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?

Specializes in cardiac, ICU, education.
truth.....

but people will be able to say " i know ONE professional nurse" and hopefully they know you by name......

take the challenge for one week and put your heart and soul in it... then get back with me....LOL

I have to agree with eriksoln (at least to some degree) about this one. Being professional and being in a profession are 2 different things. Sure, you should dress for the job you want, not the one you have, but it takes a great deal more than a professional appearance. However, I do have to remind my students too often to look professional before they even hit the floor (my pet peeve).

Specializes in M/S, Travel Nursing, Pulmonary.
Too bad you did not attend a better program. All the PhD's in my university have ( and most of them still do) a great deal of bedside nursing experience; myself included - at the bedside 15 years before I started teaching.

I think some hot topics going around my head are cooling off and coming to a head. I've discussed issues with nursing leadership and education with you and llg a lot and we've gone back and forth about it.

I'm starting to wonder if the solution was so simple and evident that I missed it, almost like a "Who's buried in Grant's Tomb" riddle.

I think I'd be much more comfortable with an education system that, as one climbs the ladder from one degree to another, requires clinical experience more so than it does now.

To get your ADN should require "X" amt. of clinical hours. To get your BSN should require "X+Y" and so on. For MSN and beyond, you should have to have much "front line bedside care" experience to allowed in the program. It can require a certain amt. of hours and diversity of fields/specialties worked. And do it in a serious manner, don't allow the nurse who spent their entire career giving flu shots to write a paper to get out of the requirement (DISCLAIMER: Not say that does not have its place, but if thats all you've done, you should diversify, just as if all you have done is ICU, same goes for you, so on so forth).

Specializes in M/S, Travel Nursing, Pulmonary.
I have to agree with eriksoln (at least to some degree) about this one. Being professional and being in a profession are 2 different things. Sure, you should dress for the job you want, not the one you have, but it takes a great deal more than a professional appearance. However, I do have to remind my students too often to look professional before they even hit the floor (my pet peeve).

I like that. That speaks to me. As long as your mind is still on pt. care, not "Hmmm, what color does admin. like most, I need to grab their attention." :eek:

The "professional look and appeal" is............the icing on the cake, not the body of the meal.

Specializes in cardiac, ICU, education.

Are we looking at this the wrong way? Should there be different names for different levels of nursing?

Truth be told I always thought of nursing as a profession, but I guess we can hardly call ourselves that when less than 50% of nurses get Bachelor's or higher level degrees (like all other professions). Also, we can not decide if we are technicians under the direction of other professions or independent autonomic health care providers.

Should we consider an NP or CRNA or educator/MSN/PhD the professionals and RN's non-professionals? Look at the threads for "technical vs. professional nurse" and it is like another world war is starting.

Frankly, my education and work experience seems to make me a professional in what some on this thread call a non-professional field. Other members of other professions have less education than I do, but consider themselves professionals. At the master's level and above in nursing we have:

  1. Skill based on theoretical knowledge and evidenced-based research
  2. Professional associations
  3. Extensive period of education
  4. Testing of competence
  5. Institutional training
  6. Licensed practitioners
  7. Work autonomy
  8. Code of professional conduct or ethics
  9. Self-regulation and policing
  10. Public service and altruism

So why should I not consider myself a professional when a lawyer who has less education then I do does consider themselves as such?

Why do we call a dentist or a chiropractor with less education than a DNP a doctor but the ANA now says that we cannot refer to a DNP as a doctor?

I think because we are letting ourselves believe that we are not professionals. There is NO universally accepted definition of a profession. Sure, there are definitions, but we seem to ignore those definitions (especially when we refer to athletes as professionals). Maybe it is time to define ourselves and stop letting other groups and their definitions of professionalism define us.

Specializes in M/S, Travel Nursing, Pulmonary.
are we looking at this the wrong way? should there be different names for different levels of nursing?

truth be told i always thought of nursing as a profession, but i guess we can hardly call ourselves that when less than 50% of nurses get bachelor's or higher level degrees (like all other professions). also, we can not decide if we are technicians under the direction of other professions or independent autonomic health care providers.

should we consider an np or crna or educator/msn/phd the professionals and rn's non-professionals? look at the threads for "technical vs. professional nurse" and it is like another world war is starting.

frankly, my education and work experience seems to make me a professional in what some on this thread call a non-professional field. other members of other professions have less education than i do, but consider themselves professionals. at the master's level and above in nursing we have:

  1. skill based on theoretical knowledge and evidenced-based research
  2. professional associations
  3. extensive period of education
  4. testing of competence
  5. institutional training
  6. licensed practitioners
  7. work autonomy
  8. code of professional conduct or ethics
  9. self-regulation and policing
  10. public service and altruism

so why should i not consider myself a professional when a lawyer who has less education then i do does consider themselves as such?

why do we call a dentist or a chiropractor with less education than a dnp a doctor but the ana now says that we cannot refer to a dnp as a doctor?

i think because we are letting ourselves believe that we are not professionals. there is no universally accepted definition of a profession. sure, there are definitions, but we seem to ignore those definitions (especially when we refer to athletes as professionals). maybe it is time to define ourselves and stop letting other groups and their definitions of professionalism define us.

i agree.

i think though we should........be harder on the requirements to be accepted into higher degree programs.

maybe this works better for you:

eliminate adn.

require (x) amt of clinical time for passing bsn program.

require (x+y) amt. of work experience to be accepted into msn program, with requirements forcing diversification of experience.

require (x+y+z) for the next degree, so on, so forth.

this would get rid of the people i described before, the ones who realize nursing really isn't for them hence they hide behind an education to avoid it. i'd be more...........confident and have much more faith in nursing leadership of our educational system insisted on a certain level of rl work experience.

