What do you mean I'm not a REAL nurse?!?

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    When a nurse is just starting out, their career life is hard, exciting, nerve racking, and a little bit on the scary side; so why would a nurse need the added concern that they are not a real nurse-just because of what field they have chosen? This article is about considering stigmas that may be associated with certain fields within the nursing world, self-discovering, and figuring out what kind of nurse you are now, and to think about the type of nurse you could become-as written by a newly

    What do you mean I'm not a REAL nurse?!?

    During my last week of RN school, I noticed there was this unspoken expectation for all RN graduates to become hospital nurses, apparently, I did not get the memo! At my pinning ceremony, I watched many of my fellow classmates holding up signs for the school Flicker account that said, “#PICU RN; # ICU RN; #MedSurg RN” and so on. I listened to how excited they were that they would be starting new grad internship programs at the local hospitals surrounding our areas-I shared in their excitement! We had finally done it; all the hard work, long nights of studying and writing papers were over-we were now RNs (well, until we passed the NCLEX, but that’s for a different story).

    My classmates would rush over to where I was and ask, “Hey girl, what hospital are you going to be working at?”

    I would reply, “Oh I’m not going to a hospital-right now anyway. I’m just going to stay where I’m at. I’m the nurse (I was a working LPN during RN school) at a day training facility for adults with varying levels of developmental disabilities.” My classmates would scrunch their faces up, then raise their eyebrows and force a smile, and reply with “Oh, that’s awesome.” Then just as quickly, they would scurry away. It made me think, what the heck was that?? I slowly started to feel like my classmates thought I was less of a nurse than they were but surely that wasn’t correct; unfortunately, I had this nagging sensation in the back of my mind. I saw no reason to leave my current job; even though my current job was more in the way of case management, fixing minor injuries, and paperwork-I had never felt like I was less of a nurse, than right at that very moment.

    RN pinning came and went. The ATI NCLEX review week and NCLEX Predictor came and went, yet I continued to have this nagging sensation. I went and got my hair done and one of the ladies in the salon asked, after I told my ‘life story’ as many of us do to pass the time while getting our hair done, “So what hospital do you work? I will definitely go where you work!” As flattered as I was, a mental rolling of the eyes occurred. So, as many times before and many times to come, I smiled and thanked the woman for the compliment, then proceeded to explain my line of nursing. The obligatory slow nodding of the head, the forced smile, raising of eyebrows, and the “Oh, I see…” comment.

    So, what is it? I was truly questioning myself at this point. It wasn’t just because of a few fellow classmates, or an older lady at the salon-it was everyone I encountered really. It became very frustrating to see people’s disposition change so drastically once they found out I was not a “real nurse.” You could almost hear the thoughts going through their minds, “Oh yeah, she’s a RN. Well thank goodness, I know her; or, well thank goodness someone at this very moment is qualified to save my life.” But, the second you mention that you work in a little clinic, take care of cuts and bruises-your automatically not a real nurse anymore??

    I couldn’t understand it. I could talk the talk. My friend from school would get onto me all the time. I would use words like, ecchymosis and erythema all the time. I would recognize meds-no I’m not a pharmacist/pharmacist student, but I recognized them, knew what they were used for and at times knew some of the regular doses and usual times for administration. I recognized abbreviations used by nurses in the hospital charts, e.g. ABT; VRSA; CTA; bil; the old way to write number 1 ( i ). I was getting good at interpreting, at a super basic level, certain labs or at least guessing which labs a physician would be more than likely to order for certain suspected disorders/diseases. When nurses would talk about having to handwrite in charts on Med-A patients, I too would scrunch my face and make that-UHH! face, because I knew how much information goes into that type of charting. So, I couldn’t understand why, when people-even some nurses, would give me that, oh-she’s not really a nurse look.

    I have met so many different types of nurses. I have met your “basic” (I use this very loosely) hospital nurse, case managers-who are RNs, LPNs and RNs that are MDS Care Plan Coordinators, mental health APRNs who have specialized in mental health/psychiatric clinical nursing, DONs in LTC facilities, schools, and IDD facilities. I have met RNs that work for the Department of Public Health, RNs that are nursing instructors, RNs that are CNA instructors. I have met nurses that work with patients that have intellectual developmental disabilities (IDD); nurses who specialize in wound care, I have even met a nurse that is a Parish Nurse-which I found awesome because it was a type of nursing path we had learned about approximately two weeks before I graduated and thought to myself-yeah, I will never meet a nurse in that field. The list of different specialty positions, settings, et, goes on and on, yet there was never one time did I look at these nurses and think: they aren’t real nurses. So, how does a nurse answer this question; the answer is: you don’t.

