Nurses Speak Out on Qualities One Should Have To Enter The Nursing Profession
The individual who chooses to become a nurse enters a profession with substantial responsibility that sometimes involves dealing with people who are experiencing the most vulnerable and significant moments in their life. Nurses juggle physical pressures, emotional situations, and at times, mentally taxing experiences. In order to effectively care for and treat patients, nurses must rely on their inherent qualities, as well as the ones they acquire along the way, to become what many consider the ‘ideal’ nurse.
Qualities that every nurse should ideally possess include:
“All nurses need to be compassionate, observant, and flexible,” says Patricia Bollinger-Blanc, Director of Clinical Operations at the Natick, Massachusetts-based Natick Visiting Nurse Association.
Because of the importance of showing kindness, empathy, and concern in the nursing field, some health care facilities have implemented standards to ensure patients receive compassionate care.
“One of the primary reasons why I came to work at Cancer Treatment Centers of America (CTCA) is that our approach is based on the Mother Standard of Care®,” says Dee Emon, Chief Nurse Executive and Quality Officer, “where every patient is treated as you’d want your own mother cared for.”
Emon says that this approach supports her view of the role nurses should play in healthcare, and that such a standard creates an environment where nurses have the ability to provide compassionate, personalized care for patients and their families.
DEDICATION to the PROFESSION
DaLinda Love, Corporate Director of Clinical Services at United Methodist Homes of NJ, says that a dedication to the profession is a top quality that nurses should possess.
“Not everyone can be a good nurse or a nurse,” says Love. “You have to have the inner yearning to want to make a difference in the quality of life for another human being, and to advocate on their behalf when they are unable to.”
Love calls it “serving without seeking accolades.”
There are also many different motivating forces behind a nurses’ commitment to her job, such as:
- Gaining inspiration from a family member, and would like to follow in his or her footsteps.
- Receiving compassionate nursing care themselves, and would like to “give back”.
- A thirst for knowledge and intense desire to help others in need.
- Surviving a near-death experience or life-threatening medical condition, and would like to help others survive as well.
- Being intrinsically drawn to the profession.
“Upmost, my faith has always been the center in my career as a nurse because I do strongly believe I was called to be a nurse and that God has always directed my path in nursing from day one,” says Love. “My faith gives me the hope that I can make a difference.”
SENSE of ADVOCACY
Advocacy typically begins with a nurse providing individual patients with information that empowers and instills confidence so they better understand a diagnosis or treatment; and can more efficiently express their feelings regarding their medical care. Nurses must also speak on behalf of or help patients or groups discuss their feelings when needed, such as communicating a patient’s wishes when they conflict with a physician’s (and in some cases, their families) opinion.
“We have to be able to advocate for a resident or patient and anticipate their needs when they are unable to,” says Love, who states having a non-judgmental attitude and empathy for those a nurses serve is a must, “you have to be able to take care of every type of human being: good or bad, rich or poor regardless of the illness they may have.”
Speaking on behalf of a patient is one of the duties expected of a nurse, and while some nurses possess a natural desire to advocate for his or her patients, others take more concentrated measures.
Helping to bridge the gap between patients and their health care providers, nurse advocates strive to improve or maintain the quality of care that a patient receives. In addition to addressing the medical aspect of the profession, those who concentrate on nurse advocacy also deal with social work, research, insurance, and patient education.
Nurse advocates gain qualifications through various educational programs.
- RN Patient Advocates, PLLC, is the only nationally recognized Patient Advocacy education program. They provide a Registered Nurse Patient Advocate course that educates a limited number of nurses on the advocacy process every year. It culminates with certification as an independent RN Patient Advocate.
- Healthcare Liaison, Inc. offers a Credentialing Program with training in family assistance, discharge planning, health care advocacy, communication strategies, cross-cultural issues, insurance systems, and end of life decision-making to produce Certified Healthcare Advocates.
“To truly be a patient advocate, professional nurses must become emotionally connected with those they care for,” says Emon. “The nurse’s ability to engage with a patient on an emotional level allows them to ensure that the patient’s needs are met even when the patient is unable to verbalize their own needs.”
Nursing professionals who possess a strong sense of advocacy not only greatly benefit the patient, but can also make their own job easier.
“Nurses are consistently encountering patients which are considered difficult or unlovable,” says Susan Kieffer, RN, MSN/Ed, and a professor with the Kaplan University School of Nursing.
“However, if a nurse takes on an attitude of advocacy for every patient, it can actually bring the difficult patient into compliance,” she says. “Just knowing that someone is standing in the gap for them can go a long way to improve their outlooks and even their health.”
From the fast-paced environment of an emergency room to dealing with family members at a nursing home, nurses who are tolerant and patient are better able to treat and care for others.
