I was at an advisory board meeting today where we were discussing the Department of Labor's answer to our nursing shortage. The have a new program, called the "Apprenticeship Program," where health care workers can work while they study nursing. The DOL has been surprised with the negative response to the name of the program by the nursing community. I suggested that they get a new name, like a preceptorship, internship or externship program. My point was that an "apprenticeship" does not sound professional, and even if it only is semantics (as they said), it denotes the image of a low-classed worker...something we don't need in nursing.

What do you think? Are we nurses being too sensitive about the name of this program? The DOL seems to really want to retain the name.

Doesn't sound like a lower-classed worker to me, but the grade before becoming a professional ... I guess they don't want "mentee" ...

This message has been edited. Last edited by: jheem,

I think it's a good name. They won't be fully degreed nurses yet, right?

Apprentices are people who work in the field while they are learning it, right? People who work alongside the professionals.

I suspect they don't like the term because apprentice is usually applied to a blue-collar worker. There's a little snobbery going on here.

Tinman

Apprenticeships are being revived in the UK and there are several "young apprentice" schemes. Many of them are for white-collar workers; the main intake for new travel industry professionals is through a young apprentice scheme.

There is no stigma here so far as I'm aware.

There's a little snobbery going on here.

I suppose, Tinman, and I am a culprit. You must understand that in the U.S. nursing is terribly under-valued. And, we work side-by-side some very big snobs. So, it makes sense that we don't want to be called "apprentices." When physicians call their interns and medical students "apprentices," then I'll agree to it.

To me, though, "apprentice" gives the connotation of showing students how to work, but not why. Apprentices don't learn the theoretical background; apprentices aren't scholars. Much of nursing is cerebral, making snap decisions about patients, based on their theoretical background. I don't see that aspect of learning in the definition of "apprentice."

Just call me a snob.

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Originally posted by Kalleh:
You must understand that in the U.S. nursing is terribly under-valued. And, we work side-by-side some very big snobs. So, it makes sense that we don't want to be called "apprentices." When physicians call their interns and medical students "apprentices," then I'll agree to it.

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I have had occasion to be around the local hospitals a great deal in the last several years. I have seen nurses who literally make all the difference in how a person is recovering - mediocre nurses are merely custodial (if that) while good nurses think about the whole person who is lying in that bed. A good nurse will consider the emotions, personality and entire life (family, reason for being healthy) of a patient. For that kind of nurse, no word is too lofty of a title. Whatever those interns and doctor snobs call themselves - the nurses have my vote for sainthood.

Awww, CW, that's what I like to hear.

The fact is, though, I agree that there are those nurses who only think about nursing as a job. Yet, many, as you say, consider the whole patient.

I will never forget this patient who was dying of cancer. The doctors just had to discharge (no more excuses) her because of medicare or insurance or something. As she was leaving she was so scared, and the nurses gave her the phone number of the unit in case anything came up. Sure enough, at 1:00 a.m. in the morning the lady called the unit. Her caretaker (let's hope it wasn't a nurse or it ruins the story!) didn't show up. The nurse who took the call of course had to stay on the unit and care for the patients. However, she called her niece (not a nurse), waking her up in the middle of the night, and asked her to go over and stay with the lady until a caretaker showed up. I couldn't believe it! What caring.

I guess that's one of the differences between a vocation and a profession (or job).

Interestingly, this word, "apprenticeship," keeps coming up at all the nursing meetings I have attended as a real negative about the DOL program. Nursing organizations are coming out in droves against it...because of the name. Yet, the DOL has yet to change it. I am on their advisory board, and I have told them time and time again that it is the word that is the barrier. They seem sympathetic, but not enough that they will change it. Consequently, their program is failing in several places. "Training" is another of their words that the nursing community is fighting; the nurses prefer "education."

I don't think I had realized the power of words until this situation.

Quote "..."Training" is another of their words that the nursing community is fighting; the nurses prefer "education."..."

That is because they have an incomplete grasp of the English language. Training and education are two quite different activities.

If your daughter had come home from school one day and told you that she had received sex education from a teacher you'd have been quite happy. But had she received sex training from that same teacher...!

"Quote "..."Training" is another of their words that the nursing community is fighting; the nurses prefer "education."..."

That is because they have an incomplete grasp of the English language. Training and education are two quite different activities."

This is a very common misuse in the United States! I think that many of our institutions of higher education have actually become training facilities as students are required to learn less and less outside their chosen field. EDUCATION would ideally encompass all areas of knowledge! (watch out, this is another soapbox for me!!!)

That is because they have an incomplete grasp of the English language.

