In my career, I believe that the combination of my movement between practice and teaching has made me a better nurse, educator, and dean. As both artists and scientists, nurses believe that humans are biological, psychological, social, cultural, and spiritual beings (Engel, 1977). This belief guides both academia and practice. Leaders on both sides of the diploma talk about the gap between academia and practice and the necessity for academia to produce highly functional, self-reflective nurses who are kind, caring, empathetic, and compassionate.
Recently, I reflected whether a focus on the personal and professional qualities we expect in nurses is still valuable. I believe the energy and time devoted to this cause are well worth the investment.
When my dad's healthcare journey took an unexpected turn at age 82, he was strong and active, taking care of everyone around him. He was relatively healthy, except for one thing: idiopathic pulmonary fibrosis.
My dad's illness progressed faster than we could comprehend. He left the world in the same manner he lived his life: actively devoted to fighting for every last breath. His was a horrific death that still traumatizes me.
However, the nursing care my dad and our family received lightens my grieving. The nurses gave me the strength to get through the dying process. I saw in practice the compassionate patient/family-centered care that I teach my students.
As my dad declined, you, his nurses, did not pressure us to change his status to palliative care or hospice. You never made us feel that we were wasting your time because you could not save him.
NURSES PROVIDED CARE
Despite the inevitable outcome, you did not distance yourself from my dad. You were kind and encouraging. You explained everything to him, even when he was no longer lucid and fully present. You moved purposefully and quietly about the room, completing your tasks as we sang to dad to calm him. You continued your routine care and smoothed his hair, even though he was dying.
You were patient as we slowly realized that there was no hope. I heard you advocate for my dad when the physicians wanted to give him more of a medication that had caused a paradoxical reaction which resulted in agitation.
I heard both respect and remorse in your voices when you had to put him in restraints. You promised to get him out as soon as he was calm, and you kept that promise. He did not die tied down to a bed.
As things progressed, you turned off the monitors. Holding his hand, I felt totally helpless as he passed. You told me it was over. I felt you hug me and heard you tell me how sorry you were for my loss. You said it was okay to grieve. You were patient when I couldn't leave the room. When I finally walked away, I knew I would never be the same.
I saw you. I heard you. I felt your presence. I trusted you. I needed you—and you did not let me down. I am so grateful.
Stories similar to mine are played out daily in healthcare worldwide. My heart and my respect are with the nurses doing this difficult work. What we do in practice and education to collaboratively grow novice nurses and to decrease the gap is essential. Addressing the topics of family-centered care, compassion, and caring while modeling how to provide quality nursing care is essential to nursing curriculums and clinical practicums. Palliative care and end-of-life care are crucial discussion topics throughout the curriculum. Integrating these concepts, whether in pediatrics, adult health, or high-fidelity simulation, is important. Every nursing graduate must grasp and take into practice what it means to care about and love people, to be compassionate and caring, to treat all with dignity and respect, and how important it is to smooth a patient's hair while telling him how proud he must be of his girls. I have never been more certain of that fact.
This certainty reinforces my philosophy of teaching nursing students. When I walked out of my dad's room that final day, my desire to transfer the concepts of compassion and family-centered care was embedded deep within my being. What I knew to be fact, I experienced in action.
Engel G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science
, 196(4286). 129–136. https://doi.org/10.1126/science.847460