During the celebration of Nurses Week 2014, I have been giving a great deal of thought regarding what it means to be present when engaging in the delivery of nursing care.
Having said that, what exactly is presence? And how do we nurses actively cultivate it while performing the tasks associated with our work?
It's about you
While we may frequently say that nursing care is all about the patient, the truth is that your ability to be present is where it all begins.
Think about it. When you walk into a patient's room or home, your attitude and "presence" are more important than any tool you may have at your disposal. A stethoscope is a fine thing, but if the nurse wielding that stethoscope is a million miles away, she or he may miss the telling look in the patient's eyes, a look that may indeed belie much more than any lung sound ever will.
A nurse who is present brings so much more intrinsic value to the act of nursing and patient care, whereas a nurse who is on autopilot may as well be a robot. In fact, she may actually feel as robotic as she looks.
Speaking of autopilot
Have you ever driven to work and had no memory of the trip? Have you ever finished eating a meal, realizing afterward that you inhaled it without any sense of presence or enjoyment whatsoever? Did you even taste the food in your mouth? Especially in the 21st century, we do this almost every day, most likely due to the multiple demands being made of our time (and our shrinking attention spans).
As nurses, our work can be extremely task-oriented, and in our (generally conscientious) rush to fulfill those tasks, we often cannot see what's in front of us — and that includes the patient we're caring for.
Autopilot may be fine in certain circumstances, but it can cause us to feel disconnected from our work, less satisfied, less present and less capable of connecting on an authentic level with both our patients and our colleagues.
It's also about the patient
When you walk into a patient's room or home and proceed to go about your tasks without authentically connecting with the patient, do you think they can tell? Can a patient — no matter how young or old — perceive when you're less than present?
Patients, of course, want to receive quality care. It's also certain that the vast majority of patients would prefer to receive care from a nurse or healthcare provider who takes the time to see them for who they really are, not just as another series of tasks to be checked off on a flowsheet.
We all long for connection — whether we're busy or not. I would venture a guess that many of us feel better about the care we deliver when we've looked the patient in the eye, learned something about them and provided care that is based on their actual needs and feelings, not just on the aforementioned flowsheets and lists of tasks.
Our shared humanity is what makes us all so similar, and many of us healthcare providers are indeed also healthcare consumers. If you feel better about a doctor or nurse who demonstrates a sincere desire to connect with who you really are, it's pretty easy to see that your patients also want the same. After all, it's by walking a mile in another person's hospital johnny that we truly experience what it's like to be in their place.
The other end of the stethoscope
No matter on which end of the stethoscope you happen to find yourself on any given day, take note of the connection that happens — or doesn't happen — during a healthcare encounter.
Whether you're the patient or the nurse, what is the quality of the interaction? How present are you during that encounter? If you're the patient, how present is the provider who is treating or examining you? And if you're the nurse, are you fully present, or are you thinking about your laundry or the pile of bills at home?
Being a nurse is hard work, and the "emotional labor" of nursing is significant. We have to turn off our personal feelings and attend to our patients with as much presence as we can muster, even when our home life is a mess or one of our family members just died. That's no easy task, and that's part of what makes nursing such an art.
Practice presence and authentic connection in your patient care. Make the extra effort to be present. In doing this, you can actually increase the satisfaction you glean from your work while significantly decreasing your risk of developing burnout or compassion fatigue.
Being present is an art that enhances both the art and science of nursing, and how you show up in the care you provide will categorically enhance the personal and professional satisfaction that you achieve each day.