I don't think so, Richard, and I don't think nurses are 'trained.' Interestingly (and countering my disagreement), here is one of the definitions of 'train:' "To teach and form by practice; to educate; to exercise; to discipline; as, to train the militia to the manual exercise; to train soldiers to the use of arms." Now, 'to educate' is listed as a synonym, and I must disagree with it. I do agree that 'training' is often a part of a particular education, though only a small part.

'Training' implies the physical practice that is necessary for practice disciplines such as mine. Yet, the 'training' does not imply (with most definitions) the critical thinking, making of judgments, clinical reasoning that education teaches. So, I think educators are right in not wanting to use only the word 'train' when it comes to educating nurses.

Having seen my 3 children being educated in 3 different colleges (my youngest is still in college), I also disagree with CW that education these days is 'training' students. If anything, we don't train them enough, if you talk to the Department of Labor (which is very 'training' oriented). Yet, I think education should teach students how to think critically, how to weigh evidence, how to think about both sides of an issue, and I do see that happening in education today. Of course, they also must learn how to write and speak.

This message has been edited. Last edited by: Kalleh,

Your UK colleagues at the Royal College of Nursing feel the same way. Their site talks about "career & professional development" and "education opportunities".

Education is primarily about imparting knowledge and quite often knowledge that the educator (and the pupil) have no idea whatsoever about its utility. Much of what we learn at school we never use - but that does not mean it was wrong for us to learn it.

Training, though is less about imparting knowledge athough, almost inevitably, some knowledge will be transferred. Training is far more about learning how to use and apply knowledge in new and different situations.

To continue the analogy I used earlier - the sex education classes we most of us attended gave us the knowledge of the process but we didn't become good at it until we started to do it ourselves. That our training was probably self-directed doesn't alter the fact that it was still training!

Back on the ide of apprentices being "blue-collar" types: We have seen a serious erosion of true education over the last century. As a blue-collar worker myself, I can attest to my work's being often rote, repetitive, boring stuff, but there are many occasions wherein my knowledge of physics, chemistry, and other so-called "professions" is necessary to a succesful diagnosis of a failure, and to a succesful repair.

Look back at the textbooks for yesteryear and you'll often find them written by people with Bachelor's degrees. Today, many fields don't even consider people as job applicants without an advanced degree, despite their having vast knowledge. Bill Gates is NOT a colege graduate. The Write Brothers were NOT college grads, nor was Thomas Edison. Nicola Tesla, the man who deserves the credit Edison garnered, was a college grad, but the glory went to the "simple" guy way back then!

It is my opinion that what's needed is a re-elevation of the trem, "apprentice," not another besmirching.

I think it's also interesting to note that my brother, who is a car mechanic, makes as much or more than I, with a Master's degree, employed in my profession. I have never looked down on a person with a blue collar job . . . but I know there are those that do. I find it amusing, actually, that sometimes those with "trades" are monetarily better off that those of us with higher education.

I will also applaud Asa's comment for his reminder that the best tradesmen have never stopped learning. The best car mechanics understand computers, electronics, and a plethora of other fields, despite a lack of degrees. In fact, perhaps it is because they've not been spending their time in formal academia that they can be so well-rounded in knowledge.

Education is primarily about imparting knowledge and quite often knowledge that the educator (and the pupil) have no idea whatsoever about its utility. Much of what we learn at school we never use - but that does not mean it was wrong for us to learn it.

Richard, I am well aware of your disdain for higher education. Having been a university professor for 20 years, I must disagree with you. We are in unique positions; I was a professor and you are a trainer!

Maybe the definition of "training" vs. "education" is a UK/US difference; I am not sure. Generally, though not always, "training" refers to physical learning, like military "training." Of course there is some intellectual learning to that, but a lot of it is physical. In fact, years ago it used to be called "nurses training" because there is a physical aspect of nursing.

Yet, the critical thinking and application of knowledge, to me anyway, is education and not training.

I agree, CW, that pay has nothing to do with it. Look at the sports heroes or the movie stars. That is sickening. Nurses are often involved in immediate life or death decisions, and yet make less than kindergarten teachers who in our community work 4 hours a day, 5 days a week, for 180 days. Hardly seems right!

Asa, you are part of a profession, too. I am awed by your knowledge base. There are a whole lot of white collar workers out there, including those with advanced degrees, who don't hold a candle to you. So, now, besides hating "apprenticeships" and "training," I am also thinking that "blue collar" has to go! It really isn't descriptive.

"I am also thinking that "blue collar" has to go! It really isn't descriptive."

