Celebrate the Diversity of Nursing

By Donna Cardillo, RN, MA

If you’ve been in nursing a while, you’ve no doubt heard debates about who’s the better nurse, what constitutes a “real” nurse, and whether or not nurses working in a nontraditional position are burnt out bedside nurses. Here are some common debates and misconceptions that need to get put to bed once and for all:

Nurses who leave the bedside are burnt out. There is an assumption out there that nurses who leave the hospital are no longer able to function in that setting. Some often label them as “burnt out,” insinuating that they’re “washed-up” as nurses. The truth is many nurses leave the bedside, either on a temporary or permanent basis, for a wide variety of reasons, none of them having to do with being “washed-up.” And while some need a legitimate break from direct patient care, there are many nurses who simply wish to avail themselves of the diverse opportunities that the profession offers. Others leave to attend to personal obligations, go back to school, or help with a family business. Some develop physical limitations, need more regular hours, or simply choose to work in a different environment. The important thing to remember is all nurses have career choices.

Nurses who go into management are traitors. Some nurses complain that many of the problems in health care exist because non-nurses are in positions of authority. Yet, when nurses are hired or promoted to such positions, they’re often called traitors and accused of abandoning the troops. Rather than supporting our nursing leaders, we sometimes work against them by being overly critical, impatient with their learning curve, and suddenly unfriendly.

Some of us have developed an “us vs. them” mentality, seeing anyone in a management position as the enemy. In reality, chaos would reign if no one were in charge. So, who better to lead in any health care situation than a nurse? In fact, nurses should be in more leadership roles at the administrative level and not just in the department of nursing. The higher the level of authority we have in any setting, the more power we wield in the system. This leads to greater opportunity to support nursing’s agenda of providing safe and competent care.

We should support colleagues who move into management. Support does not equate agreement in all situations or blind allegiance — just respect and empathy. Collaboration with established leadership is essential for a healthy and productive work environment.

ADN vs. BSN: Who’s the better nurse? This is the debate that just will not die. Just mention the topic to two or more nurses and a heated discussion will likely ensue. While an argument can be made about the pros and cons of various entry-level options in nursing, none of those arguments has anything to do with which produces a better nurse. Despite some program differences, both ADN and BSN grads take the NCLEX-RN exam and are held to the same rigid standards for licensure and practice.

Nursing candidates are no longer the homogenous group they were 30 years ago. Some candidates are coming into nursing in mid-life with degrees in other disciplines and significant work experience. And every prospective nurse has different career aspirations, personal and family commitments, and work/life experience.

I’m a big supporter of higher education and would encourage nurses to continue with their formal education. But whether a nurse gets that education at entry level or at a later time is an individual choice based on life circumstances, resources, and career aspirations.

Nurses in nontraditional positions aren’t “real” nurses. Why do some of us insist on pigeonholing ourselves? If we only define nursing as working at the bedside, it implies we’re only capable of doing one thing. What a narrow view! And where does that leave community health nurses, school nurses, occupational health nurses, and others? How about nurses who work in case management, utilization review, research, or recruitment? They are every bit as much nurses as their clinical counterparts.

There are many ways and places to make a difference in health care, both direct and indirect. Being a nurse is about who you are and what you know, not about where you work and whether or not you wear a uniform or scrubs to work. We are each intelligent, multi-talented, highly skilled, and versatile. We are vital at the bedside, and we are just as vital in every other aspect of the health care arena. Health care is changing rapidly — and so, too, is the role of the nurse.

It’s time to expand our vision of who we are, what we do, and what we’re capable of doing in the future. It’s time to celebrate — not denigrate — the diversity of nurses and of nursing.

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