I Want You To Know

I've had the honor of giving the Address for the Pinning Ceremony for Louisiana Tech Nursing Graduates on two occasions.  This is the address I delivered to the graduating class May, 1999.  It still rings true today.

I Want You To Know

"This is a wonderful night.  The night you've been waiting for has finally come!  I know there are some parents and spouses and possibly even some children in the audience tonight who are equally happy that you have reached this goal.  Parents are joyful that there's no more tuition to pay, spouses are thinking, "finally we can watch something on TV besides ER and Chicago Hope" and your children, if you have them, will finally get a long bedtime story read to them.  You've bought all of the bumper stickers that say, "Love A Nurse".  You've purchased every tote bag and sweatshirt emblazoned with "Nurses Call the Shots" and now it's showtime.  Now you will begin the long journey called career.

When I found out that I was going to have the privilege of addressing you tonight, my first thought was "what will I say...what memorable, prophetic words do I have for these bright faces?"  I've realized that I might not have something prophetic or memorable for you to take home tonight, but I do have some things I want you to know...things I wish I'd known as I started my career.

The first thing I want you to know is that your biggest task is still ahead.  You thought you had it made because the care plans, study groups and clinical hours were all behind you.  This may be true, but now you face another task; you must start the building processes.  You'll be constructing a work ethic, a loyalty to your co-workers, an allegiance to your healthcare facility and a commitment to your patients.  You must be very careful at this point, for this is the foundation upon which your career is built.  I want you to know that indifference, apathy, and complacency will be your worst professional enemies unless, of course, you don't want to make a difference in peoples' lives.  I work in the Emergency Department and sadness has become part of my vocation, but medical crises are not the only sad things I see at work.  I see the sadness associated with those who clock in, clock out, and collect a paycheck and call that enough.  Your career starts tonight and you'll receive rewards in direct proportion with the time, energy, enthusiasm and concern you've invested.  If you begin to hate every workday, if you dread putting on your scrubs, re-examine yourself.  Don't blame your unit director, your DON or CEO; ask yourself, "Do I have the right attitude? Am I working on the right unit? Is this the right facility for me?"  Go back to what brought you to this night; examine your heart.  Make the decision to be a positive force.

Another thing I want you to know is that people remember the little things - small kindnesses.  We as nurses tend to feel the best after a "save" - a successful resuscitation effort.  We give each other high fives and recount all of the details of our valiant effort to the oncoming shift; but the fact is that the person you worked so hard to save will go on without ever knowing about your efforts.  Your satisfaction after such cases will come from knowing that you did the best you could.  You'll find that the small kindnesses are the things that will come back to you...small kindnesses like the soft words of encouragement you whisper in a little lady's ear as she's wheeled off to OR for a hip repair, or the strokes you make through a feverish child's hair.  Those are the things I'm speaking of; those things are not wasted.

I want you to remember this night for the sake of those new nurses who come after you.  Remember how it feels to be enthusiastic and a bit idealistic.  Nurses have a tendency to "eat our young", to do our best to destroy the shine in the eyes of the new grad.  We do this because we're reminded that at times the luster has gone out of our own.  Our years of experience sometimes bring cynicism along with our skill and knowledge.  You need to know that it's easy to criticize and belittle the new grads and that bad attitudes are infectious; but if you can take that new nurse to your heart, teach them all you can, there lies the honor.  Then you've done something worthwhile.

I want you to know, too that your new license brings new responsibility.  Yours will be the first face seen for some, and the last for others.  Be sure you know that your face speaks volumes more than your words ever will.

There will be other responsibilities in store for you - things you never thought you'd have to do.  Many years ago, I worked in a chic little boutique; I did displays in the store, I dressed the store windows, I flew to Dallas and Atlanta to market regularly,  and then one day I announced to my employer that I was leaving and going to nursing school.  She was mortified and said "You're going to leave this job to carry bed pans??!!  I said proudly, "I'm going to be an RN; I won't be carrying bedpans!"  I had no idea of the surprises that were in store for me; in addition to bedpans, there were mops, brooms, hazmat gear, live snakes in buckets, smashed spiders, fish hooks, foot-long knives hidden in paper bags, and the occasional pressure washer waiting for me as well.

You need to know that sometimes with the most diligent care, the most painstakingly exact methods, and after having seemingly done all the right things, we still lose a patient.  The reason for this is simply that we don't always have the last say.  You'll see over and over that this is true.  There's a deciding force more powerful and wiser than our own.  You'll have to accept this as true or otherwise things won't make sense and will be unbearable.  Your'e about to be introduced to irony, absurdity and frustration.  You won't understand why the 40 year old father of three dies suddenly and yet the non-compliant crack-head with ungodly hypertension who doesn't take care of himself and doesn't appreciate anything you do for him seems to be indestructible.  You won't understand why God makes the choices He does but remember His wisdom exceeds our own.  And when you discover painfully that death claims not only the sick and elderly but also the innocent little ones, you'll need this truth to cling to.  When a little gentleman holds the hand of his wife of 50 years and begs you, "Please don't let my sweetie die", you'll need to be reminded - we don't have the last say.  There is a wisdom and a plan that supersedes our own.

You must know also that you need to take care of yourself.  You'll probably have the tendency to work all the overtime you can get your hands on, but don't be brutal to yourself.  Be prepared - your bladder is about to become the size of a Winnebago water tank.  Chocolate and caffeine will become your new food groups, and you will have recurrent nightmares of being run over by the 47th ambulance of the day. 

Keep a sense of humor about you.  There will be many opportunities for laughter - especially when you answer the ER phone and someone says "my little girl just kissed a dead chicken; should I bring her in?" or "my baby is scared of his hands; what should I do?" or when the caller says, "I got scared by a halloween mask in October and I've been running fever ever since; should I come in?"   You'll have to hold back the laughter too when your patient tells you in triage that he has "scrap throat" or his "asteroids are hurting" or she is afraid she might have"cereal palsy".  Be glad for the laughter; enjoy it.  It soothes the soul.

Have I made it sound like nursing is hard and unappreciated work?  Sometimes it is...and just when you think you've had enough, when you think you're going to give up the madness and be a bartender, someone walks up to you and says, "I remember you.  You were so good to my mother before she died; I don't know what we would have done without you" and then it will come back to you; you'll remember why you've come this way.  

I want to thank you for having the confidence in me that you've shown by asking me to speak to you tonight.  Thank you for thinking I'd have something you wanted to know.  

Now go from this place; go, and do our profession proud."

Thirty-three years have gone by since I sat in the place of those students; thirty-three years and my words to them that night still hold truth today.

This knife was confiscated from a patient recently.  Evidently it makes the world a little less scary for him but has the opposite impact on the ER Crew.