“Patience is so important as a nurse where you have so much accountability and responsibility but at times not the authority,” says Mary Kavalam RN, EdD. “Trying to carry out multiple doctors’ orders while complying with federal, state, hospital, and unit policies, as well as carrying out nursing care plans can be trying.”
Kavalam says that patience allows nurses to better deal with the customer service aspects of nursing while at the same – trying to save lives, dealing with confused patients, and comforting grief-stricken, sleep-deprived families.
WILLINGNESS to LEARN
“We must be able to learn new techniques, procedures, and the intricacies of new equipment,” says Bollinger-Blanc. “Health care is constantly changing, and we must change with it.”
Additionally, in order to keep a nursing license current and valid, most states in the U.S. require the completion of continuing education (CE) credits, or the fulfillment of a specific number of contact hours. However, nurses must possess a willingness to learn – not only by pursuing certifications, furthering their education, or fulfilling state requirements – but also by learning from other clinicians and patients.
THE ABILITY TO ANTICIPATE
Emon says that nurses are the first line of defense for patients. Therefore, she says all nurses must have an innate ability to anticipate through examination and observation.
“Since nurses spend more time with patients than any other clinician on the care team, their ability to ‘read between the lines’ is often a pivotal point in the outcome of health related issues,” says Emon, who gives an example of a nurse that recognizes a change in a patient’s tone, and then encourages them to seek medical attention.
“Early identification and escalation of potential concerns can, at times, be the difference between life and death,” says Emon.
According to Kieffer, nurses should possess a second sense of sight where they can read the unspoken messages and body language displayed by a patient that cannot be determined by vital signs and/or verbal communication.
“An effective nurse will know how to read those signs that can be spoken loud and clear without words,” says Kieffer.
In order to conduct a thorough observation and examination of a patient, fine-tuned listening skills are a must for a nurse. Not only is it important for a nurse to listen to orders given by a physician, but to also pay attention to the verbal cues of patients, as well as the remarks of their relatives.
“As a pediatric nurse by background, I had to rely on the identification of subtle changes in infants and children to ensure quality care and outcomes,” says Emon. “That included refining my listening skills relating to family members.”
“No matter how much time a nurse spends with a patient, they will never know the patient at the emotional depth that a loved one does,” adds Emon. “When a family member comments that something seems different, it is as critical as a monitor alarm going off.”
As a caregiver, nurses cannot deliver adequate care if they lack proper communication, which goes beyond the act of simply speaking with a patient.
“Good communication skills and being a good listener are a must because what you say and how you say it, and what you hear from a resident, a family member, physician or a team member could have a profound effect on clinical care,” says Love.
For example, using a soft, polite voice makes patients feel at ease during appropriate times, whereas a firmer tone is necessary when explaining medication and discharge instructions.
CRITICAL THINKING SKILLS
“Critical thinking skills are so important as a nurse,” says Kavalam. “For example, if a patient complains of chest pain, you can’t just call the doctor and relay that sentence…”
Kavalam says that doctors have follow-up questions and orders that a nurse must anticipate which include possible pain triggers, pain ratings, vital signs, telemetry reading, EKG, and acknowledging other physical signs of the patient.
“…so you have to be a detective trying to figure out the cause and be mighty quick about it,” says Kavalam.
TIME MANAGEMENT SKILLS
“Time management skills are crucial as a nurse,” says Kavalam, “from a hospital floor where you can have 6 to 12 patients to an ICU where you can have 1 to 3 patients sometimes in a 12 hour shift.”
“You have to hit the ground running as there are set items to do, such as patient assessments, documentation, medications to give, procedures to do… [and] repositioning patients every two hours,” says Kavalam. “Then layer on doctors needing your assistance at the bedside [and] chasing down items they requested for procedures.”
In addition to tending to new patient arrivals, Kavalam also says that patient’s families often request updates and emotional support. This can take time away from a nurse managing patient care.
“Layer on top actual patient emergencies and problems,” says Kavalam, ” and at times the nurse doesn’t have time to even go to the bathroom – you have to find coverage from another nurse before you can leave the floor.”
Time management skills also helps a nurse evade workplace burnout by increasing his or her ability to avoid creating stressful situations that can drain overall levels of energy and enthusiasm.
From rushing to the aid of an emergency to being able to help lift a patient from bed to wheelchair, nurses are expected to maintain a certain level of physical strength and endurance.
All nurses are in a position to lead regardless of his or her title, and effectively developing leadership skills allows a nurse to better steer patients towards wellness and away from sickness, guide new co-workers, and even lead physicians towards achieving a better understanding of their patients.
