I began working in a new specialty recently: rheumatology and infusion. Of all the other specialty areas that I have been in, this is truly the most unfamiliar. I feel like a sponge trying to soak up information at every turn but ultimately being too full of moisture to possibly absorb more by 3:00 pm (welcome to the float pool life). It has prompted me to think back on some things I learned in school, which was only one year ago.
They Were Right
In nursing school, my professors constantly presented a list of “core virtues” to me and my fellow classmates. They stressed that the virtues were essential components for all nurses to embody. The full list included the following attributes: diligence, patience, intellectual honesty, courage, charity, creativity, empathy, humility, stewardship, compassion, justice, faith, hope, and wisdom. We had weekly assignments that required us to consider how the core virtues wove into our recent clinical experience, forcing us to ponder more deeply the moral side of patient interactions.
To be perfectly frank with you, I did not treat these reflections with much significance. I thought that the scientific knowledge of nursing, like starting IVs and the difference between the stages of labor, was more useful than the intangible moral aspects of my clinical day. I saw the practicality of concrete scientific knowledge, while the ethical side of nursing was of back-burner importance. Looking back on my education now, I realize how very wrong I was.
Knowing the Answers
If I’ve learned one thing from being in the float pool for eight months, it’s that all skills and knowledge are teachable and learnable. There are always going to be more specialties to explore, more knowledge to uncover. It’s not possible to know every skill for every department. The scope of healthcare is incredibly vast, and it’s not realistic for me to hold myself to the impossible standard of knowing every procedure, every doctors’ preferences, every proper lab order. The question becomes then: how do I survive the float pool and perform my job well when I know I won’t always know the answers?
The answer: the core virtues. Yes, it goes back to that list of (seemingly insignificant) core virtues that my professors attempted to impress upon me during school. A few virtues, in particular, have seemed to be pertinent in my job as a float, and I’d like to mention them and expound upon them just a bit. The core virtues that I mention have assisted me as a nurse regardless of setting and specialty.
H U M I L I T Y
Humility might be the number one virtue that I utilize as a float nurse. In school, my professors stressed the importance of being humble within the nurse-patient relationship, realizing that patients and their families have vital information for achieving health goals. However, I think humility is crucial for fostering a flourishing work environment. When I enter an office, exercising humility allows me to ask for help from other nurses who permanently work within the specialty. I am open to learning new things, and humility allows me to turn to help when I need it.
C O M P A S S I O N
As a float nurse, I also recognize the importance of compassion on the job. A patient is a person, and a person wants to be recognized as more than their physical ailments, whatever the specialty. Some people suffer from arthritis in their thumbs and can no longer play the piano they love to play; some people cannot feel their toes to properly trim their nails; others have chronically low immune systems and need regular infusions to boost their body’s defenses.
Regardless of the health setting that I am in, I realize that each person who checks in is battling with a problem and yearns to have their needs met. It takes compassion (more than simple duty) to motivate healthcare providers to respond well to those needs. Being a nurse in the outpatient setting means networking with insurances, pharmacies, patients, families, and transportation services to achieve adequate help to the clients who come.
The final core virtue is intellectual honesty, which encapsulates the idea of both integrity and truthfulness. Integrity affects my work on an hourly basis.
There’s no other health care provider in the patient rooms when I take vitals. It’s my responsibility to truthfully and consistently record the exact numbers I measure. If I decide to record a blood pressure that is more “normal” simply because I don’t want to retake it, I am not only being dishonest but I am being unfaithful to my patient. When I’m pulling messages off the phone and hear a patient report that their prescribed medication requires prior authorization from insurance, it is integrity that keeps me from deleting the message and pretending I never received the request. No one would know: only me, but it is integrity that keeps me truthful even when no one is looking.
Additionally, intellectual honesty involves informing the patient of results in a timely manner, regardless of the findings. If everything is normal, that is what I relay to the patient. If there are abnormal findings, it is intellectual honesty and integrity that propel me towards contacting the patient.
“Integrity keeps me truthful even when no one is looking.”
I don’t carry a list of “The Core Virtues” around with me when I work (although it might not be a bad idea to have them somewhere in my notebook to reference once in a while).
It boils down to this: when I work as a nurse, I try to treat others – patients, doctors, nurses, receptionists – as I would like to be treated. I enter into different offices, with different cultures and protocols and vibes, every day, and the best way for me to start and end the day is to stick to the Golden Rule as much as I can. It’s something we hear from elementary school on, but it can go leaps and bounds towards informing quality nursing care regardless of setting.