Friday, July 24, 2009

Are Passion and a Calling Pre-requisites for Being a Good Nurse?

Several years of news about the nursing shortage, and now the recession, has made nursing a popular career choice. And, it is a popular choice for those seeking a second career because, in part, it is viewed as offering job security. For decades it was assumed that those entering the profession had a calling and a passion for the work before they’d even set foot in a nursing school classroom—in fact, it seemed to be a requirement. Even nurses were of that mindset, and many still are.

Recently, there was a comment posted on a forum by a nurse who was miffed when she heard a second-career nurse say, “I wish I’d gone into nursing first because it’s a recession-proof job.” Nurse Miffed is of the opinion—and I’m paraphrasing here—that someone who chooses nursing for job and salary security can’t be dedicated to the work.

I disagree. I have first-hand experience as a nurse who felt neither a calling to, nor a passion for, the profession. I grew up in a middle class family, a child of parents who never attended college. They wanted us to have the opportunities that had been out of reach for them but they didn’t have the experience to advise us about career choices and colleges. We were pretty much left to our own devices.

In my senior year of high school I knew I should be making plans regarding my life’s work but I hadn’t a clue what that might be. As the sports editor of my school newspaper, I’d developed an interest in journalism, but such a career seemed so abstract I couldn’t grasp it. My hometown was a mostly agricultural community of 1,200 people that hadn’t produced a single journalist ever. It felt like a make-believe job and I am nothing if not pragmatic, so I thought I should seek something more practical.

It was an era of television medical dramas and I was an avid fan of those programs. Watching the medical shows planted the seed of thought that maybe I could do what the nurses on TV were doing (which wasn't much compared to reality) and that is how I decided upon a nursing career. No calling. No passion. Not much thought at all. I suddenly found myself in nursing school where our instructors wasted no time whipping us into shape. I followed the rules (mostly), did what I was told (mostly) and found that I not only had some talent for nursing, but also really loved most aspects of it. By graduation our class had shrunk by nearly a third. Some of those who didn’t make it to the end had a passion for the profession, had wanted to be nurses since childhood, but in the throes of school they discovered it wasn’t what they’d imagined and their bubbles burst.

I think salary and employability are factors we all think about when considering a career, so why should nursing be put on a pedestal as being something we would pursue, no matter the wage or job possibilities.

I have used this quote by Diana Mason, PhD, RN, FAAN, former editor-in-chief of the American Journal of Nursing, a couple times before but it is so wise and so true, it needs to be repeated: “It does take a special something to be a good nurse, but it can be learned—with proper desire, skills can be gained.”

I’m certain there are untold numbers of caring, highly skilled nurses who, like me, arrived at nursing school without a passion but, with guidance from superb instructors, learned to be good nurses.

Be honest. Was it passion and calling alone that led you to nursing? Did salary and job prospects affect your decision? Please weigh in here.

Friday, July 17, 2009

Question for Nurses: Will You be an Organ Donor?

Today I noticed a question on a nursing forum asking how nurses feel about organ transplantation. The questioner wants to know if nurses would be donors and would they donate organs of family members if the decision fell to them.

For me, that is an easy question to answer. There is a young woman in my small town who received a heart transplant as an infant, due to hypoplastic heart syndrome. It has been a joy to watch her progress through the years. She was a darling child with a cloud of blonde curls whose mother dressed her to the nines—she always looked like a little doll. As she grew up she showed a talent for athletics and participated in national sports events specifically for transplant recipients. She is now attending college out of state and thriving.

One of the smartest, kindest and most mannerly men I know is alive today thanks to a heart transplant he had several years ago. He and his wife make annual trips abroad to visit their daughter’s family and revel in the fact that he can participate in all sorts of activities with their grandchildren. Not only is he alive but also extraordinarily full of pep.

Another dear friend is no longer tethered to a dialysis machine three days a week because a family agreed to donate the organs of their son following his death in an accident.

Yet another friend just received his second liver transplant. The first one was successful and performed well for several years before the need for the second transplant presented itself. Life is, once again, back to normal.

When I see these results and count the years of productive living the transplants have collectively added to the lives of my friends, how could I not be an organ donor? My driver’s license designates me as a donor. The same is true for my husband and daughter.

I have a neighbor who graduated from nursing school a year ago and works in an emergency department in a neighboring town. Last week, while walking past her house, I noticed an interesting bumper sticker on her car. It read, “Don’t take your organs to heaven. Heaven knows we need them here.” That says it very well, don’t you think?

