Nurses Leaning Into Uncertainty

Throughout history, nurses have provided care to those in need despite the cultural circumstances or political scenarios at hand. Nursing care, like medicine, is a necessary service that simply needs to be provided in a society at all times. No matter that bullets are flying, elections are being disputed, or a pandemic is raging, nurses are there with their patients even as uncertainty rules the day.

The Profound Meaning of Nurses' Week During a Pandemic: Nurses Show Up

Nurses' Week is upon us, and May 12th, 2020 is the 200th anniversary of the birth of the Florence Nightingale, the veritable progenitor of the modern profession of nursing. Meanwhile, we also find ourselves in the middle of the International Year of the Nurse and Midwife as declared late in 2019 by the World Health Organization (WHO), the healthcare arm of the United Nations. Add to this the impact of the COVID-19 pandemic, and we have a recipe for a very profound moment when it comes to nurses and the nursing profession in this global context.

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"The Nurse's Story" by Carol Gino

Please enjoy this republication of a previously published review of The Nurse's Story by my beloved colleague, Carol Gino.  

Of Bowels and Happy Nurses

So nurses, what can make a nurse happier than a constipated patient who finally moves his bowels? Pretty much nothing, I guess. (Be forewarned, the following story is full of sh*t.)

A New Nursing Infographic

Please enjoy this infographic on the ways in which nursing is growing, changing and creating opportunity.

An Unexpected Occupational Hazard: The Nurse Gets Rattled

At the rural New Mexican home where I do home-based nursing care, the pace of work and the 360-degree view of the mesas, mountains and sky is quite different from other nursing milieus. While home care may not always seem glamorous to those in the ICU, trauma or other specialties, sometimes things happen that make me realize how interesting this specialty can truly be.

Nurses As Connective Tissue

Last night on RN.FM Radio, we were graced with three guests, including the editor and two contributing authors from a new book, "I Wasn't Strong Like This When I Started Out: True Stories of Becoming A Nurse". It was a fascinating and inspiring conversation, to say the least.

And So It Was....

She breathed her last breath in her own home, surrounded by family, held in the bosom of love.

And so it was.

Where Were The Doctors?

Last week, I attended an all-day conference on mind-body medicine here in Santa Fe. At the beginning of the day, the speaker obviously wanted to know the professional make-up of her audience, so she called out various professions and had us raise our hands in response. Of course, nurses made up the majority of the approximately 225 people in the crowded room, and psychologists, counselors and social workers were also very well-represented. And when she asked about doctors, only one person raised his hand. A murmur rippled through the crowd, and there was much ironic laughter. So, where were the doctors?

The Nurse Listens

Today on the Facebook page for Nurse Keith Coaching, I posted a question about listening that really got me thinking. Listening is a skill that all nurses need to develop and hone over the course of their career. But what does it really mean to listen well, and what if we think about listening metaphorically rather than literally?

Book Review: "The Comfort Garden: Tales From the Trauma Unit"

Once in a while, a book comes along that makes one look long and hard at one's own relationship with work, the role of the caregiver, and the ways in which caring for others can take a toll on one's own personal and professional life. Laurie Barkin's "The Comfort Garden: Tales From the Trauma Unit" is a heartbreaking, inspiring and deeply thoughtful book that has done just that for me--and so much more.

RN.FM Radio is Truly Unleashed!

For those of you who follow Digital Doorway regularly, you've no doubt heard about RN.FM Radio, the new internet radio station that was founded by yours truly and two dynamic nurse colleagues early in 2012. The official moniker of the station, "RN.FM Radio: Nursing Unleashed", is an apt title as the show continues to draw high-quality guests and engender energetic and enlightening conversation.

Book Review: "The Craft of Compassion at the Bedside of the Ill"

Disclaimer: As always, I received no payment for this book review, only a copy of the book from the author in order to facilitate the writing of this post.

"The Craft of Compassion at the Bedside of the Ill" is a poetic and moving discourse on compassion by nurse, author and medicine man Michael Ortiz Hill. In this stirring book, Mr. Hill presents his view of compassion as a craft that can be learned, honed and developed, a notion that many in the nursing and medical fields would be wise to heed.

Nursing, NPR, and Where to Go From Here

Nurses and nursing are consistently in the news these days, and with issues surrounding health care continuing to come to a boil in the U.S. and elsewhere, we can expect more stories that include nurses to bubble to the top.

