We often hear that nursing is an art and a science, and I firmly believe that. The way a nurse blends those aspects of care defines the nurse. As nurses, our roles in our patients’ lives vary depending on their needs. We are teachers as well as technical experts, and our ultimate goal is to ensure our patients and families are ready to take over when the patient no longer requires our care. Why I Chose Nursing I have known that I wanted to work with children since I was a young child myself. Before the age of ten, I thought I might be a teacher.
As I enjoyed math and science, several of my aunts, nurses themselves, encouraged me to consider nursing. As a sibling of a disabled child, I was probably exposed to more medical knowledge than average, and I took my first CPR class when I was eight years old. I liked the nurses and therapists that worked with my sister, but I also had respect for the teachers that worked so tirelessly with her. I can pinpoint the moment I decided that nursing was for me, though it was a long time before I could act on that decision. My sister had contracted hepatitis A at school.
That lowered her seizure threshold enough that she ended up in the intensive care unit. As it was winter, I was not allowed to visit her. At ten, I didn’t understand the concept of RSV restrictions. I only knew that she’d been hospitalized many times and I’d always been allowed at her bedside. Somehow I interpreted that to mean she must be dying, and no one wanted to tell me. I was in the waiting room outside the ICU while my mother was in with my sister, crying my heart out. A nurse walking by stopped to ask me what was wrong, and I spilled out my fears to her.
She escorted my into the unit, telling me that she was going to find a supervisor to see if she could get permission for me to visit my sister. In the meantime, there was a room where I could wait for her…. which turned out to be my sister’s room. After failing to get permission for me to visit, the nurse returned to escort me back to the waiting room. Before we left, she took the time to explain the monitors and what they meant, and went over my sister’s plan of care and discharge criteria with me. Hugely reassured, I was content to wait in the waiting room. More than thirty years later, that nurse’s compassion still sticks with me.
The Core of Nursing If compassion is at the heart of nursing, knowledge and skill must be its head and hands. Since the earliest days of nursing, the patient’s environment has been a consideration in their care. Florence Nightingale’s theory that hydration, nutrition, rest, and a clean environment were necessary to healing (Black, 2007) is a basic principle of nursing today. The world has changed since then, and nursing has changed with it. With every technological advance or new treatment modality, nurses have been called upon to be more than caretakers. It requires skilled hands to provide the treatments our patients need.
Throughout a patient’s stay, teaching is a primary responsibility of the nurse. Patients cannot make informed decisions on their care without adequate information. Whether teaching the relatively simple task of taking medications, or the more complex management of a chronic condition, it is a nurse’s duty to make sure the patient and family are trained and prepared to assume care once the patient goes home. The teaching required necessarily varies from patient to patient, and often from day to day in the same patient as he or she moves on the continuum between health and illness.
Finally, patients need to be able to count on nurses to be authorities in their field. Nurses must be accountable for remaining competent in their practice, and for continuing their education throughout their career (Killeen & Saewert, 2007). Beliefs and Values Patients have needs unrelated to their illness or injury. Having spent my entire career in pediatrics, often my focus is on developmental needs and what activities can be provided that support normal development. Some needs, however, seem to be universal. The need for play, learning, and social contact are not restricted to children.
Meeting the emotional and psychosocial needs of the patient without compromising the physical needs demanded by the illness or injury is occasionally a delicate balancing act, and is where the art of nursing meets the science of nursing. By collaborating with our patients and families and respecting their values, a plan can be reached that both supports their needs and involves them in their own care. From a pediatric perspective, the family is an integral part of the healthcare team. Parents are the primary ally and resource in providing individualized care for their child.
Even in adult patients, who they are is impacted by the relationships that they have. Serious or chronic illnesses and injuries affect the entire family. The family, then, becomes the patient, particularly when it is necessary to make lifestyle changes. I have been fortunate enough to work in a teaching hospital for over a decade, on a unit that has a strong sense of teamwork. I have watched residents grow from unsure medical students to capable attending physicians, and have been gratified to precept and mentor new nurses into colleagues that can be relied on.
Through we have a varied mix of skill levels, values, and talents, as a team we manage to form a cohesive whole. I count on my nurses to provide outstanding care to their patients, to hold themselves and each other accountable for maintaining high standards, and to support each other as needed. I also count on them for holding me accountable when the minutia of providing care for patients or my nurses gets in the way of my seeing the big picture. In my own life, it has taken me a long while to take charge of my health.
I am currently working hard to quit smoking, and have recently lost fifty of the extra sixty or so pounds I’ve been carrying. Like a lot of nurses, I put off preventative care, and wait too long before seeing a physician when I need to. This disconnect between my professional values and my personal behavior baffles me. I cannot expect my patients and families to view me as an authority on health if I am unhealthy. This year has been one of trying to bring my own lifestyle into line with my beliefs. Vision for the Future In two years, I will have completed my BSN.
At that point, I want to take a clinical instructor position while I pursue my MSN. I seem to have come full circle in what I want to be when I grow up, and combining my love of nursing with my love of teaching seems to be the best of both worlds. In five years, I hope to have completed my MSN. By that time I will have been a clinical instructor for long enough to know if I want to translate that to the classroom or perhaps become a nurse educator in an acute setting. I know I love teaching new nurses in my current setting, however I’m unsure of whether I would enjoy teaching in an academic setting.
In ten years, my goals are much more nebulous and largely depend on whether I have chosen to move to an academic setting or remain in acute care. In either setting, there are always things to learn and opportunities to explore. Someday, I would like to open a medical foster care facility, though I have doubts about that happening in that time frame. Summary The pursuit of my professional goals is a long-term plan. I enjoy learning, have the support of my family, and the path to my goals are clearly defined. I am detail oriented, and hope that will help me to reach my goals.
As I continue on this path, each success will pave the way to the next. Time management is an obstacle in my path, as I am currently working two jobs and trying to take care of my family while pursuing my degree. I am still learning how to manage all the demands on my time without stretching myself too thin. In addition, I sometimes get bogged down in the details and lose sight of the big picture, and then tend to procrastinate until I find my way again. Fortunately deadlines are effective in making me take a step back and rethink my approach.