Time to call a duck a duck?

[eriksoln]

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?

[pedicurn, LPN, RN]

just like no one is going to interrupt an electrician (algebra, electrical theory) to wipe their butt while they are re-wiring their service.

LOL

I'm having a vision and it's not pretty

[nursemike, ASN, RN]

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.

Eh, got some pretty bizarre requests in my home improvements days. (Maybe it's me. Maybe I just look like someone who'll wipe your butt if you ask...)

[woahmelly]

i totally agree! not only would cutting the bull turn out better, more prepared nurses... it would make us look more professional simply because we know our stuff right out of school. experience is important, but focusing more heavily on all that stuff you mentioned would give us a leg up. who on this forum hasn't had a hard time adjusting to life on the floor after graduation? maybe that's why so many quit in the first year.

ianan only a nursing student but:

it's interesting, in terms of "cutting the bull", there is some practical evidence in nclex pass rates and employment rate of new grads in my area. the local bsn/4yr university has a lower pass rate of the nclex and a lower employment rate of grads versus the local cc/asn program. in talking with some nurse managers (i'm putting feelers out for the future) they actually prefer to hire the cc grads because they are trained more practically and burdened with less of the theory.

of course, this is not true in all regions. i think it is an interesting comparison with the "bsn more theory is better" mentality and the practicality of an asn.

[candersonRN]

Well I received my BSN in the early 90's but we had a 99% pass rate for boards and I knew who didn't pass (we all knew she wasn't ready-not a good test taker). Anyway my class was well prepared, we had been taking 5 patients during our last semester of clinicals and doing total care for them for 8 hours. But the new grads I see coming out now even in ADN programs are only given 1 or 2 patients and only for a few hours at a time, how is that preparing anyone for actual practice, theory not even an issue.

[eriksoln, BSN, RN]

Well I received my BSN in the early 90's but we had a 99% pass rate for boards and I knew who didn't pass (we all knew she wasn't ready-not a good test taker). Anyway my class was well prepared, we had been taking 5 patients during our last semester of clinicals and doing total care for them for 8 hours. But the new grads I see coming out now even in ADN programs are only given 1 or 2 patients and only for a few hours at a time, how is that preparing anyone for actual practice, theory not even an issue.

Yeah. Thats one thing about school I've always wondered about. Students in their final year talk about having 2...........gasp:eek:............even 3 patients as though it is some titanic sized mountain to climb. Then, they pass the meds, do an assessment and BAM, they can not be found the rest of the day till the next med it due. They go into a little cubby hole room and fill out all their paperwork. Thats not getting prepared for nursing, not by a longshot. In RL, one can not turn off the rest of the hospital and do their documentation.

Can you see it. A nurse manager approaching the nurse about some new form to fill out or to ask about something from a couple days ago and being told "I'm not really on the floor anymore, I am doing paperwork."

[jjjoy, LPN]

Yeah. Thats one thing about school I've always wondered about. Students in their final year talk about having 2...........gasp:eek:............even 3 patients as though it is some titanic sized mountain to climb. Then, they pass the meds, do an assessment and BAM, they can not be found the rest of the day till the next med it due. They go into a little cubby hole room and fill out all their paperwork.... A nurse manager approaching the nurse about some new form to fill out or to ask about something from a couple days ago and being told "I'm not really on the floor anymore, I am doing paperwork."

I know that at my program, if we completed our baths or our 5 page assessment tools on our two measely patients too quickly, the instructors would accuse of us not being thorough and send us back in, that it was not possible to be done so quickly - so no help there learning to be quick! And if we finished our patient care and charting, we were *instructed* to go read the patient charts. We weren't allowed to do much more than aide work without our instructor at our side and they didn't want us to waste our valuable time as nursing students doing aide work when we could be learning something from reading the charts.

Not surprisingly, my school was also very big on emphasizing that "nurses are professionals!"

