Not Nurse Ratched

I made it through my first day without any panic attacks or major bureaucratic hassles (major challenge for my school). Here if you don’t have your clinical clearance card in hand, they don’t let you start class. They’re literal about this: show the card or get up and walk out the door. Yikes! I got mine right before class. It was delayed because of a lack of my third hep B shot, which I can’t even get until March. I cleared this up a few times, yet the clearance wouldn’t come through. Sigh. I also went ahead and bought a stethoscope, which I need fairly imminently for my nursing technologies lab. They want us to have Littmann Lightweight II S.E. stethoscopes, which do NOT come in either lime green or orange. Oh, the agony! I chose seafoam green, but it’s really just a consolation color (“at least it’s not black”). What is it about owning a stethoscope that really signifies “nursing student”? I feel official. As soon as no one is looking I am going to drape it around my neck for a minute. Ha ha!

I had only one class today: patho/pharm I (“the rock”). My professor intones this every time she says the name of the class. She is WICKED funny. I’m so pleased. I can tolerate almost anything from someone if they’re funny. Example: she went around picking random people to ask, “Why do you want to be a nurse?” Almost everyone said, “Um, because I want to help people?” After about 10 tries she curled her lip a little and said, “Great. Do you want world peace, too?” I swear to god I almost laughed out loud. ER contacted her (and 99 other nurses) about submitting clinical vignettes for the show, and they used one of hers! This is the fast route to impressing me! I listed with intererest to her long list of accomplishments both academic and practical, but the ER link really did the trick. Is that wrong?

Speaking of ER, I may need to revise my career plans regarding being an ER nurse, because it seems that approximately half of my classmates also want to work in the ER. I wonder if it is because of that show and whether they will change their minds when they see a real ER. I’m not too worried about it, though, because now that I think of it, many of the same reasons I am drawn to the ER also apply to plain old med-surg, where I’m fairly convinced I’d like to spend a year or two getting a really broad experience base. I know that med-surg is not for pussies, but I’m not afraid of hard work. Still, I know that the best way to make the gods laugh is to make plans, and I don’t want to provide too much comic relief. I’m sure that when the time comes, I’ll end up where I need to be. Right?

I’ve been asked this question with varying degrees of curiosity and sanctimoniousness, up to and including being told straight out “You should be a doctor. Nursing won’t make you happy.” (Can I take just one sentence to implore the reader NEVER to tell another person what will make him or her happy??) I was mulling over blogging on the topic anyway, but then I read this post on Medscape Differential and decided today is a great day to mull.

Most people who ask me this question seem to be coming from an academic/intelligence angle. I’m a sharp cookie academically (even if I can’t read a map) and make stellar grades (but stay tuned!), so perhaps it seems to most people that if one has this kind of aptitude it should be applied to medical school where it can really “count.” The thing is that nursing is no longer a simpering-female occupation, if indeed it ever was. Nursing school is a Big Deal and not for the academically or personally faint of heart. Then when you get out of school, you gotta have some major ‘nads to do the job (including putting up with doctors with chips on their shoulders). Nurses are assuming increasing responsibility in patient care, and my theory is that they are packing more information into nursing programs so that we can do it competently. Med students get 4 years to take their prerequisite courses so that they can develop a solid background for the medical material: we get 2 years (or even less time, depending on what kind of nursing program is involved). I feel like there is an invisible funnel over my head into which information is being poured and crammed into my aching and protesting brain!

Others seem concerned about the human impact of the job. My boyfriend is very concerned about this and believes that I will get too attached to patients and be a basketcase constantly. But this is the main reason I chose nursing over being a doctor: I wish to focus on PATIENTS, not DISEASES. Doctors flit around focusing on lesions, broken bones, and lab tests, which is great. Someone has to do that. While they’re doing that, though, nurses make patients more comfortable, reassure them, and help manage their pain. Nurses make a medical experience either tolerable or intolerable. Doctors don’t, as a group, really make that much of a personal difference (unless they operate on the wrong leg: I concede that this does, in fact, make a personal difference). They are also really busy screwing around with paperwork and bureaucracy, god help us. That’s a major reason not to become a doctor right there!

Finally, there’s the shit and vomit category. Why would I choose a job that requires me to wipe butts and get puked on? Well, that’s not really the part I’m CHOOSING (I did not sit at my mother’s knee and say, “When I grow up, I’d like to wipe butts”), but it goes with the job. I have, unfortunately, had hospitalizations that necessitated MY butt being wiped, and I’m here to tell you that it is far better to have a nurse who does it kindly and compassionately than to have one who is mean about it. Consider this: if you have a condition that requires someone else to wipe your ass, you are already having a really bad day. No doubt about it. Don’t you want someone to perform this task who views you as a human with feelings and needs and who is deserving of respect and compassion? Also, in the nurse-vs-doctor discussion, doctors trawl through a fair amount of excrement themselves. I’m pretty sure that if you work in a hospital at all, you run a fair risk of encountering something disgusting. So this is not a deal-breaker for me.

It just seems to me as though this question is impossible to answer. These fields are really entirely different professions; nursing is not just a subfield of doctoring. Asking this question is vaguely along the lines of “Why not be a geologist instead of a nurse?” There are really good reasons to be a doctor, there are really good reasons to be a nurse, and there are really good reasons to be a geologist/professor/fireman/sex therapist. Well, maybe not a sex therapist.

So, if you, the reader, are a nurse/nursing student: don’t let anyone argue you down! If you aren’t: be nice to nurses and nursing students. We might be YOUR nurse someday!