Trading the vocation for the profession? I don’t get it. I love education so why do I hate the new recommendation that 80% of nurses should now graduate with at least a Bachelor’s Degree?
At each stage of my nursing career, I went back to school to learn more. I was driven into learning by my need to know more in order to help my patients.
When I was a nursing assistant, I wanted to be an LPN, when I got to be an LPN, I went back to school and got my RN. Once I had my Associate’s Degree, I went on to get a Bachelor’s Degree, and finally a Master’s Degree. So I can truly say, I do love education.
But here’s the rub. I love Nursing more. Nursing is a vocation for me. Nursing is a big passion, and so I was surprised when I reacted so negatively when I saw the new requirements. Something smelled funny, something wasn’t right – I felt it in my gut.
Yet, from the time I was a kid I loved the look of degrees, all those letters like alphabet soup on the parchment certificates I saw hanging on the wall of every doctor’s office. As I grew up, I wanted all those letters after my own name. I wanted to wear them like jewelry, as an ornament for my ego. I knew it equalized the power somehow. I also knew that education was a weapon. But what made me a nurse was something very different, something very special. I cared deeply about those in my charge, and for that reason, I had to know as much as I could to keep them safe. That’s why I kept going back to school. To learn, to help my patients, to gain some power to be able to defend my patients.
I spent days trying to figure out why I felt the way I did about the new nursing recommendation. And finally it came to me.
I loved being an aide, I loved being an LPN, but the next move up in my education began to push me closer to the desk and pull me farther away from my patients. I liked the intimacy of hands on care, I liked exchanging conversation and teaching patients while I made a bed, to keep them from feeling frightened.
I had spent hours learning to develop observation skills, which helped the patients heal more quickly especially if I picked up something that the doctors’ or others hadn’t. I felt fulfilled, grateful and I loved what Idid.
But then they made me a desktop nurse. Certainly I could understand why some charting was necessary for constancy of care. As the nurse coming on shift, I wanted to know the last time my patients had their meds, and how often they suffered pain.
Once, I took over their care, I had been taught to uncover their hidden anxieties and to teach them to care for themselves when they went home. I could help their families be less afraid. My education served both me and my patients. I loved the feeling that when they were helpless, I was there to help them and I knew why and how to do that.
I didn’t like it at the desk. I didn’t like telling other nurses what to do. I didn’t want to manage, I wanted to help. If I wanted to do business, then I would have gone to business school and made a lot more money when I graduated.
But nurses weren’t paid as much for experience as they were for education. I knew that. Then the truth began to emerge for me.
Nurses got higher pay for covering for hospitals and insurance companies than they did for caring for their patients. Sure our roles had expanded, and we were taught to observe, counsel, teach, do nursing diagnosis but once we fought to be paid more for our skills, they took us away from the parts of nursing we loved most. Our patients.
Once the medical system morphed into a business model rather than a healing model, we lost the elegance of the vocation, and instead had to settle for the image of the profession. That wasn’t my calling, that wasn’t what fed my soul, it was neither my path or my purpose to write codes and notes day or night. What were they giving me for what they were taking away? Status? Pay?
Less skilled workers were placed at the bedside while I was kept away.
I read articles and listened to people who tried to trick me by telling me that the profession of nursing had to change and grow so that we would be more respected in the Health Care Field. So we could make more money, have more status, and more respect. But something in me cried, “but what about the patients?”
Patients polled still said nurses were the most trusted of all the professionals so whose respect were we going for? And whose well being? Was nursing growing the profession at the expense of those we swore to advocate for?
When Nursing was a vocation, there was some element of service, certainly, but there was honor in it, and true caring.
There are nurses, and I was one of them, who had to work to support their families. That has to be honored and respected too. That’s a worthy endeavor as well. But they should be respected for what they’ve had to give up for what they got.
Why would we accept this new recommendation as an upgrade? And why wouldn’t each of us, as nurses, support the aspect of ourselves in each other that has us working at the bedside, at the desk, and making policy? Why would we settle for so much less? If we don’t stand up for ourselves, who will stand for us?