[eriksoln, BSN, RN]

I know that at my program, if we completed our baths or our 5 page assessment tools on our two measely patients too quickly, the instructors would accuse of us not being thorough and send us back in, that it was not possible to be done so quickly - so no help there learning to be quick! And if we finished our patient care and charting, we were *instructed* to go read the patient charts. We weren't allowed to do much more than aide work without our instructor at our side and they didn't want us to waste our valuable time as nursing students doing aide work when we could be learning something from reading the charts.

Not surprisingly, my school was also very big on emphasizing that "nurses are professionals!"

I got that in school sometimes. I was a CNA at the same hospital we did clinicals at. While other people were trying to find the BR and kitchen or supplies, I was doing my pt. care. At first, I'd just complete my care then go right to the paperwork like the people I described before.

Then, as you said, my instructors started in with the "Well, you did it so fast it must be wrong" attitude. I learned quickly, when I was done with ADLs and everything, go help the other students, don't be seen doing paperwork. Once a couple other people were all caught up and heading towards whatever area we would do paperwork in, I did too. But I never let myself be the first one.

[Lupan]

I once worked with an RN that had over 20 years at bedside. She gave me a piece of advise when I first entered nursing. "Nurses are their own worst enemy". Everyone wants to protect their pie but can't see that such behavior is self-limiting and destructive. I worked at a facility where management encouraged back biting amoung the nurses because they hired new nurses (cheaper) that didn't know any better. Turnover is high but they stay in budget!! As long as nurses do this to each other, we can expect no better.

[NocturneRN]

I once worked with an RN that had over 20 years at bedside. She gave me a piece of advise when I first entered nursing. "Nurses are their own worst enemy". Everyone wants to protect their pie but can't see that such behavior is self-limiting and destructive. I worked at a facility where management encouraged back biting amoung the nurses because they hired new nurses (cheaper) that didn't know any better. Turnover is high but they stay in budget!! As long as nurses do this to each other, we can expect no better.

Pretty shortsighted of them to encourage high turnover, considering the cost of interviewing, hiring and orienting new staff....to say nothing of the holes in the schedule, when staff members keep quitting.

I have to say that my hospital is pretty good at fostering more of a team spirit. Sure, you get some backbiting and gossip, but, for the most part, everyone gets along well and supports each other. People who don't care for that sort of environment don't last very long there, but those who find it a good fit end up staying for many years.

[pedicurn, LPN, RN]

I once worked with an RN that had over 20 years at bedside. She gave me a piece of advise when I first entered nursing. "Nurses are their own worst enemy". Everyone wants to protect their pie but can't see that such behavior is self-limiting and destructive. I worked at a facility where management encouraged back biting amoung the nurses because they hired new nurses (cheaper) that didn't know any better. Turnover is high but they stay in budget!! As long as nurses do this to each other, we can expect no better.

Divide and conquer ?

Probably not intended by management.... but division occuring anyway. So why did they engage in 'back biting' ? They might have chosen not to.

IMHO it's this kind of behaviour that harms nursing ...... I agree. It's pathetic and reflects very poorly on nurses

[eriksoln, BSN, RN]

Pretty shortsighted of them to encourage high turnover, considering the cost of interviewing, hiring and orienting new staff....to say nothing of the holes in the schedule, when staff members keep quitting.

I have to say that my hospital is pretty good at fostering more of a team spirit. Sure, you get some backbiting and gossip, but, for the most part, everyone gets along well and supports each other. People who don't care for that sort of environment don't last very long there, but those who find it a good fit end up staying for many years.

Yeah. I was wondering that. How does high turnover keep you in budget. High turnover is the biggest killer of business who can't get it under control.

When I was younger, I worked in the restaurant business. I knew of more than a few managers who picked the local family restaurant over others because of "lower employee turnover rate". And we are not talking about the managers with regards to the stats they were looking at.

[realist]

You are right on the money, unfortunately there will be those who do not agree with you because reality has not set in. Thanks for speaking the same opinion that I've had since entering the profession. Oh excuse me, for I mistakenly typed profession and meant to type "LABOR" !:hdvwl: