Perhaps all professions have stereotypes. For instance, the Italian chef, the cocky policeman, or the disgruntled cashier are all possible types in these professions—and they do nothing for the people who actually work in those professions. Unfortunately, nursing is the same way, having a bevy full of stereotypes that describe different types of nurses. However, with nursing, the stereotypes are something different. They are skewed, insidious, and dangerous.
On the website, TruthAboutNursing.Org, Sandy Summers, RN, MSN, MPH, and her group help to dispel some of the myths surrounding the stereotypes that nurses must endure. The nurses that these stereotypes are supposed to represent are completely at odds with what nurses actually do. They are introduced and perpetuated by the media so that the general public thinks this is what nurses are. For nurses to be respected, though, we must overcome these stereotypes and show what nursing really is. Not only does our profession depend on it, but the lives of our patients may depend on it, as well.
1. Angel
All nurses are angels. We are sent from above to provide other worldly care and make our patients feel like they are in heaven. The angel is unassuming, flinches at the sight of blood, and usually needs help finding their way out of a paper bag. Not only is this a sexist idealization of nursing, it is completely misguided. Yes, nurses save lives, and yes, nurses are often called angels by their patients. However, nurses are professionals.
We are not ones to shrink from a situation, and we certainly don’t need to turn to anyone other than our fellow nurses when there is a problem with a patient. The angel stereotype assumes that the nurse is a shrinking violet, most likely a female, who fluffs pillows and hands out orange juice. This is not nursing. Nursing can be surprisingly violent and dirty. It isn’t angelic to clean a trach or to perform post-mortem care. However, performing these duties are part of the sacred trust of the nursing profession, they don’t fit the stereotype of the sweet, clean, perfect, and unsullied angel that the media would have you believe that nurses are.
2. Battle-axe
The battle-axe is the nurse intimidator, so aptly portrayed by Nurse Ratched in One Flew over the Cuckoo’s Nest. Surprisingly, this stereotype is seen in many different media outlets, and patients tend to believe that there are these super angry, sadistic nurses that are just waiting to pounce on them. Of course, the battle-axe runs in direct conflict with the angel. While one is sweet and kind, the other is the bitch. It should be noted that all of these stereotypes are distinctly female, keeping men from even considering nursing as a viable profession.
Nurses are not battle-axes any more than they are angels. Again, we are professionals, just trying to do a job. There are no angry, sadistic nurses who would treat patients poorly simply because they are having a bad day or because they’ve “been around the block.” The battle-axe stereotype is probably the most inexplicable. Who came up with this idea that nurses could be mean-spirited bitches? Nursing is hard work, and many of us are frustrated with the profession. However, that would never translate over into patient care. If it did, we shouldn’t be nurses.
3. Naughty nurse
Perhaps the most derogatory stereotype is the naughty nurse one. If you go into any Halloween store, you will find the costumes with the tight white dresses and the short white skirts. It is embarrassing to nurses and completely degrades the profession. The naughty nurse image turns nurses into a sexualized stereotype that is completely at odds with what nurses actually do in their job. Furthermore, it projects the image that female nurses are sex objects and can be treated as such by patients in the hospital setting.
Another byproduct of this issue is that men may not want to enter the profession because they don’t want to be a naughty nurse. They don’t want their own sexuality questioned because the general consensus is that a nurse is primarily a female sex object. This means that a great deal of male candidates would rule out nursing as a profession, and that can weaken nursing as a whole. You don’t need to be a feminist to see that the naughty nurse stereotype is dangerous. It is not just good clean fun. Nurses are put down by this view of them, but they can also be put in danger by men who think they are nothing more than sexualized, bed bath giving creatures of pleasure – not the medical professionals that they are.
