men at work
Men at work

December 12, 2010 -- In one week I will graduate from nursing school. At long last! The ceremony is called "pinning" and is a throwback to the old days when nurses wore little white hats and making tight hospital corners mattered more than patient care.

I am a new nurse, entering this as a second (well, third, but who's counting?) profession. I bring the perspective of experience in other work realms, and I have less tolerance for mediocrity than my fellow nursing school students who are half my age. More to the point, I have little tolerance for mediocrity in my nursing school faculty whom, to their chagrin, I perceive as peers (indeed, most are younger than me.)

Evidently there are many like me: older men entering nursing as a second profession. "Nearly 40 percent of students studying to become registered nurses are over age 30... candidates who already have four-year degrees," [New York Times 11/7/2010: 45, Male and Now a Nurse]. I'm not 45 but 56, and have both a four-year degree and a Master's, but the idea is the same. My nursing class exactly matches that in the NYT article: 15% male. What the article doesn't mention is the darker side of this trend: education to produce degrees like mine (the school sells BSNs) is now a big business. My school (which I'd better leave nameless for now, since I'm still in its clutches) is -- let's be magnanimous here -- lackluster in the quality of its teaching though expensive ($52,000/year not including books and supplies) and very profitable ($10M profit on $40M gross revenue).

Fortunately, the quality of the education is largely irrelevant to the quality of the nurses entering the profession. Most of what we new nurses need we will learn on the job, not in the classroom. In other words, we emerge from this expensive and unnecessarily fractious process knowing almost nothing of what we'll need to know to be good at our work. New nurses need lots of nurture from the institutions that accept them before they become useful.

This raises several important questions: how can nursing education be made effective? How can new nurses ("nurses eat their young") come up to speed without getting beaten up along the way?

Why does this matter? Because we want good health care. Given that the 3.2 million RNs now in practice form the vast majority of the health care work force, we need them to be good at their jobs and to get there quickly. The present dysfunctional system of producing new nurses is ripe for an overhaul. That will be good for us all.

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