Time to call a duck a duck?

[eriksoln]

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 and everyone around them, my opinion seems even more valid. I wonder what others think about it.

I remember sitting in nursing school as the instructor drummed on and on about how "Nursing is a profession." That exact theme butted it's head into almost every single class one way or another, regardless of the subject matter. I often found myself thinking "Who cares?" or "What's the point in that?". Then came the dreaded "Dimensions of Nursing" class. It was the class all RN's must go through at one point or another (IDK if LPNs do or not). There are other names for it "Political Aspects of Nursing" I've heard among a few others. It is the class in which you must discuss the political issues that involve nursing. You are encouraged to join this and that group, Nursing as a Profession is discussed over and over, and you must do a research paper. I never really said in that class how I really felt about the whole business of nursing being a profession in fear of drawing the ire of my superiors.

What is it I had to say that my fellow students got to hear during breaks that my instructors did not? Well: Nursing is not a profession, not even with a very generous stretch. It is a labor, a trade. We are judged solely by the amt. of patients we can handle and still keep the minimal quality expected by our administration up to par. Not very much unlike a McDonald's burger flipper. The faster you can cook those patties without screwing too many up, the better you are. That's all there is to it really. If you don't believe me, take a gander at where nursing expenses falls in the budget. We are not logged next to the admin./doctors/lawyers or any of the other professionals. We are grouped in with dietary/housekeeping/security. As far as budget makers are concerned (and, lets be honest, they make the rules), we are a debt, like a labor.

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.

Ever see the movie "Man in the Iron Mask"? The King/spoiled twin tells his brother "Into the dungeon you will go, and you will wear this mask again, and you will wear it until you love it."

We are wearing the mask, but are for some reason we are unable to learn to love it. So we will forever stay in the dungeon denying what we are.

Lets face it. All the aspects of a "profession" are an illusion in nursing.

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. Unique body of knowledge: We do need to go to school and must learn a lot, but I don't know about the unique part of it. Most CNA's pick up on how to do what we do after just a couple years, without the schooling. As far as values and perspective go, lets face it, we can't even agree in here on what that is. How many "Calling from God vs. Its a job" threads/rants have you seen on this site. I've lost count. We can't even agree amongst ourselves what degree we should have. I've also lost count of the "BSN vs. ADN vs. Masters" threads.

2. Controlled entry: Phfffft. It is controlled, but not by us. The hospital/medical field administration decides this. Whatever they decide they are willing to hire is what the rule is. If they decide tomorrow to never again hire ADNs.........that's that for them. We have no say in it. Seen any "Nurses eat their young" vents/threads lately. I know you have;), even if you were a blind, deaf mute with both hands tied behind your back you can't help but run into them on here. If we truly were in control of who came into the profession, such threads would be minimal. Can't be angry about who is allowed in when its your decision who gets in.

3. Demonstrates a high degree of autonomy: Again, I lead with PHfffffft. Our job description continues to be and will forever be everything and anything they can't pawn off on the other laborers. How many of us, since the recession hit, have been told to pick it up and help out in non-nursing job related ways? Empty the trash, stock the cabinets, hand out trays, collect and clean the trays..........its endless. We are unable to define for ourselves what we will and will not do. You don't see them sending the Legal dept. any emails about helping maintenance do you? Any rules/laws concerning scope of practice are simply to protect patients from us should we decide to play doctor. No laws exist to restrict what can be expected of us away from the bedside (no, that would actually be useful, help the pt., can't do anything silly like that).

4. Has its own disciplinary system: Do I need to insert Phffffft again? Oh, I just did. We only qualify here if badgering, cattiness and petty write ups are "disciplinary". Nuff said.

5. Respect of the community: I'll resist the urge to insert the obvious lead here. I'll just point out the complaining about surveys that's been the norm lately. Lets face it folks, professions who have respect are not surveyed like this. These surveys resemble grade school report cards "Nursey doesn't play well with others". If we were "respected", we'd be the ones filling out the surveys on how to improve the model of care given.

