Ann Acka’a on duty

By Ann Acka’a,  BSN, RN, CM/DN

You may be thinking of beginning or changing your career and have decided perhaps you would like to be a Nurse in the United States of  America. So, who is a Nurse and how does a person become a Nurse in the US? And what do they do? If it is your decision, then you need to know it is one of the most gratifying professions to be found.

However, Nursing is hard work; and learning to become a Nurse requires time, long hours, study, preparation and dedication. Nursing is not for everyone and it takes more than “desire” and a “big heart” or “ money” to be a good nurse. Nursing requires intelligence, critical thinking, self-discipline, communication skills, dedication, compassion, high moral and ethical standards, endurance, as well as respect and concern for the welfare of others regardless of race, creed, culture, or  religion or the ability to pay for care.

In considering nursing as a career, some food for thoughts maybe the following to determine if nursing is the right choice:

  • Is Nursing a job or career? There is a difference between a job and a career. A job is something done in exchange for something else, usually money and nothing else or more. On the other hand, a career is something in which one is dedicated to. A career is an endeavor in which one constantly strive to be the best at one’s craft and in which lifelong learning is not only a necessity but a consuming desire.
  • Am I a good team player? In the majority of instances, nursing is a team effort focusing on a particularly identified client. No one person or specialty is more important than the other. The entire nursing team must work together for the welfare of the client.

Speaking broadly, nurses are part of a team that include and is not limited to physicians, respiratory, physical, occupational therapist and other health care professionals.

Depending on the needs of the client, the team may also include, Social workers, case managers,speech therapist, nutritionist, pharmacist, psychologist, palliative care and spiritual advisors. Speaking narrowly, the team is the group of health care individuals the nurse works with on a daily basis.

  • Am I honest, dependable, responsible, and accountable? These qualities are the hallmark of a good nurse. Nurses must be honest in their relationships with clients, their families, physicians, and other health care workers. Nurses must also be honest with themselves and be able to seek appropriate assistance in situations to which they may or are not competent. Nurses must be dependable and report for duty as scheduled and perform their duties correctly as prescribed. Nurses must also take responsibility and accountability for their own actions and behaviors- for instance if they perform a medication error it should be reported- this is a teachable moment not a punishment or blame moment. The client, physician, or other health care workers cannot be blamed when nurses make mistakes.


  • Do I care for others? Nurses do not selectively determine who they will care for. Nurses must render care to all regardless of gender, race, creed, culture, or religion or economic background. Nurses do not selectively determine the quality of care that a client is to receive. All clients deserve the highest standard of respectable care possible.


  • Do I follow directions? There is little nurses do that does not involve following directions or orders of some sort. All health care agencies have policies and procedures that guide or dictate proper behavior or actions to be taken with virtually any responsibility occuring within the institution. Nurses who attempt to take short cuts or ignore institutional policies and procedure when performing client-related tasks place themselves, clients and others at risk for injury.


  • Am I comfortable with decisions others make even when I disagree with the decisions they have made? Individuals do not forfeit their constitutional rights or their ability to make decisions when they enter the health care system. Competent clients have the right to refuse any and all treatment without the fear of reproach or retaliation even if the end result is death. Clients have five more rights, the right to” the right drug, route of administration, time of administration, dose of medication,  and medication or treatment rendered to the right client.


  • How do I handle stress or crisis? Nursing is a profession laden with stressful situations and ever-impending doom or crisis, be it client or institutional related. A client’s condition may worsen suddenly or the nursing unit may have to work short staffed due to absenteeism that is unable to be covered. Nurses must have the ability to remain calm and collected during stressful or crisis situations in order to focus on the patient- this is a skill called de-escalating that could take years to develop.


  • How do I handle frustration? Caring for clients in any health care setting can be frustrating as is working with other health care professionals. There will always be the difficult co-worker who rubs you the wrong way on all kinds of levels, to the point you would like to plan your shifts just to avoid the person. Patients may not be compliant with their treatment plan or medications or even lifestyle changes that would prolong their lives or even keep needed appointments. During a crisis, an institution may have difficulty in obtaining necessary resources or supplies. Nurses must be able to control their frustrations if they are to keep the clients welfare in mind. Losing focus could result in harm to the client or others.


  • Do I engage in behaviors that have the potential to bring harm to myself, a client or others? Using illegal substances, excessive alcohol, abusing legal substances, and engaging in unprotected sex have the potential to bring harm to oneself and others. Nurses whose judgment is chemically impaired risk harming themselves or worse, a client. Nurses with chemical dependencies are more likely to engage in illegal behaviors in order to meet the needs of their addiction and may report that certain medications were administered to a patient when in reality they never gave the drugs but instead self administered.


If one engages in any of these chemically related behaviors, one may probably say that they would never attempt to care for a patient or drive a car while impaired and they may be telling the truth- to a point. The problem is that most individuals with chemically related problems do not realize when they are physically or mentally impaired. Engaging in unprotected sex increases the risk of contracting sexually transmitted diseases such as HIV/AIDS/ HEPATITIS that unknowingly is transferred to patients and other sexual partners. Individuals exposed to HIV/AIDS or Hepatitis may not show symptoms of the disease for months or years.


  • How do I feel about death and dying? Life is fragile and individuals sometimes die. The process of dying is a normal part of the human existence. In order for nurses to work effectively with death and dying they must understand and accept their own mortality. An ancient proverb states “a child born is a child dying” because every minute of life is one more minute closer to death. Death is a visitor to those too sick to recover and death intervenes when all else medically or surgically fails.


  • How do I respond or react to abusive behaviors? Physicians may be verbally abusive to nurses and other health care workers or other healthcare workers may vent their frustrations and anger on each other. In all such cases verbal abuse should not be tolerated. Clients and their families are under great stress and pressure as a result of a serious illness that may be life threatening and the need for possible hospitalization is warranted. As such they may not always respond in a respectful or kind fashion. When clients and or their family members are verbally abusive, they are usually striking out in fear, pain, anxiety, frustration or grief. Often times, we the nurses catch the brunt of their wrath as we just happen to be the one of least resistance- We are expected to take it all and feel nothing but it has to be recognized that the nurses are humans too and feel the heat of these reactions taken out on them. For the nurse to respond in kind with being verbally or physically abusive would be inappropriate and would escalate and worsen an already difficult situation. Physical abuse should not be tolerated in any and all instances and should be addressed according to institutional policy.