What is with these martyrs?

SmilingBluEyes · Nov 18, 2003

Yea SPNTODD, well, if I came across as condescending, I am sorry. BUT Your comment about nursing and its roles being defined BY doctors shows how LITTLE you understand the field into which you are entering.

Lately I am noticing a trend here on the boards that both disturbs and perturbs me. I notice how often folks who are not even nurses yet have ALL the answers and tell US to quit whining...they KNOW it all already without having worked one day as an LPN or RN yet. WOW I am amazed....(not)

I would love you to say this statement to the ANA myself!!!!

Anyhow, I have tired of it, sorry. To students, I would say: ENTER the FIELD of nursing......being a student is a valuable experience, and YOU are valued and we WANT you......but it's not the same at ALL as being a NURSE yet. Be patient, you will see what I am saying.

Good luck!:zzzzz

Todd SPN · Nov 18, 2003

Originally posted by Agnus
Doctors do not determine nurses scope of practice.
Nurses determine the scope of practice.

Well, this certainly sounds like something I should investigate. Before I do, I want to make sure I understand what you are saying. If I understand you correctly, say, a nurse does not remove a mole on the skin using a punch because the BON says this is not within the nurses scope of practice? However, next year they may decide this is within the scope of practice? This does not make sense to me, but you obviously know more than I. It makes more sense to me that the AMA has set parameters that a nurse may practice in, thus, the scope of practice.

tonchitoRN · Nov 18, 2003

although md's do not write the scope of practice of nurses i have a feeling they have their hand in there somewhere. scope of practice tends to be politically oriented. and everything in politics is give and take i.e. one group says you do this for me and i will do this for you.

as an example: in texas an rn can take a md order from anyone, literally, the secty, mother of md, girlfriend or boyfriend of md, unlicenced personnel etc. as long as it is understood that the order comes from the md. i equate this with the game of telephone that we played as kids. this is perfectly legal. now does this sound like something a nurse would think of? or does it sound like something maybe the md association in texas spoke with the rn association and suggested "hey, we (md's) are overworked. it would make our lives so much easier if rn's were able to accept orders from someone i delegate to give orders. if you do this for me i will vote to allow your apn's write prescriptions". this is politics.

:rolleyes:

jemb · Nov 18, 2003

Originally posted by Todd SPN
It makes more sense to me that the AMA has set parameters that a nurse may practice in, thus, the scope of practice.

Poor Todd! You've answered your own misconception, but can't see it! The Nurses Practice Act, determined in each state by the state's Board of Nursing sets the parameters for nurses' practice. (Not the AMA, as you previously stated!)

Now go online and check it out yourself before you make anymore remarks based on your lack of information, please! (Or, at the very least, pay attention to the information that those who have been practicing as nurses for years have tried to share with you!)

BBFRN, BSN, PhD · Nov 18, 2003

http://www.coping.org/relations/martyr.htm

1. Martyrs are people who recognize they are being taken advantage of and choose to remain in the situation.

2. Martyrs are those who recognize that their rights are ignored and abused but choose to remain in the situation and continue to be treated this way.

3. Martyrs are people who let others know how unfairly they are being treated but choose to remain in this unfair position.

4. Martyrs often knowingly continue to enable or set up situations in which their rights are violated or ignored. This ``setting up'' is like a prediction or prophecy of failure into which, consciously or unconsciously, the martyrs play, fulfilling the prophecy.

5. Martyrs often seek sympathy for their plight. They seek support, advice, and help from others. Yet they seem stuck in their current course of action and seem to be unable to resolve it.

6. Martyrs frequently let the people whom they feel are taking advantage of them know how badly they are being treated. Martyrs often resort to badgering, nagging, scolding, threatening, belittling, antagonizing, and verbally putting down those whom they perceive to be taking advantage of them.

7. Martyrs often believe it is their obligation to remain in their position in life. They would feel guilty if they let go of the current situation. They fear taking the risk to change the situation. They are apparently comfortable, habituated, or submissive to the situation and believe a change would be worse for them and for the others in their lives.

8. Martyrs have a story line which is stereotypic and habitual. They rarely change their tales of woe. One can meet them several years later and find them still suffering from the fate they were experiencing when you last talked to them.

9. Martyrs often mask their behavior with an aura of willingness and desire for behavioral change in their lives. Usually they are only fooling themselves, since the others in their lives can see by their behavior and attitude that there is no possibility of change.

10. Martyrs are ``professional'' help seekers. They make the rounds of paid and volunteer helpers, advice givers, counselors, consultants, anyone willing to listen to their tale of woe. Unfortunately, they usually ignore the assistance, advice, or direction they are given. This frequently results in their ``helpers'' giving up on them in frustration and discouragement.

