Summary: Your faithful blogger experiences parallels between the professional life of teachers and that of nurses.
As life happens, I have just returned from a stay in the hospital following surgery. As we shall see, the timing fortuitously was on the heels of my last post, which discussed teaching as an interpersonal enterprise, and predicted that school reform ultimately will involve stronger teacher : student ratios, once and if we get right how we use additional personnel efficiently and effectively.
Back to the hospital. As the fog of surgery settled, and I became increasingly aware of my surroundings over the days immediately post op, I started to discern within the nurse ranks around me some patterns that struck me as familiar, but which remained elusive to my understanding. Those who have been blessed with post anesthetic fog and the double whammy of oxycodone will appreciate my struggle to coherence.
I persevered nonetheless, because time I had on my hands; I wasn’t going anywhere fast. Gradually the familiar came into focus.
I recognized on the nurses’ faces as they scrambled from one patient to another, to emergency to mini crisis and back, the same emotional stress that has been familiar to me as a counselor in high school working with students.
— The centrifugal tearing at cognition and plan that pulls one away from one task before completed, because the urgency of the incipient task is too great to wait upon completion of first.
— The same almost desperate attempt to cover all bases against the press of too much too do, on the part of good hearted people committed to the ethics of their profession, and to the wellness of their patients.
— The mental fragmentation from several such stops in a sequence, then later the attempt to reconstruct in a relative less intense time period, the incomplete pieces from earlier in the day, that nonetheless still need attention.
True, such is the nature of life working with people in circumstances in which emergency is to be expected. Yet to the degree such disruption becomes chronic, to that degree the level of care that nurses provide or the completeness of instruction teachers impart declines, and the danger that a critical error occurs becomes more prevalent.
Clearly, staffing levels would either alleviate or complicate such danger.
My nurses were committed professionals, communicative, mature, and hard working and, as it happened, attractive, so what could I do with all that time on my side but open inquiry into what I had recognized?
Turned out that the hospital recently had undergone staffing cuts in nursing levels as a budgetary issue and, where the nurses previously had been responsible for four patients each on this particular floor, they now had five. Do the math; workload had gone up 25%. (Might have been five patients to six, which would make the increase a 20%, still significant.) By the way, this is not to lambast the hospital administration, any more than school administrators or even state legislators who must make cuts to live within means in these difficult economic times. But the point is that patient care and, in parallel fashion, the reaching of students in schools, has suffered accordingly.
Further in my conversation with the nurses (and I swear that I didn’t contaminate the observation by suggesting it myself), a couple of them acknowledged that aside from being continually torn away from one task to attend to another more urgent one, in their newly altered circumstances they simply couldn’t get to a certain band of care that they both had been trained to do and which they considered important.
To their credit, when they were working with me, I felt as though they shut out the rest of the world, listened carefully, and responded compassionately. Our conversations didn’t go so far into the details of what they considered lower level, yet still important, but effectively deleted priorities.
However, while walking the halls, I inadvertently overheard one nurse’s conversation with another patient. The snippets of their dialogue were about the patient’s life and family, interwoven with the medical issue of the present. In this context, it struck me that perhaps nursing is like teaching, or counseling, in that the subtext of a purposeful interaction is a genuine liking and care of a patient, and a willingness to develop a relationship beyond the technical details of either medicine or learning. In fact, perhaps there is evidence that the relationship between nurse and patient is critical to the healing, just as the relationship between teacher and at risk student is shown by research to be critical to improved learning. Perhaps it is the time given to brief but genuine interactions that is lost in both school and hospital. As a result, both settings, designed as incubators of human reconstruction, become more technical and sterile, and in the process become less successful at their identified calling.
The building of relationships takes time; perhaps in the downsizing of staff it is this “soft” variable that becomes the casualty.
I know this to be true in my own work in schools; so I was surprised to encounter similar patterns in the hospital, though perhaps I shouldn’t have been. In important ways, the two settings house the work of fellow travelers.