Florence
Nightingale
Foundation

These first few months into the New Year have made me reflect on all the changes surrounding me. Being a third-year nursing student, I often ponder on what transitioning from a student to a registered professional will be like, and even more so because of the changes and challenges being faced currently by the NHS. Hundreds of memories rush through my mind as I recall the people and situations that altered my brain chemistry.

When I was just starting as a student nurse, something upsetting happened on the ward which affected me.  Feeling heartbroken, I did not show my emotions in front of the patient and relatives. As soon as I could, I hid myself away in the toilet and sobbed. Quickly, I was found there by one of the nurses who said something that changed me, ‘you have to toughen up, you can’t do it if you are this soft’. Although I do believe it was said in a goodwill, it stung. I was then released home as soon as the handover started. Grabbing my bag, I left faster than you could say ‘scalpel’. I immediately felt relieved and grateful to go home. The charge nurse checked in on me a few times afterwards, but I could not process my emotions because ‘I had to toughen up’.

A few days later, I decided to talk to a nurse who had experience in situations like mine. I told her all that had happened and with a trembling heart asked ‘How do you toughen up? Because I do not know how to toughen up. I did not know it was a requirement!’. With visible emotions rushing over me, she looked at me with a gentle smile and replied ‘you don’t, and you shouldn’t. You will learn how to cope with your emotions and how to protect them and you will build resilience. And even if you have years of experience, there will be a day, a patient or a situation that will still bring you to tears and that is ok! We are nurses because we care, and we should always be gentle. You will give the best care if you do. You should not lose that’. 

Since that meeting, the word ‘resilience’ has become one which I rely upon. American Psychological Association (APA) (2022) explains it as ‘the process and outcome of successfully adapting to difficult or challenging life experiences, especially through mental, emotional, and behavioural flexibility and adjustment to external and internal demands’. Most of us use resilience interchangeably with the word ‘toughness’. Personally, I think we should refrain from using that word in our profession.

During nursing training, we focus on patients. We emphasize care and compassion towards them, and how to work with all members of the health-caring team respectfully and collaboratively. We learn emotions we can show in front of those we care for.  However, we are not told how to look after each other. Some nurses are exceptionally good at supporting their young colleagues, but others do not know how to. When showing feelings in front of colleagues where you should feel safe, you  can be called ’emotionally unstable’, ‘softie’, or ‘panicked’  and as a result, feel like you are failing.

My ‘toughen up’ experience is one of few. Fellow students share similar stories of not being understood or emotionally supported  by senior nurses  who no longer know how to show empathy. Sadly, those are crucial moments that stay in a young nurses mind for quite some time. In nursing, you lead by example. Maybe the lack of ability to show understanding towards young colleagues’ emotions is a form of generational trauma. There is this saying that ‘nurses eat their young’. Perhaps staff shortages, time pressures and compassion fatigue force them to forget that there was a time when they were new themselves. There is a quote from the movie Beatriz at Dinner, ‘you can break something in two seconds, but it can take forever to fix it’. In nursing though, and due to the current state of NHS, forever is not a viable option. The present is all we have to enforce constructive changes. The Florence Nightingale Foundation and Student Shared Professional Decision-Making Council Programme, with sessions from NHS South East RePair Fellows have allowed me to hope for a positive transformation. If there is one thing I wish I could change, it is to teach nurses how to be kinder to students, new nurses, and each other, and that the ‘toughen up’ language could be replaced with the correct narrative, training, and example setting.

Reference:

American Psychological Association (2022) Resilience Available at: https://dictionary.apa.org/resilience

Authored by Karolina Bielinska, January 2023