The new studies being done show that intention, interaction with the caregiver, emotional support, exchange of energy and hope all help to heal. That’s the “Art of Healing.” Why now, at the very brink of these discoveries, would we settle for being Professionals when we could have the opportunity to be true Healers?
Carol
I too mourn the movement away from the bedside as I climbed the academic ladder. I remember a discussion with a mother/baby nurse in class who was not yet ready to leave the bedside and this is what I explained to her:
You can take care of that mom and that baby that needs you with your own two hands and with your heart. If that is what you need to do now, then that is what you should do.
But you have to remember you are being granted the opportunity to care for many more moms and many more babies through the hands and the hearts of others. That is a sacred gift and calling. And when you are ready, that is what you will do.
LInda,
I so agree with you with one caveat. Direct care of a patient, hands on, is a more intimate, though not more worthy service. It fills the heart more for many nurses. Yet society will build new systems and many of us will have to move up the academic ladder in order to have the power to defend our patients. My only hope is that in our reverence for the rational, we don’t think less of nurses at the bedside, or more of ourselves as we choose to get more degrees. That adds to our separation from each other and weakens our position as nurses. I think its time to revalue caretaking, revalue nurturing, and give it its place in healing. With the intention of “service” whether in management, at the desk or at the bedside, healing can be accomplished. It’s our lack of harmony and our lack of respect for each other that troubles me. Thank you so much for your feedback.
Carol
I don’t even think in those terms. For me it’s not about the rung I stand on that ladder or the Campbell’s soup of letters after my name. It’s not about who is at the bedside and who is behind the desk. It has nothing to do with the ‘healer.’
It’s all about the patient. How can I best meet the needs of that child or that father? How can I best relieve the pain and help the healing? How can I ease the suffering?
That is at the heart of what I do.
And I do that wether I am holding a hand, or sitting behind a desk, or standing in front of a chalkboard, or looking into a microscope.
Vocation-profession it doesn’t matter. I do the verb: Nursing.
(And I agree with you about that lateral violence stuff)
Linda, I love how you think. But do you think people can be taught that or they’re just born that way? I also think of my patients as the end game, always, but I have seen too often that some nurses stand on degrees to make themselves “better than” the nurses at the bedside. I’m not trying to devalue education, just to revalue nurturance and caretaking. If you believe there’s a way to help nurses understand whether at the desk, or at the bedside or making policy everyone deserves equal respect, I think that’s great and I agree with you.
Hi Carol!
Although I’m no longer working as a nurse (I’ve been disabled since 1999) and allowed my LPN license to expire in 2000, I still try to stay at least somewhat current with medical/nursing knowledge-especially substance abuse & mental health, which was my primary and favorite area of nursing. I try to volunteer, when my health allows, at a local “Wellness City” (a self help center for those with SA/MH challenges ), so I must stay well informed on these issues. I too look on education as a tool to improve patient/client/consumer outcomes, and not a “rung on the ladder of upward mobility”.
I just posted a comment today how at age 17 years, no resume, no scrubs, walked into a surgeon’s office and convinced him he needed an assistant and with two weeks of on the job training, and with some common sense I was able to assist him as he prescribed. I went on to college to graduate years later as a registered nurse but I always stop and say how do they manage to have a baby or breast feed a child in Africa without a bachelors degree we could offer so much more if we could bring intuition and common sense to the table
Forgive me for sounding ignorant but let’s return to the very core of our degrees… WHY we decided to be come a nurse albeit LPN,RN,CNP ! Surely no one said-I want to be an adminstrator and wow-the nursing tract is the way to go !
Yes we need advocates in our profession however why would there be a need for our higher degreed professionals unless we are providing direct patient care,assessing,etc.
I think in order for nursing to be truly seen as a profession the minimum needs to be a Bachelor’s. We have way too many unlicensed people already in the field that are doing a horrible job and no one is taking accountability. I for one am NOT in favor of these completely online colleges for higher degrees. The nurses come out no better and just pretending to be educated. We need real nurses. More clinically prepared nurses at a higher educational level. Get rid of the OJT people, careless, sloppy and do whatever they want.