Woman; 405; New Image for Nurses. Part 1
Eat.Good evening and welcome to woman. This is the first of two programs on the nursingprofession and I think you're going to be very surprised at what you're going to hear.With me is Dr. June Rothberg Dr. Rothberg is dean of the School of Nursingat Adelphi University. She's immediate past president of the American Association ofColleges of nursing. June is a co-founder of endcap the nursesCoalition for action in politics. Also with us is Dr.Jean Spiro. Doctor Spiro is dean of the School of Nursing at the StateUniversity of New York at Buffalo. She is chairwoman of the Board ofReview a baccalaureate and higher degree programs of the National League for Nursing.
My third guest is Dr. Joanne Ashley author of hospitalspaternalism and the role of the nurse which is a very controversial book about the nursingprofession. Dr. Ashley is an associate professor of nursing at Northern IllinoisUniversity. She's also on the board of trustees of endcap. Welcome toall three of you. And Joanne what has been the place of nursing.While within the health field for a number of years now we've had scandals.And right now they are there you know being opened up to the public. But thegreatest scandal has been. That man in the health field would have been very greedy.Mostly for profits and exploiting. The public. Andnurses have placed nurses in the position of being what I callcoolies and doggies. Now coolly in countries where you know theyhave well-defined caste systems. Is really your very lowest yourperson who has the very lowest status. Now when I use the term darkie I mean this.
Nurses have been treated like little more than domestic asses. Now the public hasn'tknown this because the public has been lied to for a century by you knowdominant persons in the health field and it's time.We tell the truth now that a very controversial statement. I thinkmaybe June and Jane had made a comment on it. I'm ready.Well I hadn't really expected that.I think there's probably some. Degree of truth but Ihave to say that there is a fair degree of exaggerationnurses have not been treated as professionals. Their contribution to thehealth care system has not been given enoughmerit. But I don't think I can buy donkeys and coolies.I didn't think you would. And I sued them because you know nobody has to agreewith me you know that.
Well the point is really isn't it that there's a broad spectrum of political thought going on withinthe profession. Yes and maybe Joanne is here and you two or maybe in there or maybeone of you is somewhere in the middle. And that's really the important thing there is a dialogue happening.What about health care and the general public definition of health care and theirattitude toward what they what they can expect from our health care system. What about thedefinition first.Well I think you're talking about the public's definition of health care I think that's almost immediatelytranslated into medical care. Which has to do you knowprimarily with the diagnosis of pathology. I think that within nursingspeak about health care we're talking about health promotion and disease prevention.So you would say that would do you think the public. Definition of health care includesnursing. I mean I hate to start messing with the terms medical care and healthcare but I mean what they're really talking about is medical care but do you think they have included nursing to the extent towhich nursing participates in their care.
Well perhaps not to the extent that we would like them to include nursing.Now Act AG like to interrupt here because the public doesn't know what nursing care is. Hospitals donot provide it the most that people get in hospitals is technicalnursing. Hospitals will not pay for professional nursing attention and free nurses togive it.Now you pay for it. The public pays for it but it's not there.Also in nursing homes there's no professional nursing going onlike nurses are taught. To give an arse you know you're seeking.Well we see what we think our nurses in nursing homes right. Right. But they'renot.You know it's part of their practical nurses or nurses aids or housekeepers orhousekeepers the law requires the there be some minimalamount and there needs to be somebody every 24 hours but it doesn't specify it and it canbe so superficial as to be nonexistent and that unfortunately isprobably the basic reason that the level of care in nursing homes
today is as bad as it is. All of that there are very very few oralmost no professional nurses available. And the point isit's not that the nurses are not out there to be employed it's that most of these.All the institutions are profit making and they are not willing to payfor the salaries of professional nurses.And yet they're robbing the public. It's a system of robbery is what I call an.Exploitation.Gross I think that when you you included to competence in yourstatement you talked about nursing homes. Yes which is what you in his response talking about when I go there talk aboutprofessional nursing in hospitals and I think that and you know we have to deal with what your definitionis.I'm talking about any American health care system which is what the public needs to look at verycarefully. It's the American medical care system. It's not health careit's been disease oriented too long. Nursing has had such a low statusthat it's. It hasn't. Nurses have been able to function. They hop from job to
job to job because they're measurable in these institutions. That reallyI say here our health care system doing it's a menace to health. You know it's athreat to health. You're not safe hardly going to a doctor or a hospital I wouldsuggest if you're at all labeled a creep around stay home stay home.You'd be safer.Now get a good nurse like him.Thank you.We can't sit here really and say to him Don't I know that it's it's anabsolute necessity that we correct the defects. Nowwe've got to look at physicians and say what's wrong with you people. Thatwould take out healthy organs just because you're greedy for money. Now I call thatand I may be different but I call that evil. I believe there is evilin people and in this country and in this country is filled with it. Now there is something wrong with somebody.They're not healthy.
