Anti-Intellectualism in Nursing

[fakenurse]

I went into nursing because I love science and medicine, and thought working with like-minded people to deliver high-quality care sounded like a great job. Since entering the profession, however, I've discovered that there is widespread mistrust and criticism of education and research in nursing. Nurses who are curious and love to ask questions are sneered at, and nurses who pursue further education are labeled "book smart" and lacking the prized "street smarts", which seems to equate to knowing how to start an IV. I've never heard of any other profession where furthering one's education is seen as a bad thing. I'm feeling so disappointed about this attitude, and really disenchanted with nursing. I loved school, I love learning, and I think more education is always, always, always a good thing. Will I always be an outcast in nursing because of this? If we want to be taken seriously as professionals, shouldn't we be embracing theory and knowledge and intellectual curiosity?

[xoemmylouox, ASN, RN]

I don't think it is so much that most Nurses look down on the well educated or those striving for more education. I think it is more that we are frustrated with the ever rising education expectations to enter the workforce. Also I have encountered those who have high degrees in Nursing, but who have never actually worked a day as a Nurse, and yet they try to change things/tell other how to do their jobs.

[LadyFree28, BSN, LPN, RN]

It depends on the culture of the organization, the unit; I've been fortunate to work in an area where practicing with a questioning attitude and critical thinking is far more of an emphasis than "tasky" knowledge, ie IV insertion skills, etc.

I wouldn't be disillusioned; your and only your nursing practice is what matters, and will take you places far more than worrying about "sneering" for asking a legitimate question and advocating for a pt, or any other issue for that matter...know that some people express feelings and knowledge base only; while others do and continue on their knowledge base.

[RNperdiem, RN]

In some ways, nursing is a performing art.

A dancer might have a great knowledge of this history of dance, but it doesn't mean that the person with the most knowledge will become the best dancer.

Knowledge, book learned or not, that enhances your performance fits a different category.

I am a big fan of nursing history and have a collection of vintage nursing books. This is for my own entertainment; it does not help me help the patient. My ACLS certification, on the other hand, really does make a big difference.

A lot of us have grown a little cautious about education of the variety that costs money to obtain. Degree inflation is a real thing, student debt is a heavy burden, and "buyer beware" is the watchwords for many places where nursing education can be obtained.

[FutureResearchRN]

Agreed completely. It is not fair to say that someone who is book smart has no common sense. I hear people say this frequently. I loved nursing school for the fact that we were encouraged to ask many questions, utilize theory and research, and not be quite so task oriented. But in real life on the job I feel as if I was taught tasks and not much critical thinking or thinking above and beyond about things. It depends on your job I suppose.

[Spidey's mom, ADN, BSN, RN]

I love science and medicine and education. There are many of us out here. I started as a second-career ADN nurse and went back for my BSN later. I attended college out of high school as well for 4 years but had to stop due to personal and financial reasons.

Personally, I have to admit that many of the classes for my BSN were . . . . fluff. However, I truly appreciated my nursing research, statistics, healthcare legal/ethics, and healthcare economics.

Nurses can be a force for change in medicine and I appreciate that as well.

[ArtClassRN, ADN, RN]

Yeah. It sucks.

Although I do notice the nurses who make the most noise about "book smart" nurses really are NOT particularly street smart either.

They are just ignorant and refuse to learn anything.

[fakenurse]

Aren't rising expectations for education in nursing a good thing? Don't we want a workforce of smart, educated nurses? Maybe the nurses with high degrees who have never worked a day as a nurse are trying to improve the field of nursing through their knowledge of the extant research.

[fakenurse]

I disagree. We don't choreograph movements to perform with every patient. We use critical thinking and evidence-based practice to inform our decisions with each patient. I don't think collecting vintage nursing books-- as cool as that is-- is analogous to having a complete understanding of, say, fluid and electrolyte imbalances or healthcare policy.

[Susie2310]

It depends on the culture of the organization, the unit; I've been fortunate to work in an area where practicing with a questioning attitude and critical thinking is far more of an emphasis than "tasky" knowledge, ie IV insertion skills, etc.

Inserting an IV actually does require critical thinking, unless one is just practicing at the "task level." For instance, being aware of the patient's condition, i.e., knowing whether the patient is on blood thinners or has severe sepsis with a systolic BP of 80, choosing the length and gauge of needle/catheter and identifying a suitable site based on patient condition and medications/fluids to be infused, foreseeing problems with insertion and preparing for them, using correct technique, troubleshooting problems with insertion, and patient teaching.

I am always surprised to read nurses refer to clinical procedures as "tasks" when one is or should be using the nursing process in assessing suitability of the doctor's orders, assessing patient condition prior to performing the procedure, foreseeing problems with performing the procedure and preparing for problems/troubleshooting problems, while performing the procedure safely and correctly, and evaluating the outcome of the procedure.

[LadyFree28, BSN, LPN, RN]

Aren't rising expectations for education in nursing a good thing? Don't we want a workforce of smart, educated nurses? Maybe the nurses with high degrees who have never worked a day as a nurse are trying to improve the field of nursing through their knowledge of the extant research.

There are nurses who do research by the bedside though; I will say that a nurse who does research by the bedside and then goes up the ladder to to be more efficient; but then again, that's just my opinion; My first take is if a research is not using an application to the research by NOT getting bedside nurses involved, then how is that going to effective advance the profession?

[LadyFree28, BSN, LPN, RN]

Inserting an IV actually does require critical thinking, unless one is just practicing at the "task level." For instance, being aware of the patient's condition, i.e. knowing whether the patient is on blood thinners or has severe sepsis with a systolic BP of 80, choosing the length and gauge of needle/catheter and identifying a suitable site based on patient condition and medication to be infused, foreseeing problems with insertion and preparing for them, using correct technique, troubleshooting problems with insertion, and patient teaching.

I am always surprised to read nurses refer to clinical procedures as "tasks" when one is or should be using the nursing process in assessing suitability of the doctor's orders, assessing patient condition prior to performing the procedure, foreseeing problems with performing the procedure and preparing for problems/troubleshooting problems, while performing the procedure safely and correctly, and evaluating the outcome of the procedure.

No disagreement there; my example being how one thinks that because they are a better nurse because they can access IVs the first time, venipuncture the first time and can access a foley the first time usually do not talk about assessing the orders, or troubleshooting; they are only talking about the "act" itself.

I've witnessed nurses crow about the best IV skills, but not assess the appropriate size for the appropriate procedure; or skip using the Bernadine to get the "wink" the "first time"; thinking of the task and not always thinking of best practice...there are nurses out there that do such bare minimums on their foundation.

I'm talking about nurses who are focused in task only; just "carrying out orders" has a certain "task" feel that I read on here from nurses, and even from nurses I worked alongside fot th nine years I have been in Nursing-7 LPN, 2 RN-who desire a position with more "skills" instead of "just following orders"; even when I broach the subject of assessing, intervening and evaluating (which includes troubleshooting), they are apt to not think that is an issue, just the tasks, the don't see the forrest and the trees; those are the nurses that I am talking about; there are a percentage that used the fundamental tasks without even realizing or even doing the nursing judgement or critical thinking that is required, or they at least don't think that they are doing so.

We cannot ignore the nurses who feel this way or perform said "tasks" and focus on only the task, not the rationales behind the said "skill" or "task"; that thought process is more beginner thought process than proficient, and there are a percentage of nurses who should be at the proficient stage that still think like this, that I have worked with and precept new nurses, that have precept ME in my beginning stages many moons ago...there's a thought procese being passed down that "hands on skills matter FIRST", critical thinking is "fluff" and that is where my point, and the disconnect IMHO lies.