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?

[jjjoy, LPN]

Zippy - I think the debate over thinking of nursings as a "profession" vs a "trade" is a seperate issue from the quality of nursing education in the US. Heck, training for nursing as a trade would boost the argument for *more* clinical hours in nurse training, would it not?

[ZippyGBR, BSN, RN]

Zippy - I think the debate over thinking of nursings as a "profession" vs a "trade" is a seperate issue from the quality of nursing education in the US. Heck, training for nursing as a trade would boost the argument for *more* clinical hours in nurse training, would it not?

that assumes that the hours of training both in clinical practice and in the class room are sufficient ...

it has previously been remarked on 'how do you fit it all in' when the standard UK /EU 3 year 4600 hour Dip HE / Advanced DipHE / Bachelors course has been discussed on Allnurses.

[nursemike, ASN, RN]

Zippy - I think the debate over thinking of nursings as a "profession" vs a "trade" is a seperate issue from the quality of nursing education in the US. Heck, training for nursing as a trade would boost the argument for *more* clinical hours in nurse training, would it not?

Although I seem to find myself leaning more toward the professional side as this debate continues, I do think we could learn something from the apprenticeship model practiced in many skilled trades. In my transition from student to working nurse, I'd have been glad for the opportunity to work for six months or a year in a sort of residency, at reduced pay but with reduced responsiblity while I learned some of the practical aspects of the field. But then, in retrospect, I can't really say I didn't get that. Typically, I did get assigned teams that were within my ability--or maybe just a little beyond my confidence level--and I had ample mentoring from my more experienced co-workers. And at full pay. Now, when I make assignments, I try hard to give our newer nurses patients that include some challenges without being overwhelming, and to offer advice and encouragement to the ones I work with. I've been fortunate, but I've seen posts from others who may not have been as nurtured, so it might be worth adopting a formal process. It would seem like a way to maintain a flexible entry into nursing while satisfying Zippy's idea for more clinical hours.

As it happens, I didn't go through a formal apprenticeship to become a carpenter, either. I learned the old-fashioned way, going to work for my Dad. But I have watched some of the skilled craftsmen on my unit, the neurosurgeons, go through the process, and it seems to work for them.

[eriksoln, BSN, RN]

Although I seem to find myself leaning more toward the professional side as this debate continues, I do think we could learn something from the apprenticeship model practiced in many skilled trades. In my transition from student to working nurse, I'd have been glad for the opportunity to work for six months or a year in a sort of residency, at reduced pay but with reduced responsiblity while I learned some of the practical aspects of the field. But then, in retrospect, I can't really say I didn't get that. Typically, I did get assigned teams that were within my ability--or maybe just a little beyond my confidence level--and I had ample mentoring from my more experienced co-workers. And at full pay. Now, when I make assignments, I try hard to give our newer nurses patients that include some challenges without being overwhelming, and to offer advice and encouragement to the ones I work with. I've been fortunate, but I've seen posts from others who may not have been as nurtured, so it might be worth adopting a formal process. It would seem like a way to maintain a flexible entry into nursing while satisfying Zippy's idea for more clinical hours.

As it happens, I didn't go through a formal apprenticeship to become a carpenter, either. I learned the old-fashioned way, going to work for my Dad. But I have watched some of the skilled craftsmen on my unit, the neurosurgeons, go through the process, and it seems to work for them.

Most certainly. I remember and agree with my instructor who used to say "You are not a nurse until you've practiced about five years."

A one year apprenticeship, reduced salary more than likely, would do wonders for a lot of new nurses. It would have helped me. I had a great preceptor, but when my time was up, it was up. Throw to the wolves after that. No well thought out assignments for me. Straight to the fire and high expectations right off the boot.

[llg, PhD, RN]

I agree that we would improve the nursing profession by incorporating more of an apprenticeship. There would be a lot of benefits.

Unfortunately, many students today seem to want more accelerated programs and would balk at anything that lengthened their training. And employers would balk at anything that added to their expense of hiring/orienting.

[AZ_LPN_8_26_13]

Maybe it's time to divide nursing in half -- and make a distinction between those who want a true profession and those who want to be a skilled trade. We could call the two groups "professional nurses" and "technical nurses."

