Note: This blog is based on a keynote address that the author gave to the graduating nursing class at William Paterson University.
As much as you feel joy and a great sense of accomplishment as a new graduate nurse, you probably also feel a little anxious about what lies ahead. But don’t fret. If you survived the NCLEX, you can survive anything! Seriously though, take a moment to savor and appreciate what you have accomplished. It has been an intense time of growth for you, and I know it comes as no surprise for me to note that there are intense times of growth ahead.
Some of you are first-generation college graduates. I was also the first in my family to graduate from college, so I understand the pressure and intense growth that comes with being “the first.” But I also know it’s worth it—all of it! I truly believe education is the way up and over any obstacles you may face. I’ve been a student my whole life and I am proud of that.
You might wonder why I, a mom of three teens who loves her job as a pediatric nurse and clinical instructor, would choose to pursue a doctorate. Well, as a doctoral prepared nurse, I get to translate my passion for providing excellent evidence-based care at the bedside to improving the care provided to individuals, populations, and communities. I do this by teaching students and frontline nurses how to identify and apply current research to everyday practice. I also generate and disseminate new knowledge. Yes, that means I do a lot of research; my research focuses on supporting nurses with clinical decision making, preparing nursing students to be both confident and competent professionals, and teaching all nurses to recognize themselves as leaders at every level—bedside to boardroom to legislation.
I know that you, like I, became a nurse because you want to help people. But each of you has a uniquely personal reason that brings you to nursing. Some of you have been inspired by your parents or family members who are nurses. Others have had personal experiences in health care, both positive and negative, that have impacted your lives. Perhaps you’ve met or worked with an extraordinary nurse, or you feel a deep desire to drive change. Whatever your why is, don’t lose sight of it—don’t lose sight of why you became a nurse. Don’t lose sight of the spark that made you apply to nursing school in the first place and kept you going through early morning clinicals and endless exams. If you set aside key parts of your humanity in your quest to become a greatnurse, you will lose the joy and gratitude you feel in this moment.
Great nurses don’t hide their humanity. Great nurses are compassionate, they are gracious in their patient care, and they share their humanity as a gift to their patients. You as a human know what it’s like to feel vulnerable, scared, and uncertain. Recognize this in your patients. Share your humanity as a gift to your patients. Let me tell you a story about a moment where I shared my humanity with a patient.
My first position as a new graduate nurse was in a nursing home. Most of us understand nursing homes to be for the elderly. But not this one. This nursing home provided care to medically fragile children whose families, for one reason or another, were unable to care for them in their own homes.
After my 6-week orientation, I was assigned to a patient in Room 10. In report I was told the patient was a 13-year-old male with a diagnosis of Duchenne’s muscular dystrophy who had a tracheostomy and was attached to a ventilator. I walked into Room 10, and met Ben (not his real name). Ben was sitting in his electric wheelchair, head hung low, eyes looking downward. His mother stood beside him. While I was asking questions and checking off boxes on my admission paper (yes, we were still charting on paper back then) Ben’s mother explained to me that she was a single mom managing the care of Ben and his two younger brothers at home, all with the same genetic muscular disorder, all in wheelchairs and all with a life expectancy of 21 years.
Because Ben’s disease was more advanced, he was the first to require an artificial airway and ventilator support. This new status made him eligible for admission to a nursing home. Ben’s mom also shared with me that because of her circumstances she would only be able to visit about once a month. It was at that moment I was reminded why I became a nurse. I became a nurse because I believed my passion for helping and caring for people could change the world, one patient at a time. And it was at that moment I recognized that I not only needed to careforthis patient and his family, I needed to really careaboutthem.
When the admission paperwork was complete, and Ben’s medical equipment was organized in his new room, he and his mom said their tear-filled goodbyes. I walked mom out of the facility, gave her a hug and promisedI would take care of her son.
Ben was a typical adolescent boy. He was feisty, sarcastic, and funny. He was also defiant and belligerent and could be a total brat! I say that lovingly because we became fast friends. You see, Ben was my first admission, and I was his first nurse at his new home.
Ben had a hard time being away from home. He often refused to take his medications and cooperate with his daily care routine. It was frustrating for the day nurses. I worked the evening shift, so when I would come in for my shift, the nurses would be complaining about how intolerable Ben’s behavior was. They would often delay administering his medications and daily care until I arrived for my shift. He drove them crazy. Not unlike my teenagers at home now drive me crazy!
One day I came into work to find Ben in a room alone crying. His wheelchair was turned off. He wouldn’t talk to me. I wasn’t sure what to think. I turned his wheelchair back on and together we went to the nurses’ station. The charge nurse quickly approached me and in an irritated voice explained that she “had had enough.” Ben refused to cooperate with his care for the umpteenth time, so she decided to punish him by turning off his wheelchair. Of course, the nurse’s form of punishment was completely unacceptable.
As a new graduate nurse, I was confident in my knowledge and skills, but I was not assertive. I definitely did not see myself as a leader. But I knew I needed to speak up. I had to speak up on behalf of Ben and on behalf of his family. At that moment, I took a deep breath and found the words and courage to speak up to the charge nurse, my superior, and advocate for Ben. To my surprise, the charge nurse listened. You see, Ben was different from the other children who lived in this nursing home. He was verbal, he protested, he acted out. Plans of care to address a child’s behavior did not exist at this facility. My ability to find my voice resulted in an interdisciplinary collaboration to develop a standardized, evidence-based behavior plan for Ben. This innovative change in practice set the standard for creating and individualizing children’s behavior plans at that facility.
This is our work as nurses: to speak up and fight for people who are unable to fight for themselves.When I talk about giving your own humanity to your patients as a gift, I’m talking about facing your fears and your hesitation to speak up. You are human when you feel uncertainty as a brand new nurse; I know it can be scary. But it is imperative that you ask questions, ask for help, listen to your gut, and advocate for your patients. This is the gift you give to your patients, who are trusting you to keep them safe.
The other lesson here is that the people you care for will change you. They will change you with their courage, their humor, their vulnerability, and their humanity. As nurses, we enter a patient’s room a stranger, and within a short time, we become their advocate, their warrior, and their friend.
Life is not always glamorous as a nurse—it can be exhausting, thankless, stressful, frustrating, and sad. It takes courage to be a nurse. But it’s not the courage portrayed by Hollywood. I like the way the poet Mary Anne Radmacher puts it, when she says, “Courage does not always roar. Sometimes courage is the quiet voice at the end of the day saying, ‘I will try again tomorrow.’”
So, as you head off to face the next level of intense growth and to find your Ben, take root, bloom where you are planted, seek out opportunities to learn, be patient with yourself, take care of yourself, take care of each other, and trust the process.
Whether you become a nurse leader from the bedside inspiring those around you to provide extraordinary care, an executive leading efforts to improve and redesign our health care system, a legislator influencing policy change, a researcher advancing the science of nursing, or an educator teaching and inspiring the next generation of nurses, it’s your vision and drive that will move our profession forward and improve the lives of the people we care for.
Always remember to be proud of the work that you do, the person you are, and the difference you make. And whenever in doubt, remember thewhythat’s in your hearts today!
Kimberly Dimino is an Assistant Professor in the Department of Nursing, College of Science and Health, at William Paterson University in Wayne, New Jersey.