4. Handmaiden
A handmaiden is someone who is at the beck and call of someone else—in this case, the doctor. Nurses are sometimes seen as the ones who are commanded to do what the doctor says and run to fetch. The problem with this stereotype, besides being wrong, is that is sets up a situation in which nurses are seen as only doing work that is manual in nature. For instance, a nurse can give a bed bath, but not make a decision on holding a benzodiazepine on a confused patient. A handmaiden can fill water pitchers, but not listen for lung sounds and determine the difference between rales and rhonchi. Handmaidens do physical work, not mental.
The public doesn’t understand what nurses do when it comes to the real intellectual work of the profession. Nurses use critical thinking as much as doctors. They often have to make decisions on the spot. They have to determine when to involve the doctors, and then they have to decide what the salient points are to relate to the doctor. Nurses are far more than handmaidens because they are far more than people who do physical work. While the physical work will always be a part of nursing, it is only a small part in this changing profession. In the past, it had a far more prevalent role, but the media has not caught up to how nursing has changed. The public just doesn’t really know what it takes to be a nurse in today’s health care world.
5. Unskilled
Finally, the stereotype that ties all of them together is that nurses are generally unskilled. Everyone knows that doctors go through an intense amount of training and that they give orders. Everyone has this sense that there is a hierarchy in the medical system and that doctors head it. As a consequence, the public thinks that nurses are at the bottom, and they are therefore unskilled. As with any unskilled laborer, they would deserve less respect and would be replaceable. Of course, none of this is true because there is a marked difference in the skill set of a doctor and a nurse. It takes particular types of skills to work as a nurse, and saying a nurse is unskilled shows complete ignorance of what a nurse actually does.
Nurses assess, meaning that they look at a patient and determine health or disease. Nurses make independent diagnoses of their own and act on them, measuring the outcome of their actions. For instance, if a patient is suffering from chest congestion, in conjunction with the other health care professionals, nurses can implement treatments such as incentive spirometry and ambulation as allowable. They can also suggest to the health care team the possibility of starting albuterol treatments if they are not contraindicated. These are not the actions of an unskilled laborer. It takes a great deal of thought and skill to assess, diagnose, and treat these conditions, and this is only one example. Nurses are skilled in helping patients holistically, and this makes them vital cogs in the great machinery of health care.
In conclusion, nurse stereotypes are dangerous to nurses and the public alike. They are dangerous to nurses because they take away from the profession. People who may want to become nurses may not because they feel that nurses actually are this way. The media does nothing to change how nurses are portrayed and actually perpetuates these stereotypes. They do nothing to find out the truth. It is harmful to the public because nurses don’t get the funding, respect, or help they need to protect their profession. When nurses are degraded, patients suffer. Management sees nurses as expendable, and this means patients don’t get the best nurses or even enough nurses. In the end, stereotypes hurt patients, and it is time for the media to get it right. The health of millions literally hangs in the balance when nurses are disrespected.
It seems that every day there are new discoveries in the field of Alzheimer’s disease. From new treatments to ways to screen for the disease, the condition is in the news as frequently as some politicians. How reliable are these findings, though? Are they published in reputable journals and are they anything more than snake oil? Here are four of the most recent new pieces about Alzheimer’s disease and a look into how likely they are to make an impact on patients’ lives.
Aducanumab
The News: An article published in Forbes points to a research article in the scholarly journal Nature that studies the effect of aducanumab, an antibody that has shown promise in attacking the amyloid plaques that form between nerve cells in Alzheimer’s. In a double-blind, four-year trial, the infusion of the antibody showed marked improvement in the symptoms of Alzheimer’s in those with moderate disease indicators.
The Background: The Nature research paper, though compelling, has several flaws that most Alzheimer’s trials suffer from: the sample size. This study, though well planned, only tested the antibody on 145 patients and all were pooled from the United States. Although the study points to positive responses, the research is far from becoming a treatment for Alzheimer’s.
Implications: The study into aducanumab is certainly intriguing, but it is not convincing. Although it offers hope for those with Alzheimer’s, it is not a cure just yet. A larger study is necessary to even bring this treatment into trials, let alone present it for approval by the FDA. While interesting, the breakthrough may not be the miracle cure patients are looking for.
