Tuesday, April 5, 2011

Nursing & Woo

For those who may not know, I am a Registered Nurse. I work in an environment where there is plenty of discussion between the same staff members day in, day out. This means I get to know what fellow staff members do outside work, what they feel about current affairs and what they believe.
Nurses come from different countries, different cultures and from all walks of life. Myself, I used to work in construction and traffic control, I ride motorcycles, I read philosophy, I hang out with sceptics, I am involved in atheism/sceptical activism. There are christians, muslims, buddhists, Australians, Americans, Indians, Chinese, Germans, French, Sudanese, South Africans… This is not unusual in nursing, or in any industry.
However, one thing I have noticed in nursing is the amount of people who believe in woo. I have colleagues who are clinical specialists in incredibly technical fields that still believe in things like naturopathy and an ordered universe.
·    One colleague is a specialist in critical care nursing, with 15 years’ experience in emergency room nursing, intensive care nursing and theatre nursing, has post graduate qualifications in these fields, can rattle off bio-chemistry and clinical pharmacology like I rattle off quotes from Blackadder, yet believes in ‘The Secret’ and the ‘efficacy’ of acupuncture.

·     I work with a nurse of 40 years’ experience, who has worked all over the world (both paid and unpaid), worked in many different fields and has neurologists that ask “how high?” when she says “jump”…wears a power balance bracelet.

·    One nurse, who upon noticing my tattoo of Charles Darwin, launched into a very informative discussion about the silliness of religion, that evolution was the only logical explanation of man’s existence and that the idea of a god was preposterous (I had hope of a comrade in arms here). I later found out she visits a chiropractor every week.
These aren’t isolated examples, these are just some of the most memorable. You may say “So what? I know 30 people in my office who believe in a random assortment of woo. The woman at the desk across from me reads the horoscope and uses ear candles every week!” But one thing about nursing is that during your training you are taught to use critical thinking and evidence based medicine/treatments.
During my university training we were informed that all our assignments had to be backed up by journal articles and texts that were peer reviewed, showed a sound methodology in how the studies were conducted and were clinically relevant (i.e. were published in the last 10 years). We even had to take a class called “Inquiry into Nursing Practice” which was all about how to research journals such as “American Journal of Clinical Pharmacology” or “International Journal of Palliative Care” and databases such as CINAHL and MEDLINE, how to appraise the quality of a study, how to ensure that a treatment regime is based evidence derived from studies that had successfully been replicated and not just because “that’s how we’ve always done it”. In fact, you could say that we are taught to be sceptics.
So how is it that people, trained to think and perform their job in such a manner, still believe in hocus pocus and snake oil? I am no psychologist (bar amateur), so my guess is that most people are capable of having two mind sets – a work mindset and a home mindset, and never the two shall meet. This allows people to be completely clinical and at the same time believe in the crazy woo and magic water and not allow the silliness to disrupt their work practice. Maybe these people work so hard while performing their clinical tasks that they need their bit of woo to counteract an often stressful life.
Whatever the reason for it, I don’t want to say these are bad or dangerous nurses for believing this stuff. Their demonstrated skill and knowledge of their clinical fields is enough to prove they don’t allow the silliness into their work lives.
However the hospital I work at is a specialised, private hospital. The hospital’s goal (besides providing quality care) is to become a major player on the world stage and to be talked about like John Hopkins Hospital or Princeton University Hospital (House’s hospital). Attached to the hospital is a special training school for doctors from all over the world to come and learn new surgical techniques. This hospital is trying to build a reputation as “one of the best”.  So while recruiting the senior staff they took only the best, with proven records of skill and knowledge. So if ‘the best’ staff from the public and private health systems of Sydney still have a high percentage of woo belief, where does that leave the rest? My colleagues may be able to clinically distance themselves from their silly beliefs, but does that mean the average nurse can? I think generally they can, as my experience within the public system shows me, but I have read what one palliative care nurse believes while they were discussing medical treatments on the forum of a certain northern based “awareness” group.
Why am I one of the (seemingly) few truly sceptical nurses? Well, I am ‘old school’ in my nursing style. No, that doesn’t mean I wear white dresses, a starched hat and allow the doctors to grab my arse and call me “darling” (I am a 6 foot, 140kg, tattooed, ugly as sin guy, so that would have to be one messed up doctor – male or female), it means that I live my job. When I’m not at work, I will research things to improve my knowledge/skill. If It is a quiet day at work, I will try to familiarise myself with a treatment or equipment that I haven’t used before. I don’t read fiction; I read books on pharmacology and pathophysiology. True, this work ethic doesn’t lend itself to much of a social life but I am of the belief that nursing is a passion, not just a job to make money so you can support a family or lifestyle. I was also an un-labelled or un-diagnosed sceptic for many years before I became a nurse.
To wrap up, a large number of nurses, even highly trained specialists, are believers in woo. However they seem to be able to distance their clinical work from this crap and provide high quality care to patients. That leaves very few who would actively recommend quack treatments in a hospital setting. But would you want your loved one, who is sick and vulnerable to be under the care of one of these few? I wouldn’t want a family member who is dying of cancer to have homeopathy preached to them in the community, let alone in a hospital setting.
Thanks for reading my rant.
The Reverend Doktor Bob.
P.s. I intend to have future posts about nursing & religion, nursing & vax ideology and psychiatric nursing vs. everyday beliefs.
P.p.s. I am not "one of the best" that was recruited from the outside, I am a bottom rung RN trying to work my way up.

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