Yes . . . what color collars do you all wear? I generally don't even wear a collar to work. But when I do, it's just whatever color my dress is . . . and NEVER is it white!

I went to college because I enjoy learning and academia. (That's why I'm still in college, though I teach now.) I was the first in my family to end up with a degree. My ancestors were in the main tradesmen, laborers, and farmers. I learned a lot of practical knowledge growing up on a farm, and I learned a lot in college: stuff I use daily. There are smart people with and without degrees, and likewise with the stupid. In my field, computer science, there are more degreed people than not. Bill Gates may not have a degree, but he came close. He only dropped out of Harvard in his final year because his company was doing so well.

I really don't see what's wrong with the term apprentice. I don't see what's wrong with the descriptive terms blue and white collar workers. A good mechanic is as difficult to find as a good doctor, and I appreciate both. In my youth, I was a minimum wage day laborer on a construction site. On my crew of 8, there was only one person who didn't have a college degree, and I was next lowest with only a bachelors. The rest were masters and PhDs.

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In my youth, I was a minimum wage day laborer on a construction site. On my crew of 8, there was only one person who didn't have a college degree, and I was next lowest with only a bachelors. The rest were masters and PhDs.

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So, PhD DOES stand for "Post hole Digger!"

Just to clear up one isunderstanding - I do not disdain higher education. My disdain is reserved for certain people in the field (many of whom I have worked with) who have spent their entire working lives in academe, have never worked in a commercial environment, whose only knowledge about money is that it is something that is drawn down from funding and who probably imagine that a profit forecast is something like the Sermon on the Mount! And. with that vast store of knowledge, seek to tell those in commerce how they should be running their businesses!

Now, Kalleh's comment "...Yet, the critical thinking and application of knowledge, to me anyway, is education and not training..."

If you believe that the term "education" means critical thinking and application of knowledge, what term would you use for the process of imparting knowledge?

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what color collars do you all wear?

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I have a "white collar" job. However, I generally wear coloured shirts. Most of the shirts I wear at work are in varying shades of blue. In fact, I only own one wearable white shirt, and can't remember when I last wore a white shirt to my job.

So, PhD DOES stand for "Post hole Digger!"

Oh, to have dug postholes. No we were mainly tearing planks off the wooden forms for the complicated foundation. The architect is a friend, and I was desparate for work that summer. On the other end of the scale, I know of a computational linguist, who teaches at Stanford and used to work at Xerox PARC, who "only" has a bachelors.

education

Interesting etymology :- Latin educo 'to educate' from e- 'out of' + duco 'to lead'.

training

< OFr trainer 'to drag' < Vulgar Latin *tragino 'to drag' < *trago < tractus < trahere.

So, the Roman idea was to lead the knowledge out of students, and the medieval French one was to drag it out of them.

I've always held with the idea that a college education should train people how to reason well (critical thinking, or logic), speak and write well (rhetoric), and do their numbers (arithmatic). That was the trivium. The other school of thought is that you fill students' brains with short-term remembered trivia for regurgitation on tests, which everybody promptly forgets upon graduation.

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If you believe that the term "education" means critical thinking and application of knowledge, what term would you use for the process of imparting knowledge?

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For some odd reason a line from Ovid just popped into my skull: "Sit tua cura sequi, me duce, tutus eris." Art of Love, Book II, I think. Was he training, or teaching?

could you translate please?

Was he training, or teaching?

Daedalus was telling his son what to do so they could get off Crete and back to Athens. Icarus did not pay attention and became the man who fell to earth.

Me pinnis sectare datis; ego praevius ibo:
Sit tua cura sequi; me duce tutus eris.
[Ovid. Ars amatoria ii.57f.]

Follow me using the wings I've given you;
I'll go before you.
Be careful and do as I do;
with me as your leader, you'll be safe.

The point being, had Daedalus trained Ikarus not to fly too high instead of "teaching" him, he would have made it.

I remember why the quote popped into my head: I had earlier had an e-mail from an aero engineer friend who was one of the MIT students who built the human-powered airplane, named, appropriately, Daedalus, that flew from Crete to Santorini, thereby reifying the legend.

A footnote to his correspondence is also appropriate here: "We call it theory when we know a great deal about something, but nothing works, and practice when it works, but nobody knows why." Einstein.

Now, you see why I consider Asa one of the most erudite people I know? Asa, if we all recognize it, I wish you would!

I really don't see what's wrong with the term apprentice.

