The #1 trait of a good nurse

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What makes a good nurse?

That’s a good question.

Ask most nursing students and they’ll say that it’s the desire to help people. Ask nursing managers and they’ll say that it’s good time management and a commitment to safety. Ask doctors and they’ll say that it’s attention to detail and knowledge of possible complications and side effects of treatments or surgery. Ask patients and they’ll say patience, focus and generosity of spirit.

All of these things are, of course, essential. And all of them miss the one thing that a good nurse needs most—more than a huge bladder, more than titanium feet, more than huge biceps:

A spine.

Nursing is a hard job primarily because the nurse is constantly being pulled between the patient’s needs and the doctor’s needs. Add the fact that we get to coordinate care, and then add the radiology department, food service, the guys from orthopedics, physical and occupational and speech therapy, the patient’s family…and about a zillion more that I’m sure I’ve forgotten. All of those people and services and therapies need to be coordinated in a way that’s best for the patient, while allowing us to do our jobs in an efficient and unhurried (in a perfect world) way.

That’s why you need a spine to be a nurse. Most new nurses don’t come in with spines; they have to grow them as they grow in their profession. As a nurse, you need to be able to put your toes on a line and say “No,” to be able to turn people down, reschedule things or push a recalcitrant MD to take action. That doesn’t mean you need to be combative or difficult to work with. It simply means that you have the guts to make sure that what needs to be done gets done in a timely fashion.

You also need a spine to make sure your patient care is safe and that you’re not getting abused. One of the best things I ever did as a new nurse was simply refuse to care for a patient who’d gotten violent with me, despite the nurse-manager’s insistence that I wasn’t allowed to refuse to take a particular assignment. I grew a spine that day, and it’s been getting stronger ever since.

So: spine. Remember that it takes a good one to have a long career as a nurse. Remember that sometimes it’s really hard to say no, even if that’s the right thing to do in the situation. Remember that being a strong, stubborn, thoughtful nurse doesn’t mean you can’t lean on your coworkers or ask for help. And remember that it’ll grow, whether you’re a new nurse or a nurse in a new situation.

This post originally appeared in The Head Nurse blog.

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Agatha Lellis

Agatha Lellis is a nurse whose coffee is brought to her every morning by a chipmunk. Bluebirds help her to dress, and small woodland creatures sing her to sleep each night. She writes a monthly advice column, "Ask Aunt Agatha," here on Scrubs; you can send her questions to be answered at

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10 Responses to The #1 trait of a good nurse

  1. Cynthia Allison Bishop, RN

    Having a “spine” IS the most important thing a nurse must have and unfortunately the first thing to go in health care providers who are now routinely “caving in” to outside pressures from reimbursers whether they be internal, local, insurance carriers or federal. It’s a sad commentary on the state of health care that it is seen now as a business rather than a service.

  2. JoBeth

    I truly enjoyed this! I feel the exact same way! So many people depend on us that you have to have that “spine”. I learned early as a Nurse that you have to speak up, speak out, and do what is necessary for the patient!
    As far as the abusive, violent patient I dealt with this on shift today! The safety of the other patients and staff were in jeopardy as well as mine. This situation puts everyone in Danger and I have decided to do something about it! Prevention #1 goal!

  3. Nursing is a hard job primarily because the nurse is constantly being pulled between the patient’s needs and the doctor’s needs.

  4. patty

    endless compassion

  5. Sandra Richwine

    Nursing is emotional, mental & physical I have gone home from work many times a shed some tears. But I wouldn’t do anything else I Love Being A Nurse!!!

  6. Nurse Shawn

    And I LOVE MY Patient’s… although still having to work on my own patience… Not so easy, esp. since I am a DO IT NOW GIRlL….

  7. Granny Rene, RN x 35 yrs.

    The #1 rule for me is: LISTEN TO YOUR PATIENT! If you do this, your patient will tell you 99% of what you need to know to treat him/her. Ask where to draw their blood, what works BEST for their pain, etc.
    As for having ‘a spine’, I had one for a VERY long time and have found that when those who wish to ‘climb the ladder’ in an institution see you as a threat for some reason, you WILL be ousted by whatever means they deem necessary, just under the radar enough so that you will have no leg upon which to stand to charge harassment or ‘bullying’.

  8. Livi

    I like this. If you think about it, “having a spine” applies to ALL of the other “good nurse traits” out there. Being able to learn from criticism instead of crumbling under it; being able to be sad and move on anyway; being able to resist your own weaknesses; being able to give yourself over to your work without losing who you are outside of work.

    Granny Rene has a good point worth thinking about. But I think problems like that can be worked around by understanding that the possession of a spine doesn’t mean coming across as a threat. Anyway, anyone who goes a really good job at nursing could be viewed as a threat by some petty jerk willing to do anything for a better position…

    • caring lpn

      I like Granny Renes’ response and LiVis’ response too. It’s dealing with the petty jerks that will do anything for a better position. The roughest part of nursing is management partiality and favoritism. A good nurse HAS A HEART and it shows.

  9. AaronLPN

    Leave your ego at home. That is the Number One rule in my book. You are there for other people. Doing things to make yourself feel important of good doesn’t add to client care. Just becasue you sent 10 faxes in one day and recieved 10 new orders doen’t mean you’ve actually accomplished anything!