Time to call a duck a duck? - page 3
by eriksoln 84,465 Views | 547 Comments
I remember having this debate with other students while I was in school. I have seen nothing during my time practicing nursing to change my mind about the issue. Now, with the recession bringing out the true colors of nurses... Read More
- 15Jul 16, '10 by JenniferSewsI have to agree with you too. I graduated from an ADN program which thankfully was heavy on clinicals and I only had to do one "leadership" type class. I was clinically prepared and it shows. But if I was really a professional I would have some sort of voice at work. Instead I care for 13-15 sometimes very fragile subacute patients. I am also expected to answer the constantly ringing phone, schedule appointments for patients, set up their transportation to said appointments, take off orders, track down lost laundry, and 1,000 other things that are the nurses responsibility because no one else will do it. ONLY the nurses in my facility answer the phone! As the nurse, EVERYTHING in the facility is my bottom line responsibility so if it isn't written into someone elses job description then I end up doing it. If I was really a professional, somewhere there would be some respect for my time and practice. Instead they try to hold the nurses to a higher standard by calling them a profession, and use that to make them pick up everyone elses slack.
I'm grateful I went into nursing with my eyes wide open and am not surprised. If I thought it would be any different I would be heading for the hills by now.
- 15Jul 16, '10 by SuesquatchRNIt is kind of pathetic.
I love many aspects of being a nurse. I have been treated with respect by physicians and patients alike. Here and there I get jerks, but so does everyone everywhere.
I have to say that I am almost done with my BSN and I know know what BS stands for. The nursing classes are all rah-rah and don't even build on the assessment skills we have but rehash them. I am not joining the ANA nor do I accept their statements as something to which my practice needs to adhere.
I know I'm smart. I know what I know. I am fortunate that, in LTC, my practice is very autonomous and if I call the doc and say, "Hey, Mary's lungs are really wet. A little Lasix maybe?" I am listened to. I also don't need to make stuff up to support that we are a "separate and distinct" discipline from medicine. We are not. We are inextricably tied to medicine and that's fine because that's what interests me. Altered energy field my tuchis.
- 6Jul 16, '10 by jjjoyThere are definitely valid points to be made in the discussion of "is nursing a profession?" The problem in my school was that it wasn't a discussion, it was doctrinal. It was as if you didn't think nursing was a profession, then you must conclude that nurses can't be professional and/or don't deserve to be treated professionally. But whether or not their particular line of work is considered a profession, a person can be professional in how they carry out their work and they should be treated professionally by others. And a job can demand critical thinking and autonomy in how to carry out their work whether or not the job fits any particular definition of "profession". Do we really think that all of the people out there who don't work in "a profession" are doing the equivalent of "mindlessly following orders" and "fluffing pillows" and "being handmaidens"?
Quote from eriksolnI agree that it's a stretch to define nursing as a profession by the above definition.Definition of a profession:
A profession has a unique body of knowledge and values – and a perspective to go with it.
A profession has controlled entry to the group eg registration
A profession demonstrates a high degree of autonomous practice.
A profession has its own disciplinary system.
A profession enjoys the Recognition and Respect of the wider community.
1) Nursing knowledge overlaps considerably with other fields. The only reason I can see to try to define a "unique body of knowledge" is to fit the above definition of profession.
2) Nursing fits this one perfectly! Yeah!
3) The majority of nursing positions rely heavily upon decision-making by others, be they physicians or other nurses. That doesn't mean most nurses have NO autonomy or that nurses CAN'T practice independently, just that MANY nursing jobs do not seem to fit the definition of "high degree" of autonomous practice relative other "professions". Many physicians would probably argue that medicine is becoming LESS of a profession what with medical practice being dictated by insurance reimbursement policy.
4) Nursing does have it's own disciplinary system with BONs, but most nurses are employed by non-nurses, don't own their own practice, and are more immediately subject to employer disciplinary systems.
5) Huh? What kind of "criteria" is that? Is there any line of work out there that meets the first 4 criteria but not the 5th and therefore doesn't qualify as "a profession"? A line of work most certainly can have recognition and respect whether or not it's considered a profession.Last edit by jjjoy on Jul 16, '10
- 16Jul 16, '10 by JulieCVICURNI think you've made some really good points. I mostly agree, although I think that in some areas of nursing we do fit the description of a profession and in some we don't. And in some ways, we might appear to be a profession and really aren't. For example, I'm ICU. I can do things like insert/remove foleys and flexiseals without a doctor's order, can remove art lines, and when I recover an open heart patient I do so on my own, with a set of standing orders. I often can write orders for a doctor that I know well because they trust me and I know they'll sign it when they get in. These are things that usually can't be done on the Tele or Med/Surg floors. However, as autonomous as that makes me feel, the fact is that if a single doctor decides he doesn't like what I've done, the official rule book will be thrown at me for overstepping my boundaries.
