Yeng Yang, MD reflects on sharing a stage with nurses and other members of a cast and crew in what she describes as practice in a medical theater.
Yeng Yang, MD reflects on sharing a stage with nurses and other members of a cast and crew in what she describes as practice in a medical theater.


I am not a nurse and yet I am intricately tied to nurses in all that I do, in direct patient care and in the many aspects of my other nonclinical duties at the hospital. Even in my health care MBA program, I am interacting with nurses.

What I am thinking about is the relationship between members of the medical team and our abilities, or lack there of, to be truly present for our patients and each other. A patient is not cared for by just the physician or the nurse alone; there is a myriad of other teammates who interact with our patients and with us in order to create a symphony of care. Delivering great and compassionate health care is like live theater; it needs actors (medical personnel), a well-designed set (unit), and the stage (health environment/hospital). I find that the “medical theater” delivers its best performance when the cast and crew have presence of mind, when we commit to teaching and learning from each other in practice, and when we keep our patients center stage.

It has been shown that when team members act rudely or disrespectfully, a team performs poorly, whereas when team members act more positively or receive positive encouragements, it performs well under pressure. I have found many examples of performances that do not uphold best practice. Poor performance is often rooted in the stress of practice.

In a perfect system, our attention can be devoted to one thing at a time with presence at all times. We do not work in a perfect system.  But we can choose to be the best version of ourselves in practice with each other and furthermore, in practice with our patients. We easily spend more time together as staff than we do with the patients and families we serve. It is important for us to model positive behaviors of care giving for each other as we cohesively deliver care to others.

I hope that as practice evolves, we can all perform with patience and respect towards each other. One of my professors said that in order to promote growth in those we lead, we not only have to meet them where they are at, we need to truly care about them and their development.  I have found this to be true in my relationships with those whom I lead and with my colleagues. Our patients deserve the best versions of us when we deliver care at the bedside, their most vulnerable moments.  When we commit to delivering care to each other, it ultimately reaches the patients and families we serve.  That's the brand of care delivery that merits a standing ovation.

Yeng Yang, MD, FAAP, is Director of UMP Pediatric and Newborn Hospital Medicine at Maple Grove Hospital.

Jennifer Johnson is a surgical services RN who finds a little levity can go a long way on both sides of health care delivery.
Jennifer Hall Johnson is a surgical services RN who has found that a little levity goes a long way on both sides of health care delivery.

We all have those friends who help us survive the uphill terrain in life with a little laughter to propel the journey.  Jen Johnson was one of those friends who helped me survive nursing school with her quick wit and tireless commitment to create community along the way.  It's no surprise to catch up with her over a decade beyond wearing whites in nursing school together and to find her creating comic community as an escape from the stress of the daily grind.  When Jen isn't working in the OR in her local community, she's traveling the world with Seattle Alliance Outreach or plotting her next steps in raising funds and awareness to combat the widespread affect of cancer.  When I recently caught up with Jen and asked her what was on her mind about nursing, here's what she had to say:

"Last fall, the nursing profession was front and center in the media thanks (or no-thanks) to criticizing comments made on a national talk show by uninformed television hosts.  With that press, nurses (and healthcare workers of all types) came out of the woodwork to state their opinions, good and bad - about our chosen profession.  I have never seen such an outpouring of support for health care workers, and I am grateful for the national spotlight the nursing profession had in the aftermath of said press.  I mean, nursing is a great profession!  Where else can you roll into work in your PJ's and then change into other PJ inspired clothing?  I wear an OR hat at work all day, so that saves a lot of money on grooming supplies.

That said, I have also noticed an influx of negativity regarding nursing, particularly in social media.  I started following a very popular healthcare Facebook site and what I saw alternated between making me proud and inspired, and sad.  I have heard the mantra "nurses eat their young" so many times and by so many people, yet I had not experienced it myself.  What I saw on social media last fall in the flurry of reactions to the aforementioned press was a cacophony of: "Behind my name are X amount of letters Alphabet Bashing", the old "I've been a nurse since (insert year) so don't dispute me because you don't know as much as I do," and various administrators of the aforementioned site arguing the professionalism of certain posts and comments...it was like I was watching the human equivalent of a tiger salamander (in case you didn't get that reference, they literally do eat their young).

