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A P R I L | M AY 2 0 1 5 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 9 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 Asso- ciation. In this installment, McVay discusses nursing education and some of her concerns about where it's headed today. So you went to a nursing school that was run by and connected to a hospital. I read recently that the whole reason hospitals started professional nursing programs was to ensure a steady supply of free labor for their facilities! That's right! I went through the three-year nursing program at Orange County General Hospital, and all of us students worked at the hospital. Out of my class of 38 students, only eight of us eventually graduated in 1958. We had regular classes at Fullerton Junior College, and then after class we'd drive back and staff the hospital every day. We lived in hospital housing and they fed us three meals a day, plus we got $5 a month for incidentals, which I thought was just great. But, actual- ly, it was a good deal for most people. You did have to buy your own uniforms, shoes, and books, but if you got to the library early enough, you could check out the books you needed. Beyond that, there were no expenses. What do you think when you hear of nursing students graduating with $50,000 or $100,000 or $200,000 of school debt? It makes me so mad. Education should be free. Healthcare should be free. And one of my worries is that if you are graduating with that much debt, everything just becomes all about the money. Is your work then about fulfilling your mission as a nurse and caring for people, or about paying back that money? Are you less likely to speak up and advocate for your patients because you need the job to pay back that money? Do you take on so many shifts to make extra money that it leaves little time for advocacy and being involved in your union? You can see where this is going. Do you feel you received a good nursing education? I think I got a very good education when it came to actual care. Working in the hospital every day was a good opportunity to use everything that I had been exposed to and to see the value, or not, of what I was learning. We spent a lot more time looking and listen- ing to the patients—watching how they moved, how they talked. It was very practical and hands on. I would have given my eyeteeth to have the education of a [Univer- sity of California] nurse, but some of them couldn't put a line in, or a nasal catheter. We were actually the ones teaching them on the floor how to do this in the '60s. What are your concerns about today's nursing programs? Beyond how expensive they are, I'm worried that nurses aren't being taught to look at the patient as a whole, that they're not even touching real, live patients. Everything is simulated and in a classroom. Patients aren't being treated as individuals with individual responses to both disease and treatment. That students are taught to focus so much on what the monitors say that they're not taking care of a patient, they're taking care of a machine. The programs today don't seem to value the kind of thinking and hands-on care I remember. It's almost like if it's not high tech, then it can't be worth very much. But sometimes all the patients need is for some- one to hold their hand. What are some of the things you wished they'd taught you in nursing school and that you think should be taught today? I wish they had taught us more history, politi- cal thinking, and philosophy. We got some surface history about Florence Nightingale and all that, but it never got in depth so that we could compare and understand the reason- ing and background for the way things were. I find that appalling. It was only later that I learned the social activist history of registered nurses, especially in the United States. What do you think about the current emphasis on pushing registered nurses to get bachelor's degrees over associate degrees, or master's degrees if they already have a bachelor's? I think people are getting the wrong idea of what makes you an RN. It doesn't matter if you have a bachelor's, master's, or a Ph.D., you must pass the state board and that is where you get the title "registered nurse." It doesn't matter what kind of degree you have, you have to sit for the same test. "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. Conversations with Kay