One day, Cortney Davis, MA, ANP, RN, began to care for a female leukemia patient who looked a lot like her. The patient was not only the same age, but had children of similar ages. It struck a chord.

"The doctors kept calling me by her name, and her by my name," she said. "When she finally died, no one was with her but the doctor and me. Her husband was away, and her kids were in New York. Her illness and death affected me so much, but I didn’t have a good way to deal with all the feelings. Finally, I wrote a poem about her, and in that act my nursing and my poetry came together," she said:

Toby

After all these years Toby,

I recall your dying.

It took altogether

Three years and eighteen days.

It took your children growing older,

Growing away from you, to say

How you didn’t look the same.

It took your husband months, he said,

To lose that ache, the need to hold you.

Then he said he tired you, and finally

Came to visit only every other day.

In the end it took one hour—

That Sunday, the day your kids

Were in New York, and your husband,

After all that time, didn’t think

That this was really it.

Davis, a nurse practitioner at a hospital in Danbury, Conn., wrote poetry as a child and throughout high school and college. She stopped when she got married, had two children and went to nursing school.

"I guess the creative impulse was being answered by motherhood and my work in the ICU and an oncology ward," Davis said. When she went back to school for her bachelor’s in nursing, she took poetry as an elective. "My professor was magical. He convinced me that it was OK for a mother and nurse to be a poet also," she said.

Davis speaks for many nurses. Ruth Madawick, RN, associate director for community care services at Provena Covenant Medical Center in Urbana, Ill., has found a way to combine her nursing perspective with what she sees through the lens of the camera.

"Nurses see people in those moments that few people see and nobody knows how many moments they will have––nurses especially know this. I see the moments that few people see with my cancer patients, and because of that I have a unique view on things," she said.

Donna Ehrenreich, MN, RN, helps nurses find their creative selves and gain balance in their lives through workshops she teaches out of her home. She doesn’t describe herself as a poet or an artist in the traditional sense of the word.

"I have always thought of art or being artistic is something about the end product, something that would be evaluated," she said.

In December 1999, Curationis published an article on the effect of using the brain––including the creative parts––on nursing education and practice.

"Effective nursing practice in the new millennium will require innovative and creative nurses who can adapt to change and have the courage to take risks in order to provide holistic, individualized, context-specific care," the researchers said.

True to herself
Some nurses may find Davis’ writing controversial. "I don’t shy away from issues such as death, dying, intimacy and sensuality—all part of a nurse’s world," she said. She is a vocal advocate of nurses’ contributions to medical literature.

"I believe strongly that nurse poets and doctor poets are both equally valuable contributors to the medical-literature field, but that we write differently. I believe that nurses share more intimate moments with patients because we tend their bodies as well as their souls over the hours, days or weeks we spend with them," she said.

Davis’ contribution has been impressive. In 1994, Massachusetts’ Adastra Press published a collection of her poetry in The Body Flute and, in 1997, the University of Iowa Press published an anthology of nurses’ writing, Between the Heartbeats: Poetry and Prose by Nurses, that she co-edited with fellow nurse and poet, Judy Schaefer.

In 1997, Calyx Books in Oregon published another full-length poetry collection, Details of Flesh. In June, Davis will publish a book with Random House, I Knew a Woman, a nonfiction account of her work as a nurse practitioner in women’s health and the stories of four patients who she treated during the course of a year.

Davis is also on the poetry review board for AJN, serves on the editorial board of the Journal of Medical Humanities, and is an online reviewer for a literature and medicine database.

Nurturing the nurse
Creative work among nurses not only provides an outlet for stress, but can nurture patients. Madawick, for example, has always used her creativity to express herself.

In her early years, she played the piano. In high school, she discovered and began to nurture an interest in photography. But on becoming a nurse, she found a fulfilling career that left time for little else—or so she thought at first. She bought a camera to photograph her niece when she was born seven years ago and hasn’t put it down since.

