nursingforsocialjustice

There are many stereotypes of nurses in popular media: the sexy nurse, the passive nurse, the obedient physician’s handmaiden, the gay man nurse, I can go on. One of the terrible ones that has re-emerged this year is Nurse Ratched. You may remember her from the film One Flew Over the Cuckoo’s Nest. It’s entertaining (maybe) but damaging to public perception of nurses, most notably mental health nurses. These horrors of the mental health, depicted as if mental health nurses are sadistic harm doers. The reality is that nurses who worked in the mental hospitals of 20th US and Canada were working with people living with acute and chronic health issues, like psychosis, developmental disabilities, and epilepsy, in a time when society wanted to hide people away.

In many ways the nurses who worked in mental institutions in the early and mid 20th century were groundbreakers in changing understanding of the connection between illness and health and the body and the mind. They were working in a time when there was not a lot known about effective treatments for psychosis, or epilepsy, or other illnesses that effected the brain. Mental health nurses in the 20th century were pioneers in the understanding of relational practice, compassion, trauma informed practice, strengths-based care. This has been lost a bit, in a time when there is so much emphasis on the role of medication and ongoing notions of a mind/body split.

In the places I work the value, the integral role of the nurse, is lost. The structure of mental health care that exists in the same way that is always has is problematic. The priority intervention seems like it is medication. Is medication the intervention that results in the most quality of life improving change for people to access mental health services?

Knowing that medication is not the most efficacious intervention, but one intervention amongst an array of diverse strategies in a treatment plan, why is the system organized with medication prescribers as the most responsible practitioner? In my experience, in the places I have worker, why is the system organized in a way that inpatient nurses purpose is to administer medications and observe and report? And is observation and reporting achieved in a way that is meaningful way that is valued on par with a psychiatrists or allied health member’s assessment? I’m not sure.

When I talk to new graduate nurses in mental health, they are sometimes disconnected from the value of nursing in their place of work and question the meaning of nursing. This is an unfortunate reality is the current structure of the systems I work within. There is little support for new nursing graduates to build their nurse identity, to develop their career planning post-graduation and registration.

How can we change this? I’m not sure, but it has to change or nurses get years into their career and feel no connection to their profession, and the end game is working for the weekend. This isn’t right in a profession that relies on nurses making decisions that can effectively result in life or death of a patient, trauma or improved quality of life. Nurses have the privilege of being with patients in time of crisis, sometimes for an extended period of time, sometimes 24/7. Nurses also have the privilege of education and training that that allows them to make critical decisions to optimize health, to suffer with, to help patients and families navigate to a complex health system. This is unique to nursing.

Nurses are special. I believe that in my core. Nurses are essential to changing the world. I believe that in my core. How we will get there, that’s an exploration I am willing to spend the rest of my life working on.

Peace,

Michelle D.