Am I Nursey Enough For You?

We nurses are sometimes our own worst enemies. Far too often, lay people demonstrate misunderstanding and disrespect for nurses. Why shouldn't they, when they learned at least some of it from us? Nurses Announcements Archive Article

In the US, the definition of a nurse is a simple one. A registered nurse is a person who has passed the appropriate NCLEX exam and who holds a valid license in his or her state. The same is true for a licensed practical nurse. That's pretty straight forward, isn't it?

As it turns out, the definitions are a bit too straight forward for some, meaning they don't allow the lay public to discern exactly how nursey a particular practitioner might be. This deficiency has inspired some nurses to take it upon themselves to establish various nursiness scales and encourage others to abide by them when evaluating those who may--or may not--be their peers.

For instance, ICU and ED nurses typically outrank med/surg, OB, and psych nurses. Flight nurses and those who work in neuro or cardiac ORs are usually located somewhere near the top of the heap, while others who give vaccinations at community clinics, educate new diabetics, or work in school health rooms come out near the bottom.

The problem with this kind of thinking is that it fosters division and disrespect among people who ought to be linking arms and presenting a united front when non-nurses demonstrate how poorly much of the general public understands the nursing profession--and who belongs in it.

In an age when medical assistants, nursing assistants, med techs, and even office personnel might wrongfully refer to themselves as nurses, we who genuinely have earned the title should insist on truth in labeling. We need to educate consumers and get after those who exploit their confusion. As nursey as these assistive personnel may appear, they have no right to appropriate the title.

Not much to argue about there. But, along with exclusive limitation, truth in labeling has an inclusive aspect as well. And that is not nearly as popular within our ranks.

The initial showdown takes place between hospital nurses and everyone else. Acute care nurses take pride in what they do, and they should, so long as they don't--even mentally--let their workplaces give them an excuse to snub other nurses.

Among the non-hospital nurses, another dust-up occurs between those who provide patient care and those who don't. Do you work with residents, visit people in their homes, give kids their ADHD meds and inhalers? Okay, you're a notch or two down from the hospital folks, but at least you're still a hands-on nurse.

What if you're a case manager, an insurance reviewer, or an IT person? Sorry, you don't seem very nursey at all.

Advanced practice nurses might as well be animals of a different species, along with those involved in upper management or teaching.

And so it goes.

Why do we treat each other this way? How can we blame the public for having a distorted image of nursing when some of us capitalize on this very misinformation--"Why yes, thank you, I am a real nurse because I work in a flashy specialty that would shine on prime time TV--leaving others to feel they have to present their credentials, point out their roots, or argue the importance of their jobs.

Can we admit that some of our colleagues do jobs that lack panache but matter greatly to their patients, clients and residents. Can we acknowledge as our peers those who keep renewing their licenses even though they now operate at a remove from the bedside--the teachers, the managers, the researchers, the volunteers?

Maybe it's time we give the rest of the world a demonstration in how to respect nurses by insisting that every one of us who has passed the test and kept the license current is just as nursey as the rest.

..."nurses take pride in what they do, and they should, so long as they don't--even mentally--let their workplaces give them an excuse to snub other nurses."

Yes. This. Perfect.

Its so true. I have been an LPN in Assissted Living and Alzhiemers care for 2yrs.. For some reason this is not an important job in nursing. Do these people, the most vulnerable in our society not need care? Assissted Living is more like LTC now, and in many cases some really do belong in SNF.

Specializes in psych, general, emerg, mash.

welcome to office politics. Its time to change jobs, but that wont help much, since most offices are like this.

If staff have a crap attitude, it aint going to change. The captain of the ship needs to get their **** together and have a staff meeting. Sometime its doctors with attitudes. Some offshore doctors bring their upbringing about women, to our shores. Read into that, if you want.

Thanks for posting this. I think we can all agree that unity among nurses would be a wonderful thing. Unfortunately it is the nature of our society for people to raise themselves up by putting others down. I think being aware of the problem, and doing our personal best to not become a part of it, is certainly a step in the right direction. As well as, when possible, reminding our friends, coworkers, etc. of the value of all areas of nursing. Thanks again for a great post.

Specializes in Geriatric/Sub Acute, Home Care.