Indicative Gene Signatures
The News: According to an article published on ScienceDaily, a group of researchers have found that younger people with a particular gene signature can show a risk for Alzheimer’s early in life. This gene signature makes parts of the brain more susceptible to the proteins that form in the condition, causing the plaques that are so devastating to the neurons when Alzheimer’s begins in earnest.
The Background: The research was conducted by the University of Cambridge, and it was published in the journal Science Advances. The researchers studied the brain tissues from 500 healthy individuals and found this gene signature common to those that are found in Alzheimer’s patients. This pattern repeated itself in the healthy brain tissue and the Alzheimer’s identified brain tissue alike, though it does not indicate why the patients with healthy brain tissue had the signature and did not have the condition.
The Implications: As with most studies, more research needs to be done to plug up the holes in this study. Why are normal brains showing the same markings as Alzheimer’s brains? Could this be a coincidence? In any case, gene therapy is in its infancy so finding genes that are indicative of Alzheimer’s, while intriguing, does not actually help cure the disease in the immediate future.
Fast-Tracking BACE Inhibitors
The News: Unfortunately, drugs to treat Alzheimer’s are difficult to come by. One drug, named AZD3293, has shown some promise in treating mild to moderate cases of the condition by reducing the amount of amyloid buildup around the neurons. Although it has been fast-tracked, it is nowhere near ready to become a treatment for Alzheimer’s, as this article in the Wall Street Journal relates.
The Background: This new drug is supported by both Eli Lilly and AstraZeneca. The two companies are rivals in the pharmaceutical industry, but since the search for a drug is so elusive, the two have teamed up. They have even agreed to split profits from the drug, which is nearly unheard of. Unfortunately, other Alzheimer’s test drugs have caused severe liver issues and other problems in humans, and none have been viable as a drug to reverse or inhibit the disease, besides Aricept and Namenda.
The Implications: Drug companies are getting closer to finding a treatment for Alzheimer’s, and this fast track is promising. It shows that the FDA is convinced enough to give the green light and allow the companies to proceed. However, the search for a treatment still remains murky, and even this fast-tracked drug can pose problems. Although it can be a bright light in the darkness of Alzheimer’s, it could be another frustrating dead end.
Intensive Research
The News: Instead of trying one method of combating Alzheimer’s, the researchers at Sutter Neuroscience Institute in Sacramento, California, are trying as many as five different methods to treat the disease, according to an article published in the Boston Herald. Among these, the use of the intravenous immunoglobulin antibodies, the effects of vitamin D on memory, and the ethnic implications of Alzheimer’s are all under investigation. All of these research projects are ongoing, but none have yet reached the point of publication.
The Background: Although this may seem like a scattershot method of looking for a cure, it actually makes sense. The current drugs for Alzheimer’s are woefully deficient. At best, they can give the patient an extra year of memory health, but they cannot stop the relentless march of the disease. They are inadequate at best, and the frantic search for some treatment means that this sort of research is the only way the medical profession is going to find something that works.
The Implications: Something in these research studies in Sacramento may end up being the cure for Alzheimer’s, or it may end up being something that slows its progress . . . or it may end up another dead end. The implication of this sort of study is the hope for a cure. It isn’t going to help patients now, and it probably won’t help patients in the near future. Someday, though, this sort of research will help patients. With the dedication of people like the researchers in Sacramento and across the country, a solution will eventually be found. It hasn’t been found yet, but everyone still keeps looking. That’s what counts.
Just about every nurse is familiar with the grief-stricken family member. Either they stoically and robotically listen to what you have to say, or they cry and scream at their loved one’s death. They are allowed to grieve because they just lost someone who may be the world to them. But what about the nurse?
