Nursing is No Longer Nursing Today

After Medscape blogger Beka Serdans received a number of responses from nurses that stated that they wanted to leave nursing, she was curious why nurses felt that way. In an online poll, she found that 33% of 282 respondents wanted to leave because of high stress and burnout, 25% cited administrative reasons and red tape, 17% said that nursing is no longer nursing today, and 12% cited inadequate staffing.

Stress, burnout, red tape, and inadequate staffing are nothing new. More concerning is the number of nurses who said that nursing is no longer nursing today. Although the wording is not quite grammatically correct, we all know the intent of the phrasing. The profession of nursing is no longer the way it was in years past, and will probably never be the same as it once was.

A number of nurses responded to the survey and posted comments of their own. One wrote, "It would be far better for the nursing profession if every nurse was seen as an independent practitioner, in the same way that physicians are viewed. That would remove the endless expensive and largely useless, superfluous layers of nurse management from the equation (thereby freeing up vast sums of cash) thus permitting nurses to do the job they are paid to do. It would result in appropriate self-regulation and I would never have had to work in the hostile environment that required me to see 180 patients during a four hour morning fracture clinic, followed by another 120 patients in a three hour afternoon orthopedic clinic."

The suggestion of nurses being viewed as an independent practitioner is an interesting one. Although nurses are independently licensed, they are not for the most part, considered to be independent practitioners. Rather, nurses are typically viewed as belonging to a group, such as the "7 West staff" or "clinic nurses" or "hospice nurses." Administrative hierarchies are generally thought to be required to "manage" these groups. And if someone has an issue with a particular nurse, the nurse's supervisor is usually sought out. In nursing, we have a long history of bypassing the nurse and going straight to his or her superior. The nurse who suggested that nurses should be viewed as independent practitioners may be on to something. Many nurses would welcome added autonomy and authority and fewer (or no) administrative layers. But my guess is there are also some nurses who find comfort in having layers of administration to buffer them.