Do you ever feel undeserving to be called a nurse?

[mtanner]

When I graduated from nursing school I immediately accepted a position on an Orthopedic/Medical Surgical floor. On that floor, I was responsible for taking care of post-operative orthopedic surgery patients, most commonly joint replacements, and general med-surg patients. On any given day, we would have 6 patients and our assignment was a mixture of the two types of patients. Because our unit had such high turnover due to our ortho patients, it wasn’t unusual to have 4 discharges and 4 admits a day. It was quite exhausting. It was especially difficult because with the extensive amount of time that 4 discharges and 4 admits takes, you also had your other 2 sick med-surg patients to care for. Often times, we would receive admits from the ED that were inappropriate for our floor but due to hospital occupancy, it didn’t matter. Trying to manage an ortho patient’s schedule and a med-surg patient’s schedule was very challenging because they were total opposite, yet often times overlapped. Our ortho patients had physical therapy twice a day, once at 8:30 and again at 12:30. Prior to PT, we had to give our ortho patients their pain meds (if it was in the allowed timeframe, q4h) but that also overlapped with the 8:00 med pass of our med-surg patients with 18+ medications due at one time. We give our ortho patients pain meds around the clock.  They are technically PRN but they are essentially scheduled. The rationale is that it is easier to prevent pain than it is to play catch up. If the patient is in pain, they will not be able to perform their PT exercises properly and ultimately not heal appropriately or gain full ROM. After 10 months of working on this floor, I decided to look for other positions as an RN. This job gave me a sense of pride because I was able to help people and do what I loved but it was physically and mentally draining.

I applied for a position at an outpatient vascular surgery office as a moderate sedation administration nurse. I was offered the position and graciously accepted. We perform angiograms, smagrams, fistulagrams, thrombectomies on AVG’s, TDC inserts, changes, and removals, IVC filter inserts and removals, powerport inserts and removals, venograms, etc. Here recently, a local dialysis access center that offers maintenance work on patients’ accesses closed down. We have since received almost all of their patients and where we used to mostly treat our arterial patients with PVD, we have been slammed taking care of our dialysis patients and making sure their accesses are working properly. I love my job, I love the OR, I have amazing coworkers, I work 4 days a week 6:30am-5:00pm, no weekends, no holidays and enjoy what I do. However, especially during the COVID-19 pandemic, sometimes I feel like I’m not a “real” nurse anymore. People will ask me what I do for work and when I tell them I’m a nurse they often say, thank you for all that you do and working on the frontlines. I feel guilty and often don’t know what to say because I’m not on the frontlines anymore, I don’t work in the hospital, I don’t treat COVID-19 patients. We were lucky enough to never slow down during the pandemic and we were able to remain open throughout the whole thing. I know what I do is making a difference for my patients because without it our dialysis patients wouldn’t be able to receive their dialysis treatment and our arterial patients would lose their limbs but sometimes I feel less than a nurse. When people think of nurses they think of the ones in the hospitals saving lives on a daily basis and fighting this virus head on. Am I really considered a “real” nurse if don’t do those things?

[JBMmom, MSN, NP]

Absolutely you're a "real" nurse! Every single patient in every single area of care needs and deserves care from a qualified individual. Kids in schools, inmates in correctional facilities, elderly or disabled people in long term care, alcoholics in rehab, psych patients, ICU patients, ED patients, med-surg patients. Everyone, period. You have the education and skills to provide care for a patient population. If someone thanks you, just say you're welcome. You're no less of a nurse than any nurse anywhere. LPN, RN, MSN, NP, nurses. All of them. People really need to stop comparing as if there's a magical hierarchy and somewhere out there are the nursiest nurses of all. The fact that you love your job even makes if better. You don't have to be miserable and overworked to be a nurse either. You can be happy, have a job that fits with your life, have hobbies and happy times. And still be a nurse, a real one. 

[sevensonnets]

I like your viewpoint, JBMmom! The only thing I'd add is to put a smile on your face. It brightens your day and everybody else's.

[Sour Lemon]

1 hour ago, mtanner said:

When I graduated from nursing school I immediately accepted a position on an Orthopedic/Medical Surgical floor. On that floor, I was responsible for taking care of post-operative orthopedic surgery patients, most commonly joint replacements, and general med-surg patients. On any given day, we would have 6 patients and our assignment was a mixture of the two types of patients. Because our unit had such high turnover due to our ortho patients, it wasn’t unusual to have 4 discharges and 4 admits a day. It was quite exhausting. It was especially difficult because with the extensive amount of time that 4 discharges and 4 admits takes, you also had your other 2 sick med-surg patients to care for. Often times, we would receive admits from the ED that were inappropriate for our floor but due to hospital occupancy, it didn’t matter. Trying to manage an ortho patient’s schedule and a med-surg patient’s schedule was very challenging because they were total opposite, yet often times overlapped. Our ortho patients had physical therapy twice a day, once at 8:30 and again at 12:30. Prior to PT, we had to give our ortho patients their pain meds (if it was in the allowed timeframe, q4h) but that also overlapped with the 8:00 med pass of our med-surg patients with 18+ medications due at one time. We give our ortho patients pain meds around the clock.  They are technically PRN but they are essentially scheduled. The rationale is that it is easier to prevent pain than it is to play catch up. If the patient is in pain, they will not be able to perform their PT exercises properly and ultimately not heal appropriately or gain full ROM. After 10 months of working on this floor, I decided to look for other positions as an RN. This job gave me a sense of pride because I was able to help people and do what I loved but it was physically and mentally draining.

