A View from the Hill
FOR IMMEDIATE RELEASE: January 24, 2001
CONTACT: Michael Auerbach (617) 722-2240
ALWAYS BY OUR SIDE
She was born to a prosperous, well-educated English family during the Victorian era. Hers might have been a relatively uneventful life; women of her social class usually received an education in domestic duties and etiquette, married and raised children. However, this young lady had a different view of the world and her role in it. She studied history, philosophy and classical literature, subjects none of her peers even broached. She learned five languages and traveled throughout Europe. She began studying science, delving into books about hospitals, public health and sanitation. Despite her family's opposition to the profession upon which she was fixated, she would not be swayed. Florence Nightingale was going to be a nurse.
Florence Nightingale, the founder of modern nursing, once defined what a nurse should be: "devoted an obedient." No one could give a better definition. Today, there are millions of nurses, all devoted and obedient to the art of healing the sick and preventing disease. The men and women who choose to enter this field certainly demonstrate this devotion and obedience, as evidenced by the rigors they endure to become nurses. These individuals must pay their dues. Those who wish to become a registered nurse (RN) must complete between two and five years of schooling (while receiving hospital training), and must pass competitive state licensing exams. Some pursue the position of licensed practical nurse (LPN), which only requires one year of training. LPNs, however, cannot perform as many duties as an RN.
After completing the required training and passing the exam, a nurse's challenge really begins. Nurses operate in virtually every medical area, from the relative calm of private health practices to the sheer chaos of the emergency room. They often work extremely long hours (sometimes 24-hour shifts), administering to several patients at once. While they labor alongside doctors who make high-end salaries, most nurses earn just enough to pay off student loans and other bills.
As if the responsibilities of the vocation are not enough, a nurse must also contend with the basic problem of fair compensation. Unlike doctors, nurses must engage in collective bargaining, wherein they must settle on a contract with administrators that includes salary increases, health and retirement benefits, and protections against unfair scheduling and similar practices. Such negotiations can last months and often add stress to the job.
At times, successful collective bargaining is delayed because of irreconcilable differences. Last year, the nurses at St. Vincent's Hospital in Worcester went on strike to protest a policy that required them to work forced overtime in the event of a staffing shortage. Hospitals insist on retaining the policy of "mandatory overtime," even if it is not practiced frequently, because they believe that there may be a situation in which staff levels are depleted or scheduling conflicts occur and they will need a "last resort" measure. Hospital administrators often cite examples of hospitals that cease certain services or close wards because of an inability to fully staff those services and wards.
Nursing organizations, on the other hand, rightfully complain that when their members are mandated to work another shift those nurses may be too tired to perform their duties and thus pose a danger to the patients. An exhausted nurse may confuse charts, improperly insert a needle or administer the wrong drugs.
The politics of nursing makes an already difficult job even more strained. There is often a divide between doctors and RNs, and administrations and nursing associations. There are even animosities between the different levels of nurses, such as nurse practitioners and clinical nursing specialists (who have advanced specialized training), nurse managers (who often serve as negotiators on behalf of hospitals during collective bargaining), and LPNs. Could we imagine Florence Nightingale having this problem?
Given the pressures and rigors of nursing, it is clear that this noble profession is not for everybody. The Princeton Review reports that many nurses leave the profession only five years out of school, frustrated with budget cutbacks and policies that hinder their ability to effectively do their job. After ten years, many veteran nurses move laterally into other areas, becoming school nurses, working in health education or joining private care facilities.
It is obvious that when nurses leave the taxing world of the hospital, they do lose their will to help others. For most nurses, the desire to care for the infirm and prevent illness is the impetus that drove them to become nurses in the first place. Even the most trying of circumstances can rarely extinguish a nurses's devotion to the greater community.
Recently, I had an opportunity to meet with some of these outstanding individuals at the State House. A group of school nurses came to Beacon Hill on January 24th to celebrate "School Health Day." Appropriately, we held a reception for them in Nurse's Hall, a section of the State House dedicated to the Massachusetts women who revolutionized health care throughout American history. Several nurses stopped by my office to voice their concerns about the importance of keeping intact programs designed to protect kids from smoking and tobacco products. True to their ideals, these women work tirelessly to protect the public's health, regardless of the environment in which they work.
In "Nurse's Prayer," an unknown author summarizes the attitude of a nurse:
Let me dedicate my life today
To the care of those who come my way
And then tonight when day is done,
Let me rest in peace if I helped just one.
Nurses immerse themselves in challenging, demanding environments. When they are on the job, nurses must be sharp and energetic. They must handle multiple tasks in occasionally chaotic situations, in a world that is dramatically more complex than the days of Florence Nightingale . Given the arduous world in which nurses serve, not everyone can meet the challenges of nursing. Then again, Florence Nightingale did not enter the profession because it was easy; she entered it because she wanted to help others. Fortunately for the rest of us, millions of others have followed her example.