Five of Nursing’s Dirty Secrets

I am a nurse. I am an RN to be exact, because LPN’s, LVN’s, NP’s and APN’s are all nurses as well. There is a sliding scale on our scopes of practice. My scope of practice is larger than an LPN or LVN’s and smaller than an APN or NP’s. There is several things that we all have in common though, and those are our dirty secrets. I am going to focus on the RN’s dirty secrets, since I know those best.

Dirty Secret 1: In most states, your education level means zilch if you are a floor nurse. There can be three levels of education for RN’s; Associates, Bachelors, and Masters. If you work on a floor in a hospital, your education doesn’t mean much to anyone, except for you. Yes, it can help you progress your career in the future, but if you are happy being a floor nurse, then it really doesn’t matter on what end of the education spectrum you fall on. Time is a great equalizer of talents and, according to Patricia Benner (education level challenge), it can take roughly 5 years to reach the expert level of nursing. Quick math 36h x 52w x 5y = roughly 9360 hours of clinical experience. Not sure where I read it but it takes 10,000 applied practice to become an expert in anything. Associates RN just as capable of becoming an expert floor nurse as a Masters RN.

Dirty Secret 2: We are a captive audience for our states Board of Nursing. I have my license in two different states now. Neither has been a pleasant experience. This dirty secret is more for other nurses. We need to come together and let our Boards know that this is unacceptable. Long wait periods with no communications between the states is ridiculous. To give everyone an idea of what we need to do to get licensed in multiple states I will give you a small example. I can apply for a license in Iowa this year, I would have to submit to a criminal background check, even though I have already submitted to one this year for Texas. For some reason one Board cannot call another Board and ask, or read the same report. Secondly, each board can take it’s own sweet time in verifying the background check and issuing a license. It is beyond frustrating.

Dirty Secret 3: Our patients are not allowed to know if we are understaffed. I had a patient angry with me because I didn’t wash her face. Now, mind you, she was perfectly capable of walking to the bathroom and wash her own face and I had four other patients on a very busy step-down unit. I didn’t have time to coddle someone capable of caring for themselves, but she snapped at me to “send the aide in to help me”. When I told her that wasn’t possible she asked why and I answered her truthfully. We didn’t have an aide on that floor and rarely did. We were understaffed. It happens more often than not and is one of the biggest concerns in nursing.

Dirty Secret 4: We are human. This is probably the hardest part for us and our patients to accept. We need sleep, we need to use the loo, and we need to eat. With Dirty Secret 3 already laid out, we miss out on a lot of the basics during a 12 hour shift. I have left work and rushed home, realizing halfway home that I haven’t peed in 13 hours. I can also pick at the same container of food for six hours because every time I have a second to take a bite, that’s all I get. On top of this, we can also be incredibly judgmental, but, if you are a patient, you will likely never know it. HIPPA says I cannot speak of such things. There are unspeakable things people have done and we take care of them, no matter what. I salute nurses who don’t judge, though I can’t think of any off the top of my head.

Dirty Secret 5: Most of us are burnt out. This job aint easy. We take care of people tho are sick, sick, sick, and sometimes it isn’t physical. We spend long hours taking care of people who can’t take care of themselves, a chunk of them who don’t appreciate what we are doing, mixed with people who can take care of themselves, but don’t, and blame others for their problems. This is not all patients, not all situations, but this, mixed with 3 and 4, burn nurses out faster than a greaser’s wheels.

These are my 5 dirty secrets to nursing. Let me know what you think our dirty secrets are!


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