Nurse is a nurse is a nurse

Riseupandnurse · May 29, 2003

How can the public ever really value and respect nursing until it learns what nursing actually is and does? And how can this happen when nursing can't distinguish or define itself? I remember being shocked in my masters' nursing theory class. I had thought it would be a class about the different ways to nurse; instead, it was all about the theories of what nursing even is.

Nursing has itself to blame for a lot of the public's confusion. RNs don't insist on a bachelor's degree as an entry level requirement. (Yes, I know there are a lot of good LPNs out there; but the problem is that the public doesn't have any way of knowing what the differences might be.) We accept the generic term "nurse" for all sorts of differently-trained people. Remember the woman who won "Survivor" a couple of years back, Tina? She was a "private nurse". What the heck is that?

And we refuse to wear anything that would really help to distinguish an RN from other caregivers. We are way too cool for hats. They may have got in the way, but at least people knew who the RNs were. A name tag is fine, but it doesn't go far enough. In the meantime, we are busy shedding our whites and wearing cute little bunny lab coats and fashionable purples and mauves. We look great, but do we look like highly trained professionals?

I know this post will make people mad, but if we really want more recognition and respect, RNs as a group are eventually going to have to bite the bullet and discipline ourselves. Otherwise, we might as well resign ourselves to our public image as bedpan carriers and handmaidens of the physicians. Sometimes I think that would be just fine, if such a role actually existed. At least we wouldn't have the agony and the struggle that go along with the critical thinking that RNs are really faced with in patient care.

Jen2 · May 29, 2003

Hello

Reading this thread and thought that I would give some of my experiences. Out of High School, I went to school to become an MA. I always wanted to become a RN but wanted to get my feet wet first. I worked in a large specialty practice in my area for four years. Gave injections, vital signs, variouse tests, and phlebotomy. I loved my job. Then the physicians decided that they were going to start doing remicaid infusions in the office. I was then taught by the PA how to do this. I loved the learning experience until I began to learn about the high infusion reaction. I then went to the physicians and told them that I felt very uncomfortable with this and was not qualified to by left alone and monitoring a patient recieving any infusion, especially one such as this. They told me not to worry and that they trusted my judgement. Til this day I do not feel that they trusted my judgement, but that they could hire me as an MA and pay me $8.00 an hour to do this kind of work (illegally of course). I then quit my job here and am know working as a phleb in a hospital. I start my clinicals this fall. Many, Many times I have been called a nurse. I always correct the person in saying "I haven't paid my dues yet." I truly know how hard it is already, and I haven't even started clinicals yet. First you have to get through the pre-reqs, and then getting accepted into a program is a goal all in it's own. Where I work at the nurses and I respect each other. I help them and they help me. I've had many nurses pull blood from a lock for me, just as I've helped nurses find veins and let them use some of my blood for a bedside troponin or glucose. We all need to respect each other and people who haven't paid there dues yet do not need to be calling themselves nurses. I honestly think a big part of this comes from the physicians. They want to think that their MA's are nurses, but if an MA started to requested a nurses pay, I bet this would change. As far as the patients go, as long as they see someone in a uniform and they need something, they think that you are a nurse. It begins with educating the people you are helping, whether your a Rn, LPN, CNA, MA, or whatever. Sorry for rambling. Just some thoughts.

MICU RN · May 30, 2003

Reminds me of a conversation I had with a friend a few days ago. SHe told me that she works at a peds office and started at the front desk, but now because they thought she was very sharp have promoted her to a medical assisstant. And they gave a raise, 14.00@hr with no benefits, but still not bad considering her education or training. This seems to be how the market is in doctor's offices and I don't let it bother me. But the longer I am a RN and I started with a ADN when I graduated in 1998, the more I am realizing that as long as we have multiple entry points with regards to education, we will always be fighting an upward battle for professional recognition. IF every one else in allied health beside resp therapy needs a min. of a bachelors degree, why do we think we are going to get the respect and compensation other professionals get who require more education? Do we want to more like pharmacist, PT, OT, ect.? Then we have to require at least a bachelors degree to get in the profession. Of course existing RN'S who don't have one would be grandfathered in. But as long as we have all the die hards clamoring that "the amount of education does not make the nurse and we don't need to upgrade education requirements because it as always worked in the past", we will continued to be looked at as "a nurse is a nurse is a nurse". I for one decided to go back to school and I got my BSN and now am going to be starting a graduate school program. ANd one of the things that motivated me was that in this speciality everyone has to have the same education level to be in the profession, no debates or rationalizations on why it is okay to have multiple points of entry. Many nurses would rather complain and threaten to write up everyone instead of taking either personal or professional action to make their situations better. Just my humble opinion.

Kayzee · May 30, 2003

I seen the play WIT, and just want to say ...if it ever comes to your town don't miss it. It was fantastic.

