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Professional Practice; Is Nursing a Profession or a Commodity?
FROM OUR COLUMNISTS Professional Practice Is Nursing a Profession or a Commodity?
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HIS QUESTION WAS posed several years ago by a physician colleague, Dr. Frank Cerra, currently Senior Vice President for the Academic Health Center at the University of Minnesota. Frank is a staunch advocate for nursing and promotes interdisciplinary practice. He “gets it.” Yet his concern for what has been happening to nursing prompted him to ask the question and me to give it serious thought. What is a commodity? The dictionary defines it as “an article of trade or commerce, esp. a product as distinguished from a service” (Random House, 1999, p. 266). Synonyms include “an article of trade [or] commerce, merchandise, product, ware, goods, stock, staple” (Random House, 2000, p. 135). How does nursing look or act like a commodity? ●
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When health care organizations advertise for nurses by using smiling pictures of nurses with only first names and no credentials, or professional models When a nursing assistant or licensed practical nurse is substituted for a registered nurse and the patient’s condition clearly requires the knowledge and expertise of a registered nurse When a staff nurse is substituted for an advanced practice nurse and the situation clearly requires the advanced practice nurse When nurses are kept off senior administrative teams or boards of directors When vice presidents of nursing are silenced from speaking to the media
These are some of the actions that organizations take, sometimes unthinkingly, to promote nursing as a commodity. But there are many things that we nurses, ourselves, do to promote nursing as a commodity.
JOANNE DISCH, PHD, RN, FAAN Director, Katharine J. Densford International Center for Nursing Leadership University of Minnesota School of Nursing, 308 Harvard St Minneapolis, MN 55455 © 2003 Elsevier Inc. All rights reserved. 8755-7223/03/1902-0000$30.00/0 doi:10.1053/jpnu.2003.21
We do this when: ●
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We refuse to wear name tags or allow name tags to only have first names on them (The commonly stated reason is for safety, yet what about female physicians or administrators?) We ask nurses to float to areas for which they are unprepared We expect novice nurses, new to the organization and the profession, to be oriented in 4 weeks to the daunting challenges facing experienced nurses who have practiced for years We resist merit systems or clinical advancement programs that will set certain nurses apart, ie, those who achieve exceptional performance or provide extraordinary patient care We sit on senior administrative teams or boards of directors and do not speak up about patient care or nursing practice issues
Schools of nursing also contribute to nurses becoming commodities when they fit all students into one type of curriculum; or when they prepare students to look for the one right answer; or when they fail to equip students with the needed knowledge, skills, and connections to effectively speak up and act as professional nurses (eg, something as simple as finishing the sentence, “I’m a registered nurse and I make a difference when I . . .”). To promote nurses as professionals, we need to help students learn, and challenge ourselves, to articulate clearly what nurses do, what difference we make, who we are, and why our voices must be heard. We need to write letters, speak up in meetings, create new models of care and education, learn, and lead. The dictionary defines “nurse” as “a person formally educated and trained in the care of the sick or infirm” (Random House, 1999, p. 908). We know that nursing offers so much more as a profession; it is not a commodity. We’ve got significant work to do. References Random House Webster’s Collegiate Dictionary. (1999). New York: Random House. Random House Roget’s College Thesaurus. (2000). New York: Random House.
Journal of Professional Nursing, Vol 19, No 2 (March–April), 2003: p 57
57
T
HIS QUESTION WAS posed several years ago by a physician colleague, Dr. Frank Cerra, currently Senior Vice President for the Academic Health Center at the University of Minnesota. Frank is a staunch advocate for nursing and promotes interdisciplinary practice. He “gets it.” Yet his concern for what has been happening to nursing prompted him to ask the question and me to give it serious thought. What is a commodity? The dictionary defines it as “an article of trade or commerce, esp. a product as distinguished from a service” (Random House, 1999, p. 266). Synonyms include “an article of trade [or] commerce, merchandise, product, ware, goods, stock, staple” (Random House, 2000, p. 135). How does nursing look or act like a commodity? ●
●
●
● ●
When health care organizations advertise for nurses by using smiling pictures of nurses with only first names and no credentials, or professional models When a nursing assistant or licensed practical nurse is substituted for a registered nurse and the patient’s condition clearly requires the knowledge and expertise of a registered nurse When a staff nurse is substituted for an advanced practice nurse and the situation clearly requires the advanced practice nurse When nurses are kept off senior administrative teams or boards of directors When vice presidents of nursing are silenced from speaking to the media
These are some of the actions that organizations take, sometimes unthinkingly, to promote nursing as a commodity. But there are many things that we nurses, ourselves, do to promote nursing as a commodity.
JOANNE DISCH, PHD, RN, FAAN Director, Katharine J. Densford International Center for Nursing Leadership University of Minnesota School of Nursing, 308 Harvard St Minneapolis, MN 55455 © 2003 Elsevier Inc. All rights reserved. 8755-7223/03/1902-0000$30.00/0 doi:10.1053/jpnu.2003.21
We do this when: ●
● ●
●
●
We refuse to wear name tags or allow name tags to only have first names on them (The commonly stated reason is for safety, yet what about female physicians or administrators?) We ask nurses to float to areas for which they are unprepared We expect novice nurses, new to the organization and the profession, to be oriented in 4 weeks to the daunting challenges facing experienced nurses who have practiced for years We resist merit systems or clinical advancement programs that will set certain nurses apart, ie, those who achieve exceptional performance or provide extraordinary patient care We sit on senior administrative teams or boards of directors and do not speak up about patient care or nursing practice issues
Schools of nursing also contribute to nurses becoming commodities when they fit all students into one type of curriculum; or when they prepare students to look for the one right answer; or when they fail to equip students with the needed knowledge, skills, and connections to effectively speak up and act as professional nurses (eg, something as simple as finishing the sentence, “I’m a registered nurse and I make a difference when I . . .”). To promote nurses as professionals, we need to help students learn, and challenge ourselves, to articulate clearly what nurses do, what difference we make, who we are, and why our voices must be heard. We need to write letters, speak up in meetings, create new models of care and education, learn, and lead. The dictionary defines “nurse” as “a person formally educated and trained in the care of the sick or infirm” (Random House, 1999, p. 908). We know that nursing offers so much more as a profession; it is not a commodity. We’ve got significant work to do. References Random House Webster’s Collegiate Dictionary. (1999). New York: Random House. Random House Roget’s College Thesaurus. (2000). New York: Random House.
Journal of Professional Nursing, Vol 19, No 2 (March–April), 2003: p 57
57