Our Spotlight series highlights a new nurse from the SHIFT audience each month. We ask the same set of questions each time, but of course, we get all kinds of answers. The individual stories and surprise twists in these conversations make us laugh, cry and feel proud. Over time, we hope to discover both what makes each of you unique and understand what ties all of us together as nurses.
Patrick McMurray is an RN with almost eight years’ experience in nursing. He got his start in cardiovascular, did a stint as a travel nurse, and worked at several different facilities before landing in his current role as a float nurse at an academic medical center in North Carolina’s Triangle region. Pat’s working on his master’s in nursing education, teaches at both a local community college and vocational school, and is a writer to boot. Needless to say, we had a pretty interesting conversation with this self-dubbed scholar-activist-nurse who believes that nursing is an act of justice.
Why did you decide to go into nursing?
My mother is a nurse too, and we actually went to the same nursing school—I mean decades apart [laughs]. But my mom wasn’t the reason I became a nurse, although she certainly was the first person that exposed me to nursing in a major way. I’ve always been interested in the sciences; I love biology, I love the life sciences. But I also love social service, and so from an early age I thought about how to combine these two things. Society told me, ‘You’re a boy, you’re not supposed to be a nurse,’ and I believed that when I was eight. But by the time I turned fifteen or sixteen, I thought ‘Forget that, I’m going to go be a nurse.’ As a profession, it gave me the best balance. It’s equal parts science, it’s also an art form of sorts, and it’s equal parts social service. Nursing divides itself equally among those things, in my opinion, better than a lot of other health professionals.
I like nursing because it allows you to have an immediate impact, and then build on that with progressive accomplishments, versus other pathways where you have to complete a master’s or doctorate before you can really call yourself a clinician or practice independently. In nursing, you can become an RN, then you can go and get a graduate degree; you could take a whole other path and be a CEO, a member of Congress, start your own business or be a research scientist. I saw all these possibilities and thought, ‘Why wouldn’t I go into nursing?’ I knew I would never get bored, and if I got frustrated, I’d have lots of options.
Tell us about a time when it was really hard to be a nurse or a time that made you question being a nurse.
For me the answer is all about the pandemic. But more than the pandemic itself, the world’s response to the pandemic. It really made me question things, because people love to say nurses are angels and nurses are heroes, but when it comes time to stand up for nurses or support nurses by wearing a mask and things like that, you see that not everyone is. You wonder how much those words mean. Sometimes I do wonder if my time and if my effort and energy would have been invested better in another way.
It’s less about the work and more about the way institutions have shown they don’t value nurses. It’s the way the community has shown it doesn’t value nurses. Last year was supposed to be the year of the nurse, but it wound up being about nurses for such different reasons—we got to see how critical nurses are, not just to health care but the fabric of our society. But then there are these really disappointing moments when you see that nurses are being put in these ridiculous circumstances and aren’t being prioritized, aren’t being heard or kept safe. Nurses are tired—and I feel like people haven’t really heard us when we say we’re tired. I can’t even really put into words how disappointing last year was as a nurse. The world showed us what they really think of nurses. We’re heroes, but they also want us to be martyrs. If we put ourselves first, if we don’t sacrifice ourselves for other people, that’s a problem. I do have hope that we can change this, but this past year was a hard reminder of the realities at hand.
Who inspires you?
Definitely my family—my mom and my grandmother are the root of who I am. I always say I was raised by women who know how to breathe fire and that’s molded me into the person I am today.
As far as people outside my family, I’ve been really inspired by a lot of activists this past year and Shirley Raines is one. She started this movement called “Beauty to the streets.” I love her style of activism because she saw a need and she just immediately jumped in and did what she did. I have always said that we need more people who not only can talk the talk but walk the walk. Thinkers are great, but we need people who can be thinkers and doers at the same time. Shirley Raines is a cosmetologist, and she provides haircuts and beauty and makeup to people in her community, on Skid Row, experiencing homelessness. She also helps organize food donations. She doesn’t have this great big organization; she just saw a need and she started fulfilling it. I’ve been really inspired by her and think about how I can translate what I see her doing to my practice of nursing.
