The Value of a Nurse? Let's Talk

It must be a terrible feeling when, as a public figure, you say something . . . and just when ill-chosen words leave your mouth, you wish you could blink your eyes and turn the clock back even a moment. Such must have been the case when Washington State Senator Maureen Walsh took on the profession of nursing. In her plead for a legislative bill excluding rural hospitals from requiring nurses to be allowed uninterrupted lunch breaks, she said something very unfortunate and ignited the ire of nurses all over the country. In referring to a small hospital in her district, Senator Walsh said, “I would submit to you those nurses probably do get breaks,” she said. “They probably play cards for a considerable amount of the day.” Oh Senator . . . bad choice of words. I recently retired following a 35-year career in nursing. My tenure of professional experiences ranged from swaddling newborns to managing the comfort of dying Hospice patients. In the mid 1980’s, I cared for AIDS patients during the time when such diagnoses ignited fear amidst ignorance. Intentionally, I touched these people with ungloved hands knowing my role as a nurse could transcend the chatter of shame and hopelessness woven with their diagnosis. Nurses teach through touch, and during the time when the stigma of AIDS induced fear, I recognized the opportunity to reach beyond the barrier of ignorance through my role as a nurse to educate with acceptance and compassion. Perhaps what Senator Walsh didn’t think about was what happens beside a patient’s bed. Many of us have kept vigil beside a sick loved one. Some know all too well the worry, angst, and helplessness felt as cuticles are picked and furrowed brows are cemented. Six years ago, my then 18-year-old nephew was randomly hit by a drunk driver and suffered a severe traumatic brain injury. For weeks, he lay comatose in a hospital bed, his face obstructed by ventilator hoses, probes, and wires working in tandem to keep him alive. He looked angelic beneath the plethora of tubes and medications sustaining life, but his situation was fluid and grave. His nurses were constant companions and became his saviors – literally. Their thoughtful attention, curious problem solving, and hands-on physical presence at his side meant the difference between life and death. Yes, the physicians and other support medical staff were hero’s worthy of another essay, but the nurses were on the frontline of intervention. From adjusting the compression boots on his lower legs to mouth care, they were vigilant. From assessing his vital signs to managing the cocktail of medications, they were skilled and competent. It was a nurse, after all, who recommended an alternative medication to the physician which would ultimately be a game changer for my nephew – paving the way for a long-awaited avenue towards recovery. Not only did the nurses tend to him, they consoled and counseled my sister and her family. It was the nurse who provided reassurance when possible, and space for acceptance when tears pierced the silences of my sister’s worry. It doesn’t take long for a nurse to enter the realm of family. Their value becomes immeasurable and their names become etched in the stone of a family’s history. Just ask my sister. 

Nurses don’t choose their profession in search for accolades, but one would not have to look far for deep appreciation for a good nurse. Value for one another comes through respect cultivated through relationships among the health care team. I know plenty of physicians who realize their patient plan can only work through the implementation directed by nurses. Having said that, there's a noted lack of appreciation for nursing often filtered from the highest level of medical administration. The evidence is clear in small ways. For years, as a staff nurse in an outpatient surgical center, I worked in a setting where physicians had a lounge with a refrigerator stocked with water and soft drinks. The Keurig coffee selections were lined in a basket next to the machine, ready to brew. If a nurse or a receptionist wanted a cup of coffee, there was a downstairs Keurig requiring 50 cents. Really, the availability was irrelevant because usually there was no time for a cup of coffee. If I wanted a glass of wine at the company buffet Christmas party, I had to buy it myself. I have no problem with a cash bar or buying my own glass of wine. But it should be duly noted that usually the week prior, those same physicians hosted a wine and dine no-holds-barred party for other physicians in our local area. Most hospitals have a doctor’s lounge stocked with refreshments where physicians can stop for a quick breakfast or lunch along their day. Yet nurses rarely are guaranteed a lunch break. Do you get what I mean? This is a systemic problem. But at the end of the day, free coffee or a social glass of wine mean nothing. Job satisfaction for nurses comes with the opportunity to use a unique combination of skills to care for and work towards healing those who find themselves vulnerable and in need.

Walking into the hospital to begin a 12-hour shift is like walking into an unknown maze. A nurse never knows if the day will flow with uncharacteristic ease or if the challenge to navigate care for a “crashing” patient will require a call to confidence amidst chaos and calmness of poise. I rarely sought extraneous applaud in being a nurse, and neither did any other nurse I worked with. Connection with patients far out-valued board room praise. When I held the hand of an anxious young woman about to undergo anesthesia, our eye contact of mutual trust defined success. When I washed the feet of a post-surgical cancer patient unable bend over, the memory remains a professional highlight – even 30 years later. Over and over again I witnessed my colleagues as advocates, speaking up for patients when they were unable to speak for themselves. I watched in awe as they commanded situations with confidence, grounded in the needs of their patients. Interventions ranged from providing comfort of a warmed blanket to life saving measures of chest compressions. Such is the mission that propels nurses to show up each day ready to face whatever arises.

 Unfortunately, the lack of respect for nursing is not isolated to one State Representative in Washington. It exists deep within the cells of the medical establishment. Although nurses propel the system of hands on caring, appreciation falls short in organizational terms. There is a disconnect when we hear of hospital executives making six figure salaries when those charged with caring for the patients they serve make a fraction of the value of a hospital stay. The fact that any given hospital floor is rarely staffed appropriately is another testament to how many hospital administrators take advantage of their nurses. Hospital nurses I know talk about how they never even have a break to go to the bathroom while on duty much less a lunch break. Time for playing cards? I don’t think so. 

In fairness to Senator Walsh, her poorly chosen words were probably not meant to disrespect nurses – but they did. Taking on hospital nurses wasn’t the smartest political choice. Social media has reflected the frustration by those who value the profession of nursing. Maybe she should visit the rural hospital in her district and spend some time with the nurses who undoubtedly propel the mission to treat the hospitalized sick in their community. Walsh could see firsthand that when a nurse walks into a patient’s room, he or she enters a sacred space. Stories of the bedside are as varied as the patients who occupy them. Nurses are called to understand the complexities of every patient and respond with competent compassion to the challenges facing every case, every day. I’m certain many of us recall how the attention of a nurse changed the trajectory of a difficult experience within the world of illness, pain, or sickness. The good rising from her unfortunate comments allows all of us to celebrate in a new light those nurses that reach into the crevices of our frailty to provide healing comfort and hope. I’m sure if a card game was arranged, most nurses I know would pass. Their work, after all, already makes them the winners.