Think back to your highschool days. Remember that class clown who tried way too hard to be funny? The not so good looking girl who never stopped digging for compliments on her looks? The not so well liked guy always asking if you and he were buddies or not? That's what nursing has let itself become. Constantly running around worrying about impressing people and all the while completely losing its focus on the primary goal. A lost teenager suffering from an inferiority complex.

Maybe if we embrace the fact that we are............:eek:gasp..............a mere labor, we will be able to dedicate ourselves to our patients. Instead of worrying about proving nursing holds a "unique body of knowledge" and making up useless, pointless "theories" and such (tell me one instance you have found a use for nursing diagnosis), we will become more useful. Focus instead on better time management, better understanding of the things we actually use on the job (the equipment for instance) and a better understanding of the tasks expected of us (study IV insertion in school instead of writing papers about why nursing is a profession).

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?

[NocturneRN]

Oh nooo. LOL:yeah:

I have to tell you guys this. I brought up this whole debate up to a nurse I LOVE last night. Now, this nurse can put all the pieces together. She is able to pinpoint process flaws and correct them before they happen and predict oncoming complications for the pt's care and anticipate what to do to avoid the problem. At the same time..............she approaches her bedside duties with every bit the motivation of a student or fresh brand new nurse. No missing turning your patients or passing water pitchers cause you are too busy boasting about the latest mistake you caught with this nurse.

Want to know what she said?

I'm telling you anyway:

"I don't care either way if history judges us as a profession or a skilled trade. Won't change anything for me or my family. (Somehow, I think most of the better nurses around the world probably think this). The problem with getting too tied up in "is it or isn't it" is you can be right either way, but in the end, thats all you get, to be right. Being right about that isn't going to make you a good nurse.

Problem is, nursing makes us run and hustle like we are laborers, and some nights thats really all you need to do. Other nights, you really need to have your thinking cap on or someone is going to lose a leg, or die.

Nursing draws upon the good aspects of both skilled laborers and professionals. We must carry ourselves like professionals, but be willing to get dirty like a laborer. All in the same night. We must bring our best both with the pen and with our hands. Simply doing the tasks/chores of the job but not applying your brains will just mean you have a pt. who doesn't get any better.............with clean sheets. Only being a desk nurse and thinking you are above the tasks means you have a bunch of patients who will get the proper medical treatment, but probably won't follow through anything after because they don't respect you.

So, really, when you get down to it, its neither a profession or a skilled trade. We are too important for either category."

And there you have it folks. The answer I've pretty much decided is right for me.

And when she was done yelling this at me (yes, she said all this in a tone that I imagine Patton used with his troops before a big battle), she quickly prompted me to help her bath a pt. cause...........well, if we have enough time to talk about stuff like this we should be doing something for the patients.

Doh.

I like this nurse!

[pedicurn, LPN, RN]

So we have come this far .....

Nursing is a mixture of trade/profession/blue collar

Then how does this odd situation affect our culture?

When we have a mix of nurses from the 'ofcourse I'm a real professional' camp and 'nah, a duck is still mostly a duck' ....what are the implications for work culture?

And when we have a mix of people who possess varying degrees of proper professional skill (from basically none to those who could handle the complexity of law/medicine/engineering) and practical skill (completely awful to being to go-to nurse for vacuum dressings)

If we understood this better ...then surely we might better understand our cultural challenges?

[*ac*]

Didn't read the whole thread, but have a quick .02.

I feel like nothing but a warm body filling a number on an fte grid. Period.

When in any kind of group setting, wether it's rounds at bedside with MDs or in a meeting, I feel like other disciplines are PRETENDING to respect the RNs opinion, because somebody, somewhere has told them it would behoove them to do so. Just the feeling I get.

[nursemike, ASN, RN]

Oh nooo. LOL:yeah:

I have to tell you guys this. I brought up this whole debate up to a nurse I LOVE last night. Now, this nurse can put all the pieces together. She is able to pinpoint process flaws and correct them before they happen and predict oncoming complications for the pt's care and anticipate what to do to avoid the problem. At the same time..............she approaches her bedside duties with every bit the motivation of a student or fresh brand new nurse. No missing turning your patients or passing water pitchers cause you are too busy boasting about the latest mistake you caught with this nurse.

Want to know what she said?

