Time to call a duck a duck?

Nurses Professionalism

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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?

Specializes in M/S, Travel Nursing, Pulmonary.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

I can never got away form the time clock. I am not aware of other "professions" who punch time clocks.

I can never got away form the time clock. I am not aware of other "professions" who punch time clocks.

Attorneys have their billable hours. Of course they have a big something we don't have. People recognize that attorneys provide a service worth billing for. Where nurses are just part of the room charge along with the toilet paper and the disposable bedpan.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Attorneys have their billable hours.

*** Totally different. Attorneys, being professionals, bill for the hours they work for their client. No time clock for them to punch, they are trusted to be professional. Nurses, like factory and other blue collar workers are not trusted to bill for their hours and so must punch the clock to prove the time they were on the job.

Specializes in being a Credible Source.
I can never got away form the time clock. I am not aware of other "professions" who punch time clocks.
That's because most professions have the misfortune of being salaried.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
That's because most professions have the misfortune of being salaried.

*** Or being a fee for service like my accountant and lawer. Either way I doubt many physicians or dentists or lawer punch time clocks.

Specializes in Spinal Cord injuries, Emergency+EMS.

the punching the clock phenomena appears to be a peculiarly USAn one - i can't speak for everyone , but those of us in the UK don't have such systems - even if other groups of staff in the hospital do ( e.g. domestics etc)

Specializes in CVICU.

Having gone from punching the clock to salaried - punching a clock is better. I can't even tell you how many extra hours of my "own" time I spend on work and don't get paid for it. At least if I was punching a clock my boss would understand just how much time and effort I'm putting in.

I think if bedside nurses were salaried they'd end up with a lot more mandatory shifts to cover for short staffing, and working much longer hours because they'd tend to stay until a job was done instead of leaving at the end of shift time. The clock is your friend.

ETA: By staying until a job is done, I don't mean to insult bedside nurses. My point is that nursing is a 24 hour a day job, and it's never done, and the tendency of caregivers is to try to get everything done before they leave for the day. The clock makes you accept that you can't finish everything and you have to leave it for the next person to take care of, and vice versa.

Specializes in Spinal Cord injuries, Emergency+EMS.

I think if bedside nurses were salaried they'd end up with a lot more mandatory shifts to cover for short staffing, and working much longer hours because they'd tend to stay until a job was done instead of leaving at the end of shift time. The clock is your friend.

there seems to be an assumption that there is only ever 2 ways of managing working time , either

a punch the clock

b be 'salaried' and have no allowance for working time in excess of contracted or the times / days you are required to work

as i've said previously in this thread havign a system where there are shift allowances etc doesn't necessarily have to have a punch card and clock unless the employer is convinced that fraud would be so widespread that it has to be done this way - given that timesheet fraud is both a criminal matter and something which could get you reported to the registration authority aside from any criminal charges ....

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Having gone from punching the clock to salaried - punching a clock is better. I can't even tell you how many extra hours of my "own" time I spend on work and don't get paid for it. At least if I was punching a clock my boss would understand just how much time and effort I'm putting in.

I think if bedside nurses were salaried they'd end up with a lot more mandatory shifts to cover for short staffing, and working much longer hours because they'd tend to stay until a job was done instead of leaving at the end of shift time. The clock is your friend.

ETA: By staying until a job is done, I don't mean to insult bedside nurses. My point is that nursing is a 24 hour a day job, and it's never done, and the tendency of caregivers is to try to get everything done before they leave for the day. The clock makes you accept that you can't finish everything and you have to leave it for the next person to take care of, and vice versa.

*** Salaried would suck. However there are other ways to get paid besides punching the time clock or being salaried. I would like to bill for services.

Specializes in CVICU.
I would like to bill for services.
That would be nice, but then you'd probably also have to manage your own insurance and worry about contracting your next job.

Excuse me.

Professional nursing organizations are on the frontlines of everything from standardized clinical languages, evidenced based practice, infection control, patient saftey, knowledge dissemination, NIC, NOC, careplans, certifications it's hard for me to think of another profession that covers as much ground so diligently.

PS - I don't disagree with all your points. Clinical competence is paramount for nursing and I certainly wish the nursing programs had given me much more preparation than I got.

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