Something that I’ve noticed recently is the tendency within this profession to self-impose limits and roles on ourselves as nurses.

We are LPN’s, RN’s, NP’s, CRNA’s, CNS’s…yes, there are different roles and responsibilities for all of us but there is one huge commonality…we are all NURSES first.

It pains me when I see people making a big deal out of the differences in letters. I realize that there are legalities, and tasks that can only be performed based on which nursing degree one holds. I am not arguing that fact.

But it’s the inter-professional division that bothers me. A coworker (somewhat) jokingly referred to the meaning of her LPN status as “Lower Paid Nurse.” It was said with a smile but underneath I sensed some discontent. She has been a nurse at least four times as long as I have, and is a person that I know I can go to when I find myself with a question about patient care or bed flow; the fact that she is an LPN and I am an RN is insignificant.

I have heard of  LPN’s referred to derogatively by RN’s as “Let’s Play Nurse” compared to the “Real Nurse” RN. This turns my stomach and makes me sad.

I have also seen newer nurses who are (rightfully) proud of their new status as GN’s or fresh RN’s but who tend to lord it over the LPN’s and C N A’s on our team. These are the nurses who don’t want to change a bedpan or ambulate a patient; they are the nurses who haven’t realized that a bed bath is a great assessment tool and a way to connect with a patient. This type of attitude makes me sad as well.

Our common denominator, no matter what the degree, is the N in our titles. We are nurses first. We are all out on the front lines, we are all caring for the patients. We’ve all “been through the war” of nursing school, and sat for the NCLEX. 

We all put our scrubs on one leg at a time, people. I just wish everyone could remember that.

STRESS?

Yesterday I had the (dubious) pleasure of answering a health-questionnaire. The lady administering it was asking all the normal questions and then got to this one:
“Are you under any stress?”

I stopped and had to think. Am I?
It’s true that I work long hours (but only 3 times a week)
It’s true that I have a husband with cancer (but in remission)
It’s true that I have money worries ( don’t we all?  )
It’s true that I have a teenager and a 20 year old (but they are both good kids)

Nah, I thought. I am really happy with where I am in my life.
I work hard, but it’s my dream job, and its something I am good at. I love my family, I adore my kids and the money stuff is always going be there. Long gone are the days when $100 had to stretch for a week. I opened my mouth to say “No” and before I could, the (misguided but earnest) lady said “Oh of course you are! You’re a nurse and you work long hours! I don’t know how you can do that, and in the Emergency Room no less! Oh yes, you are under LOTS of stress!”
She not only circled the ‘yes’ answer, she underlined it several times.
I was flummoxed.
I <em>guess<em> its a stressful job. I know that I go to work sometimes more tired than when I came home the night before. I know that I deal with a lot of things in the course of my workday that would likely make others cringe or vomit.I’ve seen people at their best and at their worst. The truth is, though, that my job is the ED is the LEAST stressful of any nursing job I’ve had. Sure, there are lots of quick decisions to be made, and there is always the hovering potential of disaster. Yet this busy place is so much better than floor nursing.

The Docs, NP’s, PA’s are always right there. No more must I page an unknown doc, only to wait for a call back and getting it, be told (crankily, more often than not) that I paged the wrong person.No longer do I have to try to decipher strange orders and strange handwriting, and then page the doc. I can just ask since the provider is generally right there. Along those lines, no longer do I have to check, recheck, triple check and then just simply rewrite the orders that have been mis-transcribed. We don’t have MAR’s, we just have order sheets. Written by the provider and handed directly to the nurse.
In the ED, we have more autonomy than I ever had on the floor. If I paged a doc when I was a floor nurse because I felt a patient needed something, I would have to wait for the doctor to come, evaluate the patient, and write the order. Sometimes they would give me a verbal order, but more often than not, they’d want to see the patient as well. And if a patient requested to speak to her provider, it was the same rigamarole of paging and waiting.In the ED, I just walk up to the provider and tell him or her if I think the patient would benefit from something. More often then not, I am told “Ok, what do you think they need?”

Imagine that–being treated as a peer! One of the Attendings recently told me that he trusts the ED nurses implicitly and if one of us tells him a patient might need this, that, or the other, he listens and generally agrees.
So stress because I am a nurse?
Nah, not so much.

Stress from the gym I just joined however, (the reason for the health questionnaire), well, that’s a different story…