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?

[SuesquatchRN, BSN, RN]

Wait...as an LPN, I was told that I was not a professional nurse, I was a technical nurse. Meaning I knew how do to basic technical procedures and had basic knowledge of why I was carrying out this order. However, the RN, with their educational background, made them PROFESSIONAL NURSES. (Case in point, the ANA only accepts RN as members).

That ANA wants to eliminate LPNs, make ASN RNs technical nurses, and only allow BSN-prepared nurses to become managers.

Psst... do not express the sentiments expressed herein in a professional transitions class (another thing most other professionals don't seem to need) or your life will be hell. Been there, done that.

[ShannonRN2010, BSN, RN]

That ANA wants to eliminate LPNs, make ASN RNs technical nurses, and only allow BSN-prepared nurses to become managers.

Psst... do not express the sentiments expressed herein in a professional transitions class (another thing most other professionals don't seem to need) or your life will be hell. Been there, done that.

Oh I had planned on going in and agreeing with the professor, reguardless of what my opinion is!

One thing I have learned in my years of being a nurse?

How to BS with the best of them... j/k ... I also learned this at Walmart, Wendys and Taco Hell, I mean Bell, basically anywhere I had to deal with management!

[anonymurse]

This is superficially similar to the question of NCO professionalism (check out this 1978 paper). But before we adjudge it identical, consider that there were once three professions: the priesthood, law, and medicine. So to call a military officer a 'professional' is a latter-day esprit de corps sleight of tongue. Why then should NCOs concern themselves over it? A soldier has always been a soldier.

Medicine is different. Doctors have always striven for as comprehensive a mastery of the healing art as possible for the times. Although this has become relatively recently very specialized, the ideal remains, and extensive general training is still mandatory. That's why a nurse has never been a doctor.

As for the term 'professional'? Office workers call themselves professionals. Cosmetologists, for crying out loud. Let 'em have it.

[pedicurn, LPN, RN]

That ANA wants to eliminate LPNs, make ASN RNs technical nurses, and only allow BSN-prepared nurses to become managers.

Psst... do not express the sentiments expressed herein in a professional transitions class (another thing most other professionals don't seem to need) or your life will be hell. Been there, done that.

Please do not let the ANA eliminate LPNs.

I used to work in NZ and left for Australia. A big reason for me leaving NZ was that the NZ Nurses Council eliminated ENs (Enrolled nurses...similar to LVNs).

This meant that healthcare costs increased as they had to pay an RN to do everything.

Also meant RNs became very overworked. When I left I had an 8-10 pt load in ED with no help for turns and basic hygiene cares.

P't complaints skyrocketed as they often had to wait too long for toileting etc ....the poor RN busy handling her crashing, sick new admits. Added to that ....they also eliminated nurse aides and replaced with healthcare assistants whose main responsibility is restocking.

I had to juggle oesophageal and pv bleeds, severe COPD and chest pain AND try to push my elderly NOFs (on a trolley in the hall) somewhere private to place a foley.

Please hang onto your LVN's and aides

[SuesquatchRN, BSN, RN]

Believe me, sister, you're preaching to the choir!

What's an NOF?

[pedicurn, LPN, RN]

Believe me, sister, you're preaching to the choir!

What's an NOF?

# Neck of femur

[nursemike, ASN, RN]

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.

Sing it, Brother! I don't guess I'm enough of a conspiracy theorist to think it's intentional, but I think a lot of the concern over professional standing tends to divide nurses. The debate over entry to nursing is a prime example. According to the ANA, and some allnurses.com members, I shouldn't be a nurse, because I'm only an ASN. My question is, who then will do what I and thousands like me are doing? And I don't mean only that associates and diploma programs are an ad hoc solution to a shortage of BSNs. Nor am I saying that nursing is only about passing meds and wiping butts and holding hands. Critical thinking is important! But it seems to me like a lot of advocates for professional standing are very nearly saying that nurses need to be doing what doctors already do, and seemingly disparage the things that nurses have always done. Why should academic nursing or political advocacy be more nurselike than, oh, say, taking care of patients?

I've heard and seen "task-oriented," used as a perjorative. I am task-oriented. I've been a nurse for five years, now. I'm well aware that there is a bigger picture. A lot of times I can even see at least some of it. But, like many nurses (and many others) I'm a work in progress, and a lot of times I have to focus on the practical aspects of my job. I respect the nursing process, and I do believe that each part of it is important, but still, without Implementation, all of the other parts are just words. I actually have used NANDA nursing diagnoses in my practice. More often, I'm just thinking about what my patients' problems are and what can I do for them. I'm pretty sure I am capable, if need be, of writing a 20 page paper in APA format about my patient's anticipatory grieving. But I don't particularly want to be a writer. I want to be a nurse, and my patient wants a cup of tea and someone to talk to, and I think that might just give us a basis to interface constructively.

[jjjoy, LPN]

Re the nursing process ... It's the fact that it is formalized as a key nursing skill that is so embarrassing.

No other profession does that. It is a 'given' in other professions....no need to formalize something so obvious.

