Monday, February 26, 2018

A Message to the Nurse's Future Self

So nurse, it's twenty years in the future, and you have two more decades of nursing under your belt. You've cared for thousands of patients, held thousands of hands, and looked into thousands of pairs of eyes. What do you remember, and what do your patients recall? What stands out for you? How does your career compare to your expectations, dreams and aspirations? How would you like that 20 years to live in your mind and heart? You can create it now.

The road to your nursing career future

Patients Remember

Nurse, what do your patients remember about you? First, they probably don't remember your name, and that's almost a certainty. Maybe a special one or two will remember, but most of them will instead recall how you cared for them and touched their lives at a vulnerable time. 

Next, they remember your kindness, the way you looked at them, fluffed their pillow, started an IV with extra care, or made them more at ease in their own home. They may not recall exact moments, but they might say, "You know, when I was in the hospital in 2014, there was this nurse who was so kind to me. I can't remember who he was, but he really made my hospitalization so much gentler. I wish I could remember his name so I could send him a note. God bless that man."

Several years ago, I interviewed a nurse for an article I was writing, and he told me that, during a hospitalization about ten years prior, a particular nurse (who happened to be a man) provided absolutely stellar care for him during a scary time. As a patient, he could very specifically attest to the ways in which that nurse's demeanor, skill, knowledge, and expertise put him at ease, reassured him that he was in the right place for his particular problem, and that he had an advocate on the floor who had his back. This experience was so profound, the result was they he immediately applied for nursing school and had that anonymous nurse to thank for his new inspiring career. So that nurse caused another human being to choose the same profession for himself.

As a home health nurse, I've spent more hours than I can count in the homes of many patients over the years. In home care, you're a guest in the patient's castle, and it's up to you to be a non-threatening presence who provides peace of mind along with skilled nursing care.

Since you don't have the many distractions that nurses in the hospital or other facility have, the focus of home health nursing is different. Instead of the interruptions of call bells, intercoms, beepers, and other sounds, you have the patient's dog barking at the FedEx guy, a cat jumping into your lap, the patient's children playing in the next room, or their spouse or loved one asking questions. It's an intimate experience, and patients greatly appreciate how you're able to provide care for them so that they can remain in the comfort of their own home.

Just a few months ago, the daughter of a very elderly former home health patient of mine found my number and gave me a call. I had left the organization more than a year prior, but my patient had asked for me and her daughter decided to track me down. I was surprised that both my former patient and her daughter remembered my name, and even more surprised that they requested that I come by for tea and a brief visit. How could I say no?

Your future self will want to be remembered, if not specifically by your name, than for the care your provided and the energetic imprint you left behind on the lives of your patients and their families.

Nurses Remember

So, future nurse, what do the last twenty years of nursing look like to you? How do you feel about your career? Did you burn out or did you burn bright? Did you care well or did you end up no longer caring at all?

What do you remember, nurse? Do you remember the kindness of your colleagues or the way they bullied one another? If you witnessed bullying, do you recall stepping in to interrupt that vile behavior, or did you look the other way? Did you speak up or was your very silence an act of complicity? Will you remember standing up to injustice or turning your back when your voice was needed most?

Nurse, did nursing over the last twenty years build you up or tear you down? Was your spirit lifted by your work or diminished by it? Did your body suffer from the stress of your work or did you care for yourself well enough to survive, and possibly even thrive?

Nurse, when you think about your patients, do you think of them with caring and compassion, or do you think of them as burdens on your nurse's soul?

When you think about your colleagues, were they a source of support or a source of complaints, rancor and resentment? How did you support one another? How did you make it through the tough times? Did you laugh? Did you cry? Were hugs readily available? Was mutual support part and parcel of your day?

The Legacy of the Nurse
A nurse's life and career are more than the sum of patients cared for and colleagues supported. Your career may involve volunteerism and giving back to your community. I've known nurses who fed the homeless and cared for wounded animals. I've also known nurses who served on the boards of directors of important non-profit organizations or raised money for favorite humanitarian causes.

Everyone leaves a legacy, whether they're aware of it or not. In your immediate neighborhood, your legacy may be the driveways you shoveled for the elders who were housebound in winter. In your child's school, your legacy may be the ways in which you consistently showed up and contributed as a well-meaning, involved parent. Your wider community may see the value you bring to the table as a mentor for young people, the substitute soccer coach, or the person who brought the firefighters doughnuts, coffee, and flowers every September 11th.