So, nurses, how do you feel about donating your organs? Will you? If not, why not?

Friday, July 10, 2009

The Possibility of Hepatitis C Through No Fault of My Own

Back in December I was scheduled for surgery at a big-city hospital and doing a lot of hand wringing in this blog as I worried about the possibility that C. diff, a nasty little bug prevalent in hospitals, might complicate my recovery. Everything is relative, as they say, and now, more than six months post-op, I’m wishing I could broker a deal to contract C. diff in place of what is hanging over me.

I returned home from a long July 4th weekend spent with no newspapers and no television, to hear a shocking item on the ten o’clock news. A hepatitis C-infected surgical tech in the OR where I had my surgery has admitted to stealing syringes of Fentanyl from anesthesia carts and replacing them with her used syringes filled with saline. Her employment in that OR spanned nearly 6 months, placing me among the 5,700 at-risk patients who had surgery during that time.

The registered letter notifying me of the dreadful circumstances was delivered the next day. The same afternoon I had a blood draw and was told it could be as long as two weeks before the hospital notifies me of the test results. So far, ten patients have tested positive for Hep C.

I have no idea what the odds might be that I could be a victim of the syringe switching tech. There are 5,700 of us patients and just one of her. How many cases she might’ve assisted each day, I don’t know. I’m sure odds makers in Vegas could give me the numbers, but it is a worry any way I look at it. The good news—and I’m hanging on tight to this—is that 15-25% of Hep C patients won’t get a chronic infection and 90% of Hep C patients are likely to recover if treated within six months. I, unfortunately, passed the six-month mark on June 10, but maybe that is close enough to still get a good outcome.

It has been reported that even if the hospital had known the tech had Hep C, disability law would not allow the hospital to treat her differently than other employees. How much sense does that make when we’re talking about a surgical tech’s individual rights versus public safety, for crying out loud?

So, I’m biding my time, trying to maintain a positive attitude and hoping for the best as I await my test results. I’m just sorry that anyone is going to suffer because of this debacle and the fact that the tech faces a life sentence is small consolation.

Tuesday, June 30, 2009

Nurse Dramas---Helping or Hurting?

I’m surprised by my interest in and excitement about the new nurse-centered TV dramas, Nurse Jackie and HawthoRNe (and Mercy projected to debut in the fall lineup). I suppose that some of my reaction is in response to the efforts of Sandy Summers who, as the former voice of The Center for Nursing Advocacy and presently that of The Truth About Nursing, has kept a close eye on TV medical dramas and diligently campaigned for the accurate portrayal of nurses and nursing.

Summers communicates frequently with writers and producers, calling them to task for relegating nurses to insignificant roles while showing physicians performing the lifesaving skills that nurses do every day. She was told, time and again, that the viewing public is simply not interested in stories about nurses, only physicians.

From reading the accounts of her interactions with TV brass, it certainly appeared that Hollywood had its heels dug in and no changes were forthcoming. I am very curious to know if it was Summers’s persistent urging, or something else, that motivated producers to give nurses a chance to star on the small screen in not one, but three, shows—a remarkable about face.

Writers have given Jackie and Hawthorne powerful roles but also personal foibles, namely Jackie’s prescription drug addiction and Hawthorne’s rebellious daughter, in addition to questionable behavior on the parts of both nurses.

It’s early in the game but the shows are stirring up controversy within the nursing profession. The Center for Nursing Advocacy wants to explore this controversy and is asking nurses to respond to the Center’s discussion board to voice their opinions.

Go to the Center’s Web site, click on ‘discussion board’ and tell the Center what you think regarding these two questions:

1. Do you think Nurse Jackie and HawthoRNe are helping or hurting nursing?
2. How can nurses, including nursing faculty, use Nurse Jackie and HawthoRNe to educate their peers and students about the importance of becoming advocates for the nursing profession?

I’d also like to hear your opinions. Please share them here.

Wednesday, June 24, 2009

From Military Medic to Mainstream Nurse: A Few Changes Could Ease Nurse Shortage

A large aging population coupled with too few nurses being educated equals a massive shortage of nurses. There’s nothing new about that equation. Possible solutions for a fix are regularly bandied about but I recently read of one that is new to me and one that makes perfect sense.

Edward J. Halloran, PhD, MPH, RN, FAAN, associate professor in the School of Nursing at the University of North Carolina, Chapel Hill put the idea on the table in a recent viewpoint article in the American Journal of Nursing (June 2009).

