What is a nurse?

sister--* · Feb 16, 2007

From my experience I've found that a Nurse's greatest role is to be a pt.'s advocate and educator.

Nursing is the ONLY medical profession that focuses on the individual as they experience the disease process. We provide intercession and education for our pt.'s, their families, and as well their physicians. We bring the pt.'s and the pt.'s family "individual human-ness" to the fore-front in the practice of medicine.

We are the heart and soul of care.

mvanz9999, RN · Feb 16, 2007

Hm....well....as a layperson, I would say the nurse is the "comforter". I haven't had much medical treatment, but the treatment I have had....it's the nurse that I remember. The nurse held my hand as I was terrified and going under anesthesia, the nurse was there when I woke up, the nurse changed my sheets when I was sick, gave me pain medication when I hurt. I saw the doctor for about 3 minutes over the course of 3 days. I can't even remember his face. But I remember the nurses.

The doctors whip in and whip out, leaving your head spinning with the information. By the time you have a question, he's on to the next patient. But not the nurse. They are there to answer questions, provide comfort, offer help. The nurse is the human in the practice of medicine.

I can't remember ever asking for a doctor. I always ask for the nurse. When I call my own doctor's office, I never ask to speak to him, I want his nurse. She is compassionate, understanding, and takes the time to listen. I tell the nurse what my concern is, because the doctor is too rushed to listen.

My 2 cents...

Jabramac · Feb 16, 2007

A physician treats diseases, a nurse treats a persons response to diseases.

miko014 · Feb 16, 2007

Perhaps this is a little cynical, but I had a terrible shift last night.

A nurse is the person who is supposed to be more than human. Each pt thinks they are the only one, and wants whatever they want RIGHT NOW. Nurses are on the front line - therefore, they are the ones who get yelled at because the doctor isn't there, because the food is gross, because the room is too warm. A nurse is stretched very, very thin quite often, and needs someone to say "thanks" once in awhile.

Really, a nurse is the one who will do whatever you need. S/he will put your needs before his/her own. A nurse is a person who will not eat or pee for 12, 13, 14 hours because s/he is too busy taking care of YOU. A nurse will talk to the doctors to get you what you need. A nurse will teach you about your medications, procedures, etc. Your nurse will speak up for you to make sure you get the care you need and deserve. A nurse will be there for you. A nurse would like to spend more time with you, taking about what's going on with you, etc, but most of the time, a nurse just doesn't have the time to do that.

There should be a national "give your nurse a break - he/she is only human!" campaign. Like those public service ads! Instead of the stop smoking ones, let's start a stop abusing your nurse one!

Sorry, I know I'm bad. Like I said, bad shift last night, gotta go back tonight. :saint:

CaLLaCoDe, BSN, RN · Feb 16, 2007

hm....well....as a layperson, i would say the nurse is the "comforter". i haven't had much medical treatment, but the treatment i have had....it's the nurse that i remember. the nurse held my hand as i was terrified and going under anesthesia, the nurse was there when i woke up, the nurse changed my sheets when i was sick, gave me pain medication when i hurt. i saw the doctor for about 3 minutes over the course of 3 days. i can't even remember his face. but i remember the nurses.
the doctors whip in and whip out, leaving your head spinning with the information. by the time you have a question, he's on to the next patient. but not the nurse. they are there to answer questions, provide comfort, offer help. the nurse is the human in the practice of medicine.
i can't remember ever asking for a doctor. i always ask for the nurse. when i call my own doctor's office, i never ask to speak to him, i want his nurse. she is compassionate, understanding, and takes the time to listen. i tell the nurse what my concern is, because the doctor is too rushed to listen.
my 2 cents...

i would certainly be happy with this interpretation of what a nurse is by the general public -- highly accurate, without a lot of fluff!!!

sometimes it takes a nurse to be that sees this "vision" and eventually becomes that very vision, mvanz9999! when all is said and done, i would hope others see an inkling of this prototype nursey in me!

