The Vital Role of Nurses

“A nurse is a person who nourishes, fosters, and protects—a person who is prepared to care for the sick, injured, and aged.”—Nursing in Today’s World—Challenges, Issues, and Trends.

UNSELFISHNESS, though essential, is not enough to make a proficient nurse. Good nurses also need extensive training and a breadth of experience. One essential requirement is from one to four years or more of study and practical training. But what qualities make a good nurse? Here are some answers from experienced nurses who were interviewed by Awake!

“The doctor heals, but the nurse cares for the patient. This often requires building up patients that have been damaged both inside and outside when, for example, they are informed that they have a chronic disease or will face imminent death. You have to be a mother to the sick person.”—Carmen Gilmartín, Spain.

“It is necessary to be able to feel the pain and anguish that the patient feels and to want to help. Kindness and long-suffering are needed. You must always want to learn more about nursing and medicine.”—Tadashi Hatano, Japan.

“In recent years nurses have needed more and more professional knowledge. Therefore, the desire to study and the ability to understand what is studied are essential. Also, nurses need to make speedy judgments and to take swift action when the situation demands it.”—Keiko Kawane, Japan.

“As a nurse, you have to show warmth. You must be tolerant and show empathy.”—Araceli García Padilla, Mexico.

“A good nurse must be studious, observant, and extremely professional. If a nurse is not self-sacrificing—if he or she has a selfish streak or resents advice from others higher up the medical hierarchy—that nurse will become unsuitable both for patients and for  colleagues.”—Rosângela Santos, Brazil.

“Several qualities are indispensable: flexibility, tolerance, and patience. You also have to be open-minded, with the ability to get on well with your colleagues and the medical hierarchy. You have to be quick to assimilate new skills in order to remain efficient.”—Marc Koehler, France.

“You must love people and really want to help others. You have to be able to cope with stress because in the nursing world, it is all or nothing. You must be adaptable in order to do the same work when at times you have fewer fellow workers—without compromising quality.”—Claudia Rijker-Baker, Netherlands.

The Nurse as a Caregiver

Nursing in Today’s World states that “nursing is concerned with caring for the person in a variety of health-related situations. Thus, we think of medicine being involved in the cure of the patient and nursing with the care of that patient.”

Hence, a nurse is a caregiver. Obviously, therefore, the nurse has to care. Some time ago 1,200 registered nurses were asked, “What’s most important to you in your work as a nurse?” Providing quality care was the answer that 98 percent gave.

Sometimes nurses underestimate their value to the patients.  Carmen Gilmartín, quoted above, a nurse with 12 years’ experience, told Awake!: “On one occasion I confessed to a friend that I felt limited when caring for very sick patients. I saw myself as a mere ‘Band-Aid.’ But then my friend replied: ‘A blessed “Band-Aid,” for when a person is sick, you are what is needed more than anything else—a sympathetic nurse.’”

Needless to say, giving such care can put great strain on a nurse who works for ten or more hours each day! What motivated these self-sacrificing caregivers to become nurses?

Why Be a Nurse?

Awake! interviewed nurses around the world and asked them, “What motivated you to become a nurse?” Here are some of their answers.

Terry Weatherson has 47 years of nursing experience. She now works as a clinical nurse specialist in the Urology Department of a hospital in Manchester, England. “I was raised a Catholic and attended a Catholic boarding school,” she says. “As a girl, I decided I wanted to become either a nun or a nurse. I had a desire to serve others. You might call it a vocation. As you can see, nursing won out.”

Chiwa Matsunaga from Saitama, Japan, has run her own clinic for eight years. She states: “I followed my father’s thinking that ‘it’s best to learn a skill that will qualify you for work all your life.’ So I chose the road of nursing.”

Etsuko Kotani from Tokyo, Japan, a head nurse with 38 years of nursing experience, said: “When I was still in school, my father collapsed and lost a lot of blood. As I watched over my father in the hospital, I decided that I wanted to be a nurse so that I could help sick people in the future.”

Others were motivated by their own experience while being sick. Eneida Vieyra, a nurse in Mexico, says: “When I was six years old, I was hospitalized for two weeks for bronchitis, and it was then that I decided I wanted to be a nurse.”

Clearly, being a nurse requires great self-sacrifice. Let us take a closer look at both the challenges and the rewards of this noble profession.

The Joys of Being a Nurse

What are the joys of nursing? The answer to that question will depend on a person’s field of nursing activity. Midwives, for example, feel rewarded with every successful birth. “It’s wonderful to deliver a healthy child whose development you have supervised,” says one midwife from the Netherlands. Jolanda Gielen-Van Hooft, also from  the Netherlands, says: “A delivery is one of the most beautiful things that a couple—and a health worker—can experience. It is a miracle!”

