Nursing as a Career in the 21st Century

To find out how nursing today is different from nursing in the past, the Museum reached out to four nurses currently practicing in the field to hear about their experiences.

Becky Baron graduated from Cedarville University with a BSN in 2012 and is a nurse on an inpatient general pediatrics unit at Dayton Children’s Hospital. She is currently pursuing an MS in nursing education from Indiana Wesleyan University.

Tori Johnson graduated from Truman State University with a BSN in 2013 and has been working in psychiatric nursing ever since. She graduated in 2017 with a Masters in Clinical Informatics from University of Washington-Seattle and is looking for a new position utilizing her experience and new degree.

Tia Leonard received her RN from the Lutheran School of Nursing and her BSN from Chamberlain College of Nursing. She has 18 years experience in multiple settings and is currently pursuing a Masters in nursing at St. Louis University. She is married with a grown son and a cat.

Sarah Popuţe graduated from Wright State University with a BSN in 2011. She has been a Labor and Delivery nurse for six years and is a Clinical Educator at Xavier University. Her career, husband (also a nurse), and daughter keep her very busy.

Why did you choose to become a nurse?

BB: I chose nursing for a variety of reasons. If I am honest, part of the reason is that while I was deciding on a career as a junior in high school it seemed like the thing to do. I had heard that there was a “nursing shortage” at the time, ensuring I would have job security. I had several friends who were interested in the profession, and I could obtain a marketable bachelor’s degree in just four years. Even then though, I knew that I was interested in the medical field, and that I wanted to help people. Nursing was a way to do both. While I had no idea what I was getting myself into at the time, I believe now that I was designed in personality and skill to do this job. I believe God led me to it for practical reasons, so that I would stay in it for meaningful reasons.

TL: I went to the University of Kansas in Lawrence after High School to study Journalism. I wanted a job that paid more than minimum wage so I accepted a position as a certified nurse assistant in a nursing home. This is where I met my first love, geriatrics. After that, I never looked back. Nothing had ever felt as good or offered such rewards as taking care of other people. I thought I was normal until I brought my sister to work with me one day and she looked around her and actually started crying. She called my job “sad” and said she felt sorry for them. I didn’t feel sorry for them, I felt fortunate that I got to come to work and be with them every day and felt like it was my special gift to take really good care of everybody. So I guess I became a nurse because it was already in my spirit, it just took the right circumstances to bring it out.

TJ: I had various interests when I was younger, like being a veterinarian or a Child Life Therapist, as they involved caring for animals or children. I’ve always been interested in science and anatomy, but I wanted a degree/career that would provide job security and a plethora of career options. Nursing seemed like a no brainer. While psychiatric nursing will always be my first love, it did lead me to nursing informatics, which is my current career focus.

SP: I chose nursing because we spend the most time with patients. I wanted to be in the action, right at the bedside, advocating for patients. Nursing is a historically female profession.

How have the women who have come before you influenced you/your work?

BB: I am currently getting a Master’s degree in Nursing Education, so I have had some opportunity to study the history of nursing, appreciating the effort of those before me who have made the profession what it is today. It is indeed impressive how far it has come. I cannot think of another profession that has been as dominated by women that has the level of respect given the nursing profession. I am certainly proud to know that the respect I enjoy as a member of the field today has come from the hard work of nurses before me. I would say that in large part it has overcome the stigma of being a career just for females, and has become something that women and men alike are proud to take part in. What has influenced me more than the nurses I have read about, though, are the nurses I have worked with. I work with several women who have been a part of the profession for over forty years. They have seen it go from being completely female-dominated to a pretty good mix of women and men. They have slaved away at night when the staffing was terrible, just trying to help each patient survive until the next shift came. They have transitioned from paper charting to complete computer dependence. I have the utmost respect for them. They have seen things I will, thankfully, never see, because they have lived through the advances of the profession. Nothing phases them, because they have seen it all. When there are days when I feel like I just cannot take the stress a moment longer, I remember what they have been through. If they can continue on in the taxing, yet rewarding, work of giving your heart and soul to caring for people, so can I.