Specializes in cardiac, ICU, education.
I'd be more...........confident and have much more faith in nursing leadership of our educational system insisted on a certain level of RL work experience.

I agree with you, but it is hard to get nurses with a lot of beside experience to go into nursing education instead of DNP, CRNA, etc. MSN education grads average about $55,000/year full time. That is almost $30,000 - $50,000 less than a new CRNA or NP. And it is not only our profession (yep, I said it). Almost all other PhD instructors, even in medicine, get paid considerably less than their "RL" counterparts. They also demand that we do as much research as possible to get tenure/keep our jobs so the university keeps getting funded. Talk about freakin' paperwork. Yes, it is just as political in the academic setting as it is in the hospital one.

Specializes in M/S, Travel Nursing, Pulmonary.
I agree with you, but it is hard to get nurses with a lot of beside experience to go into nursing education instead of DNP, CRNA, etc. MSN education grads average about $55,000/year full time. That is almost $30,000 - $50,000 less than a new CRNA or NP. And it is not only our profession (yep, I said it). Almost all other PhD instructors, even in medicine, get paid considerably less than their "RL" counterparts. They also demand that we do as much research as possible to get tenure/keep our jobs so the university keeps getting funded. Talk about freakin' paperwork. Yes, it is just as political in the academic setting as it is in the hospital one.

Ewwww.

Kinda ties into my..............why Florence Nightingale is a Fail article I'm still brewing up.

Specializes in neuro med, telemetry, icu, pacu.

the ADN programs will not go away easily...why? because the cost factor...

in the locale where i live the salaries of starting nurses is 40,000/ year...

the cost for the education of an ADN is about 10,000 here.....

if your education costs 50k-70k and you get out and only earn 40k ?????

and you can look forward to a 1-3% raise... of course, with the industry in FLUX, ummmm they might suspend all raises....

sooo.....

as far as i am concerned,unless momma and daddy are paying for your education and have no expectation of you paying them back, ( which i consider those who dont repay to have an entitlement thinking issue and need to buck up and stop lying to themselves that anyone owes them anything!!!)

who owes you anything anyway?????

SERIOUSLY--- WHO OWES YOU ANYTHING????

we have been lead to beleive LIES... that wonderful lie that a college education shall lead you to greatness and success and good money.... AHAHAHAHAHAAAA! experience says other wise...

YOU WILL NEVER get any respect simply for the education you have..... you have to EARN THAT...by your actions, words, deeds......

your education is not an assurance of good character.....

you said it yourself... folks dressed well in crisp clean uniforms and look professional have nothing to support their " looks" and " acts"....

character is defined by your actions, deeds, accomplishments, behavior......not your credentials......

and ericsoln..... your rejection of the white lab coat.... is this covert rejection ? i would love to hear WHY..... do you reject what is stands for? or are you still having an emotional reaction to those students/ fresh grads years ago who looked good on the outside yet could not carry out basic nursing tasks?

Specializes in M/S, Travel Nursing, Pulmonary.

and ericsoln..... your rejection of the white lab coat.... is this covert rejection ? i would love to hear WHY..... do you reject what is stands for? or are you still having an emotional reaction to those students/ fresh grads years ago who looked good on the outside yet could not carry out basic nursing tasks?

Its 20% this and 80%...........I've always thought they looked silly. Just do. Can't define why I think Vanilla tastes better than chocolate. I've always thought lab coats were silly though.

Specializes in Family Nurse Practitioner.
Its 20% this and 80%...........I've always thought they looked silly. Just do. Can't define why I think Vanilla tastes better than chocolate. I've always thought lab coats were silly though.

I also don't like them, thind they look silly and don't understand why if my impression of a lab coat's job is to prevent things from soiling our clothing the heck they would be white?

Specializes in Family Nurse Practitioner.
Too bad you did not attend a better program. All the PhD's in my university have ( and most of them still do) a great deal of bedside nursing experience; myself included - at the bedside 15 years before I started teaching.

ALL the professors teaching with you have a solid clinical background? Your experience is wonderful and would be most welcome by me as a student. Believe it or not my school has an excellent reputation and I find it hard to believe that your PhD programs aren't also requiring a plethera of "professional nursing" type courses. Overall my biggest complaint is I find it offensive that nursing is graduating and deluding new nurses to consider themselves a masters level professional when they haven't ever given an injection. P.S. doing it to a lab dummy doesn't count. :rolleyes:

Specializes in cardiac, ICU, education.
ALL the professors teaching with you have a solid clinical background?
Yes. They all do. For instance, one of our associate professors who teaches childbearing/OB is a neonatal nurse practitioner. Another instructor who teaches our level one clinical on a med surg floor is an adult NP with her PhD (dissertation was on patients with CHF.)

I find it hard to believe that your PhD programs aren't also requiring a plethera of "professional nursing" type courses.
Of course we have to take 'professional nursing' type courses, all professional programs do, but we also all have a significant amount of clinical background. Yes, I guess I am lucky to work in such an environment.
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