Nurses have been called many things over the years, and saint, hero, angel, and savior are just several ways they’ve been described. In a misguided sense, nurses have even been unceremoniously sexualized in the form of the tired cliché of the sexy nurse Halloween costume.
Throughout the COVID-19 pandemic, it became increasingly common to see signs outside hospitals saying something akin to, “Heroes work here.” Is the hero moniker truly helpful to the cause of nursing? Does calling nurses saints, heroes, angels, and saviors help them in any way? I posit that it’s the opposite: using such terms is a dehumanizing misinterpretation of what nurses do and who they truly are.
Heroes Work Here?
Much praise was heaped upon nurses and other healthcare professionals during the worst months of the pandemic. On many a day throughout those most challenging times, people stood outside of their homes banging pots and pans at the 7 pm change of shift to express gratitude for nurses’ hard work (never mind that it’s the rare nurse who can get out of work at 7 pm to hear such a concert, but it’s the thought that counts).
Meanwhile, the “heroes work here” banners outside hospitals reiterated the claim of heroism, putting nurses and their colleagues on pedestals that might have felt just a tad uncomfortable and precarious.
So, what’s wrong with the proclamation that heroes work in a given facility? What harm does it do when we tell a nurse they’re a saint in scrubs? What does it say when we place a mantle of superhumanity on those who serve as frontline healthcare professionals, risking their lives in the process? There’s nothing inherently wrong with a sincere expression of gratitude, yet it can sometimes not sit well with those on the receiving end.
Superhumans ‘r’ Us
Angels, saints, and heroes are individuals with superhuman traits. They are people whose qualities place them above the powers of mere mortals. They leap tall buildings in a single bound, fly weightless on gossamer wings, and perform miracles and wonders before amazed groups of onlookers.
While the work of nurses may appear superhuman and saintly to the average layperson, the day-to-day slog of hanging chemo, transferring patients, changing catheters, cleaning up feces, drawing blood, and dressing wounds may not feel so heroic or superhuman to those who perform such duties.
Nurses work on the front lines amidst the muck, mire, and bodily fluids of human life and suffering. And during their work, they can be slapped, punched, kicked, spat on, cursed at, and verbally abused.
Nurses’ work can cause them to suffer compassion fatigue, burnout, addiction, depression, anxiety, post-traumatic stress, and suicidal ideation. Are these superhuman traits and reactions? I would say they’re altogether human.
While it is simply a game of semantics, the difference between hero, angel, saint, and warrior could not be starker. When we consider angels, saints, and heroes, we might be more prone to think of creatures who have fewer needs than us mortals — these creatures with special powers have more endurance and are more impervious to the slings and arrows of life. By seeing nurses as superhuman, we can dehumanize them.
Call Us Warriors
Many nurses I’ve spoken with are much more comfortable with the word warrior than the descriptors hero, angel, or saint. They feel that warrior is a more accurate description of what they do and who they are as nurses. Healthcare delivery can feel like a battle – especially during situations like the coronavirus pandemic — and pushing through the worst times in the medical trenches makes the term warrior extremely apt.
Heroes of folklore, mythology, and fantasy are mythic, larger-than-life figures who demonstrate superhuman faculties that set them apart. I would venture that few nurses feel larger than life; in fact, most nurses are arguably more fully in touch with the realities of life (and death) in ways that many members of the general public are not.
Nurses are warriors fighting for the good of the whole against disease, illness, injury, and, at times, death itself. They engage in the battle by leveraging their human knowledge, expertise, skill, and compassion acquired through years of study, hard work, suffering, and learning. See them as heroic if you must, but also see them as the righteous warriors they truly are.
Minority Nurse is thrilled to feature Keith Carlson, “Nurse Keith,” a well-known nurse career coach and podcaster of The Nurse Keith Show as a guest columnist. Check back every other Thursday for Keith’s column.
There is no question that nurses may appear to an outside observer to be primarily task-oriented, but the reality is that an equally important aspect of nursing involves communication with all people, including colleagues and patients.
When it comes to authentic and clear communication and the nurturing of functional, healthy relationships, this includes the ability to read, interpret, and respond to one’s emotions and the emotions of others. This skill — and this is indeed a skill that can be sharpened and strengthened over time — is called emotional intelligence (EI).
The Impact of Your EQ
Your “emotional quotient” (EQ) is one way emotional intelligence is referred to in the literature and popular culture; it’s also commonly referred to as EI. Daniel Goleman brought the concept to the public with his seminal 1995 book, Emotional Intelligence. Over the last few decades, it has found its way into healthcare, the corporate world, academia, and other spheres.