TL: I have been greatly influenced by the nurses I have worked with in my many settings. Also my instructors in the various programs I have attended. When I am unsure of myself or lack knowledge on a subject, it is to the other nurses that I always turn. I hear about nurses who “eat their young”, but the vast majority of my experiences with other nurses has been positive. I have modeled my appearance and behavior after them, and bit by bit over time, incorporated many of their strategies into my own methods. I feel that nursing is like an art form that is passed down generation to generation. In this way I have inherited different things from different nurses over the years and used this to come up with my own individual style or art of nursing.

TJ: Unlike most nurses I know, I don’t have any nurses in my family that inspired me to become a nurse. All but one of my undergraduate professors was a female. They are all very smart and independent, who mold nursing students in their likeness- though you don’t realize it until you start practicing on your own. I have had plenty of nursing peers at work who have influenced me; a few have been my age, but most of them were older. There can be competition among nurses, especially when they’re in the same age range, and there is such a thing as older nurses “eating their young”, both of which I have experienced first-hand. However, I’ve had plenty more positive influences, even from older psychiatric technicians, who have been working in the healthcare field longer than I have been alive.

SP: I have a deep respect for them, and see them as mentors and friends. There is a nurse in our unit that has been working in the same position on our floor for 49 years. She has such a knowledge of her field, her stories are mind blowing, and we all have learned so much from her experiences. There is a theory that “nurses eat their young” but I have not found that to be true in my unit. As a younger nurse, you have to be able to acknowledge that you don’t know everything and be able to ask experienced nurses questions.

Why do you think that nursing is still a predominately female profession today?

BB: While nursing has come an incredibly long way in being recognized as a career for all people, it may always be dominated by females. There are inherent things about it that some people may view as characteristic of females, and it may never be rid of that stigma. I would argue though, that nursing needs both males and females. I work with men who are some of the finest nurses I know, and they have incorporated their masculine qualities into the work they do. Nursing has become a profession where males and females alike can speak their opinions, make independent, intelligent decisions, and provide compassionate care to patients. To me, compassion is the dominate quality of nursing, and it is something that is gender-neutral.

TL: It is my opinion that caregiving comes more naturally to females. We are socialized from birth to be caregivers (or at least we were in in my day, I was born in 1971). We learn by caring for our children, parents, and family the art of caring for others. In many ways, society still expects it from us and in some ways, it is probably more socially acceptable to be a part of our role (Remember the movie “Meet the Fockers, where the male main character is ridiculed for being a nurse instead of doctor). I realize that it is 2017 and that these concepts are changing and that it is now much more acceptable for me. But at the same time, change comes slow and I don’t think the world, even as politically correct as we have become, is where it needs to be to make it wholly acceptable to ALL.

TJ: Firstly, I believe that there are historical factors in play; historically, men were encouraged to be doctors or lawyers, while women were encouraged (or told) to be nurses, teachers, etc. As societal expectations have changed over the years, so have gender roles in the medical field, which is why you see more female doctors and more male nurses nowadays. However, nursing is still seen as a very emotional and nurturing profession, while men are still expected to be masculine, guarded, or stiff-lipped in this day and age. 

SP: Nursing is one of the few careers that allows you to work and still have a family, and I think that’s why women gravitate towards it more. I’m able to raise my children 4 days a week and work full time for the other 3 days. (Although, I am married to a nurse and because I teach in a nursing program and I can tell you we have more male students now than when I was in school 6 years ago.)

Are there obstacles you face as a female nurse? Or would you say that being a woman in the field is a predominately positive or empowering experience?

