Of all things pediatric nurses might have in common – the education, experience, and common patient group – what really knits this group together is one thing, says Shirley Wiggins, PhD, RN, president of the Society of Pediatric Nurses.
“I have to say we look at this as our passion where others might see it as a challenge,” she says. “Integrating the care of the child and family is our passion.”
In fact, at a recent meeting Wiggins asked what brought the nurses in attendance to the pediatric nursing field, and many nurses reported that they decided on pediatric nursing fairly early on.
What does it mean to be a pediatric nurse? “The whole emphasis on the Institute of Medicine’s patient centeredness is what pediatric nursing is,” says Wiggins. “It’s what we love to do, and it’s what keeps us there.”
Pediatric nursing works with an age range of patients that encompasses newborn babies all the way to the young adults of 18 years of age, so centering care on the patient means taking in a broad cognitive and physical spectrum. “The approach is developmental and we focus on that child and where they are,” says Wiggins. With all work done within the network of the family, pediatric nurses recognize that patient support comes in all manner of people – from the parents of an infant to the close friends of a teenager.
There are currently more than 180,000 professional registered pediatric nurses providing care, in various settings including home care, ambulatory clinics, schools, public health, colleges of nursing, hospice and palliative care, says Wiggins.
And Wiggins says pediatric nurses, who are often seen as working with the more vulnerable age groups, are amazed at the resilience of children. “There is great strength in children,” she says. Pairing that show of strength with a love of fun and goofiness lends to a very unique workday for most pediatric nurses.
“We all laugh because there are aspects of pediatric nursing that are really fun,” says Wiggins. In the seriousness of the work they are doing, they can’t forget to add the whimsy that kids often love – whether that’s cat’s ears at Halloween or singing familiar songs with the kids.
And a team approach to nursing children is essential, says Wiggins. Teams of medical personnel and child life specialists offer the support the child and the child’s family need. Wiggins says a good pediatric nurse has the same qualities that make any nurse exceptional. “Be the one that asks questions and sees issues and wants to make it better,” she says. “There’s lots of good communication when we work with others and in the Society of Pediatric Nurses we look at evidence-based standards in pediatric nursing with discussion boards and communication that looks at substantiating what we do.”
Wiggins herself said she knew during her nursing student days that this was going to be her direction. Even at the end of a challenging day in clinical, she thought of what she needed to do to be able to do have days like that for the rest of her career. “It didn’t feel like work,” she says. “It was an opportunity.”
And, yes, pediatric nurses are in a field that could make them prone to compassion fatigue because of the heartbreak they encounter routinely. When nurses mention things only another nurse would understand, pediatric nurses share a special bond of caring for ill children, some of whom do not recover. Because of that, there are lots of protections and processes in place for pediatric nurses to help manage the emotional fallout that can happen and to keep them close to other pediatric nurses who have almost all experienced similar joys and sorrows.
Wiggins points to the DAISY Foundation awards, which recognizes outstanding nurses and the “super-human” work they do with patients and families in difficult times. The awards can help acknowledge that nurses struggle with emotions right alongside families and patients they care for.
If pediatric nursing is something that intrigues you, it’s worth looking into getting some first-hand experience to see if it’s a good fit.
No one can say nursing is a stagnant profession. Even freshly minted grads can feel they are scrambling to keep up with new procedures, technologies, treatments, and processes. If you’re a nurse, you might start to wonder what skills you will need to succeed and stay current in the coming years.
There are a few qualities shared by all successful nurses. Being an excellent multitasker, having empathy, and being nearly obsessed with details never failed a nurse. No matter what your specialty, your location, or your aspirations, experts agree that a few skills in your wheelhouse will not only advance your career, but also help you satisfy your goals of being the best nurse for your patients.
“The first thing you have to have if you want to be the best nurse possible is you have to really want to do it,” says Leigh Goldstein, assistant professor of clinical nursing at the University of Texas at Austin School of Nursing. “You really have to want to be a nurse and not just bring people pills and plump pillows. To get there, you have to put in the hours and put in the study. There’s that little thing in you that tells you, ‘This is it,’” says Goldstein. “It makes learning all the other skills easier.”
