Professional Role of a Nurse, and Ruth's Special School for Insensitive Caregivers

My first year of nursing school is nearly at an end; finals week is all that's left. My final assignment in one course was to write a self-evaluation that included a section on my concept of the professional role of a nurse, and the values of accountability, responsibility, and professionalism.

The day before I wrote my essay, I had witnessed an incident in the long-term care facility where I was doing clinicals that both saddened and infuriated me. Most of the staff there are wonderful people who really and truly care; but a few of them seriously need to have empathy transplants. This particular staff member had been impatient with an elderly woman, and had done what so many unthinking or uncaring people tend to do. She assumed that "old" means "deaf, demented, and stupid," and failed to respond to the resident's needs in a respectful manner, even going so far as to talk about her as though she wasn't sitting right there hearing every word that was said.

I know, from the amount of teasing I get about not liking movies with sad endings, and refusing to watch the news or otherwise subject myself to pain-inducing emotions, that I must be more empathetic than the norm. I apparently am able to experience someone else's reality in a more vivid way than usual; or maybe I just have a really low emotional pain tolerance. But even so, it can't be THAT hard to consider the consequences of your treatment of another human being, can it?

Anyway, that's what was on my mind as I was writing... here's what I wrote:

One thing that this first experience with clinicals has made even more real to me is how critical the job of a nurse is. It's one thing to read about it in a book, or discuss it in class. It's quite another to be in a care facility dealing with real situations instead of printed scenarios.

The clients are real. They are not room numbers or diseases. They are living, breathing, thinking, feeling human beings. Every single one of them is someone's mother, father, sibling, or child; someone with hopes and dreams, memories and regrets, and someone whose life, at least at the moment, is probably not going at all the way they had planned for it to go.

The decisions I make as a nurse will impact real lives of real people – not just the individuals I care for, but also their families, friends, coworkers, and loved ones. There is no room for sloppiness, laziness, or inattention.

When you get down to the core of things, accountability, responsibility, and professionalism are all rooted in the same concept: a willingness to set aside ego for the sake of integrity.

Having integrity is rarely easy. It means being accountable; taking responsibility for my actions even if it hurts my ego to do so because in retrospect I realize they might not have been as smart as they seemed at the time.

Integrity means taking responsibility – not trying to shirk from the hard or messy or demeaning tasks, even if my ego thinks they’re beneath me or someone else hasn’t done their share.

Integrity means maintaining a professional demeanor, keeping my composure even if my ego is screaming for justice, recognition, or revenge; taking the time to dress properly even if it's uncomfortable or inconvenient; and showing respect even if my ego doesn't think its deserved.

I have come to realize that becoming a nurse means being willing to sacrifice my ego. Other careers are about advancement and promotion and accomplishment, but not nursing. Nursing is about caring – and caring and ego are simply incompatible.

If I were Queen of the World, that staff member would at this moment be strapped into a wheelchair and impounded in a facility with the most mediocre nursing staff I could find.

She would be under the influence of drugs that would paralyze the right side of her body and make the movements of the rest of her body slow, painful, and tremorous. Another drug would cloud her thinking, making it difficult for her to concentrate, impairing her memory, and causing word-finding difficulties. Cotton would be stuffed in her ears to impair her ability to hear, and a brace would hold her back and neck in an uncomfortable curvature so that she couldn't look up to make eye contact with people standing erect. Oh, and eye drops would render her vision cloudy and blurred.

She would be awakened early every morning, whether she wanted to get up or not, and dressed in clothes that someone else chose for her.

At mealtime she would be wheeled into a dining room and put randomly at a table with other residents she might not know or like, and have a tray of blended gloppy food and thickened liquids placed in front of her. She'd have to just do her best to manage the utensils with her clumsy, shaky left hand, and she'd have to eat what she was given, whether she liked it or not. And when she was finished she would have to just sit and wait, with whatever food she had spilled running down her chin and strewn over her lap, until someone came to wipe her face like a child and take her back to her room.

The staff would never make small talk with her, and they would all use baby voices when talking to her, calling her "sweetie" and "honey" instead of using her name. When she tried to speak they would act as though she didn't make sense, and would joke with each other and make sarcastic comments about her within her hearing.

She would have to ask for help to use the toilet, and submit to waiting until it was convenient for some staff member to help her. They'd always act very put out about having to take her to the bathroom *again*. Then she'd have to sit there on the toilet until they felt like coming back to wipe her bottom. She'd lose the luxury of having a shower every morning, being able to brush her own teeth or hair, and if her underwear was put on crooked or her bra pinched or the heel of her sock was twisted out of place, there would be nothing she could do but just live with it.

If she was tired of sitting and wanted to lay down, it would have to coincide with the facility schedule. She couldn't lay down if it was time for lunch, or if the staff were all busy taking care of other people's needs, or just didn't feel like going to the trouble. She'd just have to sit there with her butt going to sleep and her back aching, unable to help herself, and being spoken to and treated as though she was a stupid child.

Boy, could I make her life miserable, by simply treating her the way she treats people every day. I bet after a week or two of it, she'd be doing things a lot differently. Or maybe she'd just go insane.