By Cynthia Clark

Connect with on the Circle

Connect with on the Circle
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  • RNL Feature

A nurse’s tale

Nursing is a journey. Don’t miss the turn signals.

Cynthia Clark

As the author puts it, “To find our way, we must open our hearts and minds, listen with intention, be receptive to feedback—and not be afraid to explore new and different pathways.”

Nearly four decades have passed since I started my nursing journey. This amazing odyssey began the summer of my senior year of high school. My best friend’s parents—a physician and a nurse—asked if I would like a job working as a nurse’s aide at the long-term care center they owned. I took them up on their offer, and that decision changed my life’s course.

I’ll never forget my first day as an aide. Back then, the unit charge nurse trained us on the job. My mentor—Nurse Grey—was an imposing, larger-than-life personality who taught me the skills needed to care for patients and more about myself than I ever thought possible. Those powerful lessons formed an enduring impression that ultimately shaped my nursing career.

Stories of life
Although I benefited greatly from the tutelage of Nurse Grey and others, I learned some of the most important lessons of my life from the residents. Even today, when I close my eyes and picture them in the facility’s east wing, I can recall their names, faces, preferences—and, most of all, their stories.

Ah yes, their stories. My days were often spent conversing with them as they shared their life histories. One of my favorite residents inspired me to become a nurse—to dream big, make a difference, live with intention, and make the world a better place. I took his advice to heart.

Years later, after completing my undergraduate nursing program, I started my first nursing position. It was a dream job for any nurse. For me, an energetic, newly graduated nurse, it was amazing. Working day shift on a surgical floor, my major responsibilities included preparing patients for surgery and caring for them afterward. The hours were awesome, the work was gratifying, and life was good!

Unfortunately, the situation quickly changed. A little more than a year later, the hospital hired a new director of nursing. For reasons that still perplex me, she decided to reassign many of the nurses to various units based upon seniority. Because I had very little seniority, she assigned me to the evening shift on a medical unit where I cared for many terminally ill patients. It was a grim setting, but I quickly adjusted to my new situation.

Although I was a competent nurse, I often found myself behind schedule because I enjoyed having conversations with my patients. My charge nurse genuinely liked me and regarded me as a skilled nurse, but, on occasion, she admonished me on my inability to complete my work on time. I worked to improve my timeliness, but still there were nights when I fell short. And there was one night when I experienced a defining moment in my young career.

Have a moment?
The crystallizing event occurred late in the shift on a very busy night. I needed to remove the irrigation apparatus from a patient who had recently undergone surgery for a transurethral resection. Determined to perform the task in a swift and efficient manner, I greeted the patient and explained the procedure. But before I could begin, he said he needed more time and asked if I had a moment to chat. I sat next to him as he shared how much he desperately missed his beloved wife of 50 years, who had recently passed away. When he was ready, I removed the apparatus and was about to leave when I noticed his tears. After staying with him a few more minutes, I gathered the equipment and bolstered myself for a talking to by my charge nurse. Sure enough, she met me in the hallway and politely asked me to meet her in the conference room after completing the shift.

I was certain it would be my last night—that a firing was surely in the offing. But something amazing happened. My charge nurse said: “Cindy, you have missed your calling. Please think seriously about going back to school to become a mental health nurse. You have a genuine gift for being present and listening to others—it’s clearly your calling.” Imagine my surprise!

I realized she was right and began making plans to return to school. I will never forget the care that charge nurse showed me. She saw something in me that I did not, and rather than reprimanding and discouraging me, she opened a pathway of new discovery that launched a fabulous new phase in my career.

For more than a dozen years, I worked as a behavioral health nurse. I was blessed to be a member of a talented crew of adolescent mental health workers who treated a variety of conditions and disorders. Many of our patients were violent, adjudicated youth with a long history of criminal behavior and substance abuse. Others had been abandoned, rejected, and abused—often forgotten and left to fend for themselves. The work was challenging and often tested our team’s resolve. But we had each other. We were young, determined, and unshakable in our belief that we could make a difference.

