Dear fellow nurses

I am honored to bring Nurse Week greetings, especially in this year of unprecedented demands on nurses much like Nightingale experienced during the Crimean War.  Imagine how Florence Nightingale felt when, for the first time, she surveyed the war hospital wards, filled with moaning soldiers on wobbly cots dying from the infections of their wounds. Even with her British reserve, it is likely that she thought as she surveyed this scene, “Blimey, what have I gotten myself into?” Nevertheless, faced with the challenge of a 42% mortality rate and a largely uncooperative medical staff, Nightingale dug in—cleaned up the wards, paid for needed supplies from her own pocket, maneuvered around the recalcitrant physicians, nursed and nourished the wounded and reduced the soldiers’ mortality rate to 2%.

Think about the COVID-19 pandemic experiences of so many nurses, working in overcrowded units, with patients in hallways; in Emergency Rooms turning patients away; in nursing homes with spiking mortality rates; with patients dying alone; with inconsolable family members; with exhausted and anxious colleagues worrying about contagion, about protecting self and families. Like Nightingale, it is likely that you sighed deeply, and thought, “No way, is this what I signed up for?” And yet, you dug in—working extra hours, caring for critically ill patients experiencing a novel disease, video-phoning with patients’ loved ones, comforting the dying, reveling with those who pulled through, supporting anxious and spent colleagues. Nurses are heralded in the media as heroes—not only for their prowess at complex physical care but for their humanity in attending to patients and families isolated from each other. However, it is difficult for many nurses to celebrate this proclaimed heroism. As a critical care nurse recently confessed to me, “I don’t feel heroic, just tired and empty.”

Wars and pandemics end and a new normal emerges. Nightingale returned to London in ill health but managed to turn her stressful Crimean experiences into educating and legitimizing nurses as paid professionals. She also focused on the importance of maintaining health to prevent illness and applied those principles in her own life post Crimea. You may be heaving a sigh of relief as the pandemic winds down. You are fantasizing about “getting back to normal,” whatever “normal” means to you. However, your life as a practicing nurse is forever changed as a function of living through the crisis of the COVID-19 pandemic.  You have experienced an unprecedented level of sustained stress, including secondary stress—that extra layer of stress caused by the pressures placed on professionals who care for others in need. It is the images of dying patients, inadequate equipment, overcrowded hospitals, distraught families, and beleaguered colleagues that linger on and have changed your perspective of the practice of nursing forever.

What now? Can you purposively reflect on your pandemic experiences and answer the questions, “What have I learned about myself? How can I use this crisis to change my life and perspective, my health, and my nursing practice?”  There is great value in taking stock post trauma. Every crisis is an opportunity for personal growth, for a new resilience to emerge in ways that would not have been possible had the trauma or darkness not occurred in the first place. 

This line from Jane Hirschfield’s poem Optimism captures the essence of our choice going forward.

“More and more I have come to admire resilience.
Not the simple resistance of a pillow, whose foam
returns over and over to the same shape, but the sinuous
tenacity of a tree: finding the light newly blocked on one side,
it turns in another.”

What will it be for you? Pillow or tree? Happy Nurses Week!