I used to be a martyr at work and at home, until I set up boundaries for myself, and took responsibility for my part in how I was allowing myself to be treated. As far as this situation, who is the martyr- the ICU nurse, or the House Manager? It kinda sounds like both of them are. I agree with those who say that martyrdom is ingrained in the culture of nursing. For myself, I've had to learn to ask for help when needed, and to speak up if I'm over my head- this had little to do with my instructors in school or my superiors, and more to do with a lack of communication on my part.

SmilingBluEyes · Nov 18, 2003

NO martyr here. After being raised by a LONG suffering martyr, I decided early-on it was NOT for me. I do not fit in the role well. BUT a lot of my coworkers do, and their ways infuriate me frankly ...I keep my distance.

Todd SPN · Nov 18, 2003

Originally posted by SmilingBluEyes
Yea SPNTODD, well, if I came across as condescending, I am sorry. BUT Your comment about nursing and its roles being defined BY doctors shows how LITTLE you understand the field into which you are entering.

Lately I am noticing a trend here on the boards that both disturbs and perturbs me. I notice how often folks who are not even nurses yet have ALL the answers and tell US to quit whining...they KNOW it all already without having worked one day as an LPN or RN yet. WOW I am amazed....(not)

I would love you to say this statement to the ANA myself!!!!

Anyhow, I have tired of it, sorry. To students, I would say: ENTER the FIELD of nursing......being a student is a valuable experience, and YOU are valued and we WANT you......but it's not the same at ALL as being a NURSE yet. Be patient, you will see what I am saying.

Good luck!:zzzzz

Well Smiling, having a different point of view and expressing it is not very welcome on this board. In the past, I was put in my place and now am careful now to try and not offend anyone. My recent post about drs and scope of practice, I feel, was not taken in the context it was meant. It is awful hard for anyone to always make it crystal clear on a BB and there are many who are ready to pounce.

I, too, have noticed a trend recently on this board. Only my interpretation is lack of consideration for those lacking experience as a nurse. For some reason, many of the nurses feel that lack of respect and all the other problems in the workplace are unique to them and only they can understand. Specific to nursing, yes, but as someone who has spent 30 years in management and a one time business owner, I submit that the majority of the problems stem from the profit motive and every profession is effected similarly in some way. But in order to effect change or make someone understand something if you feel they are wrong, you must have a dialogue. Shutting down the flow of information certainly does not help newbies like me grow. And that is the crux of the problem, isn't it? "Come back and post when you know something."

I have kept the SPN designation as I am a new LPN working LTC and realize I have much to learn. One year of part-time prereqs and then one full-time year of nursing classes and I will be an RN. But, I will still only be a newbie. For every year I am a RN, others will have been an RN for one more year longer than me. I can never catch up.

Anyway, that is my perception. I didn't realize what it was going to turn into when I started typing. But it is clear too me now that this BB and I are not a good match. I need to spend my time on other pursuits. Be well, happy holidays...bye

fergus51 · Nov 18, 2003

Todd,

Nurses' scope of practice is not determined by MDs anywhere I know of. It has to do with the board of nursing that lisences RNs and the relevant legislation affecting all health care workers (for instance, child abuse notification laws which apply to doctors and nurses). Doctors write medical orders, but nursing practice is established by nursing boards and hospital policies and in the end nurses are responsible for their own conduct. So, if a doctor tells a nurse to perform surgery, she won't just obey the doctor, because she knows her scope has been set by the BON, not the doctor. The BONs have created scopes that are reasonable for nurses considering their education, and does not affect medical practice by doctors (they can't allow nurses to practice medicine).

I think one thing that a lot of students don't understand is the difference between nursing and medical practice. I don't think I did appreciate it as a student, but once you get your lisence I am sure you will come to appreciate it as well. Good luck in your future RN studies:)

SmilingBluEyes · Nov 18, 2003

Well Todd,then I wish you well. We don't have to agree....take care. I agree to disagree w/you even if YOU ARE A NURSE. I can't see at all where you are coming from ....best of luck to ya.

hoolahan, ASN, RN · Nov 18, 2003

Originally posted by Lindz
Hoolahan,

I'm not sure what state you are in, but here in California Nursing Assistants can't start IV's, give IV meds, and only an RN can hang blood. Nursing Assistants most definitely save a busy RN by doing the vitals signs and ADL's. Of course this may be different in PA where the original post is from.

