The Nurse Lessons: Traits of the Exceptional Performers

On June 6, I had a successful heart-valve-replacement surgery at Cleveland Clinic in South Florida. I was discharged after 8 days. 3 days later I went back in for another 3 days to treat a phlebitis in my lower right arm, caused by an a-line stick gone wrong during my initial stay.

A month has passed. I have recovered very nicely from both the surgery and the phlebitis, and I am filled with gratitude.

As someone who has never had a surgery before, here’s what stands out as I reflect on the experience: I was taken care of by over 100 nurses during these 2 weeks. The shift nurses that rotated in and out of my room. The nurses that manned the hall stations. The techs that supported the nurses. The nurses that showed up at 5 am to do labs. The floating nurses who were there to trouble-shoot for a more junior nurse.

I am perpetually intrigued about what makes for exceptional job performance: Anywhere. All of these nurses, I am certain, share a comparable baseline of nurse training. They all possess the same essential nursing skills. Many of them did a superb job. Yet some truly stood out. One or two did not.

"It is not enough to be compassionate – you must act.” - The Dalai Lama

What are the hallmarks of the exceptional performer? What are the factors and traits that make the biggest difference between doing a “good” and doing a “great” job?

I am writing about nurses but these observations, of course, apply to pretty much any professional in any profession. They apply to you and me.

A bit of context: I am what nurses call a “tough stick.” The veins in my arms are weak and useless for blood draws or any sort of sticks. I have for decades now had my blood drawn from my hands or veins just above my wrists.

In a hospital room where lines run into your body 24/7 and blood is drawn daily, I am the sort of patient where you better know what you’re doing. I’m a tough customer.

Encounter after encounter, as one nurse after another floated in and out my room to do their job and perform their tasks, here is what I noticed about the great ones.

Traits of the Exceptional Performers

Possess Superior Skills

That means you’re not afraid of a “tough stick.” You don’t flinch when I tell you that you can’t draw from my arms. You have drawn from every imaginable vein before. You know how to get this done. You’ve got this.

This is where experience comes into play. Experience with every potential professional circumstance. The embodied knowledge and skill that come with years of practice.

Well-honed, earned experience is a beautiful thing. In acting we call this “having a range.” Exceptional nurses have range.

Inspire confidence

Confidence is not an easy quality to describe. Hopefully you are fully confident in your ability to perform the tasks at hand – but how is this confidence conveyed to me, the recipient of your service? How do I know that I can trust you and safely put myself in your hands?

You perform a task matter-of-factly, without hesitation. You make what you do look like second-nature. Like a well-trained athlete, you perform with impeccable muscle memory. And while you make second-by-second decisions about what to do and what not to do, your thinking process is invisible to me.

You just do what you do. You don’t second-guess yourself. If you have a moment of doubt and uncertainty, this moment is yours and yours alone. All I see as I witness you is ease. A lack of undue effort.

You are comfortable in your own skin. THAT inspires confidence.

Solve problems

When you’re not up to performing a specific task, you acknowledge it. Quickly. Don’t fumble, don’t fall apart. Get help, immediately. It leaves you off the hook. It comforts me. And it makes the individual who comes in to help you feel good.

Exhibit A: When my surgeon came in and told nurse M, my nurse for that particular shift, that she needed to insert another line into my body, I noticed the panic in M’s face. After the surgeon left, M asserted that when I can’t do a stick I won’t do a stick. Well, confidence had just flown out the window. You need to find someone else to do this! I told her and thought to myself, huhmm, I can’t believe I had to explain that to her. M disappeared; 5 hours later I still did not have the new line in my body.

Exhibit B: Nurse V was asked to insert a new line. I explained to her the challenges of finding a good vein in my body. V took a quick look at my veins and said I know who can do this. She reappeared 5 minutes later with T, a phlebotomist. A quick stick. Done.

Be an Exhibit-B-person please, in every facet of your professional life.

Be present

Nurses enter room after room during their 12-hour shifts. Each room, each patient, each circumstance, each health challenge is different. It is so very easy to absorb the energy of the assorted rooms. Couple that with things that may be on your mind from your own life. Thoughts that pre-occupy you. Perhaps weigh you down.

I get it. I had nurses who entered my room a little rushed, a little flustered, a bit distracted. Their mind was clearly on something that had just happened. Their mind was not on my room. This did not serve me.

Switch gears. Transition. Leave the outside outside. Don’t be that person who brings distractions, no matter how minute, into new situations and encounters.

Have habits for being fully present. Clear your mind. Use anchoring techniques, breathing, prayer, whatever works for you. But learn how to clear your mind.

Show up present, please.

Show you care

I learned during my 2 hospital stays that folks express caring in different ways. As I got ready to leave the hospital my first time around, my partner asked so who are the nurses that stood out for you the most? We tossed about a bunch of names and both landed on two male nurses who worked together as a team in the ICU where they took care of me on 2 consecutive days. J was the one who moved around the room and took care of all the physical transactions with me. He struck me as an introvert. J didn’t chat much and moved about with a quiet intensity and keen focus on every task he was performing. This singular focus was the ultimate expression of caring. It was calming. It was powerful.

M came in frequently but tended to stand back by the door. He always inquired how I was doing and reminded me that I could call on him at any time if I needed help. M provided what we jokingly called the concierge service. I truly felt that M would, and could, take care of absolutely anything.

Potent stuff.

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Nurses are sometimes described in mystical terms. Hailed as “the angels” who show up to take care of us.

I get it now.

When we lie in a hospital bed, hooked up to machines and fueled by tubes that run into our bodies, it is easy to feel helpless. We are truly at the mercy of others.

My emotional low-point came when Nurse M had disappeared and not come back, and more importantly, the new infusion that my surgeon had ordered was, hours later, not in my body.

That is when Nurse D entered the room. I had never seen D before. D had likely shown up because my very persuasive partner had had a conversation with the nursing staff at the hall counter.

D had a big beaming smile on her face, a smile of kindness. She was a nurse of a certain age, with spunky, spikey grey hair. D exuded an earthy benevolence. I like to use the phrase “the light was on” to describe folks who are lit up from within. Folks who seem to have a connection to spirit and the divine.

D’s light was on.

I explained my situation. I help the nurses who are newer and need a little bit of support, D said without any trace of ego. I float around from floor to floor.

Then she took my hand, did a stick, put in the line.

Please call me anytime, D said, and disappeared.

I found myself getting emotional. She is the angel who showed up today, I said to my partner. The light was on. And we all get to be that angel, any time.

Related: In Praise of Impeccable Training