Questions youv'e probably never been asked before......

FireStarterRN, BSN, RN · Mar 15, 2009

These types of assignments are what put the BS in BSN I suppose...

x3xsolxdierx3x · Mar 15, 2009

errrr.....no comment....lol :)

(So much for putting this 'thread' on my APA reference page....LOL)

x3xsolxdierx3x · Mar 15, 2009

I know these questions probably diverge from the norm of what everyone is accustomed to being asked by a nursing student.......has anyone here had any experience, at all, with the 'politics of nursing'?.....if your'e able to answer even just one question, that would be great....and, such a help..... :)

llg, PhD, RN · Mar 15, 2009

--Question #1: What factors contribute to the nurse's power in her or his practice?
--Question #2: What factors limit empowerment in practice?
--Question #3: What is the role of collective bargaining (unionization) in the relationship between management and direct care nurses?
--Question #4: How can practicing nurses become involved in the political process in nursing?
--Question #5: Describe the power relationship on your clinical nursing unit(?)

Here are some ideas off the top of my head. I'll try to keep an eye of this thread and maybe post some more later. Note that I have 32 years of experience, most of it is Neonatal CNS and Staff Development roles. I have a PhD, but have worked in hospitals for the majority of my career -- and have worked in my current hospital for a little over 10 years.

Question #1: Our expertise and the service we provide to patients, colleagues, and employers. The fact that our expertise is needed to provide nursing service is the primary source of our power -- whether we know how to use it or not.

Question #2: Nurses' attitudes and knowledge about power and its use. The nursing culture is our biggest obstacle. We are our own worst enemies. As you have seen, some nurses believe that learning more about power and its use is a waste of time. However, we will never get good at acquiring power and using it if we are not willing to invest a little time in studying it. Other nurse view the study and use of power (i.e. politics) as being somehow "unclean" or "inappropriate" for nursing to engage in. We should all be too pure and innocent to be knowledgable about taint (or stench) of political maneuvering. Nurses who are good at politics -- and who provide the type of great service that gives them influence in the politics of their work envirnments are often "brought down" by their fellow nurses who accuse them of "sucking up" to management and/or to the physicians. In other words, if you are not willing to be one of the disgruntled masses who endures oppression but does nothing about it ... then you are driven out of the herd, isolated from the group through intimidation -- gossiped about, bullied, etc. People who try to get an advanced education and study these things are told that the topic is b***s***, etc.

Question #3: I have mixed feelings about unionization. I have worked for a hospital that was unionized and the relationship between the staff and the management was poisoned. It was clearly an "us against them" mentality with both sides pulling dirty tricks, lying about things, etc. I hated it -- but was grateful to have the pay and benefits that the union had won in previous contract negotiations. I would not choose to work in such a bad environment again. However, I have also worked for a hospital that did not have a union that abused its staff so badly that I would have voted to unionize if I had been given the chance. Having lived in many different regions of the country, I believe a lot depends on the local culture. In some areas of the country, there are more enlightened attitudes within the management in which a positive relationship can exist and fairness can exist without a union. I prefer to work in that type of environment. However, in other communities, the culture is one in which management views labor as needing to be "crushed" and the best protection that the staff has is to band together to form a union.

Question #4: Educate yourself, join, and donate. Educate yourself about the issues instead of just listening to gossip. Develop political skills by getting experience in working with groups and projects that relate to your work. Join unit-based committees and projects to get involved in the politics on your particulary unit. Join hospital-based committees and projects to get involved at that level. Join regional/national organizations to contribute and that level: actively participate to the extent that interests you. Donate your time and/or money. Nothing happens without the donation of time and money. If you don't have one, donate the other.

Question #5: My department is not a clinical unit. However, the decision-making structure of my hospital is a little too hierachical and centralized. Staff nurses who get involved in unit projects have their voices heard, but most choose not to participate actively in projects or committees because it would require that they come in on days off (for pay), do homework in between meetings, etc. While they would be paid for that time, it is still really inconvenient in that it would require commuting, paying for child care etc. We should be working on ways to make it easier for them to participate more in unit-based and hospital-wide activities. As for regiona and national nursing groups, very few seem interested in that sort of thing. They seem to see it as far removed from the daily reality of their lives. I must admit, I feel the same way. While I have been active in a professional organiation in the past, I currently work 2 jobs and just don't have the time and/or energy to do more by being active in an organization at this time. So, I compensate by giving money regularly.

