Saturday, June 9, 2007

Just a nurse

Once upon a time, there was a little Monkey. She was very smart, and MamaMonkey had great plans for her future. She did very well in school, got great scores on her SAT and ACT, and had a full ride scholarship to a well-respected university. MamaMonkey was excited at the prospect of a MonkeyDoctor. But the little Monkey didn't have any desire whatsoever to go college. She didn't have the attention span or the motivation. So she declined the scholarship, accepted a manager position at the local fast food joint, and moved out of the family abode, much to the dismay of the MonkeyParents.

Over the next dozen years, the little Monkey grew up. She left the fast food industry and entered the medical industry. She worked as a CNA, first in a nursing home, and then on the floor in the hospital. She worked as an EMT, and then went to paramedic school. She decided that she wanted to be a flight medic. But she wanted to get some experience, first. So she worked on the bus and in the ER.

But life tends to interfere with best laid plans. Things happened. Plans changed. And the little Monkey (who wasn't so little anymore) ended up working as a tech in an ER at the edge of nowhere. She didn't want to be a firefighter chick, and private ambulance pay sucked. She decided to go to nursing school, because after all, it wasn't that much different than what she was doing now, and the pay was better.

Fast forward a few more years. MamaMonkey has never given up trying to talk MonkeyGirl into going to medical school. "Why would you want to be just a nurse? You could be so much more!" MamaMonkey's not the only one on MonkeyGirl's back. A certain ER Physician has also climbed on the bandwagon, and is pushing for her to do something more. If she won't go to med school, she at least needs to go to PA School. She's wasting herself on nursing. Here's what I say to that.

If I'm just a nurse, I'm at the bedside when Mr. Denial has his big ol' freakin' MI. I can start the line, push the meds, and bust up the clot in his heart that wants to kill him.

If I'm just a nurse, I'm right in the thick of things when the kid with epiglottitis needs the tube and the line and the drugs.

If I'm just a nurse, I'm taking care of Mrs. Sweetness when she has her CVA, and I can take the time to explain to her family all of the big words that the doctor just used.

If I'm just a nurse, I'm there to clean all the lacerations and abrasions on the MVA victim who narrowly escaped with her life after the drunk driver hit her head on. I'm there to hold her hand when the cops tell her that her husband who was airlifted from the scene might not make it.

If I'm just a nurse, I hold in my hand the power of the narcotic analgesic. Some deserve to be touched by this power, some do not. It is not for me to decide, or judge. It is, however, wise to not call me a f-ing bitch if you want me to bestow the power of the narcotic analgesic upon you.

If I'm just a nurse, I can take special care of Mr. Neglected, the 80 year-old man whose family doesn't have time for him. I can clean him up, feed him dinner, and make him comfortable while we wait for his useless son to come pick him up. Likewise for Mr. Homeless. But he doesn't have a son to come get him. He'll just be back out on the street in the morning.

All of this, if I'm just a nurse.

28 comments:

MarlaQuack said...

You Go Monkey Girl! At the end of the day you still have to sleep with your self and if you are happy and fulfilled as a nurse tell them to, um, nevermind. You have to weigh is the money/time/effort worth the extra pay and extra aggravation that would go with being the one who sits in the chair behind the sign saying "the buck stops here?" When the day comes that you are no longer happy just being the nurse you will still have other options.

Ambulance Driver said...

Amen, sister! I get the same comments all the time, from nurses who try to convince me to go to nursing school, and doctors who try to convince me to go to medical school.

#1 Dinosaur said...

Besides, tell MonkeyMom you're making more money than you would as a doctor. (At least some doctors, like moi.)

(And by the way, not all of us use those big words with patients, nor do we have nurses to draw our bloods, do our EKGs, weigh, measure and escort out patients back to our exam rooms and take the history for us either.)

911DOC said...

i can't believe any self-respecting ER doc would ever call anyone 'just a nurse'. i couldn't do what i do without them and good nurses save my stupid ass over and over again.

still, if it's even in the back of your mind that someday you might want to be a physician i say do it now. once you become a nurse you might find it even harder to go back to school. good luck in whatever you do.

