WeekEND Reading: Veteran R.N. Juliana Adams talks about reclaiming the nobility of nursing, finding joy in the work, and how memoir is about relating to others in THE JOY OF NURSING

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By Leslie Lindsay

If you’ve been following the blog for any length of time, you probably know that I’m a former R.N. turned writer. That’s not to say that I didn’t find joy and passion in being a nurse—I did! For years, I worked with children and adolescents, helping them understand their feelings, cope with life’s curve balls, and so much more. But, oh how the books and writing life called to me.BookCover_TheJoyOfNursing

A veteran R.N. for 50 years, Juliana Adams will say one gets the calling to be a nurse “if you’re lucky.” As a kick-off for the Association for Nursing Professional Development Week, I’m sharing a special “WeekEND Reading” segment with veteran R.N. and author Juliana Adams.

THE JOY OF NURSING: Reclaiming Our Nobility (Steamboat Springs Publishing, May 2016) is about the author’s journey to be the best nurse possible, challenges in the profession, reevaluating her concept of nobility, and so much more. 

The stories are often raw, unfiltered, and revealing in nature, but done in a tasteful way in which the beginning (or aspiring nurse) can get a stunning glimpse of what the profession is really like. From her first job as a graduate nurse at a more cushy hospital, to one in a grittier E.R. (Denver General), through nursing administration/management, going back to school, and speaking/advocacy, Juliana will take your hand through the bowels of critical care nursing and help you rekindle your nursing spirit, reinforce your decision, and just be a gentle presence to lead the way.

THE JOY OF NURSING is at once a memoir of the profession, but also a guide for the disillusioned, and those in the trenches.

So grab your coffee (stat!) and join us for a little morning shift report.

Leslie Lindsay: Juliana, I’m so honored to have you pop by! Thank you for joining us and congratulations on a fulfilling career and the book. Writers will say it’s bad manners to ask what inspired a particular book, but I find the inspiration so powerful, almost as much as what’s between the pages! Can you tell us why you felt compelled to write THE JOY OF NURSING?

Juliana Adams: I wrote The Joy of Nursing: Reclaiming Our Nobility as a sequel to my documentary (Exposure, Reclaiming Our Nobility) that I produced two years prior to writing my book. While producing this film I realized that there was a depth to the nurse patient relationship that the film could not delve into and still be compatible with the primary goal of the film. I elected to produce a film just prior to deciding not to go back for a PhD in nursing, which had been a part of my career plan. As much as I loved my thesis idea, I realized that I was not resume building any longer; rather, I wanted to learn a completely different medium of communication—that of film making.  I wanted to engage the consideration of “the best and brightest students” to view nursing as an exciting professional career choice . . . and I had not seen this in media at that time.

The goals for my book initially were to explore nursing from the perspective of novice to expert, over a long term perspective.  This became even more of an issue when I encountered the first nursing career choice that I found myself in that led me to feel disillusioned, frustrated and then angry.  The concepts of nobility, Camelot Nursing, Dialogues of Discontent, and ultimately the role of inspiration in what being a nurse means to each of us then became the focus of The Joy of Nursing: Reclaiming Our Nobility.

L.L.: At one time or another, most people will have come in contact with a nurse, whether because they have been hospitalized themselves, or a have been with someone who is. It’s often a nurse’s dedication, touch, and connectedness one remembers. The “bad” nurses are remembered, too–the ones who made you feel uncared for, download (7)unimportant, invisible. Can you speak to that, please?

Juliana Adams:  My nursing career has been characterized by one position after another that was exciting and challenging.  I did not discover until well into my 2oth  – 25th years that what I had first thought of as being “really hard jobs” and even positions that I wondered why I had taken them in the first place, ALL had lessons that taught me a lot about myself—and how being a nurse had similarities and differences that were represented by the wildly diverse arenas that nurses could choose to practice.  Figuring out what inspired me led me to discover that I needed to revisit, reframe and update what being a “great nurse” looked like. I think that this is a valuable consideration for many nurses at some time in their careers.

We know a great deal about why nurses stay in nursing and why they leave (this has not changed over the last 2o years), but creating environments that promote the hands-on nurse became a very different issue for me when I decided to do “just one year” of hands-on nursing before going back to school.  To my complete surprise, what would become the toughest and ultimately the most rewarding decision I have ever made came as a result of this nursing position that was so unexpected.  I stayed in this position that I disliked to try and figure out why for 12 years!

I didn’t want to be the negative, burned-out nurse that I had been at one time in my life as the Associate Director of Nursing—the nursing leader that was the Go-To person —to rediscover the joy of being a nurse.  I wanted to figure out what conditions contributed to finding myself in this position. This journey was eye-opening from the perspective of me the nurse and the patient’s perspective.

I am often asked: “What can I do if I get a nurse that I do not like or trust?”  We can discuss this if you would like.  It is a concern that if we don’t discuss this then patients, families and visitors will take their concerns elsewhere, justifiably concluding that we as a professional group are powerless to recognize or resolve their concerns.  Once again, the hallmarks of a “profession” are that its members oversee the behaviors of their members and enact needed changes within their ranks to clearly state to the public what they can expect from the care that a Registered Nurse provides.

