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When Brokenness Transforms Nursing

Hui-Wen (Alina) Sato, MSN, MPH, RN, CCRN, is a pediatric intensive care nurse in Southern California and blogs at http://heartofnursing.blog. Her Reflections essay, “Intimate Strangers,” appeared in AJN‘s August issue.

photo by Karen Roush/all rights reserved

I’ve had opportunities to sit in peer interview panels for new grad nurses looking to start their career in our unit, an experience which prompted me to consider what it takes to be a good nurse.

The obvious qualities were, well, obvious: critical thinking skills, strong communication, compassion, teachable, team player. But I’ve had a sense for a while that we nurses have been missing something when we consider what it takes to be a good nurse. While this something is strongly tied to empathy, it’s still a bit different. I tend to think of it as the nurse’s recognition and embrace of his/her own brokenness, even as the nurse looks to take care of others who are in some manner broken.

By brokenness, if the term is unfamiliar, I simply mean the awareness that we all know what it is to suffer, to struggle, to feel lost or wounded or weak. So in speaking of brokenness, I don’t mean it as a condescending lens through which we view everyone as objects to be fixed. I […]

2017-08-10T16:30:09+00:00 August 9th, 2017|Nursing, nursing perspective|3 Comments

PTSD and Falls: For the Elderly, a Lost Sense of Safety and Control

Jack lowers his head and presses his temples with his thumbs. He whispers, “Am I going crazy?”

In the weeks after his fall and trip to the emergency department, something has gone painfully awry. He’s been having episodes of anxiety when transferring from bed to chair as well as difficulty sleeping. His once unflappable optimism has been blunted by intrusive memories and ruminations about the fall and a sense of foreboding about the future.

Psychological Aftereffects of a Fall

Though he sustained no serious injury and had been quickly returned to the assisted living facility where he lives, the fall has left him with symptoms of posttraumatic stress disorder (PTSD). Most health care professionals are unaware that falls in the elderly can cause posttraumatic stress symptomatology, acute stress disorder, even PTSD. Indeed, in some settings falls occur frequently enough to insulate nurses and other medical staff from the awareness of how terrifying such an event can be or how it can undermine one’s sense of safety and control, particularly when it results in injury and/or invasive medical treatment.

Although Jack was under hospice care at the time of his fall, the facility sent him to the hospital because of its policy on ruling out head injury. Most hospices and facilities have protocols governing their response to falls. These typically include timely response times, […]

2017-07-19T07:34:30+00:00 July 19th, 2017|Nursing|2 Comments

The Inner Stretch of Nursing

Hui-Wen (Alina) Sato, MSN, MPH, RN, CCRN, is a pediatric intensive care nurse in Southern California. Her Reflections essay, “Intimate Strangers,” will be published in AJN’s August issue; her own blog is at http://heartofnursing.blog.

There is a level of discomfort nurses are pushed to that goes beyond tight staffing, busy 12-hour shifts, and mental tracking of our patient’s disease process. It is the inner stretch of our emotional, relational, and spiritual muscles. We are pushed to wrestle with questions and issues beyond what we find comfortable, and then we must learn to live with a certain unresolved level of discomfort. We can’t go back to a perhaps safe naïveté about life as we knew it before we saw how indiscriminate some forms of suffering and death could be. Our own theological wonderings come to light, and our capacity for vulnerability and intimacy is tested when certain patients find a way past the self-protective walls we put up. Sometimes, all the big questions of life loom over us in the course of one 12-hour shift.

We are stretched in how we think about quality of life.

My everyday thoughts about quality of life usually revolve around the quality of my relationships, how much free time I had to enjoy my hobbies, what delicious food or special coffee treat I […]

2017-08-10T16:31:00+00:00 July 14th, 2017|Nursing|4 Comments

How to Support the Nurse in Your Life

Hui-Wen (Alina) Sato, MSN, MPH, RN, CCRN, is a pediatric intensive care nurse in Southern California and blogs at http://heartofnursing.blog.

A quick Google search for “how to support nurses” reveals an emphasis on recommendations for hospital management on developing structured support for nurses at an organizational level. The search also captures popular articles on how nurses provide support to their patients. Ironically, the query results provide no resources to inform the nurse’s closest support system—families and friends—as well as the general public about what kind of support the nurse really needs and how to better provide it.

I attribute these search results, at least partly, to the fact that we nurses don’t always know how to articulate what we need. Some forms of support, such as treating a nurse to a mani-pedi or a spa day (or a parallel form of relaxation for our male colleagues) are of course always appreciated. But I’m talking about support of a more substantial sort, and this is why:

The reality: Consider the real experience, and thus the real needs, of the nurse.

When I consider the experience of nurses shuttling between full 12-hour shifts immersed in the care of complex and sometimes dying patients and periods of comparatively calm ordinary life with family and friends, I sometimes think of military members who […]

2017-08-10T16:31:45+00:00 June 14th, 2017|Nursing|5 Comments

Night Watch

Editor’s note: In this tightly observed guest post, a nurse visiting a sick family member experiences the hospital as a kind of foreign country.

Eileen McGorry, MSN, RN, worked as a registered nurse in community mental health for over 30 years. She currently lives in Olympia, Washington, with her husband Ron.

The walkway is hard, the concrete cold, and I am immersed in darkness. Then there is the swish of the hospital doors and whispery stillness. The light over the reception desk shines on a lone head, bent over a book. A clipboard is pushed toward me. The paper on it is lined with names, some boldly printed, others scribbled, the letters unrecognizable. The spacious lobby is filled with individual groups of soft stuffed chairs and love seats. All of it quiet and empty. Over the chairs and sofas, the black of the midnight hour is changed into twilight.

I remember the bustle of the area at midday. Families gathered together, eyes searching the crowd for the green scrubs of surgeons. “She will live,” they say to some, and to others, “We will wait and see.” The frenzy of the day over, the empty chairs wait for tomorrow.

I sign my name in script. I use the old Catholic school script. The script preached by my mother, who is upstairs recovering from heart surgery. I walk past the chairs along walls so white they gleam. I […]