What is it to be a nurse?

I qualified in 2006,  at 27 years old.  I think, however, that my mindset has always been that of a nurse – I think that perhaps even as a child I was an unwitting, unqualified nurse! As I have discussed in previous blogs, it is hard to know whether this was nature; my natural personality, or nurture; my early experiences being aware of the subtle vulnerability of my older sibling.  My job is an absolute privilege, and I am incredibly grateful that I have found a career which I love so completely, which I find challenging and joyous in equal measure, and which fits me so well.  I cannot imagine being anything other than a nurse.

I am fully aware that, due to my experience of caring for someone with a mental health problem, being bereaved by suicide and my own depression and anxiety, I sometimes have issues with boundaries.  This is relevant both professionally and personally, and can be both positive and a complete pain in the arse.  Professionally, I sometimes find it hard to remain appropriately detached, and although this is something I work hard on and challenge myself about often, cases at work can sometimes cause me anxiety.  As a nurse I deal with life and death, with complex physical, mental health and social issues and with trying to help improve things for and with patients  – so this perhaps isn’t surprising.  It’s potentially anxiety-inducing stuff.  My particular speciality of learning disability nursing rarely brings up issues specifically around suicide, which is an important thing for me as I know I would struggle personally to address this professionally.  However, I do currently share an office with a safeguarding team, and previously with a community mental health team, and this has been difficult at points.  I am very lucky to have supportive and understanding colleagues around me – most of whom are aware of my background – and good access to supervision in an organisation which has an awareness of wellbeing.  Those who are not aware of my background are usually so sensitive and professional in dealing with traumatic issues that I am able to stay focussed on my own work rather than being emotionally drawn into theirs, as I cannot help but listen across the room.

I have had a handful of experiences at work which have been very challenging for me on a personal level.  These have including a resident who I was looking after in a nursing home making a suicide attempt, and managing a member of staff who had complex mental health difficulties and who was expressing suicidal ideations.  These moments have been very hard – proper heart pounding, feeling sick, ‘I can’t do this’ moments – and at times such situations have challenged me on an ongoing basis at work.  At some points it has not just been a case of taking a step back, taking a few minutes and going home for a good cry and to chat it through with someone not involved in the situation.  It has needed more professional reflection, supervision and support than that to enable me to emerge a fully-functional, effective nurse.  There have been times when I have realised that my personal experiences have undoubtedly made me a more rounded nurse, perhaps with deeper insight than I might otherwise have had.  I recently completed an undergraduate module in End of Life care – something which (perhaps not surprisingly) I feel passionate about.  In terms of career development, this is an area I would like to work in one day, and I believe that enough time has passed and that I am robust enough to be able to do this.  Doing the course made me realise how important my personal experience of bereavement has been in empathising at work and how, although there are few positives from going through trauma, I believe it has helped me as a nurse.

The flip side of this coin is that I also have a tendency to professionalise personal situations, which I’m sure my loved ones might say can be both helpful and frustrating.  There have been times when loved ones have been going through difficulties and I have almost certainly overstepped my personal role and crossed into a professional mindset.  Once again this has, on occasions, skewed my boundaries and meant that my own anxiety has been affected by not being able to stop myself getting far too emotionally and practically involved.  This is very difficult to manage and I am not yet in a position where I can say that I am on top of this, or even fully aware of it at times.  I find it very hard not to take personal responsibility for individuals’ wellbeing, and this is exhausting, as well as being unnecessary and disproportionate.  The tricky bit about it is that, unlike at work, I cannot take these issues to supervision and receive structured, appropriate and constructive support.  There is no one who is constantly and dispassionately monitoring and critiquing my behaviour, like there is at work, and who will pull me aside and give me some personal, as opposed to professional, guidance.  I think I would really benefit from a supervisor to help me in my personal life, just as I do in my professional life.  Of course, my close friends and family are able to highlight issues as they see them, however, they too are emotionally involved with me which can make this less than straight-forward.

Nurses are far more than the one-dimensional Florence Nightingale picture; angel-of-the-night type figures.  While this is an important side of nursing, it is not the whole picture, and I sometimes get frustrated by this simplistic and usually pretty sexist perception.  Some of the nurses I know and work with are among the kindest people I know, but also among the most humorous, most intelligent, most worldly and most determined people.  I am unequivocally proud to be a nurse in the NHS, however, with a traumatic history, it is not without its complexities on a personal level.  I am certain that there are many, many nurses across the country, and indeed the world, who also find it difficult to compartmentalise personal issues, professional perspective and the context of their own histories.  It is a process of ongoing learning to achieve the difficult balance between personal and professional worlds, and in realising where professional skills can assist with personal difficulties and where personal difficulties can add insight to professional work.