Hierarchy in Nursing?

  1. I'm just starting NS this Fall, but I've worked in outpatient care for many years. One thing I've noticed in the office is that there seems to be a hierarchy in nursing that makes it difficult for some people to "fit in." Just wondering about others' observations on this.

    When I worked at in-patient hospice a few years ago it seemed that the RNs didn't get along with the CNAs; the CNAs had their own social stuff going on and didn't chat with the nurses the way they did amongst themselves. Everyone seemed to think that the others weren't doing as much work as they were! I worked as unit clerk so I really didn't fit in with either group.

    Observations on this from nurses and/or CNAs who've been working in-patient?
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    About cingle

    Joined: Mar '09; Posts: 86; Likes: 41


  3. by   DolceVita
    Whatever you do don't include CNA's in the category of nurses or someone on this site will savage you.

    I am a tech but only a couple nurses won't give me the wind of their fart. There is also a unit clerk, even when you address her directly, looks at you as if you just spoke a completely foreign language.

    There are lazy people in all areas of healthcare. Our nurses and techs do not really mix socially. Also, techs that are in nursing school don't seem to mix with either. Go figure.

    We should get David Attenborough in to do a program on it
  4. by   Katnip
    I've seen it both ways. I've worked on a unit where the nurses socialized with each other or the docs, and did not include the techs.

    I've also worked in emergency where people really worked as a team and often socialized outside as well as inside work.

    I don't know if it's because of the nature of emergency, or the step down I worked in was just a lousy unit, (well it was anyway-so bad you couldn't get agency nurses to come in) but the ED was vastly different.
  5. by   accessqueen
    I don't know as I'd call it hierarchy, it just seems that you tend to socialize in the groups that you have the most in common with. I've worked in places where people were very standoffish all the way around, and other places where everyone is friendly. But even in the friendliest places if you look at who's eating with who, people stick togeteher along their professions, respiraroty with respiratory, lab with lab, RN with RN etc. Or the other grouping is along cultural lines, latins with latins, asians with asians etc etc. I'm not saying this in a prejudicial, or judgemental manner, this is 30 years nursing observation adn experience.
  6. by   Patchouli
    makes sense. people are comfortable with what they know and what they are familiar with.
  7. by   MedSurgeMess
    Where I work, we only have about 6 CNAs left in the hospital, all others are RN and LPN and all ancillary staff. At any given time, you might see a few from nursing, some from maintenance, security, dietary, CNAs, and even a couple of docs eating lunch or taking a breather together. Now you will always have those who are to high-n-mighty, holier-than-thou who will never mix outside their "class"
  8. by   RNperdiem
    This sounds like high school where certain groups of people always sit at certain cafeteria tables with only their peers.
    I have found a difference in the way CNA's who are nursing students are treated differently sometimes than CNA's who have no plans to pursue further education.
    The students tend to be included more in the nurses groups than strictly with the other CNA's.
  9. by   86toronado
    Where I currently work, everyone gets along. You have cliques within the group, but when one of our PA's moved recently everyone docs, nurses, techs, unit clerks, etc. got together for his going away party. I've worked other places where that was not the case, however. So it varies from hospital to hospital, floor to floor, and even shift to shift.
  10. by   keithjones
    If you watch the special features on the Lord of the Rings DVD they comment on how funny it was to watch at lunch you would end up with an orc table an elf table a hobbit table. it is just human nature to group with the familiar.
  11. by   ma_82
    In this area of profession, we have to deal to different group of people. So whether we like or not, we need to talk to them, work with them. In fact there are times also that rn's need to collaborate with older lpn's which sometimes make things a bit difficult. Where in rn's are highly educated professonally and tend to be bossy to lpn's. I see this as an observation which sometimes we cant help it but to live with it since its the part of our job. We must not deal only with our patients, but to our collegues and other members of healthcare since we are working as a team.
  12. by   CathyLew
    >This sounds like high school where certain groups of people always sit at certain cafeteria tables with only their peers.>

    well, it makes sence that work would mirror that, since most of us came from high school. :-) I see it different ways on different units. In one unit everyone is treated with respect. Just thrugh the door, on a different unit, it is dog-eat-dog. and everyone complains about their co-workers equally. I hear the RN's sit at the desk and push paperwork.... the LPN's hump the med-cart and don't help out. The CNA's have no real responsibility, so they can lolly-gag and take long breaks. bla-bla-bla! grass is always greener on the other side of the fence. Yea, there have been times when I look at the CNA's and think...wow, to be able to walk away from the day without the hanging nagging responsibility that I have. But then again. I hear them saying.....I put in the same hours, bust my ass, and look what SHE gets paid!

    there are always more than one way to look at things. But I do believe there is a class system in healthcare. be it heiarchy, chain of command, etc. different levels, different responsibilities, different' things to complain about!
  13. by   coffee4metech
    Everywhere you go in life there WILL be cliques according to race , education and occupation. Thats just how society functions it is not high school , thats the hierarchy of society. I am not saying someone is better then another its just a fact. So yes, in healthcare you have the same system as general society has .
  14. by   Virgo_RN
    Quote from DolceVita
    Whatever you do don't include CNA's in the category of nurses or someone on this site will savage you.
    Oh Dear Lord. :icon_roll

    From the Merriam-Webster online dictionary:
    Main Entry:1nurse Pronunciation: \ˈnərs\ Function:noun Etymology:Middle English norice, norce, nurse, from Anglo-French nurice, from Late Latin nutricia, from Latin, feminine of nutricius nourishing -more at nutritiousDate:13th century 1 a: a woman who suckles an infant not her own : wet nurse b: a woman who takes care of a young child : dry nurse
    2: one that looks after, fosters, or advises
    3: a person who cares for the sick or infirm ; specifically: a licensed health-care professional who practices independently or is supervised by a physician, surgeon, or dentist and who is skilled in promoting and maintaining health -- compare licensed practical nurse, registered nurse
    4 a: a worker form of a social insect (as an ant or a bee) that cares for the young b: a female mammal used to suckle the young of another
    When I was a CNA, I didn't feel the need to be included as a "nurse". I figured I'd be considered a "nurse" when I had earned the title.