Chapter 1 – Gandalf the Grey, BSN RN

“So, why do you want to be a nurse?”

Don’t you hate that question? People ask it in nursing school interviews, job interviews, on applications, and just in general life conversation. For the first five years of my nursing journey, I didn’t have a good answer to that question.

For a passionate nurse, I seemed pretty not passionate, huh?

My generation has grown up to believe that everyone gets to do what they desire and somehow make enough money to pay for a large beautiful HGTV-ready home, and car that costs more than my yearly salary… and that we’re all entitled to it.

Alas, that is not reality. Many personally and professionally satisfying jobs do not come with a salary that accommodates such living. And if, miraculously, it does, typically there are years of paying down debt, which will not allow you to enjoy the fruit of your labor.

I wasn’t one of those people who always knew what they wanted to do with their lives. I didn’t know what path to take freshmen year of college and didn’t have this burning desire in me to become something specific. I envied those who did. My friends who knew they wanted to be a teacher, a pilot, a CPA, a doctor, etc., all had a passion for it and nothing else would satisfy their professional urge.

If you are one of those people who just knew within you which career was for you, please consider that a blessing gracefully given to you. Please be thankful for that. The rest of us are out there, trying not to go into financial ruin, attempting to figure out what we should do with the rest of our lives.

I was very aware of the need to quickly make a decision about the path I was going to take, but painfully unaware of which path I wanted to take. With so many options, so much potential debt in front of me, and little time, I made not a passionate decision, but a practical decision to go with nursing.

Honestly, this was my thought process: I like teaching and I like health/medicine, so nursing makes sense, right? I won’t pretend it was more complicated than that. That’s all I had to go on.

I started taking prerequisites at a junior college and prayed that it was the right decision. I prayed I even could get into nursing school. I prayed that I wouldn’t hate it.

Surprisingly enough, I quickly found out that I loved nursing. Learning disease processes, caring for patients, and understanding the ‘why’ behind everything was so intriguing to me. I couldn’t get enough.

Somehow I got through nursing school. Coffee, prayer, and living in the building literally next door to all of my classes (and therefore waking up approximately eight minutes before each class) were my saving grace.

Throughout school, I discovered that while I loved nursing, I wasn’t sure if it loved me. When you’re taking your nursing courses, you think you know what being a nurse is going to be like, but you don’t really know yet. I was praying that once I got through school not only would I enjoy the real world of nursing, but that I’d love it enough to stay in the field for decades to come.

When I started working at the bedside, I discovered not only did I like nursing, but it liked me back and we got along well. Even as a young and naïve nurse just surviving each shift, I was able to have a profound impact on my patients. I discovered that you don’t have to be one of those expert nurses with years of experience to take good care of a patient.

In order to do the job of a nurse, you have to have an awareness and knowledge of technical things (equipment, computers, medications, diagnoses and conditions, etc.) because clearly that is important to practicing safe patient care. This is what I call the “black” part of nursing.

However, there is this side of nursing that is not technical or in nursing textbooks. I call this the “white” part of nursing. That’s when you can walk into a room and just feel the emotional climate. You can tell when you need to be comforting, motivating, supportive, or even silent. You are able to command respect from your patient and their loved ones while still being soft and gentle. You’re able to walk into the room of a patient with a completely different cultural background and still bond greatly with them. You’re able to get patients and their families to trust you quickly.

It’s putting them both together that truly makes a good nurse. I call it being “grey.”

It is in this grey blend of the black of nursing (technical stuff) and the white of nursing (creative/social/emotional) in which the good nurses live. They know enough technical information to be safe and efficient. They have enough social, emotional, and creative awareness to make their patients feel safely cared for, and somehow know how to get things done efficiently.

Having wisdom, grace, and discernment in terrible situations isn’t something that everyone carries within them. Not everyone can explain complex medical conditions to a crying patient. Compassionate care is something we assume all nurses do— simply because they are nurses. Once you get out there, you’ll realize that is not the case.

Being a grey nurse is not automatic. It takes going through some rough situations and learning from them. It means gracefully accepting constructive criticism and allowing it to make you a better nurse. It means checking your ego at the door. It means caring about the big picture. It means knowing and acknowledging the fact that while this may be just another day at work for us, it is a profound time in our patients’ lives, and our needs are not the priority.

The Good Grey Nurses

I’ve been very blessed in my short career as a nurse to be exposed to some amazing nurses. There are some nurses that just get it. They understand that big picture. They know it’s not about them; it’s always about the patient, and that fact is evident in everything they do.

You know them when you see them. You’re probably thinking about those nurses that work on your unit right now.

They’re the ones who can take on a heavy patient load, be in charge, and are somehow on time with everything. They’re the ones who know when they need to drop everything and be there for a patient during a really rough moment. They’re the ones who patients request by name. They’re the ones who you go to first when you have a bad feeling about one of your patients. They’re the ones with whom you, and your patients, feel safe.

There is something about a good nurse. Having a nursing license and job doesn’t make you a good nurse. Working for 30 years doesn’t make you a good nurse. It’s not about being a good IV starter or being best friends with all of the physicians. It’s not about having a commanding presence or knowing all of the answers to the 900 questions you get asked each shift.

While all of these things are important, it’s not all there is. It’s so much less defined and measurable than that. It isn’t measured in letters after your name, certifications, professional affiliations, or by climbing the clinical ladder. It’s something you feel when you see a good nurse care for their patients. It’s that security you see in their patient’s eyes when they come in to care for them. It’s that nurse whose patient’s family member will finally go home to sleep and shower because they know their loved one is cared for with that nurse.