To enhance personal leadership skills, a nurse must develop as an individual first, and then experience growth, enhance communication skills, increase self-confidence, and exhibit a bit of valor as well.
Catherine Robinson-Walker, best-selling author and expert in healthcare leadership, touches upon the importance of nurse leadership in her latest book, Leading Valiantly in Health Care, published by STTI Honor Society of Nursing. One point she addresses is the significance of strong leaders being able to contemplate the role they play in the problems and challenges they encounter in the workplace.
“Keeping up with the demands of providing quality patient care is, by itself, both an inspired calling and a daily challenge,” Robinson-Walker writes. “We have natural tendencies to become too attached to attitudes and strategies that just don’t work.”
As a result, Robinson-Walker says “common leadership pitfalls” tend to follow, which she refers to as “Leadership Seductions.” She identifies the following six “seductions” that hinder the ability of a nurse to effectively lead, and to make a difference with patients and amongst co-workers :
- I Am Right (being stuck in your own perspective)
- Storytelling (creating a distorted reality)
- Checking Out (choosing to disengage)
- Being Distracted (paying too much attention to the unimportant)
- No! (having just one answer: No)
- It’s All About You (focusing on everybody else)
Aside from reading books, other ways that a nurse can enhance their leadership qualities include attending workshops or conferences, and/or taking continuing education courses for nurses in Management and Leadership.
“I believe my best quality is my experience as a nurse,” says Kavalam. “I spent a year and a half on a medical surgical telemetry unit and 16 years in ICU.”
Working a certain number of years as a nurse certainly creates a more seasoned, proficient caregiver; and is not the only way the healthcare industry measures a nurse’s skill and level of knowledge. Going back to school to earn a higher degree, internships, volunteering, traveling abroad, attending conferences, and conducting research also enhance a nurse’s overall capabilities no matter how long they’ve been working in the field.
Kavalam says she has also found that nurses build upon their experiences not only from receiving formal instruction, but also from observing previous shifts working in similar situations, as well as from watching how older nurses carry and conduct themselves.
“…so now when I’m in charge of the unit, mentoring a new orientee, or just being asked my opinion,” says Kavalam, “I utilize my past experiences kind of like my own personal database of knowledge to help current patients.”
“Every nurse should possess enough humility to understand that they are not all-knowing and all-seeing and that much of the effect that they and their profession have on patients remains off-screen for them,” says Joel Selmeier, author of patient-safety.com.
Selmeier also notes that a nurse should have enough humility to understand that patients can also possess and provide valuable information and insight through their experiences in medicine.
AN ATTITUDE OF SERVANTHOOD
Kieffer believes that one of the most important qualities a nurse should possess is an attitude of servanthood.
“In the United States, there is an unspoken rule that we, as individuals, have rights and will not be anyone’s “doormat,” she says. “This is especially true for nurses who have long been mistreated by physicians.”
“We feel like if we don’t stand up for ourselves that we will be taken advantage of and pushed around,” Kieffer continues. “However, an attitude of servanthood removes defensiveness and replaces it with confidence.”
Kieffer says that embracing this type of approach recognizes others and the valuable place they hold in the medical community.
“It is a confident nurse who can extend a hand of selflessness and servanthood to those who have, perhaps, treated us poorly in the past,” she says.
Not all nurses will embody every single one of the above-mentioned qualities, and for some, it may take many years to develop a few. However, Kieffer points out that nurses themselves play a significant role in inspiring their co-workers to embrace some of the qualities every nurse should ideally possess. In the end, these nurses participate in a cycle of motivation that encourages others to grow within their profession.
Kieffer says she’s tried to develop in herself a strong sense of advocacy, discernment and an attitude of servanthood, adding, “…but to be honest, sometimes [these qualities] are easier to see in other nurses as you observe them in their practices.”
As a Christian pastor’s wife living in Romania, Kieffer says she has witnessed poverty and need beyond anything she’s had ever seen before.
“One cannot help but be affected by the sight of a family of ten living in a six-foot square concrete shack in the mountains of Transylvania where the temperatures can dip to -10 degrees F in the winter,” she says.
“When missionary nurses come to visit the impoverished of Romania, you see true advocacy where they literally fight for the wellbeing of these people,” continues Kieffer. “These nurses display discernment by assessing, diagnosing, and treating patients who speak in a language they’ve never heard and can’t understand.”
“And finally, you see servanthood,” she adds, “nurses willing to devote a season of their lives to make someone in a faraway land a little more comfortable and healthier.”
In summation, Emon simply states, “The heart of nursing is and will always be compassion.”
 Robinson-Walker, Catherine. Leading Valiantly in Healthcare: Four Steps to Sustainable Success. Sigma Theta Tau International, 2013. Print.