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?

[jadelpn, LPN, EMT-B]

Thanks for sharing that, mhy12784. That's really interesting, and I've heard similar stories. I'm sorry they put you in that situation. If your hospital has a tuition program, it seems like they would be doing everything in their power to "woo" you, so to speak, to keep you on as an NP when you graduate.

Ah, but most do not. Regardless of degree level, one has a difficult time getting a job without experience, and a difficult time getting experience without a job. Facilities do not "woo" anyone. In fact with the scripting and customer service oriented culture in a number of units, it is difficult to fathom one is even in a facility. That is were the money aspect comes in.

Tuition reimbursement is just that--they will reimburse you for SOME "approved" costs, one has to pay first, and hope that most all of the expenses are applicable. Then there's a cap--some as little as $1000 a year. Yes, better than nothing but no where near a degreed tuition rate.

Further, there is not one promise that once one gets the advanced degree that the facility will even hire as a BSN. Magically, to more than one nurse, they got their degree to find that there were no positions available to them, or they stay in the exact same job for no more pay--doing the exact same thing as yesterday. Except now, one can say "can I do anything else for you, I have the time" with more of a cheery tone, and the nurse who introduces you at bedside report can say BSN with confidence...

[fakenurse]

Hi Jadelpn- there are issues within the current nursing education system. Economic costs discourage higher education and create barriers to education and career advancement, especially among racial, ethnic, and rural minorities. This is a big problem. The answer is not anti-intellectualism. Requiring nurses to take more classes- yes, even in more theoretical subjects- will never, ever be a bad thing. We have evidence that shows that patients benefit from receiving care from nurses with Bachelors degrees. We need to figure out how to make that cost-effective for nurses, hospitals, and universities.

[mhy12784]

Ah, but most do not. Regardless of degree level, one has a difficult time getting a job without experience, and a difficult time getting experience without a job. Facilities do not "woo" anyone. In fact with the scripting and customer service oriented culture in a number of units, it is difficult to fathom one is even in a facility. That is were the money aspect comes in.

Tuition reimbursement is just that--they will reimburse you for SOME "approved" costs, one has to pay first, and hope that most all of the expenses are applicable. Then there's a cap--some as little as $1000 a year. Yes, better than nothing but no where near a degreed tuition rate.

Further, there is not one promise that once one gets the advanced degree that the facility will even hire as a BSN. Magically, to more than one nurse, they got their degree to find that there were no positions available to them, or they stay in the exact same job for no more pay--doing the exact same thing as yesterday. Except now, one can say "can I do anything else for you, I have the time" with more of a cheery tone, and the nurse who introduces you at bedside report can say BSN with confidence...

Well the odd thing is I work as an RN with a bsn degree, and I'm going going for my masters... And I work for a Magnet hospital. And I was under the impression that magnet hospitals have a high demand for master's prepared nurses, as they need a certain percentage of them to maintain their magnet status (im not going for an APN role)

I don't expect the red carpet rolled out for me because I choose to continue my education, I just don't expect me going back to school to be treated as a negative either.

[movingon2014]

The argument of whether or not to have a BSN has been going on for a long time -- definitely NOT new. Economics has always been a strong factor in the argument --- 4 years of college is NOT cheap and is a long time devoted to study! Some nurses do pursue a BSN later on, when finances and time allow it. One is not better than the other though ----- just different paths to the same destination. Both nurses may know for instance that jacking the IV bag up the pole increases flow rate ----- one learned from experience, the other from having to include physics in their 4-year college curriculum. BOTTOM LINE - both know the fact -- but learned it in different ways. How outsiders perceive nurses however is a different story. Society has dictated that "professionalism" requires at least a Bachelor's degree. So if nurses in general want to gain ground in society's professionalism-battle, they have to fight under the rules set by society.

BUT -- while thinking about this, don't forget one good thing about our soceity. Overall, nurses are still at the top of the list of "most trusted/respected" in poll results, along with fire fighters and police. And much higher-priced, "educated" persons such as attorneys ------ are at the bottom of those lists!!

[TheCommuter, BSN, RN]

Anti-intellectualism in nursing? Well, I'm going to approach a very sensitive subject...

Certain professions such as nursing, social work and elementary education, have heavily attracted first generation college students who were the first ones in their families to have ever attended college, and thus, may have been reared in homes where intellectualism might not have been a daily feature of family life.

The lower prestige occupations like teaching and nursing are filled with people who were first generation students, whose parents did not have a college degree or even go to college. While first generation students become physicians, attorneys, and college professors the reality is that education helps people up the ladder of occupational prestige one rung at a time.

Social class on campus: Part 2 - Class Myths

[Army]

Nursing is my 3rd career. I have found that those that wrap themselves in research and theory usually can't understand the nuances of practical application, regardless of the field. If they were every exposed to the practical application of bedside nursing, they probably got turned off from their exposure, hence why they chose to move on. They live in a different world. Ideally, like in the military, you had to pay your dues before you could profess your knowledge and it worked very well. Nowadays, you can bypass the whole bedside nursing thing and never appreciate what a staff nurse has to go through. It creates resentment on both sides. The best NPs and managers that I have seen, spent 15 - 20 years at the bedside and then chose to move on. They have common sense and their knowledge base is deep as well as wide. I always remember my nursing instructors' adage, (behind the backs of the A students, of course) C students made better nurses.

[LadyFree28, BSN, LPN, RN]

Anti-intellectualism in nursing? Well, I'm going to approach a very sensitive subject...

Certain professions such as nursing, social work and elementary education, have heavily attracted first generation college students who were the first ones in their families to have ever attended college, and thus, may have been reared in homes where intellectualism might not have been a daily feature of family life.