Halloran pointed out that just the U.S. Army alone, among our branches of military, has 13,000 medics currently serving and prepares another 8,000 annually to serve as active duty replacements and also for service in the Army Reserve and National Guard.

Halloran has reviewed the army manual for medics and believes that what they learn is equal to or even greater than that of associate-degreed nurses and RNs who are products of accelerated programs for college graduates with undergraduate degrees in other fields.

While military medics are well trained and could move into nursing careers following their military service, all but one state have requirements for licensure that are road blocks to this transition. Only West Virginia allows discharged medics to sit for some health care practitioner exams, including the NCLEX-RN, without completing further training.

Nursing isn’t the only profession to take a hard line and resist allowing into its fold practitioners who can successfully test, yet haven’t completed certain aspects of traditional professional education, but is that a wise stance?

Given the critical state of our diminished supply of nurses, doesn’t it make sense, as Halloran suggests, that state legislators reassess current regulations to expedite the process for medics to gain RN certification during or after military service?

Halloran points out that beginning in 2011 all branches of the military will, for the first time, train medics together in one facility at Fort Sam Houston in San Antonio, Texas. It is his thought that adjustments be made to increase nursing and medical science aspects of that training program, and gear it to give medics the skills they will need for later certification as RNs.

It certainly does seem that we are closing the door on what could be thousands of potential RNs by refusing to make changes in the certification process. With nursing schools unable to graduate anywhere near the number of nurses we need, Halloran’s idea of morphing military medic training into an as yet untapped source for producing nurses seems truly inspired.

What do you think? Should concessions be made for medics to sit for RN exams?

Friday, June 12, 2009

Will Health Care Reform Exacerbate the Nursing Shortage?

The subject of health care reform is talked about in every sort of media outlet. Newspapers and TV news programs are rife with reports of what is or isn’t happening in the crusade to provide better health care in our country. It is my opinion that everyone should have access to health care but I certainly don’t have the answers as to how it should be accomplished. It is a massive and complicated problem that should’ve been dealt with before it grew to these proportions.

But, let’s just say that, by some miracle, a practical solution is found and enacted. Great news? Problem solved? Maybe new problems?

I frequently write in this blog about the nursing shortage. There are so many aspects to it that it is a fertile subject for ideas to discuss. But, here is an obvious aspect that I hadn’t thought of until I read about it in a nursing newsletter.

Health care reform is intended to help the uninsured and underinsured receive the care they need. If, indeed, that happens, vast numbers of those who have delayed seeking care will likely do so. The nursing shortage is expected to reach a critical stage in just a few years due to, among other things, the large numbers of aging baby boomers who will need medical care. Add to that large numbers of people newly covered in some way that opens the door to healthcare access and the nursing shortage balloons into an even bigger problem.

I am for health care reform. I want everyone to have access to care. I want there to be enough nurses to care for those who need them. We need more nurses! Perhaps the first order of business by this administration and congress should be to solve the problem of how to educate greater numbers of nurses before they do anything to create an even larger shortage.

What do you think? Please let me know your opinion.

Friday, June 5, 2009

What Happens when the Economy Turns Around

The ramifications of the projected nursing shortage have been looming over us for quite awhile. Now, the recession has created an unexpected hitch that, while a boon for the present, could exacerbate a certain facet of the problem in the future. The new problematic aspect concerns the retirement of older nurses.

That retirement is expected to significantly deplete the nursing workforce in the next several years is not a new revelation. The nursing workforce as a whole is older in age than most professions, with an average age of 47, so the numbers make it obvious that nurses will be retiring in greater numbers than replacements can be educated. The exodus was expected to be somewhat gradual, however, with a certain number retiring this year, a certain number the next and so on. But, the downturn in the economy has put a different spin on the whole thing.

Large numbers of nurses who were planning to retire this year or the next, and beyond, have seen 401Ks and other retirement accounts shrink so drastically that they simply cannot afford to retire at this time. The retention of these older nurses has the obvious benefit of continued adequate staffing, putting the problem of the nursing shortage on the back burner for many health care facilities, at least for the time being. But, what happens when the economy turns around? The fear is that the sudden departure, en masse, of older nurses, their numbers having grown each year of the recession, will create a large and critical deficit in the workforce all at once.

It all comes down to the issue of the inability to produce the numbers of nurses needed to meet the demand. Just that one thing, schools having to turn down thousands of qualified applicants each year due to a lack of faculty and clinical opportunities, is so far reaching it defies imagination—at least for me.

What about the retirement issue? Are any of you delaying retirement? What adjustments have you made to your retirement plans? I would like to hear your story.