LaDonna Northington, DNP, RN, BC, professor of nursing and the director of the traditional nursing program at the University of Mississippi Medical Center, agrees that nurses need a passion for the job. “This is not for the faint of heart,” she says.
Looking ahead, here are some of the essential skills nurses will need to meet job demands at any career juncture.
Develop Critical Thinking/Critical Reasoning
The best nurse thinks outside the box. Adapting to changing situations, unique patient presentations, unusual medication combinations, and a rotating team takes awareness. Assessing and evaluating the whole picture by using the critical thinking developed in school and on the job is essential to success.
“Nursing is not like working in a bank,” says Goldstein. “It’s not 9 to 5. It’s always a unique set of circumstances. You have to tailor and adjust the care you deliver based on the picture the patient is giving you.”
According to Northington, nothing in nursing is static. Nurses can’t usually just treat one patient issue—they have to determine how the patient’s diagnosis or disease has affected them across the lifespan, she says. And nurses have to consider not just the best choice for the patient and the best option for the nurse right now, but they also have to consider those things in light of the city they are in, the timing, and the resources they have at hand or that are available to them.
Make Friends with Technology
Nursing moves fast, but technological advances are sometimes even faster. While new nurses might lack years of direct patient experience, they often have essential technological familiarity. “Most nurses are probably aware that the world of electronics has just taken over,” says Barbara Vaughn, RN, BSN, BS, CCM, chief nursing officer of Baylor Medical Center in Carrollton, Texas. “The more senior nurses who didn’t grow up in the technology world tend to struggle more than nurses who grew up with that.”
With apps that allow nurses to determine medication dosages and interactions and websites that allow patients access to electronic health records, technology is an integral part of modern nursing. “Technology is changing how we practice and will change how nurses function in the future,” says Vaughn.The benefits are incredible. Instead of having to make the time-consuming drive into the ER when needed for an emergency, a specialist might now be able to save precious minutes by first examining a patient remotely with the help of monitors and even robotic devices. Nurses will have to adapt to this new way of doing things.
Nurses have to practice with technology to gain a fluent understanding, says Vaughn. Vaughn, who is studying for her PhD, says she didn’t grow up with online training as the norm, so when her new classes required online work, she wasn’t prepared. Realizing this could be a hindrance, Vaughn asked newer nurses about how to do things, and she practiced navigating the system until she became better at it.
Whether you are accessing patient records, navigating online requirements for a class, or learning a new medication scanning program, technology will improve your work day and help you take better care of your patients. In the meantime, Vaughn just recommends playing around with the computer when faced with something new. In her own department, Vaughn recalls some nurses who were especially stressed out about learning the new electronic health records system. With training and practice, they excelled. “They were later identified as superusers for their unit,” says Vaughn with a laugh.
Adapt to the Broader Picture
With all these developments comes new and greater responsibility.
“As an inpatient nurse, you used to worry about the 4 to 6 days when the patient was under your care,” says Vaughn. “Now if you are in a hospital based setting, you are going to be more involved in patient population health.” That means an inpatient nurse not only has to get the whole story of what happened before the patient arrived at the hospital, but also think about working with the care team to give specific instructions for when patients get home that will be practical.
“The more specialized medicine gets, the more fragmented health care becomes,” says Northington. Technology and that broad view can help reign that all in—and nurses need to know how the puzzle pieces fit together and where and how patients are receiving care.
“More patients will be followed in nontraditional health care settings,” says Vaughn. “Our world and the world we know is going to change,” says Vaughn of the health care industry. With more patients being followed by health care centers in easily accessed sites like Walmart and Walgreens, telemedicine is going to become more important to understand and to navigate.
Practice Effective Communication
Thirty years ago, communication about patient care was effective, but certainly not at today’s level, says Northington. “We have to communicate,” she says. “You have to ask, ‘What do you know that I don’t know that can help this patient?’ or ‘Are these therapies contradictory?’ Nurses are in that integral place to facilitate that interprofessional education and communication.”
