Nurses are never very far away. They can be found working in hospitals, schools, home care, public health care, care facilities, offices, private practice, administration, and teaching in universities.
Marg McLenehan, RN, clinical coordinator at Vernon Jubilee Hospital, who has been a nurse for more than 40 years, and Andrea Tennant, who has been nursing for one year, talk about the science, art, past, present and future of the profession.
“I knew I wanted to be a nurse since I was six years old. My mom was a nurse and I saw how rewarding it was for her,” said McLenehan, who started her degree course at the University of Manitoba when she was 17.
It was unusual at the time as most nurses trained for three years at hospitals. She worked at Grace Hospital in Winnipeg and later in Northern Canada where she did everything from deliver babies to stitch up wounds to give immunizations.
Tennant had always been interested in the sciences and tried a few other things, including a plumbing apprenticeship, before she decided on nursing and graduated with a B.Sc.N from UBC Okanagan in 2010. She did her practicum and worked at VJH in the summers while at university.
“I knew something was missing in other jobs. What really drew me to it was that my best friend was sick and in the hospital for a long time and I spent a lot of time with her. The nurses there profoundly inspired me and that made the final decision. I think nursing chose me, rather than I chose nursing. It is a great balance of science and the humanities.”
They agree that their classroom learning was good, but they also learned a lot from experienced nurses when they went to the hospitals, and they continue to learn.
“I held the hand of the first patient who died when I was working. It was 2 a.m. and there were just the two of us in the room. You never forget that,” said Tennant.
McLenehan recalls the first patient she saw die, a cardiac arrest.
“The nurse is often the first person a patient sees in a hospital and the last. There would be no hospitals without nurses,” she said. “So much has changed but that doesn’t change.”
She cited the example of cardiac care where patients would often be much sicker before they came to the hospital because there were fewer effective drugs and less technology for them. An average stay in hospital after cardiac surgery would be two weeks of complete bed rest with only morphine for pain. New drugs and intervention procedures mean that there is much more preventive care.
Another change is that nurses must know much more about all the technology and medications used, how to interpret, manage and chart and report results. Nurses were not allowed to start IVs, now that is a routine part of their work.
“We kept learning, from other nurse, articles and the doctors, you had to remember a lot more years ago,” said McLenehan.
On-going learning is still a vital part of nursing.
“I don’t know how you did it then. I’m so inspired and in awe,” said Tennant. “Now we have access to so much information on the computer, sometimes right at the bedside.”
While science, experience and evidence-based practice are a vital part of nursing, there has always been a place for intuition and empathy.
“The art of nursing is in how nurses approach patient care. It is unique relationship we build. We look at patients as whole beings, and deal not just with the physical ailment but with the impact of the emotions on the body and healing the spirit as well,” said Tennant.
McLenehan says there is now more attention paid to all aspects of the patients’ needs.
“We would discharge patients when they were better. Now there is more insight into what their issues are and how they will be able to cope when they go home and more attention paid to rehabilitation. There is assessment and planning done for discharge,” she said.
“Nurses work much more as part of multi-disciplinary team which benefits the patients. I could never have foreseen how nursing would change over my career. We used to have to stand up when the doctors came in, now we are partners and as front-line staff we have a lot of input to patient care. We are recognized as professionals. I remember that when I started nursing, I was paid less than a girl friend who worked in a warehouse.”
Another change is that with nurses now being acknowledged as professionals, they no longer have to wear the white uniform, cap and no rings, earrings, nail polish or make-up, rules that McLenehan remembers from early in her career.
Nurses used to have to leave nursing when they got married and when that was changed, to leave when they had children. Then it went to six-weeks maternity leave and now they have the standard one-year maternity leave.
Many technical departments now rely on nurses as experts in their fields.
“Nurses have always adapted to changes in their fields. That is why nursing is so exciting and rewarding and offers so many opportunities. There are stressful moments, then there will be the time when a patient pulls you aside to say thank you and tell you the difference you have made in their lives. It’s an honour. I love being a nurse,” said Tennant.
While nursing has changed, so have patients. McLenehan noted that older patients are more likely to follow instructions to the letter, while younger patients have done their research and ask questions so they can make choices about their care.
“I can’t imagine having done anything but be a nurse. In third year university, I failed on paper and I was so upset. I thought, ‘What will I do if I can’t be a nurse?’ Fortunately, I was able to make it up and carry on,” she said.
Nurses now do basic education and then choose to specialize and can continue their education to the master’s and doctorate level. While most people see the ward nurses, there are also many nurses working in the hospital and elsewhere in leadership, planning, management and administration to keep everything running well.
Assunta Shepherd is director of acute services at VJH. She knew she wanted to be a nurse since she was in her teens and a neighbour who was a nurse talked about how much she loved the profession. Shepherd graduated from the Vancouver General Hospital program in 1979 and has worked in the wards and management across Canada as her husband was transferred with his job.
Her job includes overseeing the operation of a number of departments with an average day including everything from budgets to political issues to training to troubleshooting.
“Whatever happens throughout the day, at the end of the day, is that the patient is getting the best care,” said Shepherd.
She has seen a change in the technology of surgery with more laparoscopic (minimally invasive) surgery and more specialization in nurses’ training.
“There are more geriatric specialty nurses as more older people are admitted and they tend to have more complications from existing conditions. Years ago, there was no surgical daycare, it would never have even been thought of,” she said.
“What hasn’t changed is that people need the same thing from nurses, to listen to them and a caring attitude with their professional expertise. People come to us for help and that’s what we’re here for. We like to see people get better. I’ve put my heart and soul into my jobs.
“Nursing is a wonderful profession that will always be changing but it will always be here.”
