Hui-Wen (Alina) Sato, MSN, MPH, RN, CCRN, is a pediatric intensive care nurse at Children’s Hospital Los Angeles and blogs at http://heartofnursing.blog. Her Reflections essay, “Intimate Strangers,” will be published in AJN‘s August issue.
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 have witnessed the horrors of war and are seeking to reenter “normal” life in a peaceful country. While members of the military experience a level of turmoil that is entirely “other” for a more prolonged span of time before making their reentry, nurses navigate the back and forth between hospital heartache and the everyday norms on a day-by-day, week-by-week basis. Members of both professions sense the experiential gap between their ongoing involvement with intense human vulnerability and other worlds not as overtly exposed to human suffering on a regular basis. This gap presents significant challenges for nurses when it comes to finding the kind of support they need to sustain their own sense of well-being.
Because the experience of a nurse is so unique and the issues can be so heavy, space is needed for processing events and emotions as well as for absorbing the sheer physical toll of the work. Unfortunately, what nurses often do is suppress and/or minimize the events and their related emotions. We do this for a lot of reasons. We want to protect you from the trauma and grief. We want to protect ourselves, too. We don’t know how to navigate the telling of our stories when the telling of our patients’ stories is strictly limited by law. We don’t know if you can meet us where we are. We feel like this is our professional life and it shouldn’t overflow into our personal life. The problem is, it does overflow in one way or another. A job this intense isn’t so easily contained in a separate professional box. For nurses to live healthier, more integrated lives, we need space for our experience, and this is how our friends and family can help.
Make space with your words.
Be mindful of ways your words can make a nurse feel the job is undesirable. These reactions are not helpful for nurses who may be fighting some degree of burnout or at least fatigue.
Please replace “I could never do that job” with “Thank you for doing such challenging and special work.” While nurses understand the former is usually intended as a compliment, it still suggests a strong degree of undesirability in the work of a nurse—this is not encouraging for anyone to hear about their chosen profession.
Please replace “How can you stand working with sick people all the time?” with questions like “What kinds of things have you learned from taking care of people who are sick?” Yes, it’s obviously not easy to work with people who are not well, but can we tell you that it’s also life changing, deeply meaningful, and at times full of beauty unlike anything in the “healthy” world.
Please replace “Why didn’t you just become a doctor?” with “What was it about nursing that drew you into the work over other health care professions?” There are specific reasons we chose and love our job, and we would love to share them with you.
Make space for the demands of nursing on nurses.
It’s hard to explain why 12-hour shifts in the hospital are so exhausting and why a full 8- to 9-hour night of sleep followed by a full day off can still be insufficient for rest and restoration. You may not understand why this is so; honestly, neither do we nurses. We just know it’s a real issue, and it’s hard to hear our friends and family members say, “You only work three days a week; you’ve got it so good.” Granted, we probably shoot ourselves in the foot when we post Instagram photos of our feet up at the beach on a Thursday afternoon—it really does look like we’re always the ones relaxing while you’re at work! Don’t be fooled. Like any social media dynamic, this is only a sliver of our lives—usually the positive one—and it most certainly does not tell the whole story.
Even if none of us can explain why we are so exhausted, please make space by validating the real demands on our shoulders. And backs. And feet. And hearts.
Make space with your courageous empathy.
We nurses understand that different people have different levels of tolerance for hearing about the issues and events we deal with at work. We don’t expect or even desire everyone to engage us about it to the same degree. But what I would challenge friends and family members of nurses to consider is this: Recognize that the discomfort you feel in hearing about the nurse’s work is the same discomfort the nurse lives with in doing the work, just to different degrees. From that common ground, would you be willing to let your courage and empathy stretch a bit to support your nurse friend?
One day after a particularly difficult shift, I was supposed to have coffee with a friend who is not in the medical field. An hour before meeting up, I found myself fighting tears while at the park playing with my daughter. I felt it only fair to text her and warn her that I was a tangled web of grief. Her reply floored me. She told me she was willing to give me personal space, or come and just sit with me in my grief. I told her I would love to sit with her, but I was afraid of overwhelming both of us. She told me I did not need to protect her.
She made space in her heart, and sat with me with openness and vulnerability. She kept me from staying isolated with my experience as a nurse, and entered into my world for a while. I cannot fully explain the weight that lifted off my shoulders and the peace I had for the rest of the week because of how she made space for me. At the cost of her own comfort, she met me where I was and helped me untangle myself from my shift. I was able to return to work, restored.
Finally, for nurses: We need courage to make space for ourselves, as we let our friends and family into our world.
This means we risk being misunderstood. We risk being asked questions we don’t want to be asked, or hearing comments we don’t want to hear. We risk bringing emotions to the surface that sometimes we would rather suppress as much as possible. But as we find those friends and family members who are willing to be stretched to make space for us, we can find a new courageous, healing space not only for us individually, but together as a profession.