TL;DR Yes. A nurse should speak up in the room, out loud, before the plan hardens. I was five, at Dana-Farber, and everybody assumed I’d need sedation for my radiation mask. My oncology nurse said she thought I could hold still. She was right, and she held my hand the whole time. Nobody else in that room knew me well enough to say it.
I was five years old, at Dana-Farber, and they had to make the mask that holds your head still for radiation. It’s warm plastic. They mold it to your face and fasten it down to the table. Everyone assumed I would be sedated for it, and that was a fair thing to assume. I was five.
My oncology nurse said she thought I could hold still.
She had been with me every day for months — through the nausea, the pain, the dizziness — and she knew something about me that was not on any chart. So she said it out loud, in a room full of people who had already decided. Then she held my hand the entire time.
I held still.
Her hand was saying something the whole time she was holding mine. You are safe. You can do this. I am right here.
I do not know her name. I never did. Thirty years later I can still feel her hand.
I’ve spent the last ten years as a healthcare keynote speaker. Somebody says, “Please welcome Kelsey Tainsh,” and I walk out and tell a room full of nurses a story about a nurse. This is the one they go quiet for.
I was terrified that morning. I had no idea I could do what she said I could do. She believed it before I did, and I borrowed it from her until it was mine.
Sometimes we have to lean into other people’s belief in us until we are able to believe in ourselves.
— I’m Not Limping. That’s Swagger!, Chapter 4
That is what speaking up really is. You are not correcting anybody, you are handing them something they do not have yet. You do it out loud, while the plan is still soft. And then you stay for it.
What to do when you’re the one who knows
- Say the specific thing you know about your patient, out loud, in the room.
- Say it early, before the plan is hard to move.
- Then stay for it. You vouched for them, so be there.
She thought I could hold still. So I held still.
There’s a lot more of this in my book, I’m Not Limping. That’s Swagger! Chapter 8 is mostly me trying to thank people whose names I never got. And if you’re planning a nurses week event, or a conference where the room needs to hear what this work looks like from the table, that conversation is the best part of my year as a healthcare keynote speaker.
Book: https://kelseytainsh.com/kelseys-book/ · Speaking: https://kelseytainsh.com/nursing/
Things nurses ask me after the keynote
How do I speak up when the doctor has already made the call?
Lead with what you know, not what you object to. My nurse at Dana-Farber never said sedating a five-year-old was the wrong call. She said she thought I could hold still, which was a fact about me that she had and nobody else in that room did. It is a lot harder for a room to wave off something you actually saw.
Do patients really remember which nurse it was, or do we all blur together?
I’ll be honest with you. I don’t know her name and I never did. But I found out years later that it was my nurses who made sure my head wasn’t shaved for my second surgery, because I’d told a doctor once that losing my hair scared me most. I couldn’t pick them out of a lineup. I have never forgotten a thing they did.
My unit says speak up and then makes you regret it. What do I do with that?
I’m not going to stand on a stage and pretend I can fix your unit in forty minutes. I can’t, and anybody who says otherwise is selling something. Speaking up is cheap to ask for and expensive to do. If it costs you every time, that is a design problem sitting above you and not a courage problem in you. Say the small things where you can.
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