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?

[SuesquatchRN, BSN, RN]

To me, professionalism isn't about what tasks one is doing- it's more about the amount of responsibility one takes for one's own work.

We're back to the entire point of this discussion. One can be professional without being "a" professional. And that goes from the kid at Taco Bell to nurses. NO class can teach personal responsibility and appropriate behavior.

[Boognish]

We're back to the entire point of this discussion. One can be professional without being "a" professional. And that goes from the kid at Taco Bell to nurses. NO class can teach personal responsibility and appropriate behavior.

It may be impossible for a single class to imbue a person with a sense of personal responsibility, but it is possible to teach people what their responsibilities are and what their future employers will expect from them- and just as importantly WHY it's important for them in terms of patient care to adopt a professional attitude. I think that most people are resistant to adopting new attitudes or modes of behavior when they're simply told they should- the "why" is key.

Maybe other schools are different, but my school isn't trying to teach us HOW to have a sense of personal responsibility- they are teaching us what personal responsibility means in the field of nursing, both ethically and legally, and why it's an important quality for us to cultivate within ourselves. And it's not just the role development class that they use as a platform to teach professional behavior- it's something that they weave into the entire curriculum.

Like I mentioned before- my clinical skills instructor is constantly reminding us that it's up to us to choose what kind of nurses we want to be, using examples like "what are you going to do if you drop a pill on the floor and nobody is looking?" Obviously she doesn't expect anyone to actually answer "give it to the patient anyway," but it's a salient example of the kinds of choices nurses face every day- choices which can be difficult during an overloaded workday, and it hits home the point that behaving professionally really means taking every opportunity to provide the best possible care for your patients. She's also kind enough to remind us that none of us is going to make it through our careers without making numerous mistakes, no matter how hard we try to do the right thing every time.

[SuesquatchRN, BSN, RN]

We will have to agree to disagree. This was drummed into me when I was in school to become an LPN, when I became an RN, and now that I am close to the BSN.

[Boognish]

We will have to agree to disagree. This was drummed into me when I was in school to become an LPN, when I became an RN, and now that I am close to the BSN.

I mean, maybe it's the fact that the way they teach professionalism at the schools you have attended feels like they're "drumming it" in to you. I've been in classes that feel that way, and I have a hard time learning in that kind of environment. I get the feeling from multiple people's posts that they feel like they're being scolded in their professionalism classes. While professionalism is something they stress heavily where I'm going to school, it doesn't feel pedagogical at all. I can see how the topic might be tedious and downright obnoxious if approached a certain way.

Where I am, it feels more like they give us the benefit of the doubt that we want to provide the best possible care for our patients- and they prepare us for the obstacles we will face in trying to do so and how to overcome them, while giving us an enormous amount of support and encouragement. I have never been in a more nurturing learning environment.

[SuesquatchRN, BSN, RN]

Or that you feel you do behave professionally, and would do so whether or not you had been taught to?

Bingo.

I was taught to be responsible and honorable by my parents, as well as the much-touted "critical thinking" skills. One has them or one doesn't.

[Boognish]

oops- looks like I rewrote my post after you responded to it- but what you said relates to what I replaced it with. I can see why classes focusing on professionalism might feel condescending and pointless if you already have a strong sense of responsibility if those classes are taught pedagogically. See above.

[pedicurn, LPN, RN]

To me, professionalism isn't about what tasks one is doing- it's more about the amount of responsibility one takes for one's own work. Because no matter what tasks you're doing as a nurse, what you do has a very definite impact on the health and wellbeing of other people- whether you're setting an IV, inserting a catheter, or wiping a butt- it's important that nurses have a professional attitude towards their work.

That being said, I believe that caregivers making close to minimum wage should have a professional attitude towards their work- but since long term care facilities (where I've been working up until starting nursing school) pay so poorly, and rarely provide adequate training covering even basic job duties, that's a fairly unrealistic expectation.

If nursing schools are failing at promoting the kind of professionalism I'm talking about, they either need to find another way to do so or start using a personality inventory as a test to weed out applicants who don't already possess qualities conducive to professional behavior in the workplace. I'm not too fond of the latter- though a group home that I worked at used one, and I have to say I was impressed with the caliber of my coworkers- despite the fact that we were mostly young, all poorly paid and had no prior certification or training in the work we were doing- though the company did provide excellent training to those they hired.

You are confusing professional behaviour vs professional aptitude.

Medicine requires a definite level of professional aptitude....most nursing jobs require a lower level of this ability.

Most occupations require professional behaviour .... all about how a job is done and responsibility taken etc. This is generic and can easily be taught (whether it's taken onboard or not?)

