A License to Hide?


When I graduated with my BSN many years ago, I was filled with pride; pride for having completed a rigorous course of study and pride for having passed the most anxiety-producing exam I had ever taken – the NCLEX. I remember my professors saying that myRN professional signature should always include my licensed title and degree; RN, BSN. RN – the holy grail of credentials for those who take the challenge of nursing education and dare to confront the NCLEX. They said all other denominations of nursing come after the RN. So, I became Lisa J. Sundean, RN, BSN and now I am Lisa J. Sundean, RN, MSN, MHA and soon-to-be Lisa J. Sundean, RN, PhD. Aside from my name, what is the constant in this lineage of credentialing ancestry? You got it – RN. Registered Nurse. Hello, I am Lisa and I am a Registered Nurse. In that you can trust according to annual public polls. RN is the only designation that allows me to practice as a nurse. No other credential allows me to practice legally except the RN license.

According to the American Nurses Credentialing Center (ANCC), the proper way to display licensure and credentials is by highest degree earned followed by licensure, state designations, awards/honors, and others (ANCC, 2013). So apparently, I need to tweak the order of my signature. I will consider it. But note, RN is still clearly in the signature. Some would argue that APRN can substitute for RN, but not according to ANCC. I’m not going to argue that point. I will leave that for the APRNs. What matters is that RN is displayed somewhere in the alphabet soup of acronyms.

Several years ago, I was volunteering for a local hospital fundraising organization. While recruiting sponsors for the flagship fundraising event as co-president of the organization, I was signing letters directed toward potential sponsors and donors. Of course, my signature was Lisa J. Sundean, RN, BSN (I didn’t have the MSN, MHA yet). The hired event planner took issue with my credentials saying it would be confusing for sponsors and donors. Naturally, I argued with him and I kept the signature intact. I argued that if people knew a nurse was asking for support they would feel more confident about giving. Revenue for that event increased by more than 100% over the prior year (yes, you read correctly!). Okay, maybe my signature was not the only reason, but nurses do have credibility. For sponsors and donors, knowing a nurse was leading the fundraising effort probably helped.

Not so many years ago, I was finishing my Master’s degree program. The capstone project had me combing through hospital websites and board directories looking for RNs serving on hospital boards. I’d heard of certain hospitals that had RNs on their boards but I was challenged to locate them in the board directories. I was perplexed that very few hospitals listed nurses on boards with their RN titles. The reasons for this are complicated, but in talking about it with a particular hospital CEO and RN, I was told that as nurses move up the career ladder to more senior level executive positions, they sometime drop the RN title because it can become an impediment to further career advancement. Pause. Think about that for a moment. The very licensing credentialing that allows nurses to practice, to deliver educated care to people in need, to advocate as educated and licensed professionals becomes an impediment to personal/professional development…(sigh).

Recently I have noticed that some nurses from academia and other work settings have retired the RN title in favor of using state designations and certifications. It may be obvious to those of us who are familiar with the constellation of initials that these people are, in fact, RNs with superlative credentials. However, the general population, who apparently trust nurses inherently, have no idea how to decode these initials. They wonder, “Is this person a nurse, a professional bill collector, a doctor of neuroscience, a professional health director, or a certified entrepreneur of noetic perspectives?” In all of the high level credentialing that nurses accumulate, the only letters that really stand out to the general population are RN – Registered Nurse.

At a time when nursing is entering its “golden age” as Donna Shalala declared so emphatically in 2010 at the release of the Institute of Medicine report, The Future of Nursing; Leading Change, Advancing Health (Robert Wood Johnson Foundation, 2015), some nurses choose to hide their licensing credential. At a time when we need nurse representation and participation at so many levels for healthcare transformation, some choose to stow the RN away. It is concerning that some feel the need to hide their professional identity to advance and have influence in leadership positions.

