Time to call a duck a duck?

Nurses Professionalism

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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 if we do a Maslow-style hierarchy for what nursing needs, direct patient care should be on the bottom of the pyramid. My cyanotic patient doesn't want to tell me why he's feeling blue.

Yes, well, taking care of physiologic needs can be learned on the job in no time! How hard can it be? People without degrees in nursing do it all the time! On the other hand, critical thinking about a person's response to illness is the unique domain of nursing so that is the base of pyramid of nursing education! (tongue firmly in cheek)

Specializes in Geriatrics, Home Health.
Now, I know the pt's were not as sick then, but the load kind of makes it even for a team of 4 as we would have now. The point is, a lot more was expected of a student then; now I have SENIOR students who come onto the floor with a 2 pt. assignment that was made up on the spot. How can a student POSSIBLY command care for 2 pt's she has not seen, prepped for, or had 5 minutes to organize with?

My school stopped the night-before prep because nurses on the floor don't prep the night before their shifts; they meet their patients on the floor, usually during an admission. HIPPA also makes taking patient info of the floor very risky.

Specializes in being a Credible Source.
My school stopped the night-before prep because nurses on the floor don't prep the night before their shifts; they meet their patients on the floor, usually during an admission. HIPPA also makes taking patient info of the floor very risky.
My school also discontinued the practice for our clinicals. It was deemed impractical since we had several commuter students and because they did not want the students digging through charts without the instructor around. I don't think we missed out on anything, truth be told.
Specializes in cardiac, ICU, education.

eriksoln

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".

You have just described every MSN, Nurse administrator, nurse educators, and a host load of other nurses you have been scoffing at on many of your posts.

Would you suggest we call you a technical nurse and nurses with BSN's or MSN's professional nurses? I bet many would disagree with you.

BTW - I tried to post my answer to your question of how I believe my BSN has helped me to be a better bedside nurse (or even my students for that matter) but they have temporarily shut down the post.

eriksoln

BTW - I tried to post my answer to your question of how I believe my BSN has helped me to be a better bedside nurse (or even my students for that matter) but they have temporarily shut down the post.

Too bad it got shut down; I'd be interested in that opinion.

Specializes in Clinical Research, Outpt Women's Health.

I sure wanted to tell Tim that having a BSN does not neccesarily make you a better or smarter nurse, but just a more educated one. I wonder if he has the ability to understand the differences?

I think it would be great for all to have a BSN, but only if those of us long working nurses are grandfathered in as is appropriate.

Also, I have worked with tons of really lame BSN,s ADN's, Lpn's, CNA's, NP's etc...........as well as many very smart and effective ones in all those categories.

Specializes in Rodeo Nursing (Neuro).
eriksoln

You have just described every MSN, Nurse administrator, nurse educators, and a host load of other nurses you have been scoffing at on many of your posts.

Would you suggest we call you a technical nurse and nurses with BSN's or MSN's professional nurses? I bet many would disagree with you.

BTW - I tried to post my answer to your question of how I believe my BSN has helped me to be a better bedside nurse (or even my students for that matter) but they have temporarily shut down the post.

In all fairness, I have to admit that scoffing at any sort of authority is a popular nursing passtime. Who doesn't love to gripe about admin or recount any blunder any doctor makes? Still, if I were honest, I would have to admit my boss has her lucid moments, my instructors in nursing school knew at least as much as I did, and not everything new is bad. Fortunately, I'm old enough to grasp that honesty is overrated...

I first heard the idea of a Registered technical Nurse versus Registered professional Nurse in nursing school, and at the time it seemed reasonable, to me. Over time, I've come to believe we don't need to divide the field even more than it already is, and over the course of this thread, I've come to respect the professional aspects of bedside nursing. Rather, I have come to realize that I always did respect the professional aspect. I much prefer shifts when I have time to really think about what my patients need--not just five minutes from now, but during the course of their stay. It's great when charting a plan of care isn't just filling a box so I won't get yelled at, but actually prioritizing what needs to be done, as long as my patients aren't lying on the floor in a puddle of pee because no one had time to help them to the bathroom.

I'm bothered that a lot of the requirements of professional nursing seem to result in more basic nursing care being delegated to unlicensed staff. I don't mean that I'm just aching to do primary care, or that UAP's are lazy, or stupid. I do mean that some of the aides, phlebotomists, and transporters don't always get the big picture. I recently learned of a prime example, of phlebotomists who draw our timed PTTs at the assigned time, then hold them to send with the rest of their draws. So our heparin drips are an hour or more late getting adjusted. The answer is clear: draw our own PTTs. But, then, why are we late charting, when so much of the "busy work" like drawing labs is done for us? Why am I late passing meds? It's true, I'm having to toilet patients and fetch water every med pass, but I have aides to do that for me and they manage to get their vitals done on time. Clearly, it's poor time management on my part to show up with meds while the patients are waiting for the aides to get their vitals done so they can go to the bathroom. And while I might explain to the patient recovering from an aneurysm clipping why it's important to keep taking their colace as I help them to the bathroom, if I had a graduate degree, I'd have time to chart that education as I was doing it.

Specializes in M/S, Travel Nursing, Pulmonary.

Had a bit of an epiphany today concerning this subject. Obviously, I wrote this orig. thread because I myself was struggling to define what nursing meant to me. I threw some random thoughts out there, argued certain points I felt strongly about and tried to define what it was about the subject as a whole that bothered me. But, I never was really able to "hit the nail on the head" with regards to what I was trying to say.

Today it came to me. Funny, its like when you've forgotten someone's name and want so badly to remember it, but can't. Then, as soon as you quit thinking about it............it comes to you.

I had that moment of clarity today, my sort of "it came to me as soon as I gave up thinking about it." I now know why I think nursing is stuck in this "foot half in/half out the door" situation regarding being a profession.

I think it is time for [drums roll, trumpets blare]: Time to call a duck a duck? Part Deux. Stay tuned for the new thread coming soon.

Specializes in cardiac, ICU, education.

Looking forward to it Eriksoln

Cool, but don't call it part duex. Give it a new whole new animal.

Like a marmot, or something.

Specializes in M/S, Travel Nursing, Pulmonary.

Its up. Somehow though, for unknown reasons, someone decided to make it a "clinical vs. administrative" nurse issue. Eh, there still be other good discussions in Part II anyway.

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