WolfpackRed · Feb 16, 2007

this was passed on to me from a nursing instructor. kinda long, but i passed this out to everyone who asks me why i want to be a nurse.

what do nurses really do?

suzanne gordon

posted 02/02/2006

http://www.medscape.com/viewpublication/527_index

a vow of silence?

several weeks ago, i was invited to speak to a group of undergraduate students who had been asked to read my new book, nursing against the odds, for their history of science class at harvard university. during the hour-and-a-half discussion, one question that kept popping up was: "what do nurses really do?" as i left the room, i pondered, as i often do, why the public has so little understanding of the consequential nature of nursing practice. clearly, it's because of traditional stereotypes about nursing. but it's also because nurses have been socialized to be silent about their work or to talk about it in ways that fail to reverse these traditional stereotypes.

when i ask nurses to describe their work, many respond: "oh it's too hard to talk about. it's too diffuse, too vague, too indefinable." but i have written thousands of pages about nursing and i am not a writer of fiction. i've been able to write about nursing because i've observed nurses at work and asked them a lot of questions about their practice.

what nurses do

here is what i think nurses do. using their considerable knowledge, they protect patients from the risks and consequences of illness, disability, and infirmity, as well as from the risks and consequences of the treatment of illness. they also protect patients from the risks that occur when illness and vulnerability make it difficult, impossible, or even lethal for patients to perform the activities of daily living -- ordinary acts like breathing, turning, going to the toilet, coughing, or swallowing.

even the most emotional work nurses do is a form of rescue. when nurses construct a relationship with patients or their families, they are rescuing patients from social isolation, terror, or the stigma of illness or helping family members cope with their loved ones' illnesses.

what do nurses do? they save lives, prevent complications, prevent suffering, and save money.

why do nurses have a hard time explaining such compelling facts and acts? as sioban nelson and i have argued in a recent article in the american journal of nursing,[1] it's because they've been educated and socialized to focus on their virtues rather than their knowledge and their concrete everyday practice. they've been taught to wear their hearts and not their brains on their sleeves as they memorize and then reheorifice the virtue script of modern nursing.

if you analyze the words and images of campaigns used to recruit nurses into the profession or listen carefully to the stories nurses tell about their work, nurses may not use the available research to fully explain why what they do is so critical to patient outcomes. although many studies, conducted by nursing, medical, and public health researchers, have documented the links between nursing care and lower rates of nosocomial infections, falls, pressure ulcers, deep vein thrombosis, pulmonary embolism, and deaths, most promotional campaigns and many stories nurses themselves tell about their work ignore these data.

instead, nurses focus on their honesty and trustworthiness, their holism and humanism, their compassion, and their caring. the problem is that when they focus on caring, they often sentimentalize and trivialize the complex skills they must acquire through education and experience. they often fail to explain that caring is a learned skill and not simply a result of hormones or individual inclination. after all, knowing when to talk to a patient about a difficult issue, when to provide sensitive information, when to move in close to hold a hand or move away at a respectful distance all are complex decisions a nurse makes. to make these decisions, nurses use equally complex skills and knowledge they have mastered. but all too often nurses make these skills and knowledge invisible or describe nursing practice in terms that are far too limited.

nurses are still talking about themselves -- or allowing themselves to be talked about -- in the most highly gendered, almost religious terms and allowing themselves to be portrayed with the most highly gendered, almost religious images. indeed, as nelson and i argue, with the best intentions in the world, many modern nursing organizations and nurses reproduce and reinforce traditional images of nursing as self-sacrificing, devotional, altruistic, anonymous, and silent work.[1] just think of one of the jingles in the recent johnson & johnson image campaign:

you're always there when someone needs you

you work your magic quietly

you're not in it for the glory

the care you give comes naturally.

historical images of nursing and nurses

unfortunately, like those above, many of the images and words nurses mobilize reflect the religious origins of the profession. nurses in religious orders were socialized to sacrifice every shred of their individual identity, to be obedient members of an anonymous mass. religious nurses were taught not to claim credit for their work and accomplishments but were instead supposed to view themselves as divine instruments who willingly assigned the credit for their accomplishments to god, the bishop, the abbot, or the mother superior.

most importantly, these images reflect a time when nurses were taught to say little and do much because to talk about a good deed was to turn it into a bad one -- to exhibit the sin of pride. what nurses could accept were compliments for their deferential behavior and angelic virtues. what they could talk about was self-sacrifice and devotion and the outside agents they served.

if you look closely at the history of the problem of nursing visibility, you see that this religious depiction of nursing was not only a relic of the origins of nursing in christian penitential practice but was also a legacy of the 19th century movement to professionalize nursing. in the 19th century, religious and social reformers like florence nightingale adapted the religious template to help women who wanted and/or needed to work outside of the home find purposeful paid work. in a society where gender roles were very rigid and people prized modesty and innocence, reformers needed to make it safe for female nurses to work in public spaces with strangers -- mostly strange men.

nurse reformers helped respectable women affect this passage by borrowing religious images, costumes, language, and metaphors. the nun's cornette was transformed into the nurse's cap. in english-speaking countries, nurses were called "sisters."