Let's talk about their relationship to physicians to nurses and let's go back one of the appealing things aboutyour book was the historical information. There was lots in the book thatyou know I had never imagined was true.And let's talk about the early training of nurses firstand went on to give people some idea the hospitals schools of nursing werereally established because at a time when hospitalswere rolling into businesses CNA hundreds hospitals truly weresort of charitable you know in a way. But around the 1890s or along inthere. The prominent people sat in Madison hospital Miss Rader saidlook this is a lucrative business. Last night hospitals and a really well-runbusinesses Well they needed labor. You know the productive force nursingschools were established for you know to provide labor asource of production and this has been for centuries the role of women cheap laborof domestic gas. So this is just
been the truth of our history and I had to and I had to look that in the face and say Look.I've been in this profession and that's this health care system is part of my country.I do need to. Talk about what's going on today as far as nurses training.And if you can a little bit relate it to what happened and how it's changed nursing educationI should really say not nurses training.Well one of the. One of the very real contributions of ofJoanne's book is the fact that for many of us it documented whatwas real what was happening than many of us didn't know about it.We. Felt it but we did not have anyspecific proof there were. We didn't know the references that arecited and are so clearly relevant to this. There has been a movementagainst the Hospital School of Nursing. It has gone on for manymany years and the battles were a long and bloody and they're not over withyet. However there has been a change it's occurred
principally since the 1940s it's moved up with a fairdegree of acceleration where all 10 years ago thepredominant number of.Student nurses were graduating from schools which were hospital affiliated. Thatis no longer the case. The graduations now are. Lessfrom hospitals schools of nursing. More from Associate Degree programs whichare two year junior college programs and a very very hardrising curve of graduations from baccalaureate programs which are fouryears in length. The merit of both ofthe latter types of programs the baccalaureate the Associate Degreeis that they are truly educational they are not principally service orientedwhich is the thing that joy and is is talking about in particular.I want to interrupt you do. You know we do encourage nurses
nurses or well-educated people many of them have gone to school for 15 years because they've had tostruggle and that wasn't always the case was it I mean people did not think it was necessary tobe educated but the point is why educate someone when where theywork are not going to recognise it. They're not going to get paid for it they're not going to be employedin nursing. Of all professions women are most highly educated women arediscriminated against because there's no there's no societal force thatforces hospitals to paying arses for going to school. Now something'swrong with the logic there. After a young woman or a young man this day and agestruggles to get through school why not. Like any decent businesswhy not recruit the best prepared. To do what they're educated to do.Well Joan again I don't have your way and I would have to disagree with you. You know some ofwhat you say I think is essentially true. But I think that there are hospitals who dopay and compensate nurses based on their education and also their
experience so I don't think it's as black and white you know what I think you know what I would tell the public arewomen are nurses.Go into any hospital and take a poll.Go into your local hospital at your hospital say listen how many professional nurses haveyou got working here by professionally and I have nurses that have a baccalaureate degree andso then are you talking about registered nurses.I'm just trying to they're all registered being registered nurse means that you have to hold thelicensure which simply means that you have taken the qualifying examination whichcertifies you for a minimal safe practice. All right now I think what Joanne isdoing is she is making a distinction that those of us in the nursing professionunderstand it's part of our jargon. She is talking about professional nursing and I asked youbefore in terms of what do you mean by professional nursing.Because O'REILLY Sometimes we see women who have white uniforms on and they're notnurses and the public sometimes thinks they are so we we must now they think that the public isconfusing that they are 18 and is the same thing really as the date.
But in nursing because nursing is a woman's field everybody wears thelabel of Ari and it means nothing it's never met any. It was just something tacked on tonurses to give them a little bit of prestige one time. Legally it meant nothing. So nowwe have three levels in nursing and they all wear the label Aryan it doesn't tell the public anything youdon't tell me anything it's meaningless. All right so what do you mean professionalprofessor. A professional person. The major part of their time and their work is spent inintellectual activity. They're making judgments. Now that gets me youmay say well what's intellectual about nursing because people do well let me tell you the knowledge base innursing. But if your auditor is you know everybody does that act up to.The knowledge base and nursing is broader than the knowledge base base in medicine. Nurseslearn you know the the physiology the physical sciences. Thepsychological the sociological. And we also need ethics in liberalarts because humans are sort of you know well they're spirits they have a spirit.