A nurse is a human being, and they may have taken care of that patient for a long time. The act of caring for a patient is an inherently intimate one, and when that patient dies, nurses can feel grief, too. Even watching a patient’s family member break down can be distressing for a nurse, but so many nurses ignore it. In addition, nurses don’t often know they are experiencing it.
Debbie Gossen, RN, OCN, GMS, of the Cancer Treatment Centers of America® (CTCA) at Midwestern Regional Medical Center in Zion, Illinois is an expert on grief in patients and nurses alike. She helped spearhead special Renewal Rooms on every unit in the CTCA to help nurses express their grief.
“Grief is not universally understood by many,” says Gossen. “Grief is a normal reaction to loss. Grief becomes problematic when it interferes with daily activities and reduced enjoyment in life. Grief can exhibit a wide variety of reactions.”
In nurses, some of these reactions can range from crying in the breakroom to acting out at home. For this reason, it is important for you to recognize and deal with your own grief. You should also know when to seek out help for the grief that may not have resolved.
Dealing with and Recognizing Your Own Grief
You can experience grief in many ways, and some of them are physical. “Grief can manifest itself in a wide variety of emotional and physical symptoms, such as anxiety, sleeplessness, ulcers, headaches, joint pain, et cetera,” explains Gossen.
However, those aren’t the only ways. Most of the symptoms are psychological. Acknowledging the feeling is one of the most important steps you can take, and then you can share your feelings with coworkers and other sympathetic persons. You need to find a healing, non-judgmental place that will support your grief rather than minimize it.
In fact, Gossen advises: “Do not hold on to or suppress these feelings. You will be less effective in dealing with the sick and dying patients if you do not work through the grief. Grief is a multitude of feelings that must be expressed and processed. Nurses also need take time for themselves and prioritize self-care.”
Only by making time for yourself can nurses fully process their own grief over the loss of a patient. It should also be noted that a patient doesn’t necessarily need to die to provoke a response. Simply dealing with a patient who is suffering or dying by inches can make symptoms appear, as well.
Nurse Versus Patient Grief
It can be difficult to separate your grief from your patient’s or the grief of their family. In fact, nurses may feel that they are not really experiencing grief at all, but simply observing the grief of others without the feelings affecting them. Thinking this way could be a possible mistake.
“Sometimes we are not as accepting, forgiving, and understanding of our own grief,” says Gossen. “Nurses can be hard on themselves with high or unrealistic expectations.”
Indeed, nurses are expected to be tough, especially when it comes to dealing with the emotional side of the profession. “There’s the old saying that ‘you need to check your problems at the door before coming to work,’” Gossen continues. “Well, that type of thinking just doesn’t work anymore. In order for a nurse to be effective and provide the care our patients demand, coming to work with a grieving mind is not ideal. They need to apply the same compassion, caring, and forgiveness that they allow their patients, upon themselves.”
Self-compassion is something that is not taught in nursing school, orientation, or continuing education. It is the practice of treating yourself as you would treat your patient. If your patient wanted to weep for all they lost, you would comfort them. However, if you wanted to weep for all you witnessed, you may be reluctant to reach out for help. That is the problem nurses face when they deal with their own grief, and self-compassion is usually the answer.
When to Seek Help
In addition to denying themselves compassion, nurses are often reluctant to reach out for help. This stems from a misguided notion that a tough nurse—a good nurse—doesn’t need help for emotional problems. A good nurse simply gets used to feeling that way and becomes inured to the pain around them.
This is simply not true, and it is unfortunate that so many nurses believe it about themselves and about the profession. It is not “tough” to allow yourself to hurt mentally and emotionally. One sure way to destroy your psyche is to ignore your feelings. But when should you seek professional help after exhausting the help of friends and family?
“It is important to seek professional help when you are unable to work through the anger and pain,” advises Gossen. “When the stress response affects your mood, behavior, and thoughts you would benefit from professional help to work through these feelings. It is important to tame the stress before it bites you. Be very aware of your feelings.”
