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The Nursing Shortage

PRECEPTING: Putting Myself in Her Shoes

DEHOOG, JILL

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Journal of Christian Nursing: October 2004 - Volume 21 - Issue 4 - p 30-32
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In Brief

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You'll precept Billie Sue? my nurse manager, Karen, asked after briefing me about the new nurse who was reentering the profession after sixteen years as a full-time mom. Karen added, “Since you know what it's like to come back after several years, you're just the one for this assignment.”

“You bet,” I enthused. “I can't wait to meet her.”

In my mind I thought I had already met her. Billie Sue would be Southern born and bred, a blond in her early forties (too much older and she wouldn't be able to withstand the physical toll of resuming a nursing career). I could identify with how she must be feeling—I had left the profession and reentered after eight years. Billie Sue would show up the first day suffering from high anxiety and a need for the nearest bathroom.

The day I met Billie Sue I found out she wasn't forty. She wasn't blond, and she wasn't a Southern belle, by any stretch of the imagination. No, Billie Soo wasn't anything like I thought she'd be. After all the energy I'd spent planning our time together, putting myself in her shoes and thinking I knew her and what she needed from me, there was a lot about this woman that I had never considered. I guess I assumed that she would be, well, just like me!

A whisper from God pierced my heart. The mistake you made with Billie Soo is the same mistake you make with me. There's so much about me that you think you know, and you are wrong about much of it. You've been trying to put yourself in my shoes, too.

Ouch! Maybe I have spent much of my walk with the Lord putting myself in his shoes instead of walking in his shadow. It was time to take two steps backward and start again. I asked the Lord to show me Billie's heart, to show me what she needed from me and why he had given me this particular assignment.

It didn't take long to receive answers, and I didn't like all of them. I learned I needed to listen more than I talked, which seemed to run counter to mentoring. Shouldn't Billie listen to me, as I waxed poetic about managed health care? How could she learn everything she needed to know about nursing in today's world? I discovered that before she could learn from me, Billie had to learn to trust that I wouldn't judge her because of what she didn't know. I understood the temptation to impress a preceptor, afraid to admit being on the underside of the learning curve on a few nursing skills. Nursing isn't a career to bluff your way through. Billie needed to trust me enough to ask questions.

The similarities to my relationship with God were starting to break out like a bad case of the hives. God never gets tired of teaching me the same thing over and over. He listens to me and tailors my instruction toward my needs, helping me see needs I don't realize.

LOOKING BEYOND

What were some of Billie's other needs, and how could I help her meet them? Billie was experiencing significant life changes—the death of her husband, her youngest child leaving for college, and Billie living alone for the first time. It occurred to me that Billie wouldn't react like a new sponge, ready to soak everything in and retain it. Billie needed repetition of thought, word and deed, because she didn't learn the first time. This was not reflective of her intelligence or nursing skills. Rather, once she got it, she really got it.

Billie needed time to herself during the day, whereas my work ethic kept me running from the moment I hit the floor at 6:30 a.m. I didn't slow down until leaving twelve hours later. I rarely took breaks, so it surprised me that Billie was able to accomplish everything despite her breaks. Daily she managed to find a quiet spot and take a few deep breaths every few hours. She told me it allowed her to refocus so she could give more of herself. Unlike her preceptor, she rarely seemed exhausted at the end of the day, even though she was ten years older.

Billie never hurried. I tossed out bits of wisdom while racing to put out the next fire. Expecting a reply, I would look around for her. She was never on my heels and barely in my zip code area, as she walked at the same slow, steady pace. It drove me crazy! Would you please keep up with me? I wanted to shout. My tongue was sore from continually biting it.

My orientee told me that when things got crazy, she deliberately forced herself to slow down. That way tasks were usually accomplished with fewer complications. I formed a picture in my mind of all the complications I encountered in my rush through life. I often had to retrace steps because my haste made me forgetful.

Watching Billie, I learned to manifest peace and tranquility to my patients. Billie's quiet, calm demeanor was reassuring to a patient whose pain was spiraling out of control. When dealing with a difficult patient, Billie melted away crabbiness with her serene smile. Few things flustered her.

Billie encountered hard challenges during her orientation. One particular patient, in whom Billie had invested much time, and quality nursing care, which included the TLC any patient would enjoy, suddenly didn't want Billie back in his room. Later we discovered that a staff member had made inappropriate comments to the patient and his wife about Billie's Asian heritage, causing the patient to question his formerly favorite nurse. Had they mistaken Billie's unhurried style for incompetence?

This same coworker pulled me aside to report that Billie had been rude to an elderly patient's daughter when another of Billie's patients had coded. I was told the daughter was angry because Billie had left before she could start the mother's dressing change, even though Billie explained she had to attend to an emergency with another patient. According to the staff member, the patient's daughter was irate at Billie's rudeness, asking, “Isn't my mother as important as any other patient?”

Billie and I discussed the situation. As her preceptor, I thought it best to intercede with the nurse manager about the complaints, but Billie would not let me. She begged me to let it go, saying it was important to learn to get along with anyone who was uncomfortable with her cultural differences. She wanted to set things right—not because she was Chinese, but because she was a Christian. I watched from the hallway as Billie apologized to the patient's daughter, explaining in a more detailed way why she had left so suddenly. We discovered the daughter wasn't nearly as upset as we had been led to believe.

Billie wasn't finished making apologies. She asked me to accompany her as she sought out the mischief-making staff member. “I'd like to ask your forgiveness,” Billie told her.

“What for?” the staff member asked, eyeing her suspiciously.

“You were placed in an awkward situation because of my actions. You were forced to bear someone else's anger, and then felt that you had no choice but to go to my preceptor. That had to have been a difficult situation, and I am sorry.”

There were no further complaints about Billie.

I had wanted to charge in and fix things for Billie, but she didn't need me as her savior. She already had one and, thankfully, it was Christ's example that she followed, not mine.

OUT OF THE BOX

We hear about placing God in a box. I discovered that the box in which I try to place God is an idol box. I am creating a god I think I know all about—a god I can relate to on my terms, a god who allows me to walk in his shoes instead of following in his shadow.

I had tried to do the same with Billie Soo. Once I let go of my preconceptions, Billie began to show me her real self. I learned what she needed from me—someone willing to listen and care. We bonded in a way that could not have occurred had I remained fixed in my idea of what she needed and what she was like. And I had to come to terms with another truth: I was trying to mold Billie into my image—a common mistake among preceptors.

Billie Soo taught me more than I ever taught her. However, I had to take her out of the box I had placed her in and see her as she really was. I decided to take God out of the box I had placed him in. God is no longer my idol, a god of my own making. He is my Savior and my king, my teacher and my counselor. I discovered that as I took God out of my box of preconceived ideas, he began showing me who he really is. And I will never be able to walk in his shoes.

Copyright © 2004 InterVarsity Christian Fellowship