Time to call a duck a duck?

Nurses Professionalism

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I remember having this debate with other students while I was in school. I have seen nothing during my time practicing nursing to change my mind about the issue. Now, with the recession bringing out the true colors of nurses and everyone around them, my opinion seems even more valid. I wonder what others think about it.

I remember sitting in nursing school as the instructor drummed on and on about how "Nursing is a profession." That exact theme butted it's head into almost every single class one way or another, regardless of the subject matter. I often found myself thinking "Who cares?" or "What's the point in that?". Then came the dreaded "Dimensions of Nursing" class. It was the class all RN's must go through at one point or another (IDK if LPNs do or not). There are other names for it "Political Aspects of Nursing" I've heard among a few others. It is the class in which you must discuss the political issues that involve nursing. You are encouraged to join this and that group, Nursing as a Profession is discussed over and over, and you must do a research paper. I never really said in that class how I really felt about the whole business of nursing being a profession in fear of drawing the ire of my superiors.

What is it I had to say that my fellow students got to hear during breaks that my instructors did not? Well: Nursing is not a profession, not even with a very generous stretch. It is a labor, a trade. We are judged solely by the amt. of patients we can handle and still keep the minimal quality expected by our administration up to par. Not very much unlike a McDonald's burger flipper. The faster you can cook those patties without screwing too many up, the better you are. That's all there is to it really. If you don't believe me, take a gander at where nursing expenses falls in the budget. We are not logged next to the admin./doctors/lawyers or any of the other professionals. We are grouped in with dietary/housekeeping/security. As far as budget makers are concerned (and, lets be honest, they make the rules), we are a debt, like a labor.

IT IS TIME FOR NURSING TO GIVE UP THIS IDENTITY CRISIS, THIS INFERIORITY COMPLEX IT HAS DISPLAYED SINCE ITS BIRTH AND MOVE ON, EMBRACE BEING A LABOR AND LOVE IT.

Ever see the movie "Man in the Iron Mask"? The King/spoiled twin tells his brother "Into the dungeon you will go, and you will wear this mask again, and you will wear it until you love it."

We are wearing the mask, but are for some reason we are unable to learn to love it. So we will forever stay in the dungeon denying what we are.

Lets face it. All the aspects of a "profession" are an illusion in nursing.

Definition of a profession:

A profession has a unique body of knowledge and values – and a perspective to go with it.

A profession has controlled entry to the group eg registration

A profession demonstrates a high degree of autonomous practice.

A profession has its own disciplinary system.

A profession enjoys the Recognition and Respect of the wider community.

1. Unique body of knowledge: We do need to go to school and must learn a lot, but I don't know about the unique part of it. Most CNA's pick up on how to do what we do after just a couple years, without the schooling. As far as values and perspective go, lets face it, we can't even agree in here on what that is. How many "Calling from God vs. Its a job" threads/rants have you seen on this site. I've lost count. We can't even agree amongst ourselves what degree we should have. I've also lost count of the "BSN vs. ADN vs. Masters" threads.

2. Controlled entry: Phfffft. It is controlled, but not by us. The hospital/medical field administration decides this. Whatever they decide they are willing to hire is what the rule is. If they decide tomorrow to never again hire ADNs.........that's that for them. We have no say in it. Seen any "Nurses eat their young" vents/threads lately. I know you have;), even if you were a blind, deaf mute with both hands tied behind your back you can't help but run into them on here. If we truly were in control of who came into the profession, such threads would be minimal. Can't be angry about who is allowed in when its your decision who gets in.

3. Demonstrates a high degree of autonomy: Again, I lead with PHfffffft. Our job description continues to be and will forever be everything and anything they can't pawn off on the other laborers. How many of us, since the recession hit, have been told to pick it up and help out in non-nursing job related ways? Empty the trash, stock the cabinets, hand out trays, collect and clean the trays..........its endless. We are unable to define for ourselves what we will and will not do. You don't see them sending the Legal dept. any emails about helping maintenance do you? Any rules/laws concerning scope of practice are simply to protect patients from us should we decide to play doctor. No laws exist to restrict what can be expected of us away from the bedside (no, that would actually be useful, help the pt., can't do anything silly like that).

