We have all seen the well-deserved outpouring of public support for frontline workers in the COVID-19 pandemic, and in many instances it’s nurses who are held in the highest regard. Nurses who potentially put their own safety at risk by caring for COVID 19 patients are hailed as heroes and given high praise from the general public and media alike. This image of nursing fits in well amongst the long-held stereotypes of what it is that nurses do, and so it’s readily affirmed by society. But have you ever been questioned as to your choices as a nurse? Have you ever been told that your career aspirations are simply not appropriate, and that if you really want to go to all that trouble, you can do better than nursing?
There are several instances in my own life where my decisions regarding my career path in nursing have been met with quizzical looks and even outright scorn. For those of us who choose to pursue nursing at its highest level and strive for the highest of credentials, work colleagues, acquaintances, close friends, and family can express confusion and even derision at our time and efforts. The highly educated and ambitious RN with a career plan that moves them away from the bedside and direct patient care does not fit into those traditional images of the nurse as an angel of mercy, a doctor’s handmaid, or even as a sex symbol. We are no longer “real” nurses, and no longer “doing what nurses are supposed to do”.
I first became aware of this phenomenon when I started teaching as a clinical instructor in addition to working in the PACU at a hospital. As I shared my excitement in having the opportunity to teach and mentor nursing students, most people were encouraging and saw value in what I was doing. But one of my closest friends caught me completely off guard when they asked whether I ever have students who were simply too smart to be nurses, and, if so, did I do the “right thing” and tell them to be doctors instead? I was so surprised by this question that initially I struggled to answer. My eventual response was to simply say no, adding that nursing needs smart people too. My friend went on to say that people who were smart enough should not be wasting their time washing patients when they could be a surgeon or hold some other better job. I now realize that the greater implication of what my friend was saying is that I am not intelligent, and that nursing is the “best I can do”.
A few years later, I was once again confronted with a narrow image of what nurses are supposed to do when speaking with new acquaintances at a social gathering. As we exchanged small talk and discussed what we did for a living, my initial description of myself as a nurse was met with nods and acknowledgement of my good work. When I further explained that I was working on a master’s in nursing education with the goal of teaching full time, the reaction was one of confusion and doubt. People expressed skepticism as to my motives, saying that nurses are supposed to want to care for patients. Why would I want to stop doing that? I must be in the wrong job to begin with. The idea that a nurse might want to work in a different part of the profession or choose to pursue graduate education was seen as weird and suspect. It occurred to me that no one ever questions a teacher who chooses to be a school principal, even though they no longer teach students in the classroom. Why would that sort of career move be acceptable for a teacher, but not for a nurse?
Perhaps the most jarring incident came another few years later in my workplace. As I drew closer to the end of my master’s degree, and started pursuing teaching opportunities in the classroom, it became apparent that nurse educators were now expected to have a terminal degree such as the PhD. This would bring us in line with other academic disciplines and hold nursing to the same high standards. I started exploring options for doctoral programs and working part time as a teaching adjunct and part time in the hospital. One quiet evening in the PACU I was discussing my plans with some of my RN colleagues. One person looked up from their computer and said in an exasperated tone “Why don’t you just go to medical school? You clearly don’t want to be a nurse!” By this time, I was no longer surprised by this sentiment, although it was hurtful nonetheless. It had become clear to me that even within our own profession, nurses do not fully understand the scope of practice and the career opportunities available to us. It’s a shame that many nurses cast doubt and derision on those who choose to practice in a different way than they do. Rather than building one another up, we pull each other down, failing to recognize that nurses are valuable in every practice area at every level.
Having now finished my doctoral degree and working full time as an academic nurse educator, I can say that my career aspirations have been realized, and that I feel great enthusiasm working with my students. Yet I still have plans for further education. Maybe I will become certified in simulation, or pursue a graduate certificate in online teaching, or participate in a leadership institute. I realize that I’m the type of person who fully embraces the mantra of lifelong learning. I want to always be moving forward and bettering my skills and knowledge, accepting new challenges. And this is all for the good of the patient. I may no longer wear scrubs and work at the bedside, but I am still a nurse, and will always be.
I was recently asked what it is that a PhD prepared nurse does. This time the question came from someone who was genuinely curious and wanted to learn more. I spoke about my own work as an academic, but that nurses with doctoral degrees might also be advanced practice registered nurses or high-level administrators, employed as nurse researchers who expand nursing science knowledge, or work in policy and government. I explained that they might also spend some of their time working at the bedside, or they may not. But either way, they are still nurses.
I hope that each of us will take responsibility to educate ourselves and those around us as to the full extent of nursing practice, and the idea that all nurses are intelligent, valuable, highly knowledgeable, and skilled professionals who are doing exactly what they want to do. And that is when they are at their best.
Amanda Shilo is an assistant professor at the Endicott College School of Nursing in Beverly, Massachusetts.