Narrative Nursing

Listening for Stories

As many of my readers know, I received a M.S. in Narrative Medicine from Columbia University a few years ago. The founder of all things Narrative Med is Rita Charon, M.D., Ph.D. I was fortunate enough to have Dr. Charon oversee my initial steps into the creation of Narrative Nursing:

Dr. Charon was recently a guest lecturer for Florida Hospital and Adventist University here in Orlando.
She shared how the whole point of narrative practice is to garner better communication throughout the world of health care. However, she also used a phrase that I don’t recall having heard before. I thought this was a really incredible way of putting it and I wanted to share this with you…

We all know that when others talk, we should listen. I mean duh, right? However, Dr. Charon talked about something additional. Instead of listening to stories, we should also be listening FOR stories.

I had to contemplate this for a sec…but when the little lightbulb above my head flickered on, it makes great sense.

Listening FOR stories. Observing not just the things that are said, but the things that are unsaid. Observing the places where another leaves out key parts of the story. What are those key parts? Can we discern the story behind the story, just by listening for those omissions? When someone speaks with passion, possibly even with anger and fury, what story are they sharing without even telling the story?

This week, I’d like you to remember a time when you were able to listen FOR the story being told by a patient. Please share a few lines about how this type of listening provided more insight in the treatment of your patient.

Emergency nurses

Did you know it’s emergency nurses week? Yeah, true story!

In honor of these very special nurses, this week, I’d like to highlight the work of all those RNs in the ER. As you know, I have a love for anyone and everyone who works in trauma and emergency care. These individuals are those with such an ability and responsibility to live the message of “I’m Here.”

This week, please write a paragraph or two on an experience where you interacted with an emergency nurse in an urgent situation.
Or, if you are an emergency nurse, please write a few lines on a time you’ve been able to provide healing presence to a patient or family.

Where has Marcus Been?

If you’ve been missing your weekly dose of Narrative Nursing creativity, well, you’re not alone. I’ve missed the process of writing the prompts and sharing them with you. I apologize for the absence and I promise not to let so long go between our future communications. Today’s focus of a prompt comes from a NP who works in oncology.

I met this nurse in the company of other non-health care professionals. When we learned she was an oncology nurse, I stayed silent. Why? Because I knew someone else would ask the question; that same question she’s probably been asked a million times: “Wow, oncology! Isn’t that hard?”

Whether it’s practice of answering this question, I found her reply priceless. “I can’t always effect the outcome, but I can help the journey.”

Faithful Narrative Nursing reader: please write a paragraph about a time when you, too, have not been able to change the outcome, but you’ve been able to help a patient on their journey.

And again, my apologies for being MIA. Good to be talking with y’all again!

Courage

Does it get better?
This question was recently posed to me by a survivor of massive trauma. Even though this trauma happened over a decade ago, this survivor still has significant amounts of pain and a slew of medical issues. The question, “Does It Get Any Better?” is one that, for me, is hard to answer. Why? Because I’m only me. No one can truly know the heart, mind and soul of aother. Her trauma may haunt her the rest of her life, and it may be something that, through practice, she can learn to love. What I am most struck by is the courage it took for this individual to reach out. Allowing ourselves to be vulnerable enough to ask for help is actually a sign of strength. For this week’s prompt, please write about a time someone has reached out to you.

CNA Gratitude

The week of June 15 was Nursing Assistant’s Week. First, I tip my hat to all you CNAs and PCTs. Second, if you’re a nurse who has benefited from a nursing assistant, please share a story about him/her.

A 2008 study by the ANA found that, after working a shift, nurses were asked to describe their feelings. 50% said exhausted and discouraged, 44% said discouraged and saddened by the care that could not be provided, 40% said they felt powerless to make changes and a full 26% said they felt frightened for their patients.
This. Is. Horrible.
I hope these are not the same numbers that would be reflected in a 2015 study, but, I fear they may even be worse. These are wretched emotions for anyone to deal with, even on a limited basis. But when this is experienced after a typical shift? It’s just so sad. With so many nurses feeling this way, what is one way you may be able help your colleagues deal with end of shift emotions? What do you do for self-care?

Physical Objects and Object Symbolism

Let’s think metaphorically and symbolically this week. Think of a physical object that describes your nursing philosophy. Please take time to first, do a bit of thought exploration about your personal nursing philosophy. Then, draw a few comparisons between your thoughts and your chosen object.

I Wish…

This is a tale I wish didn’t have to be told, mainly because I wish this didn’t happen.

After a recent keynote, I got an E mail from an audience member. She echoed the compassionate elements of my presentation and then asked a direct question: Why don’t we extend that same compassion to fellow nurses?”

My new nurse friend went on to tell how she’d recently relocated to the area and had been hired to work on a floor that specialized in a new area. Like, previously she’d been an ortho nurse, now she is on an oncology floor. While she has over a dozen years of experience, she knew there would be a lot to learn, not only with this new institution and new floor, but new speciality of nursing, too. She asked lots of questions of her floor nursing colleagues, mainly about the clinical aspects of the job, but also just learning the overall feel; i.e., what one might sum up as “culture.”

Her findings? After being cold shouldered by nurses on her floor, she came to my presentation. She sat by herself, loved what I teach and was ready to return to the floor with new info and better relationships with her co-worker. Wrong. As she stood up to leave and turned around, she spotted a group of half a dozen nurses from her floor, sitting together just a few tables behind her. She came up to the table, greeted her colleagues and…? Her nurse manager stood up, never glanced in my friend’s direction and purposefully walked away. Not even a nod or a smile. As my friend described, she’s seen other nurses treated this way at other institutions. We’ve all heard that despicable phrase, “Nurses eat their young.” Seems pretty similar circumstances, don’t ya think?

This week, I want to pass my friend’s question to you: Why DO we not extend copious amounts of compassion to our colleagues, when we do precisely the opposite for patients and families?”

Hurting People…

Hurting people hurt people.

If you’ve heard me keynote, you know this is a point I return to. If we’re to be compassionate caregivers, we have to remember this truth. For our patients, for their families and also for ourselves (which is probably the hardest.)
Please think of and describe an instance where you were treated poorly. Heck, not just poorly, but where someone was intentionally rude to you. Please describe why or why not this simple truth did (or does not) apply.

The “Right” Card

I spent a few days back on the farm at the end of May, visiting my parents who have lived in the same home since my childhood. At my local church, there is a delightful woman who (literally) sends every single member of the congregation a birthday card. Every time there is illness, she sends a get well card. She is thoughtful, mindful and generous with her time to help others. However, soon, those cards will cease to come.

Millie has been fighting cancer for the last couple years. Recently, she made the choice to go on hospice. She is facing the end of her earthly life with strength, dignity and love.
After church, my mom was trying to decide on a card to send to Millie. As she flipped through a box she keeps for just such occasions, she asked, “What kind of card do you send someone who is on hospice?” My immediate response is a “thinking of you” card. Then, I was a little bewildered and ashamed because I didn’t have a better response. As we know from the I’m Here Movement, simple human presence is the foundation of caregiving…but presence is also the foundation of everything. Forget the cards or what we think could/should be done for someone facing death…what would you most want from others if you were in Millie’s position? Feel free to wander around with your response. Or, feel free to skip this one if it hits a little too close to home for you.