Doctor nurse

I have taken hold of a few interesting ideas regarding the term “doctor” since beginning my PhD studies. These ideas stem from my experiences with friends and family and also from my increased knowledge of terminal degrees and the basis upon which they are conferred.

As more and more of my family and friends began to refer to me by the nickname “Dr. Montgomery,” I noticed that others seemed to assume I had made the choice to go to medical school. Now, I have never told anyone that I have a goal of becoming a medical doctor (because I love being a nurse and would never choose to go into medicine), but that is the general assumption. The more this type of awkward situation occurred, the more I began to question the reason for the misunderstanding.

It has been my experience that, outside of an academic setting, a person introduced as “Doctor X” is assumed to be a medical doctor. Why is this so? The terms “doctor” and “physician” are not synonymous, but apparently to the general public they are. If we look at the first definition for the terms “doctor” and “physician” in Webster’s Dictionary, they are as follows:

• Doctor—(a) an eminent theologian declared a sound expounder of doctrine by the Roman Catholic Church, (b) a learned or authoritative teacher, (c) a person who has earned one of the highest academic degrees conferred by the university, (d) a person awarded an honorary doctorate by a college or university.
• Physician—a person skilled in the art of healing; specifically: one educated, clinically experienced, and licensed to practice medicine as usually distinguished from surgery.

Looking at the above definitions, it is clear that a doctor and a physician are not one and the same. So again, why is it a general assumption that all doctors are physicians? The truth of the matter is this: All physicians may be doctors, but not all doctors are physicians. Doctors come in many shapes and sizes, and they may have earned one of many degrees: Doctor of Philosophy (PhD), Doctor of Nursing Science (DNSc), Doctor of Education (EdD), Doctor of Pharmacy (PharmD), Doctor of Psychology (PsychD), Doctor of Dentistry (DDS), Doctor of Music (DM) or Doctor of Medicine (MD).

Recently, I read a New York Times article titled “Calling the nurse ‘doctor,’ a title physicians oppose.” This article reveals physicians’ concerns that patients will become confused if nurses with doctoral degrees begin to identify themselves with the title “doctor.” According to the writer, physicians in the State of New York have even gone to the state legislature to enact a law that forbids nurses to use the term “doctor,” regardless of the type of doctoral degree they have earned. This to me is ludicrous.

I believe that a nurse who greets her patients by saying, “Hello, my name is Dr. Tiffany, and I am your nurse practitioner,” is not causing any confusion. If a short discussion regarding the nurse’s level of education ensues, this type of introduction may actually make the patient more comfortable. Nurses who have attained doctoral degrees, but remain practitioners at the bedside, should be proud of their accomplishments. By all means, if you have earned a doctoral degree, introduce yourself with the appropriate title!

Physicians do not own the rights to the title “doctor.” Anyone with a doctoral degree, whether a practice degree (i.e., MD or DDS) or a terminal degree (i.e., PhD), has the authority to use the title “doctor.” Nurses with doctoral degrees have long been referred to by their professional title in the academic setting. It is obvious that the recent introduction of the nursing practice degree (Doctor of Nursing Practice, or DNP) and its attainment by nurses who wish to remain in direct patient care has ruffled a few feathers. For this reason, it is the responsibility of every nurse to help patients understand the difference between a doctor and a physician.

When people ask if I’m in school to become a doctor, I let them know that, once I earn my PhD, I will be a doctor, but not a physician. I am quick to inform my friends and family that I am a nurse and will always be a nurse. Nursing, for me, is not a steppingstone to medical school; nor am I abandoning the profession in pursuit of a doctoral degree. The reason nurses become doctors is to become better researchers, teacher, and clinicians. Those of us pursuing PhDs in nursing want to understand the philosophical underpinnings and framework of the nursing profession and add to the state of nursing science. We have no intention of practicing medicine or posing as physicians. We desire to be learned and authoritative teachers of nursing. We desire to be doctor nurses.

