I have a couple of examples of what I am talking about, I am sure you will see what you should be looking for in a manager, and what can hold you back in your career goals.

When I am welcoming new employees to my unit, I meet with them on the first day to discuss my expectations of them, and to learn about what their goals are.  I make it clear that I know that they are not going to be working for me for ever, and that I want to help them grow as a nurse while they are on our unit so they can reach those goals.  Whether that is moving to the ICU, the ED or L&D, I know they have goals, and if I know those goals, I can help them achieve them.

This is new for a lot of nurses who are used to their managers expecting them to stay on the unit forever.  They are not used to a leader helping them and coaching them to meet and hopefully exceed those goals they have set for themselves.

Contrast that to my situation.  My organization is going though a lot of changes in the department of nursing.  There are directors and higher up the organizational chart that have left opening new opportunities for those managers that are looking go move up to these positions, like myself.

Last week I sent an email to my boss explaining that I am interested in moving up the ladder.  I explained my goals and asked her if she could support me and mentor me in these new positions.  I explained why I felt that I would be the perfect candidate for one of these positions and the positive changes I could make.

I received an email back that really just shot me down.  She was completely unsupportive and did not provide any positive support or feedback.  I am disheartened, and disillusioned with her and this organization that I have put some many years into.  I am seriously considering leaving because of the lack of support given to me.

Which one would you like to have?  Somebody that wants to know your dreams and helps you to achieve them, or somebody that doesn’t ask, and doesn’t seem to care or support you when you tell them?

Pretty easy choice for me.

Today the RN and OCN on a cancer day treatment unit in Portland, Ore., freely explores her emotions through blog posts as well as brushstrokes, drawing inspiration from her 24 years in pediatric intensive care and adult oncology.

She recently concentrated on the color white, specifically the debate over the return to white nursing uniforms. “It feels like color coding,” she says with concern. The more Paradisi considers the stereotypes and rites of white in Western society, the more outspoken—and prolific!—she becomes. “White has a burden, a flawed innuendo of purity and morality. Nurses are not angels. We have very complex and complicated jobs.”

The short answer is that nurses either make peace with the emotional demands of the job or find a different one. Mostly I have made my peace with it, but some days are harder than others, and those are the days when the “how” of coping really matters. I’ve had a few of those days lately, and they’ve made me think about what I do to keep the sadness of the floor, and the enervating work that regularly confronts death, from taking over my life.

A few months ago, a patient—a woman roughly my age, 44—was actively dying. When she was admitted with a diagnosis of leukemia a year before, she was energetic and bubbly. She had been a hairstylist, and once she started to lose her hair, she borrowed clippers to shave her head. When a rounding attending told her that being bald suited her, that she had a “nice-shaped head,” my patient thought this was hilarious, and her strong laugh was hard to resist.

Now, close to death and doped up on morphine, she could not chat with, listen to or even notice the people around her. Her husband and I talked, though. In the hallway outside her room, he looked at me, shaking his head. “I don’t know how you do it,” he said, imagining the toll the job took on me.

Two years ago, when I first started as an oncology nurse, I would pretend an emotional immunity in these conversations, a placid resilience, that I did not actually feel. Over time I admitted to myself that demurring was really only a way of lying about how the job taxes me. So this time I looked at my patient’s husband and thought about an honest response. “Well,” I said, “I have three kids, and they really do rejuvenate me.” The husband looked at me, surprised, and then nodded his head.

An explanation, however, is not an action—and to stay sane in this job, you have to act. As soon as I could, I called my husband. “Hey Arthur,” I said, “how about you pick me up when I get off work and we take the kids to Max & Erma’s?”

My son Conrad, who’s 13, and Miranda and Sophia, 10-year-old twins, really like the local Pittsburgh chain restaurant. But they know it’s not a place I would ordinarily choose, so they asked me, with that unselfconscious directness children have, why I suggested going. Once again, I thought about my answer. I often try to soften or even hide the hardest truths about my job. This time, though, the truth seemed like the best idea.

