NURSING WAS NAMED the most trusted profession for the 18th consecutive year in January 2020.1 This recognition is objective evidence that we do a great job in caring for our patients; however, some moments occur for which we, as a collective, cannot be proud. As a nurse for over 25 years, I have witnessed numerous situations when nurses missed opportunities to serve patients according to the highest care and practice standards. Excellence in service that promotes dignity, respect, and safety is a right for all patients. Nurses are responsible and accountable for ensuring this right for every patient and family member during each patient encounter.
While these unfortunate situations are a reality, they are exceptions and not the rule. Extenuating circumstances, such as a failure of hospital and nursing leaders to ensure adequate staffing resources in patient care areas, are often catalysts for these unpleasant and unintended patient experiences. Inadequate staffing compels nurses to prioritize patient safety over spending the necessary quality time with patients and families to prevent adverse and sentinel events.
Because I am so proud and humbled by the privilege of contributing to the well-being of others as a nurse, I feel a sense of moral injury each time I witness or experience anything less. I feel this most acutely when older patients tell me they did not receive something that they needed, from education or pain medication to feeling unnecessarily rushed to communicate, or feeling afraid to ask questions. The poem below was inspired by their stories. It is meant to offer a voice not only for older adult patients, but also for anyone who has shared similar experiences. I challenge all nurses to become more self-aware and to reflect on the way that they approach caring for each patient during every minute of their encounters. I ask each nurse to recognize that the title “nurse” is an awesome honor that carries with it a solemn responsibility to humanity.
The impact of first impressions is not a cliché, it is a reality.
Therefore, your initial contact with me should not come across as mere formality.
Those first few moments give rise to the foundation of trust;
I need to sense sincerity, warmth, care, and compassion and not be made to feel like I'm just:
I'm just the next task on your list of things to do.
No, I'm not a thing or my condition, I'm a person who genuinely needs you.
As a matter of fact, let me say again that I'm not a task.
But it seems as much when you rush around me, so I dare not ask.
I dare not ask you any questions about my disease
because I'm afraid to upset you or make you displeased.
If I dare to make you angry, what will my consequences be?
Will you withhold my medicines, prolong my needs, badmouth, and not advocate for me?
Your actions can compound the pre-existing mental and physical anguish that I already felt;
I hope you know that I'd rather not be here, but these are the cards I was dealt.
Please use my words as a reference for reflection;
Remind yourself that a patient is a vulnerable human being; not a disease, a procedure, or your next injection.
You are the person whom I see the most;
I need to trust you and I need our bond to be close.
I realize that I'm not your only patient and you have a lot to do;
I'm not trying to make your life difficult but right now, I really need you.
Remember that you are a person and a potential patient, too,
So “do unto others as you would have them do unto you.”
1. Reinhart R. Nurses continue to rate highest in honesty, ethics. Gallup. 2020. www.news.gallup.com/poll/274673/nurses-continue-rate-highest-honesty-ethics.aspx