Friday, November 16, 2012

Nursing: What Is Our "North Star"?

Many of us nurses often refer to our profession as a "calling". We discuss how being a nurse becomes part of our personal identity, and that reporting for work means more to us than just a paycheck. But then there are nurses who approach their work like any other employed person, with no acknowledgment that there is anything more to be gained than remuneration and a means to a financial end by fulfilling the tasks required of our position. This apparent dichotomy is not surprising, but it's certainly worth exploring.

On Monday, November 12th on RN.FM Radio, Dr. Victoria Rich, the Chief Nurse Executive of the Hospital of The University of Pennsylvania in Philadelphia, spoke with me and my co-host Kevin Ross about her passion for nursing and her illustrious and awe-inspiring career. Dr. Rich is completely dedicated to the profession of nursing, and she is a truly innovative leader. You can listen to her interview with us by clicking here.

During the course of our conversation, Dr. Rich made a statement that spoke to my deeper feelings about our profession, and I believe that it's a notion important to share here on Digital Doorway. Poignantly, Dr. Rich stated:
We don't come to work and we don't have a job. We practice our profession of nursing. You're a clinical nurse who practices a profession, instead of being a staff nurse who works on a shift. My "North Star" is not where I work. My "North Star" is my profession.
In the bigger picture, this statement flips the idea of professional identity on its head, and some nurses who read this may completely disagree. However, many of us who've pondered deeply about why we've chosen to be nurses in the first place may feel a tug in our hearts when we read or hear these words. And the reason for that reaction is, I believe, that these words speak volumes to the overarching identity and sense of purpose that we have internalized through the process of becoming, being and embodying the essence of nursing.

When examining this idea further, it's of course easier on some level to consider just putting on our scrubs, reporting to work on time, and considering our nursing work as a task-oriented job that we do. Mind you, we may do it very well indeed--providing very good care for our patients along the way--but it's still "just a job".

This does not imply that task-oriented nurses can't provide excellent patient care--they certainly can, and often do it successfully. However, there's something more that Dr. Rich asks her nurses to reach for deep within themselves, and that is a sense that one's obligation lies not within your allegiance to your employer or facility, but it actually lies within your sense of fealty and dedication to the profession of nursing itself.

Dr. Rich, in her wisdom and years of experience, believes that our final place of reckoning as nurses aligns with our identity as professional nurses, an identity that rises far beyond any allegiance to employer, facility or paycheck.

I believe that we are at risk when our nursing becomes a chore and a series of tasks that we perform simply to earn a living. In this circumstance, we're at risk of many things, including (bot not limited to) boredom, burnout, unhappiness, compassion fatigue, loss of interest, and the potential to deliver suboptimal care due to our disengagement from a deeper understanding of, and feeling for, why we became nurses in the first place.

Yes, we can report for a shift, provide care, give report, and go home to our lives with nary a thought to what we're doing or why we're doing it. We can also choose to report to work with the sense that we are clinicians performing a service inspired by our desire to practice our profession to its highest potential outcome.

Our employer issues our paycheck and we strive to be good employees, fulfilling our duties and following institutional protocols and mandates. However, beneath that fulfillment of service to our employers--and our patients--lies our deeper obligation, and that is our obligation to personally represent the profession of nursing and to embody the precepts of that profession.

Each day, we have a choice, and there will be, of course, some days where our work feels like a task to be done so that we can return home to our families and the rest of our lives. However, we know that each day gives us yet another opportunity to re-embrace our calling and to rededicate ourselves to the reasons why we choose this profession again and again.

We can see nursing as a calling, as a vocation, as a job, but also as an identity. We choose our own "North Star", and that guiding light largely dictates the way that we approach our work and how we view ourselves as nurses, healers and professional clinicians.

Nurses, what is your "North Star"?
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