“A patient I like very much is dying from cancer and I was feeling sad about work,” I told them. “Seeing you guys makes me feel better, so I wanted us to go to a restaurant you really like.” All three of them sat silently for a few seconds, and then, like my patient’s husband, they all nodded.

The restaurant’s hum returned, along with the kids’ chatter. Miranda described the fifth grader who spent too long in the bathroom, Conrad bemoaned the librarian who could not control her class and Sophia complained about homework. The conversation was like a salve on my soul.

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But Memorial Day is far more than that. It’s a time for remembering all those who served and lost their lives in war.

What many people tend to forget is that along with the soldiers who go to war, nurses go as well—not to fight in battle, but to help save the lives of injured soldiers and to provide comfort to those soldiers they cannot save. U.S. military nursing has been around for several centuries—since the 1700s. Here are some military nursing facts that you may find interesting, and which might encourage you, as a nurse, to devote a little time this upcoming Memorial Day to paying even a silent tribute to military nurses.

• More than 10,000 nurses served in World War I. They traveled across the Atlantic Ocean by ship, and the journey took about two weeks.

• Somewhere between 200 and 300 nurses died in World War I. Many contracted illnesses such as scarlet fever and influenza, which took their lives. Some died in military accidents, and some died at the hands of enemy weapons.

• In the 1960s and 1970s, the nurses who went overseas to nurse injured soldiers in the Vietnam War were young women who had just graduated from nursing school. This was their first nursing experience, and they served for one year minimum. They could serve longer if they chose to.

• As the machines of war evolved, the nurses who served overseas saw and treated injuries they would never have to deal with again. For example, during the Vietnam War, napalm, a flammable liquid that causes severe burns and often death, was a commonly used weapon, and nurses saw its horrible effects.

• Today, the nurses who go overseas range in age from 20 to 60, and one-third are men. The service term is six months, but “active duty” nurses can be reposted (sent back) several times.

• The Army Nurse Corps became an official branch of the Army Medical Department in 1901. You can learn about joining the Army Nurse Corps on the U.S. Army website.

• There are 10 different nursing specialities in the Army Nurse Corps, ranging from Army Public Health Nurses to Perioperative Nurses to Psychiatric Nurse Practitioners.

• Military nurses have served in numerous wars, including the Spanish-American War, both World Wars, the Korean War, the Vietnam War and Operation Desert Storm. They have served with NATO troops in Haiti, Bosnia and Kosovo.

• During World War II, 67 Army nurses and 16 Navy nurses were held by the Japanese for three years as prisoners of war.

• Located near the Vietnam Memorial in Washington, D.C., is a memorial to all nurses who have served in all wars. It’s a bronze statue of a nurse caring for a wounded soldier. As a nurse, hopefully you’ll have the opportunity to visit this memorial someday—if not on this Memorial Day, then perhaps on another Memorial Day, or any day.

Be sure to take time to reflect on your country’s honorable military nursing history, one that still has many pages to be written—since war is unfortunately not history yet.

Read more Scrubs articles about military nurses.

Image by: Thinkstock

Where would hospitals and facilities be without the tireless, important work of the certified nursing assistants? Sometimes, the job is tough and thankless, but the CNA is the backbone that makes everyone else’s job a little easier. In honor CNAs, here are some inspirational quotes that speak to the job they do!

