Thinking About Nursing

May 8, 2013

It's National Nurses Week. I am not sure why there is only one week where the nursing profession is celebrated, as so many other job categories have a whole month. If it were up to me it would be National Nursing Year, celebrated 365 days a year.

Recently, I experienced a week-long hospital stay after a very long surgical procedure. My stay was in our own Mass General. For me, the nursing professionals with whom I interacted and from whom I received care were transformational. I was prepared to write a blog about this personal experience and I will do that in the future. I have tried to capture my own experience in several drafts that are not yet complete. It's still a bit too personal and a bit too narcissistic for that type of reflection at this moment. I will keep working on that message.

Having put off this reflection for a couple of months, I was brought up short by the tragic events of April 15, 2013. This was the date of the running of the 117th Boston Marathon. This is the date when runners, children, observers, and others were injured and killed in this city that I now call my home. The role of nurses in the unfolding of the now-never-ending story of the aftermath of the Boston Marathon 2013 is pivotal. We all have heard the story of nurses (and others of course) who were alongside the finish line or were in the medical tent as the bombs went off. We have read how they rushed toward victims of the bombing with skill and bravery. As the days progressed with repeated news stories of Emergency Rooms, ICUs, and in-patient care, I knew what kind of professional nursing care was being provided. As time progresses and now those patients most gravely affected have moved onto rehabilitation settings, I know what skilled nursing leaders are doing in Spaulding and other rehab hospitals and also in home care.

So often, the image of nursing as a "caring" profession produces predictable images of strong individuals offering a gentle smile, a soft touch, and the like. I want to present another image. It does not replace the "kind and gentle" picture that we all can easily conjure. I believe it complements that view and for me, it supersedes the image. In my nursing narrative, the nurses at the site of the bombing almost reflexively made critical life saving decisions about injured people. They decided where and when to stop hemorrhaging wounds, provide CPR, and get people to an ambulance. I would guess that in some of these decisions and actions they were supported by other nurses and physician colleagues. I would also guess that many of their decisive actions were carried out in solo, using critical clinical knowledge. It was just the nurse and the victim together at that particular horrifying moment.

In my version of the story, nurses in the Emergency Departments and in the inpatient units of our various Boston hospitals all played a key role in making moment-to-moment decisions about the care of their patients. Their role in keeping these patients alive and making progress cannot be emphasized enough. Their monitoring of the patient's condition, keeping patients safe and stable, and calling on colleagues from medicine or other health professions when needed is essential in achieving the best outcome. And now, when many of our eyes have moved on from the immediate crisis of the event, they continue to make critical decisions and provide minute-to-minute monitoring for those dealing with long term loss and disability, including the untold number of residents of our community who are dealing with the psychological wounds caused by this trauma. From the bedside to the top of the leadership ladder in patient care, nurses were (and are) making THE important decisions about the care of their patients. It is these decisions and their resultant actions that are frequently ignored in descriptions of the "caring, sensitive nurse" that are most common.

In this blog I want to celebrate Nurses Week as a tribute to the critical and important judgments and skilled actions of nurses everywhere, but particularly here in Boston. I want to hold up these examples for our students in the MGH Institute of Health Professions School of Nursing and their faculty. While all health professionals have the responsibility for compassionate and caring interactions with patients, it is the specific knowledge and skill of the professional nurse that assures patient safety and the best outcomes for all patients. Many of us interact with select subgroups of patients in rehabilitation, mental health, and so forth. It is only the nurse who provides care to every patient regardless of their diagnosis or presenting problem. To our students in the School of Nursing at the IHP: Congratulations on entering such a remarkable discipline. To our faculty and administrators in the School of Nursing: Thanks for preparing this remarkable group of students, all who have the opportunity to become leaders. To our colleagues in nursing around our community and beyond: Thank you for becoming leaders in critical decision making and exhibiting best practice all of the time, but especially during times of crisis.

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