To be a "professional nurse," you would have to have a higher level of education and be prepared to develop knowledge (research) and develop policies, etc. You would also be educationally prepared for more autonomy, leadership positions, the consideration of community health issues on a broader scale than just the bedside, etc. To be a "technical nurse," you wouldn't need that extra education. Your education could focus on just following established practice guidelines in the care of individual patients and/or small groups.

That's the schism this thread seems to be creating. Why don't we make it official?

Oh wait ... that proposal has been around since the 1965 ANA Social Policy Statement. Perhaps those people were right back then after all?

Correct me if I'm wrong, but isn't that what essentially the difference between an RN ("professional nurse") and LPN ("technical nurse") was supposed to be?? Many RNs start out by getting an ADN because of issues like economics & personal finances, family at home, etc. but then go on to become BSNs and/or MSNs as time and finances allow. Doesn't make them any less professional IMO - just shows how committed they are in spite of other things that divide their time and resources.

[eriksoln, BSN, RN]

correct me if i'm wrong, but isn't that what essentially the difference between an rn ("professional nurse") and lpn ("technical nurse") was supposed to be?? many rns start out by getting an adn because of issues like economics & personal finances, family at home, etc. but then go on to become bsns and/or msns as time and finances allow. doesn't make them any less professional imo - just shows how committed they are in spite of other things that divide their time and resources.

yeah, this kinda does exist already. msn prepared nurses who have completely missed the boat and the point of "nursing" vs. your nurses caring for patients.

like someone said awhile back, why is it that the majority of msn nurses can't take an assignment and run it proficiently? i mean, all that (tongue in check) invaluable "knowledge" and "expertise" should show its worth somehow when...........actually "nursing". but it doesn't. why? cause there is nothing tangible nor practical about anything they've "studied" that can translate to better "nursing". its just a title meant to distinguish who wants a desk job vs. those who prefer to care for the sick. its a bunch of fluff and i'm not talking about "fluffing pillows".........office nurses are above that.

i may get my wish though, due to the poor economy. a lot of the "nurse by title only" types are going to be let go sooner or later. in a crumbling economy, they go long before the beside nurse does. bedside nurse conditions will get worse, yes, but..........eh, who really wants to pay for a nurse who believes themselves to be above pt. care? all the theory in the world won't save you when hospitals decide to "trim the fat" and do away with everyone/anyone with no clear role in the hospital functioning.

[llg, PhD, RN]

Correct me if I'm wrong, but isn't that what essentially the difference between an RN ("professional nurse") and LPN ("technical nurse") was supposed to be??

I was referring to the 1965 ANA Social Policy Statement that "drew the line" between the ADN/Diploma nurses and the BSN grads. I find it ironic how the arguments in this thread mimic the discussion of that particular controversial policy statement. Apparently, many posters are unaware of the discussions that took place back then and unaware of the history of this issue.

[nursemike, ASN, RN]

yeah, this kinda does exist already. msn prepared nurses who have completely missed the boat and the point of "nursing" vs. your nurses caring for patients.

like someone said awhile back, why is it that the majority of msn nurses can't take an assignment and run it proficiently? i mean, all that (tongue in check) invaluable "knowledge" and "expertise" should show its worth somehow when...........actually "nursing". but it doesn't. why? cause there is nothing tangible nor practical about anything they've "studied" that can translate to better "nursing". its just a title meant to distinguish who wants a desk job vs. those who prefer to care for the sick. its a bunch of fluff and i'm not talking about "fluffing pillows".........office nurses are above that.

i may get my wish though, due to the poor economy. a lot of the "nurse by title only" types are going to be let go sooner or later. in a crumbling economy, they go long before the beside nurse does. bedside nurse conditions will get worse, yes, but..........eh, who really wants to pay for a nurse who believes themselves to be above pt. care? all the theory in the world won't save you when hospitals decide to "trim the fat" and do away with everyone/anyone with no clear role in the hospital functioning.

