Nursing: Trading the Vocation for the Profession
I don’t get it. I love education so why do I hate the new mandate 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.
I spent days trying to figure out why I felt the way I did about the new nursing mandate. 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 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 I did.
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. 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 profession. That wasn’t my calling, that wasn’t what fed my soul, it was neither my path of 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 sacrifice, 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 mandate 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. Why now, at the very brink of these discoveries, would we settle for being Professionals when we once had the opportunity to be true Healers?
I appreciated your comments very much but as RN in school as we speak to get my bachelor’s I believe that we can do both. It does not have to be one or the other.
I so hope you’re right and maybe if we can all keep the importance of direct patient contact in mind, we won’t be overcome and inundated in paperwork which “covers” the hospitals and insurance companies rather than adds to the excellent care of patients! Congratulations, by the way, I am really happy that their are young nurses in school hoping to accomplish all you want to. 🙂
My career path was very similar to yours, only 16 years as an LVN and now another 16 years as an RN with an associates. I say “almost” everyday, nursing isn’t fun anymore! I intentionally work 7pm to 7am because I can interact with my patients actually a little more! I don’t think present day nurses understand what our role as caregivers really means. I have long said that every nurse should be a patient, every doctor should walk in a nurses shoes, nurses from specialty units need to work on med-surg units. I worked into the dayshift (charting) about an hour the other morning; I couldn’t help but hear all the callights going off up and down the hall as I walked toward the elevator. The on-coming nurses? Most of them were at the nurses station reviewing labs, checking for new orders, crossing t’s and dotting I’s.. I’m sure it doesn’t cross any of their minds that some of those patients are afraid because their IV machine is alarming, or someone set their breakfast down and left the table too far away, maybe they need to (god forbid) go to the bathroom! But, the legality and the responsibility of “treating the patient” has shifted too. The MD used to be responsible for reviewing labs and ordering potassium replacements except in the ICU or other step-down type units! It may be more convenient to have replacement orders on admission but it also holds me responsible to make sure if they need to be given or not!! New nurses have nothing to compare the workload to so they take on all that is taught to them. I tell every new grad; “There, by the grace of God lays you or someone you care about”.