10 November 2012

nurse mode

deciphering key pieces of information, communicating them clearly, clarifying known/unknown information, picking up on small changes in symptoms, trying to present hard information in a loving way, asking the obvious or the really hard question, thinking creatively about solutions to problems,  holding a hand, calming quiet presence, bridging gaps of communication, willingness to say "that's a good question, let me get back to you on that,"presenting information clearly, knowing where to look for what information, knowing when to say "we don't know,"  being willing to cause pain in order to encourage/create opportunity for healing, a listening ear, gentle when helpful, firm when appropriate, providing dignity in times/places where there is little to none to be seen...

this is the stuff of nursing...behind the obvious stethescopes, the IV pumps or poles, shots, medicine cups, and bandages, this is where the essence of the job is, the stuff you don't necessarily notice, but that each nurse builds up an instinct for over the course of a career.  These aren't things you necessarily learn in school, they're the things you piece together from lessons learned from other nurses, from patients, from failures and successes, from physicians you respect and who respect you...they become part of how you approach the world.  Instinct.

Turns out after 11 years as a nurse, my instincts are pretty strong.  I don't even think about them.  I don't  think about which situations to apply them too and when not too, when is it appropriate or not, it has just become part of who I am and how I approach life and everyone in it.  Turns out, this includes my own family.  I've found myself in "nurse mode" with my mom and family with mom's new diagnosis.  Not by choice, but because it's an instinct evidently.

My dad does it as a pastor - goes into "pastor mode."  I've never been a big fan of him using that mode with us in his family, it feels a bit distancing on the receiving end, but now I understand it's not a choice he's making - it's an instinct.  It comes from years of doing something that, in time, becomes part of you.

My prayer is that my "nurse mode" instinct with my interactions with my mom in this new stage of illness doesn't feel distancing on the receiving end, that I can still be primarily her daughter first and foremost.

I've been in the US for the last 5 weeks or so.  When you come back from a place with very little access to current printed word resources, you pick them up and read them everywhere you go (at least in my experience).  In my most recent Pennsylvania Gazette (UPenn alumni magazine), I found a fascinating article with the following quote:

"Neonatologists were vigilant.  The nurses were even better, as much psychologists as highly skilled technicians.  They exuded optimism.  They never showed fear.  They became friends you could laugh with and cry with.  They offered eternal hope whether they believed in it or not..."  
- Buzz Bissinger (author of Friday Night Lights and writer for Vanity Fair and The Daily Beast from his book Father's Day)
I don't exude optimism, and I hope that I don't offer eternal hope that I don't believe exists, but I do believe there's a part of nursing, learned and honed over the course of a career, that parallels the "skilled technician" skills learned in school...the interaction with people part...one of the reasons I love what I do.

For some reason this trip home, I've had a lot of "nursing" interactions...opportunity to encourage a friend through the rough and tumble parts of nursing school, opportunity to hear from a friend on her first job as a new nurse and how she both loves it and is simultaneously terrified...I told them both that the fear is healthy :) I read the above article I found here at my parents' house and I've watched the first few episodes of the BBC show called "Call the Midwife."  Some really interesting writing, by the way.  One of my favorite quotes thus far:

"You made her feel safe. That’s the mark of a good nurse. A midwife, too. Everything else is just mechanics." - Dr. Turner to Chummy, the rookie nurse midwife who seems at first to get everything wrong
Spot on. That's it.