The author of the Reflections essay in AJN‘s September issue, Kathleen Resnick, confronts a question many nurses must confront at some point: what is it to be a nurse?
And a related question: what is the essence of nursing work? If you can no longer work as a nurse because of physical constraints or for another reason, are you still a nurse?
Writes Resnick in “A Different Kind of Nurse“:
My nursing career was spent in hospitals, working mostly in critical care as a bedside nurse, then in management. I worked hard and my work was a large part of my sense of self-worth. I loved patient care and the satisfaction of making a difference. As a manager, I felt my primary mission was to enable those I served to do their best work. . . . I was somebody. Now what am I? An acquaintance asked me, “Didn’t you used to be a nurse?”
Once a nurse, always a nurse.
After a period of struggle with having lost her sense of purpose and identity, the author one day finds herself in a tragic and dramatic situation in which all her nursing instincts and skills are called back into service. And they are right there, ready to respond.
The event reminds her that nothing will ever change the fact that she is a nurse, and gives her the hope to find a way to apply her knowledge in new ways. In losing a beloved profession, Resnick learns that she will always carry the profession within.
As I read your reflection, I was reminded of how I felt leaving intensive care “bedside” nursing to do community end-of-life care, and from that level of hands-on care to administrative roles, and now consulting. Each step away from the “bedside” carried the same feelings of loss that you express over what many of us nurses see as an integral part of nursing–the physical care of the patient. I, like many older nurses, continue to use my expertise to impact nursing care in other ways, but I think I will always feel like being a nurse is still a part of who I am.
I have this discussion in a slightly different context with some of my legal nurse consultant colleagues. It is my personal contention (shared by many) that what we do when we consult to attorneys is not a nursing specialty, because what we do does not conform to the ANA definition of nursing. Specifically, we do not protect, promote, or optimize health and abilities, prevent illness/injury, facilitate healing, alleviate suffering via diagnosis and treatment of human responses, or advocate in care of anybody (ANA, 2015). Another camp declares that of course it is a nursing specialty, because we are nurses. The logical fallacy (e.g., begging the question, the circular argument that requires the desired conclusion to be true; making an assertion as proof without actually offering any) is there for anyone to see. But I hear their passion.
Actually, attorney clients don’t even care if we are currently licensed as RNs (if we aren’t testifying experts) because they use us for our knowledge of hospitals, medicine, and nursing in records reviews and other activities when THEY are the legal advocates in litigation and have complete control of the case. The BON does not regulate LNC practice in any way.
However, I don’t think you will find too many of us, myself included, who would not passionately defend ourselves as nurses to the core, perhaps right after as our identities as life partners and parents, no matter what our employment status. Legally, one cannot hold oneself out as a “nurse” or allow others to do so unless actually licensed as one; it’ll be a hard habit to break. Guess when the time comes I’ll just have to learn to say, “I practiced for X years, but am no longer licensed.” It’ll be just as when my children grew up, I transitioned from “mothering” to “being a mother,” right? Always in our hearts, if not our hands.
ref.: ANA Scope and Standards of Nursing Practice, 2015, p. 1