That's a joke, people.
John (for whom I have immense respect and liking) has a post up on "lateral violence", aka "nurses eat their young with sprouts and bleu cheese." He posts some sobering stats on how many new nurses (defined here as nurses within the first couple of years of licensure) leave the profession entirely or change jobs.
Not to disagree entirely with John's point, but I have a thought on a couple of other issues that face new nurses. I thought I'd expound. Of course I did.
Issue Number One: Nobody Really Knows What The Hell It Is We Do.
We dare to care, yes. We dare to cry. We dare to work out BSA and dosages for neonates in a code. We dare to keep up with changes in legislation. We dare to influence that legislation. We dare to advocate for abused patients. We dare to work in a profession that is historically undervalued. We dare to protect our patients from doctors' errors. We dare to report our own.
In short, we do a whole lot more than caring and crying.
Yet, when I started nursing school, I was the only person in a class of forty who said something other than "I want to help people."
Nursing students are no less clueless than the rest of society. I would estimate that ninety percent of the folks I went to school with thought that a person's warm-fuzzosity was the primary determinant of how they'd do as a nurse. And all of those people got whacked upside the head with the reality of how tricky the job is--not just from the standpoint of interacting with sick people, but from the standpoint of having to be a scientist.
Aside from the one woman who went into school "to meet doctors" and the other who wanted her husband to stop bugging her about getting a job, *all* of the people who wanted to "help others" have left the profession.
All of them. That's fifteen nurses (of the ones that finished school) who have gone back to accounting, or bank tellering, or whatever they were doing before. I am one of six (SIX!) students from my graduating class who is still a nurse. Nobody, apparently, knew that it would be as hard and as intellectually demanding as it is.
At the same time, I'm watching smart young feminists of my acquaintance not enter nursing because of the helpmeet stereotype. Frankly, what this profession needs more of is smart young feminists. Yet we're not attracting them, because nursing is still seen as a pink-collar, nearly-service-industry, "helping" profession. When I talk to women who are working toward their premed degrees about what I do for a living, they're gobsmacked to discover that modern nursing is a hell of a lot more like their concept of being a doctor than they thought.
Solution? We need to be realistic about what we do. We need to tell people, every chance we get, that we are intelligent, trained, scientific professionals who are also able to steer a family through a health crisis or advocate for a rape victim. I am eternally grateful for Pal Angie, who will be getting a newly-minted RN this summer (hooray, Angie!) and who is one of the smartest, toughest, feminist, most realistic people I know. If more people could see nurses like her, we'd have no problem with a shortage.
And if more nurse-wanna-bes understood that it ain't all hugs, we'd have fewer people who ought to be somewhere else.
Harsh, but true.
Issue Number Two: It's About The Stupid Management
Sometimes I feel like a cross between Joe Hill and Emma Goldman, with the Pinkertons about to bust down my door, but it's true: Hospital management is hostile to nurses. Period.
A friend of mine who's also an RN got offered a fantastic bonus for signing on with a particular hospital which shall remain nameless. She showed up on the floor the first day after two weeks of orientation to find herself in charge of one practical nurse and twelve patients. Twelve. All of whom were in varying states of circling the drain because of nursing shortages at that hospital. She walked out after that first day and came to our facility, which (at the time) still cared about staffing rather than the latest technological widget.
We as nurses need to do two things to fix this problem: First, we need to stop signing up for extra work. When I see a nurse who's working ten days in a row without a day off, I don't see a dedicated professional. I see a person with serious issues about saying "No."
Quite frankly, the world will not end if we all start saying "No." The hospital will hire agency nurses or more full-timers, or start paying attention, at least, to staffing levels. Management might actually have to come in and work--and that, my friends, is a truly marvelous feeling, to watch your manager wipe ass for twelve hours because he hasn't had the huevos to hire new people.
Second, and more importantly, we need to agitate for safe staffing levels. When I say "agitate", I mean everything from my own technique (which involves yelling if necessary) to the technique of calmer colleagues (who speak in front of the state legislature). Every nurse can make a difference at some level in this fight. If you're crazy about writing letters and emailing representatives, you can do that. If you're nuts for making middle management uncomfortable, you can do that. And if you get a warm, fuzzy glow from saying "No" to extra shifts, you can do that.
We as nurses do need to shut the hell up and stop putting new nurses through a gauntlet. Nobody's going to be tougher, or faster, or smarter for being abused. There are, however, *systemic problems* that I think are a larger threat to the profession as a whole. We need to spend the breath we'd use debating how, exactly, we eat our young fixing those.