Nurses play a particular type of role in the lives of their families. Who does your uncle call when he sees a new mole on his shoulder? Who is the go-to family member for questions about immunizations? Who does your brother-in-law think of when he reads an interesting article on LinkedIn about the nursing shortage?

As I've discussed before, more and more nurses own businesses and contribute to their communities in various ways. There are nurse-owned home health agencies, case management services, and legal nurse consulting companies. Some nurse entrepreneurs write for magazines and newspapers, broadcast podcasts, speak at conferences, and play a role in ways both large and small.

Over the years, I've heard amazing stories from a nurse I know who worked as a helicopter and fixed-wing flight nurse, and she got her adrenaline rush by rescuing people from accidents in the vast wilderness. This same nurse worked for Doctors Without Borders in some of the most underserved and perilous conflict zones in the world, including Southern Sudan.

Nurses can have an outsized impact on the wider world, or a quiet but no less crucial impact in small-town America, England, or New Zealand.

Taking Stock of the Possible

When you look back on the last 20 years, what will you see and feel? Your nurseness is part of who you are, a significant slice of your humanity. However, your impact may be far greater than you can readily see.

In nursing school, the range of who you can be as a nurse may appear very small, a slice of the possible worlds you might inhabit as a healthcare professional and citizen. Nursing school provides us with an admittedly myopic view of what can be.

Leaving school, we embark on a professional journey with the potential for many unexpected twists and turns. What seemed attractive when we first began may fade into the background as we discover new potential paths. The myopia of nursing education may give way to the wide angle lens of the seasoned nursing professional as the world opens up at our feet.

As you continually take stock of what could be possible, your eyes may widen with excitement, fear, heightened awareness, as well as some mixture of pride or courage. The chasm of possibility may yawn before you, and it's truly up to you as you choose the ways in which you'd like to meet the challenge. If you've been holed up in a box or sitting under a rock, this may your moment to step out of your comfort zone and seize the moment.

Back to the Future

Nurse, in thinking about how you'll look back on your career, is there anything you would like to change now in order to make that future brighter, more exciting, or more fulfilling? How else would you like to engage your mind, your hands, or your values and personal philosophy?

Nurse, do some of the questions I've asked make you feel uncomfortable? Do you recognize ways in which nursing has already become burdensome and close-minded in your life and career? Are there ways in which you may already be burning out? Are your colleagues also suffering? Have you turned your backs on one another already, or are you there for each other when the road becomes murky or dangerous?

If you think about what you will feel and experience in twenty years as you look back on your life and career, what can you do now in order to alter that potential future outcome? How can you approach your work, your colleagues, your patients, and your career in a way that will make you reminisce with pride, joy, intact health, compassion, and fulfillment? How can you be more effective, more involved, more aware of the needs of the world around you?

Think hard, nurse, and consider the future you desire, and then consider how to make that future a reality by acting righteously and authentically in the present moment.

Nurse, the future is yours to create. How will you create a great one?


Keith Carlson, RN, BSN, NC-BC, is the Board Certified Nurse Coach behind and the well-known nursing blog, Digital Doorway. Please visit his online platforms and reach out for his support when you need it most.

Keith is co-host of, a wildly popular nursing podcast; he also hosts The Nurse Keith Show, his own podcast focused on career advice and inspiration for nurses.

A widely published nurse writer, Keith is the author of Savvy Networking For Nurses: Getting Connected and Staying Connected in the 21st Century and Aspire to be Inspired: Creating a Nursing Career That Matters. He has contributed chapters to a number of books related to the  nursing profession. Keith has written for,, MultiBriefs News Service, LPNtoBSNOnline, StaffGarden, AusMed, American Sentinel University, the ANA blog,, American Nurse Today, Working Nurse Magazine, and other online and print publications.

Mr. Carlson brings a plethora of experience as a nurse thought leader, keynote speaker, online nurse personality and social media influencer, podcaster, holistic career coach, writer, and well-known nurse entrepreneur. He lives in Santa Fe, New Mexico with his lovely and talented wife, Mary Rives, and his adorable and intelligent cat, George.

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