A good bus driver exhibits professional behaviour, our cleaners at work are the same. A well-trained phlebotomist probably does a blood draw just as professionally as I do

[Boognish]

You are confusing professional behaviour vs professional aptitude.

Medicine requires a definite level of professional aptitude....most nursing jobs require a lower level of this ability.

Most occupations require professional behaviour .... all about how a job is done and responsibility taken etc. This is generic and can easily be taught (whether it's taken onboard or not?)

A good bus driver exhibits professional behaviour, our cleaners at work are the same. A well-trained phlebotomist probably does a blood draw just as professionally as I do

So what specifically do you mean by professional aptitude? An ability to perform the specific duties of the job?

As far as professional behavior- it's not something that can be forced within a person. Where I'm going to school, they treat all of us students with the assumption that we have the ability to approach our work professionally, and it's something that they strive to nurture within us.

[pedicurn, LPN, RN]

So what specifically do you mean by professional aptitude? An ability to perform the specific duties of the job?

It refers to job content and specific skills needed to perform that job.

Professional aptitude ....either got the ability or haven't.

Can be fostered but not taught.

Most doctors would be under stimulated if they had to be nurses....and most nurses would be out of their depth intellectually if they had to be doctors.

Being a professional can only happen if one has the ability and is nurtured.

But acting professionally is something nearly everyone has got a shot at

[Boognish]

It refers to job content and specific skills needed to perform that job.

Professional aptitude ....either got the ability or haven't.

Can be fostered but not taught.

Most doctors would be under stimulated if they had to be nurses....and most nurses would be out of their depth intellectually if they had to be doctors.

Being a professional can only happen if one has the ability and is nurtured.

But acting professionally is something nearly everyone has got a shot at

OK, I get what you're saying. I guess I'd respond that while the professional aptitudes required of a nurse may be simpler and require less intellectual ability than being a doctor, professional behavior dictates that those skills be performed to the best of one's ability- something which most definitely does not always happen. And I've been focusing most of my post on that type of professionalism because that seems to me to be the type of professionalism that's lacking- not just in nursing, but throughout the American workplace. Which is why I see value in identifying nursing as a profession.

To explain: If a person goes to eat a meal at a five star restaurant, they have reason to expect that the food will be well-prepared and well presented; that the trained chef, as a professional, should not only be highly skilled at what he or she does, but that he or she should perform to the best of his or her ability. If I go to McDonalds (which I don't), I would not only expect the people cooking the food to have very little skill at doing so, I wouldn't expect them to make the best hamburgers they can possibly make. I would, in fact, expect that they will probably put as little effort as possible into making my food. I might wish they would take pride in every burger they kick out, but it would be naive to expect it. Why? Because fast food employees, for the most part, are amateurs in every sense of the word.

For me, identifying nursing as a profession distinguishes it as a field where people should be expected to always perform to the best of their ability. It has nothing to do with trying to artificially inflate its status or prestige, or claim that it takes as much professional aptitude to be a nurse as it does to be a doctor or anything like that. It's about saying "what nurses do is vital to the health and wellbeing of their patients, and they should strive for excellence in what they do."

[SuesquatchRN, BSN, RN]

Why? Because fast food employees, for the most part, are amateurs in every sense of the word.

Fast food employees are, for the most part, unable to find other employment for many reasons.

When I lost my six figure job in systems to overseas outsourcing I went to work at JoAnn's cutting fabric for $6.25 an hours. I then went to Walmart for a whopping $6.75.

A chef is not a professional. A chef may act professionally. A Walmart employee is not a professional. I expect him to act professionally. A physician is a professional. I do not always find that they act professionally.

You are young and idealistic. That is admirable. Looking down on those who do not do work that you consider important is supercilious and unattractive.

[pedicurn, LPN, RN]

OK, I get what you're saying. I guess I'd respond that while the professional aptitudes required of a nurse may be simpler and require less intellectual ability than being a doctor, professional behavior dictates that those skills be performed to the best of one's ability- something which most definitely does not always happen. And I've been focusing most of my post on that type of professionalism because that seems to me to be the type of professionalism that's lacking- not just in nursing, but throughout the American workplace. Which is why I see value in identifying nursing as a profession.

We should absolutely perform as professionally as we can.... agree.

I am always impressed with the professionalism of people I come into contact with in the US ....shopping, hotels, restaurants, McDonalds, rental car people etc. I have a fantastic experience in the US. Have only ever been a tourist there never lived in the US. From my limited experience the US is much better in this regard than Australia