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S E P T E M B E R | O C T O B E R 2 0 1 4 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 7 We continue our explorations of the life and career of Kay McVay, a longtime intensive care unit RN at Kaiser Permanente and pres- ident emeritus of the California Nurses Association. In this installment, McVay recounts some of the old, sexist customs that were pervasive in nursing and reinforced stereotypes of registered nurses as merely helpers of doctors. She notes, as well, the shifts in perceptions and attitude toward nurses that started after World War II and acceler- ated in the 1960s and 1970s, mirroring the great societal changes of that time. So tell us what you, as a young nurse, were expected to wear at work and how you were supposed to act around doctors. Well, I studied to be a nurse at a time when the hospitals still ran all the schools. While you were a student, you were expected to work at the hospital and live in the hospital dorms. Remember, in the earliest days, an RN could not be married or have children. I trained at Orange County General Hospital. When I was still a student, I wore a blue, short-sleeved dress and a white apron over that. This apron could stand up by itself, it had so much starch. It was the inmates at the county jail who ironed those aprons! And you get capped after you've been there about a year. I remember my cap would always fall off when I was giving people baths and more often than not be floating in the tub. We wore white shoes, and white stockings, of course. You couldn't wear fingernail polish, and your hair could not touch your collar. After you graduat- ed, you wore a full white dress and you didn't have to wear your apron anymore. When a doctor entered the room or came to the nurses' station, you were supposed to stand up and give him your chair. It didn't matter if that was the first time during the whole day that you got a chance to sit down. You were also supposed to get them coffee, light their cigarettes or cigars, and run around to look for an ashtray. That was when hospitals still allowed smoking. Wow. So when did all that start to change? Well, everything started changing around World War II. That's when women came out to work. And, for nurses, after people came back from the war and had been used to practicing combat nursing out in the field, we started doing a lot of things that we didn't used to be able to do, such as take blood pressures and draw blood. So, you know, the culture at the hospital re - flects the larger society, so as things were chang- ing in the world, our workplace was changing, too. The more progressive doctors wouldn't expect us to give them our chairs, and would wave us to stay seated when they walked up. So did all the nurses decide one day to stop giving their seats to the doctors? No, it wasn't necessarily a conscious, active decision. We sort of grew into it. For me, I remember one time I had been on my feet for four or five hours and I was so tired. It was a very busy, busy night. I had just sat down at the nurses station, and this doctor walks up. I didn't get up and told him, "Could you just wait for a couple of minutes until I'm done charting?" And he says to me, "You're supposed to get up when I walk in here." And I said, "Yes, I know, but I just can't do it right now." And he stomped off. I thought I was going to get fired. But I wasn't. Things changed on their own and, eventually, the expectations weren't there anymore. And what was it like back then to question or challenge a doctor's order? I remember one time I had this peds patient. I'm reading this anesthesiologist's order, and it doesn't look right, so I call and play the whole "nurse-doctor game": "So sorry to disturb you, I must be having a bad day, can you help me understand what this says? Etc. etc." He barks at me to just follow what's writ- ten, but if I had, I would have killed the boy. I was very worried that I would be fired, but I went above him to the head of anesthesiology and he took one look at the order and said, "I'll take it from here." Well, that doctor was fired and the head came over to me later and thanked me for catching the error. Another time I didn't like how this patient looked at all, so I had to wake up the doctor in the middle of the night and ask him to come in. He's like, "Yeah, yeah, I'll be right there." He doesn't show. So I call the second time, "Please come!" He says he'll come, but still nothing. The third time, I just said, "Get your ass out of bed and in here, NOW!" And no sooner had I slammed the phone down and walked back into that patient's room did I take one look at her and hit the code button. The doctor, a Dr. Weav- er, shows up and did a marvelous job resusci- tating her. But I was thinking, "Oh my god, they're going to fire me for what I said." Well, Dr. Weaver afterward came and put his arm around me and told me, "Kay, I promise if you ever call me again, I'll be right in." Is there still sexism in nursing? Of course. It's still there, just not as blatant. As I said, the workplace reflects soci- ety, and in society I think we're losing ground against the idea that women are inferior. You can see it when they say we can't make deci- sions about sex, about our own bodies, about abortion. We have to fight that. "Conversations with Kay" appears in each issue of National Nurse. Through McVay's stories, we docu- ment the origins of the modern staff RN movement as well as the changing practice and culture of nurs- ing and healthcare. The first installment appeared in the January-February 2014 issue. Conversations with Kay