Thank a Nurse

Nursing is such an incredible, empowering, inspiring profession, but at the same time it can be overwhelming, depressing, and anxiety provoking- anyone who is/has been a nurse can attest to that. As nurses, we are fortunate enough to be able to touch the lives of so many , and many at their most vulnerable times. Yet because of this dichotomy, we are entrusted with a large amount of responsibilities, which can be overwhelming. With increasing censuses, patient acuity, and seemingly endless charting/documenting requirements, I sometimes feel like I am not able to be the best nurse I can be. I feel restricted by these things, and at times I even question myself “Did I do anything today to really help someone, or did I just do the bare minimum?”.  Personally I find that it can be tough to cope as a nurse in this environment- we want to provide the best care and we strive for excellence, but sometimes we feel we simply cannot meet the demands.  We often leave work burnt-out, sad, stressed, tired, and  all the while wondering if all of our hard, demanding, physically and emotionally exhausting work has just gone unnoticed. Then we may start to question ourselves as nurses. Is this why I went in to nursing, to feel like I can’t keep up, and to feel underappreciated?  Then, someone (anyone!) says “thank you” and for a small fleeting minute, the weight of everything else is lifted. It rejuvenates you. Crazy how two small words can mean the world sometimes, especially when we are feeling beat down and overworked.

a little humor but I can relate!

To preface things, I guess I should clarify that as nurses, we do not do what we do just so we can have someone say thank you to us in return, because that is just not how it works. But, a small thank you goes a long way — whether it’s from management, coworkers, a patient and/or their family. Sometimes it’s the moments like these that help to remind us why we do what we do and inspire to keep doing. Whether or not we are thanked, we will keep doing our jobs (and we will be damn good at it because we are nurses, but I digress).

Anyways, I have a little thank you story that I would like to share. I had a complicated patient a while back, during a really busy shift, with constant admissions and discharges in the higher acuity section of the emergency department. The patient was maybe in her sixth decade of life, chronically sick with cancer and was brought in due to an acute issue that the cancer was obviously not helping with. She was weak, in pain and frail. Her husband was at the bedside the entire time and  was very involved in her care. He was quite doting and asked a lot of questions, and provided a lot of the crucial aspects of the history of present illness – which is not unsurprising or unexpected in this type of situation. I even remember that he knew how to deal with her complex GJ-tube that she had (also not uncommon, it always amazes me what family members take on in order to care for heir loved ones these days). He stated that he often has to troubleshoot it because it gets clogged, or clamped down,  and he was trying to explain to me all the steps he normally takes.  While I am the first to admit that I am in no way an expert or genius with all the different types of tubes and equipment people may come in with, I still wanted to give it a try, because how hard could it really be, right?  After several minutes of tinkering with the tube to no avail, I ran out to ask another coworker for some assistance. When I came back in with a coworker, we both worked on troubleshooting the tube without obvious success. Meanwhile the patient’s husband had been chiming in, telling us what we were doing wrong, and letting us know what we had to do. I could tell that he appeared to get slightly agitated/frustrated when he felt like we were not listening to him. When my coworker left, the patient’s husband vented to me and said “I am sorry to get snappy but I really just didn’t like how she didn’t want to listen to anything I had say. It’s like she didn’t want me to bother her ego. It’s not like I don’t deal with this every day. I know what I am doing”. This was a little uncomfortable for me (I am sure it might have shown in my face) because I did not want to put down my coworker, but I too felt like maybe she brushed him off a little bit and at the very least, I  wanted to let him know I heard his concerns. I apologized and asked him to show me again step by step what he normally does for his wife’s tube. I said something along the lines of “sometimes we forget that you guys are actually the experts with these things most of the time and that we can ask you for help”.  As I continued to work on the tube, the husband, patient and I had a candid conversation about this and how frustrating it must be for the patient/family to feel like they are not being listened to because we (nurses/staff) are just running through the motions doing tasks. We eventually fixed the problem with the tube, at least for the time being, and the patient’s husband and the patient herself thanked me for my patience and for listening to them. In the moment it felt weird being thanked for this.  I told them they in no way had to thank me, that I was just doing my job. He told me that “even though 4 out of 5 nurses would rush through things , not taking the time to sit and listen, it was the one that actually does, that makes a difference . We always remember the ones like you, thank you”. This really stuck with me. I was so appreciative of their gratitude.  The patient was eventually admitted to a medicine floor, and my time as her nurse had ended . The next day I arrived to work and was told there was something for me at the secretary’s desk. To my surprise, there was a bag of chocolates and a card written out to me- the card read as follows:

“Dear Hannah… I know you were upset with me last night, but nothing I said was directed at you. We think you are a super professional nurse. We wish they could all be like you. We have seen the best like you, and we have seen the worst. Thanks for being so nice”.