KevinN · May 30, 2003

Late a few nights ago, American Gladiators was on the TV and it was the gladiators against contestents in the medical field. Well, one of the contestents was a CERTIFIED NURSE. She was aknowledged as a nurse the entire show. I have never heard of a CERTIFIED NURSE before. Come to find out she was a CNA. I think if you are a CNA, great!, but you should be acknowledged as a CNA and not a nurse. There is a difference.

moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS · May 30, 2003

Originally posted by MICU RN
...But the longer I am a RN and I started with a ADN when I graduated in 1998, the more I am realizing that as long as we have multiple entry points with regards to education, we will always be fighting an upward battle for professional recognition. IF every one else in allied health beside resp therapy needs a min. of a bachelors degree, why do we think we are going to get the respect and compensation other professionals get who require more education? Do we want to more like pharmacist, PT, OT, ect.? Then we have to require at least a bachelors degree to get in the profession. Of course existing RN'S who don't have one would be grandfathered in. But as long as we have all the die hards clamoring that "the amount of education does not make the nurse and we don't need to upgrade education requirements because it as always worked in the past", we will continued to be looked at as "a nurse is a nurse is a nurse". I for one decided to go back to school and I got my BSN and now am going to be starting a graduate school program. ANd one of the things that motivated me was that in this speciality everyone has to have the same education level to be in the profession, no debates or rationalizations on why it is okay to have multiple points of entry. Many nurses would rather complain and threaten to write up everyone instead of taking either personal or professional action to make their situations better. Just my humble opinion.

Ok, point of entry has been discussed ad nauseum here. I don't want to see the topic go to that particular direction. Not to say that the poster doesn't have some very good points. In fact, when I speak to new grads at the technical college on behalf of the state nurse's association, I bring this exact point up. No one likes the idea of mandating that you are a nurse after you reach x point on the education scale. Hopefully, it drove home the idea that nurse's need to speak up for themselves.

The other point that I have to make is that when I started my "nursing" career, I was not even a nurse. I was a nurse tech. Nursing homes are relying quite heavily on the tech position nowadays. I remember doing things that an RN should have been doing, but for my ignorance, I didn't know any better. To my patients, and the aides, I was the nurse. There is one nursing home in the area, that staffs entire floors with nurse techs. One RN for the whole building, of maybe 300 patients. This of course once I recieved my RN is why I said "I am outta here" just as quick as I could.

healingtouchRN · May 30, 2003

I am a Certified Nurse (in Cardiac Vascular nursing) but the CNA should have been upfront! She/he was riding that horse!!! (oh, I was a CNA in college as well & proud of it!).

NurseJacqui · May 31, 2003

Furball...I don't know...I once worked on a floor where the 7-3 nurses would come in, take an hour to get report, then sit down and eat breakfast together, talk to their husbands and boyfriends on the phone, give a few meds, take a 20 minute break, give a few more meds, chart on patients they never asessed, then go to lunch for an hour. I doubt they shared popsicles with their patients, though. But that's another story..I saw "Wit" and actually was touched by the popsicle scene. It was sweet:)

NurseJacqui · May 31, 2003

When I was in nursing school, I was studying for a pharmacology test and a friend asked me, " Why do you need to know all that stuff anyway to be a nurse"? So I said, " Ummm...because I need to know what I am giving" He said and I quote, " Why do you have to know...you just do what the doctor says, " So I said , " Well, I need to be aware of side effects and adverse reactions. And doctors can make mistakes so I need to know the correct routes and dosages, " He said, " That's the doctor's problem...not yours, " Sad, but true.What is even sadder was that he was dead serious!

NurseJacqui · May 31, 2003

We had a tech once who recorded every single pulse she took as 80. Feeling that that was impossible, I asked her to take my pulse. She took it using her thumb. So basically, she was taking her own. Another time, a doc came to asess a pt and found him with a pulse of 23. EKG showed 3rd degree heart block. Tech recorded pulse as 76 only an hour prior. Doctor was FUMING. While many techs are wonderful, some bad ones slip through the cracks.

gwenith, BSN, RN · May 31, 2003

The Australian perspective - we do have Enrolled Nurses but the scope of practice for the Enrolled Nurse clearly states they are an ASSISTANT to the registered nurse. They can only give out and check medications if they are endorsed and that endorment is through our state registration board. Nuring Assistants are actually not allowed to give direct patient care finito! end of arguement! We do have some "techs" who do limited functions such as ECG's or other clinical measurements but usually they are trained personell. Phlebotomy - it depends - varies from laboratory staff to "retired nurses" to Registered nurses. There is state legistlation outling who can and cannot administer drugs and even enrolled nurses can only administer drugs under direct supervision of a registered nurse.

What I have been reading here is making my hair stand on end. Talk about role erosiion - if you are not careful you will find that the nursing shortage will be cured - they will have done away with nurses!

But honestly doesn't your state registration board have a scope of practice for nursing? Competancy standards? Anything?

Agnus · May 31, 2003

Originally posted by Jen2
Hello

I worked in a large specialty practice in my area for four years. Gave injections, vital signs, variouse tests, and phlebotomy. I loved my job. Then the physicians decided that they were going to start doing remicaid infusions in the office. I was then taught by the PA how to do this. I loved the learning experience until I began to learn about the high infusion reaction. I then went to the physicians and told them that I felt very uncomfortable with this and was not qualified to by left alone and monitoring a patient recieving any infusion, especially one such as this. They told me not to worry and that they trusted my judgement. Til this day I do not feel that they trusted my judgement, but that they could hire me as an MA and pay me $8.00 an hour to do this kind of work (illegally of course).

Sadly it was not illegal. A physician can hire anyone with or with out credientials or education to do anything. The way it works is that you are neither paracticing nursing nor medicine. You are working under HIS license and you can do anything he trains you to do or tell you to do.

MDs do this because they can get people cheap who are not nurses. I also think that they do not understand the debth of a nurses education knowledge and abilities and feel they can train anyone just as well themselves to do a task. Unfortunatly nurses are not simply trained to do tasks.