Two spoonfuls of trust
On the occasion of Nurses’ Week, I would like to share some thoughts on the most sacred commitment of the nursing profession, I feel, that of the public trust.
Can you stay with me . . . come back and check on me, OK? . . . will you be on tomorrow? . . . . Could you let my wife know how I am doing? . . . . thanks for being there for me . . .
How many times have we nurses heard these words? And how many times have we reassured that yes, we would be there, yes, we would check in, yes, we will pass on vital information to a loved one? Administering spoonfuls of care, much as we might a medication.
The ultimate trust placed in nurses by almost all patients and family members, just because they are nurses, is pretty amazing. Patients trust that nurses have the knowledge and skill, the persistence and patience, to offer care at the highest level. Patient and nurse forge an immediate bond to work together for the health or better health of the patient. Usually, patients do not get to choose, nor can the nurse. It is an assignment based on time and place, and because of it we nurses are invited into the most private places of human existence. What a privilege! What a responsibility! It is a sacred trust.
One of our most important and influential forebears, Florence Nightingale, proposed that nursing’s ultimate purpose was to assist the patient to achieve health by putting him or her in a condition and in an environment to heal. Nursing in Ms. Nightingale’s time consisted largely of such environmental interventions, including hygiene and close observation, since there were few other tools at her disposal. And I would say that we still do that—we create a healing environment so that the patient’s goal of health, or at least better health, can be achieved. True, we have many more tools—astute assessment skills, high tech instruments, potent pharmaceuticals and even specially designed environments to better meet the range of patients’ needs. But underlying all of this is the creation of a healing environment, based on a trust relationship, that is the expected and unique contribution of nursing as we minister to patients.
We have our work cut out for us, don’t we? But that is not new either. While there probably was not an HMO in Ms. Nightingale’s Crimea
It does seem to be more complicated, though, in today’s world. Just think of all of the factors that make up the environment that nurses have to shape into a healing encounter.
The sheer numbers of health professionals that might potentially interact with the patient entrusted to our care is mind boggling. By even conservative estimates, patients encounter about 19 different health professionals in the usual hospital stay. Then there are all of the services these health professionals offer. The array of pharmacological approaches that patients may be treated with is increasing in geometric progression, and who (besides of course our very important ally, the clinical pharmacist) will assure that meds are given in the appropriate way, in the right order, and that if adverse reactions occur they are monitored and managed safely. The nurse will.
This list could go on and on. There are all of the regulations related to insurance that in many settings nurses are responsible for checking and the need to ensure continuity of care upon discharge or when passing on responsibility to the next shift. The environment is a huge concept, ranging from our most tertiary facilities to patient’s homes. And for the most part, we nurses are responsible for coordinating care in these varied environments. Because it is the setting where our patients heal, the place where they have encountered us, and trusted themselves to our care.
For hundreds of years now we have not betrayed that trust. The public, our patients and their families, as well as the larger community, daily signify that trust because they are confident we nurses will not fail them. As we recognize Nurses’ Week and honor Florence Nightingale’s birthday, I would reflect that nursing has done a good job protecting this trust.
