New 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.” Gradually he found himself building defenses that helped him to continue doing the work. Robb calls the development of these defenses “building a suit of armor,” one he can take off when he goes home to his family—but as he describes the process, it seems clear that he’s never allowed himself to slide into callousness about his patients.
Maybe the difference is that Robb remained aware of the existence of his own defenses (and able to write about them with honesty). He knows the danger of forgetting you are wearing armor. Of some patients, he writes:
“Their suit of metal fits so well that they forget it’s still on. These are often lonely people who rail against everything and everyone. They’ve been in their armor too long and they’ve forgotten how to be vulnerable—and how vulnerability can make you feel connected and, paradoxically, safe.”
Nurses new and experienced, and many people who are not nurses, will recognize aspects of their own experiences in Robb’s exploration of this important topic.
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