“It is not how much you do, but how much love you put in the doing.” —Mother Theresa

“The charity that is a trifle to us can be precious to others.” —Homer

“They may forget your name, but they will never forget how you made them feel.” —Maya Angelou

“There is no medicine like hope, no incentive so great, and no tonic so powerful as expectation of something better tomorrow.” —Orison Swett Marden

“A cheerful heart is good medicine, but a crushed spirit dries up the bones.” (The Bible)

“There is a sacredness in tears. They are not the mark of weakness, but of power. They speak more eloquently than ten thousand tongues. They are messengers of overwhelming grief…and unspeakable love.” —Washington Irving

“Compassion automatically invites you to relate with people because you no longer regard people as a drain on your energy.” —Chogyam Trungpa

“Compassion brings us to a stop, and for a moment we rise above ourselves.” —Mason Cooley

“Compassion is a call, a demand of nature, to relieve the unhappy as hunger is a natural call for food.” —Joseph Butler

“One’s life has value so long as one attributes value to the life of others, by means of love, friendship, indignation and compassion.” —Simone de Beauvoir

“Apprehension, uncertainty, waiting, expectation, fear of surprise, do a patient more harm than any exertion.” —Florence Nightingale

“A good deed is never lost: he who sows courtesy reaps friendship; and he who plants kindness gathers love.” —Saint Basil

“Never lose a chance of saying a kind word.” —William Thackeray

“Nurses may not be angels, but they are the next best thing.” —Anonymous Patient

“Give what you have. To someone, it may be better than you dare to think.” —Unknown

“Be kind. Everyone you meet is fighting a hard battle.” —T.H. Thompson and John Watson

“Anything I’ve ever done that ultimately was worthwhile initially scared me to death.” —Betty Bender

“When I first started working in long-term care after I’d been in a hospital setting, I bet I went home crying every night for six weeks because I said this just isn’t what I like. But the more I stayed, the more I understood it’s a different kind of nursing… We’re all going to die—that’s a part of life. Just when and how, we don’t know.” —MarDee Dahlin, RN

“…[A]lthough the days are busy and the workload is always growing, there are still those special moments when someone says or does something and you know you’ve made a difference in someone’s life. That’s why I became a nurse.” —Diane McKenty

“To do what nobody else will do, in a way that nobody else can do, in spite of all we go through, is to be a nurse.” —Rawsi Williams

References:

“100 Entertaining & Inspiring Quotes for Nurses,” nursingschools.net, June 2010
http://www.nursingschools.net/blog/2010/06/100-entertaining-inspiring-quotes-for-nurses/

“Inspirational Quotes Every Nurse Should Read,” monster.com, July 2009
http://nursinglink.monster.com/nurse-supervisor-jobs/articles/8714-inspirational-quotes-every-nurse-should-read?page=1

“Great Inspirational Nursing Quotes & Motivational Sayings,” Motivation Empire
http://motivationempire.com/inspirational_nursing_quotes.php

“Inspirational Quotes & Quotations on Nursing,” successdegrees.com
http://www.successdegrees.com/inspirationalquotesaboutnursesandnursing.html

But do you have to truly get away from it all to have an exquisitely quiet moment? A survey of nurses in various locales suggests not. What is non-negotiable is regularly taking the time to recharge your batteries—whether you do it for five minutes or five days. Everyone needs a breather, but perhaps no one more than a nurse. “Nurses know that too much contact with patients without a period of withdrawal makes for scattered attention, mistakes, anxiety, depression, and loss of interest,” says Steven Hendlin, Ph.D., a clinical psychologist in private practice in Newport Beach, CA. and a Fellow of the American Psychological Association. “For people like nurses, who are always dealing with other people’s pain and suffering, not having outside stress reducers may lead to depression and early burnout.”

Searching for Serenity

There are no rules about what constitutes the ideal interlude, and it doesn’t even have to be quiet. Maybe you seek solace at a rock concert, or by cheering on your favorite sports team. Yvonne Sannes, a home health nurse in Lancaster, CA rides motorcycles with her husband almost every weekend (the fact that they’re both almost 70 doesn’t stop them). Kim Bahnsen, a Nurse-Family Partnership supervisor in Port Matilda, PA, rides ATVs with her husband and son.

On the other hand, it could be that you use this time simply to take in the beauty of the world—visiting a botanical garden, or even a favorite flower shop on your way home from work; sitting on a cliff watching the fog roll in; or taking a car ride to the nearest river, lake or ocean. Or it may be a time you go inside yourself and block out the rest of the world by daydreaming or reciting affirmations. As long as your escape gives you a chance to remember—and be—exactly who you are, you know you’re doing it right.

