Leading Through Collaboration, Rebecca M. Patton RN, MSN, CNOR
And, coincidentally President, A.N.A.
Though I didn’t have anything to do with it, the fact that the current President of ANA is a periOperative Registered Nurse is of some significance to me. It may well be to ANA and Nursing in general as well, because of things going on. I’m a member of a community called cynical_nurse, and though I mostly lurk there I do appreciate the purpose. It’s a venting community, where nurses emulate Mother Earth and Volcanoes to keep from self-destruction. Being a Registered Nurse is easy for those of us who want to be... Right. Yeah. It’s not easy. It does take someone who cares, with intelligence, passion, and compassion. Those are my thoughts, not Ms. Patton’s necessarily (though I doubt she would disagree).
One of the lessons from another session this weekend is that cynicism itself is a talent, and can be put to constructive use. Detectives, for instance, need a healthy dose of cynicism. Whether or not we RN’s need it, it’s nigh on impossible to practice Nursing for more than ... well the time period will be individual. But, it will happen. We all develop a certain level of cynicism. The World is a fairly perverse place, after all.
So I take part in cynical_nurse. The Info page there says to the effect that if you’re one of the Angels in White, that may not be the place for you. I hang out because I don’t believe I’m an Angel in White. First of all, I wear scrub green where I practice. Second of all, many of the LJ friends that know me in the Einsteinian Universe (opposed to the Virtual One, eh?) will tell you I’m no angel. And I do get my work clothes dirty, though preferably not bloody because we in the O.R. happen to believe that those Little Red Trucks do a lot more good in the CardioVascular Highway than they do on the floor, my shoes, or my scrubs.
On the other hand, I also do believe in my Profession, that being a Professional carries responsibilities to myself, my colleagues, and my communities. I do believe I make a difference as an RN, and that’s one of the reasons I’ve remained one for 27 years. One doesn’t go into Nursing to get wealthy. One may become quite rich in other ways though. There’s a t-Shirt which Ms. Patton saw at the recent National Student Nurses Association convention, and first heard or saw in Nebraska. There’s an image of Superman on the front (with RN imposed, eh?), and on the back it says, “Save 1 life, you are a hero. Save 1000 lives, you’re a Registered Nurse.”
The office of President of ANA requires a lot of travel. Ms. Patton says she’s on the road between 275 and 300 days a year. This means, the office also requires that the Nurse (because one must be a Registered Nurse to be President of ANA) to take a leave of absence from the place of employment where they practice Nursing. Think about that. It’s a two-year term of office, four if re-elected.
And the big message she brought to us is indeed, collaboration between Nurses is vital to the health and well-being of our Profession. Think I’m being self-centered there? Nursing is vital to the health and well-being of our Society. There’s a growing body of data, produced by objective research, indicating that fewer RN’s providing care in hospitals means poorer outcomes for the patients: more infections, longer stays, increased complications not related to the original problem. Simple solution, increase the number of RN’s providing care. Simple.
Have you heard about the Nursing Shortage? Fewer people want to go into the profession. There’s a lot of reasons for that, not going there in this little diatribe. Suffice this to start demonstrating: there’s 2.9 million Registered Nurses in the United States. Only (well, it’s a big number but bear with me), only 2.4 million are practicing. Nearly 500,000 RN’s are doing something other than Nursing, and I am not at all sure this number measured the retired nurses.
When asked about this (and I don’t know who said it, other than Ms. Patton), it was said that this doesn’t particularly measure a shortage of Nurses, but does measure a shortage of environments in which those Nurses want to practice. Mandatory overtime, fatigue, high patient census’ requiring that mandatory overtime, hostile work environments, and monetary compensation (PAY) which, while much better than it was when I started 27 years ago is still not truly commensurate with the knowledge and skills brought to the Profession by the practitioners.
And venues in which Advanced Practice Nurses are currently providing much needed care, and which the American Medical Association is moving to prohibit or severely restrict Nursing practice. Why? Follow the dollars.
So, this little diatribe is going out to the Public. Not even restricted to my F-list, much less the little filter which includes those RN’s who read my rantings. And some of it is pointed to a few of them... possibly in ignorance. I’ll allow my own ignorance. Possible, though, not.
