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NP & PA Student Blog

A Grim Outlook on Nursing

Published December 10, 2012 11:18 AM by Terrance Clarke
I am currently in a  class called "Societal Forces" as a precursor to my first semester of advanced assessment in the Adult/Gero Primary Care Nurse Practitioner track. The teachers are passionate and well informed. The speakers are excellent, but the subject matter...The subject matter is frankly depressing. The class theme seems to be: "Here is how messed up the system you are entering is. Good luck."

We have heard about unions pricing themselves out of competitiveness and the changes that may or may not come with the inception of the Affordable Care Act. Cultural resistance to evidence-based practice. Medicare's new community health pay guidelines. Rural primary care clinics struggling to stay solvent. Sequestering measures that go along with the fiscal cliff. The continuing gap of respect between NPs and doctors. And the pervasive lack of good management, and systemic waste, at all levels of healthcare.

Being a newly minted RN on an NP track, I think a good description of me would be naive but outspoken. My optimism is such that when presented with a half empty glass, I point out that it is full of water and air. I lean toward a liberalism so broad that I have to change my scrubs twice a day, lest my bleeding heart show through.

Still, as the snow begins to stick to the ground I find myself as grey as the sky overhead. Every point made in "Societal Forces" can be backed up with articles easily found. Message boards I trawl through put this industry in the grimmest of perspectives.

So, more experienced workers and seasoned professionals, it's the season of giving. Winter has its grip, but coming is the time of renewal and rebirth. I am asking for a gift, a boon. Is there anyone out there who is living a silver lining and would be willing to share? Is all the doom and gloom I hear about all there is? Help a brother out of this funk! 

Happy holidays, everyone! May you never find tinsel in a nook or cranny where it does not belong!

9 comments

My fellow bleeding heart. As an NP you will have the golden opportunity to change the world one little bit at a time. As has been said we have the luck to relate to our fellow beings in the most intimate of ways. We are respected above all others and our patients share things with us that they share with no one else . I love my profession.... We sometimes forget that we are well paid and always in demand.  I've known other people who are well paid in the business, computers, or financial services industries. But at the end of the day.... They have the nagging feeling that they are 'whorres for the money' they haven't really made the planet a better place, or improved the human condition. Despite all the naysayers.. Remember to do well while doing good

That is the best revenge.

Twila December 18, 2012 10:37 AM

Terrance the NP Blogger here!  What a wealth of good cheer!  I was worried when I wrote this because I was in such a lousy mood.  Who says that the internet can't be a warm and accepting place!  I will probably visit this over and over when I find myself slipping into maudlin reflection.

Terrance Clarke December 14, 2012 11:54 AM

Hang in there little brother.  You obviously have the brains and, more importantly, the heart to fight the good fight through nursing. I wish I could paint a silver lining for you.  The truth is, sometimes you need to bring along your own paint and brush.  Some battles we will win and some we will loose. Give yourself a daily attitude check and remember why you went into the field.  Hopefully it was to make a difference one patient at a time.%0d%0aI hope you quickly get out of your funk.  We need you in the trenches.%0d%0aGod bless you.

Patrica DuPont-Tyler, pediatrics - RN, CPNP, CHOC December 13, 2012 4:50 PM
Orange CA

Nursing has always had its challenges. I certainly understand your frustration because I constantly ask myself in lieu of all of the dysfunctionality of the current system, "What in the world are you doing?" However, I have always wanted to work as a nurse practitioner. One aspect of this challenging road of choice that I have realized is that prayer is everything. Without the God of Abraham, Moses, and Jacob I would never make it. I consult Him and ask His divine blessings over my life and the lives of others as well as His guidance. It is so sad that as a strong country with such wisdom and a profound global presence that we refuse to fix this very broken system. We can act as change agents one NP at a time. We have the capabilities to do so. We need to start writing our state legislatures and providing them with information regarding the situation out here and if possible submit proposals for resolve. We need to make our voices known collectively and regularly if we ever expect positive healthcare changes to ever occur. I appreciate your question! It is a valid one for daggone sure !!!

Rickae Strack, Home Health Care - RN, BSN, MHA, current NP student December 13, 2012 11:16 AM
Wichita KS

There have always been changes in society they we have no control of that impacts our lives and our practice. Look at your education and training as a gift that you, as a NP, will use to improve the lives of others. There are so many facets to Nursing  you hve to find your Niche and create our own happiness and self fullfillment. Don't look to others to give you that; it has to come from deep down inside you. If you love what you do and love helping people improve their lives you'll find your own Silver Lining in time. Take your talents and create your own healthcare business or assist some community healthcare organization offer better healthcare to it's residents. Thinker broader and you'll capture a net full of clouds with Silver Linings designed by you just for you . Keep smiling!!!

Barbara Cross, Family Practice - PhD, FNP-BC December 13, 2012 8:42 AM
Hampton VA

“To do what nobody else will do, a way that nobody else can do, in spite of all we go through; that is to be a nurse.” – Rawsi Williams

The silver lining comes from within, its not something you can describe, or explain. It is something that you experience.

When your able to provide a service, compassion, treatment or just the shread of hope can be the silver lining.

Often with nursing, it is the things that we do, that we dont see, that will have the greatest impact.  

danielle, Psychiatry/ Addictions - ARNP-BC, SBH December 13, 2012 8:14 AM
sanford FL

I would have to agree with Kim & Sallie, ultimately we got into this profession to serve our patients.

Yes, there is a lot of 'crap' that keeps piling up, but hasn't it always? Even as a bedside nurse?

I can empathize with your concerns, I'm a fellow soon-to-be ACNP (4mos til graduation).

I think in the end, we nurses will win out. We always do.

Sean December 13, 2012 7:22 AM
PA

The truth is that everything you're reading and hearing about is true. However, there's a silver lining that I see as containing two parts. First, no matter what the job looks like people will always need nurses/health care. We have job security and millions of Americans aren't that lucky. We're spoiled to think that we should love what we do every minute. The fantasy that work is the source of happiness is actually the root of a lot of misery. The goal is to be grateful for your work, whatever it is.

This leads into the second reason for a silver lining: there is always an opportunity for deep connection when people allow you into the most intimate parts of their lives. I'm grateful for this even though it can be very difficult. Connection can be uplifting but it can also be devastating to feel the joys and pains of life that our patients bring to us with every encounter. It's easy to revel in the joys and hold onto those moments. However, I try to remember that even in the difficult moments we have an opportunity to practice patience and acceptance of the human condition. Honestly, I fail at these lofty goals most days but I know that when I can root my day in gratitude and service to others I find that whatever it looks like- good or bad- that I have some satisfaction at the end of the day.

I would urge you to look for your own silver linings and define your experience for yourself. Health care needs to be reorganized and you're entering practice in a time of change and uncertainty which can often breed negativity. Your challenge will be to cope with this reality while trying to maintain your passion and positivity. It's not easy but I do believe that it's possible.

My final advice is to: stay in the moment, foster gratitude, and know that you can find the good in each moment if you seek it. I suppose that sounds rather Buddhist coming from a secularist but in my experience it's the only truth I've found. So, keep your chin up and remember you do believe your glass is half full. :)

Kimberley Hohenadel December 11, 2012 5:14 AM
Fairfax VA

The silver lining is the individuals and families you will go on to help by improving their health and easing their pain. You will likely be part of many small 'miracles'.  

Sallie Porter December 10, 2012 2:02 PM

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