BB: Being a female in the nursing profession is a lot like being a female in any area of life. Of course, there are a few people who think it is alright to treat you disrespectfully and inappropriately just because you are female, but I think being a nurse has actually made me feel empowered against it. I know I have the support of my organization, as well as my male and female colleagues, if I ever come up against someone who behaves this way towards me. I am a professional with a well-respected degree, experience, and qualifications, so I feel very confident in dealing appropriately with this kind of behavior. Overall, I would say I rarely experience this, though. In general, people I encounter in my profession treat me with respect and equality. I almost never have to worry about it.

TL: I have never perceived that my sex in any way was a detriment in the performance of my duties. As a matter of fact that is one of the reasons I enjoy working in this female dominated profession. I feel much less likely to be discriminated against. I find it empowering to work in a profession that commands so much respect but that is also primarily a female workforce. I do think it is awesome that it is changing though. In the same way that the profession should not be dominated by one race or culture, it should not be dominated by one sex. I am used to status quo, but I admit that may not be the best thing for the profession moving forward. Delivering culturally competent care will only occur with a diverse workforce. That means women and men of all colors, races, and sexual orientation. After all, isn’t that what our patient base is made up of?

TJ: As a psychiatric nurse, I face sexual harassment and inappropriate comments on an almost daily basis. However, I’ve seen male nurses receive similar treatment. You have to have pretty thick skin in psych, which I am happy to have developed.

From a quick internet search, it would appear as though there is a pay gap among male and female nurses, but I couldn’t tell you if there was pay inequality with any male peers.

There is some stereotyping about female nurses, that we’re supposed to be bubbly and fun and happy all of the time. Given my sometimes stoic personality, some patients are disappointed when I’m not bubbly like other nurses. I’m serious about my work and the care I provide. Plus, sometimes psychiatric patients need a little tough love.

I have worked with some condescending male physicians, who believe that female nurses are at their beck and call, while they joke around and talk sports with male nurses; however, once you stand up for yourself and establish a trusting relationship, they tend to provide you with the respect you deserve. They just need to know that you can’t walk all over them. Same can be said for other male staff.

SP: There are always some patients who don’t understand the scope of our practice, and are surprised with the autonomy that nurses have. For example, often times patient’s are surprised that the doctor does not show up at the hospital until they are minutes away from delivering their baby. I help them with everything to that point (pushing, laboring, fetal monitoring, pain control, etc). Sometimes I find that hard because I do have many intense responsibilities that go overlooked and the doctor gets most of the credit.

What advice would you give to women seeking a career in nursing?

BB: The main thing I would say is that, when I started out, I thought being a nurse would be glamorous like a TV hospital drama. It is nothing like that, but it is something so much better. It is a chance for me every day to encounter people I would never encounter in my normal life, and an opportunity to be a small light in their lives. You never know what people are going through, and you might be the only good thing that happens to them that day. Just being given that opportunity makes all of the hard things worth it. If you choose nursing and you go to work every day understanding your power to impact somebody, I promise that you will.

TL: I feel it is a privilege to be allowed to practice and that every time you practice you represent the rest of us. I wish that nurses would always consider the extreme honor it is to be a practicing nurse. I have had complete strangers place their absolute trust for themselves and their loved ones in my hands. I feel that a great deal of the faith you inspire from your patients comes from the way you carry yourself. Yes we all have our moments but be prepared to represent one of the most respected professions on the globe if you apply.

Second, be prepared to work. Some nurses choose to enter the field for money, and while money is a great motivator, it is not enough to do what we do. You need to know before you start that no dollar figure compensates for the lack of your bed when you are tired and your relief does not come to work on time. No paycheck makes up for the hunger pangs you experience when you are 2 hours late for lunch because the patient in room 2 had a seizure and now your other patient is on the floor. So come ready to work or consider a different field.

TJ: I would encourage anyone seeking a career in nursing to shadow a nurse, or even multiple nurses on various units to make sure it’s what you want to do.  Basically, know what you’re getting into before you jump in. Be ready to be a team player.

