|
There isn't a person around who hasn't heard or read
about the nursing shortage. This shortage, while becoming
more politically intoxicating to discuss, has become
a media endorsement for hospitals.
Daily, we read about the wonderful bonuses hospitals
are offering to recruit nurses; we read about their
inability to admit patients because of the shortage.
Legislation is pending regarding nurse/ patient ratios.
You probably know that capping the census allows the
nurse to practice safely, but did you know that the
money the hospital loses is being looked upon as potential
nurse salaries? This is an appalling notion.
It places blame upon nurses rather than the institution
and its antiquated perceptions of the non-importance
of a nurse. The notion of mandatory shifts is absurd,
but even more outrageous is the belief by nurses that
we cannot empower ourselves to do not only what is right
for the patients and the institution, but for ourselves
as well. Why do we allow the perpetuation of this type
of thinking, and how do we articulate what a nurse is
and what we do?
The answer begins by identifying the four realms of
a nurse's job that directly affect patient care. Once
identified, we can move toward changing the perceptions
of those outside of nursing and empower ourselves to
create a new reality.
Mental realm
A strong disease-based medical education coupled with
strong psychosocial education give the nurse the ability
to care for the person within the context of the disease.
In other words, nurses assess the human response to
the patients' unique illness and intervene appropriately.
Nurses have been educated to intervene with this human
response. Nurses are also the most knowledgeable professionals
in skin breakdown, and because this is a multimillion-dollar
loss for insurance companies and patients alike, it
represents an incredible demand on a nurse's assessment
skills.
Likewise, nurses know pain. No other team member is
with the patient long enough to see the minute changes
in a patient's pain level. Traditionally, the realm
of pain control has always been with the nurse.
A large part of a nurse's job is health promotion and/or
maintenance. This can be accomplished through extensive
patient education or simply by explaining to the patient
the rationale for a particular intervention. Research
has shown that nurses improve patient outcomes.
Physical/technical realm
The nurse is the patient's advocate. A day consists
of not only integrating the efforts of the medical team,
but also implementing those efforts.
A nurse doesn't just feed the patient, he/she is watching
the swallowing process, assessing functional capacity,
monitoring nutrition and assessing the patient's needs.
When ambulating a patient, gait stability and safety
are assessed.
Nurses are trained to assess the minute changes in
a patient's health status and, oftentimes, that assessment
can make the difference between a simple remedy and
one that requires more extensive monitoring.
Emotional realm
Because the nurse is trained to assess the human response,
psychosocial issues are an integral part of the work.
For this, the nurse draws upon his/her educational background
in clinical psychology.
Again, nurses are educated to respond to the human
response within the context of the disease.
It is the nurse who listens to the patient's fears
regarding a diagnosis and offers emotional and educational
support. It is the specially trained oncology nurse
who gives that incredibly frightening and isolating
first dose of chemotherapy while guiding the patient
through every step of the process. It is the cardiac
nurse's competent skills that navigate the high-tech
equipment used to keep a heart attack patient alive
all the while calming the family's fears, again, through
emotional and educational support.
The quiet wisdom a nurse imparts helps to give the
patient the courage to move through the stages of an
illness.
Spiritual realm
Nurses are the people at the bedside who help family
members cope. Many examples can be enumerated.
It is the nurse who offers a comforting hand to the
frightened patient or family member as he/she instructs
them about a new diagnosis and its implications. The
nurse is there when a distraught mother looks to find
meaning in her child's illness. The nurse is the only
team member left after a family has had a miscarriage.
Nurses have the difficult task of helping family members
say that important goodbye as their loved one is making
the transition to death.
A nurse's job is mentally, physically, emotionally
and spiritually challenging, and who wouldn't argue
that the rewards are great? However, no one is arguing
rewards. We are arguing shortages, salaries and power
struggles. We are arguing within a cultural ideal that
still sees nurses as liabilities. We are trying to quantify
the most important (and human) of issues-as if being
human can be given a price tag.
Unfortunately, in our society, these issues do need
a price tag. Nurses need to be financially compensated
for, arguably, the most important task in medicine-caring
for the human behind the medical diagnosis.
Can we quantify the nursing profession? Yes.
Empower the nursing profession by showing your professionalism,
getting involved in the issues facing nurses today and
getting involved in the issues facing medicine today.
Empower yourself by realizing that you are in a position
of power. And, above all, remember that the traditions
upon which nurses were educated stand as a foundation
upon which to soar.
The time is now. The person is you.
|
