Thursday, September 30, 2010


I needed a little time to process and think a little before writing about this topic. Southern Cathy and I headed to San Antonio last week for the Emergency Nurses Association (ENA) annual convention. It was a first time occurrence for us both; we had heard that it was very much a carnival informative and a party atmosphere great opportunity to network with other ER nurses. Although not a Texas native, Cathy spent a few years there so she was a great resource for getting around and seeing the sights; as it turns out, we had a blast. I didn't count on the doing as much reflection on my nursing practice as I have.

We basically spent 2 full days in lectures; all were interesting, informative and provided new knowledge we otherwise would not have been exposed to. Some were clinically oriented, some were skills-based, many provided food for thought. I had an opportunity to hear about the experience of a combat nurse who had spent time in Iraq, an excellent speaker who deserved and received a standing ovation after her presentation. I wound up (quite by accident) in a class that taught us how to care for the Transgendered patient in the ER simply because I was in the wrong place at the right time, but had listened two of this nurse's previous lectures and LOVED her. There were classes about policies that supported staff against violence, how to protect yourself from lawsuits (documentation, documentation, documentation), and sudden death in young athletes. I especially liked "10 Ways Not to Get Fooled at Triage".

Cathy and I chose different classes and exchanged what we had learned about during breaks. I came out of the experience with with a somewhat new attitude towards ER nursing in general and my own practice in particular. It was empowering to be among my peers, many with fewer years of ER experience, some with many more than my 34 years. There were nurses from small ER's such as mine, and others from enormous medical centers and Level 1 trauma centers. Yet at the end of the day we were all pretty much doing the same job, had many of the same concerns, and want the same things from our managers and administrators.

The common theme among the nurses that I met will come as no surprise: nurses are nobody's priority. We, as a group, are consistently being asked to do more with less, forced to follow the agenda and direction of individuals who make the rules but have nothing to do with clinical decision-making or patient care. I dare say that if they ever knew which end of the bedpan went where, it has long since been forgotten. Nurses are at the bottom of the food chain, the first to sacrifice or be sacrificed. Yet we are at the front lines of patient care, often in spite of of administrators, managers, and individuals who have been placed erroneously in leadership positions. Yet all of the nurses that I met were committed to being better, learning more, providing top-quality care. And you know, the lecturers had a mountain of alphabet soup after their names but had great ideas for us front-line nurses. These are movers and shakers that seem to be missing in the work-a-day life of a nurse, absent from the front lines but working behind the scenes. These are nurses who are intelligent, confident and get things done; their leadership inspired me. As I listened, something struck a chord with me.

I am not a manger, but I am a leader; I can be mouthy and negative, bitching about how unloved we are when I'm frustrated, or simply caught up in small bull-shit annoyances, such as sticky notes that berate nurses for missed secretarial tasks. I can be a Pied Piper, whipping my co-workers into a frenzy of indignation, or soothing them when they are over the top and overwhelmed. I can go hog-wild with practical jokes and suck others into my vortex of lunacy. I can cajole people into doing things they might not think of or even consider doing without my encouragement.

I have encouraged some of my coworkers, mainly Mikki, to be less fearful and intimidated by one of our physicians. You know the type: the all-powerful demi-God who fails miserably as a team player and was most certainly voted Most Likely to Get the Snot Beat Out of Him in high school; generally unhappy, lacks adult social skills, etc. He's just a guy, kids. Not likable, not an especially good doctor, and not good for nursing. But get on your big girl pants and stop giving him the power to lord it over you for heaven sake!

My take-home from this conference is this: I have learned that leadership is a powerful thing, especially if it is used for good instead of evil.