I'm telling you anyway:

"I don't care either way if history judges us as a profession or a skilled trade. Won't change anything for me or my family. (Somehow, I think most of the better nurses around the world probably think this). The problem with getting too tied up in "is it or isn't it" is you can be right either way, but in the end, thats all you get, to be right. Being right about that isn't going to make you a good nurse.

Problem is, nursing makes us run and hustle like we are laborers, and some nights thats really all you need to do. Other nights, you really need to have your thinking cap on or someone is going to lose a leg, or die.

Nursing draws upon the good aspects of both skilled laborers and professionals. We must carry ourselves like professionals, but be willing to get dirty like a laborer. All in the same night. We must bring our best both with the pen and with our hands. Simply doing the tasks/chores of the job but not applying your brains will just mean you have a pt. who doesn't get any better.............with clean sheets. Only being a desk nurse and thinking you are above the tasks means you have a bunch of patients who will get the proper medical treatment, but probably won't follow through anything after because they don't respect you.

So, really, when you get down to it, its neither a profession or a skilled trade. We are too important for either category."

And there you have it folks. The answer I've pretty much decided is right for me.

And when she was done yelling this at me (yes, she said all this in a tone that I imagine Patton used with his troops before a big battle), she quickly prompted me to help her bath a pt. cause...........well, if we have enough time to talk about stuff like this we should be doing something for the patients.

Doh.

Wow. Reading those words, I heard them in the voice of a friend and mentor who passed away a year ago and it choked me up. She never yelled though. Never raised her voice. But anyone who spoke to her felt they had her full attention, and when she spoke, anyone with brains enough to pour pee out of a boot listened with full attention.

I miss that gal. All this week, people on my unit have been shaking their heads and marveling that it has been a year, already. Seems like yesterday. And more than a few eyes start to well up as we reminisce, and nobody has to ask why. And I doubt she ever lost a moment's sleep about whether she was a professional, and I know damned well she didn't feel inadequate about her diploma. If PJ wasn't a professional nurse, I don't want to be, because I don't exaggerate one iota that every patient on our unit had a better chance of living through the night as soon as she clocked in.

[tewdles, RN]

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. Unique body of knowledge: it is pretty clear that nurses DO possess a unique body of knowledge. You scare me when you say that CNAs can learn to do what you do by osmosis or something...what the heck???

2. Controlled entry: you misinterpret what this means if you think that your hospital has control over entry into nursing. They certainly have control over who they hire, but who is licensed as a nurse in their region is completely out of their control. That is controlled by nursing.

3. Demonstrates a high degree of autonomy: Again, your employer has control over your autonomy...I enjoy a high degree of professional autonomy and that is common in my field. A bit more than half of all nurses work in the acute care hospital setting...there ARE other nursing experiences which are much more autonomous. Just because you don't experience it doesn't mean it doesn't exist.

4. Has its own disciplinary system: Clearly you have never experienced the disciplinary system of your state board of nursing...good for you...but it exists and to deny that is a bit cavalier.

5. Respect of the community: Have you made assumptions here based upon your own experience, the numbers do not support your notion that nurses as a group are not respected in the community?

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

I think that some nurses work for employers who do not treat them like professionals.

I think that some nurses work in environments that foster and even promote disrespect and abuse.

I think that some nurses do not feel like professionals, are not treated like professionals by their peers and coworkers, and therefore presume that nurses are, therefore, not professionals.

Honestly...your confusion doesn't affect me one way or the other...just you...and possibly your patients. I know that I am a nursing professional, I am generally treated with professional respect, and I practice my profession with a reasonable amount of professional autonomy. I probably spend a fraction of the time thinking about this issue that the OP does. Why so much less time thinking about it? Because those who are deprived of something spend more time thinking about the something...human nature...

My recommendation to the OP...take a deep breath and let go of this concern...

seriously...whether or not nursing is a profession is completely out of your control...

however, if you desire to be treated as a nursing professional...you probably need to take some action...if you desire to have more professional autonomy, you may need to find another employer or specialty.

so if it walks like a duck, sounds like a duck, and looks like a duck...we should call it a duck.

