What Nurses Stand For: Suzanne Gordon 1945, Book Review Example

An essay that describes the dilemma of the Nursing profession , why there is an ongoing shortage of qualified nurses, how the work is so often unrecognized and why the profession is considered to be on the endangered list.  (Gordon)

The Stigma of Sickness

Gordon claims that all too often patients either overlook or ignore the vital contribution made by their nurses.  They are quick to acclaim the success of the Doctors who carried out their life saving operation and ready to share this with colleagues and friends.  All too often they forget that it was the nurse who had to deal with many of the more unpleasant tasks and was the person that nursed them back to health.  Even though the nurses  are part of the patients life support system during illness, patients quickly want to forget and rid themselves of the memory.  Nurses are so often associated with trivial tasks that their true skills are so often overlooked.  The nurses ability to deal with traumatised patients handling both their anxieties and fears.  The intimate care that nurses provide to those patients facing life threatening situations.

Gordon cites a number of reasons for this lack of recognition of nurses:

• Nurses cushion the frailties of human beings; those issues of sickness that invoke fear, pain and loss of control. Adults hate being reminded of their mortality and fragile grasp on life. They find this difficult to tolerate and equally less willing to share the discomfort that the nurse helped them with;
• Doctors and Surgeons are seen as the “front office” and the skills that save human life. Little acknowledgement is made of the “back office” and all that goes into the recuperative process. It is clear that the nurses have a far more intimate relationship with the patients than the surgeons or doctors. It is this intimacy that brings the patient closer to their own mortality and even in extreme cases of terminal patients the nurses help them with dignity and care.
• The fact that nurses deal with menial tasks contrasts to the sophisticated clinical aspects of their work that often goes overlooked. Nurses go through an advanced form of medical training that requires subject matter expertise and expert judgement.  All too often this view is negated inn favour of a menial technician supporting the more senior medical staff.
• We fail to acknowledge the hands on care that enables nurses to study the patients physical condition which both allows them to save lives and determine when conditions are right to help patients prepare for death.

Weighting the Evidence in Gordon’s Argument

One of the most compelling arguments is where nurses are involved in special treatment units like Cancer Care centres.  Nurses here are providing a high level of specialist clinical care. Nurses in European centres say that they are not being provided with the recognition and rewards that this special care entails.  They state it is at the most severe in terms of payment and status of work.  It has been suggested that in order to elevate such status they require specialist qualifications beyond the basic Registered Nurse qualifications.  The counter argument is if the nurses attained such qualifications will the medical profession recognise this and make the necessary changes.  As to date there is no indication that this is the case.  (Kearney)

There is generally a lack of nursing recognition where this involves the practice of ” continuing care”  and the longer term nursing of the elderly. Nurses themselves are perceived to lack “assertion and articulation” skills that promote their values and thereby promote their recognition to others. There is also little evidence to suggest that general nursing training prepares them for this specialised form of nursing care. Nurses tend to build on their core academic skills by learning new skills in this practical setting.  This in turn goes largely unrecognised because there is no formal certification.  (Hazel B. M. Heath)

Another important and specialised area of the nursing profession relates to the treatment of the mentally ill.  The Australian Journal of Nursing Education reports a serious decline in the number of qualified nurses entering this side of the profession and as such considers it a major area at risk  ” The analysis of the both quantitative and qualitative data gathered in a longitudinal study would suggest that caring for the mentally ill is an area of nursing practice that does not attract a sustainable supply of graduates from the current pre-registration programs. The implications of these findings indicate that nursing is likely to loose this area of health care to other occupations unless: 1) action is taken to make caring for mentally ill people a more attractive career destination; and/or 2) provision is made for a registration pathway that caters for those undergraduate students for whom a career caring for mentally ill people is a priority.”  (John. A. Stevens R.N, Geoffrey. M. Dulhunty R.N and FANZCMHN)

It is true to say that since the time of Florence Nightingale nurses have produced some amazing feats of work.  Despite that fact they are seldom recognized or celebrated in any way ” The world recognizes extraordinary human achievement with the awarding of six Nobel Prizes, including the 2006 Prize in Physiology or Medicine.  No nurse has ever won. That is appropriate, because nursing, while closely related to medicine, is a distinct health science. However, there is no Nobel Prize or comparable annual award (such as a Templeton Prize or a Fields Medal) in nursing. There should be. Nurses deserve such international recognition. Alfred Nobel’s will provided for prizes to those who had “conferred the greatest benefit on mankind.”  (Gebbie and Summers).  In this sense the nursing profession is somewhat lacking in lobbying for special awards for recognition of its most outstanding members of the profession and indeed promoting the nursing profession at large.  The nursing profession can do much to help itself in this regard by increased promotion of its members and the vital service it provides to the community at large.

