Why Nurses Can't Be Idiots Part 1

When I was in college, I dreaded being handled by San Juan de Dios’s infamous nursing clinical instructors. Horror stories of these CIs’ near-terroristic approach to training student nurses were passed down from generation to generation, rendering newbies to the Nursing program shivering with fear. Their training styles and strictness were legendary. When being handled by an SJDcian clinical instructor, mistakes were punishable with not just the low scores, but with some nasty tongue whipping.

These clinical instructors were known to be unforgiving of idiots. Those who are naïve enough to believe they can survive their duty rotation without having to know why a stroke patient needs ulcer meds, or without obsessively-compulsively monitoring a patient’s IV fluid rate would usually find themselves a sobbing pile of mess outside the area, possibly for the rest of the 8-hour shift.

Before we set foot in the clinical area, we were expected to know how to do a procedure by heart. Our CIs expected us to understand every single nursing, medical, and sometimes psychiatric care given to our patients in relation to said patient’s pathology. They expect us to be caring in rendering nursing interventions, but also clinical in our approach to dealing with patient problems. We were not doctors, and we did not have to explain lab results, but we were still expected to know when values should already cause panic, then push aside that panic and render appropriate measures to secure a patient’s wellbeing. In other words, it was either we pass their critical eye, or we spend 8 hours standing in the hall way.

I dreaded being handled by these infamous clinical instructors, but when I was in the 3^rd year of my nursing education, I understood why a nurse’s training had to be brutal: it was because we were dealing with lives. The smallest mistake can harm a patient, can disable him. I learned that decisions regarding care that is not evidence-based and not rationally made can most certainly kill. I learned that, unlike some politicians who are campaigning for office this year, nurses don’t have any right to be morons, because the cost of idiocy is something that can’t be paid. People’s lives are at stake.

The dwindling standard of nursing education has long been an issue. It is manifested by the abysmal passing rate on the Philippine Nursing Licensure Examination. The cause has been proven to be the mushrooming of fly-by-night schools that started offering nursing just because it was a fad several years ago. The driving force of these schools, in other words, was not to educate but to invest in what seemed to be booming business at that time. The result: low-quality graduates. Unfortunately, some people in power would rather side with these businesses than those who spend money on getting education. Thus why “nursing schools” with pathetic passing rates were never closed when they should have been.

Just last night, I heard the most preposterous, blood-pressure-rising excuse from a former congresswoman who is now running for senator: "Hindi naman kelangan magtapos ng BSN ang mga nurses sa atin kasi gusto lang naman nila maging isang room nurse sa Amerika. Hindi naman nila kelangan maging magaling."

Here's the vid. Knock yourselves out. In fact, bang your head on the wall real hard if you're still voting for this woman.

Oh, my. Here's my response, even if the former congresswoman will probably not see it: 

Madame, I beg to disagree. You see, nurses have no right to be nurses if they are incompetent. In fact, they have no right to be mediocre, so your ideology of giving them mediocre education is unacceptable. We must always pursue for competence, safety and effectivity in the practice of our profession. That is why we have the nursing licensure exam. That is why we practice injecting our classmates with water before we actually do it on patients. That is why we have related learning experiences. That is why we have hardcore clinical instructors that would drill pathophysiology, pharmacology, and the patient’s psychology into our heads relentlessly.

Also, not every single nurse who went to those nursing schools you, Madame,  refused to close down want to be “room nurses” in America. Some of us want to be advocates, teachers, community organizers and leaders, policy-makers, public servants (which does not necessarily mean politicians). To these nurses deserve mediocre or sub-par education as well? We often forget that the contribution of the nurse to society goes beyond the clinical area, and regardless of the setting of the nursing care, we should never settle for anything less than highly skilled and knowledgeable professionals.

The training I went through and the clinical instructors that I’ve been blessed to train under have taught me one very important thing: It takes a lot of brain to take care of people and to keep them alive. It takes a lot of brain to be a nurse.