In Celebration of Nurses

In celebration of Nurses’ Week, DxR Development is profiling nurses who exemplify the qualities that make nurses among the most trusted professionals in society. In times like these, we need their wisdom and insight.

“Never stop learning.” It’s a foundational statement for Sue Erlewine’s professional nursing career, her focus as a nursing instructor, and her personal philosophy. Erlewine (MSN, RN-BC) is a hospice and palliative care nurse by training, an adjunct nursing instructor at Ohio University, and a chaplain at O’Bleness Hospital in Athens, Ohio. She’s also a DxR Nursing SELECT case study author.

Erlewine’s interest in nursing was sparked by her mother. “When I was little she bought me a series of books called Cherry Ames. It was sort of like Nancy Drew, but for nurses. It starts out with Cherry Ames, Student Nurse then Cherry Ames, Senior Nurse…I had about 15 or 16 books. Then, after I got married, my husband wanted to start his own business. I already had two kids and [we] were in a little town, and there was a community college. I thought, ‘I could get an LPN degree in eleven months.’ So I did that and I fell in love with nursing.”

Curiosity

Erlewine’s motivation was a common one. “Partially, I wanted to help people. That’s what all nurses start with, ‘I want to help someone.’ But also, I think, I was really curious about people and really curious about science, about learning. All those things came together.”

After Erlewine completed her BSN, a friend urged her to accept an opportunity to teach clinical experiences at Hocking College in Ohio. A good experience with beginning nursing students inspired Erlewine’s nursing education career. “I had the first-quarter students, so they were just completely new, completely wanted to be nurses, they weren’t jaded, you know. It was just really fun and it sort of grew out of that.”

For Erlewine, the same inquisitive spirit that drove her pursuit of excellence in the nursing profession also kept her motivated as an instructor. “I know it’s easy for nurses to get jaded, for nursing educators to just ‘Oh, those students..whatever,’ but NOT to focus on that but to focus on those who you can really help and those who really want to learn.”

Critical Thinking

While much of nursing practice and nursing education is based on established science, the COVID-19 pandemic has demonstrated the value of flexibility, in thinking and practice. Erlewine says flexibility is one of the hallmarks of great nurses and educators. “I think critical thinking is taking in all the new information and then starting to discard that [information] that hasn’t been working, and not holding on to old information just because you’re used to it or because it is comfortable or because so-and-so that you really admire said it.”

For nine years, Erlewine served on the National Board of Certification of Hospice and Palliative Nurses. In that role, she wrote questions for certification exams, based on the latest and best science. She says staying up-to-date is a crucial part of being an expert nurse or nursing instructor. “You always have change in the medical field and even though you are teaching the same sort of student (first or second year), you still had to adjust your class to what was new and what was happening in the world of medicine.”

Compassion and COVID-19

While Erlewine still loves the science of nursing and medicine, she’s equally enthusiastic about the element of ‘compassion’ in nursing practice. In practice, these values took form in her work as a hospice and palliative care nurse in helping patients who are at the end of life.

While working on her master’s degree, Erlewine began finding ways to incorporate her experience as a hospice and palliative nurse into her teaching. She authored a DxR Nursing case study dealing with a patient who receives palliative and hospice care. “Beginning nursing students often start in nursing homes and [end of life] is…prevalent. So we actually can talk a lot about it. And even in my classes, even though there was not a specific class at [the schools where I taught] for nurses on death and dying, it is sort of in every nursing specialty, so I could talk about it.”

Erlewine says the COVID-19 pandemic challenges nurses to find new ways to demonstrate compassion to patients while also maintaining safety. “How can we be caring and reassuring presence to the patients when we can’t be physically close to them and we can’t touch them? Some nurses are painting smiles on their masks. One I really love is putting pictures of themselves on their gowns, writing notes. Some rooms have glass sliding doors and [nurses are] writing notes on the glass, just poking your head in and waving. Even to hold someone’s hand with gloves on.”

Caregiving as a Chaplain

Erlewine’s experience as a hospice and palliative care nurse and nursing instructor helped prepare her for her current roles. She teaches a course on spirituality in healthcare and is a hospital chaplain. She says providing ‘spiritual care’ isn’t based in a particular religion, but involves some of the same skills that she developed in nursing practice. “There is a real spiritual component when a person is very sick, and they are lonely and they’re frightened. So to talk about spirituality as not a religious practice but as a ‘being present’ for that person.”

Erlewine says that kind of care isn’t for the patient alone. “I remember standing for a couple hours with a man who didn’t really want anything except for me to stand there with him while his wife was being coded. They worked on her for a long time. But he didn’t want to talk, he didn’t want to do anything, he just wanted me to be there. The next day when I saw him he said it meant a lot to him that I just didn’t leave him alone. Those kinds of things are spiritual, but not religious, and that’s what a nurse and chaplain can do.”

With the COVID-19 pandemic, there’s increasing evidence that healthcare providers, including nurses, need help coping, as well. “Nursing managers can be really creative with setting up the conference rooms, potlucks, debriefings at the end of shifts, and using the EAP (employee assistance program), bringing in chaplains, other people so that the nursing staff actually sees them. There are ways to support each other through this, and to note those warning signs when a person is starting to burn out or have depression. Being aware of those non-medical means. I would hope there would be more time spent in classes teaching nurses [at all levels] how to do this for your staff. Then do it for yourself, too. Because that’s something we forget, to do it for ourselves.”