Reference:

Harris, G. (2011, October 1). Calling the nurse ‘doctor,’ a title physicians oppose. The New York Times. Retrieved from http://www.nytimes.com/2011/10/02/health/policy/02docs.html?_r=1&pagewanted=all/

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

The joy of nursing conferences

To say that I love nursing conferences is truly an understatement. I look forward to attending conferences so I can meet interesting nursing professionals. I also look forward to learning the newest research on the topics presented. And I especially enjoy the question-and-answer period at the end of each session, when I can listen to input from other nurses.

All types of nurses hold membership in professional nursing organizations. At a conference, you can have staff nurses, nurse administrators, nurse educators and nurse researchers sitting in the same room sharing information and ideas. I think that’s absolutely amazing! In our normal day-to-day jobs as nurses, we may not have the opportunity to come across nurses who work in other areas of nursing. But when we take the time to attend a nursing conference, the opportunities to engage with brilliant nurses are endless.

I love the fact that, at a nursing conference, everyone is on a level playing field. Staff nurses aren’t intimidated by nurse administrators, which is often not the case at work. Everyone takes every opportunity to learn from others. There is no feeling of superiority. Novice nurses fit in perfectly with expert nurses. The career ladder is virtually flattened at a nursing conference, and I love that!

I also love that I have the opportunity to travel to different states, and I get paid time-off from work to do it. As a single woman, I look forward to traveling, but sometimes it’s challenging to gather my friends to come with me. Traveling to nursing conferences, however, gives me the opportunity to travel alone without really being alone. The more often I attend conferences hosted by the same organization, the more I get to see certain nurses. It’s really neat to meet up with the same people one time each year. It begins to feel like a reunion.

One of the best things about attending conferences is the opportunity to meet and engage in conversations with world-renowned leaders in nursing. I have had the chance to meet nursing leaders in academia and hospital administration, those leading in the clinical arena as well as those making breakthroughs in nursing science. I have gotten used to meeting the nursing authors who write the textbooks I am required to read or those who edit the nursing journals I reference in my papers. And the best thing of all is that meeting them at a nursing conference takes away the pressure of trying to “say the right thing.” More often than not, these chance meetings occur during receptions or other non-formal gatherings. There is no pressure to put on your academic hat and speak as if you are reading a portion of your thesis; you are free to be yourself in a non-threatening way.

If I could, each year I would attend the national conference of each nursing organization to which I belong. Knowing this is not possible because of time and money, I have to make the difficult decision of deciding which conferences to attend and which to bypass. I typically attend the conference with the most relevant and interesting topics and, most often, it is either geared toward women’s health or nursing scholarship. Regardless of which conferences I attend, I am never disappointed. The new knowledge I return home with and the connections I make at nursing conferences is well worth the flight layovers and hotel stays.

If you are not a member of a professional organization, I highly suggest joining at least one and, since you’re reading a blog written for Reflections on Nursing Leadership, the online magazine published by the Honor Society of Nursing, Sigma Theta Tau International, that organization is the perfect place to start. The benefits of attending nursing conferences as a member of the hosting organization are too numerous to list. If you are already a member of a professional organization, but do not attend its annual or biennial conference, I suggest you make plans to attend.

If money is an issue, don’t fret. Oftentimes, your employer will provide tuition reimbursement and, if nothing else, if you’re in the United States, you can itemize continuing education-granting conferences on your income tax return. If you are looking forward to a career in academia, or if you just like to disseminate interesting information, you can also submit poster, paper or presentation abstracts to the conference you plan to attend. You may receive a discounted registration rate for serving as a presenter. In addition, presenting at a conference is a great thing to add to your résumé or curriculum vita.

My hope is that you get as much out of nursing conferences as I have gotten. And if you see me at a conference, don’t be shy. I love meeting new nurses!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Congrats, grad!

I attended three graduation ceremonies this past commencement season. Each celebrated a different aspect of graduation.

The first celebration I attended was a dinner hosted by the UCLA Pan-African Nursing Students and Alumni Association. I sat next to one of my future classmates in the PhD program, and we talked about our anxieties as we start this new journey. Well, actually, we talked about my anxiety; she’s not anxious about starting school.

After dinner, the ceremony began. The dean of UCLA School of Nursing addressed the graduates and attendees. He talked about the need for us to give back. He reminded us that no one is able to make it on their own, so it is only right to reach back and help one another. His address made me proud to be a UCLA Bruin!

