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?
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
our knowledge of our field is what makes us trustworthy.
Not in the eyes of many members of the public, especially ones who lack a certain level of sophistry.
When presented with a type-A nurse who is the real deal (highly intelligent, analytical, thoroughly educated, knowledgeable, strict boundaries) and a type-B nurse (bubbly personality, hand-holding, free-spirited, not terribly knowledgeable, enforces no boundaries), the overwhelming majority of patients and families will pick the type-B nurse because he/she is the one who makes them feel good about themselves.
Human nature is bizarre. People claim to want the truth, but many cannot handle the truth very well. In essence, many of our patients and their families prefer the cheerful Pollyanna personality who will tell them exactly what they wish to hear. I've seen too many wonderful nurses with exceedingly vast funds of knowledge get cast aside to make room for perky, cheerily upbeat nurses who fail to rescue when something goes down. Although the perky nurse might negatively impact patient outcomes, her invigorating personality will enhance the hospital's patient satisfaction scores.
Patients and families who lack sophistication often formulate decisions based on factors such as emotion and hearsay, and they tend to be mistrustful of aspects such as formal education, research, and (yes) intellectual pursuits. These people almost always place their full trust in the type-B nurse because he/she validates their existence, reaffirms their views of the world, tells them what they want to hear and basically helps them feel good on the inside.
To many members of the general public, the highly educated clinician who engages in deep analytical thought is suspicious and untrustworthy. On the other hand, the carefree nurse who lacks a sense of urgency often wins peoples' trust. It is what it is.
Not in the eyes of many members of the public, especially ones who lack a certain level of sophistry.
When presented with a type-A nurse who is the real deal (highly intelligent, analytical, thoroughly educated, knowledgeable, strict boundaries) and a type-B nurse (bubbly personality, hand-holding, free-spirited, not terribly knowledgeable, enforces no boundaries), the overwhelming majority of patients and families will pick the type-B nurse because he/she is the one who makes them feel good about themselves.
Human nature is bizarre. People claim to want the truth, but many cannot handle the truth very well. In essence, many of our patients and their families prefer the cheerful Pollyanna personality who will tell them exactly what they wish to hear. I've seen too many wonderful nurses with exceedingly vast funds of knowledge get cast aside to make room for perky, cheerily upbeat nurses who fail to rescue when something goes down. Although the perky nurse might negatively impact patient outcomes, her invigorating personality will enhance the hospital's patient satisfaction scores.
Patients and families who lack sophistication often formulate decisions based on factors such as emotion and hearsay, and they tend to be mistrustful of aspects such as formal education, research, and (yes) intellectual pursuits. These people almost always place their full trust in the type-B nurse because he/she validates their existence, reaffirms their views of the world, tells them what they want to hear and basically helps them feel good on the inside.
I did that with a patient. I don't think she liked that I told her the truth, and I'm fairly certain she didn't help us with her HCAHPs. She said she wasn't used to nurses "talking to her that way."
And that makes me sad. I'm never afraid to learn, or afraid to say "you know what? I'm not sure." I think those are excellent teaching moments. When something like that comes up and I can't give the student an answer, I will often say "Why don't you look it up and teach ME, then we'll both learn something today."
Granted I can't say that for all my preceptors -- there is one, in particular at the site I'm currently at who prefaces nearly everything with rationale and she is awesome and I can ask anything. Some of the new grads from our program that precept us are good as well -- I just never seem to end up with them. :)
Anyway, I know there are teachers among us but they are few and far between. I am beginning to get the sense that with med passes being so vitally punctual, any vision of what is going on is lost. Push those meds, ASAP and then worry about the patient's current status later. I'm afraid of falling into step and becoming this way also because I have been so immersed in it at this point.
A lot of people are bringing up the "nurses as most trusted professionals" lists. Of course topping these lists is a good thing, and something we should be proud of, but I've always thought that there is a serious misogynistic undercurrent to our placement on those lists. We're not on those lists because the public sees us as intelligent, educated leaders. We're on those lists because we're seen as nurturing, caring, trustworthy, non-threatening maternal figures. This is a huge problem for nursing, and something that really frustrates me. All of those qualities are great, of course, but they're not what makes us worthy of the public's trust: our knowledge of our field is what makes us trustworthy.
MollyBK, did you attend a nursing program that had decent clinicals, where you gave hands-on care at the bedside? Did you get to practice the skills you learned in skills lab on actual patients? Did you have several patients to care for during your clinicals, and did you give total care? You sound very idealistic. Do you know the Nurse Practice Act for your state, and the Nurse's Code of Ethics? Of course our knowledge of our field makes us trustworthy: if you actually practice nursing within the code of ethics, and according to the Nurse Practice Act, within current standards of practice, you will be practicing competently and ethically (which is what patients want, and in my opinion is why nurses receive high scores on the trusted professionals list), and you will be exhibiting leadership. I don't see the misogynism that you are talking about, or the huge problems for nursing you are referring to, and I have been a nurse for 19 years. Do you work as a nurse?
