Finding Self-Expression in A Profession of Permission

Nursing is a profession of permission.

I had this epiphany when a patient asked me, “Can I have a couple Tylenol for my

headache?” The automated medication dispensing cabinet with a drawer full of Tylenol was in plain sight, but I could not give the pills, because I did not have a doctor’s order. I called her doctor and received the order (permission) to administer it.

Anyone can walk into any drugstore in America, purchase a bottle of the stuff, and eat it at will, but in my nursing role, I cannot administer medication without an order (permission). However, there is a reason for obtaining an order first. If this patient has liver disease or allergies, and I am unaware, calling her doctor for something as simple as Tylenol may prevent a medication error; the safety net of redundancy.

On a bad day, this lack of autonomy is tiresome.

Another example is staff meetings. Someone once told me, “For God so loved the world that He did not send a committee.” I did not fully appreciate the meaning of this statement before working in healthcare. Gathering consensus among nurses is like watching a freighter turned slowly by tugboats in a narrow harbor. It seems to take forever. In my opinion, I have the answer to the problem the nurses are discussing. It’s simple and cost effective, but no, everyone needs to give his or her input and sign off on it first. By the time the change occurs, I’ve mentally moved on.

Even using the bathroom during a shift requires asking another nurse to watch your patients while you’re off the floor. Nurses ask permission to use the restroom.

Nursing is a team activity. It’s the nature of our work. As individuals, we bring our unique experiences and voices to this work. Finding a place for self-expression is vital to our humanity — the wellspring of compassion.