authentic connection · connection · health care · nursing · partnership · rheumatology · Uncategorized

The Dynamic Partnership of Nursing and Rheumatology

Rheumatology is a complex and all encompassing field of health care that requires health professionals to consider all aspects of the individual when engaging in a therapeutic relationship. When I entered this field I was as green as a Granny Smith apple, I knew nothing about the practice. I have no shame when I admit that I researched the term and the common disease process before I went for my first interview. My nursing education did not include any formal training in this area. I had no idea at that point that I was walking into an opportunity that would provide me such expansive growth, knowledge and the fortunate ability to deeply connect with thousands of patients.

It was a dynamic fit for me right from the start. I realized very quickly that nursing and rheumatology made a great pair. It was the first focused practice of medicine that ignited my passion and created an excitement that catapulted me on an exhilarating journey. I had found a home where I could continue to expand my practice of nursing and in turn utilize all the medical knowledge that I was gaining to improve the lives of many. It was in this space I learned to be a clinician, and found ways of incorporating nursing theory on the front lines with exceptional success.

I began my journey in rheumatology with the foundational understanding that the most critical elements to creating a true health partnership with patients was to first observe and then listen to the individual. These two key elements cannot be overstated and are essential for creating the foundational blocks of a health partnership. These simple actions provide the most valuable information about the health status of each individual and the critical first step to forming authentic connections. For what investigational result written on a page, what study or value could provide such sensitive information into the complex entity of each unique human being? There is no tool more powerful than seeing and hearing the person in front of you and it is imperative when connecting with patients with rheumatic disease.

In rheumatology there are often more questions to be found over answers. The practice of rheumatology aims to identify and distinguish between degenerative, inflammatory and autoimmune diseases in patients who present with a wide-ranged of symptoms that are challenging to categorize, such as pain, fatigue, weakness or some type of disability. Often an individual will have had symptoms or findings that cannot be explained by another medical diagnosis and they end up in the hands of the health professional working in rheumatology. There is often a puzzle to be solved that requires thoughtful, intelligent and committed practice to achieve the objective. For most people they have an idea that rheumatology means dealing with patients who have arthritis, and although this is one aspect I assure you that there is so much more.

The real challenge comes once the disease or cause has been identified and the patient partnership and education begins. This is where the partnership of rheumatology and nursing make a perfect combination. Picture in your mind a 32 year old healthy and active mother of two young children. She was just told she has highly seropositive rheumatoid arthritis, and she is at an increased risk of erosive joint destruction along with other potentially serious/critical systemic complications. If you have no idea what any of that means then you are feeling her experience in that moment. This disease, the risks and the unknown have suddenly become a major factor in her identity. She has only seconds to let it all sink in before she is advised that it is necessary to initiate systemic treatment immediately because there would be a good chance of gaining control of the disease. This is followed quickly by her being asked a serious of questions; Are your vaccinations up to date, have you had testing for tuberculosis, are you planning on having any other children, are you interested in being involved in a research trial?

This patient has about ten minutes to process this, answer all the questions and learn about the disease and the medications. It is intimidating and scary. The only thing that she is actually thinking about is the fact that she went to her doctor because she had a couple of painful and swollen fingers. She is now rationalizing in her mind about the fact that she probably just irritated them when unpacking all those boxes after her move. She doubts this diagnosis and feels she does not need to take medication. She answers the questions being asked though, without truly even hearing them. Her mind is racing and she is trying to recall the name of the disease and the medication that was just mentioned.

The point of creating this picture is to identify that it is in this moment where the essence of the partnership is established, and the potential for a successful health plan is formed. It may seem simple when broken down like this. However I forgot to add in all the background noise influencing the situation. I failed to tell you that the patient’s phone rang three times during the appointment, her young daughter was growing bored and was jumping on and off the seat beside her, eager to leave the exam room. The health practitioner although invested and engaged with the patient was also training a new staff member and was focused on showing him how to appropriately capture the data in the electronic medical record (EMR). If that wasn’t enough to distract everyone, I will throw in the fact that the appointment was well over an hour delayed, it was almost 2pm and the last time anyone in that room had ate was at breakfast. This is a real life scenario. This is the experience on the frontlines in busy, high demand clinics.

Although some of the details were changed slightly this was a direct experience from my practice of nursing. Fortunately it did not include all of those distractions, I work very hard to protect the sacred space of the patient interaction. I have always felt this is a critical nursing role. Together we were able to create a safe space that provided me the opportunity to sense her fear and worry. It took only feeling connection for her to openly reveal all of the emotions and influences she was experience with the situation. Together we were able to identify what she needed to understand and accept her new diagnosis. This is the foundation for the best possible outcomes for all patients. It would not have been possible without identifying that key moment where it was necessary to step away from the checklist and take a minute to connect.

