• Megan Filoramo

Are you a "real" nurse?

It’s the worst when you want to do something and you don’t want to do it, all at the same time. Sometimes it can feel like your brain is going to explode.


I was scrolling through various nursing groups on social media and I see nurses struggling with this on a daily basis. They want to do nursing but they don’t want to. It’s heartbreaking and understandable all at the same time.

Over and over I read variations of this.

I’m not sure if I can keep doing bedside nursing.

I go to work but I am “a ball of anxiety the whole time”.

I don’t know which job to pick/stay in.


Or I think the worst I saw today: “I don’t feel like a ‘real’ nurse.”


Really, what it all boils down to is: I’m not doing it right OR I’m doing it wrong OR I’m not doing enough.


What a terrible weight to carry, especially when you are trying to do good.


So I thought about the “real” nurse comment. What is a “real” nurse? I started by looking up what the ANA says, then I jumped over to the International Council of Nurses. Their definitions of nursing are similar, with focus on the promotion of health, prevention of illness and care of the ill, disabled, or dying. They touch on the components of heart and mind, of art and science.


And I love all these definitions and components, but it didn’t define it enough for me. It was a jumping off point but when I looked at all these things, I realized the feeling of not-enoughness may come from trying to do all these things. All these things, all the time, with no room for nuances, or strengths and weaknesses, or bad situations.


The problem is, with our focus on excellence, we can dismiss anything short of that. And with this standard in place, our fear of “doing it wrong” can steal our energy and self-worth.


So I came up with this. It isn’t perfect, and it will probably change as I continue in my nursing career but I wanted something that described not just the patient outcomes of nursing but the nurse outcomes of nursing.


Nursing is decreasing suffering in the world.

Decreasing suffering through education and care and promotion of health.

Nursing is supporting patients in their moments of joy,

And challenge, and heartbreak.


Nursing is brainstorming,

The beautiful marriage of scientific knowledge and the individual patient experience.

It’s taking the “one-size-fits-all” basics

and breaking it apart to apply the parts that actually fit.


Nursing is exact.

Guarding against mistakes.

Not for pursuit of perfectionism but for fear of patient harm

And insurance of positive outcomes.


Nursing is messy.

Often trying to apply the exactness of science without extra hands on deck

With the patient decompensating, or vomiting

Or refusing care.


Nursing is creativity.

Doing all of the inside-the-box tasks and then jumping out-of-the- box to keep going.

It’s figuring out new ways of doing things

Sometimes just with medical tape, safety pins, and a sheet.


Nursing is paperwork, and phone calls, and math.

It is the busy work that allows us to do the important work.

The tasks that seem pointless but allow continuity of care.

It is attention to detail, even the annoying ones.


Nursing is connection.

Seeing the face behind the fractured hip or the ostomy.

Hearing their story and not just their heart rate or lung sounds.

Nursing is holding space for the patient, whatever that may look like.


Nursing is aggravation.

Aggravation when you know the care could be better, with more help or better supplies.

Aggravation when the patient won’t listen or continues to put up barriers.

When the exhaustion at the end of the day seems overwhelming.


Nursing is acceptance.

Acceptance that doing the best you can with the tools you have IS enough.

Acceptance that the patient may not have the skills or strength to do what is best.

Acceptance that they may not want to, and it is ultimately up to them.


Nursing is work.

It’s ok that we come home tired.

Doing all of these things is tiring,

And important, and worth it.


Nursing is one person helping another.

Not perfectly and not without setbacks

But with compassion... and every skill and hack and tool they can muster.

And that can’t be done wrong.


****


When we look at being a “real” nurse, this isn’t defined by our practice setting but rather by our willingness to go through all this for the good of the patient.


I am proud of all the work that nurses are doing. I am proud of the nurses at the bedside. I am proud of the nurses in corrections and long term care, in offices and in case management. And if I can be proud of all of you, I can be proud of myself too. Even when the anxiety of not-enoughness sets in.


Let’s keep being proud of each other, it’s the easiest way.


 

I have a request this week. In celebration of this being my 100th blog, will you pop over to facebook and tell me what nursing is to you? There is a post, just leave a comment. I want to hear how you define what you do every day, how you decrease suffering and promote wellness. I appreciate you! Click here for NursingBeyondtheJob


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