Regaining renewed respect for nursing: witnessing the care provided to a family member has re-newed a one-time nurse's respect for the profession

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Author: Teresa O'Connor
Date: Feb. 2010
From: Kai Tiaki: Nursing New Zealand(Vol. 16, Issue 1)
Publisher: New Zealand Nurses' Organisation
Document Type: Viewpoint essay
Length: 1,076 words

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... "But that the dread of something after death, The undiscovere'd country, from whose bourn No traveller returns ..." Hamlet, Act 3, Scene 1

My relationship with the nursing profession has never been easy or straightforward. I've often had a sense of being an outsider; of not fully understanding the culture and mores of the profession. My nursing career began as a student at Nelson Polytechnic in 1986. Mature students--those of us aged 30+-were relatively rare back then and there were just three of us in that category. So my introduction to nursing was alongside a gaggle of school leavers and I found both the concerns and conservatism of my student colleagues (with some notable exceptions) bewildering and frustrating. But overall, I enjoyed my study and loved the patient contact.

Once qualified, I returned for a time to my original profession, journalism, and then Landed a nursing job in a surgical ward at a major metropolitan hospital. The ward was headed by a deeply conservative charge nurse who insisted on the title "Sister" Again, the conservatism of some colleagues was a challenge. I could not understand or participate in Long conversations about home appliances and weddings. It was as though feminism (and remember this was after the Carlwright Inquiry) had passed many of my colleagues by.

An oppressive culture

While I loved nursing, I found the nursing culture oppressive at times and the system crushing. The multi-cultural environment of the hospital was fascinating and challenging, as were the politics of health as crown health enterprises were being established. In a listener editorial, I railed against the health changes as outlined in Ruth Richardson's Mother of All Budgets in 1991 and, in so doing, came face to face with the conservatism and duplicity of nursing and health management. The theory of nurses having their own voice was lauded; the actual practice was condemned. It was an enlightening expose of nursing leadership's subordination to the corporate culture. [Plus ca change, plus ca [a meme chose?] And it left me with a distrust of, and cynicism towards nursing leaders and what nursing leadership actually means, which has been hard to shift.

I subsequently began my association with Kai Tiaki Nursing New Zealand and have observed, written about, commented on, criticised, condemned, applauded, admired and angst-ed over all things nursing for some years. In that time I've become a bit jaded about the profession; bewildered at times about nurses' actions and reactions; frustrated by their seeming apathy on occasions; confused by their unwillingness to speak out publicly against what is happening in health and what it means for patients and their claim to be patient advocates; angry at the classism in the attitudes of too many to enrolled nurses and caregivers; despairing at the future of nursing education and the profound silence which so often emanates from colleagues in the tertiary sector; gobsmacked by what prompts some of the letters to the editor; and confounded by the continuing conformity of many nurses.

The essence of nursing

But recent exposure to the essence of nursing, as practised at the bedside of my dying mother, has restored my faith in the profession; helped me understand more fully why nurses are among the country's most trusted professions; and enabled me to observe anew and appreciate afresh what too often sounds trite and formulaic, ie to nurse a patient and their family in an holistic way.

Being with someone who is dying, particularly when that person is a beloved mother, is to hover in a strange twilight zone; an in-between world: in between wakefulness and half-sleep; in between the enclosed world of the hospital room and "normal" life outside; in between deep grieving and great humour; in between profound loss and rich memories; in between life and death. It takes a special person to be able to understand that world, to enter that territory and care for the person hovering between life and death and tend to those who are loving and supporting that person on their final journey.

In the four days my mother spent in the medical unit at Nelson Hospital travelling towards "the undiscovere'd country", she and her extended family were cared for by a number of nurses. They all had different skills; different strengths; different approaches; different ways of being with my mother and with us. But they all had a profound respect for what was happening in that hospital room and an understanding of the individual nature of the journey and of family members' individual responses to it.

There were, of course, the practicalities to be attended to: the sponging and turning; the pressure area care; checking the adequacy of the morphine infusion; providing "lazy boy" chairs, mattresses and bedding for those who stayed overnight, and the clinical skills involved in that care. But there was also the more subtle care-the reassuring touch; the sympathetic glance; the unspoken understanding. When one is in a state of heightened emotion, such gestures have a particular resonance.

As it became obvious that many people wanted to pay their farewells to a much loved matriarch of an extended clan and a deeply respected member of her community, my mother was transferred from a single to a double room. This was unprompted by the family. Mattresses and chairs occupied the space of the second bed. As daily a steady stream of people came and went, not once was there any hint that this may be inconvenient in a busy medical unit. Or as those gathered around the bed parted for a nurse, not once did we sense that this was in any way troublesome. And when my mother's brother, keeping vigil during the early hours of the morning, experienced respiratory distress, the nurses tended to him with skill, kindness and equanimity.

When our mother died, our wish for her to remain in her hospital room, which had become a place of deep significance, rather than be transferred to the morgue, was understood and respected.

I feel deeply grateful to all the nurses on that unit for creating a culture of respect and for their skills and professionalism. I feet deeply grateful that their nursing has re-ignited my respect and restored my faith in the fundamental goodness at the heart of our profession. And I feet deeply grateful that those nurses have helped me more fully understand the privileged intimacy our profession affords. Thank you from the bottom of my heart.

By co-editor Teresa O'Connor

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Gale Document Number: GALE|A219898137