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This site is for student nurses or nurses starting out. Letters to a Young Nurse are blog posts written like letters to help you find your way and make your journey as a nurse less difficult. 


Loving Strangers

"Bless the Nurses" with Christie Watson on Kate Bowler's The Everything Happens podcast.

During COVID Kate Bowler did an interview with a UK RN named Christie Watson. During COVID Christie returned to floor nursing to stand beside other nurses during this terrible time in healthcare. She saw the devastation of COVID and the inability of families to be with dying loved ones because of COVID lockdowns in hospitals. She talked about the horrible way patients were alone when they were dying from COVID. She says, "loneliness can kill. It kills more people than heart disease". Christie interviewed nurses during the pandemic and found the common denominator that allowed and helped nurses to continue to get up and go to work during a very dangerous time in the world was the ability of nurses to love strangers. She says we have to leave the thought that we are different from our patients. "Love is a series of small actions that make another person's humanity possible." As a nurse, you cannot connect to a patient if you refer to them as a room number, diagnosis, client, "them and me". Everyone has a name, and everyone deserves to be loved and comforted. Christie met a nurse who had worked with homeless patients who were often dependent on drugs and alcohol and had committed thefts and other offenses. It would have been easy to think of them as less. But she knew the importance of nonjudgmental love. When you are busy judging a patient, you don't have time to love them. When you create distance and boundaries by referring to patients as him and her or them you cannot serve patients in a meaningful way. During COVID, nurses were putting their families at risk every time they came home. And patients were dying alone because there were not enough nurses and other healthcare staff to be with everyone that was dying. All of this guilt can and has impacted nurses.

So how do we keep loving strangers in times of crisis and times of remission? COVID is not over, there is consensus among many researchers and scientists and physicians that COVID may never be over but hopefully it will become as innocuous as the flu. One way that Christie suggests in helping us with our feelings towards others is to use Reflective Practice.

Reflective practice is learning from experience and is a way of gaining new insights of oneself with patients. It can also be used while an event is happening with a patient. It is a tool to consciously think about a patient or a situation or an event that was positive or negative. When you are having trouble loving a patient take a few minutes to think about them. It can help to write down what happened and what makes the situation or patient difficult. What could you have done differently? How could you have improved the interaction? What went well? What worked and what didn’t work?

Listen to the entire podcast here:

Steps for Reflective Practice are:

  1. The situation – who, what, where. Think of the situation in detail and what part did you play in it, what was the outcome?

  2. Emotional state – how did it make you feel. Be honest about how you felt during the event, were you angry, confused, afraid?

  3. Making sense of the situation – why did it happen? Was it a positive or negative encounter, how could you have improved the situation?

  4. Critical review – hindsight, what can you do differently? What did you do well? Remember the positives as well as the negatives,

  5. Future – how will this change your practice?

These steps can be used as reflection after the fact, but the steps can used while going through an encounter or situation.

" What you may not have considered is that you have been subconsciously reflecting your whole life: thinking about and learning from past experiences to avoid things that did not work and to repeat things that did. For example, after tasting a food you do not like, you remember that experience, think about it, and when you next see that same food, you know to avoid it. In medicine it is one of the best approaches to convert theoretical knowledge into practice."(Koshy et al., 2017)

Here is an example of an encounter I had with a young man who was arrested for theft. He was so high from fentanyl that he could not stay awake during the Intake interview. He got extremely angry when another RN and I decided that we could not accept him. The police officer had to take him to the local hospital for medical clearance. He reported using a large quantity of fentanyl minutes before being arrested. If he were to be put into a sobering cell, he could die in minutes. The young man was upset that the ER staff would use Narcan and in his words, "ruin my high and make me sick!" I got quite angry in response to his inability to understand the fatal consequences of not treating him emergently. While we stood outside waiting for the ambulance to come, I reflected on this man and his situation. He had no shoes, had not washed for many days and only cared about his current high and his next fix. I asked myself what would I do if I was him? Could I survive all of the terrible things he sees everyday by being homeless? Could I survive without the drugs? So often I look at these poor people and with a grateful heart I know that "but for the grace of God go I". In another life I could be him. Who loves him? Where is his family? When you turn the situation around and put yourself in the place of the patient your heart becomes softer, and you find compassion for those who have been forgotten and overlooked. On reflection I understood why he used drugs and I promised myself to treat the next person with more patience and kindness.

It is not easy loving strangers. It is easy loving patients when we have solutions to their problems and diseases. It is not so easy when we have no solutions or when the terminal disease is taking their life. It is not so easy when they continue to do drugs and drink too much and do not want our interventions. But we signed up for this as nurses. It is our mission to help everyone, even if they don't ask for or want our help.

Kate Bowler says it best in the following poem.

A blessing for whom the call to loving action is still strong.

blessed are we for whom the call to loving action is still strong, whose every urge is to keep going, keep working, and not to count the cost. and yet blessed are we, beginning to notice that we are slowing down, inexplicably, or just pausing, staring for no reason, or starting something, but then quickly turning to another demand. blessed are we, realizing that we are beginning to lose the

thread. blessed are we who say I really can’t keep going like this, at this pace, under this weight, and also, the momentum is so strong, I can’t stop. God, come and be the hands that sit me down and keep me there long enough for me to really feel what I feel, and know what I know. come and be the wisdom to find the support system that is broad enough, kind enough, effective enough to meet the needs that are here – both mine and theirs. come and be the peace that frees me to let my hands lie gently open awhile, the grace to just receive. seek the rest you need, and a little bit more. it is a sacred space.

Kate Bowler

Here is one of my favorite songs by Sara Groves

Reflect on something good that happened this week. Did you help a patient learn how to perform a procedure? Did you work for a colleague who needed a day off? Did you help another nurse when it was your turn to take lunch? Did you help prevent a patient fall by helping them to the bathroom?

Reflect on something that was negative this week. Did you give the wrong medication to a patient? Did a family member scream at you when you tried to help the patient? Did a co-worker refuse to help you with a task? Or did she promise to help and then never had time? Did you do enough for all of your patients?

How did you love a stranger this week that was positive and negative? Share your story here.

Bowler, K. (2020, November 19). Bless the nurses. Kate Bowler.

Koshy, K., Limb, C., Gundogan, B., Whitehurst, K., & Jafree, D. J. (2017). Reflective practice in health care and how to reflect effectively. International Journal of Surgery Oncology, 2(6).

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