Last January, when a new cancer center opened at Provena, someone asked Madawick to submit artwork to decorate patients’ rooms. She wanted her photographs to reflect the natural design of the center, so she donated her most "peaceful" pieces.

"Something that might take a patient someplace else while they are going through stressful cancer treatments," she said.

The pictures hanging in the hospital are a good conversation piece that helps nurses build rapport with patients, Madawick said. "The pictures are conducive to decreasing mental anxiety and anguish," she said.

Two of Madawick’s pieces hanging in the Provena cancer center are of barns. "They really work for central Illinois because there are a lot of farmers in this area," she said.

Most recently she donated another piece, "Twilight Tranquility," of a boat on water taken while she was on vacation in Sweden.

The most rewarding part of her new creative work, Madawick said, is that she hears grateful comments from patients and patients’ families daily. But she receives other internal and personal rewards as well.

One of her first inspirations was Novie Baxter, who had end-stage cardiac disease, and who received care through Provena Covenant Medical Center home care hospice. Baxter quickly became known for telling stories and recreating her experiences as a nurse midwife in rural Tennesee and Kentucky to anyone willing to listen.

Baxter endeared herself to the team of Provena caregivers who periodically visited her home: the chaplain, the nurses aide, the social worker and the hospice nurse. She affectionately called them "her girls." When "the girls" gave Baxter a 90th birthday party, Madawick snapped a picture of Baxter with her hospice nurse. She called it "Novie and the Hospice Girl" and submitted it to Hospice Magazine on a whim.

She won first prize.

"The neat thing about pictures is that they live on," Madawick said. Baxter passed away just six months after the photo was taken.

"I have my camera with me at all times––even when I am on my way to work I will take shots. I take sunrises and sunsets: sunrises on the way to work and sunsets on the way back from work," she said.

She sees photography as a necessity to maintain focus and balance in her life.

"My photography helps me to be a better nurse because it allows me to take a breather. It balances me. It calms me before I have to deal with what I have to deal with at the center," she said.

Art lessons
With her own business, Tools for Yourself (TOYS), run out of her home in Idaho, Ehrenreich works with groups of people to develop tools to express themselves through video and audio recordings, writing exercises, painting, music, poetry and dance. Her clients include nurses, health care providers, groups of patients and even families.

When working with nurses, Ehrenreich finds that motivating them to take care of themselves is often new and uncharted territory.

"We are so much into taking care of other people that we don’t take care of ourselves," she said. Ehrenreich’s mission is to help nurses become better nurses by taking care of themselves. "My goal is to help them understand that they have to pay attention to themselves. They learn that by taking care of themselves, they do better at taking care of others," she said.

Ehrenreich’s method is to help her clients realize their creative potential outside of the workplace. From that, she hopes they will develop creative ideas to contribute at work.

"Some clients realize that they didn’t have balance in their life. They become more complete once they start to discover creative self-expression," she said.

One of her nurse clients was so committed to learning how to take care of herself that she made it her top priority. She had to be at work at 6 a.m., so she would wake up at 3:30 a.m. to make sure that she had half an hour every day to read, and she found that her days at work went better because of it.

Creative healing
Many nurses also know that encouraging creative outlets for their patients is good care.

A study published in Palliative Medicine in September found that when patients at St. Christopher’s Hospice day center in London participated in an art exhibition of their own work, they gained a sense of hope and improved their quality of life while they were undergoing treatment.

A modicum of talent will suffice, but with a monumental amount, patients have produced masterpieces. Witness the paintings by Frida Kahlo, a Mexican artist, or the seven-volume Remembrance of Things Past by Marcel Proust, who wrote the volumes from bed while an invalid in France.

Creativity can create wholeness where patches of air had begun to show through the fabric of life and nursing practice.

"We women of middle age––which most nurses are––have had to unlearn that we can’t be all things to all people at the sacrifice of self. It is not beneficial to our patients or the organizations that we work for. The well gets dry when we forget about ourselves. People get sick, bitter and burned out. They stop doing a good job at work and in their personal lives," Ehrenreich said.