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Studying the Ordinary to Know the Extraordinary

Hinds, Pamela S. PhD, RN, FAAN

doi: 10.1097/NCC.0b013e318233410e
DEPARTMENT: From the Editor

The author has no funding or conflicts of interest to disclose.

There are 2 words that describe the nature of nursing, nursing practice, and thus oncology nursing. These 2 words are ordinary and extraordinary. The word ordinary sounds small, but this word may be the largest explanatory factor for all the good that happens when we as nurses give care to another person. Ordinary is a part of every patient encounter, and it is through this small sounding word that extraordinary can be recognized for what it is. In our practice, the one (ordinary) leads to the other (extraordinary).

Please consider and respect that within you which is ordinary. It is the ordinary that assures us of making a human connection even with complete strangers for whom we may be caring for the first and last time concurrently. As a nurse and as a nurse researcher, I have had the privilege of working with children and adolescents who have incurable cancers and others who will experience cancer treatments that are life-threatening. I had the opportunity to be the nurse researcher for a young adolescent during her first cancer, during her cancer recurrence, and during her subsequent high-risk treatment. From the first, she was feisty and, on several occasions during treatment, was arrested in her home state for behaviors described by her as "doing things no girl should be doing." She was far more experienced in certain ways of life than I, although I was many years her senior. She would describe her escapades to me, and I would respond in amazement "really?" When she was very ill after a bone marrow transplantation, without hair; her skin sloughing; her face, hands, and feet swollen, she asked to speak with me about the possibility of dying when you are just 16 years old-we did speak of this possibility carefully though briefly-and then she redirected the conversation, "Okay, now let's just talk about the one part of my body that is normal-ordinary, looks like everybody else." "Okay," I said, as I looked into her very swollen face, her face without eyebrows, head without hair and skin sloughing from her ears, neck, head, and torso. She pointed to her hands and said, "My fingernails-they are the one part of me that is like everyone else. Let's talk about fingernails." And we spoke for the next 15 minutes about fingernails. Ordinary meant being normal-being a part of the everyday world even when seriously ill and keenly aware of all that is unusual about oneself. It is the ordinary in us that assures others of their normality or of their belonging to the every day.

She survived that very tough period-a long hospitalization and with residual effects that affected her in important ways. Upon occasion since that time, she has reminded me of her favorite night-the night that we spoke of her fingernails, or the ordinary-the ordinary that contributed to a human connection between 2 very different persons. How is it that what is so ordinary can be so memorable to patients and their families across time and place?

Our recent research has included listening to parents of desperately ill children describe why they made certain treatment choices on behalf of their very ill or now deceased child. We do this research to learn how we can give care that will better support families of seriously ill children. The memorable moments reported by these parents include what we in oncology nursing might refer to as ordinary, yet for the parents, these moments sustain them long after the loss of their child. One father described his memorable moment as "The nurses got to know me very well. They saw me at my worst-my ultimate, absolute worst. So when they said what I remember the most clearly, I could believe them. They said, 'you are a good father.'" Five words-"you are a good father"-spoken by nurses. Almost every one of those words is a single syllable-ordinary words we could say-and yet those are the words recalled by a grieving parent over time as his most sustaining, positive memory during and after the loss of his child.

What is extraordinary for its commonness in uncommon circumstances is the human connection made by cancer nurses in their everyday work. How can we philosophically or scientifically explain the human connection that nurses make in minutes with strangers? How do these connections seem so ordinary that their extraordinary nature that helps or heals a condition in another person could be unnoticed? Ordinary is linked to the amazing and the difficult to explain. We need to continue to study the ordinary in oncology nursing for its time-spanning benefit to others.

My very best to you,

Pamela S. Hinds, PhD, RN, FAAN

Editor-in-Chief, Cancer Nursing

© 2011 Lippincott Williams & Wilkins, Inc.