Many nurses have more than one way they take refuge from the pressures of the job. Fletcher, for instance, doesn’t get to travel to exotic spots like Everest every day (or every year, for that matter), but she takes a moment for herself daily by switching on classical music after work. “I don’t use the television to escape any more,” says Fletcher. Instead of watching life, she now makes an effort to experience it.

A daily dose of Native American flute helps Paul Phelps wind down. A nurse who works half the year in the ICU at a Greeley, CO hospital, and half the year in Florida (where he cares for his aging parents, too), he also likes to bury himself in a book, taking care to choose one that has nothing to do with nursing. You might call that Phelps’ regular upkeep. In addition, he cultivates his fishing habit as often as he can in nearby creeks and lakes. “I tell my co-workers I only work to fish,” he says. The grandeur of the surrounding mountains, the trickle of cold-water streams, the occasional whir of a fishing reel, and the meditative wait for a catch all add to the serenity of those moments. “After 35 years of working in health care, I have come to understand the necessity of relaxing while away from work,” says Phelps.

To be meaningful, a time-out needn’t be the stuff dreams are made of. On days when you lose a patient or are short-handed at work, something as elementary as sitting down with a proper cup of tea can feel like a little slice of heaven. To Donna R. Pauling, a Nurse-Family Partnership nurse home visitor in Bloomsburg, PA, the perfect time out is making quilts for Quilts for Kids, an organization that distributes them to seriously ill children.

A little pampering can also go a long way. Simply keeping up with a regular pedicure–whether you do your own or go to a salon (definitely spring for the $5 foot massage!)–can lift you into another realm. To Ali Frisius, a pre-op nurse at Post Street Surgery Center in San Francisco, closing her bathroom door and easing into a hot bath with candles flickering nearby and a novel in her hand is pure pleasure. The heat of the water instantly dissipates the nervous energy she’s built up during the day. Other nurses find that just using their 15 minutes in the break room for a calming and repetitive activity like knitting or doing a crossword puzzle can be soothing. So can a brief meditation. “Simply closing your eyes for ten minutes, sitting still, with a straight back and feet on the floor—and doing this away from noise—can help you pull back into the present, slow down, and feel able to return to interacting with patients,” says psychologist Hendlin.

CONTINUE TO NEXT PAGE–>

Image By: Jupiterimages

As National Nurses Week swings around yet again, one expects to feel appreciated in some way. For some of us, it means a free meal in the cafeteria, a gift with the hospital logo on it or a “Happy Nurses Week” ad in the paper. Administrators and management smiling at you for a change…

For most of us, the one week observance is quaint and expected, while at the same time feels a bit awkward given all of the “niceness” that seems to pop-up and, just as quickly, disappear when the week is over.

But what about the REST of the year?

Most hardcore clinicians, myself included, will tell you that the much-hyped appreciation of Nurses Week does little to make them feel valued. Let’s face it: We chose a very difficult career that’s hard on the body and the soul. Relationships suffer and we have anything BUT normal work schedules. How many times have we heard someone say: “I don’t know HOW you do it–I could NEVER be a nurse!”

Nurses can tell you true stories that are so amazing, wild, incredible and ridiculous that no one could possibly make them up. No fiction writer could imagine the things we see and do on a regular basis. No movie or TV show can come close to the reality of life nurses know.

We are the ones who are privileged to be present at all stages of the lifespan. To be there for families when they experience joy as well as tragedy. To be willing and able to break the rules for the sake of making our patients’ quality of life better, even if just for a few hours.

Nurses make a difference…for somebody, in some place, at some point in their life’s journey.

Whether it is in a modern hospital, on vacation, in a shack with no supplies or running water, in a desert aid station, on a ship, in a POW or concentration camp, on board a jetliner over the ocean, in a rural health clinic, or (fill in your own blank space) wherever there are human beings in need, there have been and always will be nurses.