I agree. Assess/plan/implement/evaluate is a pretty basic problem-solving approach that tends to get beaten to death by some nursing instructors and taught as if it's something special taught just to nurses and will take time to learn well. It WILL take time to learn good assessment skills, determine the proper interventions, and competently provide care but the "nursing process" itself (aka generic problem-solving) is something I'd hope most nursing students came to the table already having a pretty good grasp of.

Yes many task orientated nurses do thrive....however I was making another point.

Why is their contribution to nursing considered equal (or even superior) to other nurses who have the same practical skills PLUS the other skills?

I hear ya! Many organizations reward nurses who are overly task-oriented because they get their meds done on time, have their charting done on time, leave work on time. Such nurses are favored among higher ups who prefer to blame problems on individual "poor time management skills" as opposed to chronic understaffing.

[CNL2B]

I also have a slight problem with the thought that nurses are not respected in the community.

What profession has been listed as the most trusted profession 8 years running?

1. Nurses - 84 percent

2. Druggists/Pharmacists - 70 percent

3. High school teachers - 65 percent

4. Medical doctors - 64 percent

5. Policemen - 56 percent

I think that the community looks at us as being professionals, obviously! Most ppl I encounter, respect the fact that I am a nurse.

I think there is a difference between what the public thinks of nurses and what other hospital employees think of nurses (meaning MDs, pharmacists, management, therapy disciplines, techs, etc.) I believe this survey reports public perception. That doesn't mean that nurses are getting the respect they deserve in their respective workplaces (I would argue that they are not.)

If you want to look at some interesting recent public perception that disagrees with your posted percentages, look up the Minneapolis StarTribune and some of the coverage of the recent nursing strike on the web. Read the comments on the articles. They number in the hundreds and hundreds. Largely, the public perception of the striking nurses is that they are lazy and greedy -- because of the economic climate, we too need to be doing more work for less money.

[pedicurn, LPN, RN]

I think there is a difference between what the public thinks of nurses and what other hospital employees think of nurses (meaning MDs, pharmacists, management, therapy disciplines, techs, etc.) I believe this survey reports public perception. That doesn't mean that nurses are getting the respect they deserve in their respective workplaces (I would argue that they are not.)

If you want to look at some interesting recent public perception that disagrees with your posted percentages, look up the Minneapolis StarTribune and some of the coverage of the recent nursing strike on the web. Read the comments on the articles. They number in the hundreds and hundreds. Largely, the public perception of the striking nurses is that they are lazy and greedy -- because of the economic climate, we too need to be doing more work for less money.

Yes, down here as well. I am often shaken by the public perception of us. With facility for online newspaper comments nowadays it is very easy for the public to voice their views. I have seen us described as ' dirty/lazy/fat/slothful/lowclass/slutty'.

I don't think the public really see us as professionals. Perhaps in the generic sense only? With the rudeness I often receive in triage....I think they think I'm pond scum

[NocturneRN]

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

I don't necessarily agree. It's just that the term "professional" has more than one application.

As I've already mentioned, I don't see much use in arguing whether nursing is a profession in the strictest sense of the word, or a trade. Call it whatever you want: it makes little difference in the end. The earliest trained nurses were nuns, which caused the occupation to follow a quasi-ecclesiastical model. With the advent of leaders like Florence Nightingale and Clara Barton, it went more to a quasi-military model. Then, with health care facilities adopting a business model a few decades ago, nursing has evolved to more of a service industry model.

Which is it? All of the above, and none of the above. Nursing, in my opinion, is an occupational category unto itself. Those who focus on the technical skills will probably see it more as a skilled trade. Those who focus on the teaching and philosophy aspect will call it a profession. And those who see the nurse as someone who does the doctor's grunt work will see it as plain hard work.

[pedicurn, LPN, RN]

I don't necessarily agree. It's just that the term "professional" has more than one application.

As I've already mentioned, I don't see much use in arguing whether nursing is a profession in the strictest sense of the word, or a trade. Call it whatever you want: it makes little difference in the end. The earliest trained nurses were nuns, which caused the occupation to follow a quasi-ecclesiastical model. With the advent of leaders like Florence Nightingale and Clara Barton, it went more to a quasi-military model. Then, with health care facilities adopting a business model a few decades ago, nursing has evolved to more of a service industry model.

Which is it? All of the above, and none of the above. Nursing, in my opinion, is an occupational category unto itself. Those who focus on the technical skills will probably see it more as a skilled trade. Those who focus on the teaching and philosophy aspect will call it a profession. And those who see the nurse as someone who does the doctor's grunt work will see it as plain hard work.

Yes, it has different applications.

I've just had a strange thought .... aren't we very similar to a commercial airline pilot? Lots of training, lots of experience,

lots of responsibility ....but no control and very little authority. Some have university education vs some have just trade type.

Lots of other people know how to fly planes but few really know what a commercial airline pilot does.

Very vital gog in the wheel but just a grunt that organisations squeeze the last bit of work out of them.

LOL....sound a lot like us