Even your mentor said "We must carry ourselves like professionals, but be willing to get dirty like a laborer." If it walks like a duck... I suggest to you that there are many, many nurses who look like professionals, act like professionals, talk like professionals, and are treated like professionals....if we call a duck a duck we will call them professionals. I am sorry that you do not share this experience.

Please don't try to take the candy away from the other children because you don't have any...you can have some too...

[carolmaccas66, BSN, RN]

Oh how so true these words are! We are not seen as professionals (like doctors for instance) who have struggled to study and given up many valuable things in our lives to become professional nurses (the least not being our time).

When I was a student everybody was just concerned about how many tasks you had done that day, & that is exactly what you were assessed on.

The same goes for practising as a RN. Nobody cares how compassionate you are, or that you spent time talking with 92 year old Mrs so-and-so cos she has no family to visit her (I know a nurse who was told off & reported for taking a reasonable amount of time to talk to a very lonely patient). My friend introduced me to a friend of hers one day who asked what I did. B4 I could answer my 'friend' replied: "Oh she's just a nurse".

Nursing is VERY labour intensive, backbreaking, knee-breaking, soul destroying work. I still say it is quite often glamourised too much on TV etc which gives younger people the wrong impression. I have been called a 'bumwiper' amongst many other things - & this was said seriously by people who weren't nurses - that's how they see us, or they say things like: "What on EARTH made you want to be a nurse?" Most people can't understand why we do this profession.

Most nurses who have been in nursing for years are very hard hearted in my experience. Some just need to retire and get out.

And it is true that every year we do more & more, & it's usually tasks that have nothing to do with nursing. As you said who would see a lawyer emptying bins etc? They would laugh in your face.

And sorry peoples, I don't know anyone who has a job that 'puts a wind up their skirt' or whatever it was. Most people just work to pay off their bills from what I can see.

No we are not seen as professionals at all - just seen as being there for the doctors I think.

And yes of course you have a right to your opinion - that's what these blogs are for and it makes debate/discussions more interesting.

[NocturneRN]

I think too, maybe because I was sickly when I wrote the article, I may have come off strong or unhappy. This lead a few people to believe I was slamming nursing or its importance to our cultural system. In truth, I am simply opening up discussion on where we could improve things for everyone involved, most importantly the patient.

I am happy with what I am doing. I went back and read a very old article I wrote some time ago. "Talked into a career in nursing by Stephen King". I still feel the same way I did when I wrote that.

I just wish our trade had more focus, less posturing.

"Posturing" isn't unique to nursing. Before I went to nursing school, I had a degree in secondary education----and, if you want to see empty posturing and gaseous pedagogical terms thrown around, try some of those education classes! We studied performance objectives; we studied educational philosophies; we sat through lectures on how U.S. school districts are set up; we memorized "the education process," which consisted of assessment, planning, implementation and evaluation. Sound familiar? My husband learned it as "the engineering process." And most of the world knows it as "the problem solving process."

In any academic curriculum, you're going to get some theory and philosophy, and, in many cases, it's going to be terribly tedious. (I used to think that these classes were retained in the curriculum only because the university had a lot of elderly professors on tenure who didn't know how to teach anything else.) But, often, there's a reason for it: to make sure that everyone is on the same page, so to speak. Sure, you might already be aware, without being told, that, if you get a patient with a crushing injury to his finger, you need to watch the circulation in that finger. But not every lay person or new nursing student realizes that! Nor do they often realize that one isolated injury can trigger a whole body response. Or that, if they're seeing several unusual symptoms at the same time, those symptoms can often be related in some way. Or that what feels right to the patient isn't always the best thing for him/her medically. One of the things nursing school does is to teach them to solve problems methodically, rather than just jump to the most obvious conclusion.

It's been 30 years ago (this week, in fact!) that I took what were then called "boards" (what is now the NCLEX). I still remember feeling dismayed when I came to a dozen or so questions, all about a hypothetical child diagnosed with lead poisoning. I'd never even seen a case of lead poisoning---how could I answer these questions? (The year before, I understand, there were a bunch of questions related to Rocky Mountain Spotted Fever.) But answer them I did, and I passed. And, later on, I learned why those questions were on there. The point of those questions was not so much to test what I knew about lead poisoning, as whether I knew how to apply what I'd learned to unfamiliar situations.

