your hands trembled as you filled the syringe with pain medication to administer your FIRST intramuscular injection!  Or, the mental image of this same experience with your clinical instructor peering over your shoulder, watching your every move as you drew up the medication and injected your patient.  Scary times, but thank goodness the shot was a success, and the competency signed off.  Absolutely, this was a career milestone worthy of a high-five and a happy dance!

On that first day, despite quivering lips and the knot in your stomach you managed to articulate the introductory “hello”.  An acknowledgment meant to break the ice and allow you to assume “patient care”.  Surprisingly at the end of the day, despite your initial butterflies and feeling a bit overwhelmed, you felt victorious.  Not because providing basic care was any grandiose accomplishment, but now you connected with the profession and knew this was where you belonged.  You stood steadfast, keeping your shoes planted where they needed to be – ready to meet the challenges ahead.

Recalling such first experiences triggers my own thoughts of the many uphill steps I have taken along my nursing path.  Likewise, the reference of steps makes me think of my nursing shoes.  For me and I believe for many, our nursing shoes could convey our stories.  How as we stride along in our daily routines, we gain experience and new knowledge.  Over time, and between good days and bad days we climb the stepladder from rookie to expert.  Then, mostly without being consciously aware, we become those seasoned nurses who walk with confidence and possess the intuitive wisdom to immediately size up clinical situations.

Mentioning nursing shoes moves me to share a piece I previously journaled, while recollecting the steps of my own journey.  My account, Nursing Shoes, is an evolving tribute, reflecting my growth from a neophyte to a mature, veteran nurse.  Today, I would not be the nurse and person I am if I had worn only one style of nursing shoes, or if I failed to change into new, more comfortable shoes when the fit no longer felt right.

As you track my footsteps, I ask you to read between the lines.  You will hear emotions reflecting insecurity and self-doubt typically experienced in the early stages of one’s career.  However, with maturity, self-confidence, mindfulness, and real grit one’s career can evolve into a rewarding, profitable, and memorable experience.  You too, will wear several different pairs of shoes along the way.  Some will start out feeling comfortable and just right, but in time begin to feel flawed and misshaped.  There will be times you marvel at the shine and newness of your shoes, and other days when you look down and wonder when your shoes started looking so blemished and gray.  But hopefully, there will be loads of days when you celebrate the spry bounce and agile step your shoes allow you to take.

I have been a nurse for many years, climbed many steps (and “yes” fallen backwards a time or two), held various roles, and worn a number of different style shoes.  Before I tell you my Nursing Shoes story, I will answer the question commonly asked of seasoned nurses like myself.  That being, “What wisdoms do you have to share with nurses just starting their careers, and for those nurses feeling overwhelmed with the demands of the profession (probable all nurses at some time or another)?”  Here are some approaches I recommend to keep your shoes feeling balanced and to maintain a steady step.