4. Has its own disciplinary system: Do I need to insert Phffffft again? Oh, I just did. We only qualify here if badgering, cattiness and petty write ups are "disciplinary". Nuff said.

5. Respect of the community: I'll resist the urge to insert the obvious lead here. I'll just point out the complaining about surveys that's been the norm lately. Lets face it folks, professions who have respect are not surveyed like this. These surveys resemble grade school report cards "Nursey doesn't play well with others". If we were "respected", we'd be the ones filling out the surveys on how to improve the model of care given.

Think back to your highschool days. Remember that class clown who tried way too hard to be funny? The not so good looking girl who never stopped digging for compliments on her looks? The not so well liked guy always asking if you and he were buddies or not? That's what nursing has let itself become. Constantly running around worrying about impressing people and all the while completely losing its focus on the primary goal. A lost teenager suffering from an inferiority complex.

Maybe if we embrace the fact that we are............:eek:gasp..............a mere labor, we will be able to dedicate ourselves to our patients. Instead of worrying about proving nursing holds a "unique body of knowledge" and making up useless, pointless "theories" and such (tell me one instance you have found a use for nursing diagnosis), we will become more useful. Focus instead on better time management, better understanding of the things we actually use on the job (the equipment for instance) and a better understanding of the tasks expected of us (study IV insertion in school instead of writing papers about why nursing is a profession).

I know many of you will be upset with me and my views. They are what they are. I make no apologies for them. Not having a well liked opinion has never stopped me from saying what I feel needs said before.

So...............am I wrong? Why?

Specializes in M/S, Travel Nursing, Pulmonary.

I'm confused. A lot of the stuff in the areas of your post under quotes from me............are not from me. IDK. Maybe they are your anssers, they kinda fit in that way if you look at it that way.

Specializes in ER, cardiac, addictions.
I'm confused. A lot of the stuff in the areas of your post under quotes from me............are not from me. IDK. Maybe they are your anssers, they kinda fit in that way if you look at it that way.

You're right----sorry about that. I tried posting your remarks in italics, to separate them from mine, but it didn't work. My point was just that I think you're doing a disservice to nurses who wear suits and work at desks, because often they're doing jobs that are just as important to the patient as what we do at the bedside.

Honest question. If we, as nurses were named/considered/officially/declared/whatever a "profession" at this very moment, how would this change nursing today?

Anyone ever been so tired that when trying to spell a word, and spelling it correctly, it still looked "funny?" Reading "profession" so many times, makes the word seem unreal.

I hardly know what to say to this ramble. I've been nursing for almost 30 years in various capacities from flight to critical care to public health and I still consider it a great privilege to be a nurse. I work hard every shift but feel grateful for the opportunity to meet and work with my patients. Yes, physicians and the general public can be a pain in the rear and disrespectful but that's about them, not about me. A person's world shrinks dramatically when they become ill, especially to the point where they require hospitalization, ie, nursing.If I can make a positive difference in their lives just for a moment, just with the tasks,duties etc. I perform then how lucky I am. I don't give a rat's patootie if what I do meets the criteria of what someone has decided a profession is.

Here's what I do know....if I were a patient and someone with your attitude and cynacism entered my room I would be immediately aware of your lack of caring and empathy and approach to your practice. Do us all a favor and get out now.

Specializes in ER/Trauma, Home Care, Corrections.

"the recession bringing out the true colors of nurses and everyone around them." Sounds like you have a low opinion of nurses and everyone around them.

