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?

[ZippyGBR, BSN, RN]

If you have to punch a clock and wear a uniform, you ARE a laborer.

that makes doctors and lawyers 'labourers' then ... if you use that measure ...

show me a lawyer who does not know to the minute how much chargeable work s/he has done this week, ditto Doctors in private practice or Hospital doctors who are subject to monitoring for compliance with contracts ...

both wear uniforms as well, the white coat or it's modern infection control compliant equivalent for the Docs and the suit (plus gowns and wigs and other such regalia ) for the lawyer as advocate ...

Simple.

Also, what "profession" do you know of has to leave the office early with a cut in pay for the day if work is slow?

again a symptom of how nursing manages itself in the US vs elsewhere ...

[ZippyGBR, BSN, RN]

Quite UNTRUE.

The distinction between laborer and tradesperson, either of whom may or may not wear a uniform, is made between the skill required to perform the task and the level of responsibility.

In the machine shop, for example, the laborer will unband the stock and position it for use. The laborer may cut the stock to the specification of the machinist (or their SOP). There is very little thought required to fulfill the laborer's duties. The machinist (a tradesperson), however, has the responsibility of converting the raw material into the finished part which meets the specification ordered by the engineer. The engineer (a professional), is responsible for developing the specifications to ensure that the finished part will be suitable for its application.

Nurses are most certainly not laborers. Bedside nurses are analogous to machinists, electricians, etc - they (we) are skilled tradespeople. The CNAs fit the laborer bill.

there are no labourers in Nursing

HCAs /CNAs with proper training are technicians especially at level 3 ( for the rightpondians) and Nurses are professionals becasue guess what we make treatment decisions ...

[Not_A_Hat_Person, RN]

I have long thought about how expensive it would be if electricians and plumbers had to document every wire or hose used and explain why they chose that particular item and diagnosis for the problem, but also needed an order from the company before they could actually perform the task, and then document retrospectively what they had just done. You know, for safety, and in case they get sued for malpractice if the place burns down or floods. Nothing would EVER get done.

About 10 years ago, I had some temp jobs at state agencies, including the one that managed Boston's Central Artery Tunnel Project. That's exactly what happens.

[Music in My Heart]

there are no labourers in Nursing

HCAs /CNAs with proper training are technicians especially at level 3 ( for the rightpondians) and Nurses are professionals becasue guess what we make treatment decisions ...

I will speak only of what I know... nursing in California; outside of a few horrid hours at Heathrow, I've never been to England. Here, I'll stand by my statement. CNAs are laborers, nurses are skilled tradespeople operating within a very narrow set of parameters established by the professionals: the physicians. I see the analogy of shop labor vs. skilled machinist vs. professional engineer to be quite apt.

[RunningWithScissors]

About 10 years ago, I had some temp jobs at state agencies, including the one that managed Boston's Central Artery Tunnel Project. That's exactly what happens.

Is that the tunnel that has been under construction for like over a decade and still nowehere near completed?

[ZippyGBR, BSN, RN]

I will speak only of what I know... nursing in California; outside of a few horrid hours at Heathrow I've never been to England. Here, I'll stand by my statement. CNAs are laborers, nurses are skilled tradespeople operating within a very narrow set of parameters established by the professionals: the physicians. I see the analogy of shop labor vs. skilled machinist vs. professional engineer to be quite apt.[/quote']

and then those on the left of the pond wonder why Nursing as a poor profile and status , and why other nations registration authorities consider a US awarded RN to be insufficient for registration elsewhere in the world ...

psychomotor interventions do not make people 'better' ( ref the lesser emphasis on a few psychomotor skills in Uk pre -reg , incidentially all skills that many UK registered nurses can and do do a) and others groups behave towards you as you let them ... i f you want to be seen as second rate handmaidens then by all means do so ... it doesn't mean everyone wants to and that those elsewhere in the world aren't ...

[morte, LPN, LVN]

Is that the tunnel that has been under construction for like over a decade and still nowehere near completed?

I'm pretty sure it is finished....isnt that the one where the ceiling tile fell, killing someone?

Leslie will know.....

