Is this the publics perception of nurses? - page 5
i am a charge RN in a cvicu. yesterday i took care of a man that was pod1 5 vessel cabg on a balloon pump and multiple drips. i had post op'd the pt the previous day so i had developed a repor with... Read More
Dec 27, '02Most people consider that if you can do a job without a university (4-year) degree, you are a blue collar worker. Hence the low status of nurses in the public's eye. I personally think that most ADN's have done more work academically than some people with 4-year degrees....but in many people's eyes a profession requires that you have to get a 4-year degree to practice it, and so they don't consider nursing a profession or see nurses as professionals.
If you don't believe it, try telling the next person you meet that you have a Bachelors Degree in business....see how differently they treat you!
Dec 27, '02Personally I doubt seriously that the comment the patient made had anything to do with different degree levels. You have to think about this for a minute. What was the patient's age? It was not so long ago that the vast majority of nurses were diploma prepared nurses, programs were run by the hospital, they worked in the hospital, they trained in that same hospital. For many of the older folks that is their knowledge of how nurses are educated. In my years I have run into more than a few older patients that did not realize that the way nurses used to be trained is not the way most nurses are educated anymore. I have upon occasion had an older patient that does not understand why we don't wear caps anymore and say out loud that they wish we did. I take no offense to this because I know enough nursing history to realize why the patient has the perception that nurses don't need a college degree.
In the hospital that is my host hospital there was a nursing program there for a number of years, run by the nuns. Bronson Hospital in Kalamazoo had a diploma program up until just a few short years ago.
Of course the public has very little understanding of what we do actually. What true education has there been by the profession to the public on this? I'll tell you something, I do wound management and infection control. Out of all the docs I work with there is only one that insists I call him before I change any wound orders, and it is a rare event that he doesn't want to look at the wound himself. The other docs simply write for wound nurse to eval and treat. I write the orders and they sign it. No, it wasn't like that in the beginning, but as they watched me do my thing and consistantly heal wounds that had been nonhealing, wounds that were complicated and often very nasty, the docs I work with have become quite comfortable with whatever I think is appropriate. I tell you this because not too long ago I had a patient with necrotizing fascitis that had a large area of her thigh removed, this was done in another facility. When she came to me I looked at the wound and then the current treatment and decided that something else would work better. I explained to the patient what I was going to be doing and why. She looked at me and in a very snotty voice said "Well, I guess that would be the doctor's job, don't you?! I really wanted to go BLAHHHHHHHHHHH, um sure. But I didn't. Instead I explained what my role was, how frequently I speak to the physician regarding the wound, what is charted, what notes I put in progress notes each week for the physician to look over and sign and so on. She was still quite doubtful that this could be done this way, but after a couple weeks and excellant healing going on she decided that just maybe a nurse could make those decisions. I wondered how much heart failure she would have if I explained the way nurses function in an ICU. Situations like this are because of the public's perception of nursing and what we are all about, but ultimately it is our own fault for not being able to clearly educate the public. And of course it must also be noted that depending on where you work and what policies there are, will also make a difference in what a nurse is allowed to do. When I worked in a neuro ICU when a patient was crashing the nurses were expected to know what to do, to do it and then call the physician once at a point the patient could safely be left to do so. Large teaching hospital, however in a smaller rural hospital where a friend worked in an ICU what I did would have gotten her fired.
I find it best that when a patient expresses thoughts that are clearly not the way things are is to not get angry or upset by them, but to take the moment to educate the patient as to what nurses do day in and day out. I also usually throw in something about the nursing shortage, the causes and what is likely to happen if nurses are not shown more respect, so we can keep the nurses we have and attract young people into the field. It is often an eye opening experience for the patient and their family. Don't get upset, educate instead.
The docs don't care what specific degree a nurse has, nor does the public. Only other nurses seem to think it matters. Except for the one doc I work with I have a fantastic working relationship with the physicians I work with. Not because I have a BSN or because I do have an ADN, but because I have been able to do what I do effectively and well, not only wounds but in infection control also. I have made a point to make sure I educate myself on the new things, the new guidelines etc... and in my very humble opinion it is those things that garner respect. Not a degree level, but the ability to know how to do my job and do it well. Some CEO's make money I will only dream about, but that certainly does not make me respect them. I have an excellant pharmacist that I work with, she has a doctorate but that is not what makes me respect her, I respect her because she is absolutely fantastic at her job. I have meant people that are dumb as a box of rocks with advanced degree's, it is not the degree that makes a person, it is their ability to use the knowledge and experience that they have. If there was ever a point in my life that in order to get a job or go somewhere else in the job I have that I had to get a BSN than I would, but at this time I am happy and quite satisfied with what I do and it does not require me to have any further formal education than I have, so why do it? For respect? No, I have a great deal of respect now, from my manager to my coworkers to the physicians and last but not least from my patients because as they heal and they see what is taking place they understand what I do. I also take time nearly everytime I see a patient to explain why they are healing and what products I am using and why I am using those specific products. If you don't educate your patients as to what you are doing and the why behind it than they will never understand why they should offer you respect.
Dec 27, '02Originally posted by Susy K
I didn't mention in my post that a BSN would accomplish all of the things you listed. I simply mentioned that having ONE point of entry would eliminate confusion among ourselves, and, as evidenced by this patient, the public. Or are you arguing that if we had one method of nursing education, it would NOT eliminate public confusion?