It's that ability----which comes as much from nursing theory as from how-to lectures and demonstrations----that makes nursing school an education process rather than just training. Some nursing students---especially those with a background in health care or prehospital care---have already grasped the process behind that ability, and are already applying it in nursing clinicals. But others have not. And still others have grasped it partially, but don't yet understand how to apply it to new situations.

[eriksoln, BSN, RN]

I think that some nurses work for employers who do not treat them like professionals.

I think that some nurses work in environments that foster and even promote disrespect and abuse.

I think that some nurses do not feel like professionals, are not treated like professionals by their peers and coworkers, and therefore presume that nurses are, therefore, not professionals.

Honestly...your confusion doesn't affect me one way or the other...just you...and possibly your patients. I know that I am a nursing professional, I am generally treated with professional respect, and I practice my profession with a reasonable amount of professional autonomy. I probably spend a fraction of the time thinking about this issue that the OP does. Why so much less time thinking about it? Because those who are deprived of something spend more time thinking about the something...human nature...

My recommendation to the OP...take a deep breath and let go of this concern...

seriously...whether or not nursing is a profession is completely out of your control...

however, if you desire to be treated as a nursing professional...you probably need to take some action...if you desire to have more professional autonomy, you may need to find another employer or specialty.

so if it walks like a duck, sounds like a duck, and looks like a duck...we should call it a duck.

Even your mentor said "We must carry ourselves like professionals, but be willing to get dirty like a laborer." If it walks like a duck... I suggest to you that there are many, many nurses who look like professionals, act like professionals, talk like professionals, and are treated like professionals....if we call a duck a duck we will call them professionals. I am sorry that you do not share this experience.

Please don't try to take the candy away from the other children because you don't have any...you can have some too...

Thats not candy you have in your hand there. Unless denial is chocolate flavored all of a sudden.

LOL at the state/nurses get to choose who is licensed and who is not. Sooooo.........as they currently are in NY, when the businesses decide they are only hiring BSN................what good does being allowed the ADN license do you? After the business (the non-nurses) set the standard, the BON just follows suit. They don't make any decisions.........they just adjust and cater their "policies" to whatever the non-nurse decision makers are saying.

And yes, you can technically have your license after an incident but be fired by your employer. In essence, you are not being disciplined by the "nursing" BON. Won't do you a bit of good unless you can relocate to the other side of the country once you've been fired........................for forgetting to empty the trash cans. Again, actually having your license in this case is simply cosmetic. If you have a bad rap with the business suits and get black listed..........well, nuff said.

Your post kinda reminds me of a lot of the administrative type nurses I knew a few years ago. You know the type............hasn't seen the bedside except through pictures in the hospital news flyer in years, has some special title and area of "expertise" that they are accountable for () and...........for the most part are invisible other than in the lunch room and a few emails they send the nurses. These people walk around the hospital, strutting like they owned the place and had it all figured out. Annoyed the hell outta the bedside nurses more than anything else.

Well, these were your "I am a professional" nurses. Guess who was excused out the door first when the recession hit. Yep. Most of them were told "You have no practical role to the hospitals functioning and we are relocating your (cough, ahem) duties to other people". It happened overnight almost. One day the hospital is full of em, next day................well. Some even tried to return to bedside nursing but, most were given a nice, political "you are overqualified" pat answer.

They had the "I am a professional" part of nursing a little too blown up and lost their value because of it. Didn't have the "get down and dirty" part that is necessary for all nurses, even the one's who say nursing is a profession. And they all felt they could be autonomous and had a body of knowledge that was so unique too.

[eriksoln, BSN, RN]

"Posturing" isn't unique to nursing. Before I went to nursing school, I had a degree in secondary education----and, if you want to see empty posturing and gaseous pedagogical terms thrown around, try some of those education classes! We studied performance objectives; we studied educational philosophies; we sat through lectures on how U.S. school districts are set up; we memorized "the education process," which consisted of assessment, planning, implementation and evaluation. Sound familiar? My husband learned it as "the engineering process." And most of the world knows it as "the problem solving process."

