The future of nursing lies with the nursing students of today. What is the legacy we, practicing nurses, leave for them? What responsibility do we have as individuals and as a union to build a society that provides for a decent quality of life, meaningful work and creative opportunities for future generations?
If we don’t ask these questions and put together an analysis of where we are and where we are going as a profession, we risk nursing being victim to forces that appear to be beyond our control.
Nursing education, historically, was designed to uphold the strict class-based hierarchy that existed in hospitals: Director, Doctor, Supervisor, Head Nurse, General Duty Nurse and Nursing Assistant. While the titles have changed and greatly expanded, the hierarchal configuration has not changed much. The big difference is that insurance companies and bean counters are now in charge who can manipulate the reimbursement systems that are always in flux.
How has nursing education changed? Programs today emphasize autonomy and theoretical constructs that the healthcare system, by design, renders impossible to implement. Thus, the culture shock that new grads are faced with starts them off in a state of confusion. What preceptors, mentors and colleagues offer make or break the nurse as she/he attempts to negotiate a system that says one thing but often times does another.
Nursing programs appropriately promote “critical thinking” in our houses of education and employment but people who question the status quo or attempt to actually make creative changes often find management unreceptive to these creative ideas. Sometimes these leaders are labeled as unrealistic at best, troublemakers at worst.
As nurses in our facilities, we are told we are “professionals,” that we have a voice in “shared governance,” and that we are “compassionate caregivers.” The reality is that some management programs are really designed to meet metrics that are often unattainable because we simply don’t have the staff and resources to comply. Often times management creates venues for our participation, but tries to get us to rubber-stamp CEO-type policies. But if we can get away to participate at all — and delivering compassionate care requires us to forego lunch and breaks and leave late — we are charged with being “disorganized” and having “time management issues.”
Democracy v. hypocrisy
The contradictions in the broader society are mimicked in our hospitals, clinics and schools. We are very fortunate to live in a democracy. But income inequality has widened to proportions not seen since the 19th Century, the Voting Rights Act is being gutted and labor laws and union rights are under attack, putting that very democracy under attack.
We must strive to live up to the ideals expressed in the motto on the Statue of Liberty: “Give me your tired, your poor, your huddled masses, yearning to breathe free.” That means an end to talk of constructing walls and promoting xenophobia and instead working with other unions, students, advocates and others to embrace America’s diversity.
The U.S. is the wealthiest nation on earth, but we have some of the worst health indices of the developed world and conditions in some of our communities that rival those in many underdeveloped nations. Nurses are on the frontlines to combat these conditions.
Owning our destinies
NYSNA has identified key legislative areas that can be addressed to change some of these challenges: safe staffing laws via enforceable nurse-patient ratios, overhaul of the healthcare system via a single payer system, reversing the climate change that has created not only a healthcare crisis but endangers the future of our planet. Why?
Patients need adequate professional and ancillary staff to be able to receive humane, quality care.
Families cannot be healthy if they must compromise their health care needs as they balance survival needs like food, shelter and education for employment, such as the current system forces them to do.
Finally, there are no jobs on a dead planet. The dependency on fossil fuels and further exploration of the use of non-sustainable, dangerous and toxic energy sources will lead to further climate change demise.
As individuals, we don’t have control of our future to the extent that we should. We need to use our union as the tool through which we can fight for safe staffing on our units, in our workplace and in our state. We need to support and encourage our new nurses to fight along with us as they confront the challenges of the “real world” of healthcare. We can win if we continue to fight for further gains through our contracts and we continue to organize in our communities.
A safe and healthy planet and a kinder, gentler nation should not be a utopian dream. The future lies within our youth — and the tools we leave them to build with.