I was delighted to have a personalized thank you card from this family, especially because I took a lot of my time trying to sit and listen to them when it was really busy and I felt like I had thousand other things to do. But I was also slightly taken aback that he thought he upset me. I didn’t want him to have to apologize for me when he was only advocating for his wife/loved one when he felt like no one was listening to him regarding the care of her GJ tube. But overall it was very heartwarming and gratifying to get this thank you card from him and his wife. Unfortunately, I later found out that the patient became septic and was transferred to the ICU earlier that day where she later passed away. Even though his wife was so sick , her husband took the time to write me this note and thank me on behalf of her and him. I was so touched, and still am.

We have the amazing ability to make a difference to people during a fragile time for them. There is no way we can remember ALL of our patients- usually we seem to remember the ones where something drastic, sad or crazy happened- but we have to keep in mind that they will likely remember their experience with us. Trust me, people will let you know when they have had a bad health care experience, they are usually not shy about this. I like to tell them that I am sorry they have had a bad experience in the past and let them know that I am going to try do my best to make it so that their next experience is maybe not so anxiety provoking or maybe not so negative in their mind. Sometimes, just acknowledging their concerns and sitting in listening for a few minutes (which seems like an eternity when you feel like you have 100 other things to do) goes a long way for patients/families. And maybe, just maybe they will thank you for listening to them.

Many times at work, I am juggling anywhere from  3-7+ patients in the emergency department, meaning their acuity can range anything from non-urgent to life-threatening. Ideally, if there are higher acuity patients in my assignment the ratio is better, but that is not always the case because things are ever-evolving in the emergency department. At any given time however, the constants are still the same: patients are requiring assessments, IV placement/bloodwork, pain management, medication administration, assistance with activities of daily living (ie: getting up to the bathroom or commode), patient education, food/drink, documentation (a whole other beast)…etc. So there are days when I am literally running  around from one room to another, trying to get all the needed tasks done, all the while, feeling slightly dejected that I am not spending as much time listening/talking to my patients as much as I would like to. I try my best to try to give all my patients my full  attention and try to present myself as though I am not rushed,  (even though in the back of my head I already have a mental checklist of the next 5 things I need to do as soon as I can leave the room) because that is what I would want for my loved one if they were the patient. But the sad reality is, that doesn’t always happen and I know that the majority of the time some patients get put on the back burner while I attend to someone who may be “more sick” or someone who more often than not, may be making more of a scene (overuse of the call bell, yelling out and disrupting staff and other patients, using obscene language , etc). This constant chaos leaves me feeling really burnt out and frustrated, but also makes me feel that I am not always doing a good job at my job (major sad face here).

Recently however, I had a few patients/family members acknowledge how busy the department was, and how busy I was running from room to room and despite all of that , they thanked me. Even though I felt like I didn’t necessarily do much for them to warrant being “thanked” for, I was elated, shocked, taken aback. These two small words went such a long way and were so gratifying to me, especially at a time where I was stretched thin and probably didn’t/couldn’t provide the best, most thorough nursing care ever. Moments like these inspire me to not give up hope and they remind me of why I became a nurse! (Am I the only one who gets over excited,happy, emotional when a patient/family member thanks me?)

And finally, this one sums it up perfectly — This gentleman came in to triage,  sat down complained of chest pain and was going through the triage process when he slumped over and became unresponsive and pulseless. He was quickly rushed back to a room and CPR was initiated. He received 1 shock for V tach and compressions were resumed while we attempted to get access in him for meds. As I was putting in the IV I felt his leg move and alerted the team- hes alert, hes awake!!! He started to move all extremities and then he was able to start talking to us. It was an amazing and satisfying feeling when you can revive someone like that. We quickly carted him off to the cardiac cath lab …and he ended up doing well and is now home recovering! He sent us this lovely card after the fact:

We Really Have the Best Jobs (info covered to protect privacy)

The fact of the matter is, we do have amazing jobs. We save lives. We get to be part of miracles like this. We don’t always get thanked, but when we do, it makes it all that much more beautiful.

XOXO,
Hannah

Food for thought: Think about a time a coworker thanked you for something you did, and think about how it made you feel. I know I am genuinely so appreciative of this, because I know we all are feeling the weight of patient census and acuity. I know that personally, when I have been thanked, it has gone a long way in my mind. I try to be mindful and thank my coworkers when I get the chance, because we are all bogged down and overwhelmed at times and we often forget to let each other know that we appreciate each other and recognize how hard we all work on a daily basis. It fosters an environment of caring- which is what we should all be about. Lets start the cycle of taking care of ourselves and one another, and appreciating and recognizing each other for all our hard work. Before you call out your fellow nurse on “why haven’t you done this or that” while getting/giving report, stop yourself and put yourself in their shoes– You don’t know what else they had to deal with on their shift.  Be appreciative of what they have done (versus what they haven’t done) and say thank you for that. Kindness and gratitude go a long way.  Thank your coworkers for coming in to work and putting their patients first, despite dealing with their families, personal issues, own crises. We all have lives outside of work, and sometimes we forget that. Thank them for coming in and doing their best they can to be a part of the team with you- recognizing that they may have left all their troubles at the door in order to do so. Don’t wait until shit hits the fan or some big/remarkable case happens to thank your coworkers (we are often good at thanking each other and recognizing each others’ hard work during extreme situations like codes, traumas, etc..) but sometimes we forget to say thank you to our coworkers in less “obvious” situations.  Thanks to all my amazing coworkers, who not only deal with my annoying/complaining ass,  but inspire me to be better every day. I love you all.

