Time to call a duck a duck? - page 4

by eriksoln

78,960 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


  1. 6
    Quote from eriksoln
    I never said I don't like nursing. I said I don't like the "inferiority complex" it so boldly displays. The CNA's taking a couple years to figure out what we are doing is a bit over the top, but it got the point across.

    You hear about med-techs in Texas? Many of our responsibilities are being divided up into other groups (some nurses will tell you they remember the day when there was no such thing as phlebotomy) and being given to people with...........certificates that take a month or two to earn.

    Anyway, my point is, we would further the "profession" by...........not worrying so much if we are one or not.



    LOL. I'm not angry. Do I sound angry? btw, IDK what "work should blow wind up your skirt" means. eh, I don't wear a skirt, maybe thats why.

    I'm just suggesting that the desire/obsession with being considered a "profession" is holding us back. Its like we are rebels without a cause.
    I didn't think you sounded angry or that you hate nursing....

    Now I will continue reading the rest of the thread.
    Jessy_RN, CCL RN, hubcap56, and 3 others like this.
  2. 7
    Quote from BluegrassRN
    I 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..... I don't care how good of a laborer you are, you aren't a great nurse.
    I don't see that "trades" by definition only require physical labor and not intellectual labor. Or that nursing has to be considered "a profession" in order for it to be acknowledged as more than "just following orders" and mindless manual skills.
    Jessy_RN, talaxandra, oliviajolie, and 4 others like this.
  3. 2
    Quote from jjjoy
    Or that nursing has to be considered "a profession" in order for it to be acknowledged as more than "just following orders" and mindless manual skills.
    Yeah, I've often wondered. We work so hard to be a profession to get the respect we deserve. So if we only fulfill 4 out of 5 criteria for being a profession, then we don't deserve respect? How messed up is THAT?
    Bella'sMyBaby and eriksoln like this.
  4. 12
    Quote from eriksoln
    I know many of you will be upset with me and my views. They are what they are. I make no apologies for them. Not having a well liked opinion has never stopped me from saying what I feel needs said before.

    So...............am I wrong? Why?

    After 30 years in this field, I've come to the conclusion that the is-nursing-a-profession-or-not discussion doesn't much matter, except as an attempt to categorize a complex occupation that doesn't fit very well into any category. In my case, I DO see nursing as a profession----a field that requires specialized formal education, intellect and creative problem solving skills, as well as manual skills and the ability to conform to prescribed procedure----and treat it accordingly. Others, who take it just as seriously and are no less competent, might see it as a trade. That's fine with me. I just try to do my job in as professional a way as possible, and those whose opinions I value usually treat me as a professional in return.
    Jessy_RN, jackiesue94, hubcap56, and 9 others like this.
  5. 7
    I don't have too much to add that hasn't already been said, but I wanted to say:

    Excellent post, Erik! I agree with much of what you posted.
    Jessy_RN, Chin up, ohioSICUrn, and 4 others like this.
  6. 8
    I read these forums daily and usually do not jump into thr fray but here goes!
    I have been an RN for almost 25 yrs now and i have to say that I agree with the OP-with a few exceptions.
    In my own career, I truly felt I was able to actually "practice" my profession when I did home health, was a clinical manager at a outpt clinic, and as an outpt case manager. During those times, I was actually involved in the collaborative team practice that nsg school (BSN) drilled into my head. My nursing assessments and recommendations were taken seriously and we worked together to formulate the plan of care that was best for our pt's.
    However, I do not think that is the norm for most nurses-esp. in the hospital setting
    Jessy_RN, Chin up, oliviajolie, and 5 others like this.
  7. 24
    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's it in a nutshell, I think: nursing is much more than a series of tasks. Have you ever worked with a nurse who merely came to work and performed whatever tasks were required of him/her, without seeing the bigger picture? It doesn't work well.

    I remember one nurse I used to follow, when I worked on a tele unit some years ago. This woman was skilled enough at starting IVs, inserting Foleys and NGs and doing other "nursing" tasks, but there her competence ended. One night I was making initial rounds after getting report from her, and I noticed one patient looking pale and apprehensive, lips slightly bluish; respirations somewhat labored, who said (just like in the textbooks), "I...don't know what's wrong....but....I....feel like....something bad....is about to...happen." O2 sat 82%. I glanced at her IV, which was infusing saline at 125/hr. I turned it off and listened to her lungs: splash!