I’m going out of order a bit here. So what. The Gallup Poll has listed Registered Nurses as #1 for professional honesty and ethics every year but one since 1999. That’s to this current year, so we’re talking about the past eight years, but one, RN’s are considered by the general public as the most honest and ethical professionals they deal with. The only year some other profession beat us was 2001. Can you guess which one? If you say firefighters, you win.
Think about what kind of Voice that gives us, Colleagues. Think about it.
Doubt the power of that voice? Another lesson, this one from Ireland. There, 75% of the RN’s are members of the national professional nursing association. There, the Irish were dealing with Nurse Prescriptive Priviledges, meaning what medications can a Registered Nurse prescribe to treat a patient. Here in the States, this is managed on a state-by-state basis, and is so far considered in the scope of practice of Advanced Registered Nurse Practitioners.
In Ireland now, 100% of RN’s have prescriptive privileges. Using role modeling determines who may prescribe what, so allow me a parable as it were. I’m a Staff Nurse. This means, using the Irish model, I could prescribe medications considered as over-the-counter without needing to obtain an order or prescription from a medical doctor, which is the current situation here in the States. For the more potent medications, ARNP’s receive the privilege.
Parade Magazine (read your Sunday Newspaper much? That’s where you’ll find it.) recently ran an article listing the top 10 jobs which don’t require a college education. Right next there to Auto Mechanics, guess what they listed? Nursing.
Excuse me? Now, for those of you who don’t know, there’s three ways to become an RN. Well, no, there’s one way to become an RN, there’s three ways to get there.
There’s Diploma Programs, though very, very few anymore (and most that still are in existence are affiliated with a Community College or College), founded and run by a Hospital to educate nurses. Both of my sisters went through Diploma programs. Diploma programs must meet the same standards as any other Nursing program for the quality of education they provide. Historically, they were the first means of becoming educated as an RN.
There are Associate of Science of Nursing programs, providing either an ASN or an ADN degree, which are run by Community Colleges. And there is a Bachelor’s of Science of Nursing (BSN) degree, these programs run by colleges and Universities. And yes one may pursue more education for a Masters or Doctorate, but one of those three must be acquired before one can sit for the Board of Nursing Licensure examination.
Um, did you happen to notice the frequency of the word, ‘College’ there? So I am not at all sure how Nursing wound up on that particular list. Also, I hope this begins to point out to those of my readers that aren’t Nurses, just how much education is required to become one, and in the practice of the Profession just how much of it is something you don’t see.
DeCarte said, ‘I think, therefor I am.’ Hopefully you’ve heard that, even if in some joking manner. I, and every one of my RN colleagues on my F-list and in my Profession, think like a nurse, therefor we are Nurses. We’re Registered Nurses by dint of our licenses, but you know, take that license away and we still think like Nurses. You can’t take that away from me. Alzheimer’s Disease may be able to, but you can’t.
So what’s got me so riled up to run on at the keyboard this long?
Simple: remember what I said about the Irish Nurses Association having 75% of all RN’s in Ireland as members? Well, 80% of United States RN’s do not belong to any professional nursing association. Not even their state nursing association, which in good probability makes them a member of ANA as well. So 20% of us are out here shouting our hearts out on issues that affect your practice, your license, and your livelihood by extension. Issues that affect all people’s access to safe, quality health care. Issues which affect safe, non-hostile workplaces. And doctors are doing their damndest to find ways to limit our practice (and by extension pad their wallets), even though we provide a cost-effective, safe, quality service which is in a shortage. In part because those same MD’s contribute to those hostile workplaces.
I’m not asking you to join to help our voices. Yes, there are other things you need to buy. I need to buy them too.
Join your voice to ours, join a professional association, for your patients.
Those of you reading my little diatribe here, check out the ANA. Do a Google to get their web site, but it should still be http://www.nursingworld.org/ for lots more information. While you’re there, check out the ANA Foundation. Why? Make a small tax-deductible donation to help provide scholarships to educate new nurses. Go check out my association’s website, http://www.aorn.org as well. Check out the AORN Foundation too, for the same reason.
OK. I'm off my soapbox. Partly because my seared ahi noodle salad is here, and the beer's great, and I'm hungry.