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?
But it goes far beyond that. We spent one of our lectures discussing the importance of documentation. Yeah, it may seem like a no-brainer to document patient care thoroughly and honestly- but the fact is it's not getting done. One of the number one reasons for nurses getting their licences suspended and revoked is incorrect documentation- either for failing to document care or falsifying documents. Does the fact that we had a lecture and discussion on documentation mean that every single one of my classmates is always going to document correctly? No, but I expect that they'll do better than someone who was simply told to document without a discussion of the ethical and legal ramifications of failing to do so.
Boognish
85 Posts
The main reason that nursing programs are starting to require courses in professionalism is that a lack of professionalism among nurses has been identified as a specific problem in the healthcare workplace, whereas that hasn't been a problem with doctors (however, maybe MDs should be required to take courses on interpersonal communication and holistic care). And by a lack of professionalism, I mean a lack of the qualities I mentioned. They're not just arbitrarily picking on nurses based on prejudice and assumptions- the drive to increase professionalism is based on evidence. For example- did you know that only about 38% of nurses are compliant with federal handwashing guidelines? That should be unacceptable considering the fact that nosocomial infections are currently a leading cause of death in the US. Complying with health and safety guidelines is, in my mind, one hallmark of professional behavior.
The OP compared the role of the RN, as he sees it, to the McDonald's burger flipper. This is troubling to me not only because the knowledge base that one needs in order to practice nursing well is far more vast than that of a burger flipper, but also because of what comes to mind when I think of the attitude towards work of the average fast-food employee. I've worked in fast-food. People play hooky, come in late, cut corners, try to do as little work as possible, complain all day about having to be at work, and generally don't care at all about the quality of the finished product (well, in the case of fast food, neither does their employer). None of these things should be acceptable in nursing- because the kind of behavior one sees in the average fast-food employee is unprofessional, and patients deserve care of a higher caliber than the service one would expect at the taco bell drive thru.