Unpacking the wisdom of the Gritty Nurses

Talking about mental health challenges and bullying in the workplace isn’t always easy. But registered nurses Amie Archibald-Varley and Sara Fung are using their platforms as authors and podcast hosts to make sure those stories are heard. 

Their new book, The Wisdom of Nursing: Stories of Grit from the Front Lines, sheds light on the importance of nurses in the health-care system and the challenges they face on a daily basis.  

Archibald-Varley said that while she and Fung were nervous about “talking so viscerally about our own mental health struggles,” they wanted to write the book “to let other people know that they were not alone.” 

Archibald-Varley and Fung spoke to White Coat, Black Art host Dr. Brian Goldman about their shift from practicing nurses to advocates for health-care providers. Here is part of their conversation.

What have your experiences been as racialized nurses? 

Amie: I think that my experience is probably very similar to other folks’ experience that are racialized. Unfortunately, one of the things that we don’t talk enough about is racism within nursing, racism within our health-care system.

And I wouldn’t say that all of my experiences have been drowned out by some of these types of things. But it has coloured the way that I interact, particularly with patients. 

We just need to do a better job of understanding what these things are and what they look like within our health-care walls and actually deal with them and combat them.

Sara: I think there are a lot of stereotypes when it comes to treating people that are of a certain ethnicity or race. And one of the things is treating pain. So I think that racialized patients, often their pain isn’t taken seriously or there are perceptions on how certain groups express their pain.

Sometimes if people aren’t as vocal, then they don’t get the attention that they deserve and that’s an issue, too.

Sara, can you give an example of that? 

Sara: I’ve had several patients that are of Asian descent, like myself. And when I would ask them, “Can you tell me what your pain is from one to 10?” they would say “It’s an eight or a nine.”

And then when I would go and I would ask the primary care provider, “Could you give this person stronger pain medication?” They would say, “Oh, well, they don’t look like they’re in pain.” And I said, “But it’s not about how they look, right?” 

We need to trust patients and treat pain the way they say it is. Pain is what the patient says it is. And it doesn’t matter if they’re not vocalizing their pain or they’re not presenting a certain way.

Can you tell me about what was going on for both of you at the same time that helped you connect? 

Amie: Sara was the first person who recruited me in a previous role, where I was a labour and delivery nurse but then moved into leadership. But then the second role, I recruited her.

We both had children that were similarly aged. But then we further bonded over the fact that there were some mental health challenges, particularly bullying.

There were just no supports. You would think that in health care that we would have better supports for mental health and people would be more understanding, but we found that that was the complete opposite.

I remember just saying to Sara, “Hey, nobody listened to us. Why don’t we just create our own table?” 

You talked about being bullied. Can you say a little bit more about that? 

Amie: I might just discuss, “Hey, this was what we discussed previously in this meeting.” And then the [meeting] leader might have been like, “No, we’ve never had that conversation.” And it would make me look like I was crazy. 

Or it would go to situations where I was actually being yelled at and demeaned in front of my peers and colleagues, to which colleagues would turn to me and say … “Are you OK? Like, that was really unprofessional. I don’t know why this individual is treating you this way.”

It got so bad to the point where I would hear this one individual coming down the hall and I would be terrified. I’d turn off the light in my office. I actually would hide underneath my desk to avoid this individual. And obviously it got to a point where it was untenable and it was unsafe for me to be there. 

Sara, you were having experiences of your own. Can you talk about those? 

Sara: Yeah, in a different organization, I actually started in a role and the person that held that role previously was still on the team. So I thought, this is a perfect situation because they’re still on the team, they can tell me everything I need to know, they can introduce me to everyone. 

Well, it turned out the exact opposite happened, where this person seemed bent on making sure that I did not succeed … and this person would purposely not give me information I needed to do the job. So, when people say that poor teamwork leads to poor outcomes, that’s a perfect example.

They would cut down my suggestions in front of a large group of people. They would purposely make comments about my physical appearance, which made me very uncomfortable. I remember going to my office one day and just locking the door and crying because I didn’t know what to do and I didn’t have anybody to talk to. 

So it wasn’t really until Amie came along that I felt like I had someone to talk to that understood what I was going through. 

What made both of you pivot from actively nursing to advocating for nurses and helping them tell their stories?

Sara: I think that I just realized that there was so much fear and silencing in nursing that we would always have these, what I call, break room conversations – where we would vent to each other, but nothing was ever done about it. And we were not speaking to the right people … We were preaching to the choir. 

And what really shifted for me was I realized that we needed to talk to more people and we needed to have a bigger platform. And so advocacy, the podcast, writing the book is a way to reach more people and keep this conversation going and eventually switch the mindset of more people. And I think just having power in numbers, having more people hear a story, more people know they’re not alone and know there is something that can be done is really empowering.

We can’t have this conversation without talking about the fact that more nurses are leaving the profession or thinking about leaving the profession than ever before, young and old. Why is this happening?

Amie: I think this again speaks to the fact of nursing being silenced as a profession. And we’ve been sounding the alarm bell for many, many years.

We saw the crippling effects of COVID-19 on the workforce through burnout, through mental health distress, through moral injury where nurses were just saying, “You know what, I’ve had enough.”

Organizations and governments have not put their money where their mouth is in relation to nursing retention.

What do you think the system needs to provide so that we retain nurses?

Sara: I think the first thing is very simple. Listen to what nurses have to say. This toolkit … was created with an incredible amount of input from a wide variety of nurses at all different levels, all different practice settings. It is a playbook for how we can bring nurses back to the profession and retain the ones that are still here. 

Amie: Yeah, so almost taking it one step further. So not just listening, but acting, right? I think there’s one thing to say, “Oh, we hear you.” But another thing to actually enact and make policy changes that will actually empower and bring nurses back to the bedside. 

Radio story produced by Jennifer Warren. Edited for length and clarity.