When you are aware of your feelings, you are better able to make judgements about how you can navigate the waters. Grief is not a cookie-cutter “disease.” It doesn’t follow five steps, and it is often different for everyone. If you are feeling angry, sad, apathetic, or anything in between, you may be experiencing some sort of grief, and professional help may be necessary.
In the end, diagnosing and treating grief in nurses is difficult. Nurses often can’t recognize it and don’t want to face it when they do. However, it is one of the most important steps a nurse can take if they want to remain psychologically healthy. Grief is a slippery thing, and getting in touch with your feelings is the best way to deal with this potentially devastating problem.
As Gossen states, “It is not something you ‘do’ and ‘get over.’ Grief is a lifelong process of working with and understanding that in which we have no control. Acceptance, acknowledgement, and understanding are critical in the complex layers of grief.”
Every nurse who has stepped on a unit knows that nursing has its problems. Unfortunately, when confronted with these problems, many nurses feel as helpless as some of the patients they care for. Management is nonresponsive, there are no unions to support the common good, and one nurse can’t seem to make a difference. However, with the advent of social media, that primary assumption is changing. Nurses can affect change in the profession, and this is primarily through grassroots efforts.
What is a grassroots effort? It is an organization of nurses that come together of their own accord to affect change from the bottom up. They are usually not supported by larger, more established groups, but sometimes they are.
“Nurses need to understand that they have a voice and a powerful one when they all act together,” says Doris H. Carroll, BSN, RN-BC, CCRC, vice president of the Illinois Nurses Association (INA). “There is no way a single person can do it, but a group can. It is important to not be complacent, to stand up for patients and stand up for yourself. Standing up for you ultimately means standing up for your patients.”
Nurses can get involved in grassroots efforts in many ways. First, large, nationwide efforts exist that are fighting for the betterment of nurses across the boards. One notable example of this type is Show Me Your Stethoscope (SMYS), a group initiated completely through a Facebook group. Unions are another engine of change in the nursing landscape, though they aren’t present in every state. Finally, patient advocacy groups can allow nurses to become part of the stories of patients who have experienced medical errors.
The important part of the equation is for individual nurses to get involved in any way they can to become part of the conversation that will change nursing. “With today’s online availability, look for a cause you are interested in,” states Catherine Stokes, RN, BSN, executive chair of NursesTakeDC with SMYS. “Use Google and look for groups that you are advocating for. Ask to join; make friends; offer your participation.”
It really can be as easy as that to be part of the solution to change the landscape of nursing.
Large Scale Movements for Nurses
Large scale grassroots movements sound like they would be obvious, high profile groups, but they often are not. In fact, not many nurses know that grassroots movements exist, particularly if they are not on the internet or connected with social media.
One of the most popular groups large scale groups is SMYS, which was started after the insensitive comments made about nurses on The View. Why get involved with a group this large? What possible difference can one voice make?
“It is a place where any nurse can bring their idea to the table,” explains Jalil Johnson, BSN, MS, ANP-BC, the national director of SMYS. “There are other nurses that have the same interests, and the group helps to actualize that. We help with the empowerment in what individual nurses think is important. Our method is different in that we don’t direct nurses in what they should be involved in. It is driven by the nurses.”
SMYS is a grassroots efforts that seeks to be all-inclusive for nurses, but you don’t have to be a national director to affect change on the national level or even around your neighborhood. The group suggests talking to your local legislators, sending letters and emails, and corresponding with those who are in positions of influence to create the changes you want to see. Essentially, your level of involvement in large scale groups such as SMYS is completely determined by your comfort level.
Johnson adds: “We want to empower nurses to have voice and talk about the struggles publicly. We are not sure if legislators are aware of the problems nurses are facing. We want to connect to them and to let them know. We want to unite around issues to move conversation forward without getting bogged down in the specific issues to make change happen. Our goal is to move the conversation forward.”
