Anecdotes From the Life of a Nurse (1)
HOW IT ALL STARTED
Looking back over the past 20 plus years of nursing, I am reminded of what brought me into this profession. Frankly, it was my mother's fault.
I was at loose ends, graduated from high school and starting college. And I couldn't think of a blessed thing to put down for my area of study. Sure, I loved books, but did I really want to be a librarian, or edit or write them? That would have been just like saying "I love movies, so I should be an actress" (shudder). I had all sorts of interests, but nothing I wanted to make into a full time job. Most importantly, while I wanted to make decent money, I also wanted to do something important. Something that would make me feel that I made a true difference in the world.
My mother, whom I respected greatly, had decided to go to nursing school after we kids were pretty much grown up. Not only did she make it through the program, she was at the top of her class. Through nursing, she rediscovered the intelligent, capable, and driven woman she always was, but had never been recognized for. She took me aside, and told me that with my brains and common sense, I would be a great nurse.
What can I say? I believed her. And, of course, I really had nothing better to base my whole life on. I went through the pre-testing, and applied. By the end of that first year, the stress and fast pace of nursing school had weeded about about a third of our class. We had multiple college and nursing based classes throughout the day on Mondays, Wednesdays, and Fridays. Then prep needed to be done for our clinical work, which basically occurred in the hospital setting on Tuesdays and Thursdays. On those days we presented case studies for the patients assigned to us, generated care plans (Nursing school LOVES it's care plans), then were given over as free labor to the nurse assigned to our patient. All of this was to give us experience in the hospital setting, with actual people. It also allowed us to practice our newly acquired skills in starting IVs, giving medications, etc. If we were lucky, the nurse we were assigned to would actually let us practice, under her watchful eye, those all important skills. If not, well, let's just say a lot of bed baths and bedpan work were done in those years.
Weekends and evenings were spent entirely in study, and prepping for the next week. As a result of this intensity, many of us banded together in small study groups, which I attribute to keeping my sanity, and my nose to the grindstone. Looming over us was always the fear that we would crack, or not pass an important test. Sometimes I would think that the whole point of nursing school was to break and toss out as many students as possible. It was like some grueling cross country marathon, where the winners got the chance to run another mile, then another, and so on. I think I can be forgiven for thinking "Gosh, this is really hard! Nothing could be as hard as this". Of course, I was only in my early 20s, and had no REAL frame of reference, or experience, to base that on. Boy, was I in for a rude awakening!
Now, to put you in the right mindset, you have to understand that the time was the late 1980s to early 1990s. There had been a downward trend of RN job needs during the early 1980s, pretty much started by hospital administrators trying to cut back on staffing costs, and replacing those RN's with nurse's aides and LPN's. Hospitals were just starting to realize that Registered Nurses actually made a difference in how people recovered while in the hospital. And how RN's played a pivotal role in the prevention of infection and bed sores, as well as providing high quality assessment skills, providing much needed patient education, and filling the extremely important role as the patient advocate. They were starting to realize that, while nurse's aides and LPN's were important in the functioning of the hospital, they could not utilize them exclusively, and expect good patient outcomes. However, they also didn't want to pay the higher salaries for the RN's. Therefore, the general response from hospital administration was to save money by limiting the AMOUNT of nurses on the floors, which of course meant a higher patient ratio for each nurse.
To be fair, this was not the policy of ALL hospitals. But enough of them did this to make quite a difference in the health care setting. No matter how hard each nurse worked to try to give quality care to their patients, you can only do so much in an 8 hour period. When that same nurse had anywhere from eight to fifteen patients, well you can imagine what that meant. If you were a smart nurse, you organized, prioritized the severely ill, and leaned on the nurse's aides. Heavily.
Completely ignorant of the politics and policies of hospital administrations (and their ever greedy attempts to save money in staff and supplies), I finally graduated nursing school. By this point, our class was down to about a third of the original influx of students. Now, this didn't mean I could start practicing as a nurse yet. My next step was the dreaded NCLEX, the national exam that must be taken in order to obtain the coveted RN license. In other words, I had just won that grueling marathon, and my prize was to be allowed into the next race immediately after... the hundred yard sprint. Failure was not an option.