Forget the flowers… I’d rather be a cactus. Analyzing the flawed system of recognizing nursing skill.

The idea of being recognized for performing a job above the level of the expected competencies is relatively common. In the general business world, it seems as if any Joe Schmoe can sharpen a pencil and end up with an extra framed certificate for the wall and a congratulatory slap on the back.

In the field of nursing there is a serious discrepancy between the expectations of high-level performance and recognition.

The Daisy Awards are the established standard for nurse recognition. These awards are given to nurses who are nominated by someone who witnesses them showing high levels of compassion while performing their job. It’s a beautiful reminder of one of the core necessities of nursing, an accepting and giving heart. With that said, I want to make myself completely clear, this article is not a cut at the Daisy Awards (a pruning?). This article simply points out that there are plenty of other perfectly good vegetation in the nursing field that simply keep getting manure piled on top of them.

Daisy’s are relied on by many healthcare organizations as THE way nurses are recognized for excellence. So, (stay with me here, I get wordy) if a nurse is not recognized for a specific act of compassion, by a person who happens to know about the award, how to nominate someone, has the motivation to follow through with the nomination, and is in a state of mind to write a comprehensive nomination letter… nurses are not recognized.

I work with an exceptional group of nurses. Nurses who have had to fight through bureaucratic crap to simply be able to provide good care. Nurses who have had to frequently fear for their own personal safety and the safety of those around them. Nurses who have been sexually assaulted, physically assaulted, threatened, insulted, and generally not treated like someone who is trying to help you or your loved one deserves to be treated… or any human being for that matter. Nurses who deal with all of that and still come to work with a smile. Nurses who can have a patient scream in their face and then moments later are helping them wash their body before bed. Nurses who have been injured by violent patients and still have a passion for the job. Nurses who deserve to be recognized for the specific skills that they bring to an organization and how those skills better the organization, their specific unit, and patient care/outcomes.

The Daisy Awards were just handed out. The before mentioned nursing staff only had two nurses recognized for two specific incidents of compassion. Two. Two very deserving nurses who show far more skills than only compassion on a regular basis. Two very deserving nurses of an entire staff of nurses who all bring their own amazing strengths to the table.

Contemplate the message that sends to nurses.

I’d like to make the argument that the Daisy Award has its value but it’s time to expand healthcare’s knowledge of botany. I don’t want to be a Daisy. I want to be a Cactus, allow me to explain.

A Cactus is adaptable.

A Cactus has chosen to live in a desert landscape with extremely limited resources. Pushed to physical extremes, a cactus molds itself to its environment in order to best survive the circumstances.

Nurses find themselves working in conditions that are unsafe, unstable, and without the basic resources necessary to provide quality patient care. When a nurse is able to provide good care in that environment, it’s because they have learned to think on their feet, problem-solve under extreme pressure, and make the best of what they have. Adaptability is highly valuable.

A Cactus is protective.

The spines of a cactus can be intimidating to an under-educated observer. Those spines can be misinterpreted as aggressive or an unwillingness to compromise. With further analysis it is easy to discover the true purpose of those spines, protection.

Nurses have to protect their patients from medical complications and medical mistakes. Nurses have to advocate (often times firmly) for what is in the best interest of the patients in their care. Nurses often fight uphill battles to protect their patients, their coworkers, and themselves. The majority of patients will never know how hard their nurse fought for their care. The development and utilization of those spines requires serious levels of intelligence and bravery. Providing protection is highly valuable.

A Cactus is strong.

A cactus is not going to bend to the ground during a storm, it’s going to stand tall and collect water. A cactus is not going to be trampled on by those who are unwilling to accept their presence in their path, it’s going to stand tall and use those spines. A cactus is not going to be picked out of existence for someone’s convenience, it’s going to stand its ground. A cactus will not wither in a drought, it’s ready. A cactus is built to survive.

It requires strength to be treated poorly and continue to work in the best interest of others. Nurses endure cruel patients/families, poor working conditions, witness countless tragedies, and often have to sacrifice their personal needs for the needs of the job. It takes strength to manage this and not wilt under the mounting heat and pressure. Strength is highly valuable.

From a personal standpoint, I have not been awarded a Daisy award. I am one hell of a nurse and I know that. I also am self-aware enough to know that being who I am is not conducive to being compared to a delicate flower. If I were compared to a cactus, all of my coworkers and patients would likely smirk but wholeheartedly agree. I have spines and I have earned them.

Simply put, gardens are vast and varied and that’s what makes them beautiful. A field of daisies takes on a new dimension of beauty when a few pops of color are added to the mix. It’s time that the field of nursing recognize the variety in their garden… even us cacti.

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