What Does it Take to Be a Nurse?

Nursing is a profession that you must love with a passion to gain fulfillment. It is not one of those jobs to just earn a buck. You have to really love what you’re doing, because the demands and responsibilities that are expected of you can be overwhelming. Unless you have a purpose propelling you forward you can drown. So what are some qualities that make a good nurse? Compassion, patience, problem solving, organization, communications, understanding, a desire to excel, management and above all honesty and integrity.

Let me start with the first quality, compassion. Sounds simple, but at times you will have to dig deep to allow this quality to be expressed well. It is true especially with psychiatric and behavioral compromised patients. Rule #1 the patients pain and suffering (be it physical, mental or emotional) are what the patient says it is. Drug seeking patients will give you every story under the sun to express the pain and suffering they are experiencing. They have been around this track before and know the key words to give the nurse to reveal pain or anxiety that is worthy of a sedative medication. But as a nurse you have to be a compassionate person and not let this underlying knowledge cloud you from treating the patients complaints as valid. There are many ways around this and a good nurse will have the compassion and finesse to handle this situation (but you can not win them all). You will, as well, be dealing with patients that have illnesses that are terminal, and during your watch can lead to their finial breath. You will be dealing with a multitude of family issues, and learning which members are here due to guilt and therefore they feel they need to take charge and interrogate you every-time they get or make constant demands as if their family member is the only patient you have. These are struggles families go through and I have to say I myself have been that family member. So I simply put myself in their shoes and have understanding that this is how they need to handle the stress of a loved one near death or extremely ill, with no diagnosis as of yet. I give them compassion and even at times just blow off any rude or condescending remark. Now, I’m no angel and I can not say that I’ve handled every incident with such great delicacy, but I can proudly say that a majority of the time I did well. “How can you just sit back and take it?”, you might ask. Well, this is my passion and an inner desire to reach out and help another human being during a time when they need it the greatest and this extends to the patients family as well. Humans react during times of stress in ways that they would not ordinarily. I take this into consideration while caring for my patients and try not to take things they say and do personally. I know deep inside that I am doing my best and I can live with that.

Second is patience and I don’t mean patients, that’s just a given or you don’t have a job. We’ve all heard that saying, “Don’t pray for patience, because when you do God will test you in every way”. Maybe that’s what caused the creation of the Department of Motor Vehicles, we all prayed that prayer to many times. Well, in nursing sometimes you have to ask for things more than once, you have to stop in the middle of a busy day to call a physician to confirm an order that is not very legible, take that little elderly man in room 6-b to the bedside commode for the umpteenth time because your nursing assistant is busy or wait patiently as your 89 year old lady takes her 23 pills one by one so she does not get choked, patience.

Then there is problem solving. You may think that a nurses job is to do what ever the doctors have assigned her to do. Well there are times when they even look to us for feedback on deciding what there next move may be or a wound vac is not working and the wound nurse is caught up with 12 other previous calls and it may be the end of your shift before she can get your way, so you problem solve. You may also use it to solve a solution with a difficult co-worker or family member. There are times when the textbook method does not seem to work and you may need to modify it in order to treat a particular patient, such in the case of adhering a bandage to a dementia patient who continually keeps pulling it off and restraints are not an options. Management is always looking for ways to improve the flow on the floor or how to help make life easier for their employees and they welcome your thoughts and ideas.

Organization is a high must. Your working in such a fast pace schedule that if you don’t lay out a game plan when you find out your assignment, you will spend all day trying to catch yourself, and even when you do make a plan, there is always procedures and new orders that can change it so add being flexible to your list of qualities. I am an obsessive compulsive organized person so I would show up at least 30 – 45 minutes prior to my shift starting. I’d receive my assignment of usually 5-7 patients. I would comb the charts for previous orders for IV solutions, dressing changes, dietary order, medical history and etc… I had made my own personal template to keep all this handy dandy information at my finger tips, so at any given moment if asked or needed to consult for my own need, I was prepared. I also made a graph of my work shift in hours and mapped out all the meds. that were due for each patient on the hour and every hour, as to not miss my appointed times. Dressing changes were included on this graph when a lull in med pass was evident. This was updated during the day as new orders were written. Then I was ready to receive report from the nurse whose shift was ending. By the information she gave me I would prioritize my assessment schedule, those who were most unstable would get my immediate attention to assure that on shift change they are doing well. Then I would meet with my nursing assistant and convey to her what my plans were for her help during the day and to make sure she had the same info. as I did. Then you do your assessments. Now some nurses pref ere to document as soon as they complete an assessment, but I’ve found that I would get interrupted more often. Seems that if someone thinks you have time to type then you have time to help them with a need, be it co-worker or patient family member. So I just keep an assessment form that I made to jot down some quick notes that I refer back to when I get time to document later and I hit all my patients one by one from most unstable to stable. You’ve also need to keep track of all the new orders written during the day and be able to implement them into your schedule and make sure they get done and if not pass that information on to the next shift change nurse. Remember your not super women and you can not do it all.

