As nurses we have access to information on reflection and resilience, and we know to adhere to the Nursing and Midwifery Council's code.
But, sometimes, when I am teaching nursing students, I am asked questions that link to these, but are about the smaller details – “what’s it actually like to be a nurse” type of questions. This has led me to write down all the ‘rules’ I’ve picked up over the years. I have found these helpful in my own practice and hope you will too.
1. Never lose your keys
Ah, the infamous 'keys'. On my third day of being a nurse, I was given the keys to various cupboards and doors. I remember the weight of them – not just because there were so many of them on the keyring but the responsibility that came with them.
2. If it isn’t written down, it didn’t happen
This goes for everything and anything: medication charting, daily notes, handover, risk assessments, and student testimonies. If it isn't documented and then something happens or is raised, it is very difficult to investigate or resolve.
3. Always be able to defend your practice (if in doubt – see rule #2)
This isn't a case of covering your back; rather of being able to show your rationale for decisions made and actions taken.
"Don’t make the mistake of thinking someone you work with is ‘just' a support worker or 'just' a housekeeper"
4. Never type when angry
How do you stay calm if you've just been punched or had a cup of tea scald your chest as it was thrown at you? This is a difficult one, but nursing documentation should always be objective.
5. There's no such word as 'just'
Don’t make the mistake of thinking someone you work with is ‘just' a support worker or 'just' a housekeeper. I've had the pleasure of working with many support workers who knew more than I did, worked harder, and had wonderful ways of reaching people that other team members (myself included) were in awe of. These staff may have spent more time on the ward than you, have built supportive relationships, and are a font of knowledge. If you're on an unexpected double shift, or are the only nurse on nights, and you've made friends with the housekeepers and support workers and respect them as peers, they'll hopefully feed you, keep you in coffee and generally help you keep going throughout your shift.
6. Don’t dump on the next shift
Everyone is doing a job and a half (maybe more). It might sometimes be tempting to leave a task you could do now for the next shift. But think how you would feel if you walk on shift and stuff has been off-loaded onto you?
7. Look after your staff and they will look after you
Make sure everyone gets a break and takes it. Don't dodge difficult conversations – avoidance is a great coping mechanism, for all of five minutes. Accept that sometimes being a leader is uncomfortable. Always strive to be fair and remember that saying “thank you” to staff at the end of a shift will always be appreciated.
8. Never make a selfish brew
It is always worth asking colleagues if they’d like a cuppa. Links nicely to rule #6.
9. If you don’t look after yourself, how can you support others?
As caregivers we are so bad at this. We promote self-care, but often we don't practice it ourselves. We need to take our own advice.
10. Just because you have a PIN doesn’t mean you can’t...
…empty the dishwasher, run the hoover around someone's flat, provide personal care when someone's been doubly incontinent, pick up a prescription or take a dog to the boarding kennels while their owner is in hospital. I've done all these things, but I’ve known nurses who wouldn't. Isn’t this part of holistic care?
11. Don’t be afraid of silences
We don't like those ‘uncomfortable silences’ and are quick to fill them. But it's not about us, it's about the other person. Sometimes patients need a moment to decide how to respond or just to absorb what’s been said. Learn to sit with them and ride out the discomfort.
12. Avoid making promises or keeping secrets
You care, that's why you're a nurse. But making promises that are hard to keep puts pressure on you to go above and beyond every time. Worse still, if you can’t deliver, you will have failed in the eyes of the person you're working with and possibly damaged that supportive relationship. So, accept that it is OK to do well enough (this can also help you with rule #15). And remember, nurses don’t keep secrets. Make sure patients understand the boundaries of confidentiality, however much you don’t want to have that conversation.
13. Treat others how you would want your loved ones to be treated
We all know, and should be following, the 6 Cs of nursing. But when you are in the middle of supporting someone, it can also help to ask yourself: would you stand for this if it was for your mum or someone else that you loved?
14. Take a breath
It’s easy to jump in and make assumptions when we’re stressed. Watch your tone. Ask yourself – how am I coming across? Step back, take a deep breath, think, consider – and then speak. You never know, it might go differently.
15. Don’t take it home
Be aware that ‘what if’ questions are like click bait. They don't get resolved; they only lead to more questions. Take a moment to reflect, or just tell (don’t berate) yourself that you fell for it, and then go and do something else. Put work away when you're not there.
Nursing isn’t an exact science, but in my experience if you follow these rules, you won’t go far wrong.
Angela Glaves is a senior lecturer in mental health nursing at Sheffield Hallam University, community mental health nurse for Sheffield Health and Social Care NHS Foundation Trust and co-founder of the Heavy Metal Therapy project.
