I had the honor and privilege last night of being inducted into the Honor Society at Le Moyne College, my alma mater, as a community leader. In addition, I had been invited to give the keynote address for the ceremony which paired both the honor society induction as well as a recognition of the graduates from the nursing programs graduate and undergraduate tracks, separate from the larger school wide graduation they will attend next week. The whole evening was such an honor, as well as a wonderful experience, to be back in a place I spent so much time, yet feels so far in the past. It was wonderful to see the way the program has grown since I was completing my bachelor’s in a cohort of less that 20 students.
I have included below a slightly shorted version of what I spoke to the graduates and inductees last night. I hope you enjoy. And to all those of you with a graduation of your own in the coming weeks, Congratulations!
Le Moyne College Address
Day one of orientation to my first nursing job, in the NICU at St. Joseph’s Hospital, sometime around 8am I decided that Nursing was hard. My orientation had felt like starting over. In many ways, it was, since so little of what I did on a daily basis there had been covered at all by the adult med-surge heavy clinical time of the St. Joseph’s College of Nursing program. I remember on that first day, standing awkwardly, over a human the size of my hand, arms spread, individually inserted through the isolette doors, sweating, as panic took over and I realized that maybe God hadn’t granted me good enough hearing to assess and calculate the heart rate of a neonate, at 180 beats per minute through a cheap disposable stethoscope that crushed into my ears leaving pain for minutes after they were removed.
I hear nothing I panicked.
Wait, is the heart rate really nothing? I wondered, looking to my preceptor for some kind of guidance as the anxiety in me swelled.
Surely she too would look at least a little panicked if this baby were truly pulseless, I comforted myself and listened on. Waiting, as my eyes darted from clock, to baby, to monitor, and back again.
Close your eyes.
I heard, from over my shoulder. And as I did, I began to hear it, the slight, methodical, regular, hum of a racing neonatal heartbeat.
You can do this. I told myself. And finally, I think I started to believe it.
Nursing school had left me feeling run down, as I am sure everyone in this room can appreciate. I began to question everything, chiefly, my decision to become a nurse. In my last semester I had panicked, not yet finding a specialty that seemed to fit. By coincidence I had landed in the NICU. And by the second set of vital signs, eyes closed, I knew I was in the right spot.
Four months into my nursing career, as I finished my extensive orientation, I was back in the classroom at Le Moyne, finishing my bachelor’s in the same place it had all begun, four years prior, having left Ly Moyne after my Sophomore year to attend Nursing School. So in the spring of 2008 as my “college” friends graduated with Bachelor’s degrees I had crossed the stage to accept my Associate’s degree from St. Joseph’s College of Nursing. So there I was, back at Le Moyne to wrap up my degree, while working my first job as a Registered Nurse.
I came into it frustrated. All of my friends were gone, moving on to grad school, first jobs, internships, new cities. Their undergraduate work was behind them. I dragged myself to the first weeks of classes irritated, as if my career, my future, had nothing to gain from another year of college. I knew my parents valued my completing my degree, and somewhere deep inside my stubborn head I too knew I would benefit from it. But at the time, in the moment, it felt useless.
It was a few weeks into the semester when for our Professional Issues and Trends class Barb Carranti guided us to a hidden computer lab somewhere below the science center where we were instructed to write, for an hour and a half, about a day at work. Start to finish, what we did, not the subjective things, but rather, the objective data; the tasks, the procedures, the assessments and subsequent interventions.
To this day, I remember exactly what I wrote. At first I sat there struggling with the assignment, unsure of what to write or how to write it. I stared at the blank document for what felt like hours, struggling to put into words a day of nursing. Finally I gave in, starting with one word, and then another, until suddenly, with a rush I felt physically move through me the words began to pour out and onto the page. It had been my first trip to MRI with an intubated baby. At a few hours of age he had begun having presumed seizures, they continued through the next few days and were confirmed by an EEG. We were taking him to the MRI scan to evaluate the cause by looking at his brain. He had seized on the way down and continued to throughout the test, requiring additional sedation to keep him still for reliable results. Moments after we had returned to the NICU and settled in, the attending physician pulled me aside to tell me the MRI results, prior to sitting the parents down to discuss with them that anoxic injury was seen over 90% of their sons brain. His prognosis was grim. The doctor cried, the parents cried. I too was given permission to cry, and so I closed my eyes, and made no effort to fight back the few tears that finally made it down my face.
