Nursing: Moment by Moment

Charslight

Marty&Makau said:
"Helping is not a relationship between equals. A helper may see others as weaker than they are, needier than they are, and people often feel this inequality. The danger in helping is that we may inadvertently take away from people more than we could ever give them. We may diminish their self esteem, their sense of worth, integrity, or even wholeness"

I am sure the first nurses were motivated by a desire to alleviate pain and suffering. In the days of limited technology, a soothing voice, a reassuring hand, bandages, prayers and warm water might have been all they needed. I am sure many patients were soldiers who died while being cared for by a nurse. Knowledge of the body was limited, as was an understanding of disease, and pathogens. In some ways life was simpler as people stayed focused on the basic tasks. In other ways, life was more complicated as people struggled more physically, without electricity, or water and labored over back breaking duties that are now taken over by machines. I am sure that people who cared for others had a fundamental desire to help. Despite all the bells and whistles of technology in the 21st century, I believe that the fundamental desire to do good is still the basic philosophy behind every nurse. However, with the changes and complicated lives that people experience today, the average nurse has to broaden his or her scope of practice. This involves being able to multitask, prioritize, think quickly and wear many hats. The nurse has to be a caregiver, server, mediator, philosopher, gopher, helper, critical thinker, gate-keeper, social worker, police person, communicator, problem solver, spiritual advisor, life coach, shoulder to cry on, advocate and teacher. The nurse must above all be non-judgmental, for nursing is an art as well as a science.

I love my job because I help people. Sometimes that means I have to take charge, which automatically puts the patient and myself on unequal ground. Often I go home at the end of the day smiling because I felt I made a difference. However, maybe I am smiling because someone had to suffer to give me the opportunity to shine. The unsuspecting patient stroked my ego. I even got a thank you card, telling me "I was a gift from heaven, an angel," my 'selfless care' gave them a new outlook on life. My fast thinking, knowledge and expertise saved my patient's life when he collapsed with fluid around his heart. I knew CPR could kill him. The adrenalin was flowing; I was invincible as I sped down the hallway with no time to lose, as a very sick vulnerable man lay slumped in the wheelchair, I was pushing. His life was in my hands, I did not give a hoot about his self-esteem at this point. That would come later. I was doing a good deed, and it was after hours too, but boy, did part of me feel good! I prayed for his survival.

Nurses can be control freaks. We decide what patients may eat and drink. We measure their urine, and whatever goes in and out of their bodies. Patients have no privacy. We open their gowns, to expose their private parts, sometimes without asking, especially if it is an emergency. We control their pain medicines. Before puncturing their skin to put in an IV line, we say. "You are just going to feel a little poke." A little poke? Who believes that one? We do this to 'help' people.

Whatever kind of nurse one chooses to be, ultimately the experience one has as a nurse, build down to moments. Nursing is about moments, and being in the moment. You have to be open to see those moments. You cannot save the world, but you CAN make small changes moment by moment. However, you have to be open to see those moments. As a new nurse, I felt like I was going to change the world. I felt invincible, and consequently increasingly frustrated with what I felt was an inability to make a difference. All it took for me to understand the impact I was actually making, was to have someone say 'Thank you" with tears in their eyes, have someone pass away peacefully while I was holding their hand, because I had controlled their pain, or to have someone survive because I acted quickly and smartly.

I will never forget the wealthy attorney with who came in completely intoxicated with holes in his socks and wearing a diaper. I was firm with him, and took care of him as he went through detoxification. He told me about his life and some of the stupid choices he had made. I administered Valium when he started to shake, but above all, I listened, and I asked many questions. I asked him to come back in a month to see me when he was sober - I was surprised when he did. He reinforced the love I have for my job. He will never know how much impact he had on me that day.

Patients often teach us more than we do them. When I got report on a 49-year-old male with an old spinal cord injury, paralyzed from the neck down, I stepped into his room with trepidation not knowing if my presence would be met with anger, resentment, fear, or boredom. Imagine my surprise when this delightful, charming man, greeted me with a song, and proceeded to make my day feel blessed. If courage ever fails me, I will remember this moment.

At that same moment there was a beautiful woman in the adjacent room, who was also paralyzed with Multiple Sclerosis. My heart prayed that their spirits could meet in space, through the concrete hospital walls. They were both the most positive people I have ever encountered.

I am proud of what I do. Many nurses can be controlling and co-dependent, but somebody has to do this job and do it well. Even if patients do feel vulnerable and humiliated, most nurses do respect their dignity. I think patients survive the humiliation we put them through because they know we care. Patients are fragile to begin with. A good nurse has to take charge, be gentle and firm, have a sense of humor, avoid pity, but be empathetic. One day my life might also be in the hands of a nurse. If this nurse has a big heart and brains to match, if her need for control is balanced with her compassion, if she is able to wear many hats, my vulnerability will yield to trust, because I will know that she has my best interest at heart, and that she truly cares.

References

Argument and Persuasion. In Marty. &. Makau, Argument and Persuasion (pp. Chapter 3, Page 89).

Nursing: Moment by Moment

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