2.27.2008

Generativity versus Stagnation

I'm comfortably tired. The next few weeks are going to keep me busy, this is the first chance I've gotten to sit down and do nothing all week! Yesterday and the day before were my first two days of med/surg this semester, that gets its own post next (since I owe a journal entry on those days, and it's due tomorrow!). Tomorrow I have my Home Care day with the local VNA (visiting nurse's association), Friday I'm giving a crash-course in first-aid to a troup of girl scouts (stop snickering, you), Saturday and Sunday will hopefully be devoted to spending some quality time with what few friends I have left, then it gets REALLY busy. Monday has me up at 7AM to drive across the state and give a talk to another community college's nursing class about starting up a Student Nurse's Association. After that, it's med/surg 'till midnight! The next day, I've got a state SNA meeting for all the chapter presidents early in the morning (focused on mobilizing Nurses in the political process), then..you guessed it! Back to med/surg! Fortunately on Tuesdays we get out a little early, because.....class begins at 8AM on Wednesday. I volunteered to do some kind of "read across america" function for Dr. Seuss' birthday on the Friday after that. Rather than reading, I was told I could do any kind of nursing-related demonstration without set beginnings or ends, so I figure I'll bring the laptop, the electric stethoscope and maybe some curlex to play with. Then, a little more time to rest before it's off to the NSNA convention in Grapevine TX.

Organizing the trip has been a little frustrating, since people kept changing their minds about going. Thankfully we're traveling with a relatively large number of students, four of which are first-year students! It'll be nice to set the next year's senior class up with a few key people who are looking beyond the limited coursework. This will be the most first-year students we've ever taken to a convention, we'll be getting them involved with the resolution and parliamentary stuff, as well as selling some coffee mugs and shirts. Gotta make some money back, hotels and plane tickets are expensive! A very small percentage of NSNA members actually go to the conventions, and it's a shame. There are great speakers, seminars and focus groups about everything from pharmacology to disaster response to the image of nursing in the media, nursing specialty groups like nurse midwife, travelers, and nurse anesthetists, how to manage people, how to be managed by people, you name it. Throw in a HUGE job-fair full of hungry recruiters and put it all in a swanky resort and you've got a winner.

Besides all of the interesting things to do there, I've appreciated the chance to connect with the faculty outside the structured academic environment. I got a lot out of it last time, when our program's director hung out with us, told us stories and gave us advice. This time, one of my clinical instructors from last year will be joining us. I'm looking forward to that, all of my clinical instructors (well, maybe with one exception) have been people I'd love to hang out with outside of school.

Meeting student nurses from other states is interesting, too. From diploma nurses all the way to graduate and doctoral students, every entry into practice and state is represented. Supposedly some states are hosting international students this year as well, I think that's a new thing. The chaos of the convergence of all of these different people with nothing in common but Nursing was most apparent to me in the House of Delegates. This is where the parliamentary business of the national organization is performed. Last year we got a resolution passed after a couple rounds of nailbiting debate and voting. This year, the resolution on the table was written by me and a classmate, so it will be -extra- exciting.

It's hard to motivate people to get involved with anything outside of the bare-minimum required to get licensed. It's like exercise. Feeling tired? Weak? Lethargic? Exercise might seem like it will make you weaker and more tired, but in fact it actually addresses the source of that weakness. The same holds true for Nursing School. If you just condition yourself to doing the bare minimum (and the academics are trivial compared to science or engineering), what makes you think you'll suddenly be able to summon the extra cleverness, motivation or spirit that practice demands of us? So far, Nursing seems like it can be a frustrating, disheartening experience to people or groups of people who passively accept their situation instead of advocating for themselves and their profession. It's a lonely scene to be a loner in.

There's a point where some of us wake up, take a look around, and realize that we aren't merely health care pros that show up for work and then leave at the end of the shift. We're a cultural institution. We're the most trusted profession in the US (according to polls). We're the conscience of a health care system blinded by monetary economics. We also comprise well over half the health care work force. Despite all this, Nursing gets the legislative shaft because "oh, this is hard enough already, I shouldn't have to do extra work, let someone else handle it". This is what makes things -easier-, not harder. Networking, forming professional relationships outside of the workplace, accumulating contacts for research, education and employment isn't merely a strategy for professional success.

What I'm talking about is the nature of the bonds between us that take our seemingly hopeless, impossible task and turn it into something that we can execute faithfully while taking joy and pleasure in our work....a method for providing context to the grim realities of life and death we're charged with managing

...and finally, when it's OUR turn to lie in that bed, to meet our fates with grace and serenity, comforted by the knowledge that the nurses we trained to replace us face THEIR task with all of the best wisdom, compassion and ambition we could preserve from our memories of our teachers back when we were students.

The alternative is to be in that bed surrounded by unmotivated, apathetic nurses-turned-technicians, and receive the level of care that goes along with that.

You don't have to accept pressure ulcer formation. You don't have to accept clients lying in their own filth for hours at a time. You don't have to accept the judgment of a politician that claims emergency departments are swell places to receive routine medical care. You don't have to accept bureaucratic dictates when they start to negatively impact patient care.

I realize a lot of this sounds like wistful idealism from someone who isn't even licensed yet, and I don't want to offend anyone else who has been frustrated or disheartened by these trends. When I look around at the other health care blogs floating around I see the same kind of nascent mob-intelligence that's been springing up in other fields, it's just restrained a little bit by tradition still. The apathy I've seen in my peers gives me pause, though, and it's given me an opportunity to reflect on the challenges that lie ahead.

I learned today that the director of our program will be leaving before the semester is through to take a position geared towards...what was it..some kind of state-wide faculty and staff development position. Her role at our school seemed to be geared towards faculty and staff development, so most of the students didn't get to interact with her much. I spent a bit of time with her between her being our faculty adviser for the SNA, along with my habit of occupying administrative offices whenever I'm in school. Like many of the faculty members, she's been an inspiring influence. When I heard the news I was sad at first, but then I realized I'm about to leave this place also, and we'll both be working to improve things wherever we are.

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