In 2007 a student nurse called Lisa Kenyon wrote to the Kai Tiaki asking questions about nursing. I’ve reprinted her letter here and then my response. It seems relevant at the moment
I am a year-one nursing student from Waiariki Institute of Technology, doing my bachelor of nursing at Windermere in Tauranga. I have recently been out on my first practicum for three weeks and have come away with a multitude of questions. I am a 34-year-old married woman with a child, and consider myself experienced in the traumas and joys that life can bring. After finishing my practicum, which I thoroughly enjoyed, I was left reflecting on my personal experience with the elderly.
I cared for a dear man who unfortunately died in my second week of being his student nurse; I was so privileged to have spent that time with him and his family. But I was left with a list of questions and thoughts to which I have no answers. Maybe there are no answers and maybe, with more nursing experience, these questions will make sense, but for now I want to share my thoughts and wonder how other experienced nurses or student nurses have overcome these difficulties.
The questions that bother me are: Can a nurse “care” too much? Don’t patients deserve everything I can give them? How do I protect myself and still engage on a deeper level with the patient? How do I avoid burnout? Why can’t I push practice boundaries, when I see there could be room for adjustment or improvement? Isn’t it okay to feet emotionally connected to the patient? Don’t I need to continually ask questions, if nursing is to change, or will that just get me fired?! Finally, am I just being a laughable year-one student, with hopes and dreams and in need of a reality check?
I would really appreciate feedback from other student nurses who have felt the same or from experienced nurses with some insight into these questions, as I am left doubting what kind of nurse I am going to be.
Lisa Kenyon, nursing student, Waiariki Institute of Technology, Tauranga.
My response below:
I was pleased to see Lisa Kenyon’s letter, Questions haunt nursing student, in the December/ January 2006/2007 issue of Kai Tioki Nursing New Zealand (p4). The questions she has reflected on indicate she is going to be an amazing nurse.
I believe nursing is both an art and a science, and our biggest tools are our heart and who we are as human beings. I was moved by her letter and thought I’d share my thoughts. The questions she posed were important because the minute we stop asking them, we risk losing what makes us compassionate and caring human beings.
Let me try to give my responses to some of the questions Lisa raised–I’ve been reflecting on them my whole career and continue to do so.
1) Can a nurse “care” too much?
Yes, when we use caring for others as a way of ignoring our own “issues”. No, when we are fully present in the moment when we are with a client.
2) Don’t patients deserve everything I can give them?
They deserve the best of your skills, compassion and knowledge. Sometimes we can’t give everything because of what is happening in our own lives, but we can do our best and remember we are part of a team, and collaborate and develop synergy with others, so we are resourced and can give our best.
3) How do I protect myself and still engage on a deeper level with the patient?
I think we have to look after our energy and maintain a balance in our personal lives, so we can do our work weft. We also need healthy boundaries so we can have therapeutic communication.
4) How do I avoid burnout?
Pace yourself, get your needs met outside work, have good colleagues and friends, find mentors who have walked the same road to support you. I’ve had breaks from nursing so I could replenish myself.
5) Why can’t I push practice boundaries, when I see there could be room for adjustment or improvement?
I think you can and should, but always find allies and justification for doing something. Sometimes you have to be a squeaky wheel
6) Isn’t it okay to feet emotionally connected to the patient?
Yes, it is okay to feel emotionally connected to the patient, but we also have to remember that this is a job and our feelings need transmutation into the ones we live with daily.
7) Don’t I need to continually ask questions, if nursing is to change, or will that just get me fired?
Yes, you do have to ask questions but it is a risky business. Things don’t change if we don’t have pioneers and change makers.
8) Finally, am I just being a laughable year-one student with hopes and dreams, and in need of a reality check?
No, your wisdom and promise are shining through already and we want more people like you. Kia Kaha!
Ruth DeSouza RN, GradDipAdv, MA, Centre co-ordinator/Senior Research Fellow, Centre for Asian and Migrant Health Research, National Institute for Public Health and Mental Health Research Auckland University of Technology