Thursday, April 10, 2008

Current Events: Nursing School and the UN Convention on the Rights of People with Disabilities


I went to Niagara University back when they had a huge undergraduate nursing program. One of the best things about being in nursing school was “clinical” (the time we spent working with patients applying things we’d learned in class), and one of the best things about NU was that you got to have clinical at a wide variety of facilities spread across Western NY.

I still remember dragging myself out of bed at quarter-of-five (20+ years later I still cannot call it 4:45 because it still sounds too close to 4:00am!), pull on my highly attractive uniform and stagger over to Clet Dining Hall (which is much fancier in these pictures than I remember it!) to eat breakfast and meet up with the people from my clinical group. From there we would carpool to our assigned facility.

We would arrive at the hospital before the day shift would begin, have a meeting with our clinical instructor, pin on our caps and work until mid-afternoon. Then we would have another meeting with our instructor and head back to campus, where on a good day I would fall into bed and sleep until supper time. (On a bad day I would have French!)

I learned a lot during my clinical rotations—about medicine, about people and about myself. It was great.

One year I was assigned 2 consecutive rotations at the same hospital. I don’t really remember what type of unit I was on for the first rotation, the second was a vascular surgery unit.

The first rotation was awful. The staff on that floor was sour, they were perpetually annoyed with us. They let us know each and every day that they just didn’t have time for student nurses. They taught us nothing, showed us nothing—and the unit itself was chaotic, disorganized and unpleasant. The staff and patients there were all miserable. The nurse manager was ineffectual: controlling and obnoxious to her staff and they, in turn, were rude to us. We would have been glad to do all the mundane, routine work like making beds and personal care for them. Our instructor was searching for things to teach us, we wrote endless careplans, but we got no hands-on experience whatsoever.

The second rotation was amazing. On that floor they put us to work. They gave us assignments, they asked us to do the routine and taught us how to do much more than that. They were nice to us, happy to see us. They gave our instructor lots of opportunities to teach us and often the staff taught us themselves—all day long people would ask us to observe or help them with something. And they were really nice. I can remember being in a room making a bed and having one of the staff nurses coming in and helping me make the other side.

The patients on that floor had really challenging health issues yet everyone there was upbeat and positive. It was a very challenging rotation with lots of meds and procedures and information to learn—and it was really fun!

My clinical group and I were amazed by the difference in the dynamic of those two floors. We spent nearly every car ride discussing it. We could not imagine what would make two units in the exact same hospital so different from each other.

Clinical conference was usually spent discussing patients and medical information, but over lunch one day someone mentioned the contrast between our experiences to our instructor.

While our morning meetings remained clinical in focus, our afternoon sessions became management seminars. She was a good teacher and asked lots of questions: Was one of the nurse managers smarter? (Not smarter, but definitely different,) Older or younger? (No.)Was it the staff on the floor? The patient mix? (Not really.) She gave us articles and books to read and kept the discussion going.

Eventually we came to the conclusion that—drumroll please—

LEADERSHIP CREATES CULTURE!!!! In fact, the primary role of leadership is to create culture.

Doesn’t seem like that big a revelation right now, but to a 20 year old kid who had always taken such things for granted, it was huge.

(We did learn more about management and leadership in other courses, but this was my introduction.)

So I graduated from college and I went to work in small facilities and large facilities, I’ve had a family and belonged to churches and book groups, I taught Sunday school for my children and volunteered in their schools, I became a disability advocate, taken classes, shopped, worked and lived in many different groupings since then.

Our maxim proves true every time:

LEADERSHIP CREATES CULTURE!

And this is why it matters that the United States has not ratified the UN Convention on the Rights of Persons with Disabilities which will be ratified in May. Our country through their absence is making the statement, as our leaders, that the 10% of our population with disabilities—a number that will be growing steadily as ‘America ages’—are not a priority.

Our leadership is not interested in sending a message that people with disabilities are valued in this country, or that being part of the international leadership on behalf the 650 million people with disabilities worldwide is of any importance or interest.

And does our culture reflect this? Take a look at the abuses, injustices, hostile laws, exclusive situations that have happened in this country—just since the beginning of this year….

A non-stance on disability rights by the leadership in our country is unacceptable.

To learn more and to take a stand go here, here, or here!

4 comments:

Anonymous said...

You have a wonderful site, Terri. Thank you for a model blog that I can learn from. My comment today is to say that I doubt any action by the UN or the US would've prevented the cop from dumping the quadriplegic from his wheelchair. Check the distance between you and your clinical instructors (leaders) and citizens and the US Congress. I don't think behavior is effectively changed by government proclamations.

Terri said...

Thank you for your comment. It is very easy to get discouraged by the political process--the voter rates in this country show that many people feel the same way.

Legislation is the way that congress bridges distance and sets culture--schools were not integrated until there was a federal requirement. Now this was (and is) imperfectly implemented around the country, but it started with a cultural decision made by leadership.

It is a long and arduous process, but check out this post to see some of the progress that has been made in history:

http://bbandbohmy.blogspot.com/2006/04/unrealistic.html

Don't lose hope!

Anonymous said...

Thank you, too, Terri, for your upbeat response. I am not without hope. My 30-year career has been all about influencing people to change their behavior. While culture has a modicum of influence I still disagree with you on the effects of legislation on culture. Your blog is far more influential than any statement from the UN for sending a message that people with disabilities are valued in this country. Barbara

Anonymous said...

Good Job! :)