As I sat there in the lab, writing about the day, I cried again. This time, the tears came more easily. I was feeling all of the same emotions, but they were different. I was reliving all of the same activities, but they too suddenly carried a new weight and significance.
I learned two powerful things in that lab that day. First, the intended lesson: that what nurses do and what we say that we do are so rarely on the same page. That when we are asked to write or talk about our work we struggle, and usually, we either give up or simply focus on comfort and hand holding. Two incredibly important pieces of what we do, but still, just two of the many pieces. I left class that day with a new ownership over my daily work. A connection to it that has stayed with me in the years since, an awareness of the variety, depth, and importance of the daily tasks and activities a nurse goes through.
The second thing I learned was that I love to write. Not just because I like to string pretty words into powerful sentences. But when I write, when I sit and force myself to make these words, sentences, and paragraphs, I force myself to feel, evaluate, and grow. That growth has made me a better person, a better nurse, a far better advocate for my patients. Since that day I have made an effort to write down the experiences I have that I am struggling to process. In my years as a NICU and then PICU nurse, these experiences have been many.
Writing has allowed me to be vulnerable in my experiences. I am a supporter of nurses being emotionally available to their patients and families, but also firmly believe that at all times we should be the strongest person in the room, not the one falling apart or needing comfort. The risk in developing this ability however, is the opposite extreme, a calloused heart. Through writing, and a decent amount of wine, I like to think I have found a balance that has allowed me to be vulnerable to myself, my family, my coworkers, and now to millions of other nurses around the world.
Last night, as I headed upstate from New York City on the bus, I watched video after video of TED talks. Two of these videos featured Elizabeth Gilbert, the author made famous by the bestseller Eat, Pray, Love. In these talks she spoke about the difficulty of returning home to what you do after great success or great failure, as well as the importance of finding your way back and continuing on.
She referred to your home as the thing that you love more than yourself. For many of us, that thing is nursing, the service to and care of others. Like a best selling writer, we too experience great success and great failure.
For us, the success is not a bestseller, nor is the failure a flopped manuscript or project. For nurses, the catapult to success or failure happens almost daily, some days I have experienced both extremes over the course of a 12hour shift. The failures may be a patient loss, an error, or even more unnerving, the inevitable entrance of burnout, that at least temporarily removes all love and passion from nursing, removes the ability to care well for your patients or yourself, and often leads you down a path to guilt and further feelings of failure.
Success may be placing an IV on the first try, having a family thank you wholeheartedly for your care. Being recognized on your unit by coworkers and administrators for the great work you do, being supported by thousands of nurses around the world for saying what we all were thinking. For many of you, today is the first of these great nursing successes, being inducted into an honor society, recognized for your academic achievements and superior performance.
But like writing a best seller, living in the glory of that success is not a permanent arrangement. It is so important to have a vehicle to bring you back to home, to the core of what is important to you. For Elizabeth Gilbert, it is the writing that brings her back, to her home as a writer. For us though, I think it is more complicated. Leaning on nursing to bring you back to that place is risky. Nursing is rarely neutral, and relying on it too greatly can cause burnout, skewed perceptions, and anxiety. For this, I feel that it is so important to have something else that brings you back to that home.
For me, it has been writing. The expression of not only what I do, but how it makes me feel. The vulnerability in expressing these successes and struggles that has time and time again brought me back to my “home” and grown me into the nurse that I am.
I urge each of you to find a vehicle that will bring you back home. That will temper success and failure and keep you neutral. It may be volunteering, working on a committee, writing, painting, or any one of many other things. Learn to find a place for vulnerability in your work as a nurse, in your life as a human. It will make all of the difference.
By the time I finished my Bachelor’s I had learned to flawlessly complete an assessment despite my arms separated by a plastic wall. I no longer needed to close my eyes to count a heart rate, my ears had become numb to the pinch of a brutal stethoscope. At the point that the anxiety over how to be a nurse shrunk away, the passion for being one crept in. I learned here at Le Moyne College to never say “Just a Nurse”, but once I had reached this point the lesson was unnecessary, that notion was suddenly so far from my truth.
I hope each of you will spend some time basking in the success of today, but that tomorrow you will start to find a reliable path back to your home. I hope that your career will be as full of passion as mine has been, as fulfilling, challenging, and rewarding. Thank you for inviting me here today. It has been my honor. Congratulations.