Large scale grassroots movements need many nurses working together to move the conversations forward for better staffing ratios, attention to medical errors, and nurse bullying, but they are not the only ways that nurses can get involved. There are many other ways nurses can get involved in organizations that aren’t “official” and still get their voices heard.
Joining Nurse Unions
Unions have a bad rap in nursing and across the nation. Nurses have lost their jobs by attempting to form or join unions in their states, and that is a blow to the grassroots movement. National Nurses United is one of the largest unions in the nation, and it is worth getting involved with it. Like the American Nurses Association, it is not essentially grassroots. These organizations are really driven more by boards than by nurses who are interested in creating change on their own.
However, smaller unions are often more powerful with grassroots efforts, and this is where nurses can make a difference in the profession. “Joining a union is an opportunity to join an organization that has an infrastructure in place to assist in getting change,” explains INA Vice President Carroll. “It is easier than doing it on your own. Joining the union is one of the best ways to do it.”
So, how exactly do unions help nurses? “We fight for labor issues on all of our units on a daily basis,” Carroll states. “It is not just about wages. We negotiate for self-scheduling and floating. We impact ratios. Illinois is one of first states that has a law that all hospitals have staffing committees to address staffing issues based on acuity.” Unions can fight for these issues in the profession that need to be addressed, and the infrastructure of unions makes it likely they will get accomplished. The downside is the difficulty of getting unions in place, but once they are, they are a powerful grassroots effort for nursing change.
For example, the Illinois State Union worked with SMYS to organize the 2016 rally in Washington, DC. Not only did the group donate a great deal of funds to the cause, they also arranged for important legislators, such as Representative Jan Schakowsky, to appear at the rally. Without the joint effort of unions and large scale grassroots nursing efforts joining in on the conversation about nursing, the changes would be less likely to come to pass.
Getting Involved with Patient Advocacy Groups
Patient advocacy groups may seem like an odd area for a nurse to affect change in the profession. They are essentially groups started by laypeople after they encounter life-changing issues when interacting with medical institutions. “The majority of advocacy groups are started by patients,” says Deena Sowa McCollum, BSN, RN, a patient advocate. “They can focus on topics such as medical error transparency. For instance, the mother of a victim of medical errors can speak out. Many hurt families are starting groups.”
How does this help nurses to change their profession specifically? “Groups are influencing nurses whether we are involved or not,” McCollum continues. “When nurses advocate for themselves, they sound to [the] layperson like they don’t want to work too hard. Patient advocate groups have stories. Nurses have stories about these problems but don’t share them. There are errors every day, but we don’t use stories about real people. Advocates are sharing war stories, and that makes a difference to the public perception.”
When patients are injured, their loved ones speak out. They are sharing their stories, going on talk shows, and drawing attention to themselves. Nurses, on the other hand, are not doing this. If nurses could get involved in these groups and make themselves part of the solution to the problems, they could affect changes for nurses as well as patients. Some patient advocacy groups tend to reject nurses as part of the problem, but many realize that nurses are caught up in the same medical machinery their loved one was. By coming together, patient and nurse, more change can happen.
This makes patient advocacy groups a very powerful tool for the grassroots effort. It is important to find a group and get involved. “Start by Googling advocacy groups that you believe in,” suggests McCollum. “Get on Facebook. Put in a search for advocacy groups. Nurses need to find the right group. Advocacy groups want to know how can you help us for our end. How can we all stand up on our end for safety? Don’t be defensive or try to defend the nurses. There are nurses and other people that desperately want what is better for the patient.”
Strategies for the Individual Nurse
All of this boils down to the individual nurse. How can you, the nurse reading this, get involved in grassroots efforts? How can you make a positive change in the profession that you love?
“Nurses can start their own movements,” says Stokes. “Using social media, start a movement for your cause, find like-minded people, and ask them to participate.” It really can be that easy, but it isn’t necessarily the only way.