The best part of the event, and the part that made my eyes tear up, was when each graduate was called and asked to light a candle. They were then given a stole to wear with their regalia during the official campus graduation ceremonies. Playing in the background was the song “Never would have made it,” by Marvin Sapp, dedicated to the families and friends of the graduates: "Never would have made it, never would have made it without you. I would have lost it all, but now I see how you were there for me."

As each of the graduates walked to and from the center of the dance floor, I visualized the day I will walk that path, light my candle and receive my stole. I know it may be a bit early to think about my own graduation, but I believe in always keeping an end-goal in mind. When I feel like giving up, when I think the program is too much for me to handle, I will undoubtedly think ahead to my graduation. I will think about the day I am addressed by my doctoral dissertation committee as Dr. Montgomery. I will think about my participation in the doctoral hooding ceremony. And I will surely smile when I think about my graduation party. It’s going to be the celebration of the decade, and yes, I have already started to plan for it.

A week after attending that dinner, I attended two graduation ceremonies for my little sister. She participated in the Black Graduation Ceremony Saturday evening and the college commencement Sunday morning. The Black Graduation is always fun to attend because it’s a more intimate setting and is geared specifically toward the African-American community. The evening began with a traditional African-American family dinner—fried chicken, catfish, collard greens, macaroni and cheese, steamed vegetables, peach cobbler and sweet tea. After eating, the guests were ushered into the auditorium where we watched a slide show of the graduates until the ceremony began. I was proud to watch my sister walk across the stage. I ran up to the stage to take a few pictures of her and walked back to my seat with a gigantic smile on my face.

My sister Brittany and me

The next day, we woke up bright and early to attend the college commencement. I was sitting in the audience with my mother, aunts, cousins and my sister’s friends. We used our phones to communicate with my sister to figure out when she would line up to walk across the stage. We also made pacts with the families sitting nearby, promising to scream for the other families’ graduates. As my sister prepared to walk across the stage, I stood as close to the stage as security would allow and took a few pictures. When her name was called, my family and I screamed and hollered. (My voice was hoarse for the next two days, but it was worth it.) It marked the culmination of my sister’s college experience. Following the ceremony, the entire family went to lunch to celebrate my sister and her awesome accomplishment.

These celebrations were the last college graduations I will attend before beginning the final leg of my own formal education. Attending the graduations reminded me of how inspiring graduations are. When you graduate with a new degree, your accomplishment is celebrated by many people, not just yourself. I look forward to making my family proud, again. I look forward to walking across the stage and being hooded, again. I look forward to dressing up in graduation regalia for the final time. I look forward to taking graduation pictures. I definitely look forward to my graduation party. I look forward to it all!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Do you know the way to San Jose?

Why did I decide to go to San Jose State University (SJSU) for nursing school? The answer is simple: because my godsister lived there. Choosing a school for this reason was quite possibly the most ignorant thing I have ever done, but it was a great choice and everything worked out just as it was supposed to. I don’t know that I would have had the same experiences had I not gone to SJSU. My professors, mentors and friends all shaped my college experience and I honestly cannot imagine having gone to another school.

I first began to think about college in the 10th grade, when my English teacher assigned a college portfolio project. We had to attend a local college fair at California State University, Long Beach and include college pamphlets and other materials from the fair. We were also asked to list three colleges we were considering applying to, providing a one-page write-up on each. I chose to write about Hampton University, the University of San Francisco and San Jose State University. I chose the University of San Francisco, because it is a private school, and Hampton University, because it is a historically black university, but I really wanted to go to SJSU.

My desire to attend SJSU was solely based on the fact that my godsister lived in the city. I had always looked up to my godsister as if she were my biological sister. I have fond memories of spending time with her at my godparents’ home. One time in particular, I was in 7th grade, and my mom took me to visit them. My godsister asked how I was doing in school. When I told her I was getting good grades, she confirmed that with my mom and said she wanted to reward me. She took me on a shopping trip to the mall. The clothes she purchased for me that day became my most cherished pieces of clothing. I wore the pants and shirts until long after they were too small for me.

