YAY! I started yesterday-three classes online, plus a TA position with a level 4 undergraduate class entitled Clinical Instruction for the Rural and Underserved. I started that class today and was glad to meet all the great men and women who are interested in serving rural populations in New Mexico and around the world. I will be assisting in facilitating their class while the professor takes some of the students to Bolivia for clinical training. I wish we had such a class when I was an undergrad (although I wasn’t in a BSN program) as these students are being given a great opportunity to apply their skills in an international setting. I know that participating in this class will give me the ‘refresher’ that I need (having been out of nursing for five years) and get my brain rolling again. Our professor really seems to have her finger on the pulse of learning opportunities that are available throughout New Mexico and I hope to be able to participate in some of these clinical experiences in the coming months.
I began reading about Nursing Theory yesterday and today- a subject I am very interested in. For many years, nurses have attempted to legitimize the profession by trying to come to some consensus on how we should be thinking, and presenting ourselves to the health profession and the general public. I have my own theories about how we should do this, as I have outlined here-especially in my critique of evidenced-based practice and how it relates to nursing. I have been really pleased with the reading so far, although I haven’t agreed with all the concepts. One that I do agree with however is “The Rhetoric of Rupture: Nursing as a Practice With a History?” I wish I could share, but you need to subscribe to a medical journal to get the full article. The basic premise states that nurses and those that represent them have done a great disservice to the profession by continually trying to redefine the profession to appeal to young people, while discounting the accomplishments of the nurses before them. Anyone who has practiced as a nurse knows that our jobs do and always have required high levels of expertise and critical thinking that would be interesting to any contemporary woman (or man) but that the institutions within which we must practice preclude us from realizing our full potential and seek to undermine our accomplishments (and essentially give MD’s all the credit for them).
Historically, we haven’t been in a position of power or influence as a predominately female-centered profession, nor do we (mostly) sing the praises of our profession to others. The truth is, that we are trained for, and have the brain power to perform tasks that require a wide range of diverse and challenging skills and often DO perform these skills. The problem is that when we do, it’s usually in a clandestine way as it’s often “technically” ‘against doctors orders’, or we have called the MD to tell them what needs to be done, and they say “sure, go ahead”. My feeling is that the supposed ‘autonomy’ of practicing as a nurse is basically non-existant (in a corporate hospital environment anyway), and that makes nurses who were told they would have all this power to influence the health of their patients and be able to practice somewhat autonomously are being sold a bill of goods. Frustration among nurses, when they have to perform tasks against their better judgement at the direction of doctors, runs rampant. Are we willing to tell our friends and family that the only way we practice autonomy is by breaking the rules or lying? It’s no wonder that most nurses don’t encourage their daughters, sons and other family to enter in to the profession. The whole medical model needs to change. It won’t change until medicine and nursing (and perhaps other health disciplines) are taught to honor and respect one another’s knowledge base. But, nursing can’t seem to get to the first step- explaining exactly what that knowledge base is and why it’s important (Nursing Theory). How do you quantify advocacy, ethics, morals, intuition in the face of a ‘scientific’ profession that won’t even acknowledge qualitative research? I simply don’t know.