Someone upthread was insulted by the idea that nursing is a labor instead of a profession. I find THAT insulting. I come from a long line of union laborers - millwrights, carpenters, electricians. These people in my family were without exception brilliant, intelligent craftsmen who took great pride in doing a job properly, in being reliable and honest and fair. There is no insult in being skilled labor. Hell, most of those laborers make more money than we do and have better benefits.
I agree that nursing is hurt by it's lack of identity in the sense that so often it seems to be creating things to appear to be more of a profession than it really is. The biggest thing I keep hearing in my classes for my BSN are that it's difficult to get groups of nurses together to make a difference in politics, etc. That nursing societies suffer from lack of interest in membership or participation. To me, that says that most nurses just want to do their job when they're at work and then go home to their personal lives.
And, just my own pet peeve? It drives me insane when people complain about stuff like the waitresses at the Heart Attack Bar and Grill wearing stethoscopes and naughty nurse outfits, or someone like Helen Mirren stating that she thinks a lot of hookers used to be nurses. I think it makes us all look like humorless twits when people get into a snit about that sort of crap.
- 25Jul 16, '10 by allthesmallthings"IT IS TIME FOR NURSING TO GIVE UP THIS IDENTITY CRISIS, THIS INFERIORITY COMPLEX IT HAS DISPLAYED SINCE ITS BIRTH AND MOVE ON, EMBRACE BEING A LABOR AND LOVE IT."
Certainly, nursing has an inferiority complex; NO DISAGREEMENT THERE. Just look on any of the many, many Internet postings in which nurses attempt to convince themselves that we are "better than" those "overrated" MD's, and that the MD's greater education doesn't matter, and that "we do all the work" and we keep "picking up on" their mistakes; and how we're so underpaid (quit whining, we make a decent salary) for back-breaking (ladies, if your're breaking your back, maybe you need to review basic body mechnics that any idiot can learn, and/or call for help, or just do some back exercises and core training like a sensible person) drudgery (get over it, how is your self-respect determined by whether or not cleaning up crap is part of your job? if you don't have pride in your job, WHATEVER it involves, that's no one's fault - not culture, not admin, not MDs, not patients - but your own, I don't care if you're a CEO, a janitor, or a burger-flipper.).
And, YES, I have ALWAYS firmly believed that nursing diagnoses were cooked up by the nursing equivalent of the women's lib movement to try to "convince" nurses that "we're as good as doctors - see, we even have our own 'diagnoses', we're so darn clever!" Please. I never treat a patient's "impaired respiratory status", I treat pneumonia and COPD, and if I ever had to recite a nursing diagnosis in front of an MD, or a patient, I would try not to cringe and apologize as I did it. Enough bull, we're here to fight germs and degenerative processes, not give the nursing profession's ego a good stroking (read that last word any way you want it).
And, to keep going on my soapbox, if you have to "diagnose" someone with something psychosocial that nursing may be more concerned with than medicine, such as "breast-feeding, interrupted" or "coping mechanisms, ineffective" or "communication, impaired" and write out goals and a plan for it, what kind of an idiot are you? No offense, but treating someone psychosocially is just being a human being with empathy and a little common sense. And for treating physical impairments, I am perfectly fine with treating someone both medically (e.g., antibiotics, O2, for pneumonia) as well as with common-sense nursing (e.g., turn-cough-deep-breath, incentive spirometer, and positioning) instead of wrapping myself up with "impaired respiratory status."
However, my eyes bugged out when you said that CNA's can "pick up" what we do after a couple of years of watching. Even if you could pick up some hands-on skill like inserting an IV by just being in the room when it's done, what we DO is only half the face of nursing; it's also what we know, of course, from our classroom experience, and from our (hopefully) training in professionalism, therapeutic communication, psychology, research, scientific practice, critical thinking, etc. You show me the CNA who has "picked up" the A+P of pulmonary hypertension, or Maslow's hierarchy of needs, and you're showing me someone much smarter and more intuitive than everyone who went to nursing school to get that knowledge.
That opinion aside, I suppose one could argue either way that nursing is a profession, if we go by the definition that you provided. I think of it as a labor-intensive profession, and I think of it as a profession because of our knowledge, our bureaucracy and certification/licensure (LPN, RN, APN, and of course all the NCLEX and certification stuff), and the fact that we're supposed to conduct ourselves with professionalism.