[jjjoy, LPN]

psychomotor interventions do not make people 'better' ... i f you want to be seen as second rate handmaidens then by all means do so

If one points out that nurses in some practice settings *are* restricted in their practice in one way or another (eg need to obtain a physician order for a medication), they are in no way suggesting that those nurses are nothing more than 'second-rate handmaidens'.

And you may disagree with the assertion that nurses are akin to skilled tradespeople but it sounds like maybe you're suggesting that skilled tradespeople only practice psychomotor skills, perhaps mindlessly done once mastered, which I think would be inaccurate. Assessment, judgement and application in novel situations are practiced in many roles whether or not anyone labels those roles as part of a "profession" or not.

[Music in My Heart]

and then those on the left of the pond wonder why Nursing as a poor profile and status , and why other nations registration authorities consider a US awarded RN to be insufficient for registration elsewhere in the world

Interesting. I work with a nurse from Germany and she states that US nurses hold a much higher profile than do those in Germany.

psychomotor interventions do not make people 'better'

Well, I guess it depends to what you're referring. Certainly, those patients who are dehydrated or with electrolyte imbalances are 'made better' by the infusion of the appropriate fluids. Those with infections are 'made better' through the use of appropriate antibiotics and wound care. Those with cancer are 'made better' through the appropriate combination of cut/burn/poison.

With all of those, it is the physician/NP/PA who establishes the parameters and specifics of the treatment. At least here in the US, it is not up to the nurse to decide which medications to give, which tests to order, or which diets to order.

I'm really interested to hear how things are different in the UK.

if you want to be seen as second rate handmaidens then by all means do so ... it doesn't mean everyone wants to and that those elsewhere in the world aren't ...

Well, what I want really has nothing to do with it. Regardless, though, going back to my original point, I do not see a skilled tradesperson as equivalent to a "handmaiden" (though I must admit that I don't really know what it is that handmaidens do so perhaps it takes a great deal more skill than I'd imagine).

I'm wondering if you could describe how the UK nurses function above the level of a skilled trade.

[backatit2]

EVERY profession could be learned through on the job experience and considered a "labor" or "trade." i was a teacher. do i think i could've learned to teach without spending 4 years in college? yes. could a nurse or a doctor do a good job without college? yes. they did it for...forever! extensive education wasn't required years and years ago to be a nurse or a teacher.

BUT - since the standards have changed and become higher, look at how much further we've advanced in almost every field. so, yes, nursing (just like any other "profession") COULD be considered a "trade," but having higher standards and making it a "profession" reserves the jobs for those who are the best and weeds out the ones who aren't the brightest. oh, and the difference in pay doesn't hurt!

i only recently decided to return to school for my BSN. before that, i always viewed nurses as professionals. when i was in the hospital, i couldn't tell the difference between a CNA or a nurse or a housekeeper for that matter without seeing their badge, but i reserved my "real questions" for the nurse because *I* as an average joe put my trust in the "professionals."

[Music in My Heart]

yes, nursing (just like any other "profession") COULD be considered a "trade," but having higher standards and making it a "profession" reserves the jobs for those who are the best and weeds out the ones who aren't the brightest.

Ouch.

Most of the tradespeople with whom I've worked are every bit as bright as most of the nurses that I've met, and most of them are highly educated in their fields and in possession of very specialized sets of skills.

I deplore the low opinion of the trades in evident in this thread.

[backatit2]

Ouch.

Most of the tradespeople with whom I've worked are every bit as bright as most of the nurses that I've met, and most of them are highly educated in their fields and in possession of very specialized sets of skills.

I deplore the low opinion of the trades in evident in this thread.

you're turning it into something it isn't. my husband is a "tradesperson," but he's not responsible for people's LIVES. he's great at what HE does, but if he couldn't pass the classes and exams required in nursing school (which he couldn't) then he would and SHOULD be weeded out. what's "ouchy" about that?

edited to say: by the way, this is how nursing and EVERY profession works! there are WAY more applicants to nursing school (where i am) than there are acceptance letters. i, for one, would be very annoyed if someone way less qualified than i were accepted - wouldn't you? they only take the "best" and that's the way it should be. i WANT the best taking care of me, or my child, or my mother. who doesn't?