As a pediatric intensive care unit (PICU) nurse, I often joke that I am in an occupation and environment that is highly antagonistic to my basic survival as an introvert. I am inundated with people through my 12-hour shifts—critically ill patients, anxious family members, and coworkers with whom I need to coordinate care constantly. Most sounds in an ICU setting are designed to trigger a sense of urgency, and the alarms continue to echo in my head when I get home. Despite the high level of stimulation, I am confident that this profession is where I belong as an introvert. My introversion allows me to bring a quiet, therapeutic presence to my patients and their families in the midst of the ICU chaos. And I have found ways to care for myself so that I can not only survive but thrive as an introvert in this profession.
As an introvert, I have come to recognize that there are three main strengths I bring to my patients and their family members.
I am an astute observer.
To be an effective nurse, I need to get to know complete strangers as well as possible in my shifts so that I can best anticipate and meet their multi-faceted needs to the best of my ability. I can see when a nonverbal child has become anxious when his parent has left the room and wants his door left ajar. I notice when a father is dissatisfied with a doctor’s answer but unsure whether or not to press with more questions. I recognize when a mother is uncomfortable with a medical intervention and needs someone to address her discomfort. My inclination to watch and read people carefully allows me to see and address underlying needs that may not yet have found a voice in this chaotic and intimidating environment.
I ask purposeful questions, and I listen carefully to the responses.
“How are you?” is generally one of the worst questions for me to ask my patients and their family members. It is too broad, and as a result it tends to elicit a broad response such as, “I’m doing okay” or “Hanging in there,” which provides little to no real information. In my practice, it has become increasingly important to me to ask more purposeful questions such as, “What can I do today to help make this situation a little easier for you?” If I am extremely busy in the room with nursing tasks that cannot wait, I make it a point to tell the parents when I will be free to listen to their concerns, or I make it a point to assure them I am still listening to them talk even if I am not able to sit still in the conversation.
I think carefully before speaking.
In a PICU, fear, confusion, and exhaustion run high. Clear communication with patients and their family members is of utmost priority. As an introvert, I am inclined to think through my words before speaking, which helps to minimize miscommunication.
Beyond the hospital walls, my introversion also serves me at home. Understanding the dynamics of my work environment and their effect on me as an introvert has helped me to develop methods of self-care that well work for me.
I set limits at work and at home. I tend to need a mellow day both the day before and after I have worked a 12-hour shift. As much as I am able, I arrange my schedule as such. My husband understands I need him to take on even more proactive interaction with our children when he is home so that I can have more personal space on my “recharge” days.
I make space for quiet time. Nursing is a very social profession, and I am fortunate to work with people who value teamwork and minimize drama. That said, I will sometimes choose to sit alone outside on my breaks or unapologetically minimize chit-chat if I know my social energy level is running low.
I make space for reflection. I thrive on the depth of the issues and the sense of significance in my work, but if I do not have space for reflection to untangle all my thoughts, I become edgy and scattered. I keep my car radio off during my commute to sort out my thoughts and gain a better sense of where I am on an emotional and social level. This allows me to bring a more self-aware and present self to the people I will encounter at my destination—be it at work or home.
Hobbies allow me to further process all of the issues at work. On solitary walks, I will take photographs that encapsulate certain sentiments associated with my patients. Photography allows me to memorialize patients with whom I have otherwise not gained a sense of closure. I write about my experiences in my journal or my blog, of course ensuring protection of patient privacy. Many coworkers have stated that I have been able to express through my writing what they have difficulty articulating to their own friends and family about the very unique challenges, joys, and heartaches a PICU nurse experiences on a regular basis. While I may be quiet in person, my writing has given a strong voice to not only myself but also my fellow nurses, which I find both humbling and empowering.
Lastly, I have learned to be more comfortable with myself as an introverted nurse. I can bring my strengths in the contexts I am comfortable in and offer them to my patients in a way that is both therapeutic for them as well as for me—their introverted nurse.