Not in the eyes of many members of the public, especially ones who lack a certain level of sophistry.
When presented with a type-A nurse who is the real deal (highly intelligent, analytical, thoroughly educated, knowledgeable, strict boundaries) and a type-B nurse (bubbly personality, hand-holding, free-spirited, not terribly knowledgeable, enforces no boundaries), the overwhelming majority of patients and families will pick the type-B nurse because he/she is the one who makes them feel good about themselves.
Human nature is bizarre. People claim to want the truth, but many cannot handle the truth very well. In essence, many of our patients and their families prefer the cheerful Pollyanna personality who will tell them exactly what they wish to hear. I've seen too many wonderful nurses with exceedingly vast funds of knowledge get cast aside to make room for perky, cheerily upbeat nurses who fail to rescue when something goes down. Although the perky nurse might negatively impact patient outcomes, her invigorating personality will enhance the hospital's patient satisfaction scores.
Patients and families who lack sophistication often formulate decisions based on factors such as emotion and hearsay, and they tend to be mistrustful of aspects such as formal education, research, and (yes) intellectual pursuits. These people almost always place their full trust in the type-B nurse because he/she validates their existence, reaffirms their views of the world, tells them what they want to hear and basically helps them feel good on the inside.
To many members of the general public, the highly educated clinician who engages in deep analytical thought is suspicious and untrustworthy. On the other hand, the carefree nurse who lacks a sense of urgency often wins peoples' trust. It is what it is.
I remember watching a show where a comedian opined "we are a nation full of C students" years ago; you post reminded me of that.
I will say that in my own career travels, I've seen more patients be respectful of my knowledge; I'm far from bubbly, but I think having the right combination if smarts and effective communication is what gives us our respect; there will be outliers, big to me, amongst the "C student" populace, there still is a large percentage that seek out advice; especially once it's known that we are nurses.
MollyBK, did you attend a nursing program that had decent clinicals, where you gave hands-on care at the bedside? Did you get to practice the skills you learned in skills lab on actual patients? Did you have several patients to care for during your clinicals, and did you give total care? You sound very idealistic. Do you know the Nurse Practice Act for your state, and the Nurse's Code of Ethics? Of course our knowledge of our field makes us trustworthy: if you actually practice nursing within the code of ethics, and according to the Nurse Practice Act, within current standards of practice, you will be practicing competently and ethically (which is what patients want, and in my opinion is why nurses receive high scores on the trusted professionals list), and you will be exhibiting leadership. I don't see the misogynism that you are talking about, or the huge problems for nursing you are referring to, and I have been a nurse for 19 years. Do you work as a nurse?
Well said.
OP, Embrace the fact that the application of the knowledge we have competently makes us front line leaders; one hones their practice as such, gains the trust of the public that we serve.
Historically, nurses have been front line leaders in the community, gave people access to health care even in the most undesirable places (and STILL do! ), and that we are the face of healthcare; the expectation is that our vast knowledge and what we do with is powerful enough; the public is VERY cognizant of that, and that transcends all groups and cultures.
I haven't been in school for a long time, but the BSN program I attended was definitely "dumbed down" in compairson to other science degrees. The biology, chemistry and math. were watered down versions that were used most commonly for AD for ancillary health programs or technical certifications that did not require a degree at all. "Real" science majors took the full strength classes where as BSN students took the light version.
I was one of those 'real science majors' who never understood why nursing students took fluffy, abridged versions of the basic biology and chemistry that I took. I know people may say it's not knowledge they use every day (honestly I don't use all the stuff I learned in general chem II everyday either, and I work in a lab...) but I wish nursing was held to the same standards as other STEM fields. Nursing shouldn't be the 'easy option for people who couldn't handle med school prereqs,' which I fear is the reputation today's programs are setting us up for. It should be different, certainly (from med school), but I think a big part of the reason that nursing isn't as highly respected as I think it should be is that we are settling for lower and lower standards of entry. Sure, there's something to be said for it being skills based and a vocation, but I dream of so much more for nursing. I think someone who can administer IV drugs should garner more respect. Nurses aren't simply skilled laborers, or at least they shouldn't be. I have no interest in the 'doctor' approach or job description, but I still want to know the how's and the why's of what I'm doing. I want to understand the orders, not just follow them. And I want to graduate from nursing school with that knowledge. I think it's important for a program to stress the science.
Nursing shouldn't be the 'easy option for people who couldn't handle med school prereqs,' which I fear is the reputation today's programs are setting us up for.