    The nursing profession has grown far greater than Florence Nightingale could probably ever have dreamt it could. There are nurses that perform triage over the phone, nursing informatics nurses-I mean honestly, how many nursing students (current) or practicing nurses actually knew what a nursing informatics nurse was before learning about it in school?!? So, how should you react when persons look at you and give you that, “Oh, they really aren’t a nurse.” Just smile, and do what nurses do best-educate. Nursing is by far the coolest career a person could ever decide for themselves! The different specialty areas to choose from, and sub-specialty areas in those areas, it is awesome just how far a nurse could go. I like to think to myself, is the APRN more of a nurse than the RN? Is the RN more of a nurse than the LPN? Is the CRNA more of a nurse than the GNP? The answer to these questions is no. All of these nurses are nurses in their own rights-they all struggled through nursing school some way or another.

    We should teach people that nursing is just a big umbrella with many different areas and sub-areas, et. We should remind ourselves, as nurses, that just because we are different does not mean one nurse is less of a nurse than the other. We should be proud of the nurses we have become, and the type of nurses we are. No matter what type of nurse you are: mental health nurse, LTC nurse, hospital nurse, female/male nurse, whatever the background you came from that made you the nurse you are-own it! Teach the community that we are many, and we are always evolving! So, to end, I will introduce myself proudly. “Hello, my name is Grace. I am a LPN, (waiting on my RN license to be sent to me) who proudly runs her own clinic at a facility that cares for and promotes those with IDD to be as independent as possible. It is nice to meet you; what type of nurse are you?”
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  2. Poll: Is there a stigma regarding nurses that do not work in hospital/acute care settings?

    • Are you serious, of course there is!

      67.02% 63
    • I have not experienced this, but know others who have.

      19.15% 18
    • Neutral on this.

      3.19% 3
    • I have never experienced this, and I don't know anyone who has either.

      7.45% 7
    • No, this is an absurd poll.

      3.19% 3
    94 Votes

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    About #Nurse2017

    I am a LPN, pending RN. I am new to my profession but I am loving every moment of it-the bad and good.

    Joined: Aug '17; Posts: 6; Likes: 34

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  4. by   stephalina6
    I have chosen to excel in Nursing Informatics and you won't believe how many times I hear that I "used to be a nurse", or "Why did you hang up your nursing hat?", or "Why did you decide to leave nursing?". I'm to the point where I giggle at it now and politely educate the person who makes the comment about what Nursing Informatics is. But believe me ... my blood would boil when people would ask me that. And these are fellow nurses and nursing students I worked with who would ask such questions.
  5. by   momrn94
    IDD Nursing! My personal all time favorite! Best wishes to you.
  6. by   GeminiNurse29
    I'm a psych nurse and apparently, we aren't "real" nurses either Personally, I never cared for hospital nursing. To each our own!
  7. by   JBMmom
    I had a similar experience when I finished nursing school and got a job in long-term care. Many of my classmates started conversations with "I'm sorry", as if I faced a fate worse than death as another "not real nurse". I've since started an acute care job, while keeping my long term care position per diem. I know the acute care experience will help open doors for me, but I don't think it's the end all be all of nursing. We're all nurses, providing care in many ways with many sorts of services. I've never understood the talking down to others, but it happens in all walks of life.
  8. by   3ringnursing
    The patient's where you work are so lucky to have you!

    Rock on, nurse!
  9. by   wernicke
    I'm experiencing this now, as a new grad about to start working at a pediatric home health agency (with a specialized new grad program so will get plenty of training). First I thought people felt badly because, after spending four years lining up a hospital job (worked as clerk then PCA), I was unable to take it because of an out-of-the-blue, fluke-of-genetics medical problem requiring fairly urgent major surgery. I would've had to have gone on medical leave right away and that's not feasible.

