Full disclosure – Although I am blogging to chronicle this journey, I have an ulterior motive for this one. I am hoping to reconcile with myself, in front of you, some workplace challenges I was having prior to my departure for this endeavor. I hope you find my thoughts worthwhile…
We have barely been at orientation 3 days, and already a Good Shepherd Volunteers (GSV) motto resonates strongly. Perhaps it is subconsciously part of the reason we ended up with this organization, but it is a slight variation on a growing theme in my mind and in my life – just love. In a world where we are inundated with anger, hate, pain, sorrow, and negativity: all too often we rush to judgment.
As a new nurse, it was necessary for me to listen to every detail as a patient attempted to explain their medical complaint. I would often get chided for spending too much time in a patient’s room as I was trying to listen to them and complete an extended physical assessment as I learned to classify, eliminate, or reduce a collection of signs and symptoms in order to decode the medical problem. I was also humble and kind to patients, in part because they had to suffer my poor I.V. catheter insertions or took deep breaths until they saw stars as I learned to discern different types of lung sounds. As I gained experience as a nurse and had a larger database of experience to draw from, I learned to dismiss erroneous “data.”
Although pattern recognition is integral to the success of an emergency room nurse, it can also become dangerous. I can name many specific times I accidentally dismissed an important complaint, a change in status, or a gut instinct. I can also remember many instances when I was unsure about something and I went to a peer or doctor and my concern was completely validated.
A major change I saw in the culture of nurses where I worked was another form of dismissal – judgment. Like leaving school early, a rush to judgment can mean there’s no need to ask ‘why’ or probe any deeper. Without face-to-face conversations, I have witnessed people being dismissed for arriving at 3:00 a.m., having a complaint deemed a non-emergency, or not having the vocabulary to clearly articulate what is wrong. I can also share some contributing factors:
- When work is with people, people can become work – It is surprising how easily that line gets blurry.
- Cross-cultural barriers – it can be exhausting, especially for a new nurse, to attempt to navigate the needs of cultures he/she does not understand.
- Socioeconomic barriers – Many people have a glorified view of what emergency work is; making it frustrating to deal with primary care for the poverty stricken, exhausting to attempt to ensure learning in those with limited education, and boring to consider the value you can offer in public health.
But the biggest problem I had with being in a unit with a culture of judgment is that I was a part of that sort of culture. Sometimes we do our best to resist the culture that surrounds us, but we (including I) are not always at our best.
just love - I will admit, it is often hard not to pass judgment on people. Would patients be more likely to receive the care they need if we could at least suspend judgment until we had a conversation with them? Would we be more open and present during that conversation as well? What if instead of judgment we start with just love, don’t we have to first look the person in the eye, shake their hand, or greet them? If we approach the patient with love first, won’t we try to dig a little deeper to get to the heart of the problem at hand? For instance:
- Is this her 4th STD this quarter because she is in an abusive relationship?
- Was dialysis missed because they are new to it and do not understand that missing dialysis can be incompatible with life?
- Do you understand all the medications you take? Would you if you were functionally illiterate or read at the level of the national norm – 5th grade?
- Were you or would you have been concerned about your high blood pressure at 23? – Because I have met people with kidney failure by then.
Do you have to do this as an emergency room nurse? Absolutely Not.
Will you be financially rewarded for doing it? Most likely, No.
But could it start to shift a paradigm in this country?
Can we return to loving our neighbor, and not just our actual neighbor who looks and lives just like us?
The natural progression here leads to another new-to-me GSV motto – “take off your shoes.” Take off your shoes and walk with those you care for or walk in solidarity with those you care for. Take off your shoes and you may notice a lot quicker when you step on a stone or step off of the intended path. Take off your shoes and maybe leave a smaller footprint.
By now you likely know I am going to Thailand and do not speak the language. I have already heard so many stories of being a silent presence and connecting with people in a way that seems to rarely happen in America. Stories where a previous volunteer in Thailand had a meaningful connection with someone whose speech was impacted after a stroke or suffering tuberculosis of the brain. Stories of a culture where as a volunteer they had time to sit with someone for 20 minutes and just offer them positive intention. It reminds me of fishing with my dad and brother in Canada. Sometimes we fish together for 8 or 9 hours and say very little. That time is immeasurably meaningful to me, and it is something I have always cherished. Perhaps this silent time is more common and valued in Thailand because they prioritize relationships more than we do. I cannot wait to find out.
Lastly, perhaps you are unable or unwilling to ‘just love’ right now. In Susan’s massage therapy school they talked a lot about always entering a room with unconditional positive regard. Can we at least try to suspend the judgment awhile and show people that unconditional positive regard? I hope so, and I am ready to try harder.