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EDITORIAL Success: Yours, Mine, a& Ours n the spring of each year, many experienced nurses welcome new graduates to their practices. These new nurses come with hopes of success. If I were to ask experienced nurses to describe success, they might tell me that the successful nurse is a leader, is published, or is involved in research. A patient, how- ever, might say that a good nurse is one who is confi- dent, competent, or cheerful. The patient would be correct, because nursing is caring for the health of people. All activities of nurses are directed ultimately to- ward promoting health and doing so with care. If I were a young nurse starting out today, I would be ap- prehensive that this work I had been educated to do- promote health-not be taken away from me. I would be loath to take a job looking after machines or, worse yet, looking after paper. I would seek a position in which I could develop my clinical skills in direct nurse-patient interactions. I would be eager to retain the personal contact with patients that comprises good nursing and that makes nursing useful to society. Nursing has long realized that a key to our collec- tive success is our social utility. Lewis Thomas, a noted physician and author, has written on the historic con- fusion about what nurses do or ought to do. He wrote from his own family experience: “When my mother became a registered nurse at Roosevelt Hospital, in 1903, there was no question in anyone’s mind about what nurses did as professionals. They did what the doctors ordered . . . . It was an exhausting business, but by my mother’s accounts it was the most satisfying and rewarding kind of work. As a nurse she was a low person in the professional hierarchy, always running from place to place on orders from the doctors, subject as well to the strict discipline from her own adminis- trative superiors on the nursing staff, but none of this came through in her recollections. What she remembered was her usefulness” (Thomas, 1983, pp. 61-63). Nursing has divested itself of many of the tasks that Thomas’s mother would have routinely per- formed: preparing meals, sweeping floors, transport- ing patients, and serving tea to physicians. In the pro- cess, nurses assumed more management responsibili- May/June 1992 ties to coordinate the growing number of technicians and support personnel. In delegating patient care to others, registered nurses slowly excluded themselves from the function that previously had been their most important source of fulfillment: close contact with patients. Thomas summarized the impact that losing this type of work has had on our profession; as he sees it: “Along with everything else nurses did in the long day’s work, making up for all the tough and sometimes demean- ing jobs assigned to them . . . [nurses] had the match- less opportunity to be useful friends to great numbers of human beings” (1983, pp. 64-65). When nurses are useful, patients are successful- that is, they give birth; they improve or recover; they die with dignity. A patient’s success belongs to the patient, but enabling patients to be successful is the hallmark of good nursing. Health care is experiencing another wave of change, brought about by new technologic and scien- tific advances and by financial constraints. In hospi- tals, lengths of stay are shorter and levels of acuteness of patient’s conditions are higher. Many procedures and treatments are no longer performed in hospitals but in ambulatory centers. To accommodate these changes, the roles and responsibilities of nurses are changing again-and expanding. In many settings, pa- tient care is so complex that it is impossible to stan- dardize all protocols or procedures. The complexity of health care demands that expert professional nurses be close to patients; nursing experience and expertise are central to the recovery of and promotion of health in the patient. Expertise is not longevity, however. Nurses do not become successful and expert clinicians by virtue of the duration of their tenure. Novice nurses need to plan and work to be successful in nursing. My advice is this: Take a challenging first job. One of the strongest predictors of later career success is a stimulating first job. Take a position in which you can develop your knowledge. Do not protect yourself from challenges by taking a position in which you are sure you will be comfortable. Our success is intrinsically tied to the success of the new nurses who enter our ranks each year. Wel- come their questions, encourage them to observe pro- ficient nurses, challenge them to learn a clinical area well, interest them in the varied aspects of nursing work, and involve them in collegial relationships. Karen B. Haller, RN, PhD Editor Reference Thomas, L. (1983). The youngest science. New York: The JOCNN 165 Viking Press.

Success: Yours, Mine, and Ours

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E D I T O R I A L

Success: Yours, Mine, a& Ours

n the spring of each year, many experienced nurses welcome new graduates to their practices.

These new nurses come with hopes of success. If I were to ask experienced nurses to describe success, they might tell me that the successful nurse is a leader, is published, or is involved in research. A patient, how- ever, might say that a good nurse is one who is confi- dent, competent, or cheerful. The patient would be correct, because nursing is caring for the health of people.

All activities of nurses are directed ultimately to- ward promoting health and doing so with care. If I were a young nurse starting out today, I would be ap- prehensive that this work I had been educated to do- promote health-not be taken away from me. I would be loath to take a job looking after machines or, worse yet, looking after paper. I would seek a position in which I could develop my clinical skills in direct nurse-patient interactions. I would be eager to retain the personal contact with patients that comprises good nursing and that makes nursing useful to society.

Nursing has long realized that a key to our collec- tive success is our social utility. Lewis Thomas, a noted physician and author, has written on the historic con- fusion about what nurses do or ought to do. He wrote from his own family experience: “When my mother became a registered nurse at Roosevelt Hospital, in 1903, there was no question in anyone’s mind about what nurses did as professionals. They did what the doctors ordered . . . . I t was an exhausting business, but by my mother’s accounts it was the most satisfying and rewarding kind of work. As a nurse she was a low person in the professional hierarchy, always running from place to place on orders from the doctors, subject as well to the strict discipline from her own adminis- trative superiors on the nursing staff, but none of this came through in her recollections. What she remembered was her usefulness” (Thomas, 1983, pp. 61-63).

Nursing has divested itself of many of the tasks that Thomas’s mother would have routinely per- formed: preparing meals, sweeping floors, transport- ing patients, and serving tea to physicians. In the pro- cess, nurses assumed more management responsibili-

May/June 1992

ties to coordinate the growing number of technicians and support personnel.

In delegating patient care to others, registered nurses slowly excluded themselves from the function that previously had been their most important source of fulfillment: close contact with patients. Thomas summarized the impact that losing this type of work has had on our profession; as he sees it: “Along with everything else nurses did in the long day’s work, making up for all the tough and sometimes demean- ing jobs assigned to them . . . [nurses] had the match- less opportunity to be useful friends to great numbers of human beings” (1983, pp. 64-65).

When nurses are useful, patients are successful- that is, they give birth; they improve or recover; they die with dignity. A patient’s success belongs to the patient, but enabling patients to be successful is the hallmark of good nursing.

Health care is experiencing another wave of change, brought about by new technologic and scien- tific advances and by financial constraints. In hospi- tals, lengths of stay are shorter and levels of acuteness of patient’s conditions are higher. Many procedures and treatments are no longer performed in hospitals but in ambulatory centers. To accommodate these changes, the roles and responsibilities of nurses are changing again-and expanding. In many settings, pa- tient care is so complex that it is impossible to stan- dardize all protocols or procedures. The complexity of health care demands that expert professional nurses be close to patients; nursing experience and expertise are central to the recovery of and promotion of health in the patient.

Expertise is not longevity, however. Nurses do not become successful and expert clinicians by virtue of the duration of their tenure. Novice nurses need to plan and work to be successful in nursing. My advice is this: Take a challenging first job. One of the strongest predictors of later career success is a stimulating first job. Take a position in which you can develop your knowledge. Do not protect yourself from challenges by taking a position in which you are sure you will be comfortable.

Our success is intrinsically tied to the success of the new nurses who enter our ranks each year. Wel- come their questions, encourage them to observe pro- ficient nurses, challenge them to learn a clinical area well, interest them in the varied aspects of nursing work, and involve them in collegial relationships.

Karen B. Haller, RN, PhD Editor

Reference

Thomas, L. (1983). The youngest science. New York: The

J O C N N 165

Viking Press.