There is some evidence that indicates the private sector is taking certain initiatives in order to give nurses the recognition they deserve.  This particularly for those helping the US Military in times of war, for example : ” An RN with a disability who overcame discrimination to achieve a successful nursing career. An African-American Navy nurse who heroically saved the life of a dying Iraqi boy during Operation Iraqi Freedom. What do these two minority nurses have in common? They were the two top prizewinners (RN Category) in the 2004 Cherokee Inspired Comfort Awards, a national recognition program sponsored by health care apparel manufacturer Cherokee Uniforms. The awards honour health care professionals who have touched the lives of others through exceptional service, sacrifice and innovation.”  (Anon)

Arlie Hochild 1940 – The Second Shift

Arlie Hochild in 1940  wrote the book “The Second Shift”  where she made the point that women, despite making considerable progress, are still responsible for doing the bulk of the household chores. In  fact those women responsible for doing most of the food and shopping work have not made much societal progress at all.  She went on to elaborate that whilst women are spending more time with their work and careers the men have not taken up more of the burden and do not spend more time at home caring for the children, the so called “second shift”.

Breaking With Traditional Values

Breaking with traditional values needs to be examined from a number of different perspectives. For example consider:

• The changing of roles in modern society where families become reliant upon “two incomes” from both parents;
• Emerging democracies like India where the roles of society have been fixed for over 100 years and now they are compelled to look at the same circumstances as other families in the Western democracies;
• The psychological aspect of the ” hunter gatherer” whereby the male perceives himself as the dominant species and “breadwinner” of the family.  The resistance to change as he sees his role being threatened and the loss of respect from the family unit;
• The concept of role reversal whereby the “full time” female partner has a demanding career and the workplace is extremely demanding i.e. Doctor, Nurse, Lawyer and those involved with “on call” work requirements.  Here the male partner has to take “the second shift” and help out at home with looking after the Children – doing house chores, feeding the children and looking after them.  More importantly looking after the wife when she returns home and not just passing the baton.
• Men still leave the women to deal with the bulk of the shopping requirements, particularly food shopping;

Examining some of these arguments in more detail:

The Changing of Roles in Modern Society

As families become more reliant upon two incomes in order to sustain a desired standard of living, it changes traditional values and imposes certain strains. Where one or both of the roles involves travel and prolonged stays away it can lead to a breakdown in the relationship.  The partner may feel unloved and abandoned, equally having to deal with the “second shift” alone.  Lack of engagement by either parent can have traumatic impact on the children too.  This role change has caused parents to carefully re-evaluate their positions. If it is to work it requires a great deal of harmony, give and take, compassion and empathy for one another’s work life. In essence it could be argued that these are key virtues of a successful marriage. Equally, much of this requires common sense upon the marital partners. Unfortunately it does bring to the surface the darker elements of our personalities i.e. greed, selfishness, egoism and in the males often a factor of dominism. The other aspect here is one of communications between the parents. Both have to be “good listeners” and try to accommodate each others point of view. Modern society tends to make parents more dismissive and as such leads to communication breakdowns.  “I think the confidence level is higher,” Rounds said. “Girls are brought up today being told, ‘You can do anything you want.’ The world has just changed so drastically the past 20 years.”  (Nann)

Emerging Democracies Like India

As we move towards a more integrated global economy and the concept of democracy spreads, then we will influence cultural values of nations.  This is best examined from the perspective of emerging nations like India.  Here the female is being better educated, given more work opportunities and essentially careers similar to that of men.  The key issue here is dealing with historical cultural issues where it has been accepted that the women in marriage are bonded into domestic servitude.  The also gives rise to the caste (class) system whereby the more affluent families have servants and these are bonded to the family for life, such that the children of the servants are immediately bonded into servitude without even having the chance to progress ” Kolkata (Calcutta)  which continues to shape its culture of servitude today: first, servants are essential to a well-run and well-kept household; second, servants are ‘part of the family’ and bound to it by ties of affection, loyalty, and dependence; and third, servants comprise a category with distinctive lifestyles, desires and habits”.  (Qayum)

The Psychological Aspects

A difficult area to venture without specific expertise.  It is considered however, that in historical terms, we have been a male dominated society.  From the perspective of origin man was the provider for the family ( the hunter ) whereas the female was the organizer and care giver (gatherer). Like any animal species we evolve and ultimately to a state of equality. Although we may not have achieved that state today, nevertheless the western democracies have moved a long way towards it.  Certain “Male psychological traits” are embedded  though, for example the concept of the “alpha male” who seeks to be dominant both with other male relationships and his family.  Whilst females may find certain elements of this behaviour attractive e.g. confidence, self-reliance, decision maker etc, nevertheless they will be totally be alienated by the more negative aspects of selfishness, greed, intolerance, aggressive behaviour and anger.

The Concept of Role Reversal

The aspect of role reversal whereby the woman becomes the main income provider and the husband takes on the domestic role often leads to separation. ” More women are ditching their role as homemaker and returning to the workforce as primary breadwinner, leaving their husbands to stay at home with the kids. According to a report from the Indiana University of Pennsylvania, the divorce rate among married couples doubles when a woman earns 51 to 75 percent of the family income”  (Anon, How to Cope With Role Reversal in Marriage).  The concept here is that most men do not readily adapt to change. Equally they secretly see their dominance being impacted and as such feel threatened in the family group. This in turn leads to a loss of control and often they seek solace by forming new relationships where they can regain a sense of status and power.