Social class on campus: Part 2 - Class Myths

I think you bring up a great point as far as intellectualism being absent from home life where survival is paramount.

I think that gaining more education should not be cut down; however, I think that the "resentment" that sometimes could be palpable on both or shall I say many sides towards the entry to our practice that is displayed on some of these forums is a bit unfortunate; on the other hand if there will be an entry point, so be it; but it should be without the undercutting of nurses whose practice can shape future, competent, knowledgeable nurses, regardless of entry or background.

Sometimes the "profession needs to be elevated" talk reminds me of nursing history on how "the undesirables" were in the occupation; we are FAR from that time period, and professionalism isn't solidified with a higher degree; I can bet there are more nurses out there that continuing to hone their practice, it's just the ones who do the bare minimum and voice their negative opinion that get the most attention, despite them being in the minority.

[Ally082]

While I agree education is a good thing it is another thing altogether when you take intelligent, well trained, educated experts with 20+ years in their field of expertise with certifications up the ying yang and tell them they are no longer competent or worthy because they don't have a BSN.

It's terrible that experienced nurses are being treated this way but I think the OP's observation is that some of the new grads and students are being treated unfairly, no... hated for this and blatantly discriminated against in certain circles. At least that's the way it looks to many people. It's breeding toxic work environments in some cases and discouraging the future generations of nurses. I'm sure many will say they could care less, so are those people admitting there is a bias against new grads (BSN), students etc.?

These trends are happening to the workforce in many industries across the country. My friends and family in IT, teaching, Pharma etc. are going through similar situations with education/promotion. Outsourcing management positions to people who have no experience in their field. Then these managers implement change that just doesn't make sense. They should be promoting from within but they don't. It's wrong. However these fields don't seem to have the same attitude towards interns ( students) that bedside healthcare jobs do....why? I honestly don't understand, we just want to learn and help.

I have so much respect for nurses, it's just hard to understand why those we look up to the most have so much contempt for us.

~Work hard. Be kind. That is all.~

[livefully]

I have to say that in my (very limited) experience, nursing is becoming an intellectual field. Yes, by nature, it is task-oriented, but with the advent of technology, patients being kept alive longer, doctors releasing some responsibility to nurses, a nurse without "critical thinking" skills cannot make it very far.

[BrandonLPN, LPN]

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.

Ok, I'm sorry but anyone who's never worked a day as a nurse should never be in a position to make policy changes or changes to practice or whatever. They can't improve the field until they have some experience in it. The people who ought to be leading the profession are nurses with a higher education AND years of experience.

[BrandonLPN, LPN]

As for the whole critical thinking vs task-oriented debate....

Bedsdide nursing will always have a "tasky" componet in the sense that the nurse will spend most of his time performing tasks such as administiring medications, administering treatments, personal care and performing focused assessments based on the established medical diagnosis. These patients are here because they need a qualified, skilled nurse to monitor their symptoms, to update the physician of any changes in condition and to carry out the physican's orders. Of course all this requires critical thinking, but it also requires skill, experience, speed and the ability to hit the ground running. For schools to put an emphasis on the tasks of nursing isn't a bad thing. For schools to hammer home the basic skill sets of nursing is not anti-intellectual. It isn't mutally exclusive with teaching scientific rationale and critical thinking. Schools really could (and should) teach vocational skills along with theory.

What I see some posters imply here is that it doesn't matter if a new grad nurse never inserted a Foley or successfully started an IV, because "they'll learn it on the job anyway". As if spending time on manual skill takes away from valuable class room time. There's time for both. New nurses hitting the floor lacking practical experience IS a danger. And an expense. Yeah, sure, they'll "catch up" eventually, but do you want to be one of their patients in the interim?

"Vocational" shouldn't be such a dirty word. It seems to mean "stupid" or "poor" to a certain, shall we say, "privileged" segment of the population. There's really just is a huge chunk of being a bedside nurse that is vocational in nature. Moreso than most other healthcare careers. We can add more theory and EBP to the nursing education model, sure. But I fail to understand the drive to eradicate the vocational, hands-on aspects of the profession. As though it was something to be ashamed of.

As for nurses supposedly putting you down for asking questions or for having more education..... maybe. I'm not you so I don't know what you've experienced. But I do know that whenever a new nurse, for any reason, say that most of the experienced nurses are picking on them or have an attitude toward them, I'm skeptical. Maybe it's your approach. If you go around implying that RNs who don't pursue their BSN are holding the profession back, well, that's pretty passive-aggressive. Your LPN and ADN co-workers will label you as a snob.

[nursel56]

I don't agree with the premise that there is widespread anti-intellectualism in nursing. Most of the nurses I know are in the process of getting to the next rung above them. I would go so far as to say that it's those nurses who are perfectly content with their lives as LPNs or ADNs who are the outcasts.

I would also say that mistrust and/or resentment towards academia is not equivalent to mistrust of education in general. It is the framing of the education argument itself as a false dichotomy that breeds the mistrust. You might also speculate that describing of ADN nurses as "uneducated" and promoting the idea that they are more likely to kill their patient than a BSN nurse doesn't really warm them to the cause.

If they have pursued miultiple paths of education other than the route claimed as the second component of the false dichotomy why would they not feel resentment? An excellent analysis of this dynamic is in the article below. It describes the culture of academia, which is set apart from the simplistic "against education" we hear so often in this debate. Other professions may operate differently than nurses do, but I'm not aware of any that have assignments to write papers on the topic of why one subset of the same group is better than the other.

A Policy Perspective on the Entry into Practice Issue

If you happen to work somewhere that really against education in any form I don't see why you would talk about your plans at all.