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Self-awareness and its impact on my future Nursing Career

First I would like to start by introducing myself. Hi, my name is Caelyn and I am a second-year nursing student at the University of Scranton. Now based on those three pieces of information, there is not a whole lot you can know about my life but you can make assumptions. You can make assumptions about my ethnicity and my religion, where I grew up, how many siblings and pets I have, what kind of family I grew up with. You can make assumptions about what kind of nurse I want to be and where I went to high school . You could make assumptions about what sports I play, what kind of friends I have, and so much more. You could write a 600-page book using just my first name, my major, and the school I chose by making assumptions about who I am.

As a human, I see people and I wonder about their lives and who they are, and I often find myself people watching on the beach or in a park and I will make up stories in my head about who a person in my general vicinity is. People are very complex in my head but there is a 99.99% chance that all my assumptions are false because they are based on nothing but a person’s body language and current physical appearance. I like to think I am a decent person but I do make assumptions about people without meaning to.

Depending on the tone of the comment or question or the expression on someone’s face when they stare at you, it can make you feel small and apologetic for standing out or it can just make you feel ... different. I learned over my life that I do not tan, like at all, and I need to wear a lot of sunscreen and can get sunburn in the winter. I learned to love my freckles because without them I look like a potato, trust me, the DMV and my school photos edited them out as acne and I do not look like me. For many people a similar example is getting mocked for having glasses or braces. Being called four-eyes or metal mouth is not the greatest feeling so I cannot imagine what people like Auggie go through.

Perhaps I will have to treat a patient who is sexist, hates Irish people, or is threatening. I still have to provide them with the same care that I would any other patient. I have experience people making fun of me for the way I look and I have experience people treating me different because I am female, and I just choose to resort to sarcastic responses and make them see that I am no different from any other person. I need my patients to know that THEY are no different than any other person. There are many examples of treating criminals, racists, sexists, and many other...interesting...patients in television shows.

I remember growing up little kids used to poke my face or point and ask me why I was polka dotted. Some kids even thought I had some contagious disease just because of my scattered melatonin! In elementary through high school and even college people comment on my freckles and the fact that I am as white as a sheet of paper and I glow in the sun like Edward Cullen. It makes you feel, different.

Now I want you to remember what assumptions you made about me and compare them to what I am going to tell you.

I have always wanted to be a pediatric nurse, but now I am also interested in psych nursing.

My last name is McGowan, I come from an Irish and Roman Catholic family - aside from Irish American I do not know what other heritage I am from.

I grew up in Yorktown Heights New York and have only ever lived in the house I currently live in and in the tiny room I have shared with my older sister since I was born. I have an older sister and an older brother, we are each about 2 years apart. I also live with my parents and my dog bailey. My grandparents, aunts, uncles, cousins, and some even more extended family have been a very present part of my life and although they drive me crazy sometimes, I would not trade them in for the world.

I went to an all-girls catholic school in white plains which closed after my junior year, so I went to a different all girls catholic school in Rye.

I played soccer until third grade, basketball fourth through eighth and volleyball eighth, in high school I played softball as a sophomore, golf as a junior, I was in the stage crew at an all-boys catholic school. When I went to a new school for senior year, I was the new kid and I was terrified. So, I tried out for the soccer team and made varsity, ran track in the winter, and played softball in the spring. I chose Scranton a week before the deadline and only told one person and it was not my parents.

My best friend from home is a girl I met as a senior at my new school and even though she goes to school in Ireland, we talk every day. I was terrified of her for most of senior year and sometimes still am very intimidated. No one aside from family, has ever been that kind to me. My best friends at Scranton were made in some of my least favorite classes.

All of these assumptions are basically harmless. None of them would affect my health or risk my life, but that is not always the case. As a future nurse, I need to always make sure to make my patients feel comfortable, welcome, and calm. I need them to know that I am not judging anything about them or their lives, and I need to show them that. I need to gain their trust so that I can give them the best care possible.

