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“Constant attention by a good nurse may be just as important as a major operation by a surgeon.”

Dag Hammarskjold

Chapter Objectives

Analyze how paradigms affect our perspective on nursing.

Analyze the impact of bullying in academic and practice environments.

Analyze the accountability that deans and administrators in practice environments have in combating bullying.

Define pay it forward (PIF).

Apply the PIF model to nurse educators, point-of-care nurses, and nurse administrators.

Analyze how components of being future-focused can create nursing’s preferred future.

Before beginning this chapter, I would like to emphasize the importance of the content conveyed in the preceding chapters. Every nurse must learn and internalize this knowledge and insight because it provides a wonderful and timely foundation for nursing’s future. Each of us has the obligation to welcome the next generation of nurses into our profession. It is our responsibility to help our new colleagues develop the necessary knowledge, skills, and abilities that will create a strong foundation on which to build their practice and to improve nursing overall. This chapter discusses the obligation that we all have as nurses to leave our profession in better condition than we found it.

The impetus for this chapter came to me while I was doing data analysis for a qualitative research study that three colleagues and I are conducting on the meaning of being a nurse in an intensive care unit in Ha Noi, Vietnam. A prominent theme noted by each of the researchers was the positive relationship between the senior/experienced nurse and the early-career nurse. The early-career nurses acknowledged how much they appreciated the thoughtful guidance they received from the senior/experienced nurses and their head nurse. Because they reported similar positive relationships during their nursing school clinical experiences, they anticipated that this support would continue as they entered the profession.

Throughout the nearly 10 years that I have been the director of the Vietnam Nurse Project (VNP) at the University of San Francisco, School of Nursing and Health Professions, San Francisco, California, I have noticed a trustful and respectful relationship among nurses in Vietnam. This is quite the opposite of the “eating our young” attitude that is sometimes prevalent in U.S. nursing culture. When I shared the “eating our young” concept with my Vietnamese nurse colleagues, they were shocked and could not see any advantage or benefit to this type of behavior. Although I am not naive enough to believe that this type of behavior doesn’t exist in Vietnam, I can say with great confidence that it is not part of their practice when welcoming new nurses into the profession. I believe that nurses in the United States could learn a great deal from their Vietnamese colleagues about caring and compassion among all generations of nurses. Cooperation is so integrated into the Vietnamese nursing culture that every VNP volunteer who has traveled to Vietnam with us has ...

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