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?

[JulieCVICURN, BSN, RN]

I have but it's irrelevent

This I must seriously doubt, because if you had you wouldn't be waving the flag of ignorance about what it means to be such and how it doesn't pertain to any of this discussion.

[PMFB-RN, RN]

trust me, they are constantly worrying about it. as a former business owner, i know that first-hand. even if you "pay" someone else to do that for you, it is a constant worry.

*** no they are not. i am close friends with some of these people and it's a no brainer for them. there 1600+ physicians and more midlevels. for them owning the practice as a group is not something they have to think about. a couple shareholder meetings a year and a annual check in the form of profit sharing is all they have to think about. i too am both a business owner and (former) independant contractor.

and the statement

contradict each other.

*** of course they do not. an independant contractor in exactly that, independant. mixing up issue an individual may face with issues a group of prosessional joined together in a llc or other type of corperation doesn't lead to more understanding.

all i can say is if you don't absolutely love every nurse you work with, then don't start an llc with them. instead of co-workers who can come and go, you have now entered into a independent contracting business with them.

*** you make an exellent point worth consideration and discussion. one would have to weigh the possible downfalls with the potential benifits. despite the way you say it above an llc or other type of corperation made up of a group of professionals is different than independant contracting. among other ways it's different is you go from dealing with one person, yourself, to dealing with a group.

profit sharing, health insurance, marketing, hospital contracts, negotiations, board of directors, etc. it is no where as easy as it seems.

*** well it seems hard to me. however the benifits would be substancial and may make the difficulty worthwhile. one would have to look closely.

notwithstanding the fact that more and more physicians and crna's are becoming employees because of the headaches and/or hospital demands. look at the cleveland clinic as a prime example.

*** i know of some examples of this, the mayo clinic would be another. however i see nothing that indicates more and more crnas in particular are doing so. if you have some data i would like to see it.

[JulieCVICURN, BSN, RN]

For them owning the practice as a group is not something they have to think about. A couple shareholder meetings a year and a annual check in the form of profit sharing is all they have to think about.

This is quite possibly the most laughable thing I have ever read.

[msn10]

No they are not. I am close friends with some of these people and it's a no brainer for them. There 1600+ physicians and more midlevels. For them owning the practice as a group is not something they have to think about. A couple shareholder meetings a year and a annual check in the form of profit sharing is all they have to think about. I too am both a business owner and (former) independant contractor.

1600 physicians in one group has got to be a record. I am glad you have friends in the group, and maybe some don't care, but they will be the first ones out of the group because they obviously have no clue about what is going on in their own corp.

Profit sharing, health insurance, marketing, hospital contracts, negotiations, board of directors, etc. It is no where as easy as it seems.

*** Well it seems hard to me. However the benifits would be substancial and may make the difficulty worthwhile. One would have to look closely.

Careful before you assume the benefits would be substantial. My husband 'owns' his own group and he too knows it is a matter of time before hospitals will do to his group what they have already done to the pathologists, ER docs, and radiologists. I can't site the reasons why I know this on the thread, but ask any manager on this site and they will almost always concur.

I am sorry but I have to respectfully disagree with you (and agree with JulieCVICU) on the fact that owning your own business is easy and you just hire someone to manage everything and never worry. I owned my own medical business for years. Had 45 employees and hired people to do my marketing, business management, and other non medical tasks. There wasn't a day that went by that I didn't somehow worry about the business. I was extremely lucky to have sold the business in 2008 before the recession and now I teach because I love it and it was always a passion of mine. Being in the ranks instead of on top can be very rewarding as well.

Although their is not much data for CRNA employment either way, I live in a major metropolitan area and their are no longer any independent or CRNA groups, all of the 14 area hospitals (50 mile radius) employ their CRNA's. There are only a handful of CRNA contractors in the state and they are at the small rural hospitals where it is not advantageous to employ them. As far as your references for MD employment on the rise. Here you go:

Doctors are choosing to work for a hospital to avoid the headaches of being their own business. I've had doctors tell me the hours are better and the salary is steady.

http://blogs.tcpalm.com/health_lifestyle/2010/04/more-doctors-becoming-hospital-employees.html

"It was obvious to me that a solo practitioner in internal medicine really couldn't survive any longer,"

Koch may have been ahead of the curve, but many doctors in private practice are now contemplating similar moves, giving up ownership of their practices to become part of hospital-owned practices or larger groups with multiple specialties

http://www.ctmirror.org/story/12135/doctors-private-practice

[PMFB-RN, RN]

1600 physicians in one group has got to be a record.

*** my mistake. that should have been over 1600 providers. that would be physicians and nps and pas and crnas all together.

i am glad you have friends in the group, and maybe some don't care, but they will be the first ones out of the group because they obviously have no clue about what is going on in their own corp.

*** they seem pretty comfortable and it's been around for about 100 years. since you don't have any idea who i am talking about you are not really in any position to say who does and doesn't have a clue.

careful before you assume the benefits would be substantial.

*** well as i said it would have to be looked at carefully.

i am sorry but i have to respectfully disagree with you (and agree with juliecvicu) on the fact that owning your own business is easy and you just hire someone to manage everything and never worry.