When a person sees someone who looks, acts, sounds, smells, or seems different, they often stare because it is new to them. People make assumptions about someone based on how they differ from what is deemed “normal.” Sometimes the target of these assumptions remain completely unaware, but if they do find out it can be psychologically damaging. Assumptions can be harmless, but in a profession like nursing, they can be extremely harmful. Pope Francis’ encyclical “La Dato Si”, Father Boyle’s book Tattoos on the Heart, and the movie “Wonder” have many common themes that can be crucial lessons for those in the nursing profession.

This class and the materials we have studied served to increase awareness of how assumptions and reactions that people make can take away a person’s dignity. Nursing school has taught students how important it is to maintain every patient’s dignity, and how not making assumptions saves lives. If a patient comes into the hospital and they are acting intoxicated and perhaps they smell like alcohol, a nurse might assume that this person is “just another drunk,” may give them fluids and send them home as soon as they sober up. This person may have a serious illness and the nurse’s assumption could cause serious harm or even kill that patient. Diseases like diabetes, epilepsy, or Alzheimer’s, a traumatic brain injury, or having a stroke are just a few things that may present themselves as the patient looking like they are intoxicated. As Pope Francis states in his above-named encyclical, “Disregard for the duty to cultivate and maintain a proper relationship with my neighbor, for whose care and custody I am responsible, ruins my relationship with my own self, with others, with God and with the earth,” (Paragraph 70).

If an individual has an expressive face, or is naturally not very good at masking their emotions or thoughts, they may offend someone they encounter. Nurses need to control their natural responses not react to things when meeting a patient or family. Nurses must listen to their patients and ask good questions to learn as much as they can. All of their questions and comments need to be grounded in and in pursuit of the facts.

Nurses need to ask each new patient if they were born with ovaries because not everyone who was born female identifies as female and some have even had surgeries and drug therapy to have their external body match their inner self. They need to gain the patient’s trust before learning something like this and it is easy to lose someone’s trust if they react in any way that can be taken negatively. If a patient comes in and they are pregnant and want an abortion, or want to become pregnant and cannot so they want medical procedures to help, nurses must be aware of their own limitations, morals, and predisposed feelings about these procedures and recognize if they are not going to be able to give the patient the best care possible. It is not a sign of weakness or judgement if the nurse recognizes that certain situations oppose their moral standards and they need to ask a coworker to provide the care to that patient. This needs to be done non- judgmentally and the nurse needs to point the patient in the best direction for what they have requested – regardless of their personal comfort level.

Someone with a facial deformity like Auggie from “Wonder,” might get stared at because he looks “different” just because he was born with a genetic deformity. No one chooses how they look, so why should Auggie get judged because of how he looks? His classmates and people who saw him assumed that he was weird or had a contagious disease. Many people stared at him or drew attention to the fact that he looked different. Most of his classmates stared just because they were curious, but others spread the hateful rumor that touching him gave people the plague. His best friend, Jack Will, said that in the beginning he was only nice to him because the principal asked him to give Auggie a tour of the school and then Jack Will felt responsible for him.

Depending on the tone of the comment or question or the expression on someone’s face when they stare, it can make a person feel small and self-conscious for standing out or it can make them feel ... just plain different. A similar example is getting mocked for having glasses or braces. Being called “four-eyes” or “metal mouth” is not the greatest feeling so imagine what people like Auggie go through. Pope Francis touches on this when he says in his encyclical, “We were conceived in the heart of God, and for this reason each of us is the result of a thought of God. Each of us is willed, each of us is loved, each of us is necessary,” (paragraph 65).

Father Boyle writes of a time he walked into a church that was filled with homeless people and it smelled rank. He had to keep his composure, while other people were talking about how bad it smelled. The people who were living there knew what it smelled like and they probably felt awful for not being clean, but Fr. Boyle not commenting and acting completely normal maintained their dignity the way a nurse must do their very best to maintain every patient’s dignity. One of the people with Fr. Boyle commented that it “used” to be a church, and Boyle responded that many would say it is “finally” a church (Boyle 72-73).

