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Rural Emergency Medicine: Stigma & Stereotypes


Lee Falls, SC

I practice in the rural, northwest corner of South Carolina, also known as “The Upstate.”  It is a place of expansive lakes, white-water rivers and the mist covered foothills of the Blue Ridge Mountains. The area includes thousands of acres of Sumter National Forest.  The natural beauty is breathtaking.  Sumter National Forest and our various parks are laced with hiking trails, which are lined with unique plants and trees, some found nowhere else.   Fish and game abound.  In fact, our wooded hospital grounds support a flock of at least 30 wild turkey.  And last deer season, the only deer I saw were the three does grazing at the end of the ED driveway one night, spotlighted by two of our paramedics.

We have a lot of wonderful things here, things that are gifts of the rural life.  We have good people, the salt of the earth types who care about personal morality and Southern courtesy.  People who bring you a glass of sweet tea when your car breaks down.  We live with a low crime rate, and minimal illicit drug use compared with more populated areas.  It is a good place to raise children.  It’s also a cool place to practice, where a busy summer shift can bring an acute MI, a near drowning (from inner-tubing on Class IV white water while drunk), a pit viper bite, a bull goring and many other pathologies, more or less interesting.

But, as physicians in a rural area, we pay a price.  Because we have to endure a certain stigma.   Read more »

Nursing Bloggers Dish About The State Of Their Profession

I was following an interesting conversation on Twitter between several nurses. They were expressing concern about how nursing stereotypes were damaging to their profession. I invited them to discuss the subject with me via podcast.I have summarized some key points below.

You can listen to the whole conversation here.

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Participants:

Gina from Code Blog (6 year veteran blogger, and has spent 11 years as an ICU nurse)

Strong One from My Strong Medicine (an anonymous blogger, athletic trainer and nurse of 3 years)

Terri Polick from Nurse Ratched’s Place (has held various positions in nursing, including psychiatric nursing for 20 years)

Current Nursing Challenges:

1. Nursing Instructor Shortage – nursing instructors make about 25% of the salary of nurses who do clinical work. Therefore, there are long wait times to enter nursing school due to instructor shortages. Many students can’t afford to wait, and choose other careers.

2. Inequality of Respect – some nurses feel that they have to continually prove themselves despite their training and qualifications. Patients often express disappointment or annoyance when they see a nurse practitioner (rather than a physician) in a group practice. Some doctors still expect nurses to give up their chairs when they enter the room.

3. Nursing Stereotypes – the “naughty nurse” and “nurse Ratched” images are still very much in the forefront of peoples minds when they think of nursing as a specialty. Some people believe that nurses simply pass out pills and make coffee, when in reality they are active in complex technical procedures and saving lives. These stereotypes and misconceptions denigrate the education and technical expertise of nurses.

4. Primary Care Doesn’t Pay: nurse practitioners incur higher debt and have lower salaries than specialist nurses. Just as in the medical profession, there are no incentives for nurses to choose careers in primary care.

Strengths of Nursing:

1. Nurses Are Better And Brighter Than Ever – since getting into nursing school is so competitive, the quality of individuals who are entering nursing school has never been higher.

2. Job Flexibility – nurses can easily transition to part time work for maternity purposes. Nursing careers offer a wide variety of work experiences – from nursing home work, to cardiothoracic surgery. One license offers hundreds of various opportunities.

3. Job Satisfaction – saving lives and serving patients contribute to a sense of job satisfaction.

What can be done to improve and advance the US nursing profession?

1. Establish an Office of the National Nurse. The National Nursing Network organization is promoting this initiative. The National Nurse would act as a government spokesperson for nurses-  promoting preventive medicine, increasing awareness of nursing, and securing financial support for nurse education. He or she would be the chief nurse officer of the US public health service.

2. Do not be afraid to speak up. Nurses should feel comfortable defending their professional ideals, and discouraging stereotypes.

3. Blog to raise awareness of nursing challenges and successes.

**Listen to the podcast**

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