Good communication isn’t always easy. Beth Boynton, RN, MS, author of Successful Nurse Communication, says the most effective communication is based in speaking up and in listening.
Especially in fast-paced and dynamic health care settings, the underlying interpersonal relationships can have a huge impact on how colleagues communicate and relate to each other. Nurses need to not only recognize the dynamics at play, but also learn how to work within the environment.
“We all think this is easy,” says Boynton, “but we have to recognize this is harder than meets the eye. Be patient with the learning curve.” Nurses might be assertive about speaking up for their patients’ needs, but not for their own, explains Boynton. So, as nurses look to the future, they should be mindful of not only fine-tuning their ability to speak up, but also listening to both patients and colleagues in return without judgment so everyone can work towards the best possible outcome.
Stay Current
“The nurse of the future has to stay committed to learning,” says Northington. “Take what the research is saying and use the best practices. Ask the questions like, ‘Why are we doing it that way?’ and ‘What can I do differently that will produce a better outcome?’”
To be the best nurse, you must stay current in the newest developments. Take the time to learn new procedures, but also recognize where your skills need updating. For example, if you know you’ll need to deal with chest tubes, don’t just assume you’ll know what to do when the time comes. Make an active effort to gain current experience.
Develop Mentoring Relationships
Every nurse needs a mentor. It doesn’t matter what your role is, how many years of experience you have, or even how many months you have been practicing. If you want to advance and learn the intangible skills needed to excel in nursing, you need to actively cultivate a mentoring relationship. Nurse mentors are often found at work, through networks, or within professional organizations.
Refine Your Personal Compass
A little bit of a thick skin will do wonders for any career nurse. “You have to defend your patient from everyone and take care of them,” says Goldstein. That means when a physician makes a call you disagree with or you overhear an unfriendly comment, you need to speak up when it matters and let it roll when it doesn’t.
And some of the personal work nurses have to do isn’t easy, including reflecting on and adjusting for any personal feelings or prejudices they have about patients in an open and honest manner. “We need to be able to take care of people no matter what their circumstances or color or what they did to get here,” says Goldstein. “You can’t treat patients differently. You need to take care of them and not make a judgment.”
Prepare for the Unexpected
You never know what your day will bring, so lots of personal reflection, discussions with others in your profession, and cultivating skills can help you when you are faced with something you’ve never had to deal with before.
“I think whether you are starting out as a new nurse or you are a seasoned nurse, nursing care is constantly changing, and being flexible to those changes is paramount,” says Princess Holt, BSN, RN, a nurse in the invasive cardiology department at Baylor Medical Center in Carrollton, Texas. It’s not easy, she says, to constantly adapt to new approaches and new practices, but nurses need to sharpen their focus. “When I get frustrated, I always go back to put myself in the mindset of my patient I am caring for or of my physician who is making this order or of the family I am taking care of to find new ways of looking at it. It grounds me and helps me understand.”
Developing all the coping skills to deal with job stress is a personal approach that nurses will cultivate as they go.
“New nurses don’t always take care of themselves and the emotional baggage you take with you,” says Goldstein. “You have to incorporate those experiences into a coping strategy that you have to develop on your own. Every nurse needs to figure out what they need to do to handle that.” And if you aren’t able to really learn how to cope, nurses must have the skills to either recognize that some kind of career shift is necessary (maybe even just moving from the ER to postpartum, suggests Goldstein) or to be open to hearing it when others recognize it.
Recognize Your Private Life Impacts Your Career
Nurses have to realize their career choice is 24/7. And while you have to balance your life and leave the hospital behind, you also have to somehow adapt to always being a nurse first. Family picnics can turn into a mini diagnosis session, neighbors might ask you to look at a child’s rash, and your private life can impact your job very directly in a way that won’t happen in other professions. “Nurses are held to a higher standard than the average citizen,” says Goldstein.