Rachid Assam from Dreux, France, is a State-certified nurse anesthetist in his early 40’s. Why does he enjoy nursing? Because of “the satisfaction of having contributed to the success of an operation and of being a member of a profession that is fascinating and constantly progressing,” he says. Isaac Bangili, also from France, said: “I am touched by the expressions of thanks we receive from patients and their families, especially in emergency situations when we  manage to recover a patient for whom we thought there was no hope.”

One such expression of thanks was sent to Terry Weatherson, mentioned earlier. A widow wrote: “I cannot let the occasion pass without referring once again to the relief that we gained from your calm, assured presence throughout Charles’ illness. Your warmth was a shining light, and it became a rock from which we gained strength.”

Facing the Challenges

But along with the joys of nursing come many challenges. There is no room for mistakes! Whether giving medication or drawing blood or inserting an intravenous device or even simply moving a patient, a nurse must be extremely careful. He or she cannot afford to slip up—and this is especially true in lands where litigation is common. Yet, sometimes the nurse is placed in a difficult situation. For example, suppose the nurse feels that a doctor has prescribed the wrong medication for a patient or has given orders that are not in the patient’s best interests. What can the nurse do? Challenge the doctor? That requires courage, tact, and diplomacy—and it carries an element of risk. Sadly, some doctors do not take kindly to suggestions from those they view as subordinates.

What have some nurses noted in this regard? Barbara Reineke from Wisconsin, U.S.A., a registered nurse for 34 years, told Awake!: “A nurse must be courageous. First of all, she is legally responsible for any medications that she administers or treatments that she performs and for any harm caused  by them. She must be able to refuse to carry out an order from a doctor if she feels it is out of her scope of practice or if she believes that the order is incorrect. Nursing is not what it was in the days of Florence Nightingale or even 50 years ago. Now the nurse needs to recognize when to say no to the physician and when to insist that the doctor see the patient, even if it is in the middle of the night. And if you are wrong, you must be thick-skinned enough to take any ridicule you might get from the doctor.”

Another problem nurses have to face is violence on the job. A report from South Africa says that nursing personnel “are recognised as being at higher personal risk of abuse and violence in the workplace. In fact, nurses are more likely to be attacked at work than prison guards or police officers and 72% of nurses don’t feel safe from assault.” A similar situation is reported for the United Kingdom, where 97 percent of nurse respondents in a recent survey knew a nurse who had been physically assaulted during the previous year. What causes this violence? Often, the problem comes from patients who are on drugs or who have been drinking or who are under stress or who are affected by grief.

Nurses also have to contend with burnout caused by stress. Staff shortages are one factor. When a conscientious nurse cannot give adequate care to a patient because of work overload, stress soon builds up. Trying to fix the situation by skipping breaks and doing overtime seems only to lead to more frustration.

Worldwide many hospitals are understaffed. “We lack nurses in our hospitals,” says a report in Madrid’s Mundo Sanitario. “Anyone who has needed health care recognizes the importance of the nurses.” What was given as the cause of this shortage? The need to save money! The same report stated that Madrid hospitals had a deficit of 13,000 nursing professionals!

Another reason given for stress is that shifts are often too long and wages too low.  The Scotsman stated: “More than one in five of Britain’s nurses and a quarter of nursing assistants have a second job to make ends meet, according to the public service union, Unison.” Three out of 4 nurses feel that they are underpaid. As a result, many have considered leaving the profession.

There are a number of other factors that contribute to the stress of nurses. Judging by the comments that Awake! obtained from nurses around the world, the death of patients can have a depressing effect. Magda Souang, from an Egyptian background, works in Brooklyn, New York. When asked what made her job tough, she answered: “Watching at least 30 terminal patients whom I had cared for closely die in a period of ten years. That drains you.” Little wonder that one source says: “Continually investing oneself in patients who die can take a tremendous toll on personal resources.”

The Future for Nurses

The growth and influence of technology increases the pressures in the field of nursing. The challenge is to reconcile technology with humanity, the humane way of dealing with patients. No machine can ever replace a nurse’s touch and compassion.

One journal states: “Nursing is an everlasting profession. . . . So long as humanity exists, there will always be a need for caring, compassion, and understanding.” Nursing fills that need. But there is an even greater cause for a bright outlook in the matter of health care. The Bible shows that a time will come when no one will say, “I am sick.” (Isaiah 33:24) Doctors, nurses, and hospitals will not be needed in the new world that God has promised.—Isaiah 65:17; 2 Peter 3:13.

The Bible also promises that “God . . . will wipe out every tear from their eyes, and death will be no more, neither will mourning nor outcry nor pain be anymore. The former things have passed away.” (Revelation 21:3, 4) In the meantime, however, we should be grateful for all the attention given and sacrifices made by the millions of nurses around the world, without whom hospital stays would certainly be less pleasant if not impossible! How appropriate, then, the question, “Nurses—what would we do without them?”

