Not Just Math and Science

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I recently remembered something that I had pretty much forgotten: being a nurse requires creativity. Being a nurse means you are a creative person.

Let me back up. My husband and I have been talking a lot about creativity lately- what it is, what it means, what it looks like- because our definitions have grown very skewed, a veil over our eyes that has kept us from being able to identify it in ourselves. It’s not that we aren’t creative or full of ideas; we just have been labeling it as that. And that truly is a loss, as we have discovered.

For most of my life, I have equated creativity with artistic proclivity such as the ability to draw or paint or sing, usually materializing in the form of someone with brilliant tattoos who carries around an expensive camera at their side. Someone carefree and whimsical, someone with visions of grandeur and a disregard for menial things like budgets or timelines. And that is definitely not me. Before I started really delving into writing, which is very clearly a creative endeavor, and before my husband started calling out these qualities in me, I saw myself as linear, rationale, organized. I even had a nickname of being the “rationale” one, which I never really contested, although I always felt a bit hurt by the label. I didn’t want to be uncreative (aka boring) and I didn’t want to always be the reliable one. But in the midst of a strict nursing schedule, work out schedule, and stringent eating requirements, I figured everyone else was right. I wasn’t creative.

To make a long story short, my husband Seth has helped me over the years to realize that I am not only very creative but that even during that time- when I was working full time and seemed to be very organized- that I was operating in creativity because I was a nurse. And nursing requires a very unique type of creativity that many nurses don’t realize. And I’m writing this blog post because I wonder how many nurses feel the same way? That you are the sum of rules and time tapes, medication deadlines and charting restrictions, rather than dynamic problem-solver who manages one of the hardest jobs day in and day out. Admittedly, it is less fluid than being a freelance photographer but it’s no less artistic. I’ll show you what I’m getting at.

Say you have two ICU patients, one is sick and you’re titrating Levo and Vaso and running fluid boluses. You’re managing a vent, a feeding tube, an A line, a central line and you’re busting it to make sure the bags don’t run dry, the pressure doesn’t fall too low, the patient gets turned. Now in your other bed, you’ve got a walkie talkie who needs ice chips and to take a walk and some help in using the urinal (omg seriously, can you not do it yourself??) But you’ve found yourself in a tricky situation where you’re needed in both places and yet you can’t be there. You’ve got to find a way to elicit help from others, delegate, and prioritize in order to keep everyone safe. In that moment, you’re not worried about getting your charting done on time; you’ve realized that there are bigger things going on and that you’ve got to find a way to make it all work. And you do. If you’re a bedside nurse, you’ve got loads of creativity leaking out of you as you problem-solve every hour of the day, as you communicate with difficult family members or staff, as you form a picture in your mind that is so much more than tasks. As you impact people, who are so not linear.

When I was functioning as the family care nurse in the ICU, helping to coordinate donor patients, family meetings, and a whole host of other miscellaneous jobs, I had an encounter where I found myself completely in over my head. A grandmother was dying and the family was bent on blaming someone, so naturally, that became anyone in sight. The physicians, the hospital, even me. They were grieving an inevitable, natural death but they didn’t know how to process it and so the situation became riotous. With the entire family running back and forth from the hallway to the room, yelling and cursing, shouting into the air, it was my job to do something. They were scaring the other patients and it was quickly approaching a level where I would need to call the police to intervene. This kind of behavior wasn’t good for anyone and it couldn’t go on.

Then I did something that was risky and possibly even uncouth, based only on a gut feeling, a thick skin, and the kind of courage that only a nurse can have. But I did it because I was responsible for finding a solution to this problem and I would go down trying. At 26 years old, barely strong enough to pull a woman twice my size, I dragged the mother, the leader of this family riot, into the hallway and out of the ICU. Once out the door, I whipped her around to face me while she kept yelling, not even saying comprehensible words, and with my blue eyes blazing, I told her to shut her mouth, probably in about as many words. I will never forget the look on her face as her jaw dropped to the floor, stunned into silence. She immediately stopped talking, probably out of complete shock that this tiny white girl would command such a presence before her, and started to listen to me. We stood in the hallway and I explained, clarified, comforted, snapped her back to the reality of the situation and twenty minutes later she was hugging me and thanking me for bringing her back down to earth. Was that rational? Definitely not. Was it even the most logical solution to the problem? Probably not. But thank God it worked because I had to get creative to stop the mayhem and restore order. I had to find a way to make this better.

As I prepare to start NP clinicals, I find myself training for similar scenarios, ones that require a depth of understanding and communication that goes far beyond training in a classroom. Skills that only come from experience and freeform thinking, skills that are born out of creativity. How do I get someone who has been smoking for thirty years to consider quitting? Do you think telling them that smoking is bad for them and that they should quit is going to work? No, it won’t. They’ve heard it before. But if I can get them to think about what they might lose or how far they would have to get before considering stopping, then maybe I’m getting them somewhere. Closer to where I believe they should be. And this is only one of so many scenarios that I will encounter in primary care that require finesse in order to solve.

Everyone has heard from a nursing instructor or a textbook that nursing is an art, not just a science. But I wonder how many of us have lost that realization, who don’t acknowledge that what we do everyday requires intense problem-solving, creative solutions, and out-of-the-box communication? It’s more than giving meds on time, keeping people from dying, clocking in and out, and administering health advice as a provider. Being a good nurse or NP requires accessing that core creativity that each of us possesses and using that to excel at our jobs.

Some people probably doubt that creativity inside of them and that’s a shame. It’s part of what makes us human, relatable, and worthy of confiding in. But it’s true. Nursing is so much more than math and science. In fact, I would venture to say that nurses are some of the most creative people in the world.

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