In any academic curriculum, you're going to get some theory and philosophy, and, in many cases, it's going to be terribly tedious. (I used to think that these classes were retained in the curriculum only because the university had a lot of elderly professors on tenure who didn't know how to teach anything else.) But, often, there's a reason for it: to make sure that everyone is on the same page, so to speak. Sure, you might already be aware, without being told, that, if you get a patient with a crushing injury to his finger, you need to watch the circulation in that finger. But not every lay person or new nursing student realizes that! Nor do they often realize that one isolated injury can trigger a whole body response. Or that, if they're seeing several unusual symptoms at the same time, those symptoms can often be related in some way. Or that what feels right to the patient isn't always the best thing for him/her medically. One of the things nursing school does is to teach them to solve problems methodically, rather than just jump to the most obvious conclusion.

It's been 30 years ago (this week, in fact!) that I took what were then called "boards" (what is now the NCLEX). I still remember feeling dismayed when I came to a dozen or so questions, all about a hypothetical child diagnosed with lead poisoning. I'd never even seen a case of lead poisoning---how could I answer these questions? (The year before, I understand, there were a bunch of questions related to Rocky Mountain Spotted Fever.) But answer them I did, and I passed. And, later on, I learned why those questions were on there. The point of those questions was not so much to test what I knew about lead poisoning, as whether I knew how to apply what I'd learned to unfamiliar situations.

It's that ability----which comes as much from nursing theory as from how-to lectures and demonstrations----that makes nursing school an education process rather than just training. Some nursing students---especially those with a background in health care or prehospital care---have already grasped the process behind that ability, and are already applying it in nursing clinicals. But others have not. And still others have grasped it partially, but don't yet understand how to apply it to new situations.

Yeah. I had a friend who studied...........wait for this one.......... Chimney Sweeping and I recall him saying something about "There are chapters in this housing codes book that make no sense, sounds almost like they are frustrated philosophers or something."

I didn't ask what it was, but I bet its what U R talking about. I don't doubt there is a "Sweepers Process" or something.

I do think it is most extreme in nursing though. As I said, we are FLOODED with people who consider nursing their image. I've known lawyers and certainly doctors too who act like that but, my gosh, nursing is flooded with this stuff.

Those who consider it their image, like another poster said, are the first to die out, give up on the whole thing when reality smacks them down. Sometimes though, they hang on, become disgruntled, refuse to participate in nursing as a whole cause they are too busy trying to convince everyone they are some sort of "professional" they are not. You know the type.........doesn't answer their own call bells much less anyone else's, always "needs a hand" whenever a task they consider dirty comes up, loves to spend hours at the desk documenting how a pt. said it was noisy on the unit they were just transfered from (because they have to write up a very professional sounding entry).

[nursemike, ASN, RN]

I'm really starting to like "craft" as a description of what we do. Seems to me a way to recognize both the science and the art, the technical skill, and the occassional elements of magic. We practice nursecraft.

I know--magic is going a little overboard, but darned if it doesn't feel that way, sometimes. But, bear in mind, I'm a guy. And by that, I mean more of a 1950s guy than a 1990s guy. I'm not someone who was ever much in touch with my feminine side, except perhaps with some animals. With humans, I think I have always tended to use my sense of humor as a way of breaking the ice without really getting too close. So, now I find myself pretty regularly forming an emotional bond with total strangers. Maybe that's still some of the crotchety old bachelor in me--it might be easier to make a serious commitment when I know it's only gonna last a week or so. I rarely recognize the ones who are readmitted months later. Still, I like it when I find myself somehow knowing the right thing to say or do without knowing how I know it. There have been a few shifts where I have realized, and some where the patient did, too, that I was just the nurse someone needed at that particular moment in time. And I have seen that with other nurses, as well. I suspect it happens with all of us, and probably a lot more often for many than for me. But that it happens at all is kinda spooky and neat.

