musical directions for a nurse.

Nursing, like music, is a science best served as art.
But unlike musicians, we often loose our way. We are not very good at finding our voice, or for that matter, in providing direction to our nursing kin on the subtitles of timbre and pace that flux and dance across our shift.

Is it any wonder that some wards end up resonating with dissonance and disharmony?
Lets have a look at some of the  notations used to guide the musicians through their own score and transpose them into out own profession.

Anima Soul
Appassionato Passionately
Oh gosh, don’t just be a 9-5 nurse. Be a Beethoven. Be a Bono. Be a Miles Davis.
Look at what you have. Nursing can move and lift and heal. How many other professions can make the sort of differences to people that ours can. You know what I mean. Find your instrument and find your muse.
Nurse with bravura.
Bravura (With) boldness and spirit

Colla voce (lit. with the voice.) To follow the solo instrument or voice
There are times when you will have your own solos, and there are times when you must follow others. Whether it be senior staff, doctors, hospital policy, or patients wishes.
Appreciate the talents of your fellow musicians. Learn when to listen, and when to provide an expert accompaniment to the voice.

Dolore Grief, sorrow
Managing grief whether it be a patients or your own, is yet another skill you will need to play the piece well.  The secret is, that it is no skill at all. As long as you are authentic the right music will come. And in its own time, the grief will fade.

Duo A duet
Dont forget to buddy. Two of you is far more powerful than one of you. Drawing up drugs, debriefing, planning care, performing interventions. Always look for the duet.

Legato . Smooth
Lento Slow
Smooth and slow, some of the best direction you will get. Even when the situation calls for rapid, urgent response the trick is to stay in the music. Smooth and slow will ultimately be much quicker and far more effective than hurried and rough.
The ability to remain focused and calm as others around you blow up in an uncontrolled crescendo, is one of the hallmarks of a great nurse. It is a skill like any other. And with practice it will improve. That’s what separates a great musician from a hack. Practice, practice, practice.

Lontano As from a distance
There is time for getting in real close, squeezing the juice out of every note. Pressing your cheek against the ink of the staves.  But there are also times when it is important to maintain a little professional distancing from your work.  There are instances when the best thing you can do for your patient is to remain off stage. Dont get caught up in their drama, even when its particularly…er…dramatic. By keeping some internal perspective, the correct course of action will be far more evident.
Of course, there are times when you need to maintain a very physical distance from the music. The orchestra can be a dangerous place. Exit stage left.

Lunga pausa A long pause
Perhaps one of the most powerful communication techniques there are. When talking to your patients or taking a history make sure you give them space to tell you what they want to say as well as what you want to hear.
If a patient is trying to tell you something important, or if your own gut feeling is that there is something else going on that for whatever reason has remained unspoken, wait till they have finished speaking and then leave a long attentive pause. If they don’t speak, remain with it. Just wait quietly.
Alternatively, ask them if there is anything else they need to say and then pause at the end of their reply.
Often this space will open a much deeper level of conversation, cutting through to the important stuff.
Its not easy to do, and shouldn’t be used all the time, but just as in a piece of music: the space between the notes can sometimes be more important than the notes themselves

Misterioso Mysterious
There are great mysteries within the hospital. They run quiet counterpoint, often far below the dense chords of science and technology that pulls at our attention with all its sharps and flats.
Being open to this mystery is an important part of the art of nursing. Listen carefully.

Obbligato Indispensable, cannot be omitted
There are things that you must do or must know that are indispensable. Know them and do them.

Prestissimo As fast as possible
This is the way you are going to have to eat your meals, ’cause there are twenty other things you need to be doing.
This is the way you are going to have to empty your maxed-out bladder, ’cause there are five patients all wanting a bedpan….now.
It has always been this way. It always will be.

Scherzando Playful

1. Nurse soft. Play hard.
2. Swap densities as required.

Senza Sordini Without mutes
Now, more than any other time in its history, nursing needs a voice. Speak up. Step up onto the rostrum and conduct.
Find your own drum and do not be afraid to hit it loudly with a big mallet if a strong beat is what is required.  Gather your best players and go out into the world and show them your art.

Troppo . . Too much
Going Troppo is a real risk for nurses who fail to care for their instruments.  You need to look after yourself and find your own balance point. Just like the strings of a violin, if the tension is too loose, everything sags, your work becomes sloppy. And it quikly effects the strings around you. But if you wind yourself too tighly, your sound becomes harsh and sctatchy, and at a very real risk of breaking.

Volti subito (v.s.) Turn the page quickly
You can never play the same sheet of music exactly the same twice. So, play the phrase and then move on. There is probably going to be something even more interesting just over the page.

[ photo credit: jrossol ]