Nursing: A dying art

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Once upon a time I was 14 years old and so anxious to follow my “calling” to the nursing profession I proudly put on a volunteer Candy-stripper uniform. That marked the onset of my 53-year journey of bedside nursing care. In the early days as a volunteer, a nurse’s aide and later as student nurse at Mass. General Hospital, my quiet observations of nursing professionals helped me formulate an image of the nurse I hoped to become and, truth be told, what I did not want to become.

But beyond a doubt, my truest teachers were, and still are, the patients and their families who have shared my professional path. Sharing in their fears, sufferings, courage and often their deaths has given me priceless life lessons. Nursing is my artistic expression. Yes, I have chosen a profession that constantly challenges us to maintain knowledge and proficiency in the sciences and technologies that affect our patients. The biggest challenge has always been to uphold our nursing ideals and to actually practice compassionate, hands on nursing care in the course of our working shift.

During my 45-year career at Rhode Island Hospital, the Evening Bulletin/Providence Journal has shared my opining about the frustrations of working on the front lines. In each and every writing my goal was to inform my fellow Rhode Islanders of the staggering obstacles nurses were facing in the delivery of patient care and how aware we were that our efforts were falling far short of the high ideals that called us to this profession in the first place. In the early ’70s John Hanlon was the first to give a voice to staffing concerns after meeting with me and a few colleagues. I had a few chuckles recently when rereading that column. In it he cited that as RN’s we were making about $5 an hour and that we had discussed that the word “strike” was a horrid association with “nurse.” Little did I know that by the early 90’s I would be joining hospital colleagues to organize a union. Having been part of that successful process is one of my proudest professional accomplishments. I would even be serving on the union board the year we painfully had to advise our members to vote “yes” to strike after a failed contract negotiation. The Journal has shared my op-ed about the wrongs of mandatory overtime and the editors titled it Hospital Slavery. Mark Patinkin kindly wrote of my sentiments in one of his columns and a contribution to the Her Voice section of the Journal let me share again in a titled piece, The best I can’t do.

Professional nurses are not naive or ignorant to the fact that all corporate and management offices in the health care field are burdened and struggling with federal mandates and that many factors are changing the face of our work place. The health care field has become a prominent business. Our patient care jobs are being remotely and dispassionately micro managed by business minds who know not what we do. In recent years Lifespan has spent hundreds of thousands of dollars on consultant groups and mandatory employee classes. It was deemed important that all hospital staff change their concept and the terminology about a patient.  “Patient” would now be referred to as “customer.” Everyday the front line staff is well aware that we are thrust into a far more intimate and potentially life altering relationship with the “patient” who comes through the door than someone might have with a “customer” who is looking to purchase a coat. It sure makes us wonder if management and front line employees exist and function in a parallel universe! Corporate language can boast that their facilities “deliver health care with care”. The full burden of delivering that care rests on the backs of those of us who strive every day to uphold the ideals of our profession with one hand tied behind our backs in an ever increasing stressful working atmosphere. Our hospital emails speak of the administration’s gratitude and praise. Those words ring hollow on our units that are short staffed. Those words ring hollow to the ever-increasing number of employees being walked to Human Resources to answer to newly perceived management grievances.

Presently, fear and mistrust of management is the highest I have ever experienced. Yet, somehow administrative salaries and perks continue to boggle our minds while we try to function with inadequate or non-existent equipment, minimal staff levels and an air of meanness toward employees that is almost palpable.

The art of practicing nursing is slipping away. Vulnerable human beings still place themselves in our hands but our focus is more centered on communicating with computers and following directives that often make little sense. There is little time left to look our patients in the eye, hold their hands, share their fears and offer calming, compassionate reassurance. We are missing a valuable opportunity to learn from them and their families. The term “evidence based practice” is so frequently used in the medical field these days. There are few who could deny the healing value of the human touch, after all it’s a backbone of our nursing ideals. Once upon a time giving bed baths, back rubs and holding a patient’s hand provided a nurse the opportunity to really connect and accurately assess the physical, mental and emotional state of his/her patient. Indeed, all these dimensions of our nursing care were as important, sometimes more important, than dispensing pain medications. Corporate and management decisions have made that aspect of our nursing nearly nonexistent. How very sad for our nursing practice and, more importantly, what a monumental loss for our patients!   

Maureen Renaud, RN lives in Providence and continues to speak out about a profession she has devoted her life to.

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