Learn Where to Learn
Yes, nurses in school learn the hands-on nursing skills like hand hygiene and infection control, says Goldstein, but, like any nursing skill, mastering them takes time.
Some hospitals have new nurse orientation programs that help new nurses acclimate to the setting, but if you don’t have that option, rely on your own observations, ask questions, and take classes to help get you up to speed. When you’re on the job, watch others to see how they incorporate things like patient safety into their routine interactions with patients. And Holt, who has worked in departments from ER to interventional radiology, says moving around builds skills. “I have seen it all,” she says, “and there is still more to see.”
Put It All Together
When nurses consider all the skills they need to succeed, some are easier to gain than others. “You need to understand what goes on behind all the mechanics,” says Northington. “It’s the knowledge behind the skills you need. They can teach nurses things. Nurses have the rest of their lives to learn things. We need nurses who know how to think, to problem solve, [and] who know when they are in over their heads to call for help. The most dangerous nurse is one who doesn’t ask a question.”
And nurses must keep moving forward and adapting even when the pace seems relentless. “We’ve come a long way,” says Northington. “And in 20 years, nursing won’t look like it looks now. Nursing is one of the best careers because it’s always evolving.”
Sharon Tissell, RN, dreamed of one day helping those around the world without the fortune of growing up in a loving, middle-class family like hers. Tim Harrison, RN, MPH, flew for 10 years with a medical helicopter service and knew he had the right skill set to make a difference. Martina Ford found that she thrived in multicultural settings.
All three of these nurses have found their professional sweet spot, which, at most, pays them a modest stipend and requires them to endure Spartan—and often dangerous—living conditions for months at a time. They are humanitarian medical relief nurses who make multiple trips each year to the very places we see in the news that we are told to avoid.
Places like the Syrian-Lebanese border, which is experiencing the largest exodus of refugees in recent history as Syrians flee their country after a brutal government crackdown and civil war began in 2011. Or South Sudan, Africa’s newest nation where ethnic rivalries have destabilized a fragile government and led to violence, bloodshed, and the internal displacement of tens of thousands. Or the Philippines, where Typhoon Haiyan flattened towns and villages, crippling a country’s capacity to deliver basic services and medical care to its people.
What motivates Tissell, Harrison, and Ford to return to these situations time and again is the opportunity to offer unconditional care, comfort, and compassion to the world’s most vulnerable populations. Across vast geographic, cultural, and ethnic boundaries, their work goes to the heart of what nursing is.
They don’t let politics and war keep them away, although these are often the factors fueling the crises at hand. While fearless, humanitarian relief nurses are hardly reckless, receiving intensive security training from their sponsoring organizations and working on highly coordinated teams where personal safety is valued above all else. Moreover, these nurses hardly see what they do as a personal sacrifice.
“It’s not about you,” says Harrison, a nurse with Médicins Sans Frontières (MSF), or Doctors Without Borders, who lives in Maine when he is not traveling for MSF. “It’s really about the direct connection between donors [of humanitarian aid] and beneficiaries. You’re simply the conduit.”
Wearing Multiple Hats
While nursing can be a satisfying career, it also runs the risk of being repetitious; working internationally can be a “way to break out of the doldrums going into your shift every day,” says Sue Averill, RN, cofounder and president of One Nurse At a Time, an organization that provides information and scholarships to nurses who want to work in humanitarian relief. Averill herself has gone on eight missions with MSF and several others with Medical Teams International (MTI), based in Tigard, Oregon, and with Smile Train, based in New York City.
Averill says experiences in the ER, ICU, surgical, and critical care floors are great preparation, as are courses in public health and tropical diseases such as Dengue fever, malaria, and others rarely seen in the West.
Also invaluable are critical thinking skills that empower you to be resourceful and in situations where supplies, medicines, and equipment are limited. Reorienting yourself to medicines that may be similar to those in American hospitals but with different branding, dosage levels, and packaging is also key.