L.L.: I bet I’m not the only mother who will say this, but I so, so remember my OB nurse. Her name was Jen and she had long dark hair and the kindest eyes, and the efficiency and no-nonsense approach that seemed to put me and my husband at ease. This was my first baby, too, so greatly appreciated. The second experience was different. I had more than one nurse during my labor and delivery, but only one stays in my mind, the one who was there to swaddle my baby and hand her to me.  My perception was that she was a little more brusque.  I don’t recall her name. This bothers me. Do nurses remember us—their patients—as much as we seem to remember them?

Juliana Adams: YES! If you go to my Facebook page I have a quote that has received over a thousand responses, and that is: “Nurses bring care to patients but what we as nurses get back in return, is a whole lot more.”  There are so many “firsts” when you are a nurse, but as I often state, this sentiment of feeling valuable to patients is on the back of my book as a quote: “You know when you have a great nurse, you can just feel it.” Patients expect competence and they expect to feel cared for. There are so many professions that much of what they “do” is at some future risk of being replaced in some manner, but assessing patients holistically while in the process of delivering a skill that reflects the education and experience that a professional registered nurse is educated to provide—in a CARING manner—is unique to our profession. This is not BS.  Valuing this uniqueness is at the heart of “reclaiming” our nobility. For our profession to remain “the most trusted profession,”  the concept of caring is integral to the “value” that nursing and all other health care members are challenged now to explicitly articulate to the payers of healthcare and the recipients of care, our patients.

L.L.: THE JOY OF NURSING is about reclaiming our nobility. Even in nursing school, this concept nursing was highly controversial. In many regards, it was all very “noble,” while at the same time, there were heated debates about nursing being an “occupation vs. profession,” a “career v.s. a job.” How I detested these download (1)delineations!  How can a nurse (or aspiring nurse) make sense of it all?

Juliana Adams: I remember thinking that “Theoretical Perspectives, Professional Issues and the History of Nursing” all were SO uninteresting as a student and even for the first decade or more of my practice!  They would later become very important as I worked and experienced competing missions of  providing care, deciding whether to take a position or not, and figuring out what was working and what was not within the 3 pillars of nursing: academia, leadership and the hands-on nurse. Theories on Trans-cultural nursing became a huge issue in my life when I went to Europe to work in several foreign countries as did the recognition that what characteristics were the hallmark of a professional nurse verses being viewed as a “trained” (not educated), skill/task oriented employee.  Not valued as more than what a time-motion study employee had to offer (and that could be delivered by a less expensive LPN or paramedic) delineates that tasks alone do not encompass what a professional nurse contributes. Our contributions are more complex then the way that they are often portrayed on TV.

I have asked myself throughout the years: Do I look like the nurse that I envisioned a great nurse looking like when I dreamed of becoming a nurse? Leah Curtain describes this as “caring presence.” I get this concept now.  It’s not something you can be taught; it’s something you learn along the way, hopefully from more experienced nurses that model this attitude, this characteristic.

L.L.: I’ll be honest: I became disillusioned with the life of a nurse. I was commuting 1-hour each way for three 12-hour shifts at a pretty major institution. While I loved psychiatry/psychology/pediatrics (my chosen field), I felt discouraged with recidivism rates, the toll it took on  my body, mind and spirit. Caring for other children was just too much when I had my own precious babies at home who needed a mother. Can you talk about that, please?

Juliana Adams: I worked the entire time I was pregnant and had children. I have been paying for tuition for myself, my husband, and our children since . . . forever! I worried and felt guilty that I wasn’t as good a mother as I thought I should be. I also had kids later in life (age 37 and 39), and it did help to share my angst with other working-moms, my fellow nurses. It was also at this time that I realized that with all of the variability within nursing, I could make choices that reflected what was most important at that time in my life ( working days or evenings, going for high paying jobs when my husband was in medical school, having flexible hours doing research, going part-time and then back to full time).  I knew I was valuable to my employers and I knew that I had to value my feelings, stress and mental and physical health.  I was determined to make work work for me. That being said, I know what you mean when you just can’t give, especially to children when you have children at home. Frustration, exhaustion and stress are ALL opportunities to have new doors open in your life.

“How do you know when it’s time to quit” is a valuable question that I was once asked at a job interview. Why was this being asked at a job interview? I wondered. But it was a great question.  In my book, I describe the exact moment to why and when I left the Emergency Department position that I had loved. I knew exactly when that now was.

L.L.: Aside from the myriad stories (which are great!) of being in the trenches as critical care/E.R. nurse, you assert on several occasions in THE JOY OF NURSING that nursing care is *not* “like medicine, only less,” but “about caring,” it’s about the nurse’s ability to connect, show compassion, and be there for the patient. Would you say that’s right? Or did I read that wrong?

