"So, Which Hospital Do You Work In?"

Whenever I tell someone that I’m a nurse, the inevitable question follows: “So, which hospital do you work in?”

While I have nothing against hospitals (well, maybe I do!) or nurses who work in them, I have chosen to forge a nursing career utterly free of the hospital environment. Although many colleagues assured me that it was professional suicide to do so, I chose to eschew the one or two years of Med-Surg that most nurses undergo after graduation, and I entered directly into community nursing and never looked back.

My History

Over the last 15 years, I’ve worked as a nurse in two urban community health centers that served low-income Latinos, held a position as a Nurse Care Manager for several cutting-edge case management programs in the same low-income urban neighborhoods, worked as a visiting nurse, a hospice nurse (inpatient and outpatient), as well as a stint as a nursing professor and as the sole Public Health Nurse for a New England town of 25,000 people. Meanwhile, I’ve maintained a popular nursing blog, have contributed chapters to several books about nursing, been interviewed on radio and internet radio, and been published on a variety of nursing websites as a regular contributor.

Despite my lack of hospital experience, I have never felt encumbered by a less-than-interesting career or by the sense that something is missing from that career. Needless to say, if I was to seek a position in a hospital-based program or unit, I might have to first spend a year or so in Med-Surg, and that would be fine. Meanwhile, my career is wholly satisfying and I have never lacked for interesting and remunerative work.

The Public’s Perception

When someone reflexively asks me what hospital I work in, I am immediately reminded that the public simply has no real idea what nurses do and simply base their image of nursing on images from television and the movies.

If you ask the average American what their image of a nurse is, they will most likely describe a nurse in scrubs working in a hospital, or an older American just might conjure up the image of a nurse in starched whites with a little cap on her head. Those images indeed still persist, despite the efforts of some in the nursing community to counter that outdated stereotype.

Sadly for us, Nurse Ratched (of “One Flew Over the Cuckoo’s Nest” fame), is probably the most famous nurse in the American zeitgeist after Florence Nightingale, so many Americans may either see nurses as crazed sadists armed with arm-length needles or angels of mercy who serve as a doctor’s handmaiden amidst the horrors of war and disease.

What Does It All Mean, Anyway?

The public has a particular perception of nurses that is skewed by television and the media’s ability to create cultural icons that are difficult to overcome. It is the mission of many nurses to change that perception by providing a new paradigm in which nurses are perceived as trained and competent professionals that work in a variety of clinical settings.

From a personal point of view, I feel it is equally important for both nurses and the public to understand that, while hospital nursing is a crucial aspect of the profession, there are scores of nurses who choose to work in community-based positions that do not involve employment by a hospital. While some hospital nurses may see non-hospital nurses as somehow inferior (an erroneous perception that I have personally encountered during my career), non-hospital based nurses contribute a great deal to society and to the nursing profession as a whole.

Whose Responsibility Is It?

Nursing has changed a great deal, especially over the last 100 years, and I believe that it is in the collective interest of all nurses to take responsibility to mold and recreate the public’s perception of who we are and what we do, not to mention our own self-perception of the profession.

So, when someone asks me what hospital I work in rather than simply asking me what kind of nursing I do, I see it as my personal mission to educate that individual regarding the myriad functions a nurse can perform and the many environments where that can occur.

Public perception of nurses does not necessarily negate our efficacy or our importance, but it can indeed impact our self-esteem, our profession’s standing, as well as the cultural and societal significance of our work. It’s up to us to educate those around us that nurses are not akin to the nurses portrayed on television. We are real people doing real work. Nurses make a difference in people’s lives. We always have, and we always will.