Bringing Redemptive Voices from Greek Tragedy to COVID’s Frontline Clinicians

Bearing witness.

I enter my patient’s room and hear the sucking click as the door slides shut behind me. Vacuumed silence, negative pressure—but all the pressure in the world seems to settle onto my shoulders, my head, and down through my back, filling my feet like wet cement.

I need to move. His oxygen saturation is dropping again. He’s grimacing. Is he in pain? I wonder as I step closer to the bed. My pulse quickens as I take in the scene before me: glassy eyes inset upon a sunken, sallow complexion; bleeding mouth; the imperceptible rise and fall of chest to the biddings of the ventilator; swollen limbs. A lock of hair falls into my eyes, but my PAPR hood prevents me from pushing it aside. His heart rate and respiratory rate are higher now. Maybe he needs more sedation. If only he could speak. I take in a measured breath of filtered air as I suction his breathing tube. Breathe.

The doctor appears and is talking to me, but her voice is barely audible above the steady stream of air rushing past my ears. We’re practically shouting. The plan, a combination of trial and error, science, and visceral, pit-of-the-stomach intuition, is shaky at best.

As she moves away toward the door, I want to call out to her, to beg her to stay, to look upon the suffering and feel its weight, but I am silent and she disappears into a sea of blue scrubs. I am alone in this sealed room […]

2020-08-27T09:45:26-04:00August 27th, 2020|Nursing|1 Comment

Reexamining Resilience

Words matter.

As I have been presenting at various nursing gatherings and conferences about the topic of resilience in light of work-related grief, I have been struck anew by the definitions of resilience that I find in the literature.

  • The ability to return to a state of normalcy or to “bounce back” from adversity or trauma and remain focused and optimistic about the future (Dyer & McGuinness, 1996).
  • The “ability to face adverse situations, remain focused, and continue to be optimistic for the future” (Kester & Wei, 2018).

While I understand and very much appreciate the intent (and necessity) behind these definitions, I have to ask whether we are adequately exploring the meanings of the words used within these definitions and the implications for what nurses should expect of themselves in seeking to be resilient.

Does short-term resilience look different from long-term resilience?

For example, in the definition presented by Dyer and McGuinness, a resilient nurse should be able to return to a state of normalcy. There is certainly a need for nurses to be able to maintain a steadfast mind and emotional state in the short-term moments of acute crises with their patients. A nurse returning to work after a difficult shift just the day before has to find […]

Adapting to the Emotional Toll of Nursing

take2refectionsillustrationsept2016New nurses may find themselves confronted with great human suffering, enormous technical challenges, and the norms and pressures of the nursing profession and the individual workplace.

Most eventually learn the skills and knowledge they need to succeed in the profession. But some may struggle more than others with the emotional intensity of the work. A question that seems to come up a lot when nurses write about their work goes something like this: How do you keep caring as a nurse and not get burned out? How do you develop a resilient professional persona?

This month’s Reflections essay, How I Built a Suit of Armor (and Stayed Human),” by Jonathan Peter Robb, enumerates the challenges faced by a sensitive new nurse and the ways he found to protect himself over time. Here Robb, a district nurse for the National Health Service in London, England, describes one kind of challenge he faced:

The weight of being responsible for a person’s health wasn’t one I had prepared for. Sitting in lectures doesn’t train you for the moment when you’re standing at the end of a bed looking at a patient who is struggling to breathe, semiconscious (but who just last week was sitting up and talking), and thinking: Did I miss something? Is this my fault?

As Robb writes, “caring hurts.” […]

The Challenge of Bearing Witness to Patient and Family Suffering

“How do I honor this pain so that it teaches and blesses and does not destroy?”

By Jacob Molyneux, AJN senior editor

Illustration by Neil Brennan. All rights reserved. Illustration by Neil Brennan. All rights reserved.

This month’s Reflections essay (Why?) is by a pediatric chaplain. As the title indicates, it’s about the questions we all ask in the face of suffering and loss. The precipitating event for the author is the baffled, enraged cry of a father who has lost a child, and her own struggles with the impossibility of giving an acceptable answer—to the child’s parents, or to herself as a daily witness of loss and suffering.

How does a chaplain, or for that matter a nurse, witness the pain of patients and their families time and again and keep from either shutting down or being overwhelmed by the stress and emotion? As we’re often reminded, self-care matters or there’s nothing to give the next time: yoga, gardening, humor, family, cooking, whatever works for a person. Is it enough? Yes, and no, says the author. Here’s an excerpt:  […]

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