It’s all about the Brown Stuff
Received Date: Oct 10, 2019 / Accepted Date: Oct 17, 2019 / Published Date: Oct 24, 2019
Any experienced hard-working nurse knows what this jargon means in practice. Nurses have long expected that code brown would be an essential part of their job and an experienced practice nurse knows they will be removing all kinds of brown stuff. The task of washing away human being’s excretions is an important part of the job duties. Nurses must realize this is what they signed up for.
Interestingly, I was brought back to this awareness with a recent experience I had in a small rural town in western Virginia. I drove there to pick up reclaimed flooring for my house and I was greeted by a lovely married couple, both nurses. I knew immediately-nurses, as they both looked sleep-deprived from working the night shift. I felt guilty I had disturbed their slumber and I wanted to quickly load the truck and leave so these nurses could return to their much-needed rest.
The couple was both friendly and talkative when I asked how long they had lived in their beautiful rural surroundings. He had been a medic in the military and became a nurse when he had returned to civilian life and she wore a sweatshirt from a college in my hometown where she had coincidentally worked prior to attending nursing school. We spoke about their nursing careers as we loaded flooring into my vehicle. The obliging nurses were adept, conscientious, and unfaltering in their assistance. I knew they were my kind of nurses and I liked them at once.
The gentleman began by telling me about his work in medical-surgical nursing and emphasized how difficult it was to keep new graduates at the small hospital where they worked. His wife talked about the frequency and dangers of opioid addiction she saw as an emergency room nurse in a small rural town. They loved nursing but were concerned that new nurses did not understand that it was really hard work. He talked about his work helping turn patients, lift patients, and other traditional male nurse tasks that were added duties of his job. He was not discouraged about his work duties though – he was more troubled with new nurses who did not want to make a career that included changing diapers, drainage tubing, suctioning, and various collection bags and containers that were all filled with the brown stuff.
I listened intently afraid at first to let them know I was a nurse educator and I waited until the right moment to say, “What do you think nurse educators could do to improve new nursing graduates’ transition into practice?”. He responded with a sizeable list and I didn’t have a pen, paper or a phone signal. I worried that I would forget (something that is occurring more frequent of late). But, what left a lasting impression on me from our conversation, was what he said more than once, “tell nursing students it’s about the brown stuff”.
More than ever, I am worried that I am not adequately preparing nurses for the real world of nursing post-2020. The aging population and a 33% percent retirement of the nursing faculty in the next 3-5 years,  are some of the concerns that I have recently addressed at conferences, writings, and with my colleagues in nursing . I am certain that most of the recent and almost there retirees knew what it meant to take of the care of the brown stuff, but I am not so certain that students enrolled in nursing school will be ready to care for the number of patients and loved ones that will be producing all kinds of brown stuff.
As a young nursing student, I was once told by my very wise nursing leaders and teachers; that you may not love geriatric care, but you better be able to tolerate care for the needs of these patients. It stuck with me. The duty to clean patients and care for basic needs was crucial to my responsibilities as a nurse. I did not try to avoid it or get someone else to do it. I signed up for it as part of my role as a professional and caring nurse. I am not so sure that my current clinical and classroom teaching today adequately portrays the role of the nurse in the physical care of patients. It seems that testing, competition, technology (online), depersonalization, and personal advancement in the field of nursing are winning. The total care of others entrusted to us, not so much.
I worry that my time is running out to pass along all the core beliefs of the value of nursing care to human beings. I think we still have time to make sure this remains essential in our values, beliefs, teachings, curriculums, and institutions in nursing. It really is about caring for the brown stuff and so much more – because the role of the nurse includes the hands-on practice of care to others. Importantly, we will need to continue the discourse of the fundamentals of care in nursing practice while ensuring that those who chose nursing know what they signed up for.
For me, what I recall most about that picturesque fall day was the nurse that reached out to me as a caregiver and teacher – as he walked me to my car door and repeated one last time as I left, “Make sure they know it is about the brown stuff.” And I said I would.
- Fang D, Keston K (2017) Retirements and succession of nursing faculty 2016-2025. Nurs Outlook 65: 633–642.
- McQueen L, Cockroft M, Mullins N (2017) Imogene King’s theory of goal attainment and the millennial nurse: An important mentoring tool for nurse educators. Teaching and Learning in Nursing 2: 1.
Citation: McQueen L (2019) It’s all about the Brown Stuff. J Nurs Care 8: 493.
Copyright: © 2019 McQueen L. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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