Now is the time to display the RN prominently along with other credentials. How else can we take credit for nurses’ roles in health, healthcare, and social justice? The public trusts us. Do we trust in the power of the RN? Let’s commit to leadership influence using the licensing credential that we worked so hard for; the licensing credential that we must hold to advance our nursing education, to provide bedside care, to be recognized as nurse leaders. The RN is not a license to hide. The RN credential is one to display proudly and be empowered by. If career advancement is at risk by our credentials, perhaps the alternative approach is to advocate for all that the RN stands for.

2016 is just days away. Now is nursing’s time. Be an RN. Happy New Year to all my colleagues.

 

References

American Nurses Credentialing Center. (2013). How to display your credentials. Retrieved from http://www.nursecredentialing.org/DisplayCredentials-Brochure.pdf

Robert Wood Johnson Foundation. (2015). Campaign for Action Five-Year Celebration Video. Retrieved from https://www.youtube.com/watch?v=SLM5zC7zmF4&feature=youtu.be

Spiritual consciousness and healing


This is my first time posting a blog and the experience has been both exciting and a little uncomfortable. I am moving out of my comfort zone, writing from my heart and soul. I’m thankful for the experience and hope to get better with time.  Here it goes!

As a young child, growing up in a rural village in the Pines region of Mississippi, and spending time with my mother’s side of the family in my beloved Louisiana, I was in love with the beauty of the infinite universe. I was very connected to the earth that I loved to play in and smell, the flowers I loved to smell and pick, the tomatoes, okra, onion, squash, peas and butterbeans that I loved to eat and that I helped my grandfather nurture and pick when they were ripe, the love and care of my father and mother and older brother, my ancestors, grandparents – both maternal and paternal – and great grandparents, great aunts and uncles and cousins and the infinite universe of goodness, simplicity, love, and beauty. The freedom and love of being a child of the infinite universe allowed me to sense into the universal rhythms of light and dark, activity and rest, stability and change, being and becoming, even though I didn’t have an advanced vocabulary for these things at that time. All of these experiences represented a universe where healing, love, and nurturing occurred. In the past few years, I have come to see these experiences as reflecting spiritual consciousness. I cherish being in touch with spiritual consciousness, and, thus, carefully tend to it patiently as a potentiality for nursing’s healing mission. Can the nurse working within spiritual consciousnes help other human beings experience healing and their own spiritual consciousness in order to transcend suffering of psychic, physical, social, existential, and emotional pain? I believe so.

Within the nursing context, I view spiritual consciousness as the unfolding of loving energy and various modalities of integrating nature and meaning whereby nurses facilitate healing. The nurse’s spiritual consciousness soothes worries and brings healing to others when they are in fear, pain, or suffering. Spiritual consciousness illuminates the universal need for humanization in nursing situations whereby dehumanizing circumstances deny or strip human beings of their dignity and humanity. Spiritual consciousness is the loving consciousness and healing energy that human beings tap into to restore harmony in times of disharmony.

Spiritual consciousness is evolved consciousness for nursing. It can be cultivated by nurses worldwide to facilitate healing. The nurse, in spiritual consciousness, being loving toward another during moments of the other’s suffering, brings healing energy to the situation. Spiritual consciousness is characterized by spaciousness and lightness. It provides a glimpse into the goodness and beauty of the universe, and the freedom not to get bogged down or trapped in mere physical and limiting aspects of being. I believe it is central to nursing’s healing mission. Thus, the notion of spiritual consciousness challenges each of us in nursing to experience this loving energy and to discuss it for better understanding the usefulness and limits of spiritual consciousness for facilitating healing. images

The human mind’s binding capacity can be warded off by shifting into spiritual consciousness. Spiritual consciousness does not include limited and bounded views such as hatred, sense of division, greed and power over others, malice, or separation between us, other human beings, earth, plants, animals, rocks, trees, rivers, stars, and the moon. In spiritual consciousness, we are all universal one.