Gemini Interrupted said...

It was "just a nurse" that managed to help me keep my sanity while my daughter lay in ICU for three days- and I remember everything about her. Can't recall the Dr's name. If you love what you do - you are a lucky woman!

Stephanie said...

I will take a nurse over an MD anyday! When my 28 week preemie was in the NICU--the nurses were my lifeline--I think I met with Dr's twice during his 3 month stay. Let me tell you I got quite an education from my "just" nurses. BRAVO for you! BTW I found your blogg through my "notorious" pediatricians blogg--he of course is the much talked about flea.

karrvakarela said...

I'm new to the blog but I think I would love to work with a nurse who's as committed as you seem to be. It's a helluva important job.

Having said that, I can also understand what the ER doc meant - he thinks you're not reaching your potential and the most obvious way to improve on that is to come up the hierarchy, ie, from nurse to doctor. It was a compliment to your skills and talents.

Come Back Brighter said...

I can't see you ever being just anything

GuitarGirlRN said...

Karkarvela: Not to bust chops, but an MD is not a step up the "hierarchy" from a nurse. RNs and MDs are both professionals who have different roles in the health care system. They are seen by the hospital as coworkers and colleagues--one is not "superior" to the other.

If Monkeygirl wanted to rise in the "hierarchy" she should get her Masters degree and become a Nurse Practitioner specializing in emergency medicine. Then she could work in the same capacity as a PA, but have even more autonomy: in some states, as long as an NP has a current practice agreement with an MD, she does not have to present each case to the MD nor does she have to have the MD sign off on her work.

OK, lecture over. Besides, who in their right mind would want to go through residency? three (or more) years of no sleep and no pay and misery? No thanks!

Barbara said...

Beautifully put! :)

Nurse K said...

Heh--I was a neuroscience major getting straight As with big dreams to go to med school until I got knocked up. Now I'm 'just a nurse' too, and I'm damn glad I am!!! I'll go back to skool and become a NP (not a PA, thank; that's what biology majors who have never worked in medicine and have no 'medical instincts' do, pardon my slam).

911DOC said...

question. to move up the nursing ladder do you have to get better and better at patient care, or better and better at paperwork and meetings?

i submit that there's plenty of room for doctors who eschew meetings and paperwork, but less and less room for nurses of the same ilk.

especially someone like you, monkeygirl, being as articulate and opinionated as you are, you might want to jump for the top of the heap lest someone unfairly knock you down.

mielikki said...

I too, am proud to be "just a nurse." Great post.

ERnursey said...

No such thing as "just a nurse" nursing is the hardest, greatest job you'll ever do.

Joeymom said...

Nurses rock. There is no such thing as "just a nurse."

When my first was born, my gall bladder went bad- I was still in the hospital from the c-section. It was the nurses who figured out what was going on, because they had seen what I could take- the doc (and the floor nurse) kept saying it was "just gas." The NICU nurse and the nurse for my OB saw what shape I was in and they both pitched a fit until the doc sent me for a sonogram- and lo and behold, I really was in pain! Funny that. (I vaguely remember the NICU nurse, who got involved because we had to send the baby back to the nursery because I was in too much pain to feed him, saying something like, "this lady hasn't even taken the percocets because she's saying it doesn't really hurt that much... and now she can't move because she's in pain? The lady who has been walking all over this floor for two days? And you think this is GAS? What planet are you FROM?")

SeaSpray said...

Nurses are angels on earth! Thank God for nurses and doctors.

If you are happy with what you are doing - that is a gift because not everyone is.

I think he meant it as a compliment in that he obviously sees your are capable of even more.

I will always be grateful to my wonderful nurses. I also have the utmost respect for the nurses I have worked with in the ED and around the hospital. They work hard and are truly dedicated and compassionate people and a lot of fun. :)

Amanda said...

The "you should go to med school" thing always gets to me. People just don't get that that nursing and medicine are two different professions. When you want to be a nurse, being told to be a doctor instead because you're "too smart" to be a nurse is a flat insult.

Intelligent people are too smart to care for people? Too smart to do all the things Monkeygirl just listed?

But if you're dim, it's kinda hard to make it through A&P from what I understand...