BTW: For the record ... a lot of BSN students ask these types of questions because they are studying these issues in school.

Vito Andolini · Mar 15, 2009

hello everyone,
my name is howie, and i'm (finally...long story...lol) finishing up my bsn degree this semester. iv'e been a long-time member of allnurses.com, and i visit frequently and enjoy everyone's posts.
recently, a professor gave us an assignment to interview a nurse, with regards to a set of questions she had asked us to ask them. i have spoken to a long-time nurse, in my family, however, i was interested in how members of allnurses.com would respond to some of these questions, based on your own clinical practice experience.....
there are several questions, and, honestly, unless youv'e been approached by another student, in a past-life......i'm pretty sure that you may have never been asked these questions before.......lol......
if your'e very passionate and zealous, it would be an honor to have you all try to answer them...............and, if not all of them, perhaps you could pick out one? i do think that this q/a could be beneficial to perhaps nursing students, who are about to graduate, in preparation for what they'll encounter in their practice.........who pass-by and see this thread..............
--question #1: what factors contribute to the nurse's power in her or his practice? i'm not sure nurses have much power. rather, we have it but don't band together very well and command respect.
--question #2: what factors limit empowerment in practice? nurses are mostly female and of a mindset or personality type that wants to serve and be helpful. this type of person is not generally politically astute, is too trusting, maybe has been taught that assertiveness is not nice. this is changing since older people are entering the field and because people are changing careers and entering nursing.
--question #3: what is the role of collective bargaining (unionization) in the relationship between management and direct care nurses? management hates unions generally and bedside nurses often feel guilty about it and resent the dues. it usually makes for a lot of tension.
--question #4: how can practicing nurses become involved in the political process in nursing? check out the ana website, get involved with your state nurses' association, get involved with your local senator or congressman.
--question #5: describe the power relationship on your clinical nursing unit(?) a lot of charge nurses let the aides walk all over them. a lot of managers do not discipline well.
thank you!
howie

i hope this helps. your questions are not strange or new at all. good luck in school and thanks for your soldier work. god bless.

Pediatric Critical Care Columnist · Mar 15, 2009

Hi Howie!! (Sorry, I couldn't resist.)

--Question #1: What factors contribute to the nurse's power in her or his practice?

We provide the skills and services that are what bring people into hospital. While our role is subordinate to the physician's we bring something to the table that they can't... a presence in the relationship that is unique to nursing. We can choose to withhold those services by moving to other careers, by seeking advanced education that will give us even more power over our own practice, or even by calling in sick. Once we receive our registration, we have the power to choose where our career will take us. But we have to be willing to do what must be done. Thomas Edison said, "Opportunity is missed by most people because it is dressed in overalls and looks like work."

--Question #2: What factors limit empowerment in practice?

I agree that being a predominantly female profession makes it more difficult to achieve cohesion in seeking empowerment. There are those who fear a loss of respect if they speak up for themselves (funny, isn't it?). There are those who fear retribution if they speak up for themselves or others (and yet we're a "caring" profession). There are those who fear change, even when that change is an improvement. And there are those who fear involvement because it implies commitment.

--Question #3: What is the role of collective bargaining (unionization) in the relationship between management and direct care nurses?

It's often quite adversarial. In Canada the vast majority of nurses who work in facilities are unionized; the employer is ultimately the provincial government and since they are also the law-makers, they can make unions seem almost toothless. That's the case in Alberta where nurses are "essential" services and are not permitted to strike. (Any sort of collective action is considered a strike, so a ban on overtime, for example, could result in fines for the provincial executive, the local executive and the individual nurses involved.) Add to that the stacking of the labour relations board with government lackeys and you get a board that rules in favour of the employer in 95% of all disputes. It's sort of like beating your head against a tree. But when unions and employers find common ground and work together to improve working conditions, morale and employee retention, they directly improve patient care and outcomes. An example of this is the creation of a mutually acceptable mechanism for documenting unsafe workloads and staffing with the potential for patient or nurse harm. It provides an opportunity for nurses on the front line to formally express their concerns and an opportunity for the employer to demonstrate a need for more staff, a different staff mix or some other adjustment to the matrix of the unit. When this process is developed properly and communicated properly, it's a great tool.

