Excuse Me, I’m Not Just a Room Nurse

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Art by Jang, Color by Pakun and Swedy

Art by Jang, Color by Pakun and Swedy

Little knowledge is dangerous. And for a person running for public office, blabbing things like, “Hindi naman kailangang magaling ang nurse” is an absolute suicide.

Earlier this month, senator-candidate Cynthia Villar was the talk of the town as hundreds of Facebook users express their disappointment to the early favorite now turned public enemy political aspirant.

Her interview with Winnie Monsod can be seen in Pagsubok ng mga Kandidato, a special TV program where candidates are invited to the hot seat as they answer various political questions. Mrs. Villar caused an uproar in the nursing community when she delivered blatantly belittling statements regarding the competence of Filipino nurses.

In the said show, Villar claims that “Actually hindi kailangan ng mga nurse na matapos ng BSN. Kasi itong ating mga nurse gusto lang nilang maging room nurse. Or sa America and in other countries e ano lang sila, yung parang mag-aalaga. Hindi naman sila kailangang ganoon kagaling.

An erringly similar statement also troubled me a few months ago when my teacher said, “Ang tingin ko talaga sa mga nurses e katulong na may lisensya.”

For the first five seconds, I felt the sudden gush of catecholamine inside my blood vessels. I was about to stand up and lash out to this seemingly mindless woman but then my conscience got the best of me. I decided to shrug it off my shoulders and assured myself, “My teacher is clearly undereducated to what the profession really is.” (Note: I am a registered nurse.)

Clearly, these women and every other people who shares the same delusion, are not aware of the how broad the nursing practice is.

Bullying in the hospital is often experienced by nurses. May it be from doctors, patients, or worse, allied health practitioners, incidences of belittling and underestimating are no longer new to the nursing profession since the time of Florence Nightingale.

There is no absolute reason why this happens but perhaps the fact that “virtually anyone can enter a nursing school” plays a huge role.

Unlike the Doctor of Medicine, screening in Nursing education in the country is not mandatory. As long as you have a high school diploma and a certificate of GMRC, you can enrol in BSN.

Bigger schools, however, such as UP and UST, require a promising report card and excellent entrance exam results. Sadly, among smaller schools, this is not always the case.

Because of the lenient policies and their disappointing passing rates in the licensure exams, many nursing schools were forced to close down. These schools’ permit to offer BSN was consequently revoked.

Nursing education takes 4 years to complete. But based on experience, those were  the longest 4 years of my life!

When I was still a student-nurse, I was not pleased with what students from other paramedical (or even non-medical) courses say about nursing.

I often hear, “Kunwari magaling pero wala ring alam yang mga yan” and “Andali-dali lang naman ng course na yan.” Back then, I used to think perhaps these people’s courses are more difficult than mine.

Well, no one can really tell which is “harder” than the other since we cannot compare apples with oranges.

However, I would like to challenge those who claim ‘Nursing is easy’ to enroll BSN. As I see it, only BSN has a curriculum where students juggle their lecture subjects with their requirements and clinical rotations in RLE (or to other courses, internship).

This difficult and very stressful battle lasts for at least four, agonizing semesters.

The subjects that student-nurses need to tackle every semester are no joke.

Unlike other courses such as Radiologic Technology, Respiratory Therapy, and Medical Laboratory Science which have specialized or focused subjects, nursing subjects are broad and problem-based.

Somewhat similar to medical clerks, student-nurses are rotated in various health settings, including the surgery, medicine, obstetrics and gynecology, and pediatric wards.

And let’s not forget the commonly feared operating room and intensive care unit. Students are also assigned in the community, where they are challenged to transform ordinary objects to vital resources that the people can use to improve their lives.

No other allied profession works closely with the physician. This puts a huge pressure to nurses who, unlike doctors who undergo more than 10 years of education and training, have to cram all major subjects in almost two years (since the first two years of BSN are allotted for general subjects)!

Imagine all these that a student needs to accomplish just to graduate!

The struggle does not end with graduation, however, because in order to practice the profession, graduates need to pass the 500-item licensure exam.

The life of a nurse does not become easier but instead even more difficult once he gets employed.

