Hmmm- Is Nursing a Talent?!

Is nursing a talent?

This is, evidently, the thought that went thru the mind of Michelle Collins of “The View” (according to one of her now deleted tweets). I really go back and forth on this statement. Is it a talent? If it is a talent, can’t all careers be a talent? Or are we just truly that special?

I do know that I have worked with some co-workers (nurses, doctors, techs, etc) that should NOT be in the healthcare field. They are in it for the wrong reasons. But does that mean SOME nurses have talent and others don’t? So then we think about-what classifies something as a talent? Does that vary person to person? If so, was Collins in the wrong?

I think about my first couple months off of orientation as a staff nurse. On this day I had a student nurse with me. I was showing her what I did, she gave medication with her instructor, she asked me questions. This is a teacher aspect of nursing. I remember getting a report and one of our patients was end of life.

How do you approach someone who is at the end of their lives? This is not the first time for me. I used to work on Oncology and Palliative Care units as a tech, I also worked in the Emergency Department. We dealt with death all of the time. End of life is what I seem to do fairly well-Palliative Care probably will be where I end up in the long run of my career. I think I help my patients transition comfortably.

But back to the nursing student with me. I asked her a few questions 1) how are you with death? 2) have you come across someone who has died? 3) have any one in your family passed? 4) are you okay with dealing with this aspect of the career? If not, is there anything I can do to make it better for you to process it?

Back to the patient. I knew her. I had her as a patient before. When I had her previously, she was awake and talking. I never saw family visiting her (this is common). When we walked into the room, I had the student nurse evaluate the situation. She was sitting up in the bed, but pretty much non responsive. Her family (whoever they were) decided that they wanted her on tube feedings. Why? Perhaps they were in denial? Perhaps they didn’t understand how close their loved one was? Perhaps they were hoping for a miracle? I do not judge why-if they are around, I just try to help them with the process.

The student nurse stood back while assessing. I could tell, she was not that comfortable. She didn’t know what to do. At first it was difficult for her to engage with the patient. How do you engage with someone who is not talking back? With someone who is not looking at you? With someone who is not talking, eating? With someone who Cheyne-Stokes breathing pattern? Someone who is clearly not going to make it to the end of our shift. Her legs are mottling. Even newborn healthy babies respond in some way to contact.

We step out of the room, and I asked her how she felt. She said that she was overwhelmed but okay. I reviewed the situation with the doctor and in the long run-he called the family. The family still did not come in. For whatever reason, I do not judge.

I knew the mission of this particular patient. But before I spent time with her, I wanted to introduce myself to my other patients for my shift. I did just that, quick visual assessment. Introduced myself, made sure they were not in any distress, made sure they were not in pain, etc. Basically making sure they were vital, stable, and happy.

Upon returning to the room, nothing changed much other than her breathing slowed. I reviewed this with the student nurse. It’s one of the signs. I reminded the student that, as far as we know-someone’s hearing is the last to go so it’s okay to talk to them. She did but you could tell it was awkward for her.

I approached my patient and I brushed her forehead, held/rubbed her hand and told her “it’s okay to go, everyone here is going to be okay. It’s okay to be comfortable. You don’t have to suffer any longer. Your family is going to be alright.”

I rubbed her leg and repeated that she was free to go. “Just relax.”…”Just let it all go Ms. ____.”

I could tell…we could tell- her shoulders relaxed at that moment. As if a big weight has been lifted from holding her down. Then she passed away within a few minutes. She was not alone. She was comfortable. She did not struggle. She appeared to be in no pain.

I saw that tears were starting for the student. She removed herself from the room. I stayed, turned off the tube feeding, put her head down and went out to call the doctor to pronounce. I left the oxygen on until the time of death was called.

After I hung up with the doctor, I went to the student (who was in the break room). I asked her if she was okay. I asked if it was something in particular.

She looked at me and said (as she’s wiping tears)-“you read about it all of the time but you do not expect to see it happen. You hear that it’s okay to tell them to go but to actually see it is…WOW!” And she thanked me for the experience. This did not shock me. I have had this experience many times before. As a nurse or as a tech, I had always told my end of life patients that it was okay to go and I’d witnessed them go by the end of the shift.

Is that a talent? Or just mere compassion? caring? Can compassion be a talent? Can everyone do it?

I don’t necessarily think it’s talent but I certainly don’t think everyone can do it. Be it, the end of life process or the birthing process or the psych process or the trauma process or the teaching process-one nurse cannot necessarily do another. But hear me out-I don’t think Miss Colorado was in the wrong for doing what she did. I actually applauded her and shared the clip (before this The View fiasco). I was proud of what she did. Nurses are important. Police are important. EMTs are important. Doctors are important. Teachers are important. We are all important. I cannot sing-thus I don’t have that talent. I cannot do standup comedy-thus I don’t have that talent. I can, however, help the process of dying-is that a talent (I know that not everyone can do it)? or a calling?

Is it a matter of potato, patato? Does it really truly matter? Or is it the context of how the ladies on the View (quite frankly, I was more offended by Michelle Collins and followed by Raven than I was Joy Behar) presented it?

Either way, I stand by my previous blog post-I hope this social media publicity sheds light to the real issues facing nurses and healthcare. I hope that there are adequate staffing ratios so I can do my nursing talent/calling and spend that time with my dying patient as I was able to do with the above patient.

Her, like a lot of other patients, remain with me. I think of them often. This is not a job that I leave at work.

#NursesUnite

#compassion, #joybehar, #michelle-collins, #nursing, #palliative-care, #talent, #theview

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