The #1 trait of a good nurse

That’s a good question.

Ask most nursing students and they’ll say that it’s the desire to help people. Ask nursing managers and they’ll say that it’s good time management and a commitment to safety. Ask doctors and they’ll say that it’s attention to detail and knowledge of possible complications and side effects of treatments or surgery. Ask patients and they’ll say patience, focus and generosity of spirit.

All of these things are, of course, essential. And all of them miss the one thing that a good nurse needs most—more than a huge bladder, more than titanium feet, more than huge biceps:

A spine.

Nursing is a hard job primarily because the nurse is constantly being pulled between the patient’s needs and the doctor’s needs. Add the fact that we get to coordinate care, and then add the radiology department, food service, the guys from orthopedics, physical and occupational and speech therapy, the patient’s family…and about a zillion more that I’m sure I’ve forgotten. All of those people and services and therapies need to be coordinated in a way that’s best for the patient, while allowing us to do our jobs in an efficient and unhurried (in a perfect world) way.

That’s why you need a spine to be a nurse. Most new nurses don’t come in with spines; they have to grow them as they grow in their profession. As a nurse, you need to be able to put your toes on a line and say “No,” to be able to turn people down, reschedule things or push a recalcitrant MD to take action. That doesn’t mean you need to be combative or difficult to work with. It simply means that you have the guts to make sure that what needs to be done gets done in a timely fashion.

You also need a spine to make sure your patient care is safe and that you’re not getting abused. One of the best things I ever did as a new nurse was simply refuse to care for a patient who’d gotten violent with me, despite the nurse-manager’s insistence that I wasn’t allowed to refuse to take a particular assignment. I grew a spine that day, and it’s been getting stronger ever since.

So: spine. Remember that it takes a good one to have a long career as a nurse. Remember that sometimes it’s really hard to say no, even if that’s the right thing to do in the situation. Remember that being a strong, stubborn, thoughtful nurse doesn’t mean you can’t lean on your coworkers or ask for help. And remember that it’ll grow, whether you’re a new nurse or a nurse in a new situation.

This post originally appeared in The Head Nurse blog.