Today in the chart

Our nursing skills are measured by how quickly and efficiently we can identify and fix a problem in our current healthcare system. This includes thinking and preparing for worst-case scenarios before they happen. Our systems thrive because of nurses’ abilities to catch and fix problems. We save lives by tapping into our quick critical thinking and ability to take action. As an ER nurse, I loved my job for many reasons, including my ability to fix and attend to the tasks assigned to me during my 12-hour shift; checking the boxes as I charted helped me feel as if I was accomplishing and fixing something every day. 

However, I didn’t get into nursing just to check off boxes; I wanted to do more, to make a difference in the lives of others. This is why I ultimately chose to work in the ER, to be able to offer my presence to other human beings to co-create healing spaces during some of their most difficult times in life.  

Our healthcare systems are not always set up to support this level of human care. For example, in the ER, we are celebrated by how quickly we can accomplish tasks, how quickly we can start an IV and grab blood, how quickly we can discharge our patients, and turnover rooms. Yet, we are not celebrated for the extra time we take with our patients, offering them our presence and listening intently to their hearts and needs.  

I remember the man experiencing homelessness who asked me to stay with him as he changed into a gown because he was not sure he could do it alone. The woman who said she thought she was dying and asked if I would just stay with her because she was scared. The child who would not let me leave his side because he thought the IV fluid would kill him. What my patients desired and needed the most was something much more than a checked-off box, they needed my presence, and in the ER, this was the hardest thing to give.  

I remember knowing the importance of my presence yet explaining over and over to this little boy, “Dear, this is just fluid, water, that is going into your body that will help make you feel better. You will be fine; I need to check on my other patients now.” He would just look at me and say, “Please don’t leave me, please don’t leave me, you don’t know for sure, this could kill me.” I tried to explain to him, “it’s okay, don’t be scared, you are safe, you are going to be just fine.” I look back on this now, and I realize what I was telling him was, “Don’t feel scared, don’t feel bad; you are okay.” What my patient was telling me was they were scared, and they did feel bad, and they needed me to listen and to just be with them to make sure it was going to be okay. I stayed as long as possible, but eventually, I had to leave. 

I look back now on my patients, and I realize at the heart of their needs was the desire for me to lean in, care courageously, and be a steady presence for them as they grieved. The man experiencing homelessness was grieving the loss of body autonomy. This woman knew she was dying, grieving the loss of life and community, the child grieving the loss of safety and trust. They all wanted me to be with them, listen, and hold them as they navigated their losses as best as they could; ultimately, it was my presence they wanted the most. 

Grievers need not be fixed; they just need to be heard. This understanding has helped me come alongside my patients, colleagues, friends, and loved ones as they are grieving. It also has offered me a deeper connection and satisfaction with my patients as I courageously care for them not by fixing but by being. However, it has taken me a while to learn and remember that my presence is the most important gift I could give to anyone. As nurses, we are uniquely situated to hold both our ability to fix ailments and check off tasks alongside our ability to offer our full presence to create spaces of healing for others to feel seen, heard, and cared for.  

What does it look like to give your full presence to someone? To attune and hold the unfixable with compassion, grace, and generosity. Ultimately it is your presence shared with me, and my presence shared with you, that will heal us all.  

As we celebrate our abilities as nurses to fix problems, let us also take a moment to think about our abilities to heal through our presence. I invite you to give yourself the gift of your presence as you think about the following journal prompts: 

1. When did someone offer you their full presence? How did it make you feel? Why?
2. When were you the recipient of someone who did not offer you their full presence? Maybe they were multitasking or not fully listening to you; how did this make you feel? Why? 
3. What are some ways you offer your patients your full presence? 
4. How do you offer your presence in a system that does not celebrate this nursing component? 

Tara Rynders, The Dancing Nurse Educator and Nightingale Luminary, is the CEO and Founder of The Clinic, an arts and play-based immersive theater company that offers workshops and keynotes to create more sustainable, (Re)Brilliant, and equitable healthcare systems. 

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