Being able to communicate crossculturally and understanding cultural biases are as important as having strong medical training, Averill says. For example, a small white pill may be perceived to be inferior to a large white pill or a colored capsule in certain cultures. Local people and medical staff may “imbue [Western nurses] with qualities [they] may or may not have,” she adds. “People believe that simply because you came across the world to help them that you come with something better than they have,” even when that may not be the case.
That’s why it’s critical to have frequent conversations with patients to understand cultural biases and figure out how to work around them. One major strategy is to make sure you and your translator are “on the same page,” suggests Averill.
Relief work also requires nurses to wear multiple hats, she adds: “You’re a human resources person. You’re diagnosing and treating. You’re hiring and firing.” But perhaps most importantly, you’re teaching local people to think critically.
Averill was once tasked with setting up a hospital for Darfurian refugees in an isolated village on the border between Western Sudan and Chad. The endeavor required training local workers, including a woman who said she was a traditional birth attendant. After asking the attendant how many weeks pregnant a local woman was, the attendant said “36,” when the woman was nowhere near full-term. It was then that Averill realized that the attendant was unable to count.
In a similar vein, other workers claimed to know how to take pulses and blood pressures, but in fact didn’t understand how to do either. Another worker wore the same pair of gloves as she screened patients for malaria.
“They were doing these tasks rotely and not understanding what they mean,” Averill says. “That critical thinking piece wasn’t there.”
So, Averill went over the basics, teaching the staff how to take vital signs, the importance of glove disposal and frequent hand washing, and how to do A/B/O typing for blood transfusions. “It was really fun to see the light bulb go on,” Averill says, similar to the one going off in her own head as she stretched her own skill set.
Similarly, Ford had little experience in obstetrics before traveling with MTI to the Nakivale Refugee Settlement in Uganda last year. The local midwives were eager to see a “muzungu,” or white person, to deliver a refugee woman’s baby. So with “no IV, no monitors, no electricity,” Ford says she stepped up to the plate and did it. “It was mind-blowing.”
“When you’re talking to people about going on these trips, many people like the idea of it,” she adds. “But nothing is what you think it’s going to be.”
Street Smarts
Having a successful experience as a humanitarian relief nurse also requires emotional fortitude, flexibility, and the ability to think on your feet, says Harrison. Being a medical transport nurse for Boston MedFlight not only gave him a broad skill set in obstetrics, pediatrics, and trauma care, but also taught him the importance of teamwork and maintaining equilibrium in situations that are fluid and unpredictable.
Harrison first encountered MSF in 2004 working on a volunteer assignment in Chad with another medical assistance organization. What impressed him about MSF was its long-term investment in communities lacking the medical infrastructure to contend with disease outbreaks and public health emergencies. He also observed that MSF didn’t do “drop-in medicine” like other relief organizations did, allowing it to have a larger impact; he also admired MSF’s independence from government funding and its neutral stance towards political debates and conflicts. With several international assistance trips under his belt, he decided to apply for a full-time nursing position with MSF.
After a lengthy interview process with MSF, Harrison was accepted in 2008 and left Boston MedFlight with the blessings of his boss. That year, Zimbabwe was being devastated by a cholera epidemic caused by the breakdown of water sanitation and sewage systems in urban areas; the disease spread quickly to the countryside after city-dwellers visited relatives in rural areas.
Harrison’s first assignment was to manage a database that tracked the epidemic as it moved from cities to towns and villages. Later on, he joined a team responding to malnutrition and cholera in prisons around Harare, the country’s capital. Rather than focusing on the prison’s water delivery system, the MSF team focused on chlorinating the water supply, boosting the immune systems of prisoners through antibiotics and nutritional therapy, and getting infected prisoners into treatment.
After six years with MSF and multiple trips to conflict zones throughout Africa, Harrison says the work brings out his street smarts. “I seem to have the mentality that [MSF] can put me some place in the world and I can work out what’s going on,” he says.
At no other time was Harrison’s even-keeled temperament tested more than a harrowing trip to South Sudan late last year. His experience also underscores how rapidly the situation on the ground can change and the importance of staying alert and in contact with team members.