As a nurse, especially early nursing such as in the clinical setting, students often walk into a patient’s odor-filled room are tasked to not react. Sometimes people come in for medical attention for pain or illness that make them neglect their personal hygiene. Nurses must make sure to get all the information from the patient, and if that patient thinks that they are being judged because they smell badly, they may become defensive and not tell the nurse what he or she needs to know. Often patients need help showering and going to the bathroom. These patients can be very aware of the fact that they need help doing personal things that they used to be able to do for themselves. Nurses need to not only mask their expressions and try to get through the moment, they need to make sure while doing that, they maintain the patient’s dignity. Pope Francis states, “Christian thought sees human beings as possessing a particular dignity above other creatures; it thus inculcates esteem for each person and respect for others. Our openness to others, each of whom is a “thou” capable of knowing, loving and entering into dialogue, remains the source of our nobility as human persons,” (Paragraph 119).

Throughout his book, Father Boyle wrote about the “homies” and how they have tattoos all over their bodies, and they do not have many clothes so they might be ripped or smell or ill-fitting, and people may make assumptions about them. They might assume that tattoos and a rugged appearance automatically mean they are hateful and dangerous people. These people often have very little information about those upon white they are casting judgement, perhaps only their physical appearance and the way they talk. Boyle discusses how the “homies” were raised, or more accurately how they raised themselves, and had to grow up way too fast and were forced to join a gang as a means of survival. He talks about their vernacular which to some people signals that they are uneducated which makes many people assume they are not trustworthy and not deserving of respect.

Nurses, depending on their concentration or specialty, may have to treat people for injuries and illnesses that may or may not be due to illegal activities. These patients may be in gangs like Father Boyle’s “homies”, but as he mentioned they may have just been in the wrong place at the wrong time and gotten injured or killed. They may have gotten in a fight and gotten injured, but as a nurse, it does not matter how a person got sick or injured. What matters is making the patient comfortable and helping them get better. Nurses may have to treat people in gangs, prisoners, people who cause accidents, maybe even the perpetrator of a terrorist attack. It does not matter who the patient is, because they are all to be treated with the same care and dignity. Pope Francis states, “Any technical solution which science claims to offer will be powerless to solve the serious problems of our world if humanity loses its compass, if we lose sight of the great motivations which make it possible for us to live in harmony, to make sacrifices and to treat others well.” Nurses might have to sacrifice their own comfort to treat someone that may not be seen to others as deserving of good treatment.

Pope Francis and the other authors of the encyclical discuss caring for the world and for each other as being of key importance to the common good. The book “Catholicism” reviewed some of the times the Catholic Church failed to do that. The research surrounding the Avignon papacy tells about some of the more troubling things the church did because no one, not even the church, is perfect. But as both Father Boyle and Auggie’s Principal Mr. Tushman (aka Jason Guidean) mentioned, perhaps instead of changing how we look and act to fit others’ expectations and instead of forcing others to do the same to fit ours, maybe we should try changing how we see. If we change the way we see the world, maybe more people would feel welcome and happy to be a part of it. Perhaps people would get along better if all the hatred, judgment, ridicule, and social hierarchy was left at the door.

As a future nurse, I need to always make sure I make my patients feel comfortable, welcome, and calm. I need to demonstrate that I am not judging anything about them or their lives. I need to gain their trust so that I can give them the best care possible. People have made assumptions about me and sometimes they are harmless, but sometimes they are hurtful. I have been bullied, mistreated, used, and left behind by people I thought were friends my whole life so I know how it feels. I hope that my past experiences, content from this class, and my nursing classes will help me to become more and more aware of my reactions and how they impact the care that I am giving to the patients entrusted to me.

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Caelyn McGowan
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