Nursing school is rough and not for the mildly interested; I’ve seen plenty of students fail out because they’re too distracted or not committed enough. However, I’ve also seen student obtain their BSN, while being a single mother to two kids and working a full time job. If it’s something you really want to do, you’ll be fine.

Nursing is not for the faint of heart. It doesn’t matter what specialization you choose or what kind of setting you work in. Patients, their families, and your peers are putting faith in your abilities to provide safe and efficient nursing care. I’ve had plenty of days where I didn’t get a lunch or I had to pee for 5 hours before getting a break in order to get my work done and do it well. You have to have drive and be a self-starter.

It’s definitely not a career for everyone, but not everyone stays in bedside nursing either. There’s plenty of other things you can do with a nursing degree and a few years providing direct patient care under your belt, so to speak.

SP: It is not for the weak. It is hard, intense, and all encompassing. But the rewards of seeing people healed, seeing a new life enter the world, or helping families grieve is something that is indescribable. I’m so thankful to my patient’s for letting me be in those delicate life moments with them. If you’re interested in nursing, shadow a nurse for a whole shift and see if the work we do fits you. Go to a school where you will graduate with your bachelors in nursing, because that is where hospital requirements are heading. There are many different routes to take, but getting your bachelor’s degree is so much more beneficial in the long run.

What does the future of nursing look like?

BB: There have been so many changes in nursing even in the short five years that I have worked in the field. Technological advances have greatly increased possibilities in caregiving, and medical research has changed the way that we do things. Many more nurses are being encouraged to obtain advanced degrees, which has been great for the profession as a whole, but not so great for having experience nurses at the bedside. Honestly, it is hard to predict where the profession will be in twenty years, but wherever we go I hope that compassion is always at the heart of it. People do not stay in the field of nursing unless they desire to be a part of the meaningful work of helping others. I believe this will never change.

TL: This is a difficult question. As legislation and patient expectations and needs are changing, so is the face of the health care delivery system as a whole. It is very difficult to envision what that health care delivery system will look like in the future and even more difficult to envision nursing specifically, but whatever the future brings, I see nursing as a major driving force in the future of health care. I believe LPNs will continue to be relevant in long term care as an affordable option for the care of patients in nursing homes. But advance practice nursing with specialties in everything from informatics to hospice to NP providers will make nursing look completely different and more diverse than the traditional picture of the nurses of the past. I find these changes exciting and I am glad that I will be here to see it.

TJ: As I just finished my Master’s in Clinical Informatics, my main interest is in how technology improves care for patients and makes nursing care more efficient. One major worry with improving technology is that “robots will replace nurses”. I doubt that will happen, as patients always need a human touch. However, I do believe that nursing will involve more technology, to make care safer, easier, and more efficient for everyone involved.

I hope more nurses become more involved in the politics and management of healthcare in the future; nurses have seen health care from the bottom up and can be very useful in times of transition or implementation.

SP: The future of nursing is bright, but I will be honest: Healthcare is ever-changing, and one of the most recent trends is the idea of patient satisfaction effecting insurance and hospital compensation. To put it plain and simple: if the hospital does not score well on patient surveys, we don’t get reimbursed. So hospital management has cracked down on nurses to be more doting, more like a hotel than a hospital. The bottom line though is this: we can do everything for your comfort, but sometimes healing and medicine is not fun or comfortable. Patient’s don’t have the knowledge we do, and can't judge our medical decisions correctly. That is what we are trained for. But now, with the “customer is always right” initiative, nurses are stretched to do more of everything: respond to call lights faster, while running codes, while prioritizing which room needs more acute care and medical attention, while making sure the family is happy and medications are given on time. It is hard and nearly impossible. We are losing a lot of great nurses simply because the demands are unattainable. Insurance reimbursement needs to find a middle ground, stop treating the patient like a customer, because the safety of our patient’s lives depends on it.