Based on experience, being a novice is not an excuse once you are hired. Other members of the healthcare team will ridicule all your flaws, even a simple erasure in your chart (which is by the way, unique to the nursing profession).

My teacher and Mrs. Villar’s idea of a nurse’s job is a mere handmaid to patients and doctors–the one who is always ready to wipe the feces of comatose patients and feed those who are incapacitated.

If this is the case, then may God have mercy on their souls.

In my experience, a nurse’s job is more than bedside care (feeding, cleaning, bathing, etc). I was in charge of the patient’s chart, and every procedure and prescription goes through the nurse.

The nurse is therefore expected to know everything about the patient–what was his lab results, latest vital signs, input and output measurements, and a lot of other data pertinent to the patient’s health and in most cases lengthening the client’s life. I don’t see any other professional who is trusted with so much responsibility other than the nurse.

Patients often ask the nurse for information regarding their condition. Nurses relay all significant changes to the doctors. Doctors rely on nurses for drug administration and calculation and even ask for a 24 hour update of the patient’s conditions.

And here we are, harassed by bigots saying nurses are only “katulong na may lisensya.”

The nurse receives doctor’s orders and translate the latter’s instructions in a more humane language. Knowledge in the purposes and effects of procedures and medications is vital to the nurse because without it, a doctor’s order can go uncorrected and a patient may die.

And yet we have a senator candidate who says nurses don’t need to be “magaling.”

So why the bullying?

If there is someone to blame for this social illness, it is the educational system that nursing suffers.

Nursing education has become a cash cow for many schools. Because of the greener pasture promised abroad, many high school graduates pursued BSN. Some were even forced by their parents to enroll although they wanted to become engineers, teachers, or accountants.

The sudden boom in nursing aspirants caused an increase in the number of nursing schools. What used to be a “true calling” for service to humanity has become a garage sale with a “Come one, come all” slogan.

Soon after, these schools produced thousands and thousands of graduates, too many to supply the limited employment capacity of local hospitals.

This must be a reason why many people question the competence of a nurse. They all see RNs as products of a massive yard sale rather than a rigorous four-year curriculum.

The solution to this problem is pretty simple. The government must raise the bar for nursing schools.

Stricter admission must be implemented. If a national entrance exam is needed, then administer an entrance exam. As long as it will not cost too much, then why not?

A national exam will gauge the academic abilities of an applicant, whether he is ready to purse nursing or not. I don’t think it would be difficult for the government to search for people to prepare exam questions for such a test. After all, we have an NMAT (National Medical Admission Test).

Stricter retention policies must be implemented once the applicant is accepted in a nursing school. Nursing requires a good heart, caring hands, and a sharp mind. Those who are unable to display these must be advised to pursue another degree.

Grades are objective measures of a student’s performance. If a school wishes to produce only the best and qualified nurses, then it must keep a high standard that its students must meet. Those who fail to do so must consider other courses.

Finally, the quality of education must be strictly monitored. Instructors must be academically prepared to teach. So-so teachers who are both incompetent and uninspiring need to leave the academe and those who are only in for the money should resign.

Instructors need to be constantly screened if they are able to teach. A master’s degree and/or clinical experience must not be the sole basis for hiring. They must also be assessed in terms of their teaching methods, ability to motivate students to learn, and their devotion to teaching.

Just like students, instructors must also undergo seminars and trainings in order to keep abreast with the latest trends in the profession. Since nursing is a dynamic and evidence-based profession, schools must treat researches and journals more seriously, and not mere requirements for classroom subjects.

The nurse is the information hub of the hospital. Without nurses, a hospital will be severely paralyzed. The vast scope of nursing practice makes the nurse a cut above the simple handmaid. Definitely, not everyone can become a nurse. But anybody can become a maid.

So next time you want to call an RN a lowly servant who just happened to hold a license, consider this quote I read from an anonymous writer:

“I am a nurse. I battle the angel of death everyday.”

Now ask yourself, “What do you do for a living?”

Although I am pursuing another degree at the moment, I am always proud to be an RN–an academically prepared, time-tested registered nurse.

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