It’s probably because I’ve based my understanding of how sexual assault victims are examined on what happens in episodes of Law and Order SVU or NCIS that I have been under the impression that police detectives and physicians are the only ones who examine the victims they encounter in the emergency room.  I am embarrassed to admit that, until very recently, I had little understanding about the critical real-life role forensic nurses play in caring for victims of sexual violence.  

Forensic nursing is a relatively new subspecialty of nursing, and the men and women who work in this career field do so in different settings and in various roles.  In the United States, the most common patient population for forensic nurses to work with is those who have been sexually assaulted.  I didn’t know that forensic nurses are often the ones who interview and examine victims of sexual crimes, collect evidence, collaborate with law enforcement officials and provide expert testimony. 

In a 2006 forward to the book, Forensic Nursing: a Handbook for Practice, Vice President Joseph Biden wrote, “Forensic nurses play an integral role in bridging the gap between law and medicine.  They should be in each and every emergency room.”  There is incredible value to having them there.  Victims of sexual assault suffer physically and psychologically at the hands of their attackers.  Without quality, sensitive health care, they may be forced to wait for long periods of time before they can be seen by already overworked staff.  They can be further traumatized during the invasive medical examinations, interviews, and evidence collection.    

This week, November 7-11 in Forensic Nurses week.  IAFN has created a documentary about forensic nurses.  If you, like me, could use more information about what these amazing professionals do, I encourage you to view it here: http://www.youtube.com/forensicnurses.

Last week I attended an on-line webinar titled, “Nursing Guidelines for Using Social Media,” hosted by representatives from the American Nurses Association (ANA) and the National Council of State Boards of Nursing (NCSBN).  Both organizations recently published guidelines for nurses on the responsible use of social media, and the speakers discussed the recommendations in the context of real-world nursing scenarios.  

Social media offers tremendous opportunity for professional growth because if provides a platform for nurses to communicate, collaborate, and inform.  It has transformed how we interact with our colleagues and patients.  I can use Facebook to share important health-related articles and to keep up with happenings at the School of Nursing at my alma mater.  I can learn about events at my local health care services provider on Twitter, and stay on top of issues that impact nurses by frequenting and commenting on discussion forums for nurses. 

In their book From Silence to Voice, Bernice Buresh and Suzanne Gordon wrote that talking about nursing is our moral imperative.  Blogs, like Theresa Brown’s (http://well.blogs.nytimes.com/author/theresa-brown-rn/), have afforded us an accessible means of sharing stories about our practice so that the public better understands what we do and why it’s so important. 

And yet, there is also tremendous potential for misuse.  In fact, according to a 2010 survey of boards of nursing, 33 of the 46 responders reported receiving complaints about nurses who violated patient privacy through the use of social networking sites.  Our use of social media has the potential to blur the lines between the nurse-patient relationship and to reflect poorly on our profession or our place of work.  Nurses at a hospital in Wisconsin were fired for taking a cell phone picture of a patient’s x-ray and posting it on the internet.  Nurses at a hospital in California were disciplined for discussing a patient’s case on Facebook. There are many other examples.

Despite the potential pitfalls, we shouldn’t avoid the use of social media; we should simply use it responsibly.  Reflect on boundaries that may be crossed when thinking about accepting a patient’s friend request on Facebook.  Consider the difference between venting about a challenging day in an on-line forum and in a chat with friends over a drink after work.  Be vigilant about safeguarding your patient’s privacy.  Know your institution’s policy on the use of social media.  If one doesn’t exist, advocate for and participate in the development of one.  Be familiar with the guidance ANA and NSBCA provided on the use of social media. 

But don’t stop talking about nursing.

During a recent (and thankfully rare) visit to a physician’s office, I wanted to ask a nurse a question. In the sea of brightly colored and dissimilarly patterned scrub-wearing people, I could not readily discern who was a nurse, receptionist, or nursing assistant. Only the physicians and nurse practitioners, in their street clothes and lab coats, were easily identifiable.

Whether or not to standardize nursing uniforms is an issue that has been hotly debated. Some argue, particularly in acute care settings, that what amounts to camouflaging nurses is a way to hide their dwindling numbers in staffing plans. Others applaud that the traditional all-in-white, cap-wearing RN has gone by the wayside.

In my case, finding a nurse was no big deal. I just asked to speak with a nurse and was quickly pointed in the right direction. (They do wear name tags in this practice, but titles are not always visible from a distance.) But under different circumstances–say, if I were hospitalized with a serious medical condition and being examined, questioned, and visited by multiple people with varying roles and responsibilities–I can see how this would be problematic. (Did my registered nurse just tell me it was okay to eat post-operatively, or was that the housekeeper?)

Some hospitals are implementing uniforms color-coded by role. Nurses at one New Mexico hospital will soon be wearing black uniforms to make them easily identifiable. Some are reverting to the all-white tradition, though in the form of scrubs and without caps. Nurses at some health care facilities are staunchly defending their desire to choose what they wear, so long as it adheres to existing dress code policies; while others are wearing white pants with any choice of top.

The way we present ourselves can and does impact the way we are perceived, not only by our patients, but also our co-workers. I’ve always been bewildered by those who work outside of pediatric settings but choose to wear cartoon character prints from head-to-toe. Or those who wear scrubs, not because they are so comfortable they feel like pajamas, but as though they actually were pajamas—wrinkled and ill-fitting.