Jheem, first of all, nurses are kinda like Chicago; that is, we are considered a second-classed profession, with physicians being the premier healthcare workers. Likewise, Chicago is always second to NYC here in the U.S. That means, we have to fight for our status. If we give up and call ourselves "apprentices," we will again have lost a battle of respect for nursing. Whether you like it or not, "apprentices" are considered tradesmen here in the U.S. It may not be fair, but it's the truth. As I said previously, were physicians willing to use the term "apprentices," then I would suggest our using it in nursing. Not until then. And, believe me, that will never happen!

Richard, I apologize if I came across too strongly with the word "disdain." I just recall some of our private conversations about higher education, and you and I don't agree on that.

If you believe that the term "education" means critical thinking and application of knowledge, what term would you use for the process of imparting knowledge?

Richard, to me they are all "education." I educated my students on the etiologic factors of breast cancer, preventive measures, early warning signs, pathophysiology, treatment modalities, care of the patients with chemotherapy and surgery, etc. This was all done in the classroom, with lots and lots of real stories. Then...I took them on their clinical experiences where I helped them apply what they learned in class. I asked questions about their care, the patients lab findings, etc. I believe it is all a part of education.

Kalleh, to me the first part of what you were doing was certainly education, albeit specialised rather than general education. The second part was training.

It might well be that, from the term "education" one could infer that training could take place. However, I think that the distinction is a useful one. It is possible to train someone in a skill with there being little, if any, any educational input. A simple example is that of using a keyboard. Education has taught us all about letters and spelling; our physical education has taught us how to use our arms and fingers; keyboard skills training enables us to use the keboard effectively. Just about the only educational input is that of the qwerty layout - all the rest is training.

The converse is also possible. Knowledge can be acquired (say, the knowledge of language structure and vocabulary) and that is an educational process. But nobody will ever become good at using the language unless he or she applies the learning by practising the language. And that, when facilitated by a language coach, is a training activity.

Most personal development will be a mixture of learning (education) and pracising (training).

Kalleh, in my experience: what people call you and how people perceive you has little to do with one another. But I see why you're riled, so please do carry on the good fight.

Interestingly, that whole perception of nursing that we have here (i.e., low-level job) isn't the same in other countries. Our foreign nurse expert just today was saying that nurses are shocked when they come to America. They are used to a high-status job abroad and find that the nursing profession here in the states is woefully low on the job totem pole, so to speak. College counselors will question students with high ACTs or SATs about their wanting nursing; a common response is, "You should try medicine instead."

Kalleh, in my experience: what people call you and how people perceive you has little to do with one another.

Yet, physicians make quite a point to have you call them "doctor," don't they? Just like how one presents himself has a lot to do with your perception of him (suit versus jog suit, for example), job titles have a big effect on the perception.

Yet, physicians make quite a point to have you call them "doctor," don't they?

And I don't think any better of them for it. That's why I'm happy with my primary care physican: he has email and we're on a first name basis.

Just like how one presents himself has a lot to do with your perception of him (suit versus jog suit, for example), job titles have a big effect on the perception.

Salesman versus mobster? In Silicon Valley, suits are for the disfunctional guys on mahogany row and sales people. Beards and suspenders are for the old-time Unix gurus. And the rest of us just dress casually. I've noticed that the really low paying and high paying jobs include an obsession about clothing.

(And don't get me started on Casual Fridays.)

jheem: what people call you and how people perceive you has little to do with one another.

Kalleh: Yet, physicians make quite a point to have you call them "doctor," don't they?

jheem: And I don't think any better of them for it.

That's because you're an intelligent and thoughtful person, jheem, who can look beyond labels and think for yourself. Many people in this label-obsessed world of ours can't or won't.

Sadly, I do think there is a link between what your label is and how people treat you. I have several examples but one in particular springs to mind: when I was temping years ago, not long after graduating, I was covering reception for someone who was off sick. A visitor arrived who was training someone for their NVQ (don't get me started on those ), and he was chatting to me while waiting for her to arrive in the reception. At one point he asked me: "Do you have any qualifications?" Note the do you have any qualifications rather than what qualifications do you have?. Because he assumed I was the regular receptionist, he also assumed I was lacking in education (and training!). I responded with a smile that I had a degree and he had the good grace to look embarrassed, but he was not the first or the last to assume stupidity on my part simply by observing me in such a role.

As to the doctor thing, that is so true. Over here at least, doctors and nurses no longer call patients "Mr / Ms So-and-So"; they use first names. This supposedly is to make patients - particularly those in hospital - feel more at ease with the whole daunting experience, and I agree that it can be helpful. However, it also signifies an even wider power gap between doctors and patients - just try responding to "How are you today, Cat?" with "Better than yesterday thanks, Sarah" and see the response you get! Although I like the informality of first names, I think it should go both ways - and at the very least a doctor should ask my permission to call me by my first name when first we meet, just out of politeness. A patient in hospital loses enough dignity without being subjected to a regression to childhood, where everyone called you by your given name but you weren't allowed to reciprocate.