    Well, I called her doctor immediately and did all the usual interventions (the IV Lasix resulted in 2700 cc of urine within 30 minutes), and she ended up spending the night in ICU, although by that time she was feeling significantly better. As I transferred her, she said, "Thank you....I think you saved my life."
    As an afterthought, she added, "You know, I kept telling that other nurse all evening that I didn't feel right and was having trouble breathing, but she just said I was fine and didn't do anything about it." In other words, he just let that saline keep on running for eight hours, without ever checking the patient's sats or listening to her lungs. No doubt she reasoned that she was following all the orders, so that must mean that nothing bad could happen, right?

    THAT is one big thing makes a (competent) nurse different from unlicensed personnel with a lot of procedural skills: the ability to foresee and prevent problems. And that's also why it takes a lot more than learning a bunch of technical skills to become a surgeon.
    trixie333, LPNnowRN, VanLpn, and 21 others like this.
  8. 4
    Quote from JulieCVICURN
    I 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.
    Yeah, sometimes I can't get over the thought process that leads one to believe laborer = loser.

    If you really believe that, you need to go out and create for yourself a new "body of unique knowledge" lol, and ready up on the Mason's Guild. Yeah, such losers there. People kill themselves to be accepted.

    Its also important to point out, I don't equate not being a profession with not acting professionally. I was a landscape laborer for a long time and had to deal with irate customers (yelling at me for what the boss charged them last month, some other laborer was smoking in front of their kids). I had to handle these situations with a professional manner. But that does not make me a professional while I do it.
    Chin up, morte, PetiteOpRN, and 1 other like this.
  9. 2
    Quote from NocturneRN
    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's it in a nutshell, I think: nursing is much more than a series of tasks. Have you ever worked with a nurse who merely came to work and performed whatever tasks were required of him/her, without seeing the bigger picture? It doesn't work well.

    THAT is one big thing makes a (competent) nurse different from unlicensed personnel with a lot of procedural skills: the ability to foresee and prevent problems. And that's also why it takes a lot more than learning a bunch of technical skills to become a surgeon.
    In Australia, we are SUPPOSED to be a profession too.

    However ....Why is theory such as Maslow's considered part of our 'academic core' ? Maslow is very basic ...it's so easy one could learn it in high school.
    Why is the nursing process considered so highly? Again so very basic (and obvious) it's embarrassing. It's a basic problem solving process that any intelligent person uses.
    A smart senior high school student could handle this 'professional' stuff.
    I have been ripped off obtaining my BScN.

    Hospitals realize this....that's why they value those nurses who have learnt 'a bunch of technical skills' JUST AS HIGHLY as those who have these plus the broader picture.

    Which then leads us to the big point. Why do so many areas perform well with so many of those nurses with 'a bunch of technical skills' leading the pack? They are good at performing skills quickly and moving patients through ...conveyer belt nursing. Not much else gets considered ...nothing collapses.

    IMHO there was a good glimmer of hope years ago that we might become real professionals. What has happened?
    Perhaps the following factors have contributed to the bedside nurse deskilling:
    - Large nurse shortages in the past contributing to reduced entry levels nursing schools (prior to this recession)
    - Increased use protocols and other processes = reduced professional autonomy
    - Arrival mid-levels who have carved their chunk out...taken a bit of doctor ground and taken quite a big chunk of our ground (the stuff that used to grab me as a younger nurse.... great for professional development is now not my domain)
    Chin up and eriksoln like this.
  10. 1
    Quote from eriksoln
    Yeah, sometimes I can't get over the thought process that leads one to believe laborer = loser.

    If you really believe that, you need to go out and create for yourself a new "body of unique knowledge" lol, and ready up on the Mason's Guild. Yeah, such losers there. People kill themselves to be accepted.

    Its also important to point out, I don't equate not being a profession with not acting professionally. I was a landscape laborer for a long time and had to deal with irate customers (yelling at me for what the boss charged them last month, some other laborer was smoking in front of their kids). I had to handle these situations with a professional manner. But that does not make me a professional while I do it.
    Yes agree.
    There is GENERIC professional (coming to work on time, controlling ones emotions, certain level written and verbal communication)
    and there is PROFESSIONAL which mainly pertains to the level at which information is handled.
    Too many nurse confuse the two
    eriksoln likes this.


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