Who Took The Sacred Out Of Service?
I just read the Gallup pole saying that the public trusts nurses more than any other professionals. There was that warm flush of “Wow! Isn’t that great!” before I came spinning back to down to earth again. Why? Why, do they trust us? Do they trust the image of who we used to be, not who we are now? Do they know that in the thrust to be considered “professionals” though we became more educated, we were taken away from our patients’ bedside, and put at the desk to become shills for the hospitals and insurance companies who were not caring for our patients? Are we taking the responsibility and are we acting ethically – as though we should be trusted? Are we still effective advocates for our patients?
One of the things Nursing fought long and hard for was the right to inform, to teach our patients and to protect them from harm. Do we do that now? Do we have the time or intention to keep them from the dangers we know exist in health care today? In the process of our heady ascent did we ever wonder who took the nobility out of Nursing, the care out of caretaking, the sacred out of service? And even more important, the art out of healing.
Hey, I know as much as anyone else how little good a defenseless defender is and so I realize we had to fight for the power to change things. I also know that you can’t feed your kids, keep your house or pay your bills on values. But did we accomplish what we hoped for? As soon as we got more degrees and better pay, the “business of medicine” took us away from the bedside and replaced us with caretakers who had 6 weeks of training. We were sent to the desks to make sure others did the “caretaking” well, but without any of the skills it had taken us so long to learn. Unfair to the CNA’s and the patients. The machine of medicine convinced us that we were more important now.
Our degrees did help us learn the science of medicine, but in the process it devalued intention, caring, nurturing, the very things any progressive civilization should offer its weak and vulnerable by social contract.
I wrote the book “The Nurse’s Story” in 1982, and I did two cross country tours. I appeared on television, radio and print to help change the “Image of Nursing.” I wrote for the American Journal of Nurses and for RN magazine because I wanted “us” to be recognized for more than carrying bedpans and gauze pads. Then, I wanted the patients to know that we were more than handmaidens for doctors so they could trust us. And I got my wish I suppose.
The Health Care System did change. Now I know that all of us are working for the insurance companies, that doctors are as powerless as we are, and that as nursing moves on to advanced degrees it often takes us as much time as medical school. It’s all the business of medicine and nursing. The downside is that we too are being bought and paid for by the “for profit insurance companies and pharmaceutical corporations” who are sacrificing the old, the young the disabled, and the poor to feed the corporations that run the temples for the savage god MEDICINE. The truth is that we, as nurses and medical professionals, are party to that plan if only by refusing to look at it-for hiding our eyes.
So, what do I want now? I want the nurses at the bedside to be rewarded and acknowledged for staying there and using all they’ve learned to help the patients heal and go home– for without us there are more and more patients dying in hospitals. According to the latest statistics some 15,000 a month die in hospitals. Bedside nurses should have more status and money. Especially since some of the latest studies on healing show that intention, energy, and caring speed healing.
I want the nurses at the desk to be acknowledged for their education in science, anatomy, physiology and technology, but even more for their sacrifice of not having the rewards of intimacy in helping and healing because they don’t have the time to do it and its no longer their job description except in Critical Care. In my heart I know that no little kid ever dreamed of being that kind of a nurse even if you offered them the superpower of being able to read an EKG and the ability to pierce a vein for an IV quicker than a vampire. Still recognition is important and so is money to support a family.
Nurse Leaders? Those who help make policy and watch a nurse’s back? What do I want of them? I want them to understand the importance of recognizing that compassion can’t be taught but it can be valued and the nurses at the bedside with all the new tools of healing that we can’t yet prove should be respected. They shouldn’t be minimized for it or made less than those with degrees.
Florence Nightingale did a lot of cleaning up, got rid of a lot of invisible germs which carried disease and held a lot of hands in order to offer comfort. She had a calling and she was a healer. She fully admitted she had no clue what nursing was because they didn’t really know what disease was. Well, since her time, we have discovered some causes of disease, some things that keep us well, but the smartest among us know that the Mysteries of Life and Death still exist and no matter what we do, sometimes the healing is one of the spirit and soul not only of the body. For that we can’t write a policy, we can’t do a care plan but we can acknowledge the nurses who can stay and do it.
All nurses lose power by splitting, by not teaming, by not acknowledging the value of each type of nurse who wants to play a part in developing a humane and effective health care system. But sometimes policy makers really believe that what works on paper works on the wards. I want them to know that isn’t so and to take that into consideration.