I also remember a time when my godsister really came through for my little sister and me. It was Christmas time, and we had a tree, but no gifts under it. At the time, my godsister was working at BEST. I looked out the window one afternoon and noticed her walking to our house with a large black trash bag. It was filled with toys! She put the toys under the tree, talked to my mom for a while and left. Those were the only toys we received that Christmas. My mother didn’t have the money to buy anything for us, so that year my godsister stepped in as Santa Claus.

She and her husband married and moved to Washington when I was 12.Fortunately, they moved back to California when I was in ninth grade, settling in San Jose. In the spring of my 11th-grade year, they had their first child. I thought it would be nice to live close to them so I could help with the baby. With them being in close proximity, I also felt like I was on my own, without being completely alone.

The summer between my 11th and 12th grades, I spent a week in San Jose with my godsister and her family. I had the opportunity to see the city, and we even took a self-guided tour of the SJSU campus. Oddly enough, the day we went to campus was the first day of the 1999-2000 school year. I enjoyed walking around the campus; it wasn’t too big and it wasn’t too small. I had the chance to see the building that housed the School of Nursing. Because the students were already on campus, I also had the chance to interact with them. Some of the boys even flirted with me. College boys! Oh yes, this was definitely the school for me!

When I talked with my mom about applying to college, she told me I should apply to Long Beach City College, because she couldn’t afford to send me anywhere else. I was crushed, but I applied to SJSU anyway. I knew I didn’t want to stay in Long Beach after graduating from high school. Long Beach is a nice city and all, but I knew that, if I didn’t venture out, I wouldn’t amount to much. I had watched other classmates who graduated before me, and I noticed a trend—staying around home provided a sense of comfort and security that prevented them from reaching their full potential. I didn’t want that for myself. I wanted to become everything I had the potential to become.

SJSU was the only school I applied to. I was accepted and I traveled to San Jose with my mom and godmother during the spring of my 12th-grade year for freshman orientation. During the orientation, I enrolled in my fall-semester classes and I was given a tour of the campus. I came back to school the following Monday with my college ID. It was official; I was going to college and it wouldn’t be at the local city college. I showed the ID to all my friends and teachers.

I spent the summer after high school graduation working to save money for college, then began school at SJSU in August. The rest is history, or maybe just another blog post.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Birds of a feather

I recently went to lunch with a group of my sorority sisters. On the drive to the restaurant, I was hot and, by the time I arrived, was a little irritated because of the heat. But as soon as my sorors began arriving, all of my frustration suddenly left.

I sat in close proximity to women of all ages, some old enough to be my mother and some young enough to be my sister. They come from diverse socioeconomic statuses, were born in various states, have attained a variety of educational levels and have made careers for themselves in various professions. Some are parents, and others are grandparents. Many of us live in different cities, and some of us had never met. Still, we all have something in common—we are college-educated women bonded through our love for Alpha Kappa Alpha Sorority, Incorporated.

In case you are wondering, Alpha Kappa Alpha is the first college sorority in the United States to be established by African-American women. It was founded on Jan. 15, 1908, by nine students at Howard University. Seven other women were soon added and are grouped with the original nine as the revered 16 founders of the sorority. The mission of the sisterhood is to “cultivate and encourage high scholastic and ethical standards, to promote unity and friendship among college women, to study and help alleviate problems concerning girls and women in order to improve their social stature, to maintain a progressive interest in college life, and to be of service to all mankind.” I was initiated into the sorority in the spring of 2006, alongside two other women. Now, back to my lunch.

Sitting at my table with approximately 20 others, I was awed by the women who surrounded me. Three have PhDs and two, not including me, are currently enrolled in PhD programs. One is the great-granddaughter of Thurgood Marshall, the late U.S. Supreme Court Justice. One is a relative of the first black mayor of New York City. Another is a charter member of the Alpha Kappa Alpha chapter at MIT. Other attendees included educators, social workers and lawyers. Just sitting with them inspired me. And to think I know and have a relationship with the vast majority of the women at my table is absolutely amazing! These aren’t women I barely know; they are women I meet with monthly to plan and prepare for community service programs and sorority events.