So, by now you may have some idea if nursing is a career for you, but if you still need more time let’s move onto communication. Now communication does not stop at the end of your sentence. You have not truly communicated if the person you have communicated to does not understand your message. So in turn that person may repeat back to you what they believe you have said. If they got it right, then you have communicated, if not, you may need to restate yourself till they do. Nursing you communicate constantly with nurses, nursing assistants, doctors, therapist, family, patients and etc… You have to realize that peoples lives depend on you relaying and receiving the correct information. Yep, that’s right! You can save someones life just by being a good communicator. The tiniest error can be devastating. Take for instance the recent error in California with a famous actors newborns. The nurse received an order to give a dose of heparin, she did not hear the message correctly, she did not question the abnormally large dose. The adverse effects could have been disastrous, but thank heaven the babies came through fine. What happened? Who ever gave the order did not communicate correctly and the message was not received. When in doubt, ask. Even if that means calling a physician at 1:30 AM. Of course you want to use the resources of your charge nurse and fellow nurses before you make that call, that’s what you are all there for to give support and help. If someone has not communicated in a way that you feel you have truly understood or you have understood but the message does not make sense (like an incorrect medication dose), you need to confirm that what you understand is correct. This should be your constant method. Don’t second guess or make it up, there is no room for this in the medical field.

Now we come to understanding and I really feel we touched base with this on compassion and patience. You sometimes have to be able to put yourself into the patients shoes. How would you feel if your were being given a bath by a complete stranger. Wouldn’t you want the utmost privacy, so be understanding. Draw that curtain, so if someone walks in your patient is not exposed to the world. Only uncover what part of the body you are cleaning. Not only does that give them some feeling of privacy, but the elderly can get cold easily and this makes it more comfortable for them. Besides when your patients feel like you do take the time to be understanding, they in return can be understanding that it took you a little long to answer that call bell because you were bathing someone else. Also it can be for co-workers as well. Say a nurse begins to feel ill and needs to leave her shift early. That’s understandable, we all get sick from time to time. The patients can not take care of themselves so buck up and take on an extra patient and share the load. Or you walk into work and find out your being floated to another floor. Come on bite the bullet and be understanding, someone has to do it. Now if it turns your way constantly, you’ve got my permission to argue the fact that it’s someone else’s turn.

Once you begin to get settled in your career, don’t become complacent. There are always new and improved techniques you can learn, courses you can take and of course the never ending CE’s (continuing education) to earned. Become specialized in a particular area, such as IV access, phlebotomy, wound care and/or charge nurse. Be the best you can be in whatever area of nursing you choose, if it’s school nursing, skilled nursing facility, floor nursing or a private practice. Which ever area you choose there are always updates to keep on-top of and constant brushing up on previous learned skills. So let the desire to excel carry you to places you’ve never been before.

I’ve mentioned several times the position of a charge nurse. He or she is the lead nurse on the floor and gives assignments out to the other nurses according to the level of knowledge each nurse possesses. They are also your right hand man when your needing some input or assistance, as well as the one who you can refer dissatisfied patients and family. This would be in the area of management, but let’s not stop there. You could pursue floor manager or office manager. There are teaching positions at universities if this is your gift, but that’s not really what were talking about. Management I’m referring to is the line of authority on the floor. You’ve got your floor manager, then your lead charge nurse, then the RN or LPN, nursing assistants. You need to be able to delegate responsibilities to the level of knowledge and performance that individual has shown the ability to handle, and you are responsible that it gets done properly.
You will also need to keep up on physical therapy, radiation treatments and lab orders to name a few. These areas will receive an order to do the job, but as the nurse for this patient you will be the final check point that it did get done. So, if one of these areas has missed there schedule treatment, you will need to follow up with them to have it completed.

Nursing is a job that will require your integrity. Your honesty will be respected by all those who you work with. Let’s face it, your all depending on each other and who wants to depend upon someone who has been found to be dishonest and unreliable. We don’t want to admit we make mistakes, but if you find that you have, own up to it. Explain to your charge nurse what has happened and you can work together to find a solution to rectify the mishap. Don’t try to cover up if you made a mistake or missed a treatment or medication pass. Your honesty and integrity will be the foundation of your nursing, never, never give into temptation that no one will find out. Someone will and you will loose the respect of your piers.

All in all I can say that nursing has given me fulfillment in my life that I am able to help people in some of their most crucial moments. It’s not all been a bed of roses, there have been tears shed, frustrations, aggravation and feelings of being overwhelmed, but I would not trade my job for anything. So if you feel you’ve got what it takes, sign up for nursing classes and I’ll see you at the next shift change.