After doing the registry shift the other day I have been thinking about what it is to be a nurse versus a midwife. I know and have known for a long time that I would never be satisfied as 'just a nurse'. It wasn't enough for me. I have been pondering why that is.
I think that working as a nurse turned out to be not at all what I thought it would be. It isn't what I tried to teach nursing students when I was still doing that. Well wait, it can be sometimes. But more often than not, nursing is about completing tasks.
There. I said it. Yes, being a nurse is about getting tasks done. With a little patient education thrown in. It seems that most nurses I work with are about getting their jobs done so they can sit at the nurse's station. I look at their interactions with doctors and midwives (myself included). Rarely is it a team approach to patient care/diagnosis/treatment. It's a doctor (or midwife) giving orders, the nurse running off to complete the orders. Rarely does a nurse make a suggestion to me. I have even asked at times, 'what do you think?'. And the response is usually "I don't know" (not always). I want to include the nurses in the POC...I try to tell them what my thoughts are and why we might be approaching a situation a certain way. Some of interested in learning but most are just like 'whatever, let me do my job so I can go home'. And god forbid I want to do something that means more work (??) for the nurse, such as intermittent auscultation, etc.
When I was in nursing school, I thought nursing would be about that team approach to healthcare. Multiple disciplines working together to achieve the best outcome for a patient. I thought everyone would be equally respected. Yes, I was d*mn naive. After all, I had no healthcare exposure prior to nursing ( Iwas a bartender!). But lets face it, nurses don't get any respect, especially not from doctors.
When I began to teach I tried to instill in nursing students this picture of what I thought nursing was supposed to be like. But really, once you get out in the 'real world', you quickly get beaten down into your place.
I always though that certain specialty areas offered more autonomy, such as L & D or the ER. And they do, but still I see the same behaviors. I don't see nurses that are willing to fight and advocate for their patients. And that's what nurses are supposed to be - patient advocates. But instead many become steamrolled by the juggernaut called healthcare. It's hard to always 'fight the power'. It wears you down quickly. Maybe that's what I am seeing where I work.
As a midwife, I have a great deal of autonomy. I can spend a lot of time with patients. I get to give the orders instead of being told what assinine things I need to go do to a patient. Maybe that's an issue for me - I am a type A personality and I like control. I am learning to give more and more of that control to patients though :)
I would love to hear thoughts from nurses and from lay people who have had nursing care that made a difference (negatively or positively) in their lives.
*Sorry about the rambling!*