nurse reformers tried to desexualize nurses just as nuns (women who weren't really women) had been desexualized before them. nursing students wore ugly uniforms, were not allowed to marry, and were sheltered in cloister-like dormitories in or near the hospital. nurses were said to be self-sacrificing and morally superior and would thus create order out of the chaos of the 19th century hospital.

focusing on nurses' virtues also helped nurses in their long battle with medicine for what became, in the 19th century, the highly contested terrain of the hospital. before the 19th century, very few doctors had ever set foot in a hospital. in the 19th century, scientifically oriented doctors were moving into the hospital in greater numbers and wanted to control the hospital. they were not pleased to see a group of women who wanted authority and education competing for a sphere of influence (even a separate female sphere) inside the hospital.

doctors were happy to have trained nurses but only if they were their servants. they wanted nurses to know what to do and how to do it but not why they were doing it. they didn't want anyone to know if a nurse had acquired scientific, medical, or technical mastery. because nursing at this time was feminized, women with no political, legal, economic, or social power had to make a deal with medicine, and the deal was that nurses could have virtues but not knowledge.

in the 19th century, nursing was thus constructed as self-sacrificing, anonymous, devotional, altruistic work. while this was a functional bargain to make over a century ago, this template reigns today in spite of the fact that things have changed dramatically for women -- which is why it's time for a change.

now is the time for change

i believe the public knows that nurses are kind, caring, and compassionate and that they provide patients with more information than doctors do. people don't know, however, that nurses have medical knowledge, participate in medical cures, and have technological know-how. i believe nurses can advance knowledge of their profession if they amplify their caring stories and include anecdotes that help us understand that doctors don't do all the curing.

the public needs to know that nurses -- regular, ordinary bedside nurses, not just nurse practitioners or advanced practice nurses -- are constantly participating in the act of medical diagnosis, prescription, and treatment and thus make a real difference in medical outcomes. nurses can help the public understand that nursing is a package of medical, technical, caring, nursing know-how -- that nurses save lives, prevent suffering, and save money. if nurses wear not only their hearts, but also their brains on their sleeves, perhaps the public, like those students at harvard, will finally understand what nurses know and do.

references

gordon s, nelson s. an end to angels. am j nurs. 2005;105:62-69.

suzanne gordon, assistant adjunct professor, school of nursing, university of california at san francisco; journalist, arlington, massachusetts; author, nursing against the odds: how health care cost-cutting, media stereotypes, and medical hubris undermine nurses and patient care (cornell university press, 2005)

disclosure: suzanne gordon has disclosed no relevant financial relationships.

Tiwi · Feb 17, 2007

The public needs to know that nurses -- regular, ordinary bedside nurses, not just nurse practitioners or advanced practice nurses -- are constantly participating in the act of medical diagnosis, prescription, and treatment and thus make a real difference in medical outcomes. Nurses can help the public understand that nursing is a package of medical, technical, caring, nursing know-how -- that nurses save lives, prevent suffering, and save money. If nurses wear not only their hearts, but also their brains on their sleeves, perhaps the public, like those students at Harvard, will finally understand what nurses know and do.

That may have been long, but it was worth reading. As for that ad...

JaneyW · Feb 17, 2007

I speak at career day each year at the high school. I tell them a nurse does three main things: Care, Teach and Advocate. The rest of the posters have done a fine job of explaining those things in better depth.

burn out · Feb 17, 2007

A nurse is anything and everything the patient wants them to be. A nurse will jump through hoops to get "their" patient what they ask for or need. They will take on an army to protect their patient from whatever. Being a nurse is alot like being a mother.

ICUPM · Feb 19, 2007

A Vow of Silence?

Hey brickyard - outstanding post. I'm a total noob to this field but my very early observation is that Nursing is waaaay under rated. This article sheds a lot of light as to why and how that happened.

UNC? How could you?! (I'm a State and Duke grad)

nurse4theplanet, RN · Feb 19, 2007

It is hard to pin down the exact function of a nurse, as our profession is very diverse as well as our job description. I agree with all the statements made thus far.

I think the most important role as a bedside nurse, is that I am the last person who can ensure the patient's safety...in fact, maintaining my license is dependent upon that. That is a huge responsibility and speaks volumes to the education that nurses receive.

No, we aren't doctors, or pharmacists, or respiratory therapists, or dieticians...but we must be able to function at an educational level that allows us to recognize when there is a break or a mistake in the system that could harm our patients and act accordingly.

Advocate is not necessarily the word for it. I can see why nurses are sometimes call 'angels'...we are sort of like the pt's real life guardian angel but the term is a little mystic...anyone got a good word for what I am trying to describe?