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For anybody that has been a nurse for a few years you have already learned this, especially if you have worked at more than one hospital.

Nurses, or even healthcare is general, is a pretty small and close knit group. If you are working in the same town you went to school in, then you probably know at least one nurse at every hospital in your town. If you have worked at other hospitals, then you probably know somebody at every hospital in your town. But it is definite that somebody you work with now knows at least one other nurse at every hospital in your town.

For this reason, I tell my nurses, don’t burn your bridges. What you say or do here will eventually make it to the hospital on the other side of town.  Here’s an example…completely fictitious of course:

When I was staffing in the ED, the manager was interviewing a nurse. This nurse was somebody I went to school with.  She was an average student, but the know-it-all in the class (we all had one of those, the phlebotomist or EKG tech who think they know everything). She was a complete pain in school.

When he was giving her a tour of the unit, we ran into each other. She came over gave me a hug and was sweet as pie, although we never got along in school. After her interview, the manager came and asked me about her.  I told him the truth, I don’t know about her nursing skills, but she was a difficult person to deal with in school and I don’t think she would be a good fit for the team.

She didn’t get the job. This happened with two other people that I was asked about that I worked with in other EDs.

I don’t feel bad about it, because I don’t think they would have been successful here, and I don’t think they would have been a good fit for the team. It was their behavior that caused me to give a bad reference.

What I am saying is….we have hard jobs already. When you are feeling stressed and having a bad day, learn how to keep it in check. Because one day, you may not get a job in another department or hospital because of how you acted on your unit today.

Fredrik Broden for Scrubs Magazine

Myths and misconceptions abound in every profession, and nursing is no exception. Sometimes these myths come from colleagues, sometimes from people outside the profession—either way, they don’t serve us well.

So, the next time you hear a stereotype you know is nonsense, use your know-how to clarify, inform and enlighten.

Myth: “Real” nurses work in hospitals.
Fact: More than half of all nurses work in hospitals, but that doesn’t make them more “real” than the rest of us.

I used to work in an emergency room, and I can tell you for certain that I am every bit as much a nurse since I left as I was in the hospital (I’ve done everything from conducting medical exams for insurance companies to preparing nurses to take their boards for an education company). Yet from the day I stepped out of the hospital into the world of nontraditional nursing, the questioning (“Why did you leave nursing?”) started. And it has never stopped. I always give the same answer, very calmly and very proudly: “I never left nursing. I’m still a healer, teacher and nurturer.” I have a very broad view of who a nurse is and what a nurse does. While many of us wear scrubs, there are still nurses who wear uniforms, business clothes, even overalls. Being a nurse is about who you are, not about what you wear or where you work.

Myth: You can always tell a good nurse by how much she (or he) knows.
Fact: An excellent store of information and experience is essential in a nurse, no question about it. But a deep sense of empathy and compassion are equally important. A nursing instructor at a community college told me that she always explains to new grads, “Patients don’t care how much you know until they know how much you care.”

Myth: Patients like to be called by their first name. It’s just friendlier.
Fact: With all the available techno-communication—from email and text messaging to Facebook and Twitter—we’ve become an increasingly informal society, and sometimes we automatically address people by their first name. Many patients are more comfortable with formality in the health care setting, and the use of surnames and titles helps maintain the professional relationship. Plus, there are many people, especially older individuals, who consider it disrespectful to be addressed by their first name. The bottom line: Be sensitive to your patients’ preferences. It’s probably safest to start out with formal forms of address and progress from there.

Myth: Apart from the language issue, most foreign-trained nurses find that working in an American hospital is not much different from working in their home country.
Fact: Foreign-trained nurses now account for about five percent of the total United States nursing workforce, and are an intrinsic part of our health care system. Thank goodness, because there are some parts of our country that are suffering from a nursing shortage. Most foreign-trained nurses, despite their high skill level and excellent training, still have to sort out a host of cultural issues and professional expectations that they often hadn’t expected.