Specializes in CVICU, Obs/Gyn, Derm, NICU.
I hardly know what to say to this ramble. I've been nursing for almost 30 years in various capacities from flight to critical care to public health and I still consider it a great privilege to be a nurse. I work hard every shift but feel grateful for the opportunity to meet and work with my patients. Yes, physicians and the general public can be a pain in the rear and disrespectful but that's about them, not about me. A person's world shrinks dramatically when they become ill, especially to the point where they require hospitalization, ie, nursing.If I can make a positive difference in their lives just for a moment, just with the tasks,duties etc. I perform then how lucky I am. I don't give a rat's patootie if what I do meets the criteria of what someone has decided a profession is.

Here's what I do know....if I were a patient and someone with your attitude and cynacism entered my room I would be immediately aware of your lack of caring and empathy and approach to your practice. Do us all a favor and get out now.

Why is (I assume) the OP a bad nurse because he doesn't think nursing is a profession?

Caring and empathy are not just the domain of the 'nursing is a calling' nurse ....or the 'professional' nurse.

I am a very caring and kind nurse .... my p'ts and coworkers tell me I am very kind and nice to my p'ts.

However, nursing is not a real profession to me.

I have insight into the roles of real professionals and also have a non-nursing masters degree ....this experience has allowed me to compare the role of nursing vs other roles. Therefore I have concluded nursing is not a real profession (at least not most of the time)

...if I were a patient and someone with your attitude and cynacism entered my room I would be immediately aware of your lack of caring and empathy and approach to your practice. Do us all a favor and get out now.

Ouch! if the OP's attitude seems that bad, you must not think very highly of many of your nursing colleagues. Either that or the nurses in your neck of the woods are totally different than the one's in mine. I've met so many nurses with bad attitudes... if they took your advice to 'get out now' I think the local health care facilities would be in dire straights!

(I'm not saying all the nurses I've met have a bad attitude, or even most of them. But I've met A LOT of nurses - as a nurse, as a student and as a patient - who seemed rathing lacking in their approach to practice.)

Specializes in cardiac, M/S, home health.
I hardly know what to say to this ramble. I've been nursing for almost 30 years in various capacities from flight to critical care to public health and I still consider it a great privilege to be a nurse. I work hard every shift but feel grateful for the opportunity to meet and work with my patients. Yes, physicians and the general public can be a pain in the rear and disrespectful but that's about them, not about me. A person's world shrinks dramatically when they become ill, especially to the point where they require hospitalization, ie, nursing.If I can make a positive difference in their lives just for a moment, just with the tasks,duties etc. I perform then how lucky I am. I don't give a rat's patootie if what I do meets the criteria of what someone has decided a profession is.

Here's what I do know....if I were a patient and someone with your attitude and cynacism entered my room I would be immediately aware of your lack of caring and empathy and approach to your practice. Do us all a favor and get out now.

I've been an RN for 16 years, but have been in the nursing field (as CNA & LPN) for "almost 30 years" as well. I agree with everything in your 1st paragraph. and in fact, I think the OP would agree fully with what you wrote as well. Therefore, it surprises me the lack of...caring and empathy in the second paragraph directed at a nurse colleague with 4 years experience (per his bio). We grey heads need to set an example and try to encourage, and dare I say, care about our colleagues as well as the patients.

Specializes in med/surg, OR, private duty, HH.
I'm really starting to like "craft" as a description of what we do. Seems to me a way to recognize both the science and the art, the technical skill, and the occassional elements of magic. We practice nursecraft.

I know--magic is going a little overboard, but darned if it doesn't feel that way, sometimes. But, bear in mind, I'm a guy. And by that, I mean more of a 1950s guy than a 1990s guy. I'm not someone who was ever much in touch with my feminine side, except perhaps with some animals. With humans, I think I have always tended to use my sense of humor as a way of breaking the ice without really getting too close. So, now I find myself pretty regularly forming an emotional bond with total strangers. Maybe that's still some of the crotchety old bachelor in me--it might be easier to make a serious commitment when I know it's only gonna last a week or so. I rarely recognize the ones who are readmitted months later. Still, I like it when I find myself somehow knowing the right thing to say or do without knowing how I know it. There have been a few shifts where I have realized, and some where the patient did, too, that I was just the nurse someone needed at that particular moment in time. And I have seen that with other nurses, as well. I suspect it happens with all of us, and probably a lot more often for many than for me. But that it happens at all is kinda spooky and neat.

