What Is Your Definition of Success As a Nurse?

(NURSEINTERUPTED) In his book “The Measure of a Man” author Sidney Poitier advises that “A person doesn’t have to change who he is to become better.” There couldn’t be a more appropriate quote than this to capture my thoughts about nurses. Throughout nursing school, our orientations, and preceptorships no one talks to us about what success “really is.” We are reassured, with a friendly pat on the shoulder that “we want you to succeed here!” “OK, great,” you think. You’re suddenly feeling flushed, your heart rate quickens, a tightness forms in your throat, and your stomach cramps in response to what is meant to be a reassuring pep talk. But it isn’t them about to take on four patients today, alone, for the first time ever. You wonder what exactly they mean by “success.” Nursing instructors used that word so many times your last year of nursing that it hadn’t occurred to you to actually listen—you just wanted to get on with the show. But now here you are, the star of the show, and lives are “officially” in your hands to protect and advocate for—including your own.

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The Arizona Republic recently ran an article indicating that right now is the best time to become a nurse, that there were jobs to be had everywhere. While this article was obviously poorly researched from the beginning to its end, rightly inflaming jobless nurses throughout the state, one particular quote resonated with me. “Nursing can be the most successful career if it’s done well.” This statement about our profession couldn’t be more elusive, comical, or infuriating. In fact, it is reminiscent of a thoughtless sound bite tossed out there to make a neat conclusion to a news article. Well– I scoffed, thinking to myself “what does ‘success’ mean?” “What does ‘done well’ mean?” “Does this idiot have any clue about what he is saying?” I’ll bet the author, who isn’t a nurse, wouldn’t be able to answer these questions because not even we can ourselves.

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Ask any nurse this question, about success, and no doubt you will get confused looks and faraway expressions as they try to wrap their head around the question. I’ve asked it myself. These are some answers I heard time and time again at the bedside: “When I make it down to the ICU and away from taking care of this many patients,” “When I can be the manager instead of just the nurse,” or “When I have lasted for thirty years like (insert name).” I’ve heard many variations of these answers over the years. I kept asking because I was truly curious about discovering an answer to a question that had eluded me for quite some time. What has always bothered me is that I didn’t hear nurses talking about advancing their education, remaining true to their inner selves, finding and being their authentic selves, achieving the balance between nursing and family, or answers that were more centered on them as humans.

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I had eventually decided that success meant being the best, getting the sickest hearts and always challenging myself, making it to “the” ICU and not just the cardiac surgery step down I was on—because, after all, that is where all the real action was and only the best nurses make it there. In my own mind, I would have succeeded as a nurse when I was able to receive patients rolling right in from the surgical suites, or patients on balloon pumps and ECMO with all the drips I’d always wanted to learn about. I couldn’t have been more wrong. Hindsight, of course, is 20/20. There are so many ways I could have thought differently or done things differently. You see, I focused on all of the external things or situations around me as a means of deciding what would define my success as a nurse. Going at the pace I was, taking on the amount of stress I did at work, with grad school, with being a single parent, and helping my grandmother during her last two years of life nearly killed me. My physical health suffered greatly. I never made the insurance plan I’m asking you to make today. I didn’t know any better.

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When we don’t take the time *at the very beginning of our careers* to reflect on (and journal) an honest assessment of our truths, values, beliefs and biases; to decide what our goals are as both a human being and healthcare provider or how we will get there– we become lost at sea later on. Why? Because there is no destination or goal to achieve. Humans in healthcare require a compass to guide us through increasingly demanding, rapidly changing, and increasing hostile working environments. The worst thing any of us can do is slowly fade into the surroundings of our career, becoming invisible to society, to our families, and to ourselves. The identity a corporation makes for you coupled with the identity of being a nurse can very easily overlap, eclipsing all the other parts of you.  There is no better way to set sail on a course to nurse burnout. Remember that inner turmoil is a sure pathway to both emotional and physical illness.

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I’ve written about how the profession of nursing and nurses themselves are redefined, reshaped, and fashioned into the “package” corporations want you to be. I’ve also talked about how you are conditioned and groomed to take on the thinking, values, beliefs, and goals of your workplace—no matter what your personal ones are or whether they even match up with those of your employer. For these very reasons it is crucial to know who *you* areBEFORE you assume the image, beliefs, values and priorities of a corporation. It’s also important to know where *you* are headed right out of the gate. You must decide on your purpose, and set some goals to focus on—that meet your definition of success. This kind of reflection and documentation is what I like to call an “endurance plan.” Another way to think of it– it’s your own personal “life insurance.”

