Life of a Nurse Nursing Week 2013 (May 5)

It is Nursing Week time to take a pause and celebrate how much we do as staff nurses 24/7, as we strive to deliver quality care in environments that can range from street-side, community clinics, to primary care, and the areas of hospitals, nursing homes, and long-term care. The complexity of settings can be characterized by acuity, academic teaching facilities, community agencies, urban and rural, rehabilitation, palliative care, specialties and general medicine.

In my new practice of adult medicine I am certainly living the theme of 2013 Nursing Week: Nursing: A Leading Force for Change, the group of nurses I practice with can easily describe the challenges of providing quality care in the context of acuity, complexity, the prevalence of altered cognitive function in the forms of confusion, delirium, dementia, and keeping up with corporate, professional, and personal demands.

We understand that as nurses we need to be involved in generating solutions, indeed Linda Silas, Canadian Federation of Nurses Union (CFNU) president, described how “Governments and hospital administrators are constantly asking nurses to do more with less — less budget, less staff and fewer supplies even”. “They too have a responsibility to address and resolve problems when the quality of care we can provide to patients suffers. They must make allies of nurses — the largest group of health-care providers and the best frontline resource — because we are a voice for patients with insights into the issues and ideas for the solutions.” The opportunities to lead change emerge when staff nurses engage in short-term projects to improve patient care, even at an individual level by reviewing Best Practice Guidelines relevant to practice, work environment, and personal care such as Preventing and Mitigating Nurse Fatigue in Health Care. We have opportunities to be on committees, to be advocates at point of care for managing pain, to explore ethical dilemmas, and we need managers who are accessible, effective, and know how to advocate for resources for their staff.

There are elements I have included in my professional toolkit that will be familiar to many of you, accountability, empathy, respect and dignity, honour and integrity, values that encompass the art of nursing. The concrete knowledge of assessment, technical skills ranging from aseptic technique, teaching a patient on care of their ostomy, to administration of medications and the know how to monitor lab values, side effects, efficacy, and to know when something like analgesia is needed, in the area of science. It is my organizational abilities to admit a new patient, monitor a patient receiving blood products, attend to a patient who has been incontinent, and answer a ringing phone in the span of 15 minutes, we by necessity learn how to juggle priorities and in a healthy work environment I know my teammates are but a call for help away.

I have always believed I am contributing to change, certainly change has been a constant and unrelenting force in the health care system, by being an active participant in the Registered Nurses Association of Ontario I am influencing nursing and health care. I am active not reacting to change, it includes being a life-long learner, learning to balance work and life, to work through cycles of compassion fatigue, burnout, reality shock whatever you want to call it. I know that to be successful leading change I had to develop my own vision of nursing, develop leadership skills, practice leadership, be resilient, pragmatic, innovative, generous by precepting and mentoring others in the same manner I have received that kind of support, and to model the way of professionalism, caring, healer, and team player.

Also to lead change you need a dose of bravery because what needs to be changed is not always apparent to other stakeholders, that's when you pull out of the toolkit the ABCs of change management, others have to see why they need to change...practice...knowledge...attitude...and leading change is a journey so it's a good idea to find interesting landmarks and rest areas along the way. Sometimes change is about timing, it can be about crisis, 2013 is 10 years since SARS and the lived experience of nurses engineered changes related to infection control, personal protection equipment (PPE), and that we are brave souls who willingly enter isolation environments (with our knowledge, skill, and PPE). Take time to celebrate, take time to share what it's like to be a nurse, take time to consider how you will contribute to your profession, and take time to rest prn. Namaste