A profession looking to gain more prestige through academia
Nursing has been very good to me. It has helped me grow as a person and given me insight and skills that helped me become a better husband and father. For the most part, my career has been fulfilling. However, I think the profession has been losing its way for some time.
Ours is a caring profession, and there is a long-held belief that we choose it for ourselves for that reason. We have compassion, we want to care for others, we believe in human touch. It’s not rhetoric. And because of that, I personally have never felt the need to take actions to legitimize the profession or apologize for its emphasis on caring. I wish I could say that is true for nursing as a whole.
Academically focused training is a big part of the problem, promoting the concept that more is…well, more. At one time, nursing schools admitted students based on their marks, commitment to volunteerism, past work experience, interviews, references and performance on an essay explaining the motivation for pursuing this career. Now, those selections are based on who has the highest GPA, a practice that eliminates a huge number of otherwise worthy candidates. Do high marks in high school make for a better nurse? Interestingly, many medical schools are reverting to assessing more subjective criteria in addition to looking at GPA.
I had a placement in a long-term care facility during my first semester in nursing school. I was then able to secure casual employment for the remainder of my time in school. Nowadays, many students are not introduced to the clinical setting until third year; the schools justify it by saying students are better prepared at that point. But early exposure to real patients, to opportunities to build relationships, develop skills and flex compassion are critical, aren’t they?
When I was a nursing manager, I would hire new graduates to work at the bedside who then demonstrated they were clearly not practice ready. Their clinical and people skills were not up to par, and this must have been partly a reflection of how they had been taught and who had taught them. From what I’m seeing, the number of instructors who have ever actually nursed is shrinking. And by “nursed,” I mean six 12-hour shifts in a row, working understaffed, not being able to get a bathroom break, having people die in your arms. (And doing it year in and year out — not just on a casual basis or for a few months between getting licensed and starting a master’s degree.)
I don’t believe that nursing schools employ equal numbers of experienced clinical instructors and research-driven professors or that they provide students with enough real-world experience. Caring for people, not preparing for careers in research and management, needs to be at the root of nurses’ training. Unless there is a better balance in our education programs, we might as well agree that we will have to eventually adopt a hands-off approach to patient care and limit ourselves to doing computerized care plans and coding. Is that how we want to prove our worth?
A quotation from H. G. Wells comes to mind: “Losing your way on a journey is unfortunate. But, losing your reason for the journey is a fate more cruel.” We can try to find our way back to the path or stop the journey, reassess and start over. Hopefully, our predecessors left some bread crumbs to guide us.
Editor’s Note: The views expressed in this column are those of the author and do not necessarily represent the policies of CNA.