Good grief. I'll take nurses with good heads on their shoulders any day over some lackwit. And those who say "just a nurse" might want to consider the potential impact of an entire profession filled with mental midgets who will then control their future hospitalizations.

Angry Nurse said...

I may just be a nurse but I'm the one who watches and cares for the patient for the 23 hours and 55 minutes a day once rounds are over!

karrvakarela said...

guitargirlrn: "Not to bust chops, but an MD is not a step up the "hierarchy" from a nurse.

I'm not saying it is but simply that the ER physician may have assumed so. It's quite a prevalent attitude/misconception.

girlvet said...

monkeygirl...you be my hero...

Nurse K said...

question. to move up the nursing ladder do you have to get better and better at patient care, or better and better at paperwork and meetings?

Staff nursing is quite the dead-end job. You get pay raises based on "number of hours worked" not "how good you are". You could MAYBE move into management after 20 years of staff nursing; otherwise, you would need an advanced degree. The choices for nurses to advance are mostly limited to:
1) Nurse Practitioner, masters degree
2) PA, master's degree (although no self-respecting nurse would be a PA vs. a NP when given the choice)
3) MHA (Master of healthcare admin) leading to a manager/non patient-care position (paperwork/pie charts)
4) Assistant nurse manager (AKA "The perpetual charge nurse who does some special projects as well"), may or may not need an advanced degree, but usually need a lot of years of experience.

GuitarGirlRN said...

Let's not leave out nursing education! Part of the nursing shortage is due to the fact that there are not enough nurse instructors to teach the people who want to go to nursing school! My mom was a critical care nurse for 20 years before she got her masters and became a nursing instructor (and dean of a nursing school)--and just retired after 30 years of teaching nursing, ultimately influencing generations of RNs (including me!). I plan to teach when I can't race around the ER like a maniac anymore.

Nurse K said...

Yeah, but you'll take a pay-cut or, at the very least, make about the same as you would as a staff nurse, so is it really an advancement to get a higher degree and take a paycut from a bachelor's degree position? That's why I didn't include it.

Wanderer said...

Yep, proud to be "just a nurse." Awesome post Monkeygirl!

poody said...

I hear ya sister. I have never ever wanted to be anything else than just a nurse!

marachne said...

Hey, Nurse K, what about PhD?

OK, some may argue that one could concievably take a pay cut from staff nursing to go into academia, but not necessarily, and it certainly isn't a dead-end job...plus it's a hell of a lot eaiser on your body, and you get to influence the next generation of nurses(as GuitarGirlRN pointed out), plus, for some of us, the intellectual stimulation, and the opportunity to do clinically-relevant research is exicting.

Of course, the same people who can't understand why someone that smart would want to be "just a nurse," don't understand how/why nurses would do research. Sigh

student dr. blaze said...

GuitarGirlRN mentioned above: "Besides, who in their right mind would want to go through residency? three (or more) years of no sleep and no pay and misery? No thanks!"

The process of becoming a physician is actually worse than that...she left out the four years of school that land you with ~$250K in debt and leave you with no self-esteem by the end. <--mention these stats to anyone telling you to go to medical school and it will shut them up fast. I'm beginning to think that medical students are the stupid suckers in this system--I know because I am one. :-}

Besides, the medical system could not survive/exist without nurses. People like you who are in the trenches every day, putting up with the majority of the crap that comes through a hospital--you're the heroes, IMHO. I have no doubt that I'll learn more about taking care of patients in my career from nurses like you than I ever will from faculty physicians. And for that, I will always be grateful. Thank you for all that you do! :-)

Anonymous said...

My mother and her sisters were all nurses, and loved it! A couple of them really wanted to go to med school but their parents forbade it (this was back in the ol' days). My mother was dedicated to excellence in nursing, kept up with medical advances, etc. She was a very compassionate, energetic person and much loved by her patients. At family gatherings, nursing was off-topic until the sisters went off for their own gabfests. I always wished I could successfully listen in on those conversations! I did hear a lot of laughter! There were several doctors in the extended family, too, but they were pretty much stuffed shirts and not so much fun.