pretty much since i hit the "submit" button, i've wanted to clarify my comment about my cno, and not just because she might be reading this. i think it's pretty clear from my other posts that my attitude toward nursing is pretty down-to-earth, and i'll freely admit when i see some of our senior nursing administrators in high heels and business attire, there's a side of me that thinks real nurses don't wear heels. but while i have only been a nurse for five years, i've been in healthcare long enough to see several nurses i've admired at the bedside move into middle management and staff development positions. those i've actually seen in both roles were very capable bedside nurses, and i don't think most of them were motivated to seek promotion because they hated direct patient care. similarly, most of my instructors in nursing school were still practicing in bedside positions part-time, and while i didn't really get to see them in action, i'm pretty confident they were very good nurses. so, it's entirely possible that my cno is a better nurse than me who moved into administration in the hope of improving the lot of bedside nurses. as much as i take exception to any idea that working at the bedside makes me a lesser nurse, my experience has definitely not been that msn nurses aren't capable. indeed, one of the best nurses i currently work with has her msn, and i have frequently been in awe of her knowledge base, although i think she might attribute more of her knowledge to her 15 years at the bedside than to her degree.

on the other hand, the very best nurse i've ever known was a diploma nurse, as is one of the best i currently work with. i recently had a chance to watch a truly gifted young lpn handle a difficult patient as well as i think she could possibly have been handled. so i'm not impressed with the ana position that they, and i, aren't real nurses, and i continue to believe that diversity in the entry routes to nursing is a strength, rather than a problem.

[jjjoy, LPN]

I still tend to see it as that a nurse manager is a nurse who is practicing management of nurses and the provision of nursing care... not practicing nursing per se.

Similarly, school principals are required to have taught at some point in their career, but usually are no longer actively teaching in the classroom. Not because they can't; that's just not their role any longer. They may very well jump into the teacher role at times for any variety of reasons... to keep their teaching skills up, to fill in temporarily in a pinch, to see what exactly the teachers are dealing with "on the front line", etc. The very best principals probably are also great teachers. But I'd bet a lot of teachers would make miserable principals and that no small number of highly competent principals were just so-so teachers. But teaching is still "a profession" unto itself, is it not? Or maybe teaching doesn't even fit that 5 point definition of a "true" profession, darn it?! In that case teaching is really just a vocation and teachers just mindlessly carry out the curriculum as designed by true education professionals? Of course not!

It seems that some nursing leaders in the past unfortunately bought into the false dichotomy that if nursing fell short of being a "true profession" then that meant that nurses were just automatons and hand-maidens.

[eriksoln, BSN, RN]

https://allnurses.com/general-nursing-discussion/time-some-introspective-530130.html

I can't help myself. I have to put it here. Still think nursing is a profession?

Now, IDK about you, but a big part of being a professional to me is.............you have a designated area/specialty that is your responsibility. It is up to you............not management or admin. or the housekeeper, to take care of said area of work.

For example. Take the legal department. Lawyers, professional lawyers, assigned to protecting the hospital from a legal standpoint. Fine, seems simple enough.

As "professionals", they probably get salaries, not hourly wages, and often have to stay late or take work home when something is going on. They can't just "call someone else in" because their workload is too much. They are professionals, they keep their problems "in house".

Now, take this thread I started. I was suggesting we keep the "short staffed" issues more in house, try to flex our muscle and handle it ourselves.

You will see the tidal wave of defensiveness and "Its not my problem, that for admin. and management". IDK, seems pretty much like the mentality of a "workforce"....................not of a profession. Thats just me though.

This too is part of why I think we are a skilled trade. People have this idea of being a "profession" all built up in their minds. The skies will forever be blue..........all grandmothers will suddenly stop being incontinent and our wages will soar due to our new found respect.

Phfffffft.

There are parts of being a profession that we don't want, I assure you. Do you really want to be salaried? Have to stay until all of everything they decide to assign to you is completed for the same pay as leaving on time. Have to solve every issue like being short staffed in house instead of being able to say "Its not my problem".

[Fribblet]

Professionals get paid much more inline with their education.

Professionals get hour long lunch breaks.

Professionals get bonuses.

Professionals can finish up some work at home.

Professionals can cut a day short if something comes up.

Professionals get holidays off.

Professionals spend the majority of their days sitting down, often in an office.

Professionals get to pee while they're at work.

Professionals get carpal tunnel as a work related injury, not dislocated shoulders or herniated discs.

Professional act professionally.

Professionals exert control over their profession.

Professionals have higher educational standards.

Professionals have high expectations for themselves and their employers.

Nursing is not a profession.

Nursing is labor. We are skilled laborers.