Advice

1. Sometimes you will have to sidestep, take a deep cleansing breath, rest for a bit, and then propel forward with a fresh new stride.  Avoid walking backwards.  Always venture forward, but acknowledge those times when pausing is vital for spiritual refueling.
2. Expect there will be smooth roads and bumpy roads.  Mentally parrot the mantra And, This To, Shall Pass when in stressful situations that feel unending.
3. Find a nursing friend at your workplace.  This person will be your support, your buddy, your confidante, and “have your back” in difficult situations.
4. Network with new professional colleagues.  Meet others outside your own sphere of practice by partaking in nursing conferences.  Attending is a great way to realize your concerns are not unique, provide you a forum for a professional voice, and offer spiritual renewal.  If attending a conference is out of your budget, do not give up.  Check with your employer for potential ways (e.g., presenting a nursing issue, doing a poster presentation) to receive reimbursement. 
5. Use your accrued vacation time to take those deserved sidesteps.  Do not put off mental escapes until you feel exhausted or burned-out.  Even stay-at-home vacations can be mentally rejuvenating. 
6. Take your entitled shift breaks (e.g. 15 minutes, lunch/dinner) and actually leave your unit.  A short time away can help you recharge.      
7. Embrace the humorous moments.  Laugh together whenever you can, because some days you will cry together.  
8. Learn something new each day, no matter how complex or simple.  Always understand the “why” of what you are doing.  Be curious about the “whys”.  Never forget to ask for help.
9. Beware of the symptoms of the burnout “virus”.  Almost everyone eventually catches the bug.  The weariness feeling, so typical of burnout will creep up and consume you if not recognized.  Identify symptoms early, reach out for help, and individualize treatment to meet your needs.  Realize sometimes the best option is to step away, or pronounce, “I’ve had enough”.  If the latter is best, feel proud of all you achieved and move on to your life’s next adventures.
10. Sometimes you may feel the field of nursing in which you are currently employed has become too tedious, or has caused you to feel disheartened with the profession.  Remember, there is a plethora of nursing venues, which might offer you a healthy, new perspective.  Try something different like moving onto a new specialty, a new department, or even an entirely different place of employment.
11. Always treat one another with respect.  All nurses learn respect and dignity are basic human rights, which should be part of every nurse-patient encounter.  We do a great job of upholding these integrities with patients, but I believe we fall short of doing a stellar job treating our own colleagues with respect.  You might think this accusation is a stretch, but I ask you: Why are terms like “bullying” or “lateral violence” still in our nursing vocabulary?  Ask yourself, “when was the last time I complimented a peer on a job well done?”  Or, have you ever thought to nominate a deserving colleague for a famed nursing award (e.g., The DAISY Award, The New York Times Job Market Nursing Award, Nurse of the Year (Lippincott Solutions), ANA National Awards Program, Nursing Excellence GEM Awards)?  There are many occasions to nominate colleagues.  However, such windows of opportunities typically are not acted on.  Unfortunately, when not actualized, both the worthy recipient as well as the nominator lose out on chances to feel good about something positive.   
12. The tip I feel is key to survival is to vent your feelings; tell your stories.  Use some art form or creative expression such as drawing, journaling, picture taking, singing, or sculpturing to release those stories you hold inside.  If you can, verbally share your stories.  There is nothing like a gathering of nurses to hear some wonderful, heartfelt stories.  I believe an evening of storytelling is a meaningful and therapeutic gift which employers can give their nursing staff, or nurses to themselves, during Nurses Week each May.
13. Remember this quote: “They may forget your name but they will never forget how you made them feel” (Maya Angelou).  This is for those times when you ask your “buddy” friend, “Remind me again, why I signed up for this.”

Now that I have offered some of my general survival recommendations, read on because within my Nursing Shoes musings you will find other embedded lessons and professional wisdoms.    

Nursing Shoes     

Ah, my dear nursing shoes.  They have been with me every step of the way as I have grown from novice to expert.  Just as I have changed so has the style and comfort of my shoes.  My original shoes were the traditional snug fitting, highly polished white leather nursing shoes that hugged one’s foot.  They kept my foot secure and in place.  They prevented me from slipping and falling with their soft, almost flat, non-conductive copper-colored rubber soles.  Their style truly mirrored me as the nurse I was at the time.  I wore this style as a student and a new RN.  At the time, I did little thinking outside the box, I adhered to the rules and regulations learned in nursing school, and intentionally conformed to the practices of the other nurses I observed.  I backed up my actions by the book and did nothing out of the ordinary.  The feel of my shoes mirrored my inner fear of making a mistake, or of being different.  All my actions were housed in the novelty of being a new graduate. 

After going through several of these traditional shoes, I began to wear shoes of softer white leather that gave around the contour of my feet.  My new style was more contemporary.  Now I preferred loosely fitting, white leather clogs with closed heels (open heels were not permitted for safety reasons).  The softer grip allowed my foot freedom, but the fit was not so loose that my step would wobble and cause me to fall.  My shoes were me.  They were relaxed, accurately reflecting a nurse with newfound confidence.  As a maturing nurse, I felt less inhibited in sharing ideas with supervisors and colleagues.  I was advancing, leaving the novice behind, and moving towards the more expert-thinking nurse, but I was not quite there yet.  I still had a few more changes of shoes. 

My next and most preferred shoes would be chic ones.  They offered me the ultimate support, contoured to my feet, and allowed me to move with grace.  These were the white nursing shoes designed with the latest foot technology to provide ultimate comfort and a free-spirited step.  For some, and even me, this was in the form of a white canvas or white leather sneaker fabricated specifically for the active nurse in mind.  In this style, as I walked in my supremely soft and comfortable shoes (my white leather sneakers) my step was secure.  I felt sure-footed and confident in how balanced I felt.  As I progressed, I occasionally stopped, cleaned the scuffmarks off, and smiled as I continued down my nursing path.

