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29 Oct 2009
Two Sides of Nursing: "It was the best of times, it was the worst of times"

I'm just about to start a new nursing postion and leaving my last appointment with heartfelt relief.

Why heartfelt relief? Because it brought back to me the stark and often ugly truth about nursing. This truth is that throughout my nursing career many of my nursing positions have been akin to the opening line in "A Tale of two Cities":

"... It was the best of times, it was the worst of times..."

Nursing is a complicated business. It's based on the premise of caring for other people and on the whole I think nurses do a pretty good job of caring for their patients.

What nurses don't do so well is care for each other! Therein lies the paradox of nursing. That's why it has always seemed to me to be the "best of times" as well as the "worst of times". And, I don't think I'm Robinson Crusoe either as the discussions on Nurse Uncut testify. All of us who continue working as nurses experience this best and worst of nursing.

So, what are the "best of times"?

For me, the best part of being a nurse is the genuine camaraderie that exists amongst colleagues who know and understand the difficulties of caring for people throughout difficult times. Nurses usually meet and care for people when they are physically and emotionally unwell, and never at their best by any means.

This is what keeps me in nursing. In some unexpected way, I always feel privileged to be offered someone's hand while I walk with them through their dark journey; and then when it's over to watch these people go home, knowing I have made a difference to their journey. I usually don't ever see them again and that's a good thing. It means that I've done my job well. There are many people I have met and known intimately for such short periods of time while I've nursed them and then never seen them again. This ability to develop and nurture these short intimate relationships that enable people to heal effectively, is an unrecognised and undervalued nursing skill. Nurses do this well and it's wonderful thing. It's part of what keeps me in there for the long haul.

Another good thing about nursing is the odd and often dark sense of humour that develops, to enable us to keep on nursing and manage the highs and lows of our work. I like this sense of humour and the sometimes hysterical and always muffled hilarity that happens in the tea room, pan room, nurses station and outside a patient's room. Having worked with other health professionals, I know it doesn't exist elsewhere and it's what keeps us sane.

The other "best" parts of nursing are the boxes of "thank you chocolates", tea room chats, the laughter and the bitching, the crazy night-duty world that no one else visits and the constant everchanging and interesting world where learning is a prerequisite for staying an effective nurse.

And, what are the "worst of times"?

It is, of course, the terrible culture of oppression and mistreatment that continues to exist within nursing. The worst of nursing are those times when you don't "toe the party line" which results in your exile to some sort of nursing Gulag where you are tortured and oppressed by the ruling Nursing Stasi. An extreme metaphor, I admit. But, to those of us who have experienced this exile, it seems like a harsh work camp with despotic overseers and frightened fellow inmates too afraid to say anything that might incriminate them.  It appears to be a very unfortunate truth that many nurses go into management and allow themselves to be indoctrinated into an old and ruthless system of oppressive practices. The sad truth is, if they don't wear this dictatorial and high-handed cultural mantle they are also persecuted as a "new management" dissident and banished to the "siberia of nursing" - never mind how much skill and experience they might have!

It is often said that nurses "eat their young". It could be more truthfully said that in this strict heirachical nursing culture with its wealth of historical mores, nurses eat not only their young; they also eat those more experienced nurses that threaten the long-held system of heirachy and oppression. Many nurses really do like this system and that's why it doesn't change. These nurses keep the oppressive culture alive by eating their young, or banishing those that try to make a difference. How sad that we can't manage to change this very dark side of nursing?

My last nursing position was another instance of the "best of times and the worst of times"  and resigning from it closes another interesting chapter in my now long nursing story and off I go to a different place in nursing.

And that's one of the "best" things about nursing as well - there is always another place to go and do your nursing thing!

So, in your opinion, what are the best and worst parts of your profession?

 Image courtesy of photobucket.

 

 

 

 



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Comments

jockeyd71 - says:
Added on - 02 Mar 2010 06:53PM

Scary is it not; a tales of 2 cities is my favourite book. In the US and UK I have contributed to blogs that read the same as this. Nurses with the same sad stories. As a senior CNC I refuse to go into management to tread this dark path. I often am an outsider looking in on beautiful people or potentially beautiful passionate nurses destroying each other often over miss communication or different values and minor issues like rosters. I remember when I was young getting in trouble for; my humor, being male, turning up late, getting too many weekends off on my roster, not working night shift and knowing too much. The last one was the worst crime of all.
I remember when I started doing my NP studies relief in deciding to put them to the side as senior nurses I worked with made it hard for me to work and study and telling me I was wasting my time. Not because I could not achieve NP status but because they would do their best to prevent me from putting up an NP model.
Allied health and doctors I work with ask me why are nurses so awful to each other what makes us cripple each other apparently accross continents. Is it because so much is expected of us that one minor mistake or different values or challenging the status quo are seen as letting down the team.
If nurses want to be taken seriously, if they want NP status and career paths and more nurses it is something we must fix from within.
And always I stay as not just within nursing but in health care overall I am constantly blown away by the dedication passion and commitment that professionals show to their patients and even occassionally to each other well beyond any paycheck and often beyond what people deserve. It makes no sense to me that sometimes these same people are the instigators of the same bad behaviour described in these blogs.