So, over the past weekend, I was in our stepdown subunit, and overheard a nurse on days reporting off to one of my coworkers that one of her patients had a Disturbed energy field. She was joking--sort of--but I watched my coworker, an old-school nurse if ever there was one--working magic with this dude, using old-school interventions like maintaining proper body alignment and therapeutic communication. Her "therapeutic touch" wasn't the new age version, it was rubbing his shoulders to help him relax. She demonstrated caring because she's a nurse and that's what she does. I don't know whether the guy had an aura or not, but if he did I think it was probably in better alignment by morning. At least his behavior was more appropriate. And while the problems that put him in a stepdown bed were probably scientific in nature, his most pressing needs from his POV, r/t dealing with a life-altering injury, were ones that called on the art of nursing. It was cool to see him getting both.

[eriksoln, BSN, RN]

I'm really starting to like "craft" as a description of what we do. Seems to me a way to recognize both the science and the art, the technical skill, and the occassional elements of magic. We practice nursecraft.

I know--magic is going a little overboard, but darned if it doesn't feel that way, sometimes. But, bear in mind, I'm a guy. And by that, I mean more of a 1950s guy than a 1990s guy. I'm not someone who was ever much in touch with my feminine side, except perhaps with some animals. With humans, I think I have always tended to use my sense of humor as a way of breaking the ice without really getting too close. So, now I find myself pretty regularly forming an emotional bond with total strangers. Maybe that's still some of the crotchety old bachelor in me--it might be easier to make a serious commitment when I know it's only gonna last a week or so. I rarely recognize the ones who are readmitted months later. Still, I like it when I find myself somehow knowing the right thing to say or do without knowing how I know it. There have been a few shifts where I have realized, and some where the patient did, too, that I was just the nurse someone needed at that particular moment in time. And I have seen that with other nurses, as well. I suspect it happens with all of us, and probably a lot more often for many than for me. But that it happens at all is kinda spooky and neat.

So, over the past weekend, I was in our stepdown subunit, and overheard a nurse on days reporting off to one of my coworkers that one of her patients had a Disturbed energy field. She was joking--sort of--but I watched my coworker, an old-school nurse if ever there was one--working magic with this dude, using old-school interventions like maintaining proper body alignment and therapeutic communication. Her "therapeutic touch" wasn't the new age version, it was rubbing his shoulders to help him relax. She demonstrated caring because she's a nurse and that's what she does. I don't know whether the guy had an aura or not, but if he did I think it was probably in better alignment by morning. At least his behavior was more appropriate. And while the problems that put him in a stepdown bed were probably scientific in nature, his most pressing needs from his POV, r/t dealing with a life-altering injury, were ones that called on the art of nursing. It was cool to see him getting both.

Nursecraft. I like that.

Hey, my day ended with...............a family member up my behind because they didn't understand why their mother was on Ultram, a colostomy exploding on me and a pt. (don't laugh at me, this is true) deciding he was going to take ALL his meds like suppositories. Yes, I had to spend half an hour explaining to him why protonix just wont work when taken that way.

This, all at the end of the day (started at 0630, I am done at 0730) while I am passing meds and doing I/O's.

I don't know what you call it, but I got outta there with the family member happy with me and understanding Ultram, the colostomy pt. cleaned up with all equipment changed and new, meds passed, I/O's completely done and weird guy now willing to take PO..............through the mouth. I call it magic that I only got out 15min. late and didn't kill anyone.

[wooh, BSN, RN]

pt. (don't laugh at me, this is true) deciding he was going to take ALL his meds like suppositories. Yes, I had to spend half an hour explaining to him why protonix just wont work when taken that way.

In peds we have a new directive to do "Asthma Action Plans" whenever we send home an asthma patient. So we write all their inhalers on there. Now I was being good, telling them to take their albuterol, how many puffs, how often. Then get a note back that we have to write the strength, even though albuterol only comes 90mcg/puff (For other puffers, ok, there are different strengths but albuterol only comes in 90!). So I write that all the time. Then we get a note saying we have to write the route out. Now if I send a patient home, and the family decides that they're going to go for doing their puffs rectally or lady partslly instead of by mouth, I think they have bigger problems than just the asthma, and those problems aren't going to be fixed by writing "albuterol 90 mcg/puff 4 puffs BY MOUTH every 4 to 6 hours as needed."