Although I often see my sorors at business meetings, we didn’t talk business; we simply enjoyed each other’s company. We talked about everything from our iPhones to my experience as a labor and delivery nurse to marriage and children. I can only hope they enjoyed my company as much as I enjoyed theirs. I was encouraged by those who have gone through, or are currently in, PhD programs. They gave me hope that I could make it, too. We cherished each other as sisters, although only two of the attendees are biological sisters. (My biological sister is my sorority sister as well.) We were reminded that a sister is more than a female sibling.

I came to the lunch feeling hot and bothered, but I left energized and refreshed. You see, it’s important to be surrounded by well-educated, well-mannered, high-achieving friends. We gain inspiration and support from our friends. They are the ones who egg us on when we feel like giving up. They are the ones who celebrate our accomplishments and help us bounce back from our setbacks.

Having friends you can hang out with is fine, but you have to have more than simply hanging buddies in your circle of influence. I’ve learned that the characteristics of our friends are typically the characteristics we display. They say, “Birds of a feather flock together.” If this is a fact, I want to be flying alongside my sorors.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Age is just a number

I have a confession to make: I have a slight complex regarding my age. As I enter the last year of my 20s, I have had a lot of time to reflect on my achievements and accomplishments. I must say, I’m proud of myself! I’ve done a lot in the last 28 years. But I have also been discriminated against and discredited because of my age. Unfortunately, the negative comments about my age had a greater effect on me than the positive remarks I have heard.

During the 5 1/2 years I worked in labor and delivery, there was one question I dreaded more than any other—“How old are you?” I recognize that I look much younger than I am—maybe someday I’ll learn to appreciate it—so it’s not a surprise that my patients have a habit of inquiring about my age. Still, something about asking my age makes me believe I am not as trusted a nursing professional as some of my older colleagues.

Some may say I’m overreacting, but I have seen the look in the eyes of women under my care when I tell them my age. I have also heard the change of tone in their voices. Many a night I swallowed my pride, picked my feelings up off the ground and continued to work through my shift, knowing that, solely because of my age, my patient or members of her family were suspicious of my abilities as a labor and delivery nurse.

I’ve also seen the positive side of telling people my age, but honestly, overly congratulatory folks don’t make me feel any better than their negative counterparts. When they hear that I’m 20-something, their eyes light up and they make comments like, “Oh, my goodness, I am so proud of you!” This type of reaction makes me wonder what exactly are people so proud of.

Now, if I mentioned the awards and honors, scholarships and grants, and leadership experience listed on my curriculum vitae, I would expect the shocked reaction. But, is a reaction like this warranted, simply because I became a registered nurse at age 24? Is that really a great accomplishment? When nursing diploma programs were the most highly coveted way to become an RN, 20- and 21-year-olds were graduating with a nursing license. So again, I don’t really understand the excitement about a 20-something-year-old woman who has decided to become a registered nurse.

What I have begun to tell myself, whether the comments regarding my age are positive or negative, is that age is just a number. There are numerous people who did great things at a young age:

• Martin Luther King Jr. received his doctorate degree from Boston University at age 26. He went on to become the father of the civil rights movement.
• Mark Zuckerburg co-founded the Facebook social networking site at age 20. Time magazine named him Person of the Year in 2010.
• At age 25, Lady Gaga was the highest paid celebrity under 30, according to Forbes magazine. She already has three Billboard Music Awards and five Grammy Awards, and she has set many Guinness world records, including the fastest-selling single on iTunes.
• Bill Gates was only 24 years old when he co-founded Microsoft. His company has become one of the world’s most recognizable and its software the most utilized. As a matter of fact, I am using a Microsoft program to compose this article.

As you can see, a person’s age does not have to be a limiting factor. As nurse leaders, we have to move away from the mindset that nurses need to be in the profession 10-plus years before they can make any notable contributions. There are plenty of young nurses who have the experience and drive to move the profession forward. Those of us in Generation X may not accomplish tasks in the same manner as baby boomers, but trust and believe we can get the job done.

