Confessions of a non-nurse
June 10, 2010 -- Today the Seattle Times published a piece by Sharon Randall, a nationally syndicated columnist, that offered one of the more striking combinations of good intentions and nurse stereotyping that we've seen recently. "Confessions of a home nurse" is built around the comic idea that Randall was acting as a "nurse," though by her own account a highly imperfect one, in caring for her husband after a recent operation, as well as in caring for her child after he was born years ago. Randall throws in positive accounts of the care she and her child received from real nurses, those "compassionate" "angels" whose care is apparently defined by "loving kindness" and "tender mercy," phrases she manages to use twice. We recognize that Randall is not suggesting she is a real, licensed registered nurse--we know the term "nurse" is still commonly used to mean unskilled tending--and her piece is all about how bad she is at doing even that. But her relentless equating of such unskilled care with actual nursing, in a context that really does superficially resemble professional nursing (unlike, say, "nursing a beer"), is damaging because it reinforces the idea that nursing requires little skill or education. Randall's writing comically, but the subtext--which no one will take as a joke--is that what makes a real nurse is kindness, patience, and endurance. Of course those things are important in nursing, but so are college-level science education and advanced clinical skills. Randall could probably take a stab at some of the most basic things physicians do too. But we doubt she would write a whole piece based on the idea that she was a flawed physician. We urge her to think more carefully about how unskilled and angel stereotyping makes the work of real nurses harder.
This edition of Randall's column, which is apparently distributed to hundreds of newspapers through the Scripps Howard News Service, ran in the health section of the Seattle Times. She begins:
When someone you love is on the mend, recovering from some awful ailment, you want him to have the best, the kindest, most compassionate, most professional care possible. Unless you are his nurse. In which case, be honest. You want him to suck it in, quit whining and leave you alone. My husband, bless his heart, had outpatient surgery this week to repair a small hernia in his, well, never mind. I want him to have the best care available. Unfortunately for both of us, I am it. It was never my ambition to be a nurse. A wife, yes. A mother, sure. Nobody told me being a nurse was part of the job.
Randall goes on to explain that she tries to be a good nurse, fixing her husband snacks, bringing him ice packs, giving him "pain meds every four hours, even if he's drooling," and of course, finding the lost remote so he can change channels. She admits she is not very good at it, but "it is not for lack of experience," since her "introduction to nursing duty came with the birth of [her] first child." She notes that "infants require around-the-clock care and feeding." Randall also says that soon after delivery, she had complications and had to return to the hospital with her breastfeeding baby to have surgery.
I was too weak to stand, let alone to hold [the baby]. So day and night, while I slept with a tube pumping blood into my veins, an angel disguised as a nurse would slip into the room to pick up my baby, change his diaper and hold him to my breast. For more than a week, it happened every two hours around the clock. They tried stretching the hours between feedings. The boy threw a fit. More than once I awoke to see some stranger in a nurse's uniform cradling my child and singing him back to sleep. I loved those strangers. Still do, though I don't remember their names. They told me they rarely saw "well babies" on their floor, so they fought over who got to take care of him. No need to thank them, they said, it was their job. Their job. Their loving kindness. Their tender mercy. And the fact that the boy was pretty darn cute.
Randall observes that it can be harder to care for things that are seen as less cute, noting that her father-in-law was recently in the hospital, where she wanted all the care givers to "respect who he is -- a good, capable man with a brilliant mind and a beautiful heart," but also to "care for him as if he were a helpless newborn, with the same measure of loving kindness and tender mercy that was shown to me and my child." Wrapping up, she notes that we were all babies once, and her husband is still cute,
when he's not drooling. I'm not the best nurse. He's no model patient. We're doing the best we can. It's called marriage. He doesn't need to thank me, but he will. He'd better, if he ever wants to see the remote.
It's obvious that Randall has a lot of affection for the real nurses she's met, and she also seems to respect their patience and kindness. What's missing is any sense that she realizes nursing has any intellectual content, that it requires any of the "brilliant mind" she is eager to have recognized in her father-in-law. Despite a passing reference to "professional care," her conception of nursing is overwhelmingly that of the unskilled angel, with descriptions like "kindest," "compassionate," "loving kindness," "tender mercy," "loving kindness," "tender mercy," and, well, "angel." Thus, it's not a job that requires much training or skill; it's just a matter of being really, really kind and faithful, which anyone (like a newspaper columnist) could potentially do.
In fact, if Randall had surgery and spent a week in the hospital, it's likely that those darling little angels did a little more than provide "love" and "mercy." It's likely that they helped to save her life, both during the surgery and afterwards, using their advanced skills to monitor her condition and responding to the slightest changes with appropriate treatment. Who made sure those tubes were properly pumping blood into her veins, and that all the other complex health technology was keeping her alive? Those angels spent years getting a college-level science education so they could do all that. Handing someone pain meds and providing unskilled care to a baby does not make you a "nurse." And "being a nurse" is not part of Randall's job as wife and mother, any more than being a physician, lawyer, or accountant is.
But as long as all the average person--like Randall's six million readers--thinks of nurses as unskilled angels and helpers, they're not going to see why nurses need much funding for clinical practice, education, or research, and the global nursing shortage is unlikely to be resolved. In fact, people may not even see why nurses need adequate security, or why the severe physical and emotional abuse many nurses suffer must be addressed.
After all, it's all part of being an angel, right?
See the column "Confessions of a home nurse" by Sharon Randall, published in the Seattle Times on June 10, 2010. Please send Ms. Randall your comments at firstname.lastname@example.org and please copy us on your letter at email@example.com. Thank you.