Nurses from the Philippines, for example, who make up nearly half the foreign-trained nurses, usually find they have much more responsibility here. They also have to be more independent and use more critical thinking skills. Why? Because in the Philippines, most hospitals are teaching hospitals, and the residents and medical students do most of the procedures. When they get to the United States, nurses find, for example, that they’re required not only to start IVs, but are also supposed to interact with doctors and patients’ families, even if they’re not the charge nurse; additionally, they’re responsible for discharge planning and case management. Add to all this a brand new language, and you can really see what foreign-trained nurses are up against.

Myth: One of a nurse’s main responsibilities is to help doctors do their jobs better.
Fact: Nurses are not secondary caregivers, but highly educated, skilled and autonomous members of the primary health care team who make independent critical decisions about the care of their patients. While it’s true that some nurses are extremely deferential to doctors, and some doctors are domineering types, those roles are rarely, if ever, the norm.

To read more myths—including the ones about male nurses, nurses eating their young, and the hierarchies of nursing specialties—read the complete story in the 2010 Winter Edition of Scrubs Magazine, available at your local scrubs retailer. Find a retailer who carries Scrubs Magazine here.

image: Phil Boorman/Cultura Collection/Getty Images

Yes. It can and does happen. Contrary to popular belief and myth, there really are male nurses out there!

And yes, we do encounter discrimination every so often – some greater than others, and some more severe.

I can remember when I first made the decision to be a nurse…

“You want to be a Murse?”
“I guess you didn’t want to be a doctor?”
“Are you gay?”

I have seen and heard it all from all walks of life. You would be surprised at some of the reaction and interaction I have experienced being a ‘male’ nurse.

Even after I made it through nursing school and started working, the stereotyping continued in some small way. This time it was from my co-workers…

“Oh, I’m so glad you’re here. Now we have some muscle on the floor.”
“You’re so great to work with, lifting my patients is so much easier when you’re around.”
“The doctors like you better – it’s a guy thing.”

So my gender as a nurse has been a blessing and a curse. And there really is no rhyme or reason, no prediction, and no preparation. Some patients/families out there simply do not like nor want a male nurse, while some prefer them. Same goes for the doctors, some will unconsciously treat me ‘better’ or ‘differently’, while others will make my life difficult. Is it simply because I’m a guy? And some co-workers will also unconsciously ‘like’ me simply because I have muscles. God-forbid I bring skill and knowledge to the table?!

All of these ‘challenges’ still are manageable. All of these so-called difficulties can be ‘worked around’ in most cases. Even at its most severe, I’ve only had to change patient assignments due to a patient/family/physician nursing gender preference. But, I’ve never had to worry about not practicing as a nurse.

I have balked at some things I’ve experienced. I’ve moaned and groaned at past interactions. But mostly I just let it roll off my shoulders and simply move on – because in all instances I still get to practice as a nurse in this wonderful field of nursing. I still get to do the job I love in the setting I prefer and love.

Others are not so lucky.

It seems in India – for a particular diploma nursing program – they will not accept male candidates for their program!? In fact this discrimination was petitioned – and lost! It seems that males are being prohibited to enter because the diploma program’s course work involves mid-wifery as well as pre and post-natal care?!

(insert facial expression of shock and disbelief??!!)

To make matters worse, the higher court ruled that there is a sufficient number of male nurses already working in the areas they are needed – like jail, ortho department, mental health hospitals and operation theatres??!!

Wow.

As a nurse, male or female, we are taught to be culturally diverse – including transcultural nursing. We are encouraged and trained to be culturally competent practitioners, but this – in my humble opinion – is astonishing.

How can you judge or even pre-judge, and ‘genderize’ the practices of a profession that works side by side with the field of medicine?

Correct me if I’m wrong, but do they discriminate female candidates who have an interest in being an orthopedic physician? Or a male candidate wanting to pursue obstetrics?

Original story from ‘The Times of India’ here.

As well as the original commentary from ‘The Truth About Nursing’ here.

Things that make you go hmm.

]]> http://scrubsmag.com/gender-stereotypes-in-nursing/feed/ 18 http://scrubsmag.com/nurses-eat-their-young/ http://scrubsmag.com/nurses-eat-their-young/#comments Thu, 29 Oct 2009 21:45:52 +0000 LeAnn Thieman http://scrubsmag.com/?p=6146

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There is a “myth” I think it is way past time to dispel…and if there’s any truth to it, I want us all to work for a solution.

