When I decided to go into nursing, I did so to help people. To heal and educate, to give some compassion to those that are in need of help, to lessen the effects of disease. Helping people has always been my calling. It has never been about the money. I would never and could never make a decision for my patient based on how it will affect my pay or my financial outcome. I make a decision for the best of the patient. When I was new to nursing, I believed the doctor did as well. I admit I used to have an unusually optimistic view of people and the world around me. Unfortunately, over the last few years I have seen things that have forced me to change my views, and all I can say is that humanity has a price, and the cost is rising.

At one job I was asked to give one IV anti-emetic over another because the price was lower and/or the reimbursement was higher on one versus the other. I also worked for a doctor that would tell the patient a treatment wasn’t a good option because the patient’s insurance wouldn’t pay for it. I would also be asked what insurance the patient had prior to the doctor seeing the patient.

I wish I had known this before going into medicine. If I had, I may have made a different choice. Seeing this has really made me lose faith in humanity. I see it everyday in stores and on the road, people indifferent or rude towards one another. However, in a setting where I expect compassion and respect, I am seeing something quite unexpected. It is disheartening and frustrating. It makes me lose respect for the people I have looked up to my entire life. I understand not all doctors are like this, but unfortunately, there are enough that I need to speak up.

Doctors took an oath to help those in need. They have people looking to them for help in getting better and giving them all the information they need to make informed medical decisions. They have a moral obligation to their patients. Doctors have to put their patients health above their cash filled pockets. Unfortunately, many patients cannot see this and think the doctor is giving them all the information, when, in reality, that isn’t always true.

Patients need to advocate for themselves and, as nurses, we need to educate and advocate for our patients as well. These doctors need to ask themselves why they got into medicine. Our doctors should be in this field for the love of people and medicine, not for the paycheck they see each time a patient walks in the door.

I see a lot of nursing students wanting to be spoon fed the information, wanting to do very little work to learn this information. Granted, there is A LOT of information to know, however work needs to be done to incorporate and apply this knowledge into many different settings and scenarios. I don’t see the students going that extra step to apply the knowledge. This scares me as an instructor and as a potential patient.

This is the mind set that no nurse or nursing instructor wants to see. This action tells me that the students that I am teaching are in the wrong mindset. They are not interested in learning all they can to be a great nurse. They are only interested in passing the test, scraping by and being mediocre nurses. So I pose this question to you? Do you want to be taken care of the nurse that tried their hardest to learn as much as they could or those that did as little as they could to just get by?

As a nursing instructor, it makes me cynical as to the new generation of nurses that we are breeding. Will we have a generation of nurses that can acquire the critical thinking skills needed to be a proficient and skilled nurse? Who is to blame for this next generation? Is it our fault as instructors or is it the mindset and work habits of the students?

I don’t want to see the students sitting around during lab practice or in clinicals, not taking every minute to practice their skills or soak up every opportunity to learn something new. I don’t want to see the bored faces of those that think they have practiced enough or say they know how to do it, and then come finals time, show me that they cannot do the skills and just barely pass.

I no longer want to see my nursing students with a sense of entitlement, saying “I paid my tuition, so give me my diploma”. A diploma is not just a piece of paper, it is a symbol of the education you earned. I want to tell my students that they don’t need to know this for the test and for their pencils to keep frantically writing.

I want to be a proud instructor of the students that are graduating. I want to feel safe, that if I were to open my eyes while laying in an ER and see a former student standing over me, that I can lay my head back with the confidence that I will be well taken care of. I don’t want the feeling of worry that the former student would say “that wasn’t on the test” and therefore they didn’t need to know it to take care of me.

I actually feel that a lot of nursing students that have a medical background (CNA, EMT, MA, etc) are at a disadvantage in nursing school. They have learned a different discipline in the medical field and when asked to change their way of thinking, sometimes it is a difficult task to do. Let me give you an example. Say you are a waiter for 5 years and then get promoted to manager, you have a different set of tasks that must get done, a different way of thinking and you must look at the restaurant in a different way. You are now not just concerned with getting your customers food out on time and making sure their needs are met, but you now need to make sure that the whole restaurant’s needs are met and that the restaurant is making money. Some managers can’t see past their customers food getting out on time, and therefore, they struggle to be good managers.

People with prior medical experience also have a lot of opportunity to pick up bad habits at their current medical job and sometimes that will spread into nursing school. They are constantly comparing school to “how it is done in the real world”. Just because it occurs in the real world doesn’t make it the right way of doing things. A lot of nursing students will fight the way things are done in nursing school, because they see how nurses do things at work, and want to do it that way. It becomes frustrating for the students as well as the instructors.

Some people that have prior medical experience coming into nursing school have a preconceived notion that nursing school will be easy because they see it and may even do some of the tasks that RN’s do. They can have somewhat of an attitude, if you will. This is a difficult mind set to overcome as a nursing instructor, as these students often feel and treat you like they have nothing to learn from you.