At 55 years of age and a LTC nurse for 17 years I always respected other nurses for their additional acquired knowledge in certain fields.....I felt that working with a Nurse who had worked in the ER, ICU or other units could teach Me as well as I teaching her about my field. This applies for auxillary personnel also....I learn from my Nurses aides, respiratory therapists, social workers, and administrative personnel. However, some still are perched high on their horses and look down at us. One thing I always remember is everyone gets sick at some point and older. And the major factor in Nursing is stabilizing good health as well as working with those that cannot help themselves at certain points in their life. As the old Native American saying states.....we are all connected......so that applies to Nursing as well.

Specializes in School Nursing.

Thank you for this! I find it so odd that when nurses are talking about the benefits of a nursing career, they talk about all the specialites you can work in, and how you can find the niche with the right fit for you. But some of those same nurses are the ones who will downplay the importance of one specialty over another.

I just don't see how any specialty can outrank another. Just because you are not dealing with the sickest of the sick, does not mean that you are not impacting a life on a daily basis. My IV insertion skills are no where near what an ER nurse's might be, and I would be tangled up in all the lines that an ICU nurse deals with daily. But is it the difficulty of skill or level of acuity that makes the nurse? I'd say no! It is more about the kind of nurse you are. Every nurse touches lives if s/he takes the tenants of nursing to heart and strives to do his/her best on every shift. You cannot be a good nurse and NOT make a difference, IMO, no matter what the specifics of your job may be.

Specializes in LTC, assisted living, med-surg, psych.
Its so true. I have been an LPN in Assissted Living and Alzhiemers care for 2yrs.. For some reason this is not an important job in nursing. Do these people, the most vulnerable in our society not need care? Assissted Living is more like LTC now, and in many cases some really do belong in SNF.

Sing it, sister! You are SO right---I've been in and out of AL nursing for over a decade, and I can't believe the acuity we have now that we didn't have then......In 2000 we didn't take sliding-scale diabetics, psych cases, two-person transfers, or moderate to severe dementia patients; today, we do. In 2000 we had mostly 'walkie/talkies' who still drove their own cars and were completely independent; today, those folks are either staying in their homes or moving to Independent Living communities where they don't have to cook or clean, but don't get any other form of help. In 2000, we moved wanderers to memory care and people who could no longer feed themselves to ICF; today, it takes an act of Congress to get someone out of ALF into a higher level of care, even when it's obvious that they belong there and remaining in AL would put them in danger of harm. :down:

Specializes in PCCN.

It doesnt help that most floor nurses are seen as medical waitresses and customer service agents by the general public.

Specializes in LTC.

"a nurse is a nurse is a nurse" words from my nursing school insructor

Specializes in Rehab, LTC, Peds, Hospice.

I think people would be surprised what a LTC nurse deals with. It was much easier when I started -15 years ago - (gasp). Hospitals can't keep patients as long as they used to - but they still need nursing care and in they come with their IVs and their wound vacs and multiple dx and needs. The requirements for charting and care get increased it seems every year. With 20 plus patients to boot. And Viva is completely right, (I really feel for AL nurses and CNAs!!!) assisted living is much closer to what I was used to starting out years ago in LTC - along with a good mix of 'independent living' sorts as well. Jeesh - we do EKGs now. One place I worked had a machine for ultrasounds and a PT INR that the LTC nurses did. Crazy. But their you go. (And they wonder why we can't get out on time... Lol)

There seems to be a "pecking order" in most group identities and even in families. We never seem to value the person for whatever contribution they make. Think about MD's. Wouldn't it be a pain in the butt to know you were a family doctor with an MD and have the cardiac surgeon be so glorified and so well paid, as you struggle to even keep your office open. Then we have attending physicians, residents, interns, and lowly med students. Couldn't they all be valued for their contribution? But are they? We also have attorney's who begin as lowly law students and law clerks, potentially climbing the ladder to partner. If you are a partner, you are the boss and seem to look down on all other lowly lawyers. We have judges who often look down on anyone other than judges. Think about your family. In my family, for example, we have a physician, nurses, and a nurse/attorney. Guess who is the top in our pecking order.

I have been an volunteer, an aide, an LPN and an RN for forty years. I was also a head nurse and supervisor. I tried to include all for their contribution and thank people often. Respect and recognition for the divinity in all of us is where we, as a human race, need to be. We are not there yet, may never be, and some don't want to be. By the way, aren't all these things a form of "bullying?"

True, somewhat. By licence, there is a different scope of practice for various nurses. I would also argue that floating a nurse from one are of specialty to another is not always wise. Nurses have certain transferable skills that can be used anywhere. I get that. But not all skill sets and knowledge bases are the same. Thanks to all nurses for what they do every day.