We could ask “What would Florence do?” and I suspect she would acknowledge that the unseen energy of fear and negativity that exists in hospitals today because of the pressure of the bottom line, is as dangerous as the germs we fail to see. She would know that holding the hand of a weak and vulnerable patient by someone who cares about you while caring for you would make any difficult journey easier. She would also suggest that the nurses who have a calling can work alongside the nurses who are doing their jobs well according to the policies of those nurses who use their degrees with compassion for the good of all healers. She would, in fact, ask that each nurse be the kind of nurse they’d want to have take care of them while they were sick or dying. That’s what I believe anyway. Then we’d be worthy of the trust we’ve already been given.
Carol, I can’t help thinking of hospitals that strive for Magnet Status. They encourage or almost are insistent for nurses to get their Bachelor Degrees because they need a certain percentage to get this special achievement. What does it accomplish for the patient? You have nurses with “bigger” degrees but where is the art of caring and wanting more for the patients instead of status? It doesn’t matter how many degrees someone has or credentials behind their name, that doesn’t make them a better nurse. That comes from the heart. I do get irritated when our hospital has meetings and they bring up phrases and even handed out cards with wording on them on how you should introduce yourself to your patient, and how to speak and acknowledge their name. This to me is downgrading and seems more computerized and insulting to say the least. I love my job of caring for patients and love the nurses I work with. I also love my hospital that I have been working at for almost 24 years. I just wonder if there is too much time spent by upper management on the inconsequential matters instead of on things that matter the most. Those things that would benefit our patient’s, instead of giving them robots that perform give them warm, caring, human souls that love what they do. Those that see the joy of giving and watching out, being an advocate for the patient. That is what is rewarding and satisfying.
Hi Lisa, Yes I agree completely with you and it’s true, giving “fills” those with the calling to heal but not all nurses. What I was hoping to convey was that as nurses, we all have to give and expect respect for the gifts we each bring to nurses. I believe as long as we “buy” that education is what separates us from those caretakers who don’t have it, we will fail miserably to gain the power we need to act as advocates for patients, as well as for nursing itself. If we wanted to be doctors, that’s what we would be. But once you take the “love” out, all the degrees in the world aren’t going to make a nurse a healer. Thank you so much for sharing your vision.
Yes Carol, times have changed. Until the 1940s healthcare was considered a social obligation, not something that generated profits for the private sector. It has gone from a healing profession to a business where profits sometimes take precedence over human needs.
In my humble opinion, I believe that ‘For Profit’ took much of the nobility out of nursing, the care out of caretaking, the sacred out of service and the art out of healing. Because healthcare has become a business, we see aggressive marketers. Many decisions are made based on economic reasons and not medical reasons. If it is not “good business” it may not be done, even if beneficial to the patient. Efficiency is more important than developing trusting physician/patient relationships. Patients are seen as bodies to insure rather than complex individuals with diverse human needs. Profiteers place pressure on nursing professionals and, subsequently, patient care suffers.
I suspect that Florence would be upset with how patient care has transformed. Paper work and bureaucracy have replaced hands on care by nurses with degrees. I agree that the more educated, the farther away from the patient. When quantity takes precedence over quality, patient care suffers.
The bedside nurses are possibly looked at by some as having menial responsibilities and appear low on the social scale. But are they not the most blessed? The dedicated bedside nurses experience supreme serenity from caring and nurturing while the more educated are “bought and paid for” and become shills of the medical industrial complex.
As a physician of 36 years and as a cancer survivor patient, I have always viewed nurses as angels of mercy and caregiving peers. Nurses are considered to be be the most trustworthy because they have proven themselves over time to be trusted–whether it be direct patient care or typing in endless notes to document care to be consistent with policy—the point being that nurses do whatever is asked of them and we all need to be eternally grateful for having them as part of the healthcare team. My thought on what nurses mean to me can be summarized in just two words: Thank You!!
I am currently seeking my BSN overseas in the caribbean. I am so glad I stumbled upon your blogs etc. Reading your blog is awe inspiring, and sure to motivate those in doubt or at the crossroads of their career. Thanks. P.S. are there any plans to make an I-pad version of your book?
Linda, the book is sold on IBookstore. Thank you so much for writing. It helps to know that there are those who can hear what I’m trying to say. Best of everything. And keep your heart open, so you can hear the music of your soul. 🙂