During my last week of RN school, I noticed there was this unspoken expectation for all RN graduates to become hospital nurses, apparently, I did not get the memo! At my pinning ceremony, I watched many of my fellow classmates holding up signs for the school Flicker account that said, "#PICU RN; # ICU RN; #MedSurg RN" and so on. I listened to how excited they were that they would be starting new grad internship programs at the local hospitals surrounding our areas-I shared in their excitement! We had finally done it; all the hard work, long nights of studying and writing papers were over-we were now RNs (well, until we passed the NCLEX, but that's for a different story).
My classmates would rush over to where I was and ask, "Hey girl, what hospital are you going to be working at?"
I would reply, "Oh I'm not going to a hospital-right now anyway. I'm just going to stay where I'm at. I'm the nurse (I was a working LPN during RN school) at a day training facility for adults with varying levels of developmental disabilities." My classmates would scrunch their faces up, then raise their eyebrows and force a smile, and reply with "Oh, that's awesome." Then just as quickly, they would scurry away. It made me think, what the heck was that?? I slowly started to feel like my classmates thought I was less of a nurse than they were but surely that wasn't correct; unfortunately, I had this nagging sensation in the back of my mind. I saw no reason to leave my current job; even though my current job was more in the way of case management, fixing minor injuries, and paperwork-I had never felt like I was less of a nurse, than right at that very moment.
RN pinning came and went. The ATI NCLEX review week and NCLEX Predictor came and went, yet I continued to have this nagging sensation. I went and got my hair done and one of the ladies in the salon asked, after I told my 'life story' as many of us do to pass the time while getting our hair done, "So what hospital do you work? I will definitely go where you work!" As flattered as I was, a mental rolling of the eyes occurred. So, as many times before and many times to come, I smiled and thanked the woman for the compliment, then proceeded to explain my line of nursing. The obligatory slow nodding of the head, the forced smile, raising of eyebrows, and the "Oh, I see..." comment.
So, what is it? I was truly questioning myself at this point. It wasn't just because of a few fellow classmates, or an older lady at the salon-it was everyone I encountered really. It became very frustrating to see people's disposition change so drastically once they found out I was not a "real nurse." You could almost hear the thoughts going through their minds, "Oh yeah, she's a RN. Well thank goodness, I know her; or, well thank goodness someone at this very moment is qualified to save my life." But, the second you mention that you work in a little clinic, take care of cuts and bruises-your automatically not a real nurse anymore??
I couldn't understand it. I could talk the talk. My friend from school would get onto me all the time. I would use words like, ecchymosis and erythema all the time. I would recognize meds-no I'm not a pharmacist/pharmacist student, but I recognized them, knew what they were used for and at times knew some of the regular doses and usual times for administration. I recognized abbreviations used by nurses in the hospital charts, e.g. ABT; VRSA; CTA; bil; the old way to write number 1 ( i ). I was getting good at interpreting, at a super basic level, certain labs or at least guessing which labs a physician would be more than likely to order for certain suspected disorders/diseases. When nurses would talk about having to handwrite in charts on Med-A patients, I too would scrunch my face and make that-UHH! face, because I knew how much information goes into that type of charting. So, I couldn't understand why, when people-even some nurses, would give me that, oh-she's not really a nurse look.
I have met so many different types of nurses. I have met your "basic" (I use this very loosely) hospital nurse, case managers-who are RNs, LPNs and RNs that are MDS Care Plan Coordinators, mental health APRNs who have specialized in mental health/psychiatric clinical nursing, DONs in LTC facilities, schools, and IDD facilities. I have met RNs that work for the Department of Public Health, RNs that are nursing instructors, RNs that are CNA instructors. I have met nurses that work with patients that have intellectual developmental disabilities (IDD); nurses who specialize in wound care, I have even met a nurse that is a Parish Nurse-which I found awesome because it was a type of nursing path we had learned about approximately two weeks before I graduated and thought to myself-yeah, I will never meet a nurse in that field. The list of different specialty positions, settings, et, goes on and on, yet there was never one time did I look at these nurses and think: they aren't real nurses. So, how does a nurse answer this question; the answer is: you don't.
The nursing profession has grown far greater than Florence Nightingale could probably ever have dreamt it could. There are nurses that perform triage over the phone, nursing informatics nurses-I mean honestly, how many nursing students (current) or practicing nurses actually knew what a nursing informatics nurse was before learning about it in school?!? So, how should you react when persons look at you and give you that, "Oh, they really aren't a nurse." Just smile, and do what nurses do best-educate. Nursing is by far the coolest career a person could ever decide for themselves! The different specialty areas to choose from, and sub-specialty areas in those areas, it is awesome just how far a nurse could go. I like to think to myself, is the APRN more of a nurse than the RN? Is the RN more of a nurse than the LPN? Is the CRNA more of a nurse than the GNP? The answer to these questions is no. All of these nurses are nurses in their own rights-they all struggled through nursing school some way or another.
We should teach people that nursing is just a big umbrella with many different areas and sub-areas, et. We should remind ourselves, as nurses, that just because we are different does not mean one nurse is less of a nurse than the other. We should be proud of the nurses we have become, and the type of nurses we are. No matter what type of nurse you are: mental health nurse, LTC nurse, hospital nurse, female/male nurse, whatever the background you came from that made you the nurse you are-own it! Teach the community that we are many, and we are always evolving! So, to end, I will introduce myself proudly. "Hello, my name is Grace. I am a LPN, (waiting on my RN license to be sent to me) who proudly runs her own clinic at a facility that cares for and promotes those with IDD to be as independent as possible. It is nice to meet you; what type of nurse are you?"
