This light of mine

By Mary Berg | 05/06/2015

As she begins her career, a nurse shares her philosophy of nursing. 

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“The craving for ‘the return of the day,’ which the sick so constantly evince, is generally nothing but the desire for light.”
—Florence Nightingale

Florence Nightingale, one of history’s most famous nurses, was known as the “Lady with the Lamp.” While caring for soldiers during the Crimean War, she carried a lamp when checking on her patients in the dark evening hours. As a nurse, I continually reflect on characteristics I consider most important to nursing. Throughout my life, I have observed nurses—those who provided care for members of my family, those I learned from while earning my BSN, and, since my graduation in December 2014, nurse colleagues.
 
I’ve seen nurses demonstrate attributes such as patience, compassion, intelligence, devotion, and advocacy, and I want to exhibit all of those traits. But if there is one metaphor that best communicates what I desire to be as a nurse, it is a light—like Nightingale’s lamp, to shine where there is darkness. Depending on what is needed at a particular time, nurses are lights in many different ways, and here are some of the lights I want to be.

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When my patient is rapidly declining, I want to be a red, flashing light. A nurse also needs to recognize small changes in her patient, as they may be early indicators of a downhill slide. In Nursing: Scope and Standards of Practice, Standard 11 states that the nurse will communicate effectively in a variety of formats. The nurse must always be concerned for the best interests of her patients and question rationales for certain decisions and care practices when they do not seem appropriate. As a warning light, the nurse must disclose to others observations that he or she makes regarding hazards and errors. I will speak up for that vulnerable patient who doesn’t have a voice. I will watch for changes that indicate potential problems, draw upon my knowledge and competencies, and, as a warning light, call attention to them. Warning lights announce dangerous situations in nursing, but, more often, I will be a flashlight, assessing my patients and using my beam to illuminate relevant histories.
 
A flashlight
Nurses need extraordinary assessment skills to reveal a full picture of their patients. As a student nurse, I watched nurses make thorough assessments that uncovered problems no one had noticed before. Now, as a registered and employed nurse, I am always taking a closer look, asking questions, and then asking more questions.
 
As flashlights, we shine through the darkness to uncover mysteries about our patients’ health. Using evidence-based practice, we look for information that will help us provide better care. We can’t assume we know the answer; we need to search to make sure. Standard 9 in Nursing: Scope and Standards of Practice states that nurses must use evidence when initiating changes in nursing practice. To get a closer look and find answers, we are bright flashlights, but we sometimes need to function in another way—as soft, subdued night-lights.
 
A night-light
A night-light provides comfort. I can be a night-light when my patient wakes up in the dark, scared about the future. I can be a night-light by holding a hand, listening, or just being there. I once had a hospice patient who would go in and out of consciousness, often making no sense, but, at other times, asking me to hold him tight. His restlessness was relieved when I sat at his side and rubbed his back with lotion. I was his night-light; he had no one else. In Guide to the Code of Ethics for Nurses, Provision 1 states that the nurse practices with compassion and respect, regardless of the patient’s background or health problems. A night-light brings peace to those who are anxious, but we sometimes need to open the blinds, so to speak, and be rays of hope-giving sunlight for our patients.
 
Sunlight
Many patients live in dark spaces they feel they can’t escape. I can be the sunlight that warms their skin and makes them smile. Many patients suffer from mental illness. They need to know that nurses will do everything they can to bring sunshine into their lives. Patients may have several co-morbidities that make them feel there is no hope, that their health is a series of overcast days that never end. As a nurse, I can find ways to bring sunshine to them. When caring for depressed patients, it is crucial to advocate for and protect their health, safety, and rights, as stated in Provision 3 of Guide to the Code of Ethics for Nurses. As sunlight for a patient in darkness, I can provide the warm glow of hope to someone who feels there is none.
 
The right light
Human beings need light. An exemplary nurse knows what type of light a patient needs at a particular time. For that patient who is showing small danger signs that could multiply and cause a downward spiral, the nurse needs to speak up and be a red, flashing light of warning. When more information is needed to complete a patient’s health picture, a nurse needs to be a flashlight that searches for missing information that advances evidence-based practice. Sometimes, the soft glow of a night-light is all a nurse can be, but that may be exactly what that patient needs. Patients often live in the darkness of insecurity, uncertainty, and depression. With the sunlight of hope, nurses can warm their faces, hearts, and souls.
 
Mary Berg, BSN, RN, graduated from Alverno College JoAnn McGrath School of Nursing in December 2014 and is now employed as a registered nurse at Children’s Hospital of Wisconsin on the Neuroscience Unit.
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