Hierarchy in Nursing?

Virgo_RN, BSN, RN · Jun 27, 2009

Whatever you do don't include CNA's in the category of nurses or someone on this site will savage you.

Oh Dear Lord. :icon_roll

From the Merriam-Webster online dictionary:

Main Entry:1nurse Pronunciation: \ˈnərs\ Function:noun Etymology:Middle English norice, norce, nurse, from Anglo-French nurice, from Late Latin nutricia, from Latin, feminine of nutricius nourishing -more at nutritiousDate:13th century 1 a: a woman who suckles an infant not her own : wet nurse b: a woman who takes care of a young child : dry nurse
2: one that looks after, fosters, or advises
3: a person who cares for the sick or infirm ; specifically: a licensed health-care professional who practices independently or is supervised by a physician, surgeon, or dentist and who is skilled in promoting and maintaining health -- compare licensed practical nurse, registered nurse
4 a: a worker form of a social insect (as an ant or a bee) that cares for the young b: a female mammal used to suckle the young of another

When I was a CNA, I didn't feel the need to be included as a "nurse". I figured I'd be considered a "nurse" when I had earned the title. :twocents:

Virgo_RN, BSN, RN · Jun 27, 2009

I'm just starting NS this Fall, but I've worked in outpatient care for many years. One thing I've noticed in the office is that there seems to be a hierarchy in nursing that makes it difficult for some people to "fit in." Just wondering about others' observations on this.
When I worked at in-patient hospice a few years ago it seemed that the RNs didn't get along with the CNAs; the CNAs had their own social stuff going on and didn't chat with the nurses the way they did amongst themselves. Everyone seemed to think that the others weren't doing as much work as they were! I worked as unit clerk so I really didn't fit in with either group.
Observations on this from nurses and/or CNAs who've been working in-patient?

Heirarchy exists in the entirety of society. It's not unique to nursing. There are heirarchies within every occupation, every family, every community. Heirarchies are not necessarily fair or equitable, but they nevertheless exist, and social structure is necessary in order for humans to survive.

NurseKitten, MSN, RN · Jun 27, 2009

I agree with whomever said it depends on the hospital and on the unit.

My unit wouldn't run without good unit secretaries or strong techs. They're the ones who keep the crazy head injured patients from pulling their foleys or taking swan dives off the end of the bed.

And don't even get me started on spinal cord bowel care...the RN's all help each other, but the shift is so much nicer if we have a tech to help us clean, stock and generally help keep the bedlam to a dull roar.

We all have a healthy respect for each other's strengths and weaknesses. My favorite tech relates to many of the patients in a way I can't...she has a disabled child with a neurological condition, and she can talk to them because she's BEEN there. They love her.

I've been away from that unit full time (in school) for almost a year now...and of course, I'm still friends with most of the nurses, but I'm also very close with 2 techs who have taken their place among the RN's of the world, 2 unit secretaries (had dinner with one last night!) and two of the techs who have no desire to be anything other than the best techs they can be.

It depends on the unit, and it also depends on individual personalities.

None of us are any better than the rest, just because we have a degree or credentials. I have plenty of them, myself. We merely have different jobs. If any of us aren't doing ours, or showing the proper respect for others and their role, the machine gets REAL inefficient, REAL quick.

There were nights I know the techs and secretaries would have rather had a root canal than help me clean another pile of poop or go hunting IV pumps over the whole hospital. They did it because they knew I respected them as people and professionals in their own right, and that I had their back, like they had mine.

cingle · Jun 27, 2009

Thank you all for the replies. I sounds like it's a combination of good management and cooperation amongst all levels of professionals makes for the best unit, regardless of pecking order.

I've been working in a residency program -- where we "train" the new docs -- and it's unusual in that most of the interns/residents actually want our help and seek us out for advice on everything from the computer system to where to refer patients for specialty care to which swab to use for a wound culture. It creates a very cooperative atmosphere because we (medical assistants) are very aware that we are teaching these new docs and they know they need us.