So nurses have to know the psychosocial factors influencing health caremedicine physical sciences biological sciences and many of them youknow they they don't know that much about the other parts of the human being because they'renot educated to know they're just beginning to move in the direction that nursing hasalways. You know been going. We study the total human being.Medicine has studied the organs. If you want to really look at it that way. Now it'sstrange that they know all about these organs they'll take out healthy ones isn't it. But a nurse would never dothat because that's not her function her function is to to get to know you.And to use all of this knowledge that she's got in her head and try to give you human nourishment and that's howI define nor was she legally.Legally licensed to take out organs. Right. I want to pursue this but I want to do itanother way I want to go through the back door. Where did you will study there's. Under whatcircumstances.
Under an apprenticeship system in ahospital school of nursing which. Perceived itself as partof an overall family. And the family was thehospital and the school and you didn't see a stranger.And I unfortunately at this stage in my life I am old enoughto remember back to that system where nurses stoodby a liar and male physicians to precede them in elevatorsbecause they were higher status people. It was in myexperience as a student nurse that we did the very verydaring thing.We no longer stood when a physician entered the chart room. And that was ourvery very Lawrence sized Declaration of Independence. Now you have to understand thatout in polite society men always rose for women.In this context the whole thing was reversed and that's a very very good example it'sjust a vignette of what the system was like. Physicians hospital
administrators. Were the power base.They were the people of high status nurses were wivesmothers daughters lovers.What I know is and I know I know I do they I'm sorry Idon't perceive it that way Joanne and I will I really won't allow you to distort my memories ofyour original experience and I was fairly comfortable in that it waswarm and it was supportive. And I think to a large extent we rended at.That point a relatively high level of care. How many hours a week did you work.Back 40 but at least at my school we wereour classes were part of that 40 hours it was not time over andabove the 40 hours of work but I have to tell you I rented an awfullot of direct nursing care. As in exchange for theeducation that I got and I attended a relatively progressive school of nursing
in which we did get a sociological base and we did get a psychological base and I canassure you that many other hospital schools at that time did not do it.What was a school. It was Lennox Hill Hospital which no longer has a school of nursing.And although I am sorry about it in one sense I'm happy about it in another sense becauseI think. Nurses have to be educated in institutions of higher learning alongwith other people.Oh right that's one of the issues now is yes again there's a clear issue and I'm rightthat the move is toward standardization. Yes a national standardization.Well there is I think why the professional association and there have been position papers written.To that effect. Now where is the opposition coming from for thatmove.Well the opposition I think is coming from a variety of sources the opposition is coming fromof course those hospital. Diploma schools and theirrepresentatives and the hospital administrators that are still in existence. I
would suspect that there is a strong. Motive operate of theopposition that's also coming from physician groups.And I am sorry to say that I think that there is some opposition from within the nursingprofession itself.But what form is that opposition taking.Well I think that when John was talking about you know her three year trainingprogram her education. And I went through a similar system.One aspect of it that is very fascinating largely because you don't know what's happening toyou when it's happening is that you are socialized into that system you are socializedinto believing this is the way it is to be. I was thoroughly socialized intobelieving that I was the very best nurse that could possibly be produced and thatthere was no other school in existence that was as good as the school that I was in.And much of what you said her experiences were of course mine in terms of youstood up for certain selected people. You did not
debate an issue. You were following orders and I was thoroughlysocialized into that until I went on and got myself reso she lies to bere-educated. Now I think for many nurses who have gone through thatkind of an educational system. As June said she wascomfortable I was comfortable too. Until I began to learn better.I was comfortable too. Until I did my research and found out thetruth. Now there is a very. She mentioned the term socialization.Physicians you know they go to school to medical school. They are socializedto feel.Think that the nurse is there to serve them.A servant. They've got one built in that call this that relationship between menand women were healthy and nurses and doctors. The myth we've lived with the mythof the hole in marriage between nursing in medicine two professions marriage.We were the wife. I mean we you know we played that role socialized into it.
