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 Pulmonary, Transplant, Travel RN.
There are many nursing articles alone that talk about what a profession is and how nursing fits into it. I would start your search in CINAHL ;)

But the great thing about wikipedia is that they list references. What I used to do is get the general info on wiki, go to the source, get more detailed info and cite it, or follow more references cited in that source, which gives me ample list of references.

Ah, OK. My problem is, I like the list that is presented in the original post, but can't find it anywhere. I've got a lot of other lists of criteria, but none that are anything like this one.

Ah, OK. My problem is, I like the list that is presented in the original post, but can't find it anywhere. I've got a lot of other lists of criteria, but none that are anything like this one.

:roflmao:

Wiki strikes again. Welcome to academic research and writing.

'Professional' nurses are unable to practice their 'profession' without being overseen and directed by a different and entirely seperate 'profession' (doctors). Any talk of nursing autonomy/independence is simply an illusion. Any nurse deluded by such illusions runs the risk of practicing medicine (a profession) and losing her 'professional' license. Perhaps at the most basic level a nurse could independently care for a patient's hygeine and safety...but so can CNA's...etc...who are in no way considered professional by the 'truly' professional nurses. (However, CNAs COULD be considered professionals if CNAs went to school for four years and developed CNA theories...oh wait...those theories already exist...in the form of nursing theories...sheesh..)...

At any rate, this dependence on another profession is unique among 'professions'...and a glaring example of the true nature of our 'profession'.

*we practice with and through doctors orders. Without them, we are mere hygeine/safety technicians...with a degree*

Lastly...maybe if they werent called doctors 'orders'...perhaps doctors 'requests'...or doctors 'suggestions' they'd be easier to swallow. The word 'order' just speaks to the paternal origins of the doctor/nurse relationship and is a pet peev of mine. And also...my use of 'profession/professional a million times in my post was a wee bit of self-serving humor. Sorry. :cautious:

'Professional' nurses are unable to practice their 'profession' without being overseen and directed by a different and entirely seperate 'profession' (doctors). Any talk of nursing autonomy/independence is simply an illusion. Any nurse deluded by such illusions runs the risk of practicing medicine (a profession) and losing her 'professional' license. Perhaps at the most basic level a nurse could independently care for a patient's hygeine and safety...but so can CNA's...etc...who are in no way considered professional by the 'truly' professional nurses. (However, CNAs COULD be considered professionals if CNAs went to school for four years and developed CNA theories...oh wait...those theories already exist...in the form of nursing theories...sheesh..)...

At any rate, this dependence on another profession is unique among 'professions'...and a glaring example of the true nature of our 'profession'.

*we practice with and through doctors orders. Without them, we are mere hygeine/safety technicians...with a degree*

Lastly...maybe if they werent called doctors 'orders'...perhaps doctors 'requests'...or doctors 'suggestions' they'd be easier to swallow. The word 'order' just speaks to the paternal origins of the doctor/nurse relationship and is a pet peev of mine. And also...my use of 'profession/professional a million times in my post was a wee bit of self-serving humor. Sorry. :cautious:

#1 Nurse Practitioner

#2 Nursing practice is a distinct practice from medicine despite many of the nursing tasks overlapping into medicine and based upon the orders of a doctor. I believe you are speaking to the condition of autonomy being a characteristic of a profession. Autonomous nursing decisions are a key part of nursing and a fundamental requirement for all nurses. A defining feature of the autonomy of nursing versus being the physician's assistant (not to be confused with PA) is our fundamental role within healthcare as the patient's advocate. Above all we protect and advocate for the patient, even if that places us at odds with the physician.

Those in acute care are often at the mercy of the physicians, due to the nature of the patients. Those who work outside of acute care can testify to having a great deal of autonomy.

#1 Nurse Practitioner

#2 Nursing practice is a distinct practice from medicine despite many of the nursing tasks overlapping into medicine and based upon the orders of a doctor. I believe you are speaking to the condition of autonomy being a characteristic of a profession. Autonomous nursing decisions are a key part of nursing and a fundamental requirement for all nurses. A defining feature of the autonomy of nursing versus being the physician's assistant (not to be confused with PA) is our fundamental role within healthcare as the patient's advocate. Above all we protect and advocate for the patient, even if that places us at odds with the physician.

Those in acute care are often at the mercy of the physicians, due to the nature of the patients. Those who work outside of acute care can testify to having a great deal of autonomy.

#1 Nurse practioners are unable to prescribe or diagnose without the collaboration/cooperation/ of a physician (they work 'under' and are dependent on doctors to 'grant' them this 'mid-level' autonomy. (again...nursing 'profession' dependent on a different profession... )

#2 the only truly autonomous decisions a nurse can make regarding the care of the patient are concerning hygeine and safety. Are you suggesting that we're professional 'advocates'? Without a doctor giving/agreeing to 'orders', you can advocate all day...but would be unable to care for a cure someone...outside of hygeine and safety. ...just like a CNA. You dont need a degree to be an advocate.

And those nurses that work outside of acute care...still need doctors orders. I would like to hear someone 'testify' as to how they dont. (outside of the said hygeine qand safety stuff)...

Asystole... c'mon just give in. Once you face this realization you can begin to heal. The truth sometimes hurts.. :unsure:

#1 Nurse practioners are unable to prescribe or diagnose without the collaboration/cooperation/ of a physician (they work 'under' and are dependent on doctors to 'grant' them this 'mid-level' autonomy. (again...nursing 'profession' dependent on a different profession... )

#2 the only truly autonomous decisions a nurse can make regarding the care of the patient are concerning hygeine and safety. Are you suggesting that we're professional 'advocates'? Without a doctor giving/agreeing to 'orders', you can advocate all day...but would be unable to care for a cure someone...outside of hygeine and safety. ...just like a CNA. You dont need a degree to be an advocate.

And those nurses that work outside of acute care...still need doctors orders. I would like to hear someone 'testify' as to how they dont. (outside of the said hygeine qand safety stuff)...

Asystole... c'mon just give in. Once you face this realization you can begin to heal. The truth sometimes hurts.. :unsure:

It must be different in your state from mine. Nurse practitioners here can, and do, work independently and even have their own practices. My primary care is a nurse practitioner, independent from any physician. Nurse midwives here in Arizona are fairly common and practice independently for example.

In a philosophical sense no one is truly autonomous, especially considering that everything in healthcare is regulated by state and federal law and thus under the control of another entirely separate profession, politicians.

As a vascular access nurse I am consulted by physicians to assess and place intravenous access. Granted I am consulted by the physician but the type and location of the intravenous catheter are determined by me. We may be consulted to come in to perform a task but many times how we go about those tasks is decided upon autonomous decisions. Is an electrician not autonomous because he was consulted to place an outlet by the general contractor?

Community health nursing is an entire branch of nursing that is mostly separated from medicine, so is informatics, education, and so on.

I do have to admit though, I do not see nursing as a true profession but rather as a developing profession. Most of my reservations regard the educational standards of the profession though.

I do have to admit though, I do not see nursing as a true profession.

...and the truth shall set you free! :yes:

...and the truth shall set you free! :yes:

Nope, it is not a true profession but rather a developing profession. This is largely due to the uncontrolled standards of education into the entry of the profession, not autonomy or any other issue.

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