Have you ever considered that you are lucky to work in neonatal nursing? I am not talking about being lucky to have a job, although certainly that is something to be thankful for. I am speaking of having the opportunity to do work that is meaningful, work in which we can make a difference in people's lives everyday. Not only do we make a difference in the lives of the babies and families we care for, but the work of nursing also makes a difference in our lives. Through nursing, we have the opportunity to experience personal transformation. If we are open, we learn something new everyday, not only about neonatal care, but also about ourselves.

In his book, Shop Class as Soulcraft: An Inquiry Into the Value of Work, Michael Crawford makes a case for the importance of having work that is meaningful, and how meaningful work is not as common as you might think in today's society.1 We do not always value labor or simple tasks such as fixing things around the house. Many jobs in today's market offer little in the kind of personal fulfillment that one finds in making something work or making a difference for someone else. Meaningful work not only makes a difference for someone else, but it makes a difference in us as well. When we apply ourselves to work that matters, we are transformed in the process. As nurses, we can fall into the trap of believing that our work is not valued by hospital administrators, insurance companies, or society in general. However, when we are open to personal learning, we see that indeed our work does mean something, not only to the patients we serve but also to ourselves. Our work as nurses can and should continuously transform us. We are lucky to have a job that can help define who we are as individuals and sustain us as human beings.

Merriam-Webster's dictionary defines transformation as the process of "changing in composition or structure, changing the outward form or appearance, and changing in character or condition."2 In the case of nursing, it can be viewed as changing character, or self-definition, in other words developing a new self-view or expanding consciousness.3 How things are viewed changes.

One obvious area of continued transformation is in the way we provide patient care. We must be constantly open to learning new things. It is disconcerting to find that something we have done for 15 years of practice is, in fact, wrong and probably harmful. We have to be dedicated to constant learning. We have to be open to research and changes in practice. In addition to being open, we have to learn to critically evaluate new procedures and new information before the implementation.

As we gain experience as nurses, we transform in our view of caring for others and our relationships with our patients and families. As we work with families experiencing the stress of having a baby in the NICU, we begin to see things through a different lens. As we grow to become experts, we become less judgmental. We are better able to accept situations that are different from our own. As relationships with families are enhanced, we provide better care and support. Our ability to teach them to care for their infant improves. Our personal transformation translates into transformation of care.

A study of nurses who work in adult critical care looked at how they made ethical decisions. With experience, these nurses transformed their approach to families and their own personal ethical decision making.4 In interviewing the nurses in the study, it was apparent that they transformed in their views about ethical decision making and their understanding of end-of-life care and compassion. They were also transformed in their approach and ability to work with others, both families and colleagues. This came only with experience, although having a mentor or coach helped the process. When faced with ethical dilemmas, they first had to reflect on their own personal beliefs, judgments, and knowledge. They then had to be open to learning a new approach and evaluating that approach and its effectiveness. This evaluation often created more shifts in perspective.

Personal transformation is not easy or comfortable. It can be very disorienting to change a viewpoint, a skill, or a relationship. New graduate nurses and nurses orienting to the NICU have purposely chosen transformation. As we gain in experience and become comfortable in our surroundings, we sometimes avoid transformation. We like to be comfortable in how we do things and how we think about the world. Yet to be truly experts in our field, we have to be open to constant change. We have to integrate our experiences into how we think about the patients and families we care for and our nursing practice. To continue transformation, we must make a conscious decision to be open to conflicts, dilemmas, and changes in practice. We must make an effort to learn new skills and gain understanding of our work. We must choose to look for ways to improve our knowledge and our care of patients. This desire for transformation is what keeps us excited about our work. It allows for increased creativity, increased freedom, and increased joy in our daily work. It is a continual process that we are never finished with. I challenge you to approach your work with a desire for transformation and a realization that we are blessed to be able to do the kind of work that makes a difference.

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