I applied for a position at an outpatient vascular surgery office as a moderate sedation administration nurse. I was offered the position and graciously accepted. We perform angiograms, smagrams, fistulagrams, thrombectomies on AVG’s, TDC inserts, changes, and removals, IVC filter inserts and removals, powerport inserts and removals, venograms, etc. Here recently, a local dialysis access center that offers maintenance work on patients’ accesses closed down. We have since received almost all of their patients and where we used to mostly treat our arterial patients with PVD, we have been slammed taking care of our dialysis patients and making sure their accesses are working properly. I love my job, I love the OR, I have amazing coworkers, I work 4 days a week 6:30am-5:00pm, no weekends, no holidays and enjoy what I do. However, especially during the COVID-19 pandemic, sometimes I feel like I’m not a “real” nurse anymore. People will ask me what I do for work and when I tell them I’m a nurse they often say, thank you for all that you do and working on the frontlines. I feel guilty and often don’t know what to say because I’m not on the frontlines anymore, I don’t work in the hospital, I don’t treat COVID-19 patients. We were lucky enough to never slow down during the pandemic and we were able to remain open throughout the whole thing. I know what I do is making a difference for my patients because without it our dialysis patients wouldn’t be able to receive their dialysis treatment and our arterial patients would lose their limbs but sometimes I feel less than a nurse. When people think of nurses they think of the ones in the hospitals saving lives on a daily basis and fighting this virus head on. Am I really considered a “real” nurse if don’t do those things?

The whole "saving lives" thing nauseates me, to be honest. Most of us are doing a job for money, and most of us would stop doing that job if we stopped getting paid.

Being useful, sometimes in some ways, is just semi-sweet icing on the cake.

[RNperdiem, RN]

I think you are a real nurse lucky enough to land a plum job! Compared to where you were, it sounds like you have made a move for the better.

Who are you trying to prove yourself to? Who are these people? If it is nurses, we get it.

[RNNPICU, BSN, RN]

We really need to stop this unrealistic hierarcy.  If you are a nurse, you are a frontline worker.You are caring for patients you are helping patients. You are not staying at home, you are out there. If all of the nurses were caring for the COVID patients, who would care for yours. This virus doesn't stop people from needing their health needs. We, as nurses, have to fill all of the needs, in-patient, out-patient, OR, ICU, Acute Care, etc. Nurses have direct contact with people, we have to go out, care for people as if everything is normal.... and it is not normal.

Please don't compare yourself. Others would not be able to do your job. 

Yes, the nurses in the COVID areas are very hard hit, some of them opted to work in that environment, some not. 

I too find it hard because I am not actively providing ICU level care for COVID patients, but I am in the hospital 4 days a week, I have some contact with COVID + people, but I am in my PPE. I get that it may not feel like you are doing anything heroic, but you are, you haven't stopped working. 

Think about this, would you ever tell another nurse that they aren't that great because they work on a medical floor, only the surgical nurses are great?  No, same thing applies here.

Be proud that nurses are frontline workers. We, as well as all of our other health care colleagues - Cleaning staff, front desk staff, PT/OT, RT, MDs, etc.  All of us are frontline.

 

[Ioreth, ADN, RN]

You ARE a nurse!

I think many people go through a period of imposter syndrome in our early years of nursing. I sure did, and still do at times when I'm thrown into an unfamiliar situation. I felt bad for a while earlier in the year caring for the surgical population, who were screened for covid prior to surgery, while other nurses were on the front lines caring for the sickest Covid patients. I was willing to help more, but I was needed with the surgical patients

Then Covid started showing up in our surgical patients too, mostly the emergent ones, and we realized that the front line was here too. You probably have cared for Covid positive patients too without realizing it, depending on the prevalence in your area. 

Also consider this: you are participating in several procedures that mitigate clotting disorders. One of the major long term effects of Covid is clotting disorders. You may not be right at the front, but you are certainly participating in the fight against Covid, and it may be the longer fight. You are valued and needed in your nursing role!

[Davey Do]

On 12/6/2020 at 8:04 PM, mtanner said:

When people think of nurses they think of the ones in the hospitals saving lives on a daily basis and fighting this virus head on. Am I really considered a “real” nurse if don’t do those things?

My first LPN instructor told the class in 1983, "If you can do nothing else, just be there for the patient".