    I had every intention of doing med/surg nursing and submitted dozens of applications. However in my heart of hearts I knew I wasn't going to get another offer at that hospital; that window had closed. The floor I was hoping for that knew me already had a bunch of recent grads and I knew they likely couldn't hire another newbie. All the other floors hired the nursing students who had worked for them for any new grad positions. I was about to apply to a bunch of other hospitals before an alum from my school mentioned the agency she had worked for. I PMed her for more info.

    The rest is history! I discovered that home care appears to be literally everything I love about nursing minus things I don't love as much. And I will be using my skills-most of my patients will be medically complex with vents, tpn, g and j tubes, home IVs, etc. Another alum worked here and got a PICU job right after. The agency also does staffing for hospitals so they said they could get me back into the acute setting if I wanted to.

    But, unless it proves to be a major encumbrance to my career, I don't plan on going back.

    Yet people react to "I got a job in pediatric home health" as if I said "my puppy got run over in front of me". Also had a former classmate say "that's cute". I know there are people who really, truly think that I'm not a real nurse now because I'm not working in a hospital. Others assume that those of us in the community are "hospital rejects" who "aren't skilled enough" for a "real nursing job". Nevermind how most started in med/surg and most of us could get a hospital job if we really desperately wanted to. I could request a department transfer whenever I want once I'm off orientation, which would allow me to work in a med/surg setting, but I won't do.

    It's an odd stigma, and I think it's based on genuine ignorance rather than malice. Explaining the reality of being a nurse outside the hospital may help remedy it.
  10. by   blondy2061h
    I have moved away from the bedside and into management. I get asked where I work all the time, which is still a hospital, then the follow up is, "What unit do you work on?" Well, none of them. It's not that question that makes me feel like less of a nurse, though. The longer I'm away from the bedside the more I notice me feeling it myself.
  11. by   Cococure
    This article highlights many interesting points but I will add one more...the hierarchy when you are working at bedside. Let me give you an example when I worked in cardiac I was considered a "real nurse" because of the complexity of the patients. Well now I work in post partum and all of a sudden I am not a "real nurse" mother baby nurses just hold and feed babies all day. That is the general assumption among family, friends and even patients. I once heard a bedside nurse say "mother baby nursing is cake I wish I could work there" well guess what she did and she didn't last an entire year. Nursing is a huge field with so so many options...some like bedside some like more direct patient care like home health and some like working at home or tele medicine. You are new nurse and you will see that and hear many negatives regarding this topic...just let it roll of and keep it moving. As long as you enjoy and love what you do then it's the right nursing for you!
  12. by   Elektra6
    I started out as an LPN and no hospital would hire me. I did LTC, subacute and homehealth. Now as an RN I still work outside the hospital setting. I get this all the time! The "oh" when asked where I work. Doesn't bother me. When I go to the hospital with my patients, the floor nurses are all interested in what I do and grateful for my help.

    We are all real nurses and can learn from each other.
  13. by   llg
    As some other posters have indicated, it happens all the time to many nurses -- almost anyone who doesn't provide direct patient care to a patient in a bed or in a clinic. It happens when nurses go to graduate school and go into advanced practice ... or into an academic position ... or into any position not "at the bedside." I wrote a paper in grad school about it ... should have published it.
  14. by   virgogirl
    I call it the nursing food chain and it starts with trauma nurses on top ("real nurses") and it ends with nurses who work with the elderly...it's real! I've only been a nurse for a couple of years and felt the need to try for a hospital job and I went through an OR residency and was never treated so poorly, plus the patients are knocked out...I only lasted 6 months. Now I'm working as a psych nurse (geropsych & adult). I can't say I totally love it but my coworkers are much nicer and treat me well!
  15. by   coldcasejustice
    I went through the RN program, completed everything but last 4 weeks. I got my LVN license but have not 'worked' as a nurse yet. (I did however, work as an RN extern and get paid during school.) I bring this up because my 6 yo Sons father tells me & my son "mommy is not a real nurse. She is an imposter." He has no idea the education & training I went through. Just because I don't work does not make me 'less.' So hurtful. Nothing a 6yo should hear about his mother anyway. (I got by, but struggled-school was really challenging for me.) Thank you great nurses! Nicola