Young nurse leaders, don’t allow your colleagues to look down on you because of your age. Seasoned nurse leaders, don’t discredit the wonderful ideas of your younger colleagues, based on their age. And above all else, take hold of your dreams, no matter your age.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

What was I thinking?

I went to UCLA for a tour one day and, while I loved the campus and all the facilities I had the chance to see, I felt slightly out of place. I was surrounded by young people in their late teens and early 20s, walking around in what were once known as “daisy dukes.” Am I really ready to be back in this type of environment? I don’t look like the girls in the short shorts. Heck, I didn’t look that good when I was 20 pounds lighter. I am following my dream of earning a PhD and have been accepted to the school of my choice, but the closer I get to the first day of school, the more I am beginning to wonder, “What was I thinking?”

Before even submitting my application to the PhD program, I thought about how nice it would be to live on campus and get the entire “college experience” again. I thought back to my freshman year of college, and I remember it being a blast! Living on campus provides accessibility to campus activities and events that you just don’t get when you live off campus. I envisioned meeting other graduate students and forming lifelong relationships with them. I considered the ease of staying in the library until the wee hours of the morning, then simply walking across campus, unlocking my door and crashing for the rest of the night. I took it all into consideration—and I love the idea of being a fulltime PhD student—but when I went on that campus tour, I started to become slightly anxious.

• How will I fit in on campus?
• How will I relate to the undergraduate students I meet?
• Will people think it’s strange that I desire to join campus clubs?
• What will folks think about an almost-30-year-old living on campus?

Then my thoughts went from the external questions of my appearance and the other students’ perceptions of me to internal questions of my ability to succeed in a PhD program.

• Have I really been in nursing long enough to pursue a PhD in the field?
• Will I be the youngest person in the program? And if I am, will my classmates respect my thoughts and opinions?
• Am I smart enough to be successful in a PhD program?

These and plenty of other questions swarmed my mind until I told myself, “Enough is enough!” I will fit in just right on campus. My presence will bring life and professional experiences that differ from everyone else’s. My being there will help diversify the campus and complement all that every other student has to offer. I will relate to the undergraduate students just as I should—as a mentor and colleague.

Then I told myself that anyone with good sense would be honored to have me as a part of his or her club. I am a hard worker, and I have been a committee member of various organizations at the local, state and national levels. What will folks think about me living on campus? Honestly, who cares? If UCLA thought it was a bad idea for graduate students to live on campus, there would be no graduate student apartments (of which there are plenty). I will be surrounded by other graduate students, and I plan to have a ball getting to know them.

My questions about my intellectual abilities and professional experience were not even worth asking. I did submit an application, and I was offered admission, right? Why would I ever doubt my ability to succeed? Instead of asking, “What was I thinking?” in relation to going back to school, I should have been asking, “What was I thinking?” with regard to all of those negative questions.

As nursing leaders, we have to be courageous in taking hold of our dreams. We can’t allow fear of failure, criticism or the unknown to keep us from running full speed toward our goals, especially as it relates to those of us who are still fairly young in the profession. We must not fall into the trap of counting ourselves out, solely based on our age. Ambition, enthusiasm and a willingness to learn can oftentimes make up for what we lack in experience. And truthfully, experience has more to do with what you’ve experienced, than the amount of time it took you to get the experience.

So, no more questioning myself. No more doubting myself. No more wondering what others will think. I have the dream of a PhD in my sights and I’m going for it! I hope you are taking hold of your dreams as well.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

A new kind of nursing

When I was in nursing school, a mere six years ago, I couldn’t imagine nursing other than in a face-to-face environment. At the time, I knew there were telephone triage nurses, but I really had no concept of that type of nursing. But hey, nursing is nursing, right?

We all go through the nursing process each time we interact with a patient (even if we swore we would never again acknowledge the term “nursing process” after we passed the NCLEX—I know, I said it too). The nursing process is embedded in each and every registered nurse. I’m sure we could rattle off the steps of the nursing process in our sleep: assessment, diagnosis, planning, implementation and evaluation. So again, nursing is nursing, right? Right! But in my most recent job role, I have been introduced to a new kind of nursing—virtual nursing.