As nurses gain experience sensing into their own spiritual consciousness, nursing will be better poised to meet its social mandate. Working from within spiritual consciousness, nurses are provided with multiple pathways for healings to occur. As nursing and society evolve, ideas related to spiritual consciousness and healing need further development.

Nurses and Global Peace


This blog posting will be a bit different from others I have written, but I believe the NurseManifest page is a place where we can open our hearts and souls to the essence of nursing, which is healing, caring, love, and compassion. In a world seemingly torn asunder from fear, violence, and anger, nurses are called forth to support healing on a local and global level. The call comes from something beyond ourselves, and if you stop and listen closely, I believe you will hear that calling. You are a nurse and there is a reason you were drawn to nursing: to support healing through loving kindness and caring.

A few nights before the recent violence spread around the world, from Beruit to Paris, I lay in bed cuddling my 7 year old daughter close. Every night I am blessed to be able to spend some time reading to my daughters and cuddling as they drift off to dreamland. For a few moments that evening, I found myself floating in a space where I felt like the mother of the universe was whispering to me, not in words, but through a deep felt intuitive process. I knew the goodness, the light, and the powerful strength of peace as they came through clearly to me, carrying with them the message that the mother of all, the earth as a complex system, will heal itself. After the moment of certainty passed, I was left with the usual feelings of uncertainty: how will the good and the light prevail in these times of darkness? Who will help make this happen? What is my role in this process?

Then tragedy struck, and violence and war continue to grow. The feelings of uncertainty have not dissipated, so I sit with those, but I also do remain strongly rooted in the belief that as nurses, we can support global peace and healing through our own efforts of creating local peace and healing. And that local peace starts at the place closest to us all, right from our hearts.

As we practice our own healing, creating our own peace and loving-healing processes, we can begin to spread that healing, peace, and love to others. A practice I try and do daily is called loving kindness meditation. I feel on many levels this practice is about my own healing and self-care so that I can be a better nurse, wife, and mother… and it is also about bringing that healing into the world.

I start with focusing on myself, in my heart space, and intending for myself healing through the following words:

May I know peace, joy, love, and ease. May my heart be full. May I be safe, healthy, and happy.

I than send this intention to the loved ones in my life, wishing them all love, peace, ease, happiness, health, and safety: family, friends, pets, students, and colleagues. As the circle of intention spreads outward, I send the intention and feelings of love and peace out to my “enemies” and challengers, and I end with the whole planet, with every being being sent the intention of peace, love, and healing.  The process takes  5-10 minutes.

As nurses supporting healing, we can think and act both locally and globally. Imagine if every nurse sent out an intention, a prayer, a positive thought for healing and peace for the entire mother earth and all of the beings living here. Consciousness studies show that our thoughts and intentions impact our environment and reality.  I think of Jean Watson’s call for us to practice loving kindness and  Martha Rogers’ concept of Unitary Beings. We can reflect the patterns before us, we can create shifts in consciousness to support healing.

Despite the medical system’s over-emphasis on technology-cure-illness management, I still believe that nurses are truly called toward the healing that all beings are capable of experiencing. If you have been called to be a nurse, can you return to that calling, can you spare a few moments to consider the global situation, and what you can do as a nurse to support healing from the truly local level (yourself) and on to the global level?

I would love to hear from nurses and how they are supporting peace and healing around the globe. The call has been made, how will you answer?

 

peace-signs-clip-art-peace-signs-clip-art-10h call has been made… how will you respond?

 

 

Lessons from the history of nursing… Who was Concepción Arenal?


Arenal

I recently returned from a conference in Spain about the economic value of nursing where I spoke about many promising international models of community nursing, including some that were not so new. What sparked the most conversation later was the final image of my presentation with the words of the Spanish feminist writer and activist Concepción Arenal: How many centuries will it take for reason to arrive at the conclusion on [social] justice that the heart instantly understands.

