when a nurse is handed lemons

A patient’s family handed me lemons the other day.

Literally.

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Big, fat, juicy lemons from the lemon tree in her back yard that I have big, fat, juicy plans for because when you are handed lemons…

It isn’t always making lemonade just as the lemons you are often handed aren’t usually real lemons.

Nurses are more often than not handed A LOT of lemons because when you are caring for individuals on what is often a horrible, no-good, very bad day…if not the worst day of their life…you find yourself dealing with a lot of sh…er…lemons:
patients’ problems, their family’s and friends’ problems, physicians’ and other practitioners’ problems, management problems, lab problems, pharmacy problems, radiology problems, housekeeping problems, security problems, your own family problems, aching feet, bursting bladders, raging hunger, eye-twitching headaches, computer downtime, short staffing, exhaustion…and on and on and on…

We handle it. We deal with it. It’s what we do. It’s part of our skill set; a skill set many of us come by naturally and the rest of us work very hard to cultivate and integrate into our practice. Nurses deal with it.

But nurses, just like everyone else, are human…very human. Nurses complain too. They complain sometimes about all of the above and then some. It might seem that might be all we do…to some who then shout STOP COMPLAINING ALREADY! DO SOMETHING! BE A CHANGE-MAKER! They’re right, of course. We should do something. We almost always are even if they don’t appreciate it.

Out of complaints and frustrations often comes just change as many agents of change find inspiration in their own complaints and the complaints of others. Dr. Hultquist, my Fundamentals in Nursing professor and Dean of the Nursing program I graduated from YEARS ago will be proud to know that I still recall some of the agents of change in nursing that she lectured about, all who were inspired from their own frustrations and complaints:

  • Florence Nightingale- Of course one starts with Flo when talking about change-makers in our profession! Laying down the foundations of what is today our profession, Flo was a driving force in changing the reputation of nursing and nurses.
  • Mary Breckinridge- While training and working as a nurse in post World War I Europe, she was inspired to consider that the model of care she was a part of delivering in France could be implemented in remote rural areas of the United States.  From her work as a midwife and nurse in rural Kentucky, evolved the Frontier Nursing Service.
  • Dorothea Dix- One of the pioneers of American Nurses, she became an activist for the post Civil War mentally ill helping to implement the first generation of mental health care in the United States.
  • Mary Eliza Mahoney- recognized as one of the first African American women to break the color barrier graduating from nursing school. Her work through the years of her practice helped to significantly influence the elimination of racial discrimination in the registered nursing profession.
  • Virginia Avenal Henderson- Where would we be were it not for the “first lady of nursing” who helped to define the role of the modern professional nurse, “the unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge.”…Dr. Hultquist I am certain is beaming warmly that I remember this one! Her work is credited with shifting the focus of nursing research from studying nurses to studying the differences that nurses can make in people’s lives.
  • Walt Whitman- Hurray for murses like Walt Whitman! During the Civil War, Whitman spent almost all of his free time at the military hospitals caring for the wounded and ill soldiers. He tried to provide anything that the soldiers needed, bringing them food, writing letters and attending to their physical needs. Often spending his own money for supplies, he did all he could to bring them comfort. He was with many soldiers as they drew their dying breaths.
  • Florence Guiness Blake- Blake is credited with making significant contributions in pediatric nursing and family centered nursing care highlighting he importance of parent-child relationships and parental involvement in the medical care of children. 
  • Linda Richards- Recognized as the first professionally trained American nurse. Richards established nursing training programs in the United States and Japan as well as created the first system for keeping individualized medical records for hospitalized patients.

All of these individuals were great agents of change in the history of the nursing profession…and they are absolutely, certainly not alone.

Nurses and medical staff in a Colombia hospital in the 1970s, frustrated with the lack of proper, working incubators for their frail, tiny patients, as well as increased infection rates, utilized the babies own mothers providing continuous skin to skin contact which freed up caregivers as well overcrowded incubator space. The added surprising benefit was a marked increase in survival rates, decrease in nosocomial infections and respiratory disease and overall improved breastfeeding success and maternal satisfaction and confidence. From this evolved kangaroo care, or skin-to-skin care, a technique practiced on newborn, usually preterm, infants wherein the infant is held, skin-to-skin, with an adult. Kangaroo care for pre-term infants may be restricted to a few hours per day, but if they are medically stable that time may be extended. Some parents may keep their babies in-arms for many hours per day.

Nurses and practitioners in my own NICU became agents of change asking why can’t we have ZERO babies with CLABSI infections which we have managed to do for an unprecedented six years and counting. We’re mighty proud of being a part of that change that evolved from complaining and questioning.

Yes, nurses complain a lot…so it seems. But so do teachers and cops and firefighters and store clerks and hairdressers and drivers and plumbers and students and grumpy old men and mommies and…we all complain. We are a bunch of complainers. We even complain about other people complaining expecting that they will stop complaining when we complain that they should. We’re handed a bunch of lemons in our lives, in our workplace, our classroom, our homes, everwhere and we often do complain. It’s what we do after is what counts most of all.

As for me and the lemons I was handed the other night…I have this great Lemon Chicken recipe

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