Never was the "easy option for people who couldn't handle med school pre req's ; in some areas, there are colleges and programs that require particular classes that are with pre-med students; not everywhere, but there are far more pre-req's that are surely not "fluff".
It should be different, certainly (from med school), but I think a big part of the reason that nursing isn't as highly respected as I think it should be is that we are settling for lower and lower standards of entry. Sure, there's something to be said for it being skills based and a vocation, but I dream of so much more for nursing. I think someone who can administer IV drugs should garner more respect.
We ARE respected; historically, again, that backward thinking about educated women has cast a shadow on a SMALL percentage of nebulous disconnected thinking of what nursing "is".
Nurses aren't simply skilled laborers, or at least they shouldn't be. I have no interest in the 'doctor' approach or job description, but I still want to know the how's and the why's of what I'm doing. I want to understand the orders, not just follow them. And I want to graduate from nursing school with that knowledge. I think it's important for a program to stress the science.
Are you in Nursing school?
A good-stellar program will give you the who what and why's of nursing, and help you cultivate how to create competent nursing judgement. We are FAR from skilled laborers, and in reality, of you truly look back on the history of nursing, we NEVER, EVER, were "skilled laborers" we couldn't possibly be such when public nursing was created, or when many nurses before us cared for men on the battle field; who created midwifery, of wrestling education away from the doctors and fought for autonomy that we've had for GENERATIONS; as Esme shared, mixing medications and caring for fresh open hearts, or even transplants; or help create hybrid units of caring for complex pts in progressive recovery from illness; research and pilot studies that have been replicated or policies at the unit to the federal level. That is not what a "skilled laborer" does.
Nursing is a application or analysis and applied science; no competent nurse "follows orders"; again, like I said in a previous post, I think a percentage of nurses have NO idea what they are capable of; the best
thing for you to do is to not fall into this trap.
I was one of those 'real science majors' who never understood why nursing students took fluffy, abridged versions of the basic biology and chemistry that I took. I know people may say it's not knowledge they use every day (honestly I don't use all the stuff I learned in general chem II everyday either, and I work in a lab...) but I wish nursing was held to the same standards as other STEM fields.
The college I attended didn't differentiate between nursing and science majors. We sat through the classes with the wannabe chemists, aspiring pre-med students, and biology majors. No watered-down chem, no easy-A A&P. It was the real deal. And it was tough, but it was interesting, comprehensive and it made the rest of the learning process so much easier.
That said, there are programs out there like mine that hold nursing to the same standard. It's just a matter of finding them.
As a prof of mine used to remind us, "if you're not looking at a problem comprehensively, you're not looking at all."
The college I attended didn't differentiate between nursing and science majors. We sat through the classes with the wannabe chemists, aspiring pre-med students, and biology majors. No watered-down chem, no easy-A A&P. It was the real deal. And it was tough, but it was interesting, comprehensive and it made the rest of the learning process so much easier.
****That said, there are programs out there like mine that hold nursing to the same standard. It's just a matter of finding them.***
THIS!
***Or moving to eliminate sub-par programs altogether and maintaining or replicating such standards; although I think that such programs are not the exception.
A lot of people are bringing up the "nurses as most trusted professionals" lists. Of course topping these lists is a good thing, and something we should be proud of, but I've always thought that there is a serious misogynistic undercurrent to our placement on those lists. We're not on those lists because the public sees us as intelligent, educated leaders. We're on those lists because we're seen as nurturing, caring, trustworthy, non-threatening maternal figures. This is a huge problem for nursing, and something that really frustrates me. All of those qualities are great, of course, but they're not what makes us worthy of the public's trust: our knowledge of our field is what makes us trustworthy.
As a early-30-something person, I have no actual, real-life memory of the traditional, cap-wearing, "matronly" nurse outside of old TV shows. Most people my age and younger have never had that particular cultural experience. The only misogynistic attitudes toward nurses I see in our culture is the whole "naughty nurse" fetish-thing. But that's totally unrelated to education and a whole 'nother thread topic.
Its interesting that you find it embarrassing that such traits as 'nurturing', 'caring' and 'non-threatening' are the first things the public thinks of when it comes to nurses. Why is it so important for 'intelligent' and 'educated' to come before those others? Those other traits come first because that's the nature of the nurse-patient relationship. We're the ones who give them the medication that eases their pain. We're the ones who help them with those intimate bodily functions after surgery or injury when they're so vulnerable and scared. We're the ones with them at 3am when the doctors and pharmacists and social workers are at home sleeping. Is it any wonder that those "soft" traits are the ones first associated in the minds of the public when they think of the word 'nurse'? Is that really such a bad thing?