It is a quotation about nurses that is so sad, I refuse to repeat it when I’m giving presentations to my nursing colleagues. I fear that by repeating it, I too am perpetuating its use.

So I will state it once now, praying that this is the last time that I, or any other nurse, ever has to hear it.

The despicable phrase is: “Nurses eat their young.”

Because I speak full time to nurses and am an expert on nurse recruitment and retention, I get to talk to thousands of nurse a year. Every now and then someone repeats this horrible phrase. Too often it is a new grad or first year nurse. I was shocked to learn that 20% of first year nurses quit in this country! Our nation is expected to be half a million nurses short within the next ten years.

We need to mentor our new nurses.

I believe strongly (can you tell?) that we need to care for each other, build each other up, help each other out. Nurses can do a lot to end this shortage by creating an environment where others want to work.

We need to “love our young.”

Ryan Burke, a 10-year-old at Lowell Elementary School in Teaneck, N.J., can testify to just how crucial a school nurse can be. Ryan was diagnosed with juvenile diabetes three years ago. “Since I’m the only diabetic at my school, the school nurse had to quickly learn how to take care of me, and she also attended conferences to learn about diabetes,” says Ryan.

Since first meeting Ryan, Ellen Keane, RN, CSN, APN-C, has continued to play a big role in his life, helping him to lead his school in three JDRF (Juvenile Diabetes Research Foundation) walk-a-thons. Ryan was even selected to meet President Obama at the White House this past summer as a representative of the JDRF in the 2009 Children’s Congress.

“Knowing how well [Ellen] takes care of him allows both of us (especially his mother) to go to work and not worry about him all day,” says Bill Burke, Ryan’s grateful father. “She has kept his school life as close to normal as it can be, which is our greatest hope, other than a cure.”

Scrubs Magazine caught up with Ellen about the challenges and rewards of being a school nurse, and her work with Ryan. Along the way, she debunks the common misconceptions about school nurses and gives helpful advice for new nurses. Read the interview, then see the heartwarming photo gallery of Ellen’s work with Ryan.

Scrubs: How did you become a school nurse?

Ellen: I’ve been in the nursing profession for 35 years. I became a school nurse back in 1991, after being an RN for 15 years. It was a natural evolution as I had been working as a pediatric nurse in a local hospital. I’m also the mother of four children and it was a natural affinity to move into a school nurse role.

Earlier in my career, I focused on adults, working in various nursing positions inclusive of Hospice, Pediatrics, Coronary Care, Emergency Room, Medical-Surgical, Visiting Nurses, etc. Raising four children was wonderful, but working full-time was challenging, and School Nursing presented itself at the right time and place in my life.

I’m now completing my 18th year as a school nurse. Over the years I have gone back to school, receiving a master’s of science in health education/community health, and more recently returned to school and received another master’s of science in nursing as a family nurse practitioner. I believe this has added another dimension to my expertise as a school nurse, although I don’t work in the role as a family nurse practitioner at school. My school district has been very supportive of student nurses rotating through my office as a clinical experience, which has been an enlightening experience for the future nurses. I’ve been fortunate to also work in the role of instructor within my office, and I’ve taught nursing at some colleges.

I’m lucky to be in a profession that I truly love. Nursing has exposed me to so many different kinds of people and conditions over the years. It has given me the gift of appreciating the life I have been given and, in turn, sharing it with my family, friends, students and patients.

Find out what advice Ellen has for new nurses.

image: © istockphoto.com/rob blackburn

The public’s image of nurses as “angels” can be frustrating. Many nurses do not consider themselves “angels.”

In fact, some nurses consider this characterization unfair and demeaning. Nurses are competent, intelligent and skilled professionals who treat patients.

But sometimes – just once in a while – we encounter an “angel” story that doesn’t offend us. This is one of them.

I had been awake and working for almost 32 hours. I’m an organ procurement coordinator and we frequently work 24-hour shifts, but this day had pushed me past my limits. I was beginning to think that I wasn’t cut out for the world of organ donation, that I was too old for what is clearly a young person’s game. At 35, I’m the oldest person at our organization who takes a full call schedule. I was exhausted, but instead of feeling exhilarated by the medical miracle I had helped accomplish, I was feeling defeated. I kept thinking Why do I do this to myself?