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Florence Nightingale—A Pioneer of Modern Nursing

Born in 1820 in Italy to wealthy British parents, Florence Nightingale had a pampered upbringing. Young Florence turned down offers of marriage and pursued studies in health and in care for the poor. Despite her parents’ opposition, Florence took up a position in a school for training nurses in Kaiserswerth, Germany. Later, she studied in Paris, and at 33 years of age, she became the superintendent of a women’s hospital in London.

But she faced her greatest challenge when she volunteered to care for wounded soldiers in the Crimea. There she and her band of 38 nurses had to clean up a rat-infested hospital. The task was formidable, for at first there was no soap, there were no washbasins or towels, and there were not enough cots, mattresses, or bandages. Florence and her crew rose to the challenge, and by the end of the war, she had brought about worldwide reforms in nursing and hospital administration. In 1860 she founded the Nightingale Training School for Nurses at St. Thomas’ Hospital in London—the first school of nursing without a religious affiliation. Before her death in 1910, she was a bedridden invalid for many years. Still, she continued to write books and pamphlets in an effort to improve standards of health care.

Some take exception to the altruistic image of Florence Nightingale, arguing that others deserved at least as much credit for their contributions to nursing. In addition, her reputation has been hotly debated. According to the book A History of Nursing, some claim that she was “temperamental, highhanded, opinionated, quick-tempered, and domineering,” while others were fascinated by her “brilliance and charm, her astonishing vitality, and the very contradictions in her personality.” Whatever her true character, one thing is certain: Her techniques in nursing and hospital management spread to many countries. She is regarded as a pioneer in the nursing profession as we know it today.

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St. Thomas’ Hospital after the establishment of the Nightingale Training School for Nurses

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Courtesy National Library of Medicine

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The Qualifications of a Nurse

Nurse: “A person who is especially prepared in the scientific basis of nursing and who meets certain prescribed standards of education and clinical competence.”

Registered nurse: “A graduate nurse who has been legally authorized (registered) to practice after examination by a state board of nurse examiners . . . and who is legally entitled to use the designation R.N.”

Clinical nurse specialist: “A registered nurse with a high degree of knowledge, skill, and competence in a specialized area of nursing.”

Nurse-midwife: “An individual educated in the two disciplines of nursing and midwifery.”

Practical nurse: “A person who has had practical experience in nursing care but who is not a graduate of any kind of nursing school.”

Licensed practical nurse: “A graduate of a school of practical nursing . . . who has been legally authorized to practice as a licensed practical or vocational nurse.”

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From the U.S. publication Dorland’s Illustrated Medical Dictionary

UN/J. Isaac

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‘The Backbone of Health Care’

At the International Council of Nurses Centennial Conference in June 1999, Dr. Gro Harlem Brundtland, director-general of the World Health Organization, said:

“Nurses, as the key health professionals, are in a unique position to act as powerful advocates for a healthy planet. . . . As nurses and midwives already constitute up to 80% of the qualified health workforce in most national health systems, they represent a potentially powerful force for bringing about the necessary changes to meet the needs of Health for All in the 21st century. Indeed, their contribution to health services covers the whole spectrum of health care . . . It is clear that nurses are the backbone of most health care teams.”

The president of Mexico, Ernesto Zedillo Ponce de León, gave special praise to the nurses of Mexico in a speech in which he said: “Day after day all of you . . . devote the best of your knowledge, your solidarity, your service to preserving and restoring the health of Mexicans. Day after day you take to those who need it not only your professional help but also the comfort that comes from your kindly, committed, and deeply humanitarian manner. . . . You are the largest segment of our health institutions . . . In each life saved, in each child vaccinated, in each assisted birth, in each health talk, in each cure, in each patient who receives attention and solid support, there is present the work of our nursing staff.”

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UN/DPI Photo by Greg Kinch

UN/DPI Photo by Evan Schneider

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An Appreciative Doctor

Dr. Sandeep Jauhar of the New York Presbyterian Hospital admitted his indebtedness to good nurses. A nurse had tactfully convinced him that a dying patient needed more morphine. He wrote: “Good nurses also teach doctors. The nurses in specialized wards like the intensive care unit are some of the best-trained professionals in the hospital. When I was an intern, they taught me how to put in catheters and adjust ventilators. They told me which medicines to avoid.”

He continued: “Nurses provide essential psychological and emotional support to patients, because they are the ones who spend the most time with them. . . . Rarely do I respond faster than when a nurse I trust tells me I must see a patient right away.”

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“I had a desire to serve others.”—Terry Weatherson, England.

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“As I watched over my father in the hospital, I decided that I wanted to be a nurse.”—Etsuko Kotani, Japan.

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‘A delivery is one of the most beautiful things that a midwife can experience.’—Jolanda Gielen-Van Hooft, Netherlands.

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Midwives get joy and satisfaction from assisting with childbirth