1. Miller, Lisa A. CNM, JD

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I was thinking about this just the other day, the problem with nursing as a job. Plainly put, the problem with nursing as a job is just that-nursing simply isn't a job. At least, not in my opinion. Call it a profession, a calling, even a vocation, but "job" won't work for me. "Job" is too simple, too uncomplicated, too minimal a word. It fails to convey the significant requirements that must be met to be a good nurse.


I actually learned the difference between a job and a profession when I first started working as an RN in labor and delivery, back in 1979. And, the difference was taught to me by 3 colleagues, Sarah, Jessie, and Lavergne, none of them nurses. Sarah was an operating room technician, or "scrub tech," Jessie worked as a tech in the delivery rooms, and Lavergne was the unit secretary on day shift. Today, I wish to honor these 3 women and personally extend a much-belated thank you for their very special contributions to women's and children's health.


Sarah's lessons to me went far beyond simple sterile technique, or knowing the difference between a Kelly and a Kocher. Sara taught me the importance of organization, planning, and the value of a quick response. She taught me that respect was a 2-way street, and that competence was more than proficiency. Sarah was incredibly strict as well as incredibly kind. She made sure that each nurse she trained truly understood the role of the scrub nurse. When I "graduated" from her training program and was allowed to fly solo as a scrub nurse in a Cesarean section, it felt like an honor and a privilege, not a job requirement. Viewing what you do as an honor and a privilege is one of the hallmarks of a true professional. I recently found out that Sarah is still working, no doubt providing the same wonderful example she once set for me. Sarah, thank you for all your hard work and devotion, I still think of you when I now first-assist!!


Jessie's lessons were a bit different. Jessie was my role model for making work fun, which is another hallmark of a professional. Work with Jessie around was easy, no matter how busy it got, because Jessie made it so, always ready with a quick remark designed to spark a laugh or smile. She took her breaks when she could and taught me to do the same, because a professional knows that sometimes just a few minutes to clear your mind could make the difference for the rest of the day-to you, and more importantly, to your patients. Skilled, quick-witted, and filled with a sly sense of humor, Jessie made working that extra shift fun (OK, maybe not fun, exactly, but at least easier). Jessie, kudos to you!!


I probably learned the most from Lavergne, or "La" as she was known to her friends. My first professional grow-up moment was provided by Lavergne, and it was after this episode that I was able to call her La. It happened late in 1979, just before Thanksgiving, and I was only 4 months out of nursing school, about 1 month out of my full orientation and preceptorship for labor and delivery. I showed up for my day shift to find the labor and delivery unit filled to capacity, no day shift charge nurse, and only 2 other nurses, both of them less experienced than me. Me, with my big 4 months of experience!! My assumption that one of the experienced night staff nurses would stay over her shift to help out was quickly proven incorrect. I stood in shock at the desk while the night charge nurse gave me the report board and wished me luck-I was in charge!! My begging her to stay was to no avail, and as she walked away, tears began to well up in my eyes and I visibly began to shake. It was at this point that Lavergne, the unit secretary, pulled me quickly aside into a small cubbyhole off of the front desk. Too many years have passed for me to recall her exact words, but it was one of the most important conversations of my professional career, and it instilled in me a courage to cope with adversity that I still call on today (although thankfully, rarely!!). Within 5 short minutes, Lavergne had quelled my tears, helped me form a plan, instructed me on whom to page, what to say, and essentially how to provide safe care with limited resources until the cavalry could arrive.


During the next 3 years, "La" bestowed upon me an education like no other. How to be cool under any circumstance (hint: stay very quiet), how to effectively run a busy labor and delivery unit, how to contribute as a colleague with residents and attending physicians, how hospital politics worked and innumerable other priceless lessons that contributed to my professional growth and success. La was a unit secretary. Most folks would consider that just a job, just like the many who view nursing the same. La showed me what it meant to be a professional, and that being a professional had little to do with the letters behind your name, or your title, and everything to do with your viewpoint and your behavior.


La and I have maintained our friendship since that day in 1979, and we continue to see each other a few times a year, even though La is retired and I am a long way from my days as a charge nurse. La continues to serve as my teacher, now in a more personal way. La, like most of us, has seen her fair share of adversity. Her perseverance and courage during challenging times have served as lessons for me in both my personal and professional life. La, I don't know how to thank you for everything you've taught me over the years, and I know you wouldn't go in for anything too sentimental, so I'll leave it at a simple thanks, to a good friend.


I hope that all of us have colleagues like Sarah, Jessie, and La in our lives and our workplaces. I hope that all of us can see and understand that being a true professional has little to do with what letters follow our name, or how many years of education we've had. And I hope that all of us will continue to enjoy our roles in healthcare and take pride in our contributions to the health of mothers and babies. In closing, let me just say that for some of us, nursing will always be just a job. Thanks to Sarah, Jessie, and La, 3 true professionals, it never has been for me.


Lisa A. Miller, CNM, JD


President, Perinatal Risk, Management and Education, Services, Chicago, Ill