Good nurses breathe instinct. They breathe discernment. Good nurses can pick out seemingly insignificant things about a patient, interpret an intricate clinical picture, somehow predict a poor outcome, and bring it to the doctor’s attention, literally saving someone’s life.

Did you read that? Save someone’s life. I have seen the lives of patients spared because of something that their nurse, their good nurse, first noticed.

And then there’s that heart knowledge that good nurses have that blows me away even more.

They are those nurses who always know the right thing to say. They know how to calm an apprehensive and scared mother enough to let them take care of her son.

They know how to re-explain the worst news a husband is ever going to hear because it didn’t quite make sense when the doctor said it 15 minutes ago. And they know how to comfort and reassure him when they see it click in his mind that his wife is forever gone.

They know when to just sit and listen to a man tell his entire life story, after he just learned that he’s essentially dying slowly. They know how to make him feel important, valued, and cared for. They know that is now their priority, not charting the assessment they just did on their last patient, or seeing if their coworker needs to go to lunch.

They’re the nurses whose instincts all of the doctors trust.

They know how to make coworkers who hate each other, work together.

They know when they need to have a come to Jesus meeting when someone is in denial about the severity of the decisions they’re making that are literally killing them. And they listen.

They are the ones with whom patients, families, and even coworkers feel comfortable being honest, even if it’s painful and embarrassing.

They also know how to quickly grab control of a room full of frantic people when things start going downhill. They know how to convey urgency, not terror. They somehow make you feel safe when someone’s life is literally a breath away.

Those nurses are my heroes. They’re who I aspire to be every time I put my badge on in the morning. They’re who I hope I have been when I clock out. They’re the good nurses.

My prayer for you is that you become one of these nurses. These nurses not only save lives, but also profoundly affect each patient they touch with their blessed hands. My prayer for you is that you believe in yourself enough to do both the mental and emotional work to get there.

In saying that, it’s hard to figure out how to be a good nurse when you’re new. It feels like it’s hopeless to get to the point of being a good nurse when you don’t even know the first thing to do when your patient starts going downhill. When you look at the nurses that have been doing this for decades and think, “it’ll take years and years before I get there,” know that it doesn’t have to. You can become a good, safe, efficient, and caring nurse without decades of experience behind you.

You just have to care.

You have to want to be better every day. Your patient has to be more important than your task list. What’s better for your patient has to be more important than what’s easier for you. You have to be willing to advocate for them when everyone is against you. You have to be willing to empathize, not sympathize, with your patient. It takes time to develop discernment in these situations, but you’ll get there. You just have to want to get there.

The white of nursing is so very different from the black. It’s much less straightforward and truly takes sitting with patients and their families in various situations to truly master it. You cannot learn this in a textbook. When you’re brand new, you might not even realize how important this side of nursing is because you’ll be so worried about just getting things done. Once you’ve been there for a patient who has an emotional breakdown after getting more disappointing news, or when they’re sad because no one visits, or once you’ve sat with a family right after the doctor told them their loved one is dying, you’ll see that white side. Not that it’ll get easier to be in that uncomfortable white space, but you’ll get better at it.

And once you’ve seen and walked in that white side, you can blend to grey. You know when you need to just get everything done, but you also know which patients need extra time. You’ll know how to support and educate a patient on getting a certain important test done that they’ve been refusing, but still get all of your meds passed and round with the physicians. You’ll become the one that other nurses look to for guidance. Your wisdom will be undeniably calming. Your presence will put both coworkers and patience at ease. Your blend of nursing grey will be so glorious that before you know it, you’ll become your unit’s own Gandalf the Grey, BSN RN.

Everyone will be happy to see you’re working on the same day as they are. You’ll be able to handle any situation that may come your way with ease, confidence, and grace. You’ll go from being a seemingly average person to the nurse that patients will never forget because you were there. You’ll make Gandalf so proud that he’ll come to your one hundred and eleventith birthday and set off the best fireworks display this side of the Shire.

And one of the beautiful things about nursing is some nurses are better at some things and some are better at others. A nursing unit is quite the team. I am somewhat of the emotional supporter on the team. I have some coworkers who are great at technical stuff (IV insertions, foley insertions, placing sutures, etc.), some who are great at having crucial conversations (calling a doctor back when they’re not being responsive to patient’s issue, pushing back to staffing when we need another nurse), and some who are great educators (can explain complicated medical conditions to people with the education of a 5^th grader). It is really lovely to see a well-functioning unit work together, utilizing each other’s strengths to best serve our patients.

Everyone blends to their own Gandalf Grey differently, with their own expertise in the mix. I’ve accepted that I won’t be the best technical-skills nurse. I really come through for patients and loved ones with emotional needs.

I love when I’m working with my technical guy who has a calm demeanor, my crucial conversation nurse who calls anyone at the drop of a hat if we need something, my nurse who is basically an educator because she knows so much, and my motivated and proactive CNA. We’re like the dream team. How safe would you feel if you knew a team of Gandalfs were manning the unit that your mom was on when she had a massive stroke?

No matter how crazy it gets, our patients are safe and expertly cared for. It’s a beautiful thing. Each of us has had our own journey to blending to our Gandalf Grey (BSN RN) and becoming a good nurse. I know they’re all good nurses and I respect and care for them like they’re my family… my LOTR family.