Notes on Nursing: Learning From a Noble Expert

I’m not sure anyone intentionally becomes an expert in their field or chosen vocation, but we likely all know when we’ve been in the presence of such an individual. In my experience, it is “noble experts” who make the best teachers. These experts don’t necessarily sit on a throne, but rather, they stay in the trenches and consistently perform their work with humility and compassion. Along the way, they demonstrate, explain, and guide their colleagues through quiet participation, or, more actively, through championing foundational truths and moral endeavors and mentoring and leading others. Their influence extends beyond the workplace into both their own lives and the lives of others, and often into history. 

What is so attractive and awe-inspiring about such individuals? Why do they leave behind impressions that we often recall after being with them? Noble experts need not be our colleagues or peers. Some of the people I hold in the highest esteem are not people I have personally worked with, and in some cases, they are people I will never meet—Florence Nightingale, for example. The noble experts in my life influenced me personally as well as professionally as an oncology nurse. In this blog, I’m remembering The James River Clinic. 

I began work in the field of oncology nursing in 1989 in a “mom and pop” private practice group—the James River Clinic. Owned by three medical oncologists, the practice employed four other nurses besides myself. We all found our way in delivering outpatient chemotherapy treatments, as the specialty was young, and the nursing team largely novice. Under the attentive guidance of those three oncologists, and later two more, our nursing team slowly honed their expertise. The providers’ investment in our development was not meant to make us doctors, but to develop us as oncology nurses. They taught us the medical side of cancer care and related treatments. They shared their knowledge in every interaction, never belittling or reproaching us when repetition was needed. They recognized that by investing in us, the practice’s brand was taking root in the communities we served—we became experts together. 

Symptom management, therapy selection, disease progression, image interpretation, and the principles of hospice care were the basis of many teaching moments. In those early years, I mastered the critical oncology treatment- and disease-focused patient assessment. I learned to intuitively recognize and act on unexpected outcomes and incorporate the physician’s plan of care into my nursing interventions and decision-making, as we all did. Collaboration was close and mutual. I discovered my niche in patient education and became a champion for nursing specialization as well as safety in the infusion suite.  

Whenever I speak of “the beginning” of my career, I always give kudos to those oncologists at The James River Clinic, who I feel raised me professionally. The collegial relationship between doctors and nurses, each recognizing that no one is an island, continues to be the standard against which I compare my lifelong relationships with other health professionals, as well as those in my personal circle. I’m less fulfilled when I am relegated to a distance from the providers I work with. 

One of the oncologists with whom I worked at the James River Clinic (now Virginia Oncology Associates), John Mattern II, DO, kept a paperweight from the Rotary Club on his desk for years with a simple but profound message: “Of the things we think, say, or do, 1) Is it the truth? 2) Is it fair to all concerned? 3) Will it build good will and better friendships? 4) Will it be beneficial to all concerned?” Personal inquiries, you might say, but I believe such considerations apply to our professional lives, as they support an authentic investment in the potential of others regardless of their role or station. I read these words every day as I came and went from Dr. Mattern's office. These noble intention are commonplace in the nurse-physician relationships I covet to this day. 

Robin Atkins, RN, OCN, is a symptom management triage nurse with Virginia Oncology Associates in Norfolk. She is a self-identified southern Virginian and proud baby boomer. Atkins graduated from Riverside School of Professional Nursing in 1985, where she received her RN, and has worked in outpatient oncology since 1988. She and her husband have two adult children, seven grandchildren, and two cats, Gracie and Annie. She enjoys the serenity of living in the country, RV camping with friends in Virginia’s state parks, and canoeing.

More From Robin's Notes on Nursing Series:

• Staying a Nurse