BY: Fidelindo Lim, DNP, CCRN In December 2001, the graduating class of New York University’s College of Nursing asked me to give a speech during their pinning ceremony. As part of nursing education, the pinning ceremony goes back to the time Queen Victoria presented a pin to Florence Nightingale for her pioneering work during the Crimean war.
Today, a pin may be presented to a graduating nursing student by a faculty member, a mentor, or a loved one as a symbolic welcome to the profession. My own pinning happened in 1987, and I still recall the overwhelming emotion I experienced as I inched ever closer to becoming a nurse.
It’s not easy to think of something original to say to a group of enthusiastic future nurses. The NYU program coordinator suggested I speak from the heart. After digging deep into my heart—hoping to channel Florence Nightingale—I decided to share my impressions of what patients thank us for when they say “Thank you, nurse.” Over the years, I’ve noticed that the predominant theme of those thank-you cards we get from patients is gratitude for the little things we do for them—answering the call light promptly, speaking compassionately, giving them something to drink, placing the phone by their ear when they’re unable to, holding their hand, bringing them a newspaper, and (my personal favorite) trimming their nails and washing their hands. (I did so much of that I could have been accused of illegally practicing podiatry or cosmetology!) I never heard a patient say, “Thanks, nurse. That catheter was really fabulous!” But many patients recall, even years later, the time you washed their hair because they couldn’t walk to the shower.
Recently, when I reread Florence Nightingale’s Notes on Nursing: What It Is, and What It Is Not, I realized she was writing about similar little things. Referring to keeping the bedside spotless and other housekeeping issues, she admonished, “If a nurse declines to do these kinds of things ‘because it is not her business,’ I should say that nursing was not her calling.” These little, seemingly menial gestures may not get us nominated for the Nobel Peace Prize. But as with peacemakers, what nurses do moves and soothes the human heart and spirit. The enchanting (though not entirely mysterious) thing is that as we strive to bring about positive changes in our patients, we’re transformed ourselves. I’m certainly not the same “nurse-person” I was at my pinning ceremony 28 years ago.
In one of the final post-conferences of my undergraduate training, we were asked what field of nursing we were interested in practicing. I enthusiastically replied that I’d like to be a nurse-teacher so I could touch more lives in a shorter time through health education (I imagined a classroom of students as opposed to a few patients). I still believe in teaching, but less on merely reaching more nursing students as on touching their lives and influencing them to make patient teaching as routine as taking temperatures. I’m convinced the nurse’s best weapon in the era of incurable diseases is patient education – primary prevention is ever more important.
Today, nurses walk a delicate line between tradition and technology, computer skills and compassionate service. To bring greater awareness to their challenge, I sometimes ask nursing students, “If you were Florence Nightingale, what would you do if your patient’s arterial blood gas results showed a pH of 7.25, carbon dioxide of 58, bicarbonate of 29, and a partial pressure of arterial oxygen of 80?” One time a student replied without missing a beat, “I’d open the windows to provide pure clean air, hold the patient’s hand, and call for immediate intubation.” I grinned with satisfaction that at least for that student, my teaching had been a success.
These days, “pure” perhaps refers to evidence-based knowledge and “clean” to the honest, no-nonsense compassion we give patients. To our new colleagues, I’d like to stress that whatever field of nursing you pursue, don’t forget to do the little things, share your knowledge with all, and invoke Florence Nightingale—the founder of modern nursing for our modern times.
Note: A variation of this article was published in 2009 as The little things we do. American Nurse Today, 4, 40.
Fidelindo Lim is a clinical faculty at NYU College of Nursing and a per diem nurse educator for NYP Weill Cornell and Hospital for Special Surgery.