Lindz, I didn't think the original poster was a CNA at all. What I read was that she was pulled, or I assumed pulled, to the ICU, not her normal unit, and did "mostly nursing assistant type stuff". I have been in similar situations being pulled for maternity for example, where they didn't give me an assignment because 1. ICU could get busy and need me back, and 2. b/c it wasn't my forte, so I did vitals, pm care, blood sugars and really functioned more as an aide, but if one of the nurses needed a dressing done, I did that, or really just supported them, and I am a RN, so that is whjat I was referring to. If the origianl poster is really a CNA, then yes of course, my suggestions/interpretations were inappropriate.

Just didn't want you to think we are nuts here in NJ! :)

Agnus · Nov 19, 2003

touchitoRN, I hope you understand that neither your state's nurses assocaiation nor the american nurses assocaiation set the scope of practice. They are not a part of the BON. They are lobbiest.

The nurses association represents the interest of nurses. The BON does not represent the interest of nurses. It represents the interest of the consumer.

The composition of the board, as to the types of individuals that sit on the board, are different in every state.

A few still have an MD in an advisory position. The board in any state is composed primairly of registered nurses.

Some may have an LPN, and some may have a CNA. Some may have 1-2 consumers outside of the industry. Usually there is an ANP, today.

The number and required chacteristics of the RNs varies from state to state.

Characteristics can be anything from, ADN, BSN, MSN etc. to various specialities and or length of time in practice.

The BON also utilized nurses (not doctors) on various committies that study and examine issues. It is these committies that make recomendations to the boards.

All that physicians are able to do is lobby the legislature when they are trying to keep another group from doing something that they consider their exclusive domaine. They cannot dictate anything. They lobby wether it is against Chiropractic, Osteopathy, nursing or anything else. The burden of proof is on the MDS to prove thier case.

I see that you are likely unfamiliar with the political process and the workings of the BON. Might I suggest that you volunteer to assist the board as needed, such as sitting on a committe?

Might I suggest that you become involved more directly with you state's nurses association and take a more active role. Learn about the legislative, advisory and lobbying process.

I promise you would not be wondering and speculating about your parctice any longer, and would not be sitting back and feeling it was all out of your hands because "MD's" have control of it.

Indeed MD's have the ability to re gain control of your practice. All it takes is for nurses to back off and give it to them. Right now you do not know who has contol. What a shame.

Referring back to taking orders from the MD's secretary. If that is legistated into your laws, in texas, who's license do you think this secretary is working under? It is not yours it is the physician that gave her this ability.

If you take such an order , you are obligated to use you nursing judgement as to wether it is a sound safe and efficatious order.

I seriously doubt that no matter what your state's particular laws are that you are obligated to take orders relayed by the secretary. I seriously doubt that you cannot demand that the physician give them directly. Many nurses in thier practice require a written order and will not take a phone order. That is thier perogative and many nurses exercise it.

I am very much involved in the political process. I can tell you the give and take is not between lobbiest groups, as in nurses and doctors associations, it is between legislative groups. I am afraid you are a bit confused here.

You heard or learnd in HS that the deomocrats and the republicans in (Federal) congress and the senate do this give and take which is true and is what I am talking about. Those groups within the legislature (congress and the senate) are not the same as constituant groups represented by lobbiest. MD's would fall under the latter category, as would nurses.

Do not think that for one minute that this issue you speak of with your state was not carefully reviewed and studied before it was ever agreed upon by the two associations and then agin review by the BON to determing if indeed this was something that would fly in the face of consumer safty.

You can bet the MD who does this is fully culpable for any error or wrong should he issue an order through his secretary and injury resulted.

Please, don't speculate. Educate yourself. Get involved. Be on a first name basis with the leaders in your associantion, with the BON and with your legislators.

I think a lot of people here are confused about the role of the BON. The BON is not a legislative part of the government it is enforcement.

efy2178 · Nov 19, 2003

It is important that nurses who except an assignment that is "overwhelming" understand they are putting the patients at risk. There is no legal defense for this. You need to refuse the assignment before you are given report for it. Taking on a new ICU patient when already staffed to the max is just plain dangerous.

Nurses must take care of themselves in order to be able to take care of patients. Hospital administrations should assist them. There is so much burn out amongst nurses who have become martyrs and don't know how to change this behavour. The problem is, administrators readily accept this behavour and then come to expect it. Our thinking has become so distorted that when a nurse with a reasonable perspective comes along they are often castigated for being seemingly 'selfish'?

Bottom line: Do whats best for the patient and know your own limitations. Remember, you don't do your fellow nurses or patients a favor by playing the martyr.

My tow cents worth.