--Question #4: How can practicing nurses become involved in the political process in nursing?

Pay attention. Keep current with plans for change in your workplace, your community, your state and your country. Use your critical thinking skills to analyze the impact these changes might have. Write letters to the editor and to legislators, attend information pickets, talk to others about all the implications contained in a proposal. You don't have to join an association to be effective, but there is strength in numbers.

--Question #5: Describe the power relationship on your clinical nursing unit(?)

Our unit is all stick and no carrot. Everyone is unhappy but no one will do anything about it... except quit. Our management has said, in public, that we are all replaceable. They violate our collective agreement in a dozen little ways and after being reminded of their obligations, they smile, nod and then just do it again. And because our unit is the only one of its kind within 200 miles, people suck it up rather than rock the boat. Those of us who do rock the boat find ourselves singled out for "special" treatment that is very carefully implemented so that there's no way to prove it's retaliation. Sometimes I regret moving my family 800 miles so that I could take this job.

The profession of nursing in North America is heading for stormy seas; there are many nurses who are unwilling to continue working under unsafe and unhealthy conditions and are leaving the profession behind. Meanwhile the problems facing nurses are being given more attention than ever. It may yet get worse before it gets better, but I really believe it WILL bet better. We can't wait for our "prince" to come, we have to get involved and make positive changes.

x3xsolxdierx3x · Mar 15, 2009

Wow....honestly, I had thought this thread was destined to meet an early demise, after the first few hours without a response......lol......but, thank you SO MUCH to everyone who has responded! :)

Even beyond the assignment, I think it's great that we think about things like this, in general, to explore ourselves, in relationship to the profession.

Thank you everyone! :)

allnurses Guide · Mar 15, 2009

Question #1: What factors contribute to the nurse's power in her or his practice?

--Question #2: What factors limit empowerment in practice?

--Question #3: What is the role of collective bargaining (unionization) in the relationship between management and direct care nurses?

--Question #4: How can practicing nurses become involved in the political process in nursing?

--Question #5: Describe the power relationship on your clinical nursing unit(?)

1. Power is being to stand up for yourself, your coworkers and your patients. If I don't agree with an order, I question it, explore options with the doc, and either choose to comply or refuse. Power is believing in your own education, knowledge and judgement, and not allowing oneself to pushed into practices that may be wrong just because you are afraid to stand up and say so.

2. I am limited by the scope of practice set by the BON. I am limited by how far I can go against the Powers That Be before I lose my job. Limitations involve poor staffing, incompetent management, adversarial coworkers and doctors. Fortunately for me, that isn't routine at my job!

3. Unionization where I work has provided decent working conditions, protections, the ability to have a life outside work without being at their beck and call. It has provided adequate staff to meet patient needs. I've been here more than 20 years, I can no longer even name all the CEOs and managers I have outlasted.

4. Through unions, professional organizations, contact with college and university faculty, and paying attention to the bills going up at either state or federal levels. There are some interesting interships for nurses in Washingtion DC.

5. There are formal and informal structures. Those of us who have been there a long time tend to have informal power, we use it through charge nurse committee meeting, process meetings, and the union. The manager and director of our unit have been getting overruled by higher management, lots of frustration lately. We've been taken over by an outside hospital chain, even though it is supposed to be a "partnership", with community members making up 50% of the board of trustees still; all our management are now employees of the chain. Which has no other union hospitals in it. And keeps violating the contract. The smell of strike is beginning to waft about.

chevyv, BSN, RN · Mar 16, 2009

Reading the posts regarding unions sparked my memory of having to watch a video during orientation that was anti union. I couldn't believe I had to watch that video! Now that I'm on the floor I would vote union in a heartbeat if it would improve conditions (and pay :) )

MP5PDW · Mar 16, 2009

You should look at the nurse anesthesia profession for answers to these. Nurse anesthesia is what nursing COULD be like as far as power, influence etc.