Monday, April 09, 2018

Nurses: Moving at the Speed of Trust

Seeking a career in nursing could be characterized as an exercise in trust. We nurses willingly endure a grueling educational experience; place ourselves in the hands of nursing professors and professional nurse preceptors; and otherwise trust that the blood, sweat, tears, and expense of pursuing our goal is worthwhile. In essence, we move at the speed of trust as we enter the universe of a nursing career.

moving at the speed of trust
Photo by Alternate Skate on Unsplash

Trusting Ourselves
The first act of trust intrinsic to our nursing journey is trust in the self. Even while our peers, colleagues, friends, or family may caution us against a nursing career, there's that small, still voice in our head that tells us that nursing is the choice for us.

Becoming a nurse is a laudable goal that's fraught with uncertainty. Many questions arise: Will there be jobs when I graduate? Will I actually like nursing? Will I burn out, be eaten alive, or kill a patient along the way? Am I crazy to want a career in healthcare?

Even as self-doubt creeps in, many still take the plunge in pursuit of a nursing career for a variety of personal reasons. For some, it's the allure of a seemingly endless parade of rosy job statistics and earning potential for registered nurses. For others, it's the end goal of becoming a nurse practitioner, nurse anesthetist, or nurse midwife. And when you get right down to it, many nurses will tell you they simply like helping people, so why not do so as a member of a highly respected profession?

Once we become nurses, the trust continues as we make life-and-death decisions on behalf of our patients, plot our nursing career trajectory, and play the game of survival in whatever healthcare milieu we've chosen. And, when we're tired, burnt out, or at the end of our rope, there's the trust in ourselves to know when it's time to walk away, change course, or otherwise shake things up.

Trust in the self is essential to nurses and nursing, and those nurses who lose that trust must be diligent to not lose it for long since it's so crucial to happiness and satisfaction, not to mention safe nursing practice.

Trusting Others

Nursing is by and large a collaborative profession, whether in the clinical space, academia, or the research center. Few nursing tasks are performed in a vacuum, thus trust in our nursing and non-nursing colleagues is generally central to the performance of our jobs.

The OR circulating nurse places her trust in the other professionals within the surgical suite. The home hospice nurse trusts that the social worker's notes are up to date regarding the patient's psychosocial situation. The school nurse must have mutual trust and respect with both the teachers with whom she collaborates, as well as the students for whom she provides care. And the collaborating professor and clinical preceptor must trust that each is providing their shared students with the best possible knowledge and experience.

When the code team rushes in to attempt to save a patient, solid trust must inform every action of every person on that team. And when the flight nurse leaps from the helicopter to assess an injured hiker on a windswept mountaintop, the trust between that nurse and other members of the flight crew must be completely in sync.

The successful delivery of healthcare is imbued with teamwork and trust, and healthcare teams move decidedly at the speed of trust.

Broken Trust

Nurses' trust is often broken by employers in regard to poor management, overwork, and feeling less than valued by the powers that be. When nurses feel like so much cannon fodder, their trust in "the system" is damaged, sometimes permanently. And when their voices seem to count for nothing, some nurses simply stop speaking out, retreating into a sullen, defeated silence. This can then lead to unhappiness, burnout, poor health, stress-related illness, or internalized oppression manifesting as bullying and incivility.

Nurses' hearts are broken every day. When nurses treat their nursing brethren like scapegoats and targets, demoralization results. And when managers dismiss nurses' complaints or belittle their needs, we often see the development of a hard, soulless stoicism bordering on masochism. Nurse martyrdom leads nowhere but burnout and discontent, and patient safety can be compromised as a side effect.

There are many giving souls who are working diligently to turn around this broken trust when attrition from the profession is the last thing we need in the face of rising healthcare costs and a rapidly aging population. We need these activists more than ever -- our profession cannot afford to hemorrhage its best and brightest due to lack of trust in the nature of the profession and the soul of healthcare.

Trusting the Future

Nurses are indeed trusting in the future. The nurse practitioner career track is simply on fire right now, and nursing remains the most trusted profession in the United States for more than 16 years running. The public places its trust in nurses because it rightly sees nurses as the lifeblood and connective tissue of healthcare, despite the public's ongoing relative ignorance about what nurses actually do.

Nurses and potential nurses who apply to NP school, associate and BSN degree programs, and CNA or LPN training courses are doing so because they are trusting the durability of the nursing profession and the nursing brand.

Those who seek nurse training within the armed forces know that their contribution will be both life-saving and crucial to the military's readiness and operations. Nurses who care for schoolchildren do so because they see the unequivocal importance of child health to the success of the educational process. And those who engage in important nursing research understand that advancing nursing's collective knowledge and evidence base is intrinsic to the future for generations of nurses to come.

The future may be unwritten, yet nurses know that they will be a central part of the future of healthcare. Without the expertise and knowledge of nurses, the healthcare machine would grind to a halt. And without the lifeblood of nursing at its core, the system would fail patients bereft of nurses' compassion and skill.

Nothing is ever truly certain, and the only constant in the universe is indeed change (unless one also agrees that death and taxes are equally as inevitable). However, if those who wish to become nurses continue to trust themselves, then our nursing pipelines will be filled for years to come. And when those nurses emerge from their education, even more trust will be needed to affirm that the teams those nurses join are cohesive, healthy, communicative, and effective, and that the employers they choose to work for treat them fairly and kindly.

We nurses must trust ourselves to make prudent career decisions, remain in the profession for the right reasons, and remove ourselves from the fray when we're burnt to a crisp.

Nursing is a wide open field with limitless possibilities ranging from the healthcare front lines to the outside-the-lines worlds of nurse entrepreneurship and business. We nurses must trust ourselves, trust in the process, and trust in the solidity and power of the profession to propel us forward into a limitless, exciting, and albeit unknowable future. Trust is the thing that makes us become nurses, and trust is what keeps our heads and hands firmly in the game.


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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