Doing the work. Making it better. Every hour of every day. 52 weeks a year.

Knowing that we made a difference at the end of the shift just by being there for someone.

And THAT is why we do what we do!

The best and most beautiful things in the world cannot be seen or even touched–they must be felt with the heart (Helen Keller).

We thought the theme of doctors thanking nurses would be wonderful for the scrubsmag.com website too, so we assigned one of our writers to interview even more doctors for their sentiments. And yes, it does get sentimental! Read on.

Perhaps the doctors you work with seldom, if ever, thank you or show you their appreciation. It could be that it’s simply not their style, but chances are that deep down they’re more appreciative than you can imagine—of you, your nursing skills and the valuable role you play on their healthcare team. Not buying it? These stories, volunteered by doctors who genuinely delighted in sharing them, are sure to erase that doubt and show you that doctors do appreciate nurses.

Humble Brilliance
“In our training, doctors are so separated from nursing staff that we don’t really get to appreciate their input until we’re independently practicing,” says Anita Swamy, MD, a pediatric endocrinologist and the medical director of diabetes at La Rabida Children’s Hospital in Chicago. “I’ve learned so much from the nurses I work with—both professionally and personally. I feel that in the field of medicine, they’re the humble, brilliant people.”

Swamy explains that prior to her arrival at La Rabida, the nurses were running the pediatric diabetes program without a medical director, and doing it very well. They had developed comprehensive components that included working in schools with school nurses, holding nursing conferences for nurses throughout the state and delivering a formal lecture series.  When Swamy arrived, they accepted her into the fold as part of the team and gave her a level of respect that surprised her.

“Some of them have been doing this much longer than I have, but they still come to me to ask me for advice, even though they likely already know the answers,” says Swamy. “That’s an incredible personality trait, and it has taught me to be a little more humble. And, as far as diabetes management goes, my knowledge has been significantly enhanced by exposure to the nurses and their ways of practice. Each of us has a role, and each role is equally important.”

Dr. Swamy thanks you, Rosemary, Andrea, Anita, Cathy and Kate.

Next: “Nurses are my eyes and ears…” –>

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What’s your favorite “thing” ever about being a nurse?

I have several. Tops on the list: Working in neurology, you gain a basic knowledge of all the little weird bits of the brain that other specialties never hear of. It’s fun to stump or impress professionals with a good background in, say, urology or cardiology (or even neurosurgery!) with the blasé pronouncement that, yes, you’ve seen those symptoms before, when a patient had a blockage of the third branch of the left-lateral mid-coronal whangdoodle, but only on alternate Thursdays.

Another cool thing, along those lines, is the stories you get to tell. Did I ever tell you the one about the guy who stroked out his entire corpus callosum? How about the woman whose only symptom of stroke was that she couldn’t read out loud? Believe me when I say that Oliver Sacks barely scratched the surface in all of his books.

Then there’s the swag. When you do neurology, you get pockets full of cool things like reflex hammers and penlights. You get toothpicks, cotton swabs, von Frey hairs (that’s a set of bits of monofilament to test fine touch perception), and flip-books full of cartoons to describe and words to repeat. Walking down the hall with your lab coat pockets stuffed with testing widgets, you look like a well-groomed mad scientist.

And finally, there’s my favorite thing about being a nurse in general: the variety of people you meet. Working in an academic setting, I meet folks from all over the world. I’ve met a professional rodeo clown, an auctioneer, a couple of Nobel laureates, a guy who spent 10 years studying sociocultural norms in various groups who live in the Sahara desert, and ordinary people who do ordinary things very well. I work with doctors and nurses from countries I’ve had to look up on maps. You wouldn’t believe our parties. Or, come to that, our potlucks.

Happy Nurses Week! May your next year in nursing be filled with all the cool trivia, neat swag and interesting encounters that make our jobs so much fun.