*** a gross misrepresentation of what i have said and of my views.

i owned my own medical business for years. had 45 employees and hired people to do my marketing, business management, and other non medical tasks. there wasn't a day that went by that i didn't somehow worry about the business.

*** i don't think a sole propitorship model is any more illuminating to what we have been discussing that the independant contracor was model brough up ealier.

i was extremely lucky to have sold the business in 2008 before the recession and now i teach because i love it and it was always a passion of mine. being in the ranks instead of on top can be very rewarding as well.

although their is not much data for crna employment either way, i live in a major metropolitan area and their are no longer any independent or crna groups, all of the 14 area hospitals (50 mile radius) employ their crna's. there are only a handful of crna contractors in the state and they are at the small rural hospitals where it is not advantageous to employ them. as far as your references for md employment on the rise. here you go:

http://blogs.tcpalm.com/health_lifestyle/2010/04/more-doctors-becoming-hospital-employees.html

http://www.ctmirror.org/story/12135/doctors-private-practice

*** interesting that the second link actually supports my point:

"but many doctors in private practice are now contemplating similar moves, giving up ownership of their practices to become part of hospital-owned practices or larger groups with multiple specialties."

thos physicians are joining larger groups or working for hospital owned practices. larger group practices seem to be where it's at.

[eriksoln, BSN, RN]

HEYYY...........

Someone pointed out to me: Why can't nursing be called "A labor of LOVE"?

<_>

>_>

Ok, ok

They aren't talking about the same thing, but you get the point.

[porridge]

I thought it was common knowledge that nursing is not a profession. Legally it is defined as a "professional endeavour". Like it or not, facts are facts.

[eriksoln, BSN, RN]

I thought it was common knowledge that nursing is not a profession. Legally it is defined as a "professional endeavour". Like it or not, facts are facts.

Yes. This is the truth actually. Nursing is not considered a profession EXCEPT in its own little circle (I do now, but resent how poorly we have defined ourselves as such up to this point in time). This is a whole in the educational system. Nurses who have spent their last umpteen years inside the nursing circle forget...........the attitudes/views change are different when you step outside your comfort zone and leave the circle. I laugh at how many students are told/taught it is a profession when it is not.

[Jules A, MSN]

i laugh at how many students are told/taught it is a profession when it is not.

yeah well i cry when i think about the time and money i have wasted on courses that were not much more than a phd desperately trying to justify their high level of education and lack of any actual nursing experience by forcing professional nursing hooey down our throats. what is that saying? thou dost protest too much. if nursing truly were a profession we wouldn’t need all the fan-fare about how misunderstood and in need of an uprising we are, jmo.

[eriksoln, BSN, RN]

yeah well i cry when i think about the time and money i have wasted on courses that were not much more than a phd desperately trying to justify their high level of education and lack of any actual nursing experience by forcing professional nursing hooey down our throats. what is that saying? thou dost protest too much. if nursing truly were a profession we wouldn't need all the fan-fare about how misunderstood and in need of an uprising we are, jmo.

in the sequel to this thread, i get into the type of individual you are talking about and how they hurt the nursing profession. it's how the "ivory tower" elevator works though, unfortunately.

they realize they can not do bedside nursing, but also don't want to go back to school to completely change careers. so, they go back to school, full time, avoid any clinical experiences they possibly can, and write paper after paper until the title on their name badge excludes them from bedside care (in essence, they ride the elevator without stopping at any floor in between). they they profess to be one of us and take up seats in offices/administrative roles that would be better filled by..........well, a nurse with the same education but a little more (no, a lot more) clinical experience. people, like the business admin. and ceos, see them and truly believe them to be a good reflection of us (the nurses) and.............well, you can see this leads to a big part of the reason there is such a detachment between the decision makers and nursing.

[Jules A, MSN]

in the sequel to this thread, i get into the type of individual you are talking about and how they hurt the nursing profession. it's how the "ivory tower" elevator works though, unfortunately.

they realize they can not do bedside nursing, but also don't want to go back to school to completely change careers. so, they go back to school, full time, avoid any clinical experiences they possibly can, and write paper after paper until the title on their name badge excludes them from bedside care (in essence, they ride the elevator without stopping at any floor in between). they they profess to be one of us and take up seats in offices/administrative roles that would be better filled by..........well, a nurse with the same education but a little more (no, a lot more) clinical experience. people, like the business admin. and ceos, see them and truly believe them to be a good reflection of us (the nurses) and.............well, you can see this leads to a big part of the reason there is such a detachment between the decision makers and nursing.

i'm not sure i should ask about the location of the sequel thread r/t the chance of inciting me to riot, lol. i have also had my fill of cnl new graduates that haven't ever given an injection but definitely know how to attempt to delegate to me while i'm precepting them. imo they had no intention of ever actually being a nurse and have the well supported delusion that more indistinguishable letters behind your names makes you knowledgeable about nursing. so much of this business is about gut instinct and experience. when did the value of education overtake all common sense and hands on experience? i used to be angry now i'm just sad.

[eriksoln, BSN, RN]

https://allnurses.com/general-nursing-discussion/time-call-duck-567303.html

Me love me some rioting. Funny, someone in this post said I was the type of person who stirs the pot just to get everyone else all wound up and angry. Where did they ever get that idea from?

:oOK, I admit it

:clown:I like it a little bit.

:devil:Sometimes a lot.