Nursing: Job or Lifestyle?
In the last 6 months I have seen and participated in some heated online discussions about whether nursing is a job or a lifestyle. Opinions run a gamut from “you’re a nurse all the time, on the clock or off, and you should live a lifestyle that anyone would view as above reproach, possibly eating only apple pie and attending church every Sunday” to “when I’m not at work, I’m not a nurse, and I can do what I want.” Hospital administrators have poked this argument with a stick by insisting on potential employees’ Facebook passwords and by doing things such as firing nurses pictured on Facebook or other social media sites drinking or otherwise behaving a ways that HR, apparently, doesn’t like.
One sees the original underlying point. As nurses, we get up close and personal with people; we are often the most physically invasive people that most patients will ever meet in their lifetimes. We ask questions that delve behind the curtain of privacy that people wear around themselves. We administer dangerous drugs that can lead to death or save lives. Medical decisions may hinge on what we notice or fail to see. As such, it can be appreciated that the general public would like us to be completely on our game and, if possible, personally the type of person they wouldn’t mind knowing their deepest secrets or invading their physical space. To put it bluntly, as an example, if a nurse has to train a bright light on your perineal area to insert a Foley catheter—a painful, invasive, and humiliating, but frequent, experience for many patients—you probably want to think of her as a kind, nonjudgmental, always sober, and morally upstanding person. You might even care about her sexual orientation.
Patients care about things, and they are not always obvious. Some are, such as “I want my nurse to not be under the influence of drugs at work and I don’t want my nurse to be a child abuser.” But some are not. Example: I live in Kansas. We have farmers here. I once had a patient refuse to let me care for him when we discovered I am a vegetarian (one does “chat up” patients during procedures), because he owned a feedlot and made his living from people eating meat. He found my “lifestyle” reprehensible. Who decides what lifestyles nurses should be allowed to have outside the hospital? Some boundaries are clear. If you want to be a nurse, you cannot use drugs or alcohol at work, you cannot be a sexual abuser, you cannot abuse children, and choices such as bestiality and S&M should probably be off your plate—although I might cede the point on the S&M. Sexual “deviancies” are the most hotly contested items in nursing circles. If you’re a nurse, can you also work as a stripper? Be a “swinger”? Be gay? Does it matter what you do off the clock if you’re not hurting anyone? Where should this line be?
If patients decide, the criteria will be all over the map. If boards of nursing decide, the criteria will be all over a different map. But the most clashes may come from nurses ourselves. “You need to be a good nurse online as well as off,” said another nurse blogger to me. She was distressed about an opinion I had posted. I am not a cardboard cutout. I am a nurse, but nursing is not who I am; it is what I do. She feels differently, and her feelings are not rare. Is it reasonable to expect nurses to put in long hours and then lead morally exemplary lifestyles 24-7 off the clock? And according to whose morals? I don’t have the answers, but the questions are sprouting up like wildfire because of the capacity of social media to publicize nurses’ private lives.
About MegenMegen Duffy, RN, BA, BSN, CEN, works in an ED at a community hospital in the Midwest. She serves as a local board member of the Kansas State Nurses Association and is a contributing editor to the American Journal of Nursing. Before her nursing career, she was a freelance medical editor and writer.
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