I was in dire need of sleep, but I was hungry, and my stomach was growling so loudly I was afraid it would keep me awake. I stopped to pick up some Chinese food.

A man dressed in work boots, jeans and a flannel shirt was standing in the restaurant waiting for his food and noticed I was wearing scrubs. He saw me and made a face like he had seen something repulsive. “I didn’t think you medical types worked on Saturdays.” I replied that health care was a 24-hour/365-days-a-year kind of job, but I was really thinking Of course nurses work on Saturdays!

He said, “Oh, you want overtime so you can buy more stuff. You must get double time on a Saturday.”

I said that I was more interested in sleep than the money.

Clearly trying yet again to rile me, he asked, “Didn’t anyone ever teach you that there are things more important in life than money?”

Normally I would just smile and walk away, but I couldn’t help myself. “I’ve been awake and working the last 32 hours because I work in organ donation. I worked all night to help save a seven-year-old girl’s life. I didn’t do it for the money. Organ donation teaches you that money doesn’t mean much.”

His demeanor instantly changed. With a big grin, he said, “Oh, you’re an angel!”

I said no, I was just a nurse who happened to work in organ donation.

“No,” he said, “you’re an angel. I got my new kidney two years ago.”

I walked away with a smile on my face and a much-needed reminder of why I do what I do…all because I was wearing scrubs.

– Contributed by Jennifer Heisler, RN

image: Wong Illustration/iStock Exclusive/Getty Images

When I first decided to enter the nursing profession, I really had no idea what I was getting into. I hadn’t grown up wanting to be a nurse, nor did I give it much thought beforehand.

But I was bored and miserable working for the U.S. Postal Service and had to find something that was a lot more mentally stimulating. My mother, who is a nurse, suggested that I pursue nursing. I thought, “That’s a woman’s profession! Why would I want to do that?”

MYTH #1: NURSING IS A WOMAN’S PROFESSION

The idea of nursing being only a “woman’s profession” has given way to the idea that anyone can be a nurse. The number of men in nursing is steadily increasing, and that’s a good thing. There’s plenty of room under the nursing umbrella for both men and women.

Many so-called “manly men” like policemen and firemen pursue second careers in nursing after they retire. The step seems to be a logical one, since policemen and firemen are caretakers (of sorts) to begin with.

Variables such as flexibility of schedule, excellent pay and the daily challenges of nursing make the job very rewarding. The scientific and methodical approach to nursing is also what I would call “man-friendly.”

MYTH #2: MEN AREN’T EMOTIONALLY SUITED TO NURSING

What drew me to nursing, not as a man but as a human, was the interaction with people and the reward of helping others. That is a universal truth for nurses, be they male or female. I like to get people’s stories, finding out as much as I can about them, the way they live and who is around to assist them with their needs.

These are important aspects of caring for patients that only nurses think about while devising a plan of care. I believe that the nursing approach of caring for the entire individual should be the standard for all of those working in the healthcare field.

MYTH #3: MALE NURSES ARE JUST “WANNA BE” DOCTORS

Yes, from a man’s perspective, there are a lot of positive and negative aspects of nursing. One negative aspect is the assumption that we couldn’t hack med school. That’s obviously not the case for most of us.

Interestingly, being a male nurse truly gives us an advantage when dealing with most doctors. Doctors treat male nurses a bit differently than our female counterparts. I’ve seen many doctors talk to female nurses in ways they never would to a man.

BUT FINALLY, SOME TRUTHS ABOUT MALE NURSES

Even though I’ve debunked some myths, there are still a few “stigmas” about being a man in nursing. First, for the most part, you won’t ever get to work in a maternity ward! Second, I’ve found that a lot of young female patients are embarrassed about having a male nurse. (I always thought this was peculiar, though, seeing that most of their doctors were men!)

If a patient was uncomfortable having me as her nurse, I never took it personally. Being a nurse, I adapted and improvised. I’d simply switch that particular patient assignment with one of my female coworkers, and the problem was solved.

SO WHY SHOULD MEN PURSUE NURSING AS A CAREER?

