In Defense of Nursing

December 11, 2009

As a family nurse practitioner student, people regularly ask me a question that I find extremely rude:

“So why didn’t you just go to medical school?”

All nurses who are labelled as achievers, as do all male nurses, get asked this question frequently. People don’t understand why anyone would choose to become a nurse rather than a doctor. They assume that this decision is evidence of the fact that you must not “measure up” or “have what it takes” in some way. These assumptions have saddled nursing with a bit of an inferiority complex (here I go with inferiority complexes again), which we cope with as best we can by fortifying our discipline with ever-improving arms of academia and clinical expertise.

Although nursing and medicine are related, they are distinct disciplines. We’ve had our own pioneers, our own theorists and researchers and clinical heroes. For me, the difference comes with how we are taught to conceptualize things like health, wellness, disease, treatment, power, and empowerment. Nurses seek to address the patient holistically, as a balanced ecosystem of body parts, chemical reactions, cultural components, social bonds, economic resources, developmental stages, and idiosyncratic quirks. A nurse practitioner aims to use not only empirical or scientific knowledge in the battle against illness, but also personal, ethical, aesthetic, and sociopolitical knowledge as well. We’re trying to improve our understanding of how broad determinants of health, such as socioeconomic status, influence the human beings that we care for. And though we seek to sharpen our clinical judgment and expand our arsenal of skills in order to keep pace with modern medicine, we keep the focus on the global picture. This is the direction that nursing leadership is and always has been pursuing.

Of course, I’m biased towards my own profession, but I didn’t start out this way. I went into nursing with a very low opinion of the field. My only plan was to use nursing as a bridge to medical school. But my time in the real world, my experiences within the healthcare system and by the bedside profoundly influenced me. Which is why I really loved this column on nursing published by the Kaiser Family Foundation. It really rings true to me by acknowledging how nurses are trying to impact the system and how nurses contribute to improved medical outcomes. The article reviews some of the progress that nurses have made in the past ten years in terms of influencing how care is delivered. The authors describe nursing as undervalued, which is a statement that’s often thrown around flippantly, but they show the sad truth behind the statement. For instance, despite the fact that nearly half of all health care workers are nurses, and despite the fact that nurses deliver the vast majority of bedside care, only 2% of hospital boards include nurses on them.

Given the current health care climate within the larger global picture, nursing’s struggle against insane policies and practices (everything from understaffing and poor utilization of human resources to global inequities and evil economic practices) is an uphill battle. But I have confidence that nurses will succeed in shaping a more humane, more sustainable health care system in the future. I hope this blog post adequately captures how honored I feel to be in such good company as we move forward with our committment to a better world. I also hope I finally put to rest all those questions why I didn’t choose medical school. And nursing, if you couldn’t already tell, I love you.

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The Mirror Stage

July 23, 2009

Momma always said that trying to discern the genetic underpinnings of human nature is like trying to reconstruct this recipe for coulibiac merely from tasting the finished product. Now, Momma wasn’t Russian, but she was an alcoholic, so I didn’t take her metaphors too seriously. This article, however, gave me a new appreciation for Ma’s insight. Not only does the article use real science refute a branch of academia that I am prone to detest, but it also quotes former UNM anthropologist Kim Hill, who I know personally. Yeah, that’s right. I gots connections.

The article, which addresses the issue of rape genes and jealously genes and all that hot n’ heavy Darwin stuff, touches on something that I think is really fascinating: human evolution in the past 10,000 years. I mean, like, wow man. Maybe these trendy new genes are the reason why we’re not all dying from leaky-gut syndrome. This whole ongoing evolution thing may turn out to be a boon for chubby chasers, since obese chicks have more children. Does that mean we’re passing on the gene that turns donuts into cellulite with a greater frequency than gene that turns donuts into abs of steel? I’m thinking that the next 10,000 years of evolution will turn us into a species of buoyant blubber balls who can sustain ourselves on nothing other than corn derivatives. Also, new and improved humans will sprout flippers instead of limbs since, you know, global warming and all. Hey, we already have gills. (By the by, how awesome is it that the Missouri Association for Creation website has a tab called Get the Facts?)

Unfortunately, my vision for the New American Century has been sullied by confounding variables. Turns out property values may be the strongest predictor for obesity: that is, as your property value goes down, your waist-to-hip ratio goes up. How do you pass on your property value gene? In a trust fund? Does your property’s value count as a pre-existing condition under Obama’s endangered public option?

Whatever our evolutionary heritage, it’s obvious that we humans are pretty obsessed with figuring ourselves out. Despite the obvious genetic variability in our species, it seems that the gene for self-voyeurism is nearly universal. I hope that the current battle betwixt those macho, speculatin’ evolutionary psychologists and their more egalitarian critics yields a bunch of cool new science for me to blog about. What else am I supposed to do? I mean, I can help treat obesity, but I can’t give anyone a pill to increase their property value. YET.