Since 2009, Harrison has made trips to South Sudan, which achieved independence from Sudan in 2011 after a protracted civil war between rival ethnic groups. MSF has had a strong presence in the region since 1983, delivering primary and secondary health care in clinics and hospitals in several major cities including Juba, the capital, as well as Lankien, Bor, Bentiu, and Malakal.
On his first trip in 2009, Harrison went to Lankien to oversee a feeding center for malnourished residents. He spent time training local hospital staff who had little or no medical training. After a brief trip to the region in 2010, he returned to Malakal in October 2013 to see the fruits of MSF’s investment in the local workforce. “You could really see the change,” he remembers. “I had skilled people working for me.”
As with his previous trips, Harrison was assigned to one of MSF’s kala azar treatment centers within the Malakal Teaching Hospital. Kala azar, a tropical disease that attacks the immune system and is fatal if untreated, is transmitted to humans through sand flies, carriers of the leishmania parasite. The disease persists in Sudan despite MSF’s long-established kala azar clinics.
On December 15, 2013, a coup was attempted on President Salva Kiir’s postindependence administration after long-simmering tensions between rival ethnic groups, the Dinka and Nuer, exploded. A Dinka, President Kirr accused Vice President and Nuer politician Riek Machar of instigating the coup. The military began splintering along ethnic lines, and armed conflict began spreading from Juba to other regions.
By the week of Christmas, the fighting had reached Malakal. Harrison and an Amsterdam-based MSF team were hunkered down in their rented house in the middle of Malakal’s downtown marketplace, gunfire and mortars exploding around them. Harrison and others had been staying in touch with MSF outposts in Juba and other cities to get the latest news. “By the time it became obvious something was going to happen, we couldn’t get out,” he recalls.
The group managed to move down the street to a house rented by an MSF team from Spain. Altogether, there were nine MSF team members who had remained in Malakal, holed up in a 12 x 12 room for 36 hours until Christmas Day, when the shooting began to dissipate. By Thursday, the day after Christmas, the teams decided to make their way back to the Malakal Teaching Hospital to assist an International Committee of the Red Cross (ICRC) surgical team with a brand new set of patients: soldiers and civilians wounded in the crossfire.
When he returned to the hospital, Harrison noticed that many of the healthier kala azar patients had simply fled. He quickly switched gears and helped set up a 60-bed triage unit to deal with the sheer numbers of wounded streaming into the hospital. With his experience as a trauma nurse, Harrison jumped in to assist the ICRC surgeons with anesthesia, wound debridement, IVs, and “whatever was needed.”
Harrison’s work continued on like this until mid-January, but what was becoming painfully obvious was the deterioration of the security situation inside the hospital. Initially, the soldiers agreed not to bring their guns inside, but soon, guns and “cases of whisky” could be found on the hospital grounds. Family members of the wounded and refugees from Malakal soon began overrunning the hospital to escape the violence.
“At one point, there were 1,000 people in the hospital,” Harrison says. “It had become an IDP [Internally Displaced Persons] camp.”
What finally convinced Harrison and his fellow MSF team members who had remained in Malakal that staying was no longer an option was when teams in both MSF residences took a hit. The Spanish team was robbed of their mobile phones and laptops at gun-point by an armed group; a drunken soldier burst into the compound where Harrison and the rest of the Amsterdam team were staying and started shooting in the air. The house’s security staff talked the soldier down and got him to leave. The next day, Harrison and the entire MSF team headed to a United Nations compound outside of Malakal and were on a flight out of the county soon after.
Harrison says the decision to leave was wrenching, but one that ultimately made sense given the escalating conflict. The hardest part was wondering whether the work could be continued by the hospital’s local staff, many of whom said that it probably wouldn’t. (By February, MSF had to suspend its activities at Malakal Teaching Hospital, according to a recent MSF report.) Still, the team’s departure weighs on his mind: “How does this look that you’re having to flee? You can always leave. You can always go home. What about the people left behind?”