In terms of a framework, EI is often broken down into five realms:
Recognizing your own emotions
Managing your own emotions
Self-motivation
Recognizing and understanding the emotions of others
Managing relationships
The five realms are then described in the context of four quadrants:
Self-awareness
Social awareness
Self-management
Relationship management
Rather than being a relatively fixed number like your IQ, your EQ is a set of skills and personal attributes that can be consciously improved throughout your life and career. And when examining the five realms and four quadrants above, it’s easy to see that the highly relational aspect of nursing can benefit from a nurse focusing on their personal development in these areas.
The Relational Nurse
Most forms of nursing are relationship-based. Picture an emergency department, a clinic, a dialysis center, a home health agency, an inpatient hospice, an ICU, or a labor and delivery unit. In the daily work of a nurse clinician, effective communication with colleagues, patients, and their families is essential. This communication can exist as the lowest common (transactional) denominator or be much more, built on a foundation of emotional and relational intelligence.
Patients don’t remember nurses whose communication is unemotional or robotic; they remember nurses who went above and beyond with their kindness, compassion, and thoughtfulness. The physical skills of the nurse hold meaning, of course (e.g., skillfully hanging a unit of blood inspires patients’ confidence in their care), but mastery of communication and relationship-building is where the rubber truly meets the road.
In relationships and communication with colleagues, nurses’ emotional intelligence also comes powerfully to bear, whether as a clinician or a leader. A nurse’s ability to maneuver within a potentially complex workplace environment is based on their ability to converse with numerous stakeholders:
Doctors, surgeons, and other clinicians
Patients and family members
Case managers, IT professionals, coders, third-party vendors, and administrators
The relational nurse is a conduit, bridge-builder, negotiator, mediator, and educator, and the better the nurse is prepared to serve in these roles, the more successful they will be.
Making EI Count
It takes many players to help make these facets of nursing come alive and make their mark. Within nursing schools and on the NCLEX licensing exam, EI could play a more significant role in educating nurses about emotional intelligence. If healthcare leaders and employers chose to emphasize EI and make it a part of their orientation, ongoing training, and corporate mission and values, everyone involved would be well-served. Yet it mostly comes down to the individual nurse prioritizing their emotional intelligence and personal growth
No matter how it’s addressed, emotional intelligence has a place in healthcare, nursing, and medicine. Nursing care itself is far from having a solitary focus on manual tasks. Relationships are at the core of nursing, and EI is where nurses can genuinely choose to shine.
Minority Nurse is thrilled to feature Keith Carlson, “Nurse Keith,” a well-known nurse career coach and podcaster of The Nurse Keith Show as a guest columnist. Check back every other Thursday for Keith’s column.
It is generally agreed that a vast majority of nurses choose the profession because they find fulfillment in being of service to others in their time of need.
Compassion, empathy, and kindness are hallmarks of what “nursesness” is all about, and even members of the general public are likely to associate those characteristics with nurses. And by now, we’re all aware that nurses have been at the top of the Gallup poll as the most trusted professionals in the U.S. every year for two decades.
In light of the mystique of compassion and kindness that surrounds nurses like a golden aura, why is it that stories of nurses being unkind to one another are so rampant? What about nurses making us treat one another so poorly, leading many nurses to leave the profession altogether?
Incivility Abounds
Stories of incivility, bullying and other unfortunate experiences are ubiquitous among nurses, and common refrains repeated again and again within the nursing sphere tell us that something is wrong out there.
A new grad nurse tells the story of a preceptor who seems determined to sabotage her orientation period, assuredly setting her up for failure and job loss.
A quiet, hardworking nurse becomes the undeserving target of rude and demeaning behavior by the “queen bully” on her unit. Other nurses follow the bully’s lead when it comes to treating this nurse with disrespect.
Several student nurses realize that their clinical instructor has it in for them, ignoring their requests for help during clinical rotations and harshly criticizing them in front of patients and peers.
Nurse bullying has received significant study, including the National Library of Medicine’s documentation of this unfortunate phenomenon:
Nurse bullying is a systemic, pervasive problem that begins well before nursing school and continues throughout a nurse’s career. A significant percentage of nurses leave their first job due to the negative behaviors of their coworkers, and bullying is likely to exacerbate the growing nurse shortage. A bullying culture contributes to a poor nurse work environment, increased risk to patients, lower Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction scores, and greater nurse turnover, which costs the average hospital $4 million to $7 million a year. Addressing nurse bullying begins with acknowledging the problem, raising awareness, mitigating contributing factors, and creating and enforcing a strong antibullying policy. Nurses and stakeholders also must actively work to change the culture, and understand that bullying has no place in the nursing profession or anywhere else in health care.