Dec 27, '02Originally posted by SmilingBluEyes
That is why--- I believe, If tomorrow, we all were BSN-only RN's it would still not be NEAR enough to change the public view of nursing in general and do NOTHING to garner respect from the esteemed doctors with whom we work. I just believe the issue is MULTI-dimensional and see the BIG picture, I guess.
Dec 27, '02I WAS FLOATED FROM MY BUSY MED/SURG UNIT TO THE ICU AND THE NSG THERE ASK ME IF I COULD PASS MEDS. WELL I WAS FLOORED . WHAT DID SHE THINK I DID ON MY UNIT CROSS STITCH?????????? I ENDED UP BATHING PATIENTS. AND WE ARE ALWAYS OVER BUDGET AND THEY WONDER WHY. EVEN OUR CO-WORKERS ARE UNAWARE OF OUR EDU.
Dec 27, '02Oh how funny Trish. That would be hard to believe if I had not heard our charge ask someone floating if they would be comfortable giving an injection.
Dec 28, '02Originally posted by Pretzlgl
Funny, every single one of your posts on this thread mentioned something about the need for a BSN. To me it seems like you certainly are proporting that having a BSN would solve nursing's problems. (You may not be stating it directly, but I really think that is your underlying message). I am not arguing that one method of education wouldn't help eliminate confusion. Not at all. It just seems that your argument runs much deeper than just wanting to eliminate public confusion. I agree with other posters who say that the public really doesn't care. And I still contend it is the nature of our work and our stereotypes that contribute to public opinion. I definitely think that continuing our education is important. But I also think that it would be nice to join together - and not tear each other down.
Dec 28, '02Nursing is still regarded by the publc as the most ethical and honest of all the professions so we must be doing something right.
That said, most of Nursings problems are generated and definitly perpetuated by RNs themselves. The accceptance of stereo types by the public , hospital administrators, MDs, etc. can and will continue until we consciously make an effort to change those stero types. Too many RNs accept those sterotypes or at least aren't willing to change them.
Dec 28, '02I just have a quick note for all of you that think that the respect would follow if the pay was better. . . . . I have heard comments such as "You must be making a lot of money being a nurse" or "Nurses make really good money" and so on and so forth.
So, seeing as the public seems to think that nurses pay is up there with doctors and lawyers and such, how would actually getting those wages help the publics view of nurses?????
p.s. just in case ya'll are reading too much into this post, I am in no way being funny or sarcastic, i am very curious about your answers to this.
Dec 28, '02Nurseleigh,
You are absolutely right. I have friends even who say that I must be making pretty good money being a nurse. I think this could be due to the ads they see in the paper for agency nurses "Make $60/HOUR!!!" or hear of the double time or overtime nurses collect.
I honestly think that the public does view us in high regard. Recent polls continue to support this. But I guess we have to figure out why they hold this opinion. Is it because they view the job as simply altruistic? (therefore, money shouldn't be important to us)
I guess we have to look at other professions and wonder why they've been able to advance their pay. Look at teachers; there's a thread around here that shows they've managed to increase their pay. Why? What changed?
Dec 28, '02Originally posted by Flo1216
Diploma programs actually focus more on the nursing than the associate's does. We have to take the same sciences (a&P 1 and 2. micro, chem, pysch, sociology, english) but not the history and all that. There is a LOT of focus on clinical. I think some people get the wrong idea of diploma programs because you only come out with a diploma and it's 3 years but I actually feel that they prepare you well for the real world. And while the ADN programs here get a month off for Xmas, we only get a week. And our semesters are longer. Not to say that ADN programs aren't good...I just think a lot of people discount the diploma programs because there is not a degree. The boards are the same, the pay is the same and you can always transfer to a 4 year school and get your bachelors.
Dec 28, '02I don't know if this pt in particular was thinking about the AD/BSN/diploma, but I am a NA and sometimes the people that I work with with answer the pts when they ask for a nurse, or say things to the pt that make them "think" they are a nurse.
When I first started school, I wanted to go to the OR after graduation. My boss (Surgical services director) used to always say she'd give me a job. Now I have 1 more semester and the tune has changed. She is only hiring surgical techs now. (less money!)The patients do not know the difference, they just assume that all personel in are nurses.
It is possible that this pt in question had been cared for by a NA at some point who discussed her education and then when the nurse came in he thought the same?? Even if you were performing tasks that are distinctly "nursing" he may not have known the difference. At my job we do glucose checks, hook up suction, VS etc....
Just my thoughts......things like this have happened to me at work and I have to clarify that I am not the nurse...NOT all of my co-workers do so
Dec 28, '02This reminds me of the post about the doctor's office where a much-beloved lady there was referred to as "Nurse Judy" . So many here defended that practice when the original poster expressed frustration (rightfully if you ask me) about this.....this lady was NOT a nurse any more than I am JUDGE JUDY. THIS, I believe, hits on a HUGE part of the problem.......the public at large thinks ALL people associated with medical care that are NOT doctors "must be nurses"! It pervades everywhere. I believe the title of "nurse" belongs SOLEY to one who is licensed to do so, period. People who are NOT nurses but are called such should point that fact out. It is the truth, after all.
However, many disagreed in that thread.....That lovely lady should be called "Nurse Judy" if they chose to do so. I think the harm done is insidious and quiet, but harm nonetheless when this is permitted. And--- Herein lies another problem w/our status that we cannot agree upon even here at the boards, among ourselves. Interesting.....like those that say, as long as we squabble among ourselves, little change will effected in the way of our status in public eye---and the pay that goes with it.Last edit by SmilingBluEyes on Dec 28, '02