I think you're right Kalleh - let trainee doctors be called apprentices too, and if they don't like it, then why the hell should nurses be expected to? Words are incredibly powerful tools, and until people learn to see past them and take everybody on their individual merits, we need to be careful about the way we use them.

That's because you're an intelligent and thoughtful person, jheem, who can look beyond labels and think for yourself. Many people in this label-obsessed world of ours can't or won't.

What does that make me...chopped liver?

I guess I am losing this battle, on wordcraft at least.

Cat, you bring up so many interesting issues! I have to say I agree with you, and with Kalleh, now that we've come to this point.

I address my family physician by her first name. She is in practice with her husband, and, having two doctors with the same last name, we all call them by their first names to differentiate (Dr. Julie and Dr. Jeff, although sometimes we just call Julie "the big J").

I call my specialist doctors by their titles and last names, generally, but when I met my heart surgeon the first time, he introduced himself saying "Hello, I'm Steve Duff." From that, I decided that he was giving me the choice, and I've always called him Steve, as in "Hey, Steve, while you're in there rooting around, could you please remove some of the extra fat from my middle? And, when you close me up, could you please leave a nice vine pattern, instead of the usual 'zipper'?" (he said no to both - so much for FRIENDSHIP!)

I tend to try to keep things light-hearted.

Anyway - in my recent experiences with nurses they've always called me Mrs. Williams (ew) until I've requested otherwise. Maybe each institution is different. Seems to me, I should be treating them with as much respect as I can muster under the circumstances, seeing as they're nursing me back to health. Those doctors who come in for 3 minutes and give the nurses instruction? Well, I generally feel I owe them a great deal, too (even if they don't leave prettier scars). And what about the guy who is making sure my wheels are on right? I address him with great respect, as well. And the kids who give me my salad and fries at McDonald's, too, I generally smile at them, greet them cordially! Well! I see a trend!

If nurses don't wanna be called Apprentices, then they shouldn't be. End of story, in my book.

This may seem incredibly simplistic, but why can't they just call them student nurses? Or nursing students? They call doctors in training medical students.

I agree with Kalleh that nurses have a hard enough time achieving professional parity with the docs whose bacon they (the RNs) are constantly having to save. Why throw another monkey wrench in the works.

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Originally posted by Kalleh:
I guess I am losing this battle, on wordcraft at least.

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No, Kalleh, I don't think you are. When I said there was a little snobbery here, I wasn't saying you were a snob. I was saying that snobbery is built into our class system and shows in many ways, including the labels we use for others. I agree that student or beginning nurses shouldn't be called apprentices. That would classify nursing as a trade, which it isn't. Nursing is a profession that requires intensive formal education and training. Trades also require education, but it's more in the form of hands-on training than formal education. Tradesmen can be just as highly educated as nurses (or doctors), just in a different area and mostly taught by a different method.

Education is a broad term. It encompasses every aspect of our learning, from potty training to brain surgery. But there is a difference in types of education. Formal education entails "booklearning" and concepts which prepare you for a job, a professsion, an occupation, a career, whichever term you prefer. After the formal education comes further education in the form of OJT (on-the-job training) which refines and hones what you have learned. Education never ends. Or, at least, it shouldn't.

Tinman

I guess I am losing this battle, on wordcraft at least.

I don't think so, K. Many people are trying to control what other people call them, at least to their faces. I think that this is just fine and dandy. Please, you've won the battle as far as I'm concerned.

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Originally posted by Kalleh:

What does that make me...chopped liver?

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Sorry, K . I just take it for granted that you're great .

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I guess I am losing this battle, on wordcraft at least.

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I don't think so either. The last few posts (mine included) have supported what you say, and I think your eloquent arguments may yet sway the opinions of any who don't!

Aww, thanks, guys. The fact is, though, you all made better points than I did. It really shouldn't matter what people call you, I suppose. It's the nurse's practice that counts. I have been able to explain the problem with the "apprenticeship" name very well to the DOL. They now agree with me and tell me they will change that title. However, all of your debating skills are better than theirs. Just please don't tell the DOL your views!

On our long drive to Wisconsin today, I listened to NPR on the radio. They were talking about medical "training" of physicians. I think they mentioned that word "training" at least 10 times, and I had to smile.