05 June 2014

Savor those Golden Moments!

A couple weeks ago, we celebrated our senior nursing students at Boise State University with a lovely and memorable pinning ceremony. I had the special and distinct honor of delivering the keynote address to the graduating senior class and their assembled family and friends. In honor of nursing graduates across the globe, I’d like to share excerpts from my speech.

It began like this: “Good evening family, friends, faculty, staff, and distinguished guests—and, to our newly graduated and esteemed colleagues, welcome to the profession!

“What a wonderful, incredible time for the profession of nursing. Virtual medicine, genetic engineering, informatics, telemedicine, genomics, and other scientific and technological advances in health care are strands in the fabric of our daily working lives. Unquestionably, science combined with empirical evidence gained through careful research provide the gold standard for safe, quality, patient-centered care. However, seeking and discovering the delicate balance between the science and the art of nursing—and appreciating both—form the basis for professional practice. One without the other is an incomplete application of our craft. I’d like to illustrate this point with a lesson from my own nursing practice.

Stuff of nightmares
“As many of you know, before I started teaching at Boise State, I worked for more than a dozen years as a psychiatric nurse. I was a member of a crew of mental health workers who treated adolescents suffering from a variety of conditions and disorders. Many of our patients were violent, adjudicated youth with long histories of severe substance abuse and criminal activity. Others had been abandoned, rejected, and abused—often forgotten and left to fend for themselves. And the offenses some had committed were so grave they were the “stuff” of which nightmares are made. Our work was challenging and often tested our resolve. But, through it all, the team members had each other. We were young, determined, and unshakable in our belief that we could make a difference.

“I remember clearly one notable event. After a particularly challenging day, we were definitely looking forward to going home, but Dr. M, the psychiatrist on our team, suggested we meet for a few minutes before leaving. Dr. M is a brilliant, gifted physician. She is also a child of Austrian immigrants who survived the horrors of internment in a Nazi Germany concentration camp. Her life experiences and sharply honed psychiatric skills helped us become better clinicians and, I believe, better people.

Golden Moment
“As we gathered for a meeting none of us really wanted to attend, we had no idea the spontaneously called encounter would be a game changer. After we had assembled, Dr. M looked around the room at each of us and then said, “This is our Golden Moment.” To clarify, she added, ‘This unique intersection of our lives, this amazing coming together, is a gift to be cherished. It is not a single moment, or even a single day. Instead, our Golden Moment is an accumulation of the days, months, and years we have worked, sweated together, and supported one another to make a difference in the lives of the kids entrusted to our care.’

Savor those Golden Moments. 
Photo: Lorenzo Rossi/Hemera/Thinkstock
“A Golden Moment is the expressed joy and satisfaction of being part of a team engaged in very difficult but rewarding work. I remember a very personal lesson I learned from Dr. M. We were co-therapists for an adolescent group-therapy session that met twice a week. The kids in our group were members of a special ‘club,’ if you will. Teens who lived life on the edges of polite society, many had made their living on the streets, marketing drugs and selling themselves for shelter, food, and any number of reasons. One day, an adolescent I’ll call Ty began to share with the group his story, one of prolonged abuse and neglect. Often beaten, he would be locked in a closet for days at a time, without food or water, with only a bucket for relief.

“As he told his sad tale, I found myself deeply affected and unable to hold back the tears that stung the corners of my eyes. I had been schooled in the fine art of not showing emotion. I was embarrassed by my vulnerability because, according to theory, showing emotion was nontherapeutic and could be potentially harmful to the often-fragile, patient-nurse relationship. When the session was over, Dr. M met with me—she could see my embarrassment—and said, ‘Never, ever, be ashamed of feeling your feelings. Much of what you are learning, and so much of what I still have to teach you, cannot be learned in a textbook. Being present and ‘real’ and connecting with patients on a deeply personal and human level is often the most effective tool in our toolbox.’

“Our Golden Moment together spanned years, and it taught me lessons that have shaped and continue to shape my worldview and interactions with others. These lessons include: 1) Each person shall be afforded human dignity and treated with common decency. 2) There, but for the grace of the divine, go I. And 3), ultimately, it’s the three R’s that matter most in life—relationships, relationships, and relationships.

Use all of self
The moral of the story is: Embrace the importance of the use of “self” in the art and practice of nursing—and use every part of your self to promote health, alleviate suffering, and prevent illness.

“Using all of self involves using our nimble and capable feet to walk in the shoes of others, understand their paths, and appreciate their journeys without bias and prejudice. It means using our strong backs and shoulders to lift up and advocate for the less fortunate, the vulnerable, and the underserved. It means using our sturdy arms to embrace those who need us most—the homeless, the mentally ill, and the neglected. It means using our skilled and gifted hands to examine, massage, palpate, and touch the lives of the newly born, the children, the aging, and the dying.

“We need to use our bright minds to critically think about and consider the holistic aspects of the human condition—that special quality that sets nursing practice apart and makes our profession unique from other health care disciplines.

“We must open our hearts and be compassionate; live by the principles of non-malfeasance, social justice, and caring. And, perhaps, most of all, we must share our human spirit and cultivate hope where hope sometimes seems impossible.

“Like technology and machines that require proper maintenance, so too, must we take excellent care of ourselves. We must find time to restore, relax, and be contemplative—to enjoy quiet moments and be with the people we love and those who love us back. So, be good to yourselves as you provide for others. While we belong to a noble profession, it is also a very demanding one.

Positioned to lead
“This graduating class is well-positioned to lead the way and advance our nation’s health. Your steadfast and resolute commitment to just causes, your keen and collective intelligence, and your deep allegiance to being fearless on the side of right will take you far and set you apart from the ordinary and the mundane, if you speak with voices of measured reason and mutual respect.

“But remember, in this fast-paced, moving world, we almost never accomplish anything worthwhile solely on our own. Witness the people in this room tonight and others who have helped you along your nursing education pathway, those who have been by your side every step of the way on your journey toward even greater accomplishments and achieving your own Golden Moments. Your family, friends, neighbors, loved ones—and yes, even your faculty—have joined you on this journey, and we are all very, very proud of you.

“So, appreciate and cherish the gifts you’ve been given, and never waste them. Use them to make a difference in the lives of those in your care today and in the years to come. Never waiver in fulfilling obligations to your patients and their families. Be an advocate for a more humane and just society. Champion a world of caring and compassion; show up, make a difference, and pledge commitment to service. Be reflective and thoughtful when making decisions. You are the promise of our profession, and, tonight, we pass the torch to you, our graduates, for you are well-positioned and well-prepared to boldly and confidently lead our profession into the next generation of nursing excellence.

“So, as an uncertain world rushes on, savor those rare and quiet moments. Be gentle with yourselves as you provide care to others. You have all worked very, very hard, but, in some ways, your work has barely begun. You are clearly up to the challenge, and we honor you as you continue on your path to nursing excellence—both as scientist and artist.

“I’d like to close by reciting a few selected lines of prudent wisdom from Oh, the Places You’ll Go!, written by Dr. Seuss one year before his death at the age of 87.”

     Today is your day. You’re off to Great Places.
     You’re off and away!

     You have brains in your head.
     You have feet in your shoes.
     You can steer yourself any direction you choose!

     Oh, the places you’ll go! There is fun to be done.

     There are points to be scored.
     There are games to be won!
     And the magical things you can do with that ball,
     Will make you the winningest winner of all!

     Oh, the places you’ll go!

“So, colleagues, enjoy the ride. On behalf of all of us gathered with you tonight, congratulations on a job well done, stay in touch, and thanks for the memories.”

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.