It is much more likely that individual nurses can get involved in pre-existing groups. “Nurses must get involved,” Stokes states. “As a profession, we should not sit back and let things continue. We can’t continue the habit of ‘this is the way it’s always been done.’ It’s not really hard to type a search into Facebook, say hello, and start putting ideas out there. See where it goes. Find out who is in charge and find out what you can do.”
Carroll agrees: “Working together is essential with grassroots campaigns. Everyone comes with different experiences. It isn’t easy to organize online because many nurses are not online. We need to do this together.” The way we do this together is for individual nurses to get involved with grassroots campaigns on some level. Even if it is as simple as writing a letter or as complex as volunteering to be a national director, nurses need to come together if change is ever going to happen.
Johnson sums it up: “Change is what nurses are interested in. They aren’t interested in the methodology, or the back and forth. They want to move this forward. We believe that professional organizations are contributing. They have a seat at the table, but the conversation hasn’t moved very far since the first nurse march on Washington in 1995.”
The question is and always has been, do you want a seat at that table, too? What will be your contribution to the conversation about change in nursing?
Some adrenaline junkies may like the rush, but most nurses dread the coding patient. Patients die when they code, or they get sick enough to need a transfer to higher levels of care. Codes mean that patients are dying, and this can be frightening for the nurse. Of course, nurses are professionals. You go into that room, follow the ACLS protocols, and do your job. Regardless of the outcome, you do your job.
But how do codes affect nurses? How do you recover from something so stressful, so emotional, and so potentially devastating? It isn’t easy, and some nurses never fully recover, leading to compassion fatigue if the emotions are not dealt with properly. For this reason, it is important to follow these 7 strategies to recover after you experience a code.
1. Deal with the details.
When asked how they deal with codes, most nurses respond that they do the paperwork. It seems that patients don’t even die unless it is charted! Seriously, the amount of charting and responsibilities after a code are enormous. From cleaning the room to calling the family, a code can take a long time to recover from when approached from a purely pragmatic level. No matter how the code turned out, you will have to do something by way of documentation, and that can help to delay the real recovery that comes later.
2. Take some time for emotions.
Yes, you need to take time for emotions. Nurses don’t have time for lunch. Nurses don’t have time to urinate, and nurses don’t have time to go cry. It’s not okay, but you may need to delay your emotions while you continue to care for the rest of your assignment. You can’t shut down on your shift because you had a code, but at some point, you are going to need to face your emotions. Something traumatic just happened to you. If you don’t address those feelings of loss, anger, fear, or guilt, it will eat away at you. Allow yourself to cry. Allow yourself to scream. Get those emotions out, because they can be toxic when denied.
3. Debrief.
After the paperwork is handled, the next step is to debrief. Your manager will probably want to know what happened, and you may find yourself talking to your fellow nurses about the code. Only a nurse knows what it is like to stand next to a person, a patient that is quickly losing their life. No one else can understand that feeling, and the best people to share that feeling with are other nurses. Don’t be afraid to talk about it. You don’t have to break down, but be sure that you go through what happened. You may need to look at what you did right or wrong, but the important part is to get your story heard by the people who are most likely to understand what you are going through.
4. Rely on beliefs.
For many nurses, their personal beliefs come into play when dealing with the aftermath of a code. When you feel like you have nowhere else to turn, you can turn to your faith for support. Some nurses feel that the outcome is out of their hands. Maybe you aren’t religious, though, and that’s just as valid a stance as any other. You can still examine this from a perspective of your beliefs. You can focus on the track that person’s life had taken, how their lives had affected the people they touched, and how special it is to be there for a person as they take their last breaths.
5. Listen to music.
Music has a way of touching emotions that other methods cannot. It can draw forth sorrow or pump you up. When you are dealing with the aftermath of a code, you can listen to music and let the words or melody take you away. Perhaps you need the softer, happier tones of Michael Bublé, or the hard crushing, angry strains of Nine Inch Nails. It helps to match your mood to your music. If you are feeling wistful that the person has died, you may try more inspirational music. Let it pull your emotions from you and aid you in expressing them, even if it is only to your steering wheel.