One more thing, students with prior medical experience sometimes have a harder time on written exams. This is due to their being exposed to more experiences and therefore they may read into the question more and come up with exceptions, rather than just reading and answering the question at face value.

So to sum it up, you do not need any formal medical experience prior to entering a nursing program, however, some volunteering or shadowing of an RN to see if this is the right choice for you is a good idea. You don’t want to spend a lot of time and money to realize that you don’t like nursing and all the tasks that go with it. So good luck and don’t ever feel like you are the one at a disadvantage because you don’t have medical experience, you are and will be just fine.

As to specializing right out of school, I tell my students what I was told when closing in on graduation. I wanted to graduate and go right into labor and delivery. I was told to do at least one year in med/surg. No one actually gave me a good reason why, but knowing that they knew more than I did, I followed their advice. I am glad that I did. I worked for a little over a year on a med/surg floor at a local hospital on the night shift.

The first year is when you do a ton of learning; skills, assessments, critical thinking and most importantly, your nursing habits. I learned how to problem solve and think for myself as a nurse and rely on my instincts and assessment skills. I also learned how manage my time, generally taking up to 6 patients per shift. I mastered some of the skills that might not otherwise be done in certain specialties. I also learned how to organize information that was given to me in a meaningful way that helped me master the nursing process.

I never have regretted my first year as a nurse. I learned a ton and I think it has made me a better nurse in the long run for doing it. You have the rest of your career to pick and choose different specialties, why rush?

As nurses, are we doing our patients a disservice by showing up with all this baggage? Our patients deserve no less than our best and how can we truly help when we are carrying not only our own burdens, but those of everyone else? Other patients, our friends, our neighbors and even those of strangers? We must find a positive outlet to release this negativity. We must at the very least leave it at our patient’s doors.

Then I started to wonder if there is a correlation between more illness in our society and this constant bombardment of negativity. Is it because we are taking worse care of ourselves? Or could it be that our cells are responding to a trigger from the environment we expose them to? Is it really mind over matter? Does our chronic environment have control over the health of our body?

There is an experiment done with water that was exposed to different ideas, sentiments or feelings, both positive and negative. When the water was frozen and pictures were taken of the ice crystals that formed, it was amazing what was discovered. I know it sounds really weird, but the positive and negative was reflected in the ice formation. The “positive” water formed beautifully complex and organized ice crystals whereas the “negative” water formed jagged, random crystals. The experiment is explained and detailed in a book called “The Hidden Messages in Water” by Masaru Emoto.

So, if we are made up of 80% water and we are being bombarded by negativity around every corner from every person we encounter and everything we think and feel, what is our water doing?? And more importantly, what is going on in our cells? Could this same concept be occurring at the cellular level to create disease? I am beginning to wonder if it might have an affect? Definitely something to think about.

I want to leave you with an excerpt from an email I received the other day, quoted from George Carlin. It makes you think a little about what happened to our society and where we might be heading…

The paradox of our time in history is that we have taller buildings but shorter tempers, wider Freeways, but narrower viewpoints. We spend more, but have less, we buy more, but enjoy less. We have bigger houses and smaller families, more conveniences, but less time. We have more degrees but less sense, more knowledge, but less judgment, more experts, yet more problems, more medicine, but less wellness.

We drink too much, smoke too much, spend too recklessly, laugh too little, drive too fast, get too angry, stay up too late, get up too tired, read too little, watch TV too much, and pray too seldom. We have multiplied our possessions, but reduced our values. We talk too much, love too seldom, and hate too often.

We’ve learned how to make a living, but not a life. We’ve added years to life not life to years. We’ve been all the way to the moon and back, but have trouble crossing the street to meet a new neighbor. We conquered outer space but not inner space. We’ve done larger things, but not better things.

We’ve cleaned up the air, but polluted the soul. We’ve conquered the atom, but not our prejudice. We write more, but learn less. We plan more, but accomplish less. We’ve learned to rush, but not to wait. We build more computers to hold more information, to produce more copies than ever, but we communicate less and less.

These are the times of fast foods and slow digestion, big men and small character, steep profits and shallow relationships. These are the days of two incomes but more divorce, fancier houses, but broken homes. These are days of quick trips, disposable diapers, throwaway morality, one night stands, overweight bodies, and pills that do everything from cheer, to quiet, to kill. It is a time when there is much in the showroom window and nothing in the stockroom. A time when technology can bring this letter to you, and a time when you can choose either to share this insight, or to just hit delete…

Let me give you the full circle of the scenario of the nurse that thinks they know everything. They won’t ask questions or look up the correct answer but proceed on what the “think” they know. A mistake will get made. if that nurse didn’t admit to not knowing, they certainly aren’t going to admit to making a mistake. So they will blame the closest logical person. If you happen to be that person, get ready for explaining something you have or wish you had nothing to do with.

The sign of a good nurse is, no matter how long ago you graduated, admitting that you don’t know everything and asking questions when in doubt. Getting advice in nursing is considered collaboration, not weakness or ignorance. Please be the good nurse. It might save a life…