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Reflections on the heart of nursing

In 1995, I toured the Florence Nightingale Museum in London. On the walls were letters that chronicled a lifetime of dedication, spent caring for others—letters that were preserved for those who followed.
In recent years, I’ve thought that we may have lost such communication from generation to generation because e-mail has largely replaced letter writing, and the heartfelt reflections of nurses may have gone the way of the quill and inkwell. Then, I decided to ask my senior nursing students to keep e-mail journals about their rural clinical experiences.
And happily, I discovered I was wrong. Despite the means of communication, the heart of nursing comes through when students reflect on their nursing experiences.
Though some students approached journaling with trepidation, many related their feelings and experiences with enthusiasm and thoughtfulness. What follows are some of my students’ e-mails along with my responses.

Performing unpleasant procedures
A student working in the surgical area of a hospital wrote, “Burnt flesh has an aroma all of its own, and the fact that it lingers in the air for quite some time afterward was not lost on me.” This student later worked in a clinic, where she drew a blood specimen from a six-year-old and reported that she “was so excited to get the blood on the first stick.”
Nurses must learn that some procedures are unpleasant and some can cause pain, I replied. The reality is that we can’t avoid hurting our patients all of the time. We can, however, learn to perform painful procedures in the most efficient way, so we cause as little trauma as possible for the shortest time possible.

Caring for the vulnerable
Another student wrote, “We had a patient with a diagnosis of acute schizophrenia. Each time we walked into her room, her demeanor was different.” I suggested that caring for mentally ill patients in an acute-care setting can make nurses reach deep within to understand what is happening in the patient’s mind.
Regarding a home health experience, a student wrote, “Most of the patients we visited today were indigent.” I tried to explain that when possible, nurses should try to influence the funding for care of the mentally ill, the poor, or other vulnerable populations, such as the elderly. We should make sure legislators understand the impact of not providing funds for adequate care. The political side of health care, I offered, can be frustrating, but it can also be interesting and enlightening. Who is better positioned than nurses to teach the public about the need for funding to provide good health care?

Dealing with death
When students write about caring for dying patients, they sometimes reveal much about themselves. “The code lasted a short time, yet seemed like an eternity, everything hit me like a ton of bricks—emotions, questions, and mostly shock,” said the e-mail. The patient was 26, the nursing student was 24.
After watching a husband of 47 years talk to his dying, previously unresponsive wife, a student noted, “He said, ‘Hi, sweetheart.’ She replied, ‘Hi, honey. I love you.’ As his eyes welled with tears, I almost burst into tears myself.”
Giving a patient’s family the time they need when a family member is dying is a meaningful gift, I wrote. Working with a dying patient is one of the most profound experiences for nurses, and helping the family understand what is happening and then helping them through the loss can be touching.

Open hearts and minds
Such reflections on the humanity of our work rekindle our spirits and take us to the heart of nursing. If we open our hearts and minds, those of us who have practiced nursing for years can learn from those who are seeing nursing for the first time.

Paula Faulk Maness is an Assistant Professor of Nursing and Learning Resource Coordinator at Tarleton State University in Stephenville, Texas.


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