Surprisingly little has been written in English about this remarkable woman, whose work in social reform and the development of nursing was simultaneous with, and comparable to, that of Florence Nightingale. Born in 1820 (the same year as Nightingale), she was the first woman to attend a university in Spain (auditing law school classes dressed in men’s clothing). An early and influential advocate for women’s rights, she wrote extensively about issues affecting marginalized populations including those living in poverty and in jails.

I am just beginning to read Arenal’s original writings in Spanish, and am struck by the parallels between her writing and current conversations in nursing about social justice and cultural humility. For example, her manual for visiting (nursing) the poor begins with the philosophical questions: What is pain? (Ch. 1), What are we? (Ch. 2), and What is poverty? (Ch. 3)  Before moving on to the central chapters on the theory and practice of visiting (nursing) the poor and how to approach and handle different situations with humility, respect, and empathy, while empowering the poor to improve their condition and lives. The book ends with chapters on the importance of having respect for the pain [of the poor] (Ch. 14), and the spirit of the sick (Ch. 15).

Please join me in reading and reflecting (here in the comments on this NurseManifest blog) on the writings of Concepción Arenal. We hope to build connections with colleagues in Spanish speaking countries and bilingual academic settings around the world. Looking forward to learning more about your thoughts inspired by Arenal’s writings (comments welcome in English or Spanish).

Un cordial saludo,

Olga

P.S. Please also reach out if you are interested in working on a Spanish version of the NurseManifest Manifesto.

References and Further reading:

  1. Josep Bernabeu Mestre – Encarna Gascón Pérez (Univ Alicante). Historia de la Enfermería de Salud Pública en España (1860-1977). [The History of Public Health Nursing in Spain] Capitulo 2. Full text pdf (162 pages)
  2. Miguel de Cervantes Virtual Library Collection for Concepción Arenal, including her collected works in digital format http://www.cervantesvirtual.com/portales/concepcion_arenal/autora_biografia/

Direct links to a few of Arenal’s books that I’ll be reading and would love to discuss with others:

Humor in Health Care


There has been plenty of discussion about Kelley Johnson’s monologue and comments from The View. I just took a look at the response from the President of the American Nurses Association, who said, “Nurses don’t wear costumes; they save lives.” and its true, you won’t ever see a nurse wearing joker teeth welcoming a patient.

I am grateful to all the people who have stood up for nurses by responding, supporting, and making us feel like the honorable, trusted, and caring profession that we are. I am also thankful to Pamela Cipriano for her quote above, because that has encouraged me to take a lighter approach in this blog article. Everything doesn’t always have to be heavy or philosophical or serious, right?

While I understand what Pamela meant by “Nurses don’t wear costumes,” I will share that I did wear a costume once, when I was a staff nurse on an adolescent unit. It was Halloween and most of the nurses dressed in costumes that day. I was taking care of a particular 14-year-old boy who needed a new IV placed. In all my costumed glory, I went in and put an IV in this adolescent’s arm. His dad sat by the bedside as I did so. And his dad was a VP of the hospital. I never knew if that patient’s father was amused by my costume or annoyed thinking I wasn’t taking my job seriously. He didn’t say anything to me about it.

I sometimes think back to that experience, especially around Halloween, and wonder when it’s ok to infuse humor into health care. I sometimes use humor with patients I see for diabetes education, but then again those visits are not life or death situations. Hospital staff where I work still dress up every year, but I have never worn a costume to work again.

Personally, I like and appreciate humor. But when I’m the patient I do expect health care professionals to use it appropriately. I remember when I was a patient in room # e111, a joke that I didn’t “get” was sort of an issue I didn’t want on my mind. I’ve noticed in the Diabetes Online Community that people often discuss with frustration the jokes that are told about diabetes. Sometimes funny things happen to nurses at work, and those times (and memories) can help us get through tough jobs. In fact, humor can be one way nurses take care of themselves. Are there ways we can use humor to help people heal?

How do you use humor in health care? Or what funny thing that has happened while you were working in a health care setting? What did you learn from the experience?