Welcome to this final installment of my summer series, The Nurse Knows.
Last month I took a little trip to the theater. Instead of taking the train into the city, I drove over to the local community college to catch their production of the Shakespeare classic, A Midsummer Night’s Dream. It was actually a modern adaptation, and a very clever one at that. It was delightful to watch some of my daughter’s preschool friends, who are now adults, star in the show whilst wearing dreamy and groovy 1960’s period costumes. There I sat in the audience alongside my three children and their father, who was my husband for over a decade.
The local community college is where I received the first of my three diplomas in Nursing. It was nice to sit there with the man who encouraged me, his then 25 year old stay-at-home wife, to pursue her dream of becoming a nurse. We sat in the theater and I looked over at my grown daughters sitting with their father and felt teary eyed. I remembered once upon a time standing on the very same stage as the class president, smiling at my little girls in their fancy dresses, as I delivered the commencement address to my graduating nursing school class.
It was one of the most beautiful full circle moments of my entire life.
I warned my youngest son who’s 16 that Shakespeare can be a little hard to follow at first. The first time I got to see a Shakespeare play, I was a teenager and it was at this great dinner theater in Hopewell, New Jersey. That night I tagged along with a friend who worked at the theater where they were short staffed, I helped bus the tables and got to catch, The Taming of Shrew.
Happenstance indeed and please keep the following words spoken by Katherine in Act 2, Scene 1, in mind as you read through this piece:
If I be waspish, best beware my sting.
Now let’s travel back for a brief moment to March of 2024 when I started this publication. More often than not, I find myself on the couch in the middle of the night, sipping coffee at 2:00 am as if this were a perfectly normal occurrence. I contemplate then write about the deeper meaning of my interesting life and long career.
It’s fair to say that the use of the word normal, has been pretty much abandoned by the healthcare community. What was once thought of as normal has been replaced by the term, within defined limits, the emphasis here being on the word limit. See there really is no such thing as normal, there’s a nice little range for everything now. Although it’s been two years since I worked an overnight shift, to me there is nothing abnormal at all about drinking coffee and writing something in the middle of the night.
As a woman it irritates me slightly to pen this piece, except I feel it’s imperative I pause and clarify my intent here. The main ethical principles of a professional nursing practice are: Autonomy, Beneficence, Nonmaleficence and Justice. With the evolution of society came the addition of the principles of Fidelity, Veracity, Confidentiality and a few more. This is my professional honor code, one I always abide by, and I carry much of the ethos of my profession over into my personal life and relationships.
Every critical decision I make, trust me I make a lot of them, is based on a gold standard of care, which has to also be balanced against individual hospital policy and procedure, State and Federal law, and the available resources on hand. The decisions are quick, and further balanced with the patient’s right to Autonomy. Every decision must be able to stand in a court of law. On a personal note, I have to be able to look myself in the mirror and live with my reflection at the end of the day.
The Nurse is rather confident in her decision making abilities and is never dumb, despite the many contradictory stereotypes that persist in popular culture.
This feels like the appropriate place to mention I am a nationally certified Critical Care Nurse; I also hold a Master of Science in Nursing Leadership, with a concentration in Legal Nurse Consulting. I have chosen not to certify or work in the legal arena for two reasons; the field doesn’t require a certification and also I could never decide which side I would want to represent as an expert. So I mostly use this additional expertise to torment my coworkers with my vast understanding of legalese.
Patient safety is dependent upon many systematic factors, but it is largely dependent on the ability of each team member to communicate. Every member of the team must be a team player, one who fully understands their role. If at any point our roles are unclear or we’re in danger of crossing a line and stepping outside of our defined roles, we must speak up. Trust me I speak up. The healthcare system is a system of checks and balances, one that is modeled after the high safety and communication standards of the airline industry and the military. When the system works well, it is beautiful and it works very well.
If at any point in time, a member of the team feels an error is at play, again every team member must stop and speak up. This is the expectation in the hospital and this has been my experienced reality. It is not always pretty and the mission is not always accomplished in a sensitive manner, but this is acceptable to me. I would never work in a facility where the truth was not encouraged, or in places where the administration did not provide the staff with the necessary tools to do their job safely. Sadly these far from ideal environments exist and this is my jab thrown at some very prestigious hospital systems. One of the best things to come from the pandemic was the opportunity to get to know the multiple travel nurses from all over the country who made their way to the East Coast in 2020. The Nurse loves to talk and hear all about people’s work experiences and life stories.
For me this publication is part professional advocacy and this concept can only further my endeavor to help save some lives.
Over the years I have personally witnessed three surgeons walk out of the operating room and collapse due to hypoglycemia. Another surgeon experienced a very serious true medical emergency while performing surgery. This is only to say how absolutely dedicated these humans are to their profession and no patients were harmed in any of these frightening scenarios. During my third pregnancy, twice I was sent down to the Emergency Department when I experienced strong pre-term contractions. One of those nights I walked back upstairs and returned to work. The other night I was discharged, sent home and drove myself home. About an hour later the Nursing Supervisor called to scream at me for not getting someone to drive me home. The Nurse knows someone who is screaming usually cares about something and is feeling frustrated they are unable to do more.
