Replacing Patient-Centred Nursing with Society-Centred Nursing

When in nursing school, it took me only one day of psych clinical to reach nearly the same conclusion that such intense individualism can create a difficult if not impossible barrier to reentry into a society where individuals do not play by the rules of the milieu. Now that I am a floor ICU nurse, I feel like the structure of what we do is not entirely dissimilar. In the intensive environment of our unit, many people are stabilized with medicine and human interaction. Once the interaction begins to decline with transfers to lower levels of care, that patient's level of health often declines as well and frequently we see them return some time later.Health as a societal concept is not really discussed at the levels of power where it matters. Sure, many doctoral students have had their say in weighty dissertations, but the academic world, like the psych milieu, struck me as quite divorced from reality when I entered it to become a nurse after spending twenty some years in the working world. I would like to feel that what I do benefits both individual and society by empowering the individual to take control of their health and remain a productive member of society. In practice, I don't think this happens all that often.

I, too, have found that once caught in the web of institutionalized care, one can become mired or "dis-incentive d" to get back into the mainstream of society. In 1980, after struggling for years, I was diagnosed as a bipolar type II (major depressive) with generalized anxiety disorder and PTSD. I have been very fortunate. Because of my intellect, education, good psychiatric care and the revolution in psychiatric pharmacology I have been essentially exacerbation-free and worked as critical care RN for 34+ years until 2008 when the stresses of my personal life overwhelmed me and even with the best intentions and care, I became unable to work and had to apply for disability compensation from social security which was granted in May of 2009. Since that time, I have improved remarkably and would like to return to work and have my therapist's and psychiatrist's support for this, but getting a job is another thing altogether. No one wants to hire an RN that has been on disability. Especially, not a nurse, who has been on disability for a mental health disorder. Of course, no one will say this out loud. But when you have interview rejection after rejection, and you have sent out literally hundreds of resumes for any type of RN job available and you get nothing? You tweek your resume so you aren't asking for as much money and you find yourself almost begging at interviews for entrylevel jobs that pay almost nothing and you had a blemish-free record until the final 9 months of the last year and it hasn't yet been a full year since then and all you did was be inappropriate with management? It wasn't even a patient care issue? You pulled yourself out before it came to that? This is how society and health care repays you for all those years of work and dedication? When you get sick and do the right thing---you are punished and shamed by given a measly sum you can't live on and then told when you are well to go away? "We don't want you. You got sick. We don't get sick. Only bad people get sick. " I say, this is outrageous! It only encourages people to do two things. One, not get proper treatment. Two, if they do. Don't try to get well. Stupid & dangerous. If I ever get back to work, it will certainly make me think twice before ever jumping the gun again.....and that is what scares me the worst!!!

No kidding! The "stigma" is complete and damning--even when a person is not sick at all! The old notion that one cannot heal from these things has gotten so out-of-control it is unreal. As long as society continues to "pigeonhole" people--this happens in more than psychiatric patients--but in many other varying ways, too... we will have this mess--the reason for my insistence about not using ANY labels at all! Called a "free-thinker" by one psych nurse--disparagingly, of course... she obviously is not keeping up with the research and hasn't had much well-rounded experience in life. Another person used a "quote" of Florence Nightingale in which she disparages "martyrdom"--the context, of course, was left out; I have no idea of what Flossie actually meant... but I know I have felt like a "martyr" to the system nearly continually... and continue to fight the implications of that. This article by Leo (is it really a book, Leo?) is "right on"--and badly needed. Leo has an uncanny sense of balance and "rightness" about his thinking. I'm far too passionate: it turns people off when I "crusade". This is not normally on spiritual issues (my real career right now)... but when involving healthcare--I really do "heat" right up... I've seen too much abuse and devaluation of the human person that has broken my heart so much... by the "system" currently in place. As I say so often: we reap what we sow. The underlying "sins" of the nation show up most strongly here. Yah, Pope Benedict XVI-you, too, are "right on"!

true.