A Higher Purpose
Tissell remembers clearly what inspired her to work internationally: the National
Geographic magazines her parents subscribed to at the family’s home in Kerkhoven, Minnesota. As she perused stories about hardship and traditional cultures from all over the world, she began to realize that “not everyone had the same upbringing as me.”
Her parents, now in their 80s and extremely supportive of her work with MTI, gave Tissell both a great childhood and self-awareness. “I had a strong sense as a young person that I had a whole lot and [some] people had nothing,” she says.
Ford, too, was deeply affected by the unequal distribution of medical care throughout the world. As a childhood survivor of uterine cancer, Ford pursued nursing because of wonderful care she received at a children’s hospital in Portland. “I have a lot of guilt related to inequalities in medicine and education,” she says. She channels her guilt into providing medical assistance and communicating across cultures through trips with MTI.
With her propensity to help those in need, nursing was a natural fit for Tissell. When her eldest of four children turned 17 in 1999, she decided to join an MTI month-long trip to Honduras to set up mobile medical clinics in remote villages destroyed by Hurricane Mitch. The last two weeks, Tissell’s team packed their medicine and supplies and rode mules into the dense jungles of the Mosquito Coast. “We saw a lot of Dengue fever, malaria, a lot of infections from injuries, upper respiratory infections…and childhood disease that hadn’t be treated with vaccines,” she recalls.
Over the next 15 years, Tissell went on more than a dozen medical trips with MTI. She now works shifts at two different hospitals to accommodate and subsidize her travel.
Through her work, Tissell has provided medical care to refugee communities around the world uprooted by high-profile natural disasters and wars. She has treated famine-stricken Somali families seeking refuge in Ethiopia. She served in an IDP camp in northern Uganda to receive malnourished women and children who had fled the terror of Joseph Kony and his Lord’s Resistance Army. On a trip with Los Angeles-based International Medical Corps, she was treating civilians at hospitals in Libya just days before Colonel Quaddafi was captured and killed. And she was in a tented settlement in Lebanon’s Bekaa Valley in May 2013 providing medical care to the thousands of middle-class families from Damascus and other Syrian cities streaming across the border after President Bashar al-Assad began shelling his own people.
The families, who had left homes and careers behind, weren’t suffering from exotic diseases, but rather chronic illnesses such as lymphoma, diabetes, and heart disease that they were unable to treat without access to medicines and regular medical care. “One woman said, ‘We lived in a nice house, we had three bedrooms,’” Tissell says. “This was a total disruption of what their life had been like.”
Each time she returns to her home in Happy Valley, Oregon, Tissell arrives with photos and memories of the families she has helped. Motivated by a strong sense of divine purpose, Tissell says she is perennially awe-struck by the gratitude expressed by people who have just lost everything—and in many cases, everyone. She says she’ll never forget a Congolese woman she met in Uganda whose husband had just been shot during an outbreak of violence in their native country. When she asked the woman if she thought God had abandoned her, the woman turned to her and said, “Of course He hasn’t. Otherwise you wouldn’t have made it here.”
Archana Pyati lives in Silver Spring, Maryland, and writes frequently on health and science topics.
Katrina Sanders, RN, ONC, is a clinical coordinator at Novant Health. In addition to being a nurse for 14 years, Sanders is a busy mom of twin one-year-old girls, a five-year-old, and a 10-year-old while still earning professional credentials that add value to her hospital and work unit.
Sanders is committed to going above and beyond the call of duty for her patients and their families. She has been known to go to get their lunch from the cafeteria, locate a recliner for a family member to sleep in, or share DVD’s and laptops for family members to play with while they wait for a loved one.
Today she shares how she became interested in a nursing career at a young age and what inspires her to be the best nurse she can be.
What made you become a nurse?
I love nursing because I am able to provide comfort, passion and encouragement to my patients. At the end of the day, I feel like I gave my heart and soul to make a difference in someone’s life. I have wanted to be a nurse since I was in the 10th grade. I have a strong desire to help people and care for them in their time of need. For me, there was no moment of divine intervention, no following the footsteps of an admired parent or relative, but rather a gradual realization that nursing would be the perfect job for someone who has a big heart like I do.
