Beyond the Scrubs: What I Didn’t Learn in Nursing School

• A nurse with a nearly 20-year career shares what she wished she would have learned in nursing school. 
• From the concept of a break nurse to being able to establish boundaries and speak up for yourself, she breaks down several lessons from her time in the industry. 
• Embarking on a nursing career is like signing up for a rollercoaster you can’t see – thrilling, unpredictable, and the ride of a lifetime.

I have been a nurse for 18 years. As someone who’s zigzagged through nearly every corner of nursing – from the medical/surgical hustle, ICU, Endoscopy, home health, Tele, and Outpatient surgery to the adrenaline-pumping ER and a curtain call in the transfer center – I’ve packed 18 years of caffeine-fueled shifts into a suitcase of wisdom. Now, as I tiptoe into the world of coaching and writing, let me share some knowledge I wish was part of my nursing school’s curriculum (or even in place of that oh-so-helpful CPI class).  

The Myth of Lunch Breaks

Remember those leisurely lunch breaks you dreamed about? Nursing is like a relationship where you give 110%, and your partner (a.k.a. your shift) forgets you need to eat. The thing is, it does not have to be this way.  

It was not until in my last years of nursing that I knew of this thing called a break nurse. Yes, there are nurses on staff who relieve other nurses and take care of their patients so they can rest. You are given two, 30-minute breaks and one, 15-minute break. Reflecting, I wish I had taken up for myself when I worked as a nurse in GA versus just allowing for the current situation. You know the drill: working your tail off, expecting someone to do the right thing while building resentment the whole time, so when you say something, it’s likely not practical due to the buildup of resentment.  

Reflecting on Advocacy in the Workplace 

As I think back on the importance of breaks, it becomes clear how vital it is for nurses to advocate for themselves in the workplace. This advocacy is closely tied to setting personal and professional boundaries.  

Boundaries: Boundaries? In nursing? It was like finding a vein in a dehydrated patient — tricky but essential. It was not until the end of my career that I started learning about boundaries. Once I started learning about them in my personal life, I understood the importance of having them at work. I realized that all these years, I had been saying yes to patients (except when a guy wanted me to rub lotion on his testicles), managers, and coworkers, thinking of customer service, and trying to be the superhuman employee.  

Your Worth Isn’t on Your Name Badge: On my journey to understanding boundaries, I learned something even more fundamental — our self-worth. It’s a revelation that every nurse needs to embrace.  

Here’s a secret: your self-worth isn’t stitched into your scrubs. You’re more valuable than the rare commodity of a free hospital parking spot. Remember, they’re lucky to have you! You have a right to speak up for yourself and your patients. You have a right to rest more than 12 hours, and patients still get care; you have a right to speak openly and honestly to your coworkers and management. You have a right to find and experience joy in your career, and you have a right to rest. We are humans, not machines. Patients need us to be like that.  

The Importance of Self-Care: Recognizing our worth is essential, but it’s also just a step toward understanding the crucial role of self-care in our profession.  

In the world of nursing, you’re a superhero in scrubs. But even superheroes need to recharge. Put on your oxygen mask before helping others — and no, I don’t mean literally (we leave those in the storage room). I always felt guilty when I rested at work when I finally got a moment. But I had it all wrong. Our patients need us to feel good; they need us to have something to give; they need us to be present with them and not think about the 30 other tasks we have. 

If you feel guilty about this or someone at work gives you a hard time, pay attention. This discussion of self-care naturally leads us to an important question that every nurse should ponder at some point in their career.  

Why Are You Here? Ask yourself why you chose nursing. If it’s because of your TV crush on Dr. McDreamy, it’s time for a reality check! Ensure your drive isn’t coming from a lifetime subscription to Codependency Monthly. I’m not proud to admit this, but a big part of choosing nursing was my codependency. I needed to help myself, so I projected that onto the world.

“How you do one thing is how you do everything.” That quote has stuck in my mind for years, and I did not fully grasp it until I started seeing how my codependency was ruining not only my relationships but also my ability to have a job I enjoyed. Once I started working on my inner world, my outer world changed. I began to enjoy my job.  

Embracing Personal Growth: Understanding your motivations for becoming a nurse is just the beginning. This profession offers a whole world of personal growth and development.  

Navigating Caregiving and Caretaking: A crucial part of this journey is learning the difference between caregiving and caretaking – an essential distinction in nursing and life.  

Caregiving vs. Caretaking: You can’t force wellness on someone more than you can move a toddler to eat broccoli. Nurture doesn’t smother. Knowing the difference between caretaking and caregiving is crucial not only for nurses but also for life. It’s not your duty to try and undo 40 years of damage someone has done to their body. Remember, observe, don’t absorb. Don’t take on the responsibility or burdens that are not yours to carry.  

Understanding Nursing Culture

Learning to navigate the intricacies of caregiving leads us to another vital aspect of nursing: our profession’s unique culture and dynamics.  

The ‘Eat Their Young’ Culture: Nurses eat their young — a phrase as comforting as a bedpan. Nursing can indeed be like a high school cafeteria at times. Find your tribe, and remember, kindness is contagious — more than the common cold in the flu season. Also, recognize that people often project their behavior onto other people. I can’t tell you how frequently I heard one nurse say, ‘They won’t take reports; they are lazy and don’t want to work.’ I have never had a job as a nurse where I was sitting around, being lazy. I also found that the nurses who said this were usually the ones you would see sitting around… My point is that self-worth and confidence are crucial for surviving in healthcare.  

Finding Positivity Amid Challenges: While understanding and navigating the challenges of nursing culture, it’s essential not to lose sight of the positive impacts we have every day.  

Spotting Silver Linings: It’s easy to get lost in the storm clouds of nursing. Remember to look for the rainbows — like the patients who respond well to the treatment; the ones who lived because you and your team knew the appropriate action to take; the mother who got home to her family; the father whose son is alive because of your attention to detail and fantastic assessment skills; or the day when coffee tastes good from the break room.  

A mistake I made most of my career was being so focused on the negative that I could not even see the impact I was having on hundreds of lives. I was waiting for someone else to give me the validation I needed, but as it turns out, I could have been doing this for myself the whole time. Often, what you seek from others is what you need to create for yourself.

The Bottom Line

Embarking on a nursing career is like signing up for a rollercoaster you can’t see — thrilling, unpredictable, and the ride of a lifetime. Take these lessons, sprinkle them with your own experiences, and remember at the end of the day, your scrubs might be stained, but your spirit can shine brighter than ever! 

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