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Kassie - says:
Added on - 06 Feb 2010 12:48AM

The Pride and Shame of nursing Well said indeed. The pride of being a nurse is doing the tough job - whether in aged care, paeds, emergency or general - most of the population could not and would not do what we do, and we do it well.
There is genuine pride in getting the satisfaction of helping someone - be that helping them to live, or supporting them and their family in death.

The shame in nursing is that alothough we suffer violence at the hands of patients, relatives, public, medical professionals, allied health and other workers...noone is so cruel to a nurse than another nurse.

I am 30yrs old. I have a long time in my chosen career. I know that I am good at what I do and I am including in that list of things that I do the ability to be kind to my colleagues.
I am genuinely polite to my colleagues. I choose to be happy and polite in my work place and I choose to offer the same compassion to my colleagues (students and senior nurses) that I want extended to me and to my patients.
I am choosing to change the culture of peer violence, having suffered greatly at the hands of it.

We all know it happens, but it is so easy to take one step a day to stop it.

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Hihavaniceda - says:
Added on - 14 Dec 2009 08:16PM

Bernhard I hope you hang around here a bit ... I like the way you think things out ... and explain things :)

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nursezilla - says:
Added on - 09 Dec 2009 02:44PM

It is a sad fact That we Nurses are the distructive force to another Nurses self assurance - how many times have we heard around the morning tea room - nurses ripping the character of another Nurse to shreds - I do not mean the whinge we all have about a Nurse we work with then get over it - I mean the Malicious Vindictive Nasty attack on a character for doing exactly what the the loudest voice is also doing but if they talk loud enough maybe attention will not be on them - We have all experienced hearing or witnessing this but have sat back and thanked the powers that be that the attack was not on us - and then we wonder where all the good - caring nurses have gone?
It was the best of Times it was the worst of times - the Nursing work load is horrendous enough without letting the catty - petty attacks ruin what enjoyment we get out of work with out the support of out team mates our lives would be down the toilet - in more ways then one. It is not always the bureaucracies that ruin our working enviroment

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Bernhard - says:
Added on - 08 Dec 2009 11:36PM

Tale of two cities! I think I'll throw in another line from this book:"It is a far, far better thing that I do, than I have ever done; it is a far, far better rest that I go to than I have ever known" - and add that this should refer to nursing, if you do it with conviction and humour. Trust me, if you don't enjoy the ride, the guillotine will do more damage and with more pain. It's sad so many do actually "eat their young". When I became ADN level5 on night shift at a large hospital, I was constantly given names of 'smart-alecky" students and was told "they already have 2 strikes against them, so I'm sure you can help with one more complaint so we can terminate them now!"
Once I met these 'evil" student nurses, I generally found they were brilliant, but outspoken. If they had initiative; if they questioned all aspects of care, or the methods, then they became a danger, and had to be 'terminated' (or as in Doctor Who, 'exterminated'). I wonder how many excellent nurses were destroyed before their training finished by jealous (and probably well past their 'use-by' date) senior staff?

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illawarrior - says:
Added on - 04 Nov 2009 10:09PM

Best of times and worst of times I am optimistic that the best of times is ahead in AGED CARE .Surely the support and pressure from the public has to have an effect and will cause an upsurge and change of the guard .

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shoils - says:
Added on - 02 Nov 2009 01:18AM

Spoken with such truth! I have to agree with absolutly everything you have said except for this part "It appears to be a very unfortunate truth that many nurses go into management and allow themselves to be indoctrinated into an old and ruthless system of oppressive practices. The sad truth is, if they don't wear this dictatorial and high-handed cultural mantle they are also persecuted as a "new management" dissident and banished to the "siberia of nursing"

I have not experienced this myself (yet) I know many that have turned to the "darkside" once they have become managers but I hold myself true to my word and try my hardest not to go there. The provider I work for does not frown on me for having a different view when it comes to managing my staff infact they applaude it and encourage it ( there are less HR problems this way) Not all managers are on the bad side and eat their young alive, but then again it depends where you work and who trained you for the position ( you are only as good as your trainer)
But well written I can truely relate to everything you have said and I could not agree more!