Later, in my career the clog style-nursing shoe became popular once again.  Only this new shoe was vibrantly different.  Now these clog shoes were a multitude of colors, rather than predominantly white.  For me these shoes signified the essence of nursing.  No longer did I see nursing solely through white lens, but now I saw whirls of different colors intermingled throughout.  These new brushes of colors epitomized the aesthetic, multi-dimensional, and multi-cultural aspects of care.     

The hodge-podge of colors in the fabric of my shoes signified the diversity, deeper philosophical understanding, and phenomenology of human nature I came to appreciate.  I saw my own newfound wisdoms reflected in these colors.  In the palette of my shoes I saw:  Tints of indigo that splendidly exemplified my now advanced level of nursing intuition and critical thinking.  Spats of yellow intermingled with the luster of blue denoted the peace I felt in knowing I possessed a deeper understanding of my profession, and of who I was as a nurse.  Splashes of orange symbolized optimism, which I learned was essential to bequeath.  Gleams of red denoted my passion that all nurses tell their stories.  The glimmer of purple, my most favorite shading, I believed represented imagination, a vital attribute.  Collectively for me, these colors signify the hues of our profession as we adjust, redefine, and invent new and creative ways to handle healthcare challenges.  

Most recently as I contemplated retiring my colorful shoes and storing them amongst the dust bunnies in my closet, our world, and our profession turned upside down with the tsunami, COVID-19.  Now some frontline nurses shield their shoes with standard hospital-grade, blue foot covers.  Coverings clad by frontline nurses to complete their ensemble of Personal Protective Equipment (PPE).  Protective layers worn from head to toe with the hopes of safeguarding others and themselves from corona hitchhikers.  Sadly, despite these protective efforts, this horrific COVID wave has taken the lives of nurses.  Because of this threat to nurses, and to all of mankind, this virus can be considered one of nursing’s most monumental challenges.    

With the mounting COVID stress there are times now, especially after a stent of caring for COVID patients when one’s feet ache, a mere extension of a heavy heart.  Whether coming or going to work, one’s shoes feel lined with lead. A heaviness that changes the normal Spring in one’s step to a slow and weary pace.  Our nurses are tired, but everyday continue to put on their shoes and maintain the pandemic march.  I think about how our nurses need something special to come along (vaccine) so they can put aside those heavy, uncomfortable shoes and once again strut full-stride ahead.

When I look down and see blue covered shoes, I think of the ocean and its glimmering waters.  An intriguing mental image that gives me hope.  In this sphere of nature, I see something never stagnant, always changing, and forever creating a new tapestry of life.  This is why I have hope that change is ahead, just on the horizon as we ride the waves of this unprecedented pandemic.  At times the waves feel like they are mounting, quite over our heads.  But countless waves have risen before, and eventually folded into the sparkling waters of the shore.  This predictable rhythm of the wading ocean is what gives me hope, that COVID too will recede like the ebbing ocean tide.  Though we are experiencing rough waters at this time, a vaccine will be developed and the colossal waves will break.  Then once again, nurses, their families, and mankind will advance forward with sure-footed steps.  

Step, Step…Breathe (SSB)

Corey

[S.I.C.]

Hi bpav

Thank you for the self-help and surviving strategies you used in coping with challenges you met on the way. I have learned from you and I use them too in my daily life. I have a plan in the process of evolving as a nurse to direct my future toward private business without intentions of making much money, but for continuing my profession in another way. 

I believe, no matter how hard nurses work throughout their professional lives, they world doesn't give them the respect they deserve. I think if I can open my own business such a nursing home or a small hospital, I can hire some of my fellow colleagues, and threat them with high respect and dignity. Of course, I can try to generate income that would help survive, and help other people in my own capacity. This has been my long term dream, and day by day, I am working to make it a reality. Do you support my idea or you think it doesn't make sense. I consult you because I see great wisdom in you.

[PositiveEnergy, MSN, PhD, RN, APN]

Certainly a worthwhile endeavor.  Follow your dream, but be sure and gain as much information about what the undertaking would include.  Gather your resources and begin formulating your business plan.

[S.I.C.]

Thank you very much?