Do you not know what year she graduated from hospital school I graduated in 1961. Now that'sjust been a decade or so ago when you think about it. But I stood up fordoctors opened doors for them. And you see Iresent. A great many forces in society that would let.Such a dangerous system of education survive in this country for a century.Education how you educate people are very important. You know really nurses havelived and died not being educated. To the fullestextent of their potential in the point of it is you see they didn't live as a human being. Whenpeople control your life in front your education. People who don't view you as human.Listen you're in trouble. You say X. I havethought about this for a long long time and I just do feel very strongly it has not been fair.You see nurses have not lived in that. We haven't been treated like we lived in ademocracy. You say. I call it a form of despotism
that is by the way still very operative in the health care system. The American publictoo has been just as exploited and nursesso.So no matter what your political differences do you all agree that the fact thatnurses have been somewhat oppressed has damaged our health care system you and therefore your work hasnot yet been entitle to. That's the very definitely. Now why.Was my question why have you all not spoken up before. It's this situation'sbeen going on for a long time. Don't you have some qualms aboutwhat the profession has not done.Well but I. OK I think you are jumping to a conclusion that isnot you know in actual fact I think that the nursing profession head as. You knowdone things about this. I think what we have been talking about before and thatis the movement towards baccalaureate education for nurses. And you knowMaster preparation for nurses and even doctoral preparation for nurses. So I think that
there has been some movement there. I think perhaps one of our biggest problems hasbeen is that we are a politically naive group and we at least we have been I think until relativelyrecently. And I know in our attempts todeal with this issue have fallen short of what they should have been togain the public's attention and the public support the opposition has beenenormous has it not.Yes yes it will yes.And I think it's very very similar to what's happening with the with the entire women's movement.And as I think back now I think there were a number of us whobecame peripherally aware of what was happening in in thefield and. Thought perhaps it was our own craziness that we weresensitive to this and resentful of it. Andbegan to look at it in the whole perspective of men andwomen and perceive what was happening but almost took it as well there's nothing we
can do about it and you have to know that nurses as a group are relativelypassive and very slow to action and I think that's been part of thesocialization. But women are more. That's precisely the factit's because they are women predominantly 98 percent. When thewomen's movement. Started its ownlevel of activity its own sense of consciousness raising.I think it began to awaken a number of us and I thinkprobably we began to look at our lifestyles and ourprofessional or unprofessional situations if you want to.Characterize them as the US in those terms in feministterms and the feminist rhetoric made sense to us. And Isuppose I.Really even though you were receptive to the women's movement the women's movement has not been supportiveof the nursing and that was my greatest disappointment I have.
Felt very much sold out in no uncertain terms thatthe woman's movement rather than dealing with nursing asa symptom.Of the problem of women. All too often accused us of beingthe cause or the willing participant inall of the Depression all of women's rights thatthey perceived to have been occurring all over and all. I have feltsold out in no uncertain terms by this attitude of thewomen's movement.I would go even so far to say that. The leaders in the women's movement havebeen taken in by the very same stereotypical images. Aboutnurses that they say are unhealthy amount of women. Yes.There was an article in news magazine. I'm sorry I can't remember exactlywhen the article appeared but it was super critical of nursing. You read it you know.
We're dealing here though with an element of ignorance you say.Let us not blame women for being like we are. There's an element ofignorance. The women writing articles about mirrors donot know the facts. And they they do live by mythsstereotypes that kind of thing. We got to correct because this includes thepublic too. Women are part of the public. We're society.And we do have to overcome this element of ignorance and get our own facts andpresent things to the public openly you see as a health care being a far more seriousmatter. Then let's say a woman's movement. Women we mustemerge as adults as humans in a society.And correct because our very status poor as it hasbeen is a health problem. And as I was saying to you earlier Sandywomen might as well forget it until they liberate the nursing profession and nurses
and get their rights straightened out. We'll never see women liberated because that'san index the nursing profession is in the index of the status of women in asociety.Well would you agree we have 15 seconds I think with 30 seconds thateducation is got to be your top priority. Yes positively. Edmund Idon't I'm not talking about education of nurses but of the general public. Oh yes yes.That the meeting is going to help us do that. Because look how we're pretty sure you don't ontelevision we creep around following doctors I know have seen Thank you all forbeing here.We'll be back next week.This program was produced by a w o n e which is solely responsible for
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- New Image for Nurses. Part 1
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- This episode features a conversation with June Rothberg, Ph.D., Jean Spero, Ph.D., and Joanne Ashley, Ph. D. Dr. Rothberg is Dean of the School of Nursing at Adelphi University. She is a co-founder of NCAP - the Nurses Coalition for Action in Politics and is the immediate past president of the American Association of Colleges of Nursing. Dr. Spero is Dean of the School of Nursing at the State University of New York at Buffalo. She is Chairwoman of the Board of Review of Baccalaureate and Higher Degree Programs of the National League for Nursing. Dr. Ashley is the author of "Hospitals, Paternalism, and the Role of the Nurse." She is an Associate Professor of Nursing at Northern Illinois University. She is also on the board of trustees of NCAP.
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Director: George, Will
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Guest: Spero, Jean
Guest: Ashley, Joanne
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