So, over the past weekend, I was in our stepdown subunit, and overheard a nurse on days reporting off to one of my coworkers that one of her patients had a Disturbed energy field. She was joking--sort of--but I watched my coworker, an old-school nurse if ever there was one--working magic with this dude, using old-school interventions like maintaining proper body alignment and therapeutic communication. Her "therapeutic touch" wasn't the new age version, it was rubbing his shoulders to help him relax. She demonstrated caring because she's a nurse and that's what she does. I don't know whether the guy had an aura or not, but if he did I think it was probably in better alignment by morning. At least his behavior was more appropriate. And while the problems that put him in a stepdown bed were probably scientific in nature, his most pressing needs from his POV, r/t dealing with a life-altering injury, were ones that called on the art of nursing. It was cool to see him getting both.

Craft-I like that and you're right-sometimes it does feel like magic. I think that's why I've always viewed nursing as a calling. It's where you're supposed to be and you couldn't be anything else. Some of the most miserable(emotional and skills) nurses I know are the ones who 'settled' for nursing. And yes I just :redbeathe my job.

Specializes in M/S, Travel Nursing, Pulmonary.
I hardly know what to say to this ramble. I've been nursing for almost 30 years in various capacities from flight to critical care to public health and I still consider it a great privilege to be a nurse. I work hard every shift but feel grateful for the opportunity to meet and work with my patients. Yes, physicians and the general public can be a pain in the rear and disrespectful but that's about them, not about me. A person's world shrinks dramatically when they become ill, especially to the point where they require hospitalization, ie, nursing.If I can make a positive difference in their lives just for a moment, just with the tasks,duties etc. I perform then how lucky I am. I don't give a rat's patootie if what I do meets the criteria of what someone has decided a profession is.

Here's what I do know....if I were a patient and someone with your attitude and cynacism entered my room I would be immediately aware of your lack of caring and empathy and approach to your practice. Do us all a favor and get out now.

I had a few different answers in mind for this, but..........eh, everyone else did it for me already. Except for one thing:

Again with the "laborer = loser" attitude. Being a laborer does not equate to not caring for or lacking compassion for the patient. Nor does it make someone dumb by default. I feel I've been very clear on this.

What it does equate to is more focus on the bedside issues and less concern for title/prestige/impressing the big wigs. NOT EVEN through 9 degrees of separation could you get from anything I've posted to what you did.......................from nursing should be a skilled trade to "if I were a pt. and someone with your attitude blah blah blah".

Basic reading and comprehension is a prereq. for all nursing programs, so I know you passed it at some point. Please refresh your skills and exercise them before engaging the mouth.

Eh... Most skilled labor positions have 4-5 year apprenticeships (school +OJT) usually with a certificate, sometimes there are options in the careers with an Associates or Bachelors Degree with a few more classes. (Diploma/ADN/BSN anyone?) Many of these careers involve theory, math and science on levels that are equivalent or even more complicated than Nursing. There are state and NGO certificates required for many of these careers as well. There are also specialties and sub-specialties with many.

They usually make around the same as an RN. More in some areas, less in others.

To some, Nursing doesn't look too different. Many of these laborers (and labor orgs) call themselves 'professional' as well. Except, no one is going to expect a sheet metal worker or A/C installer (how much TRIG did you take) to fetch them a cup of ice while they are busy installing their cooling system, just like no one is going to interrupt an electrician (algebra, electrical theory) to wipe their butt while they are re-wiring their service.

Quack. Bark. Moo.

'Time Management' requires the correct amount of time to manage all this is required of our overworked RN's.

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