I thought about it and realized that I wanted to do something to bring attention to all the positive (and funny) parts of nursing...so nurses and healthcare workers of all types could maybe get a laugh, blow off some steam, and not worry about being blasted by a FB group administrator for violating an unknown (and often changing) line of "professionalism".  A small way to focus on the positive rather than be bogged down by all the negativity.
I don't care what your title or place of employment is, if you work as a nurse, you have stories.  You have seen some bad stuff.  Really bad stuff.  I've had to tell people that their family member needed an emergency surgery after delivery of a stillborn baby.  I've looked into the eyes of a patient who didn't know how far their cancer had spread, held their hand as we walked down the hall to the OR, and as anesthesia took over, said a silent prayer for them.
Heck, I've BEEN the cancer patient.
I was there when my co-worker's mom went into cardiac arrest during an endoscopy.  My co-worker was standing outside the procedure room door as the code was called, and she had to make the decision to call it off after 45 minutes of non-effective CPR.  It's tough stuff.  I'm not telling you guys this so you think I'm Super Nurse or anything.  The point is, if you work in nursing (or health care), you either have seen some earth-shattering events, or it's just a matter of time before you do.  And you have to get up the next day (possibly wearing Hello Kitty pajamas) and go back and do it all over again.
The Joy of Nursing is a Facebook group I created with the intention to create camaraderie (and to blow off some steam) within the healthcare community using humor.  Focusing on the positive and the funny stuff makes the bad stuff easier to handle.  And maybe humor is a vehicle we can take to aid in not taking ourselves so damn seriously."
Jen's FB group is: The Joy of Nursing - she invites you to join her in a chuckle.
The views and opinions expressed by our guest authors and by those who comment on their posts do not necessarily reflect the views and opinions of www.thereflectivenurse.com

Jennifer Quade, RN, BSN, HNB-BC Board Certified Holistic Nurse Revolutionary Women's Holistic Health Care Holistic Stress Management Instructor
This week's guest blog reflection is written by Jennifer Quade, RN, BSN, HNB-BC.  Jennifer is a Board Certified Holistic Nurse with a passion for traditional healing and wisdom. She runs a thriving practice in Minneapolis, helping people find balance through self care.

Hi Natalie! Thanks for your invitation to be a guest on your blog. I really believe having dialogues about our practices is super important to keep us connected, cared for and inspired as we do our work.

So what is on my mind about nursing?

Self care.

I personally feel that this might be the most foundational, important aspect of nursing.  If we don’t give ourselves excellent care, it’s nearly impossible to give others our best.  Do you know the feeling of trying to give from an empty gas tank? I bet you do...and it doesn’t feel so great. I’ve been there...and I have to constantly be on alert to make sure I’m not slipping back into over-giving. When I feel irritable, depressed, or experience body pains, I know it’s time for some serious self care. No more "sucking it up" or dealing with the imbalances.

I have been a nurse for 10 years.  After my first few years of working on the Float Team at Children’s Hospital in Minneapolis, I was burning out because I truly didn’t know how to care for myself at the level that I was giving. That’s why I embarked on my own healing journey. I have dedicated my life and my private practice to learning how to care for myself, to staying in balance, and to supporting other women, caregivers, and nurses to do the same.

Why? Because I’m interested in living a vibrant life...living my dream. I want to see nurses fully realizing their dreams, too. It has to begin with self care, which includes self awareness..."know thyself." What do you want? What do you need?

Self care...it sounds like a simple concept, but it can actually be pretty difficult to put into practice, especially when there are so many demands on our time and energy. And since nurses are amazing and are generally good at just about everything (if I do say so myself), the demands are increased! Everyone wants a piece of the action.

Take a moment to consider where your creative energy goes. Be honest with yourself. Reflect on this: am I making myself a priority?  

After years of practicing basic self care techniques and receiving support from integrative therapy professionals and traditional healers, it became clear to me that what I really wanted in my heart of hearts is to take an extended time away from the winter to travel south. After 5 years of writing about it, praying about it, talking with friends who have done it, and saving for it...it’s happening. In one week I leave for a three-month, extended trip to Costa Rica, Columbia, and Hawaii.

I’m thrilled that I have found a way to make this dream come true and I’m also excited about what this will mean for my practice and my work. I have been preparing to launch three signature speaking programs especially for nurses and caregivers. I’ll be taking time on my journey to put final touches on them so I can begin to share this message of mind-body-spirit emotional healing and self care with larger audiences.

Coming to a hospital near you in 2016:

Become the Eye of the Hurricane: Managing Stress Amidst Chaos

The Art of Self Care for Nurses

Stress & Human Spirituality

Taking three months away from my daily work is something I have never done before, so of course I have had to navigate fears and doubts along the way. Will my clients receive what they need while I’m away? Can I afford it? Am I being selfish? And more...

When these thoughts and fears arise, I take a deep, soft, belly breath. I feel my heart...and I remember why I am taking this time for myself: to fill my fuel tank so I have more to give upon my return, to take space to create my speaking programs from my center, to study with indigenous healers along the way, and to have fun. I'm realizing I can't afford NOT to do this for myself!

Let’s face it -- nursing can be (and often is) intense and exhausting. But we do it, because at the core, we have hearts of service. It is vitally important that we tend to our hearts.

Consider reflecting on the following:

  • What is your heart calling for?
  • If you had a magic wand, what would you change in your life?
  • What is one simple self care practice you can weave into your day today?

Also, consider looking at the resources page on my site. You will find a generous list of resources for self care. Enjoy!

If you’re interested in connecting with me about my speaking programs, please visit my website.

Take Care and Happy New Year!

Jennifer Quade, RN, BSN, HNB-BC
Board Certified Holistic Nurse
Revolutionary Women's Holistic Health Care

Holistic Stress Management Instructor

The views and opinions expressed by our guest authors and by those who comment on their posts do not necessarily reflect the views and opinions of www.thereflectivenurse.com