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When I was in college, I studied old videos of Skinner's rats. B.F. Skinner was the "father" of behavioral psychology. He dedicated his life to studying how far rats (and people) were willing to go in order to receive a reward or avoid a punishment.
As a culmination of his research, he randomly assigned either a yummy rat food pellet or an electric shock to be delivered to rats who navigated a maze. These rats had been conditioned to expect that they would receive a food pellet when they reached the end of the maze. However, in this experiment, their speed or accuracy had no bearing on the outcome. Sometimes they received a pellet; sometimes they received an electric shock. In all other respects, the rats received all of their basic needs. They received adequate sleep, adequate food, adequate socialization, etc. The only uncertainty was what they received when they navigated the mazes each day.
The effects of this experiment were remarkable. Some rats curled up at the start of the maze, refusing to complete the task for which they had trained for years. Other rats became overtly aggressive, attacking any other rats attempting to run the maze. Still other rats became blinded to their surroundings, oblivious to anything but the goal of completing the maze. When they finished, regardless of whether they received a reward or a punishment, they would return to the starting area and run the maze again and again. All of the rats experienced some sort of ill effect, such as sleep disturbances, appetite changes, increased aggression, self-mutilation, etc.
Nursing reminds me a lot of being one of Skinner's rats. Sometimes I get a manageable patient load--and sometimes I'm in WAY over my head. Sometimes I speak with a physician who is courteous and professional--and sometimes I get verbal abuse, condescension, or worse, despite my best efforts to be prepared and professional. Sometimes I get patients who appreciate my efforts--and sometimes I get spit on or battered. For me, that's what makes nursing so difficult. I am the person who has ultimate responsibility for the patient, but no matter how hard I try, no matter how fast I work, no matter how balls-on accurate I am in my craft, I have no effect on the outcome. Worse still, I am as powerless as Skinner's rats. Because of our hospital culture, I am powerless to speak out against managers, physicians and patients who present unfair expectations.
As a result of this powerlessness and random nature of rewards/punishments, I see the same effects in my co-workers as Skinner saw in his rats. Resignation, horizontal violence, insomnia, "nursemares", obesity, ulcers, anxiety, ETOH and drug abuse, "eating their young" and so on...
I want no part of that. The IDEAL of nursing may be noble, but the REALITY is far less inspiring. God help the patients. I can't imagine anyone in their right mind going into nursing.
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