However, I'm surprised that you don't think that nursing is prestigious / receives respect. I'm always greeted by respect from the lay public (and even by a few of my patients, haha) when I say that I'm a nurse, and I'm automatically proud of myself for being a nurse. Nursing, in a way, has the best of both worlds, when it comes to how culture perceives us...that is, we get respect for being in medicine/science/health, and for both knowing academic knowledge, knowing hands-on, practical things like how to insert an IV, or how to treat someone who passes out or has a seizure, and we're, of course, a byword for "caring" and "compassion;" but at the same time, we're not seen as Ivory Tower, self-centered, arrogant doctors who entered the profession for the money and the prestige, a sad stereotype that sometimes is directed towards MD's, whether earned or not. We're not, like MD's, automatically under suspicion for not being "down there" with the patient; we're happily considered to be "regular joes" who stand beside patients and help them, vs. some adversarial, cold, clinical relationship that may be supposed to exist between MD's and patients (again, warranted or not). To sum up, I've always received the impression that people kind of automatically approve of, like, and respect the nursing profession and the individuals comprising it.Last edit by allthesmallthings on Jul 16, '10 : Reason: incomplete sentence
- 19Jul 16, '10 by JulieCVICURNHowever, I'm surprised that you don't think that nursing is prestigious / receives respect. I'm always greeted by respect from the lay public (and even by a few of my patients, haha) when I say that I'm a nurse, and I'm automatically proud of myself for being a nurse.
I do have to say, though, that a couple of times recently someone referred to me as "just a bedside nurse" and I about kicked their teeth in. I'm not just a bedside nurse, I'm also a vengeful *****.
- 17Jul 16, '10 by CrunchRNI totally agree Erik. I don't think you sound angry at all. I am a happy nurse, but it is a middle class blue collar job if there ever was one and all that lip service given to the "profession" is wasted breath.
Nurses have no power and they never will because they do not stand together and they pull so much passive agrressive crud.
- 10Jul 16, '10 by BluegrassRNQuote from eriksolnI completely disagree with your assertion that nursing is a trade and not a profession. I think nursing is the perfect combination of physical labor and intellectual labor. What differentiates a decent nurse from a great nurse? For me, it often comes down to the mental aspects. If you don't "get it", if you can't put the labs, the assessments, the meds, the situation together, if you can't understand the A&P, the pharmacology, the pathology behind what is going on, I don't care how good of a laborer you are, you aren't a great nurse.
IT IS TIME FOR NURSING TO GIVE UP THIS IDENTITY CRISIS, THIS INFERIORITY COMPLEX IT HAS DISPLAYED SINCE ITS BIRTH AND MOVE ON, EMBRACE BEING A LABOR AND LOVE IT.
The above quote, however, is spot on. You could be rid of 10 hours of credit in nursing programs with this statement. What would all those nursing theorists do without our inferiority complex? They'd be out of jobs.
- 19Jul 16, '10 by woohQuote from eriksolnAbsolutely.
Anyway, my point is, we would further the "profession" by...........not worrying so much if we are one or not.
There's this whole tizzy about being considered a "profession." We twist and turn what we do so that we can call ourselves "professional." Well, there's lots of people that are quite professional without being in a "profession." And lots of people that are treated professionally without being in a "profession."
But some of it, we kill it ourselves. Autonomy, that one especially. I don't think nurses WANT autonomy. Oh we say we do. But how often do we get a thread: "Some teeny inconsequential thing happened, what should I have done?" and it's ALWAYS answered with a bunch of posts saying, "Call the doctor immediately." And I understand that we have to cover our behinds. But if we want to be autonomous, we have to be willing to take credit and BLAME for our decisions. Not every single thing needs an order from a doctor. I've had nurses argue that they wanted an order to do strict I&Os. Because all Hades would break loose if I put toilet hat in a toilet without a doctor knowing about it! OMG! The horror!! So I really think, there are too many nurses that would rather have their behinds covered by running EVERYTHING by a doctor than to be an autonomous professional.
But when you think of all the energy we put into meeting this random definition of "profession" when we could instead be putting that energy into....well, just about anything truly useful.... I'll just say this, I've had physicians that were impressed by my ideas, my experience, my choice of footwear, my incredible wit and charm, the outfit that I wear every Christmas, basically impressed because I carry myself as a professional and I'm a darn tootin good nurse. I've never had one that was impressed because I'm a member of a "profession" as displayed by it meeting the 5 hallmarks of a profession.