Golden Moment
I clearly remember an event that occurred after a particularly challenging day. We were looking forward to going home, but Dr. M, the psychiatrist on our team, suggested we meet for a few minutes before leaving. A brilliant, gifted physician, Dr. M is the daughter of Austrian immigrants who survived the horrors of internment in a Nazi Germany concentration camp. Her life experiences and psychiatric skills helped us become better clinicians and—I believe—better people.

As we gathered for a spontaneously called meeting that none of us really wanted to attend, we had no idea it would be a game-changer. After looking around the room at each of us, Dr. M said: “This is our Golden Moment. This unique intersection of our lives, this unexpected coming together, is a gift to be cherished. It is not a single moment, or even a single day, but our Golden Moment, an accumulation of the days, months, and years we have worked and sweated together and supported one another to make a difference in the lives of the kids entrusted to our care. We must never take this ‘moment’ for granted.”

Our Golden Moment was the incredible joy and satisfaction of being part of a team engaged in very difficult but rewarding and meaningful work. I hoped it would never end, but as the saying goes, when one door closes, another one opens. And so began the next chapter of my nursing journey.

I was having a great time as a nurse manager on a long-term behavioral health unit when a nursing professor from our local university approached me. She encouraged me to apply for a faculty position in the nursing program. At first, I thought she might be joking. I had no experience teaching at the college level and really no desire to do so. But over time, she convinced me to apply for the position.

The interview process consisted of a series of individual and team interviews with various members of the nursing program. In one of the team interviews, I was asked what I would do if confronted by a student expressing anger about a grade that he or she believed to be unfair and demanding I change it. I had no teaching experience to draw from, but plenty of experience successfully dealing with angry adolescents. I thought, maybe this job won’t be so difficult after all! I was hired and thrived in that role for the next 20 years.

Onto something
Soon after becoming a faculty member, I noticed that some students were behaving in rude and disruptive ways—in some cases, displaying hostility and aggression. These behaviors set off alarm bells in my gut because they reminded me of my earlier experiences with angry youth. “Is it just me?” I wondered. Perhaps my observations were colored somewhat by my previous clinical work. Curious to find the answer, I began learning all I could about what I was observing. I asked other faculty members if they were witnessing the same types of disruptive student behaviors. Some told me they were retiring or moving on to other employment because of the toxic, uncivil behavior adversely impacting their lives.

I knew then I was onto something, and I began studying this important issue in earnest. My concern soon extended beyond student behaviors and grew to include faculty incivility and other behaviors that might be contributing to the problem.

Over the years, the focus of my work has expanded to include the impact of incivility on patient safety in healthcare practice and how nursing educators and practice-based nurses can collaborate to prepare newly graduated as well as seasoned nurses to foster civil and healthy work environments. What began as a simple question turned into a passionate lifetime commitment to lead a coalition in building communities of civility that will improve all lives and make the world a better place.

Purposeful, intentional, mindful
Nearly five years ago, I resigned my faculty appointment and joined an organization devoted unequivocally to supporting and advancing nursing education and practice. My work as a nurse scholar, teacher, and consultant takes me to schools and practice settings large and small, rural and urban, public and private, and everything in between. In these places, I meet with nurses, faculty members, students, practice partners, community leaders, administrators, policymakers, and many others to share stories, challenges, and victories.

I often wonder what the rest of my journey will look like. There will surely be twists and turns along the way, but this I know for sure: I am dedicated to making a meaningful contribution to the noble profession of nursing. Working to achieve that goal centers me. Each day is a blessing and an opportunity to live a purposeful, intentional, and mindful life.

Nursing can take us anywhere we wish to travel. To find our way, we must open our hearts and minds, listen with intention, be receptive to feedback—and not be afraid to explore new and different pathways. This involves taking risks and listening to mentors and coaches who have led and are continuing to lead the way. Your path, like mine, may be circuitous and uneven, but I encourage you to embrace the journey! RNL

Cynthia Clark, PhD, RN, ANEF, FAAN, nurse consultant for ATI Nursing Education, founder of Civility Matters, and author of Creating & Sustaining Civility in Nursing Education, is a psychiatric nurse/therapist and an expert in fostering civility and healthy workplaces.

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