Monday, 13 October 2014

Do you know why you are a nurse? When was the last time you acknowledged the choice you made to make a difference in the world? Being a nurse is usually by choice and not by chance. Take the time to connect with your reasons you chose nursing and make this a part of your mission statement to make a difference in the world of your patients and your institution. Nursing is at the center of the patient experience even when the world shines the spotlight elsewhere. This article touches on the competition within healthcare and nursing's role in keeping the focus on the patient experience.

This question came up recently when my mother went in for open heart surgery, "Why not be a doctor? Are you happy just being a nurse?" In the course of my mother's surgery, we approached the doctors and nurses on the team with questions, alternatives and options. During this dialogue one of the nurses asked the question I have heard many times during my career as a nurse, "why not become a doctor?"

Competition in Healthcare: Just a Nurse

Last year the Association of American Medical Colleges announced that US medical schools were on track to increase enrollment by 30% between the years 2009 and 2017. Medical school notoriously super competitive would now be opening up more seats increasing the odds of getting in.

For me, nursing was not a second choice to medical school; fear of not getting accepted or of doing the work did not keep me out of medical school. I chose nursing school and for 40 years, I continue to choose nursing as my profession despite having other options.

This question allowed me to reflect again on my decision to be a nurse and the advantages of this decision. It also had me think about this competition within healthcare. Are we not all on the same team?

It is true that physicians get the spotlight in any organization and in any breaking story about healthcare. Even in the current ebola crisis, it was physicians and the work they do that was highlighted, until a nurse became the first person to contract the disease in the US. And then the first response by physicians was to blame the nurse for a "breach in protocol" that exposed her to the deadly virus. This is a scenario that most nurses have experienced at some point in their career.

I remember working in an ICU and losing a patient after he bled out from his stomach, and as the doctor walked the family out of the unit, I overheard him say, "the nurse was not able to get the blood in fast enough..." I felt weak in the knees. I had been a nurse for about 3 years and loved my job and the challenges of blending the art and science of caring in an ICU. I, along with the team of healthcare professionals worked furiously to save this man. I had a blood bath to prove it and when the attending physician blamed nurses, I felt betrayed and confused. Weren't we all fighting for the same end - excellent patient outcomes? In this case, that meant life. This was my introduction to the blame game that does permeate healthcare. Does it have to be this way? I went to graduate school to better understand what was happening in this misguided competition between nurses and physicians.

Competition in healthcare needs to be between the disease and the healthcare system not within its ranks. What is even more important is to learn from every experience. Part of the problem is that nurses and doctors do not really talk to each other. When was the last time a group of MD's and RN's sat down and talked about what it was like for each in their role within your institution? I know when I was at the bedside, in the ICU, I attempted to organize such a meeting and it was quickly squelched by Administration. The explanation was, "no time." I think it is fear. Fear of losing control? The mere presence of fear means control is already lost.

Nursing by its nature puts the good of the whole in front of the individuals performing the duties. The spotlight for the nurse comes within the intimacy of the family unit when the effort and caring are acknowledged as making a difference in their lives. This is true for me and so many other nurses I have talked with. I love being a part of patient and families support system during difficult times of their life (or death).

Physicians are tuned into the disease process while nurses tune into the patient's experience of the disease. The climate today where medication and pharmacology rules has physicians fighting disease rather than supporting health. I chose to support patients during their disease and or struggle with health along the continuum of life. It is the innate strength of the patient that ultimately supports healing. I like being for the process of healing as opposed to fighting the disease.

And it is in finding balance that nursing excels. This is why I believe it is nurses that hold the key to improvements in the culture of healthcare and the end of competition. It is time to stand up, side by side with physicians as partners in the quest for health. It is time for nursing to shift the focus to health vs disease. Nursing is part of the healthcare team and yet quite capable of leading this transformation.

This question that prompted this post, "Why be just a nurse?," is a question all nurses should reflect on and then proudly claim. What are your reasons for becoming (and staying) a nurse? The passion for making a difference, for being on the team and by the side of patients is a worthy calling and one that has changed the world of millions of patients.

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