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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. 

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Vicissitude!

Updated: Aug 16, 2023


Change. Few people like that word. And especially nurses. We would rather keep the status quo as we know it then face the unknown. I think of this in regard to working in a very busy intercity hospital. On a typical 12 hour shift a nurse would be assigned five patients (maximum in California) and by the end of the shift those five patients would be discharged, and five new patients would replace them. This hospital was so busy that one day my charge nurse assigned a patient to me from the ER near the end of my shift. I wasn't happy about that, but it got worse. I stood outside of the room waiting for the orderly to bring the patient to the room. As he got closer, I saw the orderly talking to the patient. But the patient was not talking back. When the gurney was in front of me my lower jaw hit the floor in shock. You could clearly see that the man was dead. But not just dead, his lips were purple, his skin had that gray look of death, his eyes were wide open, and his mouth was open so wide you could see his tonsils! I yelled to Clare, the charge nurse, and told her to get her booty (not quite the word I used!) over here quickly! She slowly walked over with a look on her face that immediately told me she already knew the patient was dead. But instead of admitting to it she asked, "what's wrong?" I pointed a finger at the patient and said, "why am I admitting a dead patient?" The orderly whipped around and looked incredulously at the patient. "Dead? No way!" he uttered. By that time, I had lost my patience and unkindly, but appropriately, said, "yeah, Genius, he was dead while you were having a conversation with him. Didn't you wonder why he never answered you or said anything in response?!!!" He shook his head as he tried to get the dead guy off the gurney. "Clare, why am I admitting a dead guy?" She said that the ER was packed, and they did not have time to admit him. Since I was down a patient I could do it. That was a first for me. So, you can see why I don't like change!



Vicissitudes of life can be positive and negative. They can send us over the edge or build our character. It is in the perspective that vicissitudes become positive or negative. Remember emotions are not directives or actionable, emotions are data. This thing happened today, do I become bitter or better because of it? If I dread change I will never grow. There will be days in our nursing career where there is light, as Lady Churchill says, or days of darkness. And hopefully we will get to that place where we have flown out of the negativity altogether.


One of my favorite authors, Jean Shinoda Bolen (1995) wrote:


"The inability for life to go on as usual comes about for any number of reasons.

It is not the event itself that does it but the depths into which our souls go as a result."

Crossing to Avalon


Jean Shinoda Bolen. (1995). Crossing to avalon : a woman’s midlife pilgrimage. Harper San Francisco.



It is when we make judgements about people, events, experiences and have expectations about how that encounter should go that we fall into the darkness. For example, I could have been really mad at Clare and thought that she didn't like me or thought I was a victim that she could easily manipulate. If I wallowed in those feelings, it would have ruined the rest of the day or changed my relationship with Clare to one of distrust. The charge nurse is supposed to be the one with the most experience who helps when things are "going south" with your patient. If I didn't trust her, would I call her when I needed to? I had to change my impulse to judge her and look at the situation differently. If the ER was packed, then the nurses and doctors down there could not do their jobs correctly. If I took this one task from then it would make their jobs easier, and I had the time. But I made sure that Clare knew that what she did was ok, but how she did it was not. If she had asked and explained the situation, I would have grumbled but I would have accepted the patient.



How do we get to a place where we see the vicissitudes of our days as positive and not negative? How do we embrace change and not run from it?


I found the following list years ago from one of my favorite magazines, Real Simple. If you are looking for something to read outside of the field of nursing, this magazine has lots of positivity and tips for living. Katherine Rich, a former editor gave this list to help you learn how to change. I pull it out when something is happening in my life that I need to change.

  1. Sit and be silent, or in her words, "don't just do something, sit there"(Rich, 2013). Don't run around like the proverbial chicken with its head cut off. Quiet the impulse and think about the ramifications of the decision you will make in order to change.

  2. Take time for yourself. You cannot think or make a rational decision with the kids running between your feet, the TV blaring, the phone demanding your attention and you have no idea what to make for dinner. That is not the time to be making decisions.

  3. Ignore the inner reptile! When we make decisions on impulse we are relying on our primitive brains. It is the sympathetic (fight or flight) system kicking in for survival. While you rest and digest you make better decisions.

  4. Silence the inner know it all. Be curious. Ask questions and seek out guidance from others. Especially new nurses, ask the older or more experienced nurses about what you want to change.

  5. See the world with fresh eyes. Start new and find new possibilities. Ask open ended questions and listen for the answer.

  6. Try something new and scary. I took jobs I knew nothing about but that is when you pay attention and ask lots of questions during your orientation. Looking back, those were the jobs that brought the greatest amount of satisfaction.

  7. Don't believe the common knowledge. Think outside the box. And don't believe everything you read on Facebook or Instagram!

  8. Learn to live with uncertainty. Tomorrow is not promised or guaranteed. Only this moment. What are you putting off that you should be tackling? RN School????

  9. Ask "really?" a lot. If you make that decision friends and family will tell you all the things that could go wrong. "Really?" and then look at all of the angles and make your decisions based on what you decide is right.

  10. Cast off the old skin. Get rid of those things that no longer support you. That can include other people if they no longer support you and your vision as a nurse.






What I love about nursing is it is always changing. We see new innovations every day because of changes that nurses, and other healthcare professionals have made. Wound care has made tremendous strides. The wet to dry dressing has been replaced with calcium alginate and Medi honey. Seaweed and honey, who would have thought those could heal wounds?


Did you know that hospitals and clinics did not have a Crash Cart until a nurse named Anita Dorr, with the help of her carpenter husband, put one together in 1967. Before her innovation, nurses would have to bring all of the supplies to the bedside. When time is of the essence how much time was wasted gathering all of the medications, syringes, oxygen etc.? Wow!


Mattson, L. (2015, April 20). Who is Anita Dorr and why should you thank her? | A Scrub’s Life. A Scrub’s Life. https://www.ascrubslife.com/leadership/who-is-anita-dorr-and-why-should-you-thank-her/


A pediatric intensive care nurse named Sharon Rogone, came up with a solution for babies needing phototherapy. She designed tiny sunglasses for the preemies. She used a little bonnet and called the whole thing the Bili-Bonnet. She went on to start her own company, Small Beginnings, and has since created other inventions for preemies.



If nurses had stuck to the status quo, we would not have the innovations we have today that save time and prevent injury. Keep an eye out for something that you could change for the better.


What do you need to change in your life? Would you rather be the person on the top or the one on the bottom?












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