Males are actually ideally suited to both the pressures and excitement of nursing. I’ve always liked comparing the nursing approach to that of the U.S. Marines: They adapt, improvise and overcome. Working just one nursing shift will prove that point!

Men also have a very different perspective than women on a lot of things, and it’s a good thing having them in the profession.

All in all, I love the label “male nurse.” When people ask me, “What’s it like being a male nurse?” I usually reply, “The ‘male’ part I’ve got down—it’s the ‘nurse’ part that takes a lot of hard work!”

The long hours and extreme situations of a medical environment can lead to more intense closeness than other workplaces. Nurses date nurses, nurses date EMTs, nurses date cafeteria personnel, nurses date custodial staff.

Somehow, though, when nurses do date doctors, that romance is susceptible to more intense scrutiny than other relationships.

Nurses dating doctors is a hot-button issue with real-life repercussions. When you engage in that romance, be prepared for gossip from coworkers, unhappy supervisors and possibly a damaged professional reputation. How? Because no matter how it ends, your colleagues could get caught up in your drama, and that can lead to long-term career damage. And as unfair as it may seem, that impact is more than likely to be felt most by the nurse in the relationship.

So, let’s go over a few rules to make sure you’re savvy about dating a doctor and don’t come away with professional regrets:

• Keep it quiet. Especially in the early days of a relationship, it’s important that you don’t provide workplace gossip fodder. Don’t text “Hey Stud Muffin” notes to your honey at work, which could actually be grounds for getting fired. Avoid any hand-holding, stolen kisses or other PDA (public displays of affection) on the job. If you go to lunch or take breaks together, help keep speculation under control by inviting other people along sometimes. When dating after hours, don’t go to the usual haunts where other nurses, doctors and medical technicians hang out. Always maintain your professional demeanor when working—no “babe” or “sweetie” when addressing one another. “It’s important to keep it out of the hospital, or wherever you work,” says Sarah Dolloff, a registered charge nurse at Sacred Heart Hospital on the Emerald Coast in Miramar Beach, Fla. “People do gossip at work—especially women. They’ll talk about who they saw together and stuff like that. That’s why you want to make sure you act professionally at all times at work.”
• Check the employee handbook. Always make sure you’re cool with your organization’s policy regarding workplace dating. Most nurses don’t report to doctors, but if there’s any supervisory role between you and your honey, you may be violating a rule regarding supervisors dating subordinates. “When I worked in a university hospital, we socialized quite a bit with the male residents and interns,” Dolloff says. “But in a community hospital, it’s much more formal. You’ve got to be aware of what’s okay and what’s not okay in that setting.”
• Set some ground rules. While it may sound unromantic, make sure anyone you date from work understands that you want to be discreet, and if it doesn’t work out, you still want to be discreet. “There are some hospitals that are so big, the two people might never see each other at work. But if you’ve got an orthopedic doctor working with an orthopedic nurse, for example, they’re going to be running into each other all the time,” Dolloff says. “I’d have an issue with a nurse who didn’t behave professionally when she worked with someone she was dating.”

And while fuming silences, spats in the hallway, tears and nasty remarks after a bad breakup make for good TV, they can give supervisors digestive problems. Be clear up front that no matter how the relationship works out, you want to protect your career. Make sure that viewpoint is heard and respected before moving forward, or you could be heading for real heartbreak—both personally and professionally.

Here’s one story contributed by Erica Holl, RN. She’s Charge Nurse at St. Christopher’s Hospital for Children.

“Not only do patients love the print scrubs — kids outside the hospital also respond to them. One day on my way to work I stopped at the grocery store. Of course I was wearing my scrubs, which had the characters from Blue’s Clues all over them.

As I was shopping in the dairy aisle, a little boy of about 4 years of age walked up to me, hugged my legs and would not let go. It was very sweet. I assume he was attracted to my scrubs. As the interaction continued I spoke with the little boy and his mother finally called him back. He still would not leave my side and asked if he could come home with me. His parents were gracious and eventually took the little boy back with them. As it so happens, they wound up in my checkout line and he came back to me. I believe it was my scrubs that led to this interaction.”

Do you have a story about your scrubs? Share it with us and you may get featured in Scrubs Magazine!