Juliana Adams: Nursing is NOT less than medicine’s contribution to the health of patients and we are also not as simplistically often stated by the phrase Nurses care, Doctors cure. In fact, download (8)we are there when there are no cures; we are there to assist patients and families in finding meaning to their unique health, wellness, illness, living and dying experiences. I remember when I first realized that longevity was not a value to everyone, or that fighting to live was not what I was needed for, or that where and how patients met their own destinies would often be a mystery, all of which were sacred. The nobility of nursing, I realized, did not come from what we gave to patients or because we washed their butts and did other icky things.  The nobility in nursing has always come from our patients.  Being a part of some of the most tender, painful, courageous, inspiring times in people’s lives is an honor that we are gifted by them.

The following is from a blog posting that I wrote after the shootings that have been intense over the last 30 days—that MedPAgeToday (CNN)  is reviewing for publication. “As a side note, the paradox of caring in healthcare is that because most physicians and nurses chose our respective roles precisely because we cared, sometimes the expression of how we care is unique to our roles as physicians and nurses. This caring—the compassion and the application of the physical skills we provide—is done with a unique caveat.  The truth, the facts about who did what to whom, who is good versus bad, cannot enter into the care we provide.  Sometimes not knowing all of the whys makes our jobs easier.”

Discovering “the facts” implies a level of revealing and possibly understanding someone else’s reality.  But where there are variations of what is true, disagreements result, opening the door to judgments being made.  After forming a judgment, looking for someone to blame often follows. With blaming comes the belief that some type of punishment is justified. But not by us.

L.L.: And since we touched briefly on medicine, I have to ask: how’s your daughter doing in medical school? Was her decision to become a doctor influenced by your work as nurse? Her father as a physician?

Juliana Adams: Her decision came as a complete surprise!  She was an architecture major from an Ivy League school, completely uninterested in medicine. Our son, the West Point graduate, now in Special Forces, had always wanted to become an ER Doc but then said, “For my first career I want to go in the military and then I’ll go to medical school.” Go figure!  We supported their decisions as zig-zagged as they seemed to us and were just pleased that they both chose lives of service.

L.L.:  What do you hope readers get from THE JOY OF NURSING? Who would you like to see me recommend the book to? 

Juliana Adams: One of the hoped for intentions in writing a memoir is that because the author has changed over a long period of time, hopefully so a wide variety of readers can engage with the book and see themselves somewhere within the story of stories.

Inspiration comes from so many places in life. Reflecting on life for me always was based on the fact that we are not given the gift of many years on this planet to have exactly the same values, goals, belief systems, etc. How boring that would be! It is often because of the “bad” times that we find opportunities for paths that we never would have even considered had we only been comfortable and content with our lives.

Be open to developing mantras or sources of inspiration that work and speak to you. These are yours, so they can be classed any way you make them up to be!

*For example my “external guiding principal” is: When in doubt, do the right thing.

*My internal mantra is: Go home to yourself.

* What makes me sigh and know that everything is OK is: “If the only prayer you say in your entire life is ‘thank you‘ that is enough.

*This is so seemingly small but so powerful: Do you remember the first person that told you that you were good at something? Remember . . . give this gift.

L.L.: What has captured your energy lately?

Juliana Adams:  Epigenetics and neural plasticity. Absolutely fascinating concepts that will revolutionize not just Mental Health but Physical Health!

L.L.: What should I have asked, but may have forgotten?download (9)

Juliana Adams: The profession of nursing is strong enough and needs the input of all of its members. It is within the purview of all of us to be able to poke, prod, question and challenge directions in which we see nursing moving. I have concerns that the distance between academia, leadership and the reason we are all here—the hands-on nurse—has in some places become to0 separate. In 5o years I have walked the walk.  I have been in many realms of nursing, and when I could not, with all of my experience, friends, education, zeal, and determination, make an environment “better,” I realized that this frustration was being experienced by many other nurses out there.  We as a profession must have life-lines that come from academia and leadership. We are all guardians of this laying on of hands profession. And for those nurses that are working in wonderful environments and might be wondering why can’t those nurses get it right, our experiences may be harbingers of change that you never thought would be coming your way but could be.

L.L. Juliana, it’s been a pleasure…and now what time would you like that lunch break? Is 10:45a.m. too early?

Juliana Adams: Lunch?  Really? I took a 5 minute Pepsi/Pee break and thought that was it till I got off 45 minutes after my shift was supposed to have ended!  Heck yeah, I’ll take a break and eat my lunch for breakfast!☺

For more information on Juliana, THE JOY OF NURSING (Steamboat Springs Press, 2016), or to connect via social media, please see:

Website
Facebook 
Twitter 
GoodReads 
Amazon

You can connect with me at: 

AuthorPhoto_JulianaAdams.jpgAbout the Author: Juliana Adams, BSN, MSN, MA Psychology, is an author, documentary film producer and practicing nurse. In 2012, she produced a documentary film, Exposure, Reclaiming the Nobility of Nursing. The focus of her film began by highlighting the excitement of the nurses working in the inner-city emergency room that Eugene Richard’s made famous by his controversial book, The Knife and Gun Club. Where the film ended … what it exposed … led her to further explore her own journey of moving from novice to expert.

[Special thanks to A. Barbazon. Cover and author image courtesy of J. Adams. Brain image retrieved from Wikipedia, image of nurse in scrubs retrieved from  , medical staff from on 7.28.16, nursing quotes from quotesgram.com]

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