11.4.12-Why I Do What I Do

I have struggled over the past several months to adequately describe my frustration and lack of ability to debrief the stresses of my job with others.  It's not black and white.  There aren't just good days and bad days.  There are bad days and then there are worse days.  I absolutely love my job and would not be doing anything else in this whole world.  I adore the people I work with and share their compassion for caring.  BUT IT IS THE HARDEST WORK I HAVE EVER DONE IN MY ENTIRE LIFE.    Can I stress that again?  MY JOB IS HARD, STRESSFUL, DRAINING, EXHAUSTING, AND HARD.  Did I mention it is hard?   Not that your job isn't important, not that your job isn't stressful.  But in my job, if I mess up people could die.  That's a lot of emotional accountability to take upon yourself.   We have patients that are sick, patients that are dying,  families that are challenging, doctors that are demanding, and situations and circumstances that are out of our control but that we are required to fix.  Multiply that by five patients, three days (mind you it is 14+ hour days) a week; it easily leads to exhaustion and fatigue.

BUT.....

I love it.  I wouldn't change my career for anything.  For these people, I would do anything, for these people...

...For the patient that thanks you for helping them to the bathroom,

...For the patient that is relieved when you bring them pain medication,

...For the patient that relieved because you set up their lunch tray for them because they are too drained to do it for themselves,

...For the stroke patient that can no longer hold their arm up to dress in the morning, 

...For the family that needs questions answered,

...For the patient that needs to be told what low fat and low cholesterol means,

...For the patient that needs you to hold their hair has they vomit,

...For the patient that needs someone to hold their hand when they hear bad news,

...For the family that is making funeral arrangements,

...For the family and that finds treatment unsuccessful,

...for those families, that is why I am a Nurse.

...they are why I teach,

...they are why I wake up at 0500 every day, 

...they are why I soak my calloused feet at night, 

...they are why I wake up in the middle of the night with leg cramps,
...they are why I make time to spend time when people that are important to me, because you never know when they will gone in an instance,

...they are why I take a 15 minute lunch break instead of 30,
...they are why I never get restful nights of sleep,
...they are why I breakout and binge on ice cream far too much,
...they are why I only sweat the small stuff,
...they are why I find a moment to breakdown and cry out of pure frustration,
...they are why I have laundry piled up all over the place,
...they are why I find gratitude in the small things,

...they are why I only sit down when I pee while at work,

...they are why I continue to go to school,

...they are why I am still a Nurse.

Philosophy of Teaching

Nursing 653

James Madison University

Heather Galang

Introduction

Education is the key to progression in many ways.  Without educators finding time, patience, determination, and dedication, successful teaching would be nonexistent.  Teaching is more than just valuable, but it is a means to understanding of life and how to survive.  I have had such an instrumental education that has been valuable and engaging, I feel it necessary to contribute back to a community that has given me so much.  In many ways my professors in the past have guided and educated me in order to take care of their generation in the future. 

What I Teach

Having only been a nurse for about two years, bedside cardiac education is all I know.  Bedside education is forced and pushed most of the time, out of necessity to fill requirements and meet outcomes.  Often the patient feels trapped, generally surrendering to the education out of inability to physically relocate themselves in order to avoid education.  Though this style of education is not always successful, it can be when you have, generally speaking, isolated attention.  Though the topic at the bedside over the past two years has been cardiac related in order to fill job requirements, I still have a passion for this subject.  Cardiac disease is unfortunately rampant in my family, so every patient I teach could be my mother, my father, or my brother.  I have seen the positive outcomes and lifestyle changes in my own family, resulting from this type of bedside cardiac education.  A bedside nurse first took time to teach my father about the importance of exercise and diet in order to save his life; it is the least I can do to return that favor to someone else’s father.  It is humbling to teach patients about their life and death necessary lifestyle changes and have them reach their “aha!” moment, when they realize that they have to change.  I speak of excellent educators having perseverance and patience, because this specialty topic of cardiac education, as well as multiple other topics, is repetitive and never-ending. 

How I Teach

For me, teaching patients occurs every time I enter their room.  Every conversation we have includes ‘teachable moments’, opportunities that can lead to redirecting and furthering their knowledge.  A patient may be drinking a Pepsi when I enter their room, but they are diabetic.  This presents opportunities for teaching that do not require outside resources, but could initiate further teaching using those outside resources such as brochures, specialized educators, audiovisual, etc.  When I am passing out AM medications, a patient asks questions about their upcoming procedure.  I use this as an opportunity to teach the patient and family, if available, about the procedure and what they can expect.  Teaching is never-ending, and impromptu teaching often leaves a lasting impression.  I find impromptu teaching most encouraging when I learn, often the reason why I also use it when teaching.  I learn best when I receive information in small amounts so that I have time to process the information before using it. 

I hate that I have judgments when teaching, but I think it’s impossible not to have judgments.  We are human; prone to error.  However, I find it frustrating, draining, and incredibly apathetic when patients can make lifestyle changes and simply choose against that, taking self-accountability out of their care.  Healthcare changes, in the way hospitals are reimbursed for care, require an increased focus on special areas of education, including Heart Failure, Stroke, and Heart Attacks.  Patients will need to become increasingly more accountable to their care, taking more proactive steps to prevention versus reaction.   Although I do find my role as an educator being increasingly more important because of these changes, I also struggle in teaching patients that ultimately will choose to be nonadherent.  I think that this will be a key role of research and problem solving as an Advance Practice Nurse.

How I Know I’m Making Progress as an Educator

Even though there are hurdles to jump and education is exhausting and draining, I find fulfillment as an educator in the very small mountains climbed.  I took care of a patient once, admitted with Acute Respiratory Failure, secondary to Acute on Chronic Congestive Heart Failure.  Even though prescribed by her doctors, her diet never consisted of restricted salt or fluids, she never weighed herself, and she didn’t adhere to her medications on a routine basis.  I took time away from nursing the desk to take a full hour as a bedside nurse to teach this patient about her upcoming Pacemaker Insertion procedure and her disease process.  Regardless of what teaching styles or materials I used, the mere fact of patiently taking time and dedicating myself to her and her alone created this successful learning environment.  She looked at me, after I was done teaching, and she said, “You are such a great teacher!  You should have been a Doctor, you would be so successful!”.  I thanked her, and quietly slipped out of the room.  On the other side of the wall, my thoughts?  “No.  I am exactly what I was meant to be, an educator.  I made a difference with her; that was enough success.”

Conclusion

Since education and learning is key to success in life, I know that my role as an educator is invaluable.  It is my personal and professional goal to continue my own education in order to continue to fulfill my own goals of successfully educating patients and leading them to improved health.  Impromptu teaching will continue to be my means of growth and success for others and will continue to be key to my philosophy of teaching.   I take education seriously and know that finding time in a chaotic, busy schedule is important and key to progression in health and in life.  I will take the small mountains climbed in the field of education as a measurements of success.