Regardless of whether are not uniforms are standardized, one way professionalism is expressed in by what we wear. I’m all for making nurses more visible and identifiable—both for the profession and for our patients—but I’m not sure what the answer to the uniform debate is. I do know we should take pride in whatever uniform we are wearing. For me, that means wearing pressed, blue scrubs with my large-print “RN” nametag.

My decision to become a nurse was admittedly not based on an extensive exploration of the associated pros and cons of a career in nursing.  In fact, I was originally accepted into my alma mater’s College of Engineering.  But for an eleventh hour episode of doubt that forced me to reassess my goals and strengths, I would not be a nurse today.  I was simply drawn to nursing for reasons I did not completely understand.  Eighteen years later, I thankfully don’t regret my decision to go to nursing school.  I’m also better able to articulate some of the reasons why. 

Following is a list of what I consider to be the top ten advantages of being a nurse, in no particular order:

1.     Job Security

Despite being laid off from an inpatient staff nursing position once in the late 1990’s, I have always had options for employment.  Even during the recession, the Bureau of Labor Statistics reported an increase in health care jobs.  By 2018, more than 580,000 nursing positions will be created.  Nurses are in high demand, and will continue to be for the foreseeable future.

2.    Flexibility

The nature of nursing care is that it is needed all the time, and everywhere.  As a result, you can opt to work full time, part time or per diem on day, evening or night shifts.  You can work in rural or urban settings, inpatient, outpatient, in a home setting, in a school, in a law office, in a research setting—the prospects are endless.

3.     Options

As an RN, I have worked as an inpatient nurse, an outpatient nurse, in a law office, for a medical device company, and have even been self employed.  Very few professions offer the plethora of career choices that nursing offers.  In addition to the various specialties you can choose from, nurses fulfill a variety of roles within each specialty.  Experienced nurses are in high demand in many non-traditional settings as well.  In nursing, it’s possible to explore other options without jeopardizing your career progression. 

4.     Opportunity to Make a Meaningful Contribution

It may sound trite, but it’s true:  nurses routinely make meaningful contributions to the lives of patients and their families.  The work you do on a daily basis, though frequently stressful and repeatedly frustrating, has a real and tangible impact.  I still have the first card a patient’s wife wrote to me thanking me for caring for her dying husband.  It reminds me that the work we do is important. 

5.     Lifelong Learning

The science of nursing is always advancing, and a successful nursing career requires a commitment to learning and openness to change. Attending conferences, joining specialty organizations, reading journals, attending graduate school keeps me interested in and inspired by nursing. 

6.     Variability

In the years I worked in oncology nursing, I never encountered the same patient or the identical situation twice. You can count on the unexpected and the unpredictable, which I think tends to keep things interesting.

7.    Competitive salary

Nursing offers a competitive salary and, in many cases, potential for overtime.  According to the Bureau of Labor Statistics, the mean national nursing salary is $67,720, but the range is highly variable depending on location, educational level and role.  For example, the American Academy of Nurse Practitioners reports the average salary of a nurse practitioner is $89,450. 

8.    Portability

Nursing is a career that you can take with you wherever you go.  Once you have a registered nurse license in one state, you can apply for reciprocity in another state.  (Each State Board of Nursing has different requirements, so check with them for specifics.)  

9.    Challenge

Over the years, nursing has challenged me intellectually, spiritually, emotionally, and at times even physically—and although the challenges aren’t always without frustration, they do have way of keeping me engaged and motivated. 

10.  Trusted

Since 1999, nurses have been ranked as the most trusted profession in the United States every year except 2001.  (That year, fire fighters were ranked first.)  To me, that speaks to the relationships we have and the value we bring to our patients.

My Facebook News Feed is flooded with inspiring quotes in honor of the visionary Steve Jobs, who died much too young yesterday.  This one is my favorite.

“Your time is limited, so don’t waste it living someone else’s life. Don’t be trapped by dogma – which is living with the results of other people’s thinking. Don’t let the noise of other’s opinions drown out your own inner voice. And most important, have the courage to follow your heart and intuition. They somehow already know what you truly want to become. Everything else is secondary.”  Steve Jobs

Although impressed by a number of his accomplishments, what inspires me most is his belief in our ability to shape our lives, to dream our future into reality, and to trust our intuition.  Each of us will not necessarily impact the world in the dramatic fashion that Steve Jobs did, but if we do everything we can to live our best life, to be who we want to be, and to do what we want to do, we increase our likelihood of being successful, fulfilled, and of making lasting difference. 

There is inspiration all around us:

A friend of mine worked for years at brokerage firms knowing she wanted to be a nurse.  September 11, 2001 finally prompted her to apply to nursing school and start doing what she knew she was intended to do.  I admire her decision and the sacrifice it required. 

Another friend is finally starting nursing school after years of working toward completing her prerequisites while simultaneously caring for triplets and moving around the world every few years as her husband’s military career demanded.  I am in awe of her persistence and patience. 

A former graduate school classmate has returned to school to obtain her Doctor of Philosophy (PhD) in Nursing.  She juggles a demanding academic program with two small children and a part-time job.  I respect her determination and ability to balance her personal and professional life. 

Are you thinking about going back to school? Are you thinking about becoming a nurse?  How hard are you willing to work for it?  What is holding you back? 

Your time is limited.