I spend each day at work interacting with patients I have never met, most of whom I probably never will, and I love it! Please don’t misunderstand; the reason I love interacting with patients in the way I do is not because I am not face-to-face with them but, as a proud Generation Xer/ Millennial, I use technology A LOT. I think being paid to e-mail and call patients is the greatest thing since the invention of the IV pump. After all, when I’m not at work, I spend upwards of 50 percent of my leisure time talking on the phone or e-mailing/texting my friends.

People are often surprised to hear that I am a nurse who spends all my time in an office sitting in front of a computer. Sometimes, it is even shocking to me. Back when I was in nursing school, I thought there were only three ways to ever have my own office: 1) become a nursing professor, 2) become a hospital administrator or, 3, leave nursing and work in corporate America.

Boy, was I wrong! I work in neither academia or nursing administration, but I spend all day calling, e-mailing and faxing patients. Each morning I walk into my office, look outside my huge window to see whether or not I can see the Hollywood sign that day (this, of course, dictated by the amount of smog in the air—got to love Los Angeles!), log on to my computer and begin typing my little heart out.

I go through the nursing process with each and every patient encounter; there’s nothing different about that. I triage patient e-mails and telephone calls, deciding who has the most urgent need and who should be contacted right away. I order medications, labs and radiology tests, using standing orders and a list of physician preferences. And I do it all online!

Although I sometimes miss the adrenaline rush of running to a crash Caesarean section or the excitement of a vaginal birth, there are aspects of virtual nursing I love dearly. I love chair dancing as I listen to a popular ringback tone, while waiting for the patient to answer her cell phone. I love reading e-mail responses from patients who thank me for ordering or refilling a prescription. I love receiving a call from the nurses’ station, because a patient has come in for her appointment and she wants to finally meet me. I enjoy establishing relationships with women I have never seen face-to-face!

When I get tired of staring at the computer screen and I need face-to-face interaction, I simply walk out of my office and down the hall. I have the best of both worlds. Now, if only someone would create a way for me to communicate with my patients via Facebook and text messaging, I’d be in nursing heaven!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Encourage yourself

It’s human nature to desire those in your circle of friends, family and associates to celebrate your achievements. When you are proud of yourself, you expect others to be proud of you; when you ask others for their support, you expect that support.

What I’m learning as a budding nurse leader is that not everyone is as proud and supportive of you as you may like him or her to be. A small part of me—probably the young, naive part—still believes that everyone should celebrate everyone else’s accomplishments, but life has shown me this is not always the case. We can’t always expect the same celebratory reaction from others that we have for ourselves. As nurse leaders, we need to remember it is sometimes lonely at the top.

Not everyone desires to take on leadership roles, nor do they understand the mindset of those who step into those roles. Not everyone appreciates the time and effort it takes to be on a national committee, or to produce a successful webinar, or to write and publish an article in a nursing journal. The beauty of the world comes through its diversity. If we all desired to do the same things, the lack of variety might bore us to death. Still, it doesn’t feel good when you accomplish something that was, at one time, only a dream, and the people with whom you share this information are less than congratulatory. We typically expect the people we surround ourselves with to be excited for us, so when that does not happen, our feelings are hurt. But when we put things into perspective, we begin to realize the things that are important to us are not always important to those around us. For this reason, we must learn to celebrate ourselves!

India.Arie sings a song I absolutely love. It’s about the artist’s difficulty in finding someone with whom she can celebrate her birthday. She sings, “I’m having a private party. I’m learning how to love me, celebrating the woman I’ve become.” When I first heard this song, years ago, I was reminded not to depend on the accolades of others to feel good about my accomplishments. It’s OK to celebrate yourself, whether by choice or default. There is another song I love that speaks of encouraging one’s self. This song, written by Donald Lawrence, says, “Sometimes, you have to encourage yourself. … Sometimes, you have to pat your own self on the back.” I love this!!!