I figured that if I doing nothing else, but was there for the patient, I was a "real" nurse.

Also, it has been said, "Those who know how to nurse, work medical, and those who don't, work psych". Psych nurses have often had to deal with the stigma of not being real nurses.

Here's an old comic that relates to that concept:

 

["nursy", RN]

I feel ya...I'm a school nurse working from home, talk about feeling guilty about not being on the front lines.  I have those moments every time I read a tear jerker story like the one about the doctor who has worked 275 days in a row without a day off; or the one where the docs are doing nursing care because there are not enough nurses.  However, I have to remind myself that I was a nurse back during the beginning of the HIV epidemic, and held many a hand of a dying patient, when a lot of other health staff didn't even want to enter the room of an HIV  patient.   If times were normal, you could go on a guilt trip because you aren't working for doctors without borders, or you didn't hop on a plane and fly to Haiti after their last earthquake, etc.    We all have our moments, and we all respond to what is our calling at any given time.    You are where you need to be.

[NurseLy, BSN, RN]

I felt the same way my first year of nursing when I started in rehab. 
 

someone told me, and it stuck with me, if you need an RN license to be hired for that position, that makes you are a real nurse. Other wise they would hire someone else and pay them less to do that job.? 

[Guest856929]

On 12/6/2020 at 8:04 PM, mtanner said:

When I graduated from nursing school I immediately accepted a position on an Orthopedic/Medical Surgical floor. On that floor, I was responsible for taking care of post-operative orthopedic surgery patients, most commonly joint replacements, and general med-surg patients. On any given day, we would have 6 patients and our assignment was a mixture of the two types of patients. Because our unit had such high turnover due to our ortho patients, it wasn’t unusual to have 4 discharges and 4 admits a day. It was quite exhausting. It was especially difficult because with the extensive amount of time that 4 discharges and 4 admits takes, you also had your other 2 sick med-surg patients to care for. Often times, we would receive admits from the ED that were inappropriate for our floor but due to hospital occupancy, it didn’t matter. Trying to manage an ortho patient’s schedule and a med-surg patient’s schedule was very challenging because they were total opposite, yet often times overlapped. Our ortho patients had physical therapy twice a day, once at 8:30 and again at 12:30. Prior to PT, we had to give our ortho patients their pain meds (if it was in the allowed timeframe, q4h) but that also overlapped with the 8:00 med pass of our med-surg patients with 18+ medications due at one time. We give our ortho patients pain meds around the clock.  They are technically PRN but they are essentially scheduled. The rationale is that it is easier to prevent pain than it is to play catch up. If the patient is in pain, they will not be able to perform their PT exercises properly and ultimately not heal appropriately or gain full ROM. After 10 months of working on this floor, I decided to look for other positions as an RN. This job gave me a sense of pride because I was able to help people and do what I loved but it was physically and mentally draining.

I applied for a position at an outpatient vascular surgery office as a moderate sedation administration nurse. I was offered the position and graciously accepted. We perform angiograms, smagrams, fistulagrams, thrombectomies on AVG’s, TDC inserts, changes, and removals, IVC filter inserts and removals, powerport inserts and removals, venograms, etc. Here recently, a local dialysis access center that offers maintenance work on patients’ accesses closed down. We have since received almost all of their patients and where we used to mostly treat our arterial patients with PVD, we have been slammed taking care of our dialysis patients and making sure their accesses are working properly. I love my job, I love the OR, I have amazing coworkers, I work 4 days a week 6:30am-5:00pm, no weekends, no holidays and enjoy what I do. However, especially during the COVID-19 pandemic, sometimes I feel like I’m not a “real” nurse anymore. People will ask me what I do for work and when I tell them I’m a nurse they often say, thank you for all that you do and working on the frontlines. I feel guilty and often don’t know what to say because I’m not on the frontlines anymore, I don’t work in the hospital, I don’t treat COVID-19 patients. We were lucky enough to never slow down during the pandemic and we were able to remain open throughout the whole thing. I know what I do is making a difference for my patients because without it our dialysis patients wouldn’t be able to receive their dialysis treatment and our arterial patients would lose their limbs but sometimes I feel less than a nurse. When people think of nurses they think of the ones in the hospitals saving lives on a daily basis and fighting this virus head on. Am I really considered a “real” nurse if don’t do those things?

You are a nurse irrespective of your chosen field as long as you are licensed. I do not see this inferiority complex with physicians who range in scope: pathologists, ID, surgeons, IM, radiologists, psychiatrists, etc. You think dermatologists are "saving lives" performing some of the perceived heroic attributes that the general public thinks all physicians perform? Though I do have my reservations for LTC, It is only in nursing where one finds this pitiful diatribe. 

[speedynurse, ADN, BSN, RN, EMT-P]

Nursing has become so convoluted and exhausting that if you have a job that doesn’t take everything out of you.....it’s an absolute blessing.