Reality Check

Perhaps this is why I like writing. A writer has control, of topic, plot, length, start and finish. I have complete control of my article right now. I do not have complete control of my nursing shift. I know that I'm not the only nurse who doesn't have control. I see discussion after discussion on Allnurses from many of us with questions and concerns about similar issues.

Unless you misunderstand me, this is not about control in nursing. This is not about how much independence and autonomy nurses can or cannot have. This is simply about what is beyond our control. What we can do nothing about, even when we've tried.

We nurses come from all walks of life. We come at this profession in many different specialties. We see many things that are beyond our control. We walk into our ER and immediately are greeted with a trauma, a man hit by a bullet because he was in the wrong place and the wrong time and his family is screaming. We run around placing lines, hanging blood, hanging fluids, preparing for OR, calming the family and praying "Please, don't die." We walk into our ICU and we care for the twenty-something that has been on the ventilator for several weeks and we know his family like we know our own, and they ask us with looks of expectation "Is there any change?"

We sit in people's homes and guide them through the death of their father, their grandfather, their mother, their sister. We tell them what looks like pain and what is the 'normal' process for dying. We administer the Morphine. We walk into our long-term care facility and see that staff called in and we are short staffed again. We walk onto our Med-Surg floor and have seven patients, three total care, two getting ready for OR, one that needs blood. We walk into our OR and we witness the opening of the incision and we see the tumor that will change everything. We see the baby born with complications in spite of no previous indications. We walk into our patient's room and see that he isn't responding. We call a code, do chest compressions and bagging, we push the epinephrine and the atropine, we shock and we shock again and we watch it fail, again. We try to cause change in our organization but it doesn't always work. We advocate for policy change, for safer staffing and for better protocols but we have days where nothing seems to work.

We say "I've seen it all," and we really feel like we have. The sadness doesn't seem to affect us anymore, because we've seen so much. We are tough, we are hard, but we are GOOD nurses. We earned our scars and we know our stuff. Our assessment skills are stellar and we could put a line in a rock.

But the sadness does affect us. Maybe in little ways. Maybe in ways we didn't realize. Maybe you don't do this, but when I am stressed, I over eat. I don't even realize I am stressed but then I grab three candy bars instead of one and eat half a bag of chips. Maybe we stop after work for a drink and then two or three. Maybe we skip the gym, we spend money we don't have, we snap at our family.

So here we are. Should we just give it up because of all the sadness? Because of everything that is out of our control? Should we throw our profession out and get another one? If anyone out there is like me, we can't do it. We really love it too much, or it's too much of a part of us even if we forgot that at one time we loved it. If the profession didn't mean anything to us, we would be surfing another site instead of allnurses. We go back, shift after shift, not just because we want the paycheck but because something in us must want to help others. Because really, our society needs nurses. We are part of society, and we need good nurses. We need nurses that have been through the wringer, because often, experience is the best teacher. We want nurses like us when we are sick and we have no control, or when our family is sick and we have limited control. If we can't be there, we need someone else to be who knows what they are doing.

So, if you are reading this and you are a worn out nurse, please don't be discouraged. You've earned your scars, you've see the worst. But you've done a lot of good as well, so please focus on that. Remember the patient that remembered you when they came back? Remember that family that sent you a card? That colleague that complimented you? If you are a new nurse, remember your enthusiasm now for after you have been in the profession awhile and it starts to wear on you. It's ok to let some enthusiasm go, but don't lose it all. For nursing students, don't get discouraged by the negativity. The negative may be realism, but not all of it is. Try the profession out for yourself before you give it up. For all of us, let's practice taking care of ourselves! Say no to those extra shifts if we just need a break. Let's switch jobs if we have to, even if we are afraid of change. Let's exercise, try to limit the candy bars, talk to someone who will listen. Scream or cry if we have to in the car, write privately or post in an online forum.

But don't give up on nursing. Because you are a better nurse than you know. In fact, I would be willing to bet that you are an amazing nurse. You are part of one of the greatest professions in the world. You are a nurse, and you have witnessed few things that anyone has seen. And even when you are dealing with things outside of your control, you are needed. Just ask anyone who has ever needed a nurse. I am one of those people who has needed a nurse, and who is a nurse. And, as such a person I thank you from the bottom of my heart.