My nursing practice is an extension of my activism. Nursing is an act of justice, nursing should be an act of justice. Our activism must extend beyond solely clinical areas. I aspire to have that Shirley Raines grassroots approach where when I see a problem, I do what I can d to address it, even if that doesn’t address everything. I am actively working toward making a difference, even if it seems small to other people in my community. It can grow into something that’s more meaningful, and I think a lot of our effort in nursing moving forward will need to be driven by grassroots efforts, by nurses going out into the community.
Describe your SHIFT BFF. Why are they your best friend on the job?
I have a work best friend; most nurses have a work best friend! I love someone that I can have a good time at work with, but it’s more than that. As far as love languages go, mine is acts of service. So, when someone says, ‘Oh, I gave your meds in this room because I saw you were busy,’ that endears them to me. I love that, and that’s how I try to support other people. I remember one time when me and my work best friend were giving a bath to a burn unit patient. Our patient asked to listen to music. We turned on some 90s R&B and were just rocking out with the patient while we’re giving this bath. These patients have entire body wounds and they’re in a lot of pain. The patient said it was the best bath they’d had because they were able to be distracted by the music, and we were talking and joking. So, I share that because I love someone that I can be relaxed with at work but that can also get the work done, that can help me get the work done. That’s my framework for a work best friend.
Tell us something about your specialty in nursing that other nurses may not know.
With my position in the float pool, I have to keep abreast of a lot of different types of knowledge. I can get pulled onto another unit in the middle of my shift—I’ve been pulled to three different units in a single shift. That requires you to be able to keep up with your work. You never know when you’re going to get pulled, and you can always finish charting somewhere else, but that just creates more work for you. Because you’re now assessing new patients, taking on a new workload and starting new things. This position requires consistency. You have to have a certain way of practicing nursing across different specialties—but it also has to be adaptable and flexible enough for you to be successful and change and pivot as necessary.
I don’t necessarily have prior experience in all these areas. I float across most adult specialties. I need to have a “jack of all trades” mindset and know a lot of different kinds of things. My background is in cardiovascular ICU, so I’m most comfortable on cardiac floors. But I have to float to nephrology floors, to gastrointestinal floors, and others. That keeps me on my toes. If I’m in a situation where I feel like I have a major knowledge gap, after I work that week, I will go and look up some of the concepts, the basics of nursing in that specialty or type of unit. It’s made me a better, more well-rounded nurse, and also a better educator in the way I approach experiences that I’ve had. You have to be a life-long learner as a float nurse. You have to be comfortable asking questions and with being the new person every time you work. That creates a new way to approach life in general because I’m not afraid to go into a situation where I don’t know all the facts and say, ‘How can I help? What can I do?’ The nature of my job is shifting and pivoting. Yes, that was helpful for COVID-19.
Describe your community’s health. What is your hope for your community’s health in the future?
My community is not a monolith. It’s very much a ‘mixed salad’ of people with varying circumstances and needs. We do have homelessness in the Research Triangle area; we also have people who are very well off. We have people who speak English as a second language. There are certainly resources here—but I don’t know if all of those resources are equally accessible to all people. Inequitable access is the biggest thing that drives the poor outcomes that we see. Even things as simple as wearing a mask. When the mask mandate came out, I wondered, ‘Where are people who are homeless supposed to get masks, new and fresh masks?’ And that is what motivated me to start creating these bags of basic necessities for homeless people in my community. Initially I just put hand sanitizer and masks and things like that in the bags. I figured I could go to Dollar Tree and almost endlessly buy those things. Then I asked on Twitter, and people who work with people experiencing homelessness directly told me about other things that were needed. Socks, and even things like condoms, because just because you’re homeless doesn’t mean you’re not sexually active. I was able to create a backpack full of things that people I see every day going around town need.
Community health efforts always have room for improvement. We need to extend who is receiving health services, who is receiving social services, in our community as a whole.
What is your vision for the future of nursing?