For me rheumatology has been an amazing space where I have been able to actively learn everyday, speak the language of a specialized field, identify trends in patients with certain disease processes and most important commit to the critical role of nursing in this field. Rheumatology has been an endless sea to swim in with abundant possibilities and I have not remotely found any sign of its shore. Most importantly for me, has been identifying the dynamic role of utilizing nursing theory to create authentic connections with patients to enhance and improve the outcomes of people dealing with rheumatic disease.

There is so much to be done.

E. Aitken

authentic connection · connection · nursing

New Horizons

Well hello again. It has been awhile, so of course lots of transition and growth has happened. I am on to the next adventure now, the pursuit of advancing myself as a nurse. The NP program is in full swing. Oh how it was once so far away, and oh how quickly it has pulled me deep into its grasp. The nursing role is a never-ending expansion of possibility and potential. It’s an endless opportunity to help people, not only specific to their health journey, but positively contribute to their life journey as well.


I always find it incredible to observe how every path leads to yet another, and every path creates more knowledge and growth that continues to expand without limitation. This last year has been a hard year, but the hard years are when we end up learning the most about ourselves and what we have to offer the world.


It was ten years ago this month when I walked into my first clinical placement setting as an RPN student. I had no idea where the journey would take me, the only thing I did know was that I was well on my way. I had found the place where I belonged and I had started on the path of my childhood dream. Ten years fast forward and I am still committed and passionate about the nursing profession. The connections I have experienced in my practice continue to be the driving force for everything I do.


I am excited to move forward on this new adventure that is everything about possibilities, and has a clear goal of providing the best quality care for anyone, in anyway I can. Previously I had identified specifically as a rheumatology nurse. I am proud of that part of my practice and value the experience and wisdom it brought me. I see myself in a slightly different light now. I recognize all of my experiences as a whole, before and after rheumatology. Every path and journey has contributed equally in a special way to shape me as a nurse. For now, the role has switched and I am once again a student, a nurse practitioner student. The process of shedding my old identity and embracing transition has begun. I’m welcoming it with open arms, and I’m also trying to remind myself to enjoy each step as it comes.


“Whatever course you decide upon, there is always someone to tell you that you are wrong. There are always difficulties arising which tempt you to believe that your critics are right. To map out a course of action and follow it to an end requires courage”. RWE


EA. Aitken


Health as Expanding Consciousness

I have loved writing my entire life. I mostly wrote about the things I imagined for myself and hoped for. Now I get to combine two of my long term loves. Writing and Nursing. The path I have taken has not been a straight one, and I could not have dreamed I would be where I am now. I couldn’t have even told you two months ago my life would take me to this space. There is so much history, and so much to talk about.

My goal for this blog is to talk and think about human connection and health, specifically to look at Health as an Expanding Consciousness. What does that even mean? The concept is heavy. I get it! I have been trying to figure it out for six years. My work has been focused on that and I still don’t completely understand it. To me it has been about truly unveiling myself and letting my inner soul be open to the patients I come in contact with. My experience with this has been positive. When I allow my true self to surface, people will be more comfortable doing the same. It’s about creating that safe space, that moment where it is ok to be the most vulnerable you can be and feel confident it is without judgement. It’s not easy and yet, it completely is. Everyone wants that safe space, we need it, we are crying out for it. The most difficult part is being open enough to let yourself be who you really are and creating a safe space so someone else can feel the same.

I remember my first experience of it. I was a new nurse, fresh out of the gates. I was working in the community providing services to various demographics, but this particular case was in palliative care. I didn’t have any training in this area and I was very much on my own without a support team or colleague to bounce ideas off of. I had to go to meet this patient and his family and somehow figure out what in the world I was going to be able to offer these people. Even more worrisome was being unaware of what they would expect of me? I was terrified and full of self-doubt!

It turns out that all they needed and desperately wanted was a supportive partnership. They needed me to be open to helping them move through all their various experiences by providing safety, care, guidance and reassurance through every phase they moved through. I didn’t need all the answers, I just had to be open to them and allow them to be open with me, and together we would embarked on the health journey. It was a time that will be etched into my soul forever and has shaped my practice tremendously. It is a honourable nursing role to facilitate a safe space for a family to fully embrace the death of a loved one and help them to experience all the beautiful and painful spaces that surround it.

There is nothing quite like the profession of nursing. It also has moments of such abundant beauty and at other times can be exceptionally painful. Nurses have the unique opportunity to experience the human soul and witness how human connection plays a critical role in each individual’s health. I am so fortunately that this is my work.

I am Grateful… and so the journey on the trail begins.

Emily Aitken