Men Still Leave the Women to Deal With the Bulk of the Shopping Requirements

This trend has somewhat changed owing to trends in modern healthcare, cooking and dietary conditions. Men no longer see it unfashionable to go to the market place and shop for their families. In fact most of those men with culinary experiences enjoy this, particularly when this is mixed with the `food and wine` experience.  Equally, a lot of women still do the family shopping because they are perhaps more in tune with the needs of the family, particularly the children. Shopping is often part of the maternal instinct (gatherer) that bonds the mother with the Children.

The other argument is that men are inherently lazy and if the woman agrees to do the shopping he is only too eager to agree ( more time on the golf course ).  Again this very much depends upon the nature of the marital relationship.  A most overlooked factor is that of `communications`, those with good communication skills in a relationship are much more likely to have a better understanding between one another and ultimately a more enduring relationship over time.

Lack of Female Progress in Society

” Throughout life every man and woman fits into a specific gender role. We are told what is expected of men and women from birth until death. Many people influence our view of how we should act and what we should say such as our parents, friends, and even the media. Males and females play very different roles and these differences are apparent in our every day lives. These differences are not the same as they used to be. Society has changed the way it treats men and women over time. “(Anon, First 1500 characters of The Progression of Gender Roles in American Society).   The concept of evolution and the roles that we play in modern day working society.  There is no doubt that women have made tremendous strides toward equality at work and improving the overall quality of the workforce.  There still remains certain disparities however, consider the following:

• There still remains a lack of visible female Executive and Directors on the major Corporations in the USA.   There has been significant progress and this does need ton be examined from an industry classification perspective. Nevertheless if we examine one type of industry i.e. the Film industry, we find the following: “Of the roughly 13,400 members of Directors Guild of America, only about 1,000, or 7 percent, are listed as female directors. (Total female membership, which includes people on the directing team like assistant directors and unit production managers, is about 3,000 or 22 percent.) “(Lemire)
• The actual progress of women in society varies from nation to nation. It is fair to say that in the United States women today have a fairly good equality with men in the workplace. They are not hampered by old caste systems, ancient religious beliefs prevalent in Islamic and Hindu dominated societies, they are also provided with equivalencies in Education unlike other nations. “What I do know is that women do excel in school now and in many cases more than men. Females do have dreams and accomplish their goals as well. “A 1993 survey showed that female college freshmen-recent products, most of them, of American elementary and secondary schools-have higher aspirations than male college freshmen: 27.3 percent of the women declared their intention to pursue medical, law, or doctoral degrees” (Arreola)

Comparative Assessment

Suzanne Gordon described the plight of the nursing profession, although this itself is not totally female oriented.  Alien Horchild focused on the demands placed on women and the inequalities they face.  Within nursing it is primarily the lack of recognition and merit they deserve, the majority being of female gender.  In modern society women still face challenges of perception and recognition on their roles and the valuable contribution they make. Whilst this is improving this still has a long way to go particularly in third world countries and emerging democracies.

Works Cited

Anon. First 1500 characters of The Progression of Gender Roles in American Society. 8 2009. 19 10 2009 <http://www.123helpme.com/preview.asp?id=66948>.

—. How to Cope With Role Reversal in Marriage. 2009. 19 10 2009 <http://www.ehow.com/how_2189476_cope-role-reversal-marriage.html>.

—. Minority Nurses Capture Top Awards in National Recognition Program. 2004. 19 10 2009 <http://www.minoritynurse.com/vital-sign/minority-nurses-capture-top-awards-national-recognition-program>.

Arreola, Bianca. Women’s Progress in Society. 26 9 2007. 19 10 2009 <http://englishwrit100.blogspot.com/2007/09/womens-progress-in-society.html>.

Gebbie, Kristine and Sandy Summers. “Nurses’ achievements merit international recognition.(NNA State) .” Nevada RNformation (2007).

Gordon, Suzanne. “What Nurses Stand For.” Atlantic Monthly (1997): 81-88.

Hazel B. M. Heath, Irene Schofield. Healthy ageing: nursing older people. 1999: Harcourt, London.

John. A. Stevens R.N, B.A (Hons), PhD, MRCNA, B.Hlth.Sc, M.H.Ed Geoffrey. M. Dulhunty R.N and FRCNA, FCN (NSW FANZCMHN. “A career with mentally ill people: an unlikely destination for graduates of pre-registration nursing programs .” Australian Journal of Nursing Education (1997).

Kearney, N Richardson, A Di Giulio,P. Cancer nursing practice: a textbook for the specialist nurse. London: Churchill Livingstone, 2000.

Lemire, Christy. Female directors shine, but numbers remain few. 31 7 2007. 19 10 2009 <http://www.azcentral.com/ent/movies/articles/0731femaledirectors0731.html?&wired>.

Nann, Maria. Women play a changing role in society. 11 6 2007. 19 10 2009 <http://media.www.kentnewsnet.com/media/storage/paper867/news/2007/11/06/Features/Women.Play.A.Changing.Role.In.Society-3080311.shtml>.

Qayum, Seemin. Grappling with Modernity . 2003. 19 10 2009 <http://eth.sagepub.com/cgi/content/abstract/4/4/520>.