Friends Come & Go

I remember being younger and thinking that “friends are forever” and that I would be so blessed to have my closest friends in my life forever and ever and that nothing would ever tear us apart- we wouldn’t be like other people who grow apart- because that just would not happen to us. I am blessed to have had the people I called my closest friends in my life at some point, because I truly believe they helped me become the woman I am today, but we were not lucky enough to stay “friends forever”. The funny thing is that people come and go in your life everyday, some of them strangers, and some of them friends. Life is such a crazy, fast-paced ride that before we even realize it, sometimes we lose some friends and acquaintances along the way.

At High School graduation, I remember crying relentlessly, hugging my friends close. It was a mix of excitement and sadness; I would be leaving behind my friends, my best friends to go off to college. This is one the first experiences I had with losing friends. It isn’t like I even lost friends, I just lost touch with my friends and the relationships became strained between lack of communication, distance and different interests. I think this is a fairly common experience for this age group as we moved out of our comfort zones, tried to become independent and make friends with completely new people.

Fast-forward to college:

In college, you meet so many people it is almost overwhelming. But during this time period, I believe you meet some of the people that will become your lifelong friends. This was such a fun time in my life because I felt like I had such a wide variety of friends and so many acquaintances and I just remember it as being an extremely happy period in my life. We learn so much more than what we are studying in college; we learn how to live with others, how to deal with others and how to create bonds with people that will last a lifetime. I have a couple of friends from college that I consider lifelong friends and hold dearly to my heart and cannot imagine my life without them.

Then you graduate and things change again (FYI I hate change if you couldn’t tell). You move away, or your friends move away and everyone gets real people jobs or are studying for GREs and applying to more school. Friendships and relationships become estranged and you start to see which of your friendships are resilient enough to overcome all the changes and strain. Unfortunately, you realize that it is no longer convenient for certain friendships, or that without binge drinking on weekends you and another friend no longer have common interests, or simply that you just lose touch with one another. This is a sad time because I remember reflecting on just a few months prior when I was so happy and seemed like I had such a close group of friends. Now I had a real job, and my hours were crazy and I hardly got to see my friends and it was challenging to plan outings with everyone’s varying schedules.

Over the past few years, people have come in and out of my life- for better or for worse. There have been times when I have been so upset, stayed home and cried over a glass of red wine and sulked about why my friend doesn’t want to be my friend anymore , or why I heard that this friend was talking to that friend about me and I wondered what I must have done wrong.

I still deal with the sadness from time to time because I feel like over the past few months, my relationships with my friends have changed greatly. I have a few close friends who I would do anything for, and I know they would do the same for me. But then I look back and see there are such strained relationships with friends that I don’t even know if I can call friends anymore.

We used to be so close and do everything together- laugh, cry, cry because we were laughing so much. We used to tell each other everything, not fearing judgement from each other, we used to stuff our faces full of junk food just because we didnt care. We used to know each others schedules and we used to enter each others houses without knocking. And now I couldn’t feel farther apart- I don’t know what you are up to lately, I don’t know how I would even start a conversation with you if I saw you. I would hope that it would flow easily, but then again there has been so much lapsed time. Things just seem different. There have been a few challenges our friendship faced, but I never would have guessed they would have brought things to where they are now. I guess this is just part of the changes that occur. I will always look back on these friendships and smile at the memories, and occasionally I will be saddened by the fact that things are so different now. But what I have come to realize is that I can no longer sulk on this. Friendships are tumultuous, people come and go. Despite it all, those who are going to stand by your side will continue to do so and those who will slip away will slip away.  I cannot dwell on how things are different, and I won’t consider these “failed friendships”, but ships that have sailed in different directions. Maybe one day the wind will blow us both in the same direction again, or may it won’t. But I have learned something from every friendship I have had to date: it takes two parties to make things work and I cannot solely place blame or guilt on myself for these friendships not working out- that is just life.

I am so grateful for those in my corner- through all my good times and bad- they have helped me more than I can ever express.  As I move through this journey called life- this hectic, crazy, rollercoaster- I will hold my friends close by and let them know how much I appreciate them. I will not dwell on those friends that have slipped away; everything happens for a reason.

I have always been a people-pleaser, and I always wanted to be friends with everyone and make everyone happy, but I realized that I was doing that at my expense.  I need to care about myself and want to be friends with myself before I can expect others to want to be friends with me and this is one of the things I have learned over the past few years that I still need to work on.

XO,

Hannah

How have your friendships changed over the years?