10 February 2015

Our daughter called today

Our daughter called today. She is a somewhat newly graduated nurse, having completed her nursing degree just a little over three years ago. Since then, she has been working on a very busy oncology unit, caring for extremely ill patients with medically challenging conditions. Her recent need to share stemmed from events surrounding a young mother dying from advanced and untreatable breast cancer.

The health care team had worked tirelessly, trying to control the patient’s agonizing pain with little success. It took nearly an entire 12-hour shift for a team of oncology experts to find the right combination of pain medication and comfort measures to help the patient find relief. To make matters worse, the patient’s husband was so compromised by the experience that he suffered a cardiac event and was rushed to the emergency department. He was later admitted to the hospital for his own health issues.

Our daughter was profoundly affected by the day’s events and needed to debrief to gain a deeper understanding of what had happened and to decrease her stress level because, the very next day, during her next shift, the stress of caring for very ill patients with complex issues would begin anew. We talked for the better part of an hour, discussing effective ways of coping, managing stress, and engaging in self-care.

The conversation with my daughter took place just one day after a nurse with 43 years of experience disclosed to me that she had abruptly handed in her keys, cleared her locker, and, without giving notice, had walked off the job at the end of her shift. She had simply “had enough” of dealing with an incompetent and bullying nurse manager, who seemed to care little about the nurses under her supervision.

With tears in her eyes, this seasoned and highly experienced nurse explained that, while she enjoyed the work and caring for her patients, what she couldn’t abide was working for a manager who demeaned her and her colleagues—sometimes even the patients. Though we had just met, she poured her heart out as I offered an impartial ear. She said that she missed the work, but the stress of the job was killing her. Sadly, she is yet another casualty of workplace incivility.

A soft place to land
On the surface, these stories seem unrelated, but they are bound by a common theme: The work of nursing—regardless of the setting—can be very stressful and demanding. Each of us needs a “soft place to land” and a caring mentor with whom we can share our worries and concerns; someone with whom, when needed, we can speak the unspeakable, to help us sort things out so we can clear our heads and refresh our commitment. All of us need mentors and other caring individuals who can lend support and offer sage guidance and experience-based wisdom. Being a nurse is hard work and certainly not for the faint of heart. Nursing requires fortitude, compassion, and a commitment beyond what most people ever possess.

Think about it from the perspective of a newly graduated nurse, or even from the viewpoint of an experienced nurse, for that matter. The life of a nurse is challenging. Minute by minute, nurses deal with life and death situations that affect not only the patients they care for, but their families and loved ones and, ultimately, the nurses themselves. After talking with our daughter and the seasoned nurse who quietly walked away from a profession she loves, I came away from those conversations absolutely convinced, once again, that we must provide a nurturing place to debrief and a safe space to express the myriad emotions that nurses experience every day when caring for others. In caring for others, they often forget to care for themselves. It is important for each of us to reach out to one another and listen—I mean really listen—to the voices of our colleagues and to provide that soft place to land.

Debriefing for perspective
Sharing our nursing experiences provides a platform for collective understanding, improves problem-solving, and builds collegiality, collaboration and teamwork. Nurse managers must be especially alert to the need for debriefing members of their health care team. Often, the mood of staff members following a critical incident will indicate the need for pulling the team together to process the event. But, in my experience, debriefing and the cathartic need to share often are most effective when the nurse is out of the immediate situation and away from the stressful pace of the work environment. Once home, he or she is more mentally ready to process the day’s events.

Having a mentor or colleague to discuss feelings and concerns helps facilitate critical reflection on our nursing practice and helps nurses find continued—often, lasting—meaning in their work. So reach out to your colleagues and listen with an open heart. Maybe, just maybe, they will return the favor when you need it most.

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.