Mrs. J was a patient I met during my stint as an oncology nurse. She was admitted for a total abdominal hysterectomy during one of my first weeks on the floor. She was on the call bell often, and the day nurse who gave me report was clearly exasperated. Surgical pain was a new experience for Mrs. J, and it was difficult to control, even with the PCA.
 When I walked into her room to introduce myself and begin my assessment, I was greeted by a thin, nervous appearing woman who spoke in quick, short sentences. The surgical pain in her abdomen was not her only complaint; she had multiple other aches and pains, the sheets were too warm, the blankets too cold, the pillows too soft…..I could see how the day nurse would have become frustrated with what seemed an endless litany of complaints. I adjusted her bed the best I could, and explained to her that we would work together to keep her as comfortable as possible as her body healed from the morning’s surgery.
 

The first thing I did was to call the resident and ask her to come reevaluate Mrs. J’s pain control and anxiety level. Then I made a point of stopping in to see her at least every half hour. I wanted Mrs. J. to know that she was safe and watched over. This seemed to help her calm down.
 

Later, after a change in her medications and the addition of an anxiolytic, Mrs. J. was able to communicate her fears with me.
 

It became obvious that her multiple physical complaints were her way of expressing her fears. She was scared of the upcoming chemotherapy and was concerned about losing her waist-length brown hair. She was worried about the scar on her abdomen and the upcoming staple remover in a few days. She was not yet able to verbalize the word ‘cancer’.
 

I sat with her as much as I could, allowing Mrs. J. to vocalize her worries, fears, and complaints. I realized that releasing what was bothering her verbally was as important as ensuring that her morphine dose was appropriate.
 

When my shift was over, and I went in to say goodnight, Mrs. J hugged me tightly. “Thank you” she whispered.
 

The most significant moments are sometimes hidden in the mundane events. As I rode the elevator down to my car, I realized that my most important nursing task of that night had not involved gloves, bandages, medications, or blood draws. Simply sitting by my patient’s bedside, holding her hand and listening to her talk had been the most therapeutic activity of the night.
 

I went home with a sense of a job well done.

The elections are coming.

Nurses Station encourages all readers to vote, but as to which candidate you vote for, that is up to you.

A Nurses Station reader wrote in via email concerned that Nurses Station was promoting a particular presidential candidate, Barack Obama.

I am writing this post to explain that Nurses Station does not promote either candidate in the upcoming election. The post she was referring to was an email written in by another reader as a comment. When we published her email in a post we noted that this was from a reader. Nurses Station is a forum for all nurses to discuss all their ideas.

Please feel free to write in comments with your own opinions on the election, the candidates and the issues. This forum is for all Nurses to share, discuss and debate all issues that concern them.

After two brutal 12h weekend shifts recently, where I was charge nurse, held a full assignment, oriented a new employee and cared for umpteen patients, I drove myself home with a head filled only with thoughts of ibuprofen for my aching feet and a soft pillow for my tired head.. I walked into my house, anticipating the peace and quiet of home, but instead was faced with numerous challenges before I’d even got out of my scrubs.

One child was sick, the other needed clothes washed for work the next day. The dog needed to go out, the cat needed to be fed. A family member was hospitalized and the phone was ringing off the hook with concerned relatives asking me “What is really going on?”…

I went into my room and changed into my sweatpants and T-shirt with a sigh, looking at the bed wistfully.

Several hours later, with my daughter treated with nasal strips and warm tea, my son’s clothes in the dryer and both animals with full bellies and empty bladders, I was finally able to crawl into bed. I allowed my head to sink into the pillow and curled gratefully under the soft sheets. Closing my eyes, I expected sleep to find me fast.

An hour later, I was still waiting.

And an hour after that.

My mind, which was so tired from all the tasks and issues I’d faced in the day, just would not shut off. I had a case of the ‘shoulda-woulda-coulda’s’ where I reviewed many of the day’s patients, wondering if I’d done the best, and if I could have done better. I was also mentally reviewing the tasks of the upcoming day…my first day off in three days. More laundry, grocery shopping, housework…

Eventually I got up and made myself a cup of chamomile tea. It was still relatively warm outside—which around here means at least not freezing—so I put on my sweatshirt and sat outside on the front step, next to my fragrant garden.

 I broke off a lavender frond and held it to my nose. A late-blooming datura flower dipped its head at me and I heard the scurry of a small animal as it moved through the citronella.

I closed my eyes and inhaled the scents of early autumn, feeling my mind quiet at last.

This is what I do what I do, I thought. To be able to truly relish the quiet moments, one needs to see the comparison. The sights, sounds, and smells of the hospital fell away in the smell of citronella and the hint of autumn in the air. The taste of chamomile tea washed away the tension in my neck and back. I finally began to relax.

Do you share your religious beliefs at work?  Do you wear a cross, a Star of David, a Pentagram or other religious symbol as a necklace or other piece of jewelry?I see nurses wearing symbols of their faith occasionally and it makes me wonder how patients react. 

I have cared for many patients of many faiths. I have prayed with patients when asked, regardless of whether the patient’s religious belief echoes mine or not.

I personally do not wear a symbol of my faith  to work. To me, it is a personal choice and I also don’t want a patient of any religion to feel uncomfortable if our religions differ. I keep myself very neutral.

 This is not to say that discussions of religions don’t come up; patients occasionally want to talk about God or want to pray. I allow the patient to take the lead, and make myself a quiet presence. 

What about you? What do you do? If a patient of a faith other than yours asked you to pray with them, what would you do?

Something that I’ve noticed recently is the tendency within this profession to self-impose limits and roles on ourselves as nurses.

We are LPN’s, RN’s, NP’s, CRNA’s, CNS’s…yes, there are different roles and responsibilities for all of us but there is one huge commonality…we are all NURSES first.

It pains me when I see people making a big deal out of the differences in letters. I realize that there are legalities, and tasks that can only be performed based on which nursing degree one holds. I am not arguing that fact.

But it’s the inter-professional division that bothers me. A coworker (somewhat) jokingly referred to the meaning of her LPN status as “Lower Paid Nurse.” It was said with a smile but underneath I sensed some discontent. She has been a nurse at least four times as long as I have, and is a person that I know I can go to when I find myself with a question about patient care or bed flow; the fact that she is an LPN and I am an RN is insignificant.

I have heard of  LPN’s referred to derogatively by RN’s as “Let’s Play Nurse” compared to the “Real Nurse” RN. This turns my stomach and makes me sad.

I have also seen newer nurses who are (rightfully) proud of their new status as GN’s or fresh RN’s but who tend to lord it over the LPN’s and C N A’s on our team. These are the nurses who don’t want to change a bedpan or ambulate a patient; they are the nurses who haven’t realized that a bed bath is a great assessment tool and a way to connect with a patient. This type of attitude makes me sad as well.

Our common denominator, no matter what the degree, is the N in our titles. We are nurses first. We are all out on the front lines, we are all caring for the patients. We’ve all “been through the war” of nursing school, and sat for the NCLEX. 

We all put our scrubs on one leg at a time, people. I just wish everyone could remember that.