‘Mommy, do you like your job?’

Photo by Tatiana Syrikova from Pexels

My five- and seven-year-old daughters are now old enough to understand that Mommy has a job as a nurse where she takes care of some pretty sick patients. From what I gather, their young minds really only seem to grasp that sometimes Mommy comforts her patients when they don’t feel well. As much as I would love to explain to them that my work as a pediatric ICU nurse is much more complicated and challenging than this, I also don’t mind them seeing me as someone who comforts others as a key part of my job.

But lately my five-year-old has started asking me more questions about my job: “What kind of patient did you take care of? How was your day at work? Do you like your job?” As one with a strong disdain for fluffy answers, even to a five-year-old, I’ve found myself considering how to answer her in a way that is both age-appropriate and honest.

When she asked if I liked my job, I thought about my patient writhing in agony yesterday—his loving parent present in the room—as we struggled to perform necessary interventions while also looking to get his pain under control without oversedating him. Our unit had three patients sick enough to each require two nurses, and mine was one of those patients. We were all exhausted and hungry.

I told her, “I like my job, but it’s really hard sometimes.” Curious about my kids’ perceptions of my work based on what they’ve heard from me, I asked her if she thought I liked my job. “I think so. I think I want to be a nurse when I grow up, and so does big sister!”

What would I want my daughters to know if they became nurses?

If I’m honest, my reaction to my daughter’s wish to be a nurse was bittersweet. There’s no question we need nurses. To be able to mentor my own children into this profession would be an incredible privilege. From what I’ve observed in my children thus far, I think they would do the job well. But I know the heartache I carry from 10 years in a pediatric ICU. I know how overwhelming some days can be. And I know this profession is not going to get any easier.

Do I want my children bearing those burdens, experiencing those heartbreaking days? Ultimately, the choice will be theirs, not mine. What would I want to be sure to cultivate and guard in my children—not as a clinical instructor but as their mother—if their interest in nursing or another profession involving direct patient care truly grows and stays with them into their college years and beyond?

1. The ability to gauge and protect healthy compassion for others.

I believe the majority of nurses enter the profession with a sincere desire to care for people who are suffering. I also believe the majority of nurses hit a point where they wonder how, or even if, they can preserve compassion without burning out. While I know I cannot malinger in memories of my role as witness to some of those stories, I also hope that I never lose the ability to weep with those who weep.

Preserving this balance has required constant self-assessment, paying close attention to when I’ve immersed myself too deeply into someone else’s story or, conversely, when I’ve begun to close myself off in a way that’s detrimental to my personhood and my practice as a nurse. It has also required some trial and error in learning what helps bring my internal needle back to the healthy range. My children may not turn out to be as intensely reflective as their mother, but I would still hope they thoughtfully monitor their wells of compassion and proactively take steps to maintain them.

2. The ability to recognize and nurture their own needs.

My children have watched me work as a nurse through a worldwide pandemic while also tackling the role of homeschooler in the past 14 months. They have seen me both hustle and fall apart like never before. My kids have also witnessed new boundaries and self-care practices emerge in me in response to these demands. I’ve explained what priorities are and why we need to tend to some and let others go.

I have also stopped apologizing so much and simply said, “You’re going to have to wait.” When the introvert in me has run out of energy to continue chit-chat with them, I’ve excused myself from conversations. My children have even become familiar with my practice now, about twice a year when I’m in need of a deeper level of restoration, of going to a favorite personal retreat site for two to three days. If they were to become nurses, I would encourage my children to individualize and integrate such practices in their own professional lives.

3. Security in their strengths and limitations, as well as a deep respect for teamwork.

Can I be transparent and say that nursing makes me feel amazing and terrible at the same time? I can’t deny I love the days when I feel my strengths were maximized for the welfare of my patient and his/her family. I love days when I feel organized, knowledgeable, efficient, compassionate, and present as a nurse.

There are also days when I know I’m in over my head. The patient is too sick, the pathophysiology too complicated, the tasks too many, my energy too low. I then marvel at, and humble myself before, the team that comes alongside to do the work together: the more assertive nurses advocate for what we need, the more senior nurses guide my prioritization, the medical team clarifies my confusion, the social worker provides the calming presence, and our care partners spring into action to run for the supplies they’ve kept organized. I would teach my children to know and use their strengths, but to also stand secure in their limitations so that they can delegate and ask for help when that help matters most—for not only them but for their patient.

4. The ability to identify and contribute to a healthy work environment.

One key element that has anchored me in PICU nursing has been the extraordinary management and team that I have the privilege to work with. Our managers care for us bedside nurses with fierce loyalty and recognition of our humanity. We have a unit culture in which we highly prize teamwork, mentorship, and a blame-free environment. The multidisciplinary relationships in our unit are for the most part healthy, with open and respectful communication always a priority regardless of title.

That said, we are not perfect, and constantly strive to refine our environment for the better by honoring each person’s place and contribution. I hope to teach my children to identify genuinely healthy work environments and ways to build up healthier dynamics, recognize signs of toxicity and bullying, and feel empowered to walk away rather than making themselves martyrs. I would never insist that my children attempt to do the already difficult work of nursing with the additional burden of an unhealthy work environment and would urge them to advocate for themselves.

5. A secure sense of their own convictions balanced with openness to others’ perspectives—particularly on the hard topics.

At some point, every human being, and most certainly every nurse, is forced to look suffering, illness, and death in the face. We are forced to ask ourselves what forms wellness, meaning, and a “good death” can take in an imperfect world, in imperfect bodies. I’ve developed my own convictions over the years, only to have them challenged, refined, and redefined as my experience as a nurse expanded.

Only by holding to my own core convictions while remaining open to the most opposite of viewpoints have I been able to stay moored in the many controversial and ethically challenging cases I’ve witnessed. When I think of my children coming of age in a world where medical technology continues to develop at an unprecedented pace, I hope that they will be able to stand firmly in their own convictions while gently leaning their open ears and gracious hearts towards people who may shock, offend, or simply ask to be heard in their differing perspectives.

A sense of optimism for the future.

As I finish composing this, I find myself comforted and optimistic for my children to be able to grow into grounded, healthy, hopeful individuals, regardless of what profession they eventually choose for themselves. I find myself also comforted and optimistic in moving forward after an incredibly difficult year as a nurse and a mother.