6. Quietly reflect.
Reflection is important. Yes, it has something to do with releasing your emotions, but reflection is really about becoming quiet. Sometimes, you need to let your feelings swirl in your head, and you can’t do that with all of the noise of your workaday world. Meditation is probably the best form of quiet reflection, but it is only a formal way of reflection. You could just as easily have a cup of tea after work and think about what you experienced. If you suppress it, the emotion will come out in other ways, such as hatred for your job. Take the time to look at the situation in a calm manner, exploring it and confronting the parts of the code that are salient to you. You could even write in a journal to get to the root of how you are feeling. Codes can awaken a great deal of emotions in you, and quiet reflection is a great way of soothing those feelings.
7. Share.
Sharing is therapeutic, but you have to be careful about who you share with since HIPPA is a concern—and you don’t want to violate a patient’s privacy. However, the code happened to you, it is a traumatic event, and it is part of your narrative. Therefore, it is something that needs to be shared and discussed. Again, holding it in will only lead to compensatory feelings, such as anger, sorrow, or apathy. Who do you share with? You can share with your loved ones, but sometimes they don’t quite understand. The best way to share is to have a chat session with a nurse mentor or friend, someone you can trust. Sit down with them and review the code, and then review how it is making you feel. You may feel like you are making a big deal out of something common, but every code has the ability to knock you off your game. You are not weak or a “bad nurse” for needing to deal with the aftermath of a code. You are human, and that means you deserve the same compassion and understanding as you give to your patients.
All nurses are angels. We are sent from above to provide other worldly care and make our patients feel like they are in heaven. The angel is unassuming, flinches at the sight of blood, and usually needs help finding their way out of a paper bag. Not only is this a sexist idealization of nursing, it is completely misguided. Yes, nurses save lives, and yes, nurses are often called angels by their patients. However, nurses are professionals.
The battle-axe is the nurse intimidator, so aptly portrayed by Nurse Ratched in One Flew over the Cuckoo’s Nest. Surprisingly, this stereotype is seen in many different media outlets, and patients tend to believe that there are these super angry, sadistic nurses that are just waiting to pounce on them. Of course, the battle-axe runs in direct conflict with the angel. While one is sweet and kind, the other is the bitch. It should be noted that all of these stereotypes are distinctly female, keeping men from even considering nursing as a viable profession.
Perhaps the most derogatory stereotype is the naughty nurse one. If you go into any Halloween store, you will find the costumes with the tight white dresses and the short white skirts. It is embarrassing to nurses and completely degrades the profession. The naughty nurse image turns nurses into a sexualized stereotype that is completely at odds with what nurses actually do in their job. Furthermore, it projects the image that female nurses are sex objects and can be treated as such by patients in the hospital setting.
A handmaiden is someone who is at the beck and call of someone else—in this case, the doctor. Nurses are sometimes seen as the ones who are commanded to do what the doctor says and run to fetch. The problem with this stereotype, besides being wrong, is that is sets up a situation in which nurses are seen as only doing work that is manual in nature. For instance, a nurse can give a bed bath, but not make a decision on holding a benzodiazepine on a confused patient. A handmaiden can fill water pitchers, but not listen for lung sounds and determine the difference between rales and rhonchi. Handmaidens do physical work, not mental.
Finally, the stereotype that ties all of them together is that nurses are generally unskilled. Everyone knows that doctors go through an intense amount of training and that they give orders. Everyone has this sense that there is a hierarchy in the medical system and that doctors head it. As a consequence, the public thinks that nurses are at the bottom, and they are therefore unskilled. As with any unskilled laborer, they would deserve less respect and would be replaceable. Of course, none of this is true because there is a marked difference in the skill set of a doctor and a nurse. It takes particular types of skills to work as a nurse, and saying a nurse is unskilled shows complete ignorance of what a nurse actually does.