Sometimes The Nurse is also a patient, and so are her children. The same goes for the physicians and many other licensed practitioners. There is no such thing as light duty for any healthcare worker, you are either fit enough to work or you’re not. My own obstetrician could not find the proper justification for a Medical Leave of Absence, and I worked the overnight shift until 9 days before the birth of my son.
When I say the healthcare system would like us to forget that we are all individual humans, I mean the healthcare system would like us to forget that we are all individual humans.
The Nurse knows we are all human. Maybe the healthcare system has forgotten this, but those of us humans who work in healthcare, have not. So I think this explains why many of us now come across as slightly disgruntled and scorned, and before you tell me to leave if I don’t like it,—for one second a little silence please. Perhaps think about the actual consequences of this, I sure as hell do. I hate to even think about what would happen if the experienced members of the healthcare community all gave up and stomped out.
Please believe I am the absolute farthest from disgruntled that I have ever been in my entire career. Remember I am writing this now four years after the onset of the pandemic and three facilities removed from where I stood in 2020. No the grass is never greener, the grass is different though and some lawns are better tended than others. Since then I have rekindled all of the love and passion I feel for my profession.
Let me back this up even farther to 1994 and share that way back then, is when I left the low-income subsidized housing project I grew up in. Rather early on I learned a pretty face and a nice ass will open a lot of doors, and I will not ever apologize for this fact that has truly made my life easier. I am simply grateful for some opportunities and I apologize enough thank you very much. I reserve the words I’m sorry, for use when I actually mean them.
Just know I’ve come a long way from where I started and I will never be ashamed of my “humble” beginnings. By the way that housing project was in Princeton, New Jersey because here in my home state, the most affluent towns are required to have them and this is one of the reasons I love it here. This means even my first primary education is second to none. Nope I am not from the city, I worked in the city. My personal and professional backgrounds combined are what now allow me to give the reader an accurate dose of reality.
Many of my patient stories are simply incredible. They are truly shocking, both gravity and death defying and I’ve witnessed humans beat every single odd stacked against them. I've even seen a few wake up and walk out after receiving their Celebration of Viaticum. By the way I’ve also studied Latin and read the Holy Bible cover to cover a few times. Here I share what are my rather comical and heartwarming family of origin stories, much to the chagrin of my mother.
The things I’ve seen and experienced would restore all your faith in love, humanity and God, if you’ve happened to misplace your faith in any of these things. Some of the greatest stories even made the national news, one was turned into a best-selling book, and it is always my honor to have seen the live show.
Do not ever be so foolish as to think I don’t love the work I do. My career has been long, distinguished, and included some professional accolades and very bittersweet recognition. I will always feel most proud of my first professional end of life project, I’m working on two more now, but I feel no need to ever list my accomplishments here. This publication is for fun, it’s for me and my purpose is connection, something I believe we’ve all lost over the last few years. I marvel over this inability of the rest of the world to converse and work with humans they don’t agree with. Everyone in healthcare knows the patients suffer when we don’t find ways to work together, and for the most part we do a great job of putting our many differences aside. Truth be told, I’d rather remain within the hospital bubble, where I am encouraged to speak up and am usually free from social media and division. So for me to say I wish the world was more like the sometimes toxic healthcare system, really says a lot about the rest of the world.
I know how to own and work with my strengths and I hope you find ways to do the same with yours. The simple fact is I could be doing countless other things with all this education and expertise. The fact that I choose to stay at the bedside and nurse the sick, tells you everything you need to know about me.
Smile, The Nurse knows a lot of you have no idea who you’re talking to.
Love all, trust a few,
Do wrong to none: be able for thine enemy
Rather in power than use; and keep thy friend
Under thy own life’s key: be check’d for silence,
But never tax’d for speech.
William Shakespeare, All’s Well That Ends Well.
Thank you for reading the series The Nurse Knows. I look forward to September where I’ll be taking some readers Back to School. 🖤
I of course have little to no idea to whom I am talking. I do love your love love of the work. I recently spent 24 hrs or so in a chair on a corridor in an accident and emergency department while the people ouzzled over what was wrong with me. I was quite Ill. It was a Monday into Tuesday and the department was absolutely stacked and to the uninitiated chaotic. I was so well cared for. I loved watching the staff manage the place and make sure we were all as comfortable as we could be. I thank them all profusely. I would hate(love) to see the place on a Friday or a Saturday if it was stacked approaching midweek.
Excellent Kristin, this is actually the second time I’ve read your article. My mother was an RN, who often worked tge night shift. Reading about your nursing experiences mirrors so much of my mother’’s life at work, and home. Nursing is a tough job, and served best by special gifted individuals like you and my Mom who physically work hard, and have a resilient personality and soul. I understand nursing from the perspective of being a daughter of one. I must say, I’m happy and blessed to have had some of her strength passed onto me. I’m sure you’ve instilled your children with power! Stay strong and beautiful! ✨💖🤗🙏