These statements are sadly true, and the problem is too well documented to ignore.
A Cultural Transformation
Within the nursing profession, a cultural transformation is desperately needed. Rather than nurses internalizing their oppression and taking it out on one another, members of this most trusted profession could choose to individually and collectively examine how they feel oppressed, mistreated, and otherwise overlooked. This type of examination can lead nurses to band together to create workable solutions without turning on one another like crabs boiling in a pot.
In terms of nursing education, schools of nursing need to confront bullying and incivility head-on. And since schools are so keenly focused on NCLEX preparation, this topic needs to become a part of the licensing exam curriculum so that schools have no choice but to talk about it. This ever-present reality must be thoroughly acknowledged, and schools should teach nursing students how to recognize such behavior and respond appropriately. And if clinical instructors and nursing professors are identified as perpetrators, they should be disciplined and fired if their behavior does not change.
There is no silver bullet that can singlehandedly change these dynamics overnight. However, one action by a nurse, executive, instructor, or manager can have a significant ripple effect. Nursing is uniquely positioned to be the largest segment of the healthcare workforce. We can squander or harness our potential power for our well-being. Nurses join collective action, striking for safe staffing, patient safety, or other needed changes. Positive change can be hard-won, but the camaraderie and unity it engenders are priceless.
Nurses deserve better from one another, and we can only effect change if we’re willing to do the work to dismantle a professional culture that looks the other way. Unfortunately, ignoring the problem won’t get rid of it, so let’s tackle it head-on and stop the hemorrhaging of nurses who would likely remain on the job if they were simply treated like the valuable human beings they truly are.
Minority Nurse is thrilled to feature Keith Carlson, “Nurse Keith,” a well-known nurse career coach and podcaster of The Nurse Keith Show as a guest columnist. Check back every other Thursday for Keith’s column.
In conversations with nurses around the country, I hear from older nurses who feel their age is a significant liability in today’s nursing job market. While age discrimination can be a valid concern to remember, older nurses can also leverage their professional history and life experience as a plus for employers seeking accomplished nurses with much to contribute as highly skilled healthcare professionals.
Age and the Nursing Shortage
According to the National Council of State Boards of Nursing 2020 National Nursing Workforce Survey conducted in partnership with The National Forum of State Nursing Workforce Centers (the 2022 study results will be released sometime in 2023), the median age of RNs is 52, up from 51 in 2017.
With an ongoing nursing shortage projected through 2030 by the American Association of Colleges of Nursing and numerous others, employers are not in the position to look a gift horse in the mouth when an older nurse applies.
When it comes to the numbers, there are so many nursing jobs in need of qualified candidates, and, more often than we would like, there need to be more nurses in the market. This is worrisome. As Auerbach et al stated in their April 2022 article in the journal Health Affairs, the total supply of RNs dropped by 100,000 in 2021, the most significant single-year drop in four decades. This is a universal cause for concern.
Enter: The Older Nurse
Despite older nurses’ understandable concerns that employers will pass them by for younger applicants, there may not be enough 20- and 30-something nurses to go around. There’s something to be said for length of experience, and a nurse with several decades behind them has something unique to bring to the table. Unfortunately, while younger nurses just out of school or with less than ten years of experience have fresh perspectives and energy, employers ignore older nurses’ gifts and potential contributions at their peril.
We can attest that age discrimination can cut both ways. For example, some hiring managers or HR professionals may have an inherent bias against younger, less experienced nurses, just as others may look askance at those with more years under their belts.
Truly, nurses of all ages and levels of expertise and experience have unique qualities, and this variety is healthy for the profession, the healthcare system, and employing institutions. With four generations of nurses active in the workforce (i.e., Baby Boomers, Gen X’ers, Millennials, and Gen Z’ers), each cohort can be avidly embraced, especially with a significant nursing shortage with no end in sight.
The Argument for the Older Nurse
If you’re an older nurse (e.g., 40s, 50s, or beyond), there are many arguments to make for your continued relevance. Of course, you don’t want to unnecessarily make your age an issue on your resume, cover letter, or job interview. Still, there are subtle ways in which you can leverage your status as an older, more experienced nurse in your favor.
Experience: Let’s face it — experience counts a lot in most cases. An L&D nurse with 22 years of experience has seen a thing or two. Their ability to contribute to patient safety, the delivery of high-quality care, positive outcomes, and patient education should be considered. If you’ve cared for hundreds of laboring moms and attended hundreds of births, you have valuable experience to draw upon. On your resume, in your cover letter, and during interviews, you can tout your volume of experience as a big plus for why hiring you would be smart.