What inspires you about nursing?
What inspires me about nursing is that as a nurse you can take care of the patient’s physical needs like dressing wounds and giving medications. However, as a nurse, you can also comfort them when they are scared, read a book to them or play a game with them. I am inspired to be a nurse because I know I can more than physically heal a patient.
What do you think are the most important qualities for a nurse to have?
The most important qualities of being a nurse include being attentive, being a great listener and being sensitive to people’s needs. Why? Because you can’t properly care for someone if you do not know what is physically, mentally and emotionally going on with them. In order to give someone holistic care you need to know their story.
Where do you see the future of nursing headed?
I see nurses starting to practice at the fullest extent of their education and training. Nurses will need to be skilled in the use of computer technology.
What goals do you still have for your career?
I plan to graduate in December with my BSN and then pursue my Master of Science in Nursing (MSN) degree.
What advice would you give to other minority nurses?
Be open to new experiences and do not be afraid of change. Have an open mind to whatever experiences come along and take advantage of the opportunities as they come your way.
Denene Brox is a freelance writer based in Kansas City.
One of the hot topics in nursing is the need for good nurse leaders. For minority nurses, the topic is especially important. As the patient population becomes increasingly diverse, nurse leaders of all ethnicities are going to be needed to most accurately represent the diversity of those patients.
If you are intrigued by the idea of taking on more challenging roles and increasing your responsibility but aren’t sure you have what it takes, read on. Some leaders have a natural way with both superiors and subordinates and inherently magnetic qualities to boot – the term “born leader” probably applies to these folks.
But if you weren’t graced with those qualities, you can always learn them, and wanting to do more, achieve more, and make a change is more than half the battle.
If you don’t feel like a born leader, how can you make yourself look like you are one?
1. Act Like a Leader
Come up with innovative ideas and make sure they get in front of the right people. You can start small with something in your unit and then expand into something bigger. Always look for ways you can improve your environment. Make your own work habits impeccable – be on time, be calm, be decisive, be professional, and always, always be prepared.
2. Share Your Knowledge
Leaders want to make a change; they don’t want to keep all their knowledge to themselves. Offer to make a lunchtime presentation about changes you implemented that made a difference so you can show others how to do the same. Document new policies so others can achieve the same success. Mentor a younger nurse or a nursing student.
3. Praise Your Colleagues
Have you ever noticed that a good leader offers strong guidance and opinions, but is equally free with giving praise where praise is due? If your team did something great, get the word out and include everyone’s name on documentation. Sing their praises and thank them in whatever way your department finds appropriate. Even something as simple as a fresh fruit and muffin breakfast is appreciated and remembered.
4. Keep Learning
Leaders never stop learning, and they will learn from any situation. Leaders do more than keep their certifications up to date, they learn how to do something new. Take a class in policy change. Investigate a new development in your specialty or learn about any new treatments involving diabetes or whatever chronic condition you see frequently. Join a professional organization and learn how nurses in other organizations work or how they solve problems. Study how businesses motivate workers and keep up with the changing world.
5. Make the Change
Leaders combine the information they learn, the situations they find themselves in, and the people they meet, and they use all that forward momentum to make a change for the better. How can you use those forces at work in your life to make a change? Can you start by being the best advocate for your family or an ill neighbor? Can you help your community or a local school by giving them accurate, timely information with a newsletter or a presentation? Can you make a lasting change for a repeat patient who struggles constantly with discharge instructions or one colleague who needs a little professional guidance?
Maybe you weren’t born a leader, but you can become the leader you want to be. You just have to start somewhere.
Sanders is committed to going above and beyond the call of duty for her patients and their families. She has been known to go to get their lunch from the cafeteria, locate a recliner for a family member to sleep in, or share DVD’s and laptops for family members to play with while they wait for a loved one.