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Throughout our lives as caregivers we are constantly exposed to the overwhelming phenomenon of the “human condition.” Yet, we don’t steal the moments we should in silence, with ourselves or our thoughts to process all that we see, hear, do, and are a part of. A good example of this is the grieving process. Nurses grieve but do not recognize it in themselves. We have too much to do, too many places to go, too many responsibilities. But, our role commands that we engage in thoughtful introspection about how certain experiences make us feel, whether they are affecting who we are, or infringing upon basic life functions like sleep and rest. A big part of our self -growth in life is making meaning of experiences and learning from them so they become a healthy part of who we are as people: “Why did that situation in room 222 bother me so much, why was I so irritated with him/her or the situation?” Could it be that something about your patient’s case didn’t sit well with you because of your values, biases, or beliefs?

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Ignoring stuff like this affects your care, and setting aside feelings of conflict or confusion quietly accumulates… eventually making you tired, burned out, and numb to the experiences and feelings of others while remaining very much aware of your own discomfort, agitation and impatience with the world. It’s here that the insurance plan comes in to play—if you took the time to establish your definition of success and to journal a list of your “self- truths,” now would be the perfect time to go back and visit who *you were* at the beginning, and compare to a new journal entry you will write that reflects on who *you are* today. What steps have(nt) you taken to accomplish your personal definition of success?   

The gift of journaling, the beauty in documenting your- self truths, goals, and personal definition of success is that when you become lost in the challenging and confusing work of caregiving you can come back to this compass and it can help set you back on track, help you grow, or even reveal a new course for your life. Perhaps you need to reconstruct your definition of success so you can make a new plan to reach it–or maybe you need to revise your list of self- truths and add in some explanations about why you’re changing them.. The insurance policy I am discussing is also a safety net.  

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Look, the more in tune you are with your authentic self at the beginning of your nursing career the better equipped you will be for the journey and where it may take you. I highly suggest taking a healthcare ethics course, you will learn even more about what you believe in and the “why” of how you live your life the way you do. Take notes and add them to your journal. You are a better *you* when you develop a good grip on the concept of ethics. Aside from that, being self- aware equals better care:  Patients can tell when you are being yourself or being a cold, clinical, rehearsed robot. As your career progresses, being in touch…and remaining in touch with your inner self will become harder. There will be moments where you are being asked or expected to set aside your principles or parts of who you are for the sake of workplace politics. The decisions you make in these moments will determine how you feel about yourself, how strong your presence is in this world, or how much you will allow your individual unique light to fade into the background of society.

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The world is in desperate need of creative, intuitive, and bold nurses who can add their own gifts to our profession: loud nurses, quiet nurses, funny nurses, “nerdy nurses,”–all kinds of nurses. More importantly, the world needs them to remain that way.  Hang on to *you,* remember your duty to self, engage in self- care activities, journal as often as you can about your nursing experiences and feelings so you can re- read about them later. It’s amazing how much I have learned about myself by doing this over the years. Journal about traits you see in your colleagues that you admire, or even those that are not so desirable. Chronicle the defining moments in your career—they may not always be positive moments, but what matters is that they are learning moments that help you grow or give you new insights. These moments can also help you reach your goals and achieve your personal definition of success.

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There is no wrong or right answer to what a successful nurse is, and I think there is a beauty to that. What matters is that you know what the definition is, how you will get there, and what brings you a sense of accomplishment and purpose no matter the changes, chaos, or politics surrounding you. Maintaining authenticity in this world is not always fun or pleasant, and at times it may feel as if you are alone—but when you think about it, you are the only *you* there is. There are more parts to you than nursing.  Make every day count, make every action count, but live every moment of your career from a place of awareness and allow yourself to shine. As to the question of what it means to “do nursing well?” I can only conclude that doing it well means nursing the best way you know how and by always being yourself even under the worst of conditions… I like how Sidney Poitier puts it in his book “The Measure of a Man”: “I am the me I choose to be.” If that is the true measure of a man, then, the true measure of a nurse and the definition of success in nursing could simply be accomplishing the goals you set for yourself while ALWAYS “being the nurse you choose to be.” 

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