Whether you are a current or future nurse leader, make the decision to celebrate yourself and pat yourself on the back. Don’t wait for others to congratulate you. Congratulate yourself! Sometimes, people don’t understand all you had to do to get where you are and, quite honestly, some people just don’t care. So don’t expect everyone to be as excited about your latest, greatest accomplishments as you may be. And, just in case you never hear it from anyone else, CONGRATULATIONS from me to you!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

The night hello meant goodbye

It was a night I’ll never forget. It started off like any other night in Labor and Delivery; we were short-staffed and running around like chickens with our heads cut off. I was assigned to work in triage and, considering I love working in triage, didn’t mind the constant flow of incoming patients.

A late-preterm patient, with a sweet disposition, came in complaining of ruptured membranes. She wasn’t scared, wasn’t anxious, just slightly inconvenienced. I introduced myself and began to do all the things a triage nurse does when a new patient is admitted. I had her change into a gown, noted the fluid and attempted to place the fetal monitor and tocodynamometer (the ultrasound device used to record uterine contractions).

I tried for a few minutes to locate fetal heart tones and, when unsuccessful, put a request in to the physician on call to assist me. While waiting for the physician to arrive, I brought the ultrasound machine to the patient’s bedside and tended to other patients.

The on-call physician examined the patient and asked for the assistance of another physician. Any experienced Labor & Delivery nurse understands that, when a physician is using ultrasound to locate fetal heart tones and calls for a second opinion, it’s actually to confirm absence of heart tones. Stopping what I was doing, I walked to the patient’s bedside. The second physician confirmed that there were no heart tones. I called my charge nurse to let her know I would no longer be working in triage, because I wanted to take on the assignment of the patient with the fetal demise.

I began to admit the patient while she was in triage, and she called her family to let them know what was going on. She complained to me that she was leaking a lot. I pulled the sheet back and noticed bright red blood. Leaking small to moderate amounts of blood, which we call bloody show, is a normal sign of labor progression, but this was different. Within seconds, the patient had bled through the Chux pad, down her leg and onto the sheet. It was a little more bleeding than I was comfortable with, but I wasn’t highly concerned.

As I continued to get the woman ready for transfer to a private room, she began to bleed again. This time I was concerned and called the physician, who decided the patient would be taken to the operating room for a Caesarean section. There was no urgency to save the life of the fetus, but the life of the mother was now in question. She would hemorrhage if we didn’t move quickly. The surgery went off without a hitch. The physician confirmed placental abruption as the cause of the bleeding.

I carried the baby over to the warmer and began to wipe her off. She was beautiful! A perfectly formed, beautiful little angel. I wrapped her in a blanket and carried her to the recovery room. The circulating nurse remained in the operating room with the patient while the physicians closed the incision, and the family members came with me. We were not very busy in triage anymore and there were nurses on the unit with no patients, so I decided to take my time and give the best possible care to my patient and her family.

I began postmortem care by doing something I’d never done before to a deceased infant—I gave her a bath, preparing a basin just as I would for any other baby. I washed and dried each part of her body, then her hair. After placing a T-shirt and beanie on her, I let the family sit with her as she lay under the warmer. Later, the mother came into the recovery room to grieve with her family. (There were no other patients in the room, so I allowed the family to come in, without worrying about the one-at-a-time rule.)

As morning drew near and the night shift was ending, I transferred the patient from the recovery room to her room in Labor and Delivery. Once she was settled, I excused myself and walked into the restroom, because I didn’t want her to see me cry. After a few minutes, I was able to pull myself together.

The infant was the most beautiful baby I had ever seen. Although I had taken care of plenty of women with intrauterine fetal demises in the past, this one was different. I was emotionally invested in this family’s unfortunate circumstances. I had cared for the infant as if she were my own living, breathing child. I did not want to believe we all had to say goodbye before we ever said hello.

Walking back to the patient’s room, I told the mother goodbye. I will probably never see her again. She may or may not remember me. But the experience I shared with her will stick with me forever. I have no answers to why such a beautiful baby girl was gone before she ever breathed her first breath, or why this assignment affected me in such a severe manner.

What I do know is that, when I have my own children someday, I will cherish each cry, and each rise and fall of their small chests. Not every parent gets the opportunity to hear their baby scream or feel their baby’s breath on their face. Sometimes, saying hello means saying goodbye.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.