Nursing: Trouble in Paradise?

Despite the consistently wonderful press about the trust that Americans place in the nursing profession, not to mention the heady days of new nurses being assured a plethora of jobs upon graduation, the nursing zeitgeist seems just a little diminished and subdued these days. At least for now, many new grads are hard pressed to find work and there is little to cheer about when it comes to nurses' economic standing.

I Should Only Be So Lucky

I walk into the home and am welcomed warmly by the client's two sons, as well as the home health aide that I'm ostensibly there to supervise. The client sits in his wheelchair, quietly fingering a towel that was previously placed in his lap as a diversion. I greet the client---John---and then take a seat on the couch, late morning sun streaming through the living room window.

The Disneyfication of Nursing?

A recent article on Boston.com describes efforts by hospitals to offer specialized training to nurses in customer service and courtesy. According to some reports, many hospitals are hiring outside consultants in order to boost customer satisfaction surveys in response to Medicare's new ruling that they will begin basing a small percentage of payments to hospitals in accordance with facilities' "patient experience" scores.

Gender, Healthcare and Communication

Last night on RN.FM Radio during a discussion with Beth Boynton, the nurse author of "Confident Voices: The Nurses' Guide to Improving Communication and Creating Positive Workplaces", we touched on the subject of gender and its effects on communication. Countless books on communication between the sexes have been written---the ones most readily coming to mind being those by Deborah Tannen, including "You Just Don't Understand" and "That's Not What I Meant"---and I am keen to point out that there is currently no book on the market of which I am aware that specifically discusses the gender aspects of communication within healthcare.

NurseFriendly on RN.FM Radio!

Just a reminder that tomorrow, January 16th, 2012, Andrew Lopez of Nursefriendly.com will be our guest on RN.FM Radio. Andrew is the consummate connector and promoter of nurses, and we look forward to his appearance on RN.FM Radio! Tune in or listen to the archived show afterwards.

Also, please take a peek at our new RN.FM Radio website! It's growing by the day!

"See" you there! 

What We Leave at the Door

As nurses, when we are preparing to walk into an exam room, a hospital room, or a patient's home, we bring with us a veritable toolbox of skills, ranging from biopsychosocial analysis to keen physical assessment skills. We are trained to look at the whole patient, the family system, and the multifaceted aspects of patients' lives.

However, we can also walk through that door with judgments, suspicions, preconceived beliefs, fears, projections, and a host of other "baggage" that may or may not serve the therapeutic relationship---nor our patient's chances of healing.

In my own work, I have witnessed patients and their families engaged in drug addiction, prostitution, child neglect, elder abuse, financial exploitation, and numerous other social conditions or actions that could often make my skin crawl. I also witnessed patients simply making poor choices, living in squalid conditions, refusing treatment, and otherwise choosing chaos over order, illness over health, and hell over healing.

When possible and necessary, I would intervene, and sometimes that meant calling the police or the local protective service organization. Sometimes it meant just listening and trying to get to the root of the behavior. At others, it was a call to a therapist, a psychiatrist, or a drug counselor.

No matter the situation, we health care providers bring to the situation our own life experiences, our own traumas, and a unique personal history. In this line of work, transference and projection are not just quaint vocabulary terms memorized during a requisite Psych 101 class, and if you're a nurse and you can't tell me what projection and transference are, then it's time to do some brushing up. (Perhaps that Psych 101 textbook is still in your garage somewhere.)

No matter where you are in the course of your career, you are subject to the same psychological forces as a novice nurse, and at times it is exactly our experience as seasoned nurses that can harm us the most. Cynicism, jadedness, and a sense of "I've seen it all before" can actually get in the way of our seeing the patient for who they are in the first place, so looking beyond our experience with fresh eyes and an open heart can work wonders for actually "seeing" the patient or situation in front of our very noses.

Before you walk in that door, think about what it is that you bring to the therapeutic relationship and the situaton at hand. What is the baggage that might get in the way? What are the stresses and worries from outside of work that need to be set aside? And once you're in that room, keep a sharp eye out for those projections, that sneaky transference, and the judgments that undermine your ability to be objective and most clinically effective.

And remember to ask yourself: What am I bringing to this encounter? What are the skills that I most need to activate at this time? And what do I need to leave outside that door?