Maturity and life experience: Maturity isn’t always proportional to age (I’ve known teenagers who are significantly more mature than most 30- or 40-somethings), but we can, by and large, figure that experience and exposure to the slings and arrows of life hold some value. Without explicitly drawing attention to your chronological age, you can communicate how your life experience (e.g., as a parent, a nurse, a citizen, etc.) gives you an edge.
Longevity of employment: A clear bias exists (at least in the media) that Millennials and Gen Z’ers are likelier to ditch an employer when they feel their current position has outlived its usefulness for their careers. Like any bias, its validity is highly debatable; however, what’s not debatable is that older nurses can be very clear when describing their track record of employer loyalty (if that’s the verifiable case, of course), and their desire for a new professional home where they plan to stay for a significant amount of time.
Keep Your Head Held High
You can walk into an interview with your head high as an older nurse. Professional experience, life experience, and relative maturity are factors that any prudent employer will consider.
During an interview, the older nurse can point out that, with onboarding new employees costing tens of thousands of dollars, hiring well is essential, not to mention nurse retention. With a clear demonstration of past workplace loyalty, you can verbalize how you plan to stick around, become a valued employee, and deliver a significant return on investment.
We need newer and more experienced nurses in the nursing workforce, and older nurses can leverage the ongoing nursing shortage to their advantage. However, your value should not be questioned, so make your case loud and clear.
Minority Nurse is thrilled to feature Keith Carlson, “Nurse Keith,” a well-known nurse career coach and podcaster of The Nurse Keith Show as a guest columnist. Check back every other Thursday for Keith’s column.
In healthcare and nursing, there’s always so much in our career we can say no to; however, there are plenty of things we find ourselves saying yes to.
Granted, it’s always empowering to say no to things like working a double shift when you’re exhausted, accepting bullying and incivility as normal, working without adequate PPE, and unsafe staffing levels that put your license and your patients at risk. But those enlightening moments of saying yes and recognizing latent potential can open doors of perception in your mind and opportunities in your life and career.
Saying Yes to Experience
When you sit down in your first nursing class, your lifelong pursuit of building a professional network must begin. That person in the row ahead of you? He may end up being your boss someday. That other student in the back? She might be the key to an incredible opportunity when she founds her nurse-run startup in seven years.
When the opportunity arises to join an interesting committee, become an EMR super user, speak or present at a conference, or take just one more step into commitment. What we’ll call your professional maturation, you’re embracing your evolutionary growth.
If a fantastic job unexpectedly falls in your lap, but you feel reticent to take it because you don’t want your colleagues to feel “abandoned,” this is an important moment to say yes in your best interest. Remember that many of your colleagues would do the same if they were in your shoes, and most will be happy for your good fortune.
No doubt, saying yes to experience can be life-changing.
Saying Yes to Connection
In the preceding section, we mentioned joining a workplace committee. But, again, these experiences can expose you to relationships and connections you would otherwise miss out on. And going to a nursing conference is an excellent experience, especially because you’ll have the chance to meet some fabulous like-minded people.
Your professional network is like your personal brain trust, and building that network over time is an investment that can pay more dividends than you might ever have imagined.
Saying Yes to Prioritizing Yourself
At the beginning of this article, we mentioned things that are prudent to say no to a double shift, bullying and incivility, working with inadequate PPE, and unsafe staffing. Unfortunately, knowing when to say no is as much an art as saying yes.
Saying no to the above scenarios translates to saying yes to prioritizing yourself and your needs. It’s great to help out the team and pick up an extra shift if you have the energy and stamina, but not taking the shift is a win if your reason to do so would solely be guilt.
Likewise, by saying yes to civil discourse and a violence-free workplace (bullying can undoubtedly be characterized as a form of workplace violence), you’re taking a stand for your well-being, not to mention the well-being of your coworkers and patients. Telling a bully that you won’t tolerate their behavior is a resounding yes to your psyche.
Saying yes to self-prioritization is a powerful statement of self-affirmation and valuing your needs and desires. Some might call it selfishness, but you can also call it surviving and thriving.
Saying Yes When It’s Right
As mentioned, there are plenty of things to say no to in healthcare and nursing. And we have established that there’s plenty to say yes to.
Whether it’s a novel experience, a new connection with a valued colleague, or a yes to what you want and need, saying yes can be fodder for a robust, satisfying, and happy nursing career. Saying no or yes is always your right, and knowing when to do so is key to long-term success.
Minority Nurse is thrilled to feature Keith Carlson, “Nurse Keith,” a well-known nurse career coach and podcaster of The Nurse Keith Show as a guest columnist. Check back every other Thursday for Keith’s column.