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Hihavaniceda - says:
Added on - 01 Nov 2009 07:20PM

Two Sides of Nursing This is so real and so true. There is truely two sides of Nurses. I have experenced the good, when after the years (decades) of nursing and you look at all the thank you cards and letters (I have kept each and every one, I have a box full) and you remember each and every person you have touched in a positive way and you get up and go to work the next day to do the same, because you want to help someone have a better day. That is a nurse.

Please pause for a moment and think of us nurses in country towns who suffer the same fate and hardships under managers that bully and seem to just want to put boulders in your way at each movement of tring to care for patients.... and horizontal problems from colleagues that is ignored by managment. These people do not move out of there positions and I cannot move out of my position unless we up and move town or retire or die, as there is only one hospital.

:(

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ljm - says:
Added on - 31 Oct 2009 02:26PM

I love the place I work and I also hate the place I work I love;- The commraderrie, the friendships and the mentorship that you get from other nurses can be amazing, especially when you are open to it. I work in a small rural private hospital as an EN, I am currently attending university to do my RN's. I am loving the support I get from my colleagues who have all been absolutely wonderful. I am a mature age student who has come back into nursing after many years of doing other non nursing job's. I have found a new passion for nursing which is opening so many doors for me. The diversity of this priofession is amazing and awe inspiring. I have found if you go into situations with a good attitude and willingness to learn that your experience is rewarded by those around you whether this be from your patients or your work mates. The patients are why we do what we do and I love caring for people and I can't believe how lucky I am to be involved in their lives at sometimes the worst times of their lives and be able to give them some kind of comfort.
I also hate;- This happens when management say they will support you when you tell them you are going to uni. After nearly 12 months I still look on at this statement as quite hilarious. There are no company run incentive schemes for further education as it is my choice to do uni. There are no scholarships available for employees to undertake uni. The is no study leave available for when we go on 4 week practicum each session so we have to take leave without pay, use our annual leave or work 28 days straight. The worse thing is that the person doing the roster can not even manage to give me 3 shifts per week for 12 weeks two times a year. This would enable me to be able to continue to live , work and go to uni without encountering major finacial hardship. But it is a business they are running you know!! Then in the next breath they are whingeing because they can't get enough RN's to work for them.

I truly do love nursing and look forward to at least another 20 years in the profession and continuing to learn I just wish there was a little less saying we'll support you and a little more doing!

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Nat X - says:
Added on - 30 Oct 2009 04:49PM

best and worst of times!! The worst of times. Unfortunately learning about horizontal violence (amongst colleagues) and "nurses eating their young" was perhaps one of (if not the first) lessons I learned about in my TENs training. This nastiness not only makes it unpleasant to go to work and difficult to do your job and to learn, it is downright DANGEROUS. It is so dangerous that even silly and vindictive complaints can lead you to be hauled up in front of the NUM to answer for, which can potentially threaten your good standing, self esteem and JOB itslelf !! How can you give safe and effective care when you are not supported to care for the patients, and the workplace feels like a warzone!!!. It could potentially cost lives !!! Come guys, no ones perfect but we are here to do the same job after all !!!

The best of times is when you are lucky enough to come upon a workplace (like I have now), that is supportive in both the personal and educational sense from the NUM down. It doesn't mean its a walkover, though. But having experienced the opposite kind of workplace, I can really appreciate it now, and sometimes even wonder what I did to deserve this!!! I can tell you it makes all the difference!!!!

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ruthguevarra - says:
Added on - 30 Oct 2009 02:35AM

I would like to agree with you Pc I am also new. I know at one stage I felt like I have been eaten alive. I have cried over the worst shift I've ever had. But, I am still here, stronger. I love what nursing is all about. I love it when I get to make people smile in their worst of times. For me that is the "Best of Times".I'm not here for the paycheck. I am passionate about touching people's lives and making a change in their lives no matter how small or subtle it is. To me, that's BIG!

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Pc - says:
Added on - 30 Oct 2009 01:45AM

a good read It's always good to read ur blogs
I enjoyed reading this as much as i enjoyed ur other blogs
although this is a little sad read

Being new to this profession, i would like to believe there are more "best of times" than "worst of times" in nursing and i am not too naiive to unnotice all the bureaucracies but i hope it all change with time for the better than worse.

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