During my tenure as a medical humanist at Southwestern Vermont Regional Cancer Center (2002-2005) I was an eyewitness to the complexities of communication between doctors, nurses, patients, and family members.
Recognizing that this is National Nurses Week, I find myself catapulted back in time, recalling the many nurses I admired. It was my good fortune to not only work with oncology nurses at the cancer center but also those on “the floor” when I visited cancer patients who were hospitalized. Donna Dier, in her article “To Profess…to be a professional” (Nursing Trends and Issues, 1990), “Nurses observe, listen, test, assess, diagnose, manage, treat and cure.”
One nurse in particular comes to mind—Jules Bowen. Why her? At that time (2004) she was an Associate degree RN with a Bachelor of Arts in English and taking a course in Leadership to complete her BS in nursing. Jules asked to shadow me.
“Why me?” I asked
“It’s how your role was described,” she said.
I, of course, understood the struggle to clarify my position on the healthcare team but it didn’t take me long to discover the challenges nurses encountered at the crossroads between doctors, patients, families and the institution. I asked myself if balancing difficult clinical responsibilities and multiple relationships were innate to nurses’ personalities or acquired in training. I’m not sure but what I know is nurses are masterful jugglers.
In an effort to support the nursing staff we (Center for Communication in Medicine) offered a program titled the “Nurses Conversation Hour,” which, incidentally, was funded by the hospital. The program provided a setting for nurses to discuss and write about professional challenges such as: communicating with patients who are unrealistic about prognosis; addressing loved ones who try to interfere with the treatment plan; and working with doctors who are not respectful of their role on the healthcare team. Listening to and reading the nurses’ stories left me with an even deeper appreciation of the complexities of their role and how they navigate what can be a slippery slope. Shadow a nurse and you’ll see what I mean.
Celia Engel Bandman
G. C. Curtis, RN, ICU, SVHC
As the world gets more diverse, we are encountering a plethora of different cultures with the patients and families that we care for. It is an ever challenging moment when nurses, doctors and the care teams have a patient or family who appear to be either refusing care or wanting a different approach to their care. We need to be attuned that these patients and families, just may be seeing the present hospitalization as a cultural upheaval.
I can give an example from one patient that I cared for. This patient is a very lovely senior patient who happens to be Latina. She is the matriarch of her family. Her family refuses rehab and appears exaggerated in their concerns over the patient and the care being provided by the care team. What needs to be understood is that in the Latino culture , senior citizens are revered and cared for at home by family. The family members consider it a very bad failure on their part, not to be able to provide for their own, especially a matriarch or patriarch.
It might be a good thing to look into the various cultures that we encounter in our nursing and see the world through their eyes. In doing so, we can enrich not only ourselves but also become better nurse ambassadors for our health care teams.
Celia Engel Bandman
I often refer to the origin of words. Why? I find it sometimes takes me to a deeper level and in this instance it has. The origin of the word nurse is from the Latin nutricius, a person that nourishes…
Thank you.
Celia