When I decided to go into nursing as a career it just seemed natural. My family included a long line of nurses. I had listened to the stories of experience for many years, the good things about it and the bad. I felt I had no blinders on regarding what the life of a nurse entailed. I was always ogling my own mother’s nursing textbooks, looking at pictures and reading. So I did attend nursing school in the early 1990’s. Nursing school in itself is one of the most stressful programs you can attend. I can tell you that this much is true. The aspiring nurse must have much stamina to make it through. I often wonder if this is a “rite of passage” of sorts, they make it as stressful an experience as possible without encouraging everyone to drop out. The strongest do survive. Though there are numerous things about nursing that will never change, but on the flip side there are a number of things that have changed throughout the years. No longer do we live in the era when a nurse had to stand whenever a doctor walked into the room. This career is evolving like many others and some of the changes are for the better and others are not.
I was first a charge nurse shift at a nursing home. This was back in a time when there wasn’t as much paperwork to attend to and more time to attend to your actual patients, or residents as they call them in the long-term care setting. For example, when I started, I actually had time to assist my nurse assistants give baths after finishing my paperwork and treatments and medication passes. Not any longer. Now there are special forms for everything and everything needs to be documented in multiple different places in stark contrast to nursing school teaching that taught that charting it in one place in the chart was enough.
I learned much about various types of senile dementias. Many patients who suffer from these can engage in behavior risky enough to injure themselves and others. Back then, it was also perfectly acceptable to use chemical or physical restraints on a resident who was being a danger to themselves, now it is not very acceptable. Actually, then it was more of a liability not to do so first and get the physician’s order after than to allow a person to injure themselves before you get it. In the here and now, you had better practically sit on top of the patient (not literally) monitoring them while you try to push through an act of congress in order to get an order for any type of safety restraint whether it be physical or chemical. Now, it even needs to be worded with special language that does not even mention the word “restraint” and at times that is pretty tricky to accomplish.
Back when I started nursing, jobs were easy to get. In reports we all have heard about the “nursing shortage”. Guess what? It’s always been there. Today however it would seem that either the shortage is being filled rapidly or that people have learned to work with the shortage. One example is that when I would chase after an open position, in most cases all an employer needed to know was that I currently had an active nursing license with no restrictions. This is no longer the case. My son who recently graduated from nursing school is finding it much more difficult to get the job he wants in order to obtain the experience he needs to pursue a higher degree. Why? No experience. It appears as if with no experience, facilities want to push “new grads” into a very limited number of “externship” slots. These externship slots are very much like the required “clinical training” hours that a nurse has to do while in nursing school and are required by the state board of nursing in order to be licensed. Many years ago, your education was sufficient for you to start, and everything else you needed to know you learned as you went with the assistance of more experienced colleagues. The result is that in some places we now have new nurses who have to wait many months to get their first real job.
One other thing that has changed is that there are more men going into the traditionally “female” field. This is a good thing except for the simple fact that time after time I have seen the female nurse with over twenty years of experience on the hospital floor who never gets promoted any higher. In the same unit have seen the men who graduated just a few short years before get offered higher paying positions and get promoted much faster than even the most experienced female. I do not dare to speculate whether or not this was due to a lack of motivation or not. It’s just something I have seen.
In today’s era, there has been much more of an emphasis on the patient taking more responsibility for their own health through increased decision making and questioning things they don’t know. While this is a good thing many nurses who have worked for decades on the hospital floor have made observations that they now feel they are not much more than “glorified waitresses”. I can understand where this feeling comes from since it used to be more common for patients to just do what the nurse/doctor asked and take the medications given to them no questions asked. My feeling is that patients used to feel that their doctor or nurse always knew more about what was best for them than they did. On the other hand patients didn’t know what medications they were taking either and that does nothing to help assist in catching any errors before they happen.
On a positive note many of the changes they are making such as promoting “externships” for new grads, or requiring additional certifications can help to make the professional of nursing just that, a “profession” that commands respect. Although there are some aspects of a nursing career that may not seem as pleasant as they once were, it is still a rewarding career for someone who can adapt to the changes in a positive way.