The future of nursing is outside of hospitals and clinics, outside the acute care space. We need nurses in the community more than anywhere else right now. Nurses aren’t only clinicians. We need to be out there collaborating with the community to address the problems that we see. It’s going to require all nurses, regardless of whether you have an associate’s degree, a bachelor’s degree, if you’re an LPN—I think we need to see better utilization of nurses and nursing skills outside of acute care.
I would love to see a future where nurses were empowered to work for themselves and be community advocates and organizers. I’ve always said that nursing has been bound and gagged, because nursing hasn’t been given enough space to explore what it could be and how it could exist in the world autonomously. Nursing has been beholden to societal and structural issues. I think of it like a potted plant. A potted plant can only grow so much. Nursing is that potted plant, and it needs to break the pot and be put into the ground so that we can actually flourish. We have not yet been able to fully spread our creative wings.
For a long time, we’ve been so stuck on this traditional model of what a nurse is and how nurses exist in our system. We haven’t been allowed as professionals to explore how we want to forge new features and realities for ourselves. I think we forget that we have autonomy. Not just NPs, but RNs. There’s no reason why I can’t start a clinic. Not a medical clinic, but a nursing community clinic. We wouldn’t make diagnoses and we wouldn’t prescribe things, but we would educate our community. There’s red tape that makes something like that seem impossible, but we have, for example, nurses who are starting health coaching businesses. We don’t need to reinvent the wheel; we already have the skills and knowledge. And we don’t just need nurses with advanced degrees, we need nurses with all degrees. Moving forward, if we’re going to make nursing an act of justice, it’s going to require us to explore the autonomy we have, to demand autonomy in new ways we’ve been denied in the past.
How can nurses be better to each other?
Giving people grace, that’s the biggest thing in nursing. We’re taught to be understanding and to give empathy, but we don’t reflect that back inside of ourselves. We have this culture in nursing that you should sacrifice yourself. That your job is most important. And yes, our jobs are important, but we need to remember that they’re a small part of our lives. I don’t live to work. I work to live. I work so that I can give back to my community, but also to have the things I need to live my life outside of work as well. This idea that taking a mental health day or PTO is going to put your colleagues at risk or create a staffing problem is wrong. This past year we’ve seen that mental health days are more important than ever. You don’t want a nurse who is experiencing some form of trauma or some form of distress to come to work. I think that we need to end the idea that everyone has to suffer like others did in the past, or everyone has to have taken the same path, or the same steps that others did to get to the same location, because we all know that that’s not the case.
People come from different backgrounds. There are a lot of systemic barriers that impact people. Nurses live in drastically different situations and have different personal circumstances and motivations. So, we achieve things in different ways, and we need to reinforce the idea that it’s ok for us to take different paths, even when it comes down to what degree brings us into nursing. I was an associate’s degree prepared nurse initially, and I’m a big advocate for people entering nurse via the associate’s degree or the LPN pathway. The way you start is not the most important thing. Your work is important. You are important. The biggest hope I have for nursing is just that we give ourselves the same grace that we’re taught to give others.
Describe one of your best shifts ever.
One of the things I love is giving patients baths. I had this great day on the med-surg unit, which is typically where you take a higher load of patients, when I only had three patients the entire shift. One of them really wanted a bath. Her family hadn’t been there in a while and she felt dirty. We turned on some music and one of our CNAs come to the room and soaked and untangled her hair and braided it. We had all these things that smelled good, and we were just doing it up. We got her clean and she looked like a brand-new person. We spent an hour and a half, which normally you don’t have time for, but after that, she was just full of vigor and her view of herself changed. We straightened up the room and opened the windows to let the sunlight in, and it was so nice. She said she felt better, and the bath was more healing than all the medications and other treatments she got. I love nursing because nurses make people feel like they’re human again. I want to make people feel human and I want to make them feel seen. That’s as much a part of my job as it is to make sure their blood pressure is controlled or that their heart rate is in the right range. If we could give this type of nursing care, every day, I think we’d see a lot more people stay in bedside nursing.