Sometimes I wonder why so many nurses seem miffed by the whole personal, direct-care aspect of our profession. If that doesn't appeal to you, fine. Become an RN who audits charts or does telephone triage or does clinical research. Or become an APN and take on more of a provider role. But this isn't enough for some people. Some nurses seem.... I don't know.... embarrassed to even be viewed to be in the same profession as those who do provide direct care. Some nurses seem eager to abandon that role entirely to UAP because truly educated and professional people don't do that stuff and how embarrassing for people to even associate me with people who do. I find that way of thinking disturbing.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
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I watched my boyfriend and his team of IT guys who were only hired with AS or AA degrees + certifications lose every opportunity to advance their careers to their Penn State BS interns. It's devastating to see the sheer lack of respect from corporate. The advances degree push is a societal problem that is hurting the most experienced and valuable people in the workforce. I want to say it's the same scenario but it really isn't now that I think about it, he was never forced to get a BA...encouraged (they would reimburse him) but not forced. Now that he refuses, he can't get any real promotions because they instituted a requirement for a minimum education of BA/BS and MA/MS for all positions. Thinking back on it his job was never actually in jeopardy like some nurse's jobs may be. I do get why this is so detrimental to nursing.
These policies are hurting everyone in some way, no one wants the debt of the BSN but we don't have a choice anymore. The reality for people just starting out is: No BS/BA degree = No Job and/or unemployment line. It's tough out there, people are so desperate for jobs so they will take on the debt.
You all bring a lot of perspective to the discussion regarding the policy driven dilemma in nursing. It's also eye opening to read some of the comments about education but what bothers me is if no one is treating ASN nurses this way on the floor, why are some BSN nurses getting backlash on the floor? The OP is saying nurses have to deal with the "sneers" and this backlash, what's up with that?
Most people I know in nursing work well together and this isn't the norm. It's just an attitude that is noticed more recently and there seems to be a trend in some places. Sometimes it seems like when people try to vent about it they are told it must be them...not necessarily.
I agree with your comments regarding the need to hold the degree for pragmatic reasons and I tell people who ask to get their BSN as soon as they can. The ground started to shift in the job market for nurses around 10 years ago, with the last 5 seeing unprecedented changes and upturning of old adages we thought were set in stone. If we don't evolve along with that we'll be left behind.
My personal experience is that the conflicts and common themes of heated disagreement on this board are not reflective of the nursing world as a whole. I've worked in lots of environments and all but one was mutually respectful and harmonious regarding level of education. Never sneering. Maybe it was luck of the draw, but I'm increasingly grateful for it!
The one exception was so bad that I very rarely tell anyone it must be them. In some cases, though it becomes clear that their behavior is a big factor. In such cases I take the position that it's better for them to hear it from experienced nurses on a message board than the DON who is asking them to sign a write-up. We don't always get it right, but I suppose that's inevitable on a public board where a good deal of information we might use to advise someone is not communicated by a text-only format.
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), and that we are the face of healthcare; the expectation is that our vast knowledge and what we do with is powerful enough; the public is VERY cognizant of that, and that transcends all groups and cultures.
; in some areas, there are colleges and programs that require particular classes that are with pre-med students; not everywhere, but there are far more pre-req's that are surely not "fluff". 
TheCommuter, BSN, RN
102 Articles; 27,612 Posts
Not in the eyes of many members of the public, especially ones who lack a certain level of sophistry.
When presented with a type-A nurse who is the real deal (highly intelligent, analytical, thoroughly educated, knowledgeable, strict boundaries) and a type-B nurse (bubbly personality, hand-holding, free-spirited, not terribly knowledgeable, enforces no boundaries), the overwhelming majority of patients and families will pick the type-B nurse because he/she is the one who makes them feel good about themselves.
Human nature is bizarre. People claim to want the truth, but many cannot handle the truth very well. In essence, many of our patients and their families prefer the cheerful Pollyanna personality who will tell them exactly what they wish to hear. I've seen too many wonderful nurses with exceedingly vast funds of knowledge get cast aside to make room for perky, cheerily upbeat nurses who fail to rescue when something goes down. Although the perky nurse might negatively impact patient outcomes, her invigorating personality will enhance the hospital's patient satisfaction scores.
Patients and families who lack sophistication often formulate decisions based on factors such as emotion and hearsay, and they tend to be mistrustful of aspects such as formal education, research, and (yes) intellectual pursuits. These people almost always place their full trust in the type-B nurse because he/she validates their existence, reaffirms their views of the world, tells them what they want to hear and basically helps them feel good on the inside.
To many members of the general public, the highly educated clinician who engages in deep analytical thought is suspicious and untrustworthy. On the other hand, the carefree nurse who lacks a sense of urgency often wins peoples' trust. It is what it is.