Generally, the public loves nurses. We dedicate a week to honoring them and they are regarded as a noble profession. My clients love that I am a nurse, because I offer them a level of confidence that they are seeking when purchasing services.
I became a nurse by accident; a major illness that I endured twice in my twenties led me here. I emerged years later a changed person. I no longer doubted what I could accomplish, and I felt I was well suited to the profession because I cared about my patients.
I also was thrown into a profession that is known to “eat their young” meaning that new nurses are put through some testing before their seasoned colleagues trust them. But once they do, that bond is akin to being war buddies.
Along the way I learned a few things about the profession and what it means to be a nurse, more than just the job, but what that means to patients. As I reflect one year after “formally leaving the profession” but continuing to use my hospital-acquired skills in private practice, I’ve recognized some important lessons I learned.
1. Patients are not at their best when you meet them.
When you meet someone in the hospital, they are not functioning as they do at home. Whether they have just given birth, recovering from surgery, or are sick with an acute or chronic illness, this hospital stay has disrupted their life. They may be scared or angry. They may also feel as though they no longer have control over their future.
There is also something profound that happens to a human when they have lost trust in their body, it can be heartbreaking to watch—and be on the receiving end of all of that emotion. Bottom line—someone who is ill is not at his or her best and nothing that person says should be taken personally. Sometimes the only outlet for a person who is sick or had a traumatic birth is the nurse.
Kids are especially tricky. They get sick very quickly but also recover quickly. When a child can no longer stay still in bed or gives you the first smile you have seen in days—you can rest knowing they are on the way to recovery. However, their parents can take a little more time getting over the anxiety of the hospital experience.
Keeping this in mind, when I enter a client’s home I am mindful that they are still recovering from birth. Their newborn may also be recovering from the hospital experience. I try to normalize a parent’s anxiety due to the usual sleepiness of a baby the day after coming home, and remind them of any pain and sensory overload their newborn may be experiencing at that time.
2. Patients do not always want to talk about what is going on that day.
I remember being in nursing school on rotation at a cancer center, and taking care of a tiny Asian woman with end stage breast cancer. She talked my ear off—but not about her illness or it’s impact on her life. She was a buyer for a major discount retail chain and was disgusted with practices of undercutting buyers and all the tricks they played to sell items at steeply discounted prices. Although I do not shop there, I still think of her rants about this company when I see a store.
At the time, I did not think I was learning what I was supposed to from this encounter, as I had a checklist of skills to master that was not getting any shorter. But I learned something really important that day—sometimes people need to talk about what they know and can control to feel normal or to come to terms with a terminal illness. I really did learn something important from her that day, but it took some time for me to see what that was clearly.
I keep this in mind when I am in a client’s home; typically they are overwhelmed by pain, a crying newborn, or simply how different their home now feels. This is why instead of using a checklist, I hand-write our lactation plan and review it with them a couple of times. This way, they can clearly look at what I suggested to improve their breastfeeding experience in the middle of the night, and the following day.
3. You need your coworkers to survive.
Even though the first year of nursing is a type of boot camp, the first bonds your form with other nurses will stay with you throughout your career. When seasoned professionals take the time to explain how things should be happening, you learn how much they really do care about their patients—and their profession.
I also learned that eventually even the hardest nurse can find a way to show you affection, and it will impact you. I entered this profession a little older and more confident than I would have ten years earlier; however, I was still intimidated by some of these nurses. But I learned the importance of listening closely, to learn the most about the way you should care for and constantly advocate for your patients.
In private practice this has changed because I work on my own. However, I still rely on a network of lactation consultants, pediatricians, and doulas to discuss client issues. I still have a community to ask questions of, which due to social media spans the country. Although it is different from co-workers you see everyday, it also helps me to keep my focus and use my business time wisely.
4. Read the policies, they are your protection.
The last position I held as a professional nurse did not supply a book of policies. All policies were online, as an executive’s idea of streamlining process and conserving paper. But, I never felt really confident I knew the policies because they were hard to find or offline during a review. Without being able to read and re-read them over and over again on paper, especially at 3am, left me feeling vulnerable.
Any job is like this, but when you have the liability of human life hanging over your daily job tasks, you need to know what you can and cannot do. Policies are your protection. For any nurse, as long as you stay within the policies, you will be able to deliver good care and protect your future at the same time.
This way of thinking has molded me professionally, especially as I have added credentials to my name. I wear the hats of postpartum nurse, certified pediatric nurse, lactation consultant, and postpartum doula, but I also need to know when I am outside my scope of practice for all or one of these licenses. This leaves me constantly asking clients to call their providers when I know that they should be collaborating with their pediatrician or OB instead of asking me. I hope that at some point this encourages providers to trust me and refer more patients to me, because I know how to stay in my lane.
5. I am not meant to be a hospital nurse.
The job of a nurse in a hospital is perfect for some people. They work long days a week, only a few days per week and holidays to make a living wage. If they are lucky to work for hospital systems that still pay for continuing education, they can learn and grow within that profession.
I left my first hospital job to work in public health, where I worked with clients over a prolonged period of time and watched them grow into motherhood. When I returned to the hospital environment I learned that I no longer fit there, I’m not sure if I ever did. My problem is that a twelve-hour relationship with my patients is not rewarding for me.
The framework I used in my public health position is the same framework I use for the services I provide in private practice. It is much harder in several ways to own a business and help it grow, but I can tailor the care I provide to what fulfills me as a professional. My ultimate goal is to have a mentorship program at my local high school for girls interested in maternal child nursing.
I will always be a nurse!
When I “left the profession” a year ago to pursue private practice, I thought I would be able to step away from nursing gradually. However, I have now accepted that it is a part of me that is engrained from personal experience and ethical practices. Many of the decisions I make for my business come from my training as a nurse, and I am a cautious practitioner because of this. I am a nurse, and I continue to be very proud of that credential.