A nurse is a nurse is a NURSE???????

Jenny P · Jul 3, 2001

Craig, congratulations on testing for your CCRN exam. As someone who has taken and passed that exam many times (I'm finally re-certifying with CEU's-- it's much less stressful that way!); I know that 1700 hours in a small town hospital may or may not be the same as a busy large metro hospital. But I've never been in a 24 bed hospital that had its' own ICU before. The difference is in the skills obtained and the different learning experiences that come through each of those ICU doors. After working so many years in a large CV-ICU, my neuro assessment skills are not as good as when I worked in a general ICU. I feel that there is enough of a difference in ICUs these days that I don't think any ICU nurse could substitute for any other ICU nurse in a different type of unit. With a little orientation, a CV-ICU nurse could be comfortable in a neuro ICU; but that orientation is crucial to the float.

I am in awe of some of the small town nurses that I have been priviledged to work with and know over the years. Their ability to be the jack-of-all-trades is phenomenal, and their assessment skills and ability to think on the run are honed to a higher degree than those of us who work in a larger, more controlled environment.

The real test of the CCRN exam is whether or not you pass the test-- it's very much like the NCLEX exam- you either know it or you don't.

Curlytop · Jul 5, 2001

As an ICU nurse with nearly 10 years experience in a general ICU where you'll see Ventric drains in one room and an IABP in another, patients with up to 8 iv drips going, 3 patient assignments (and charge!!!!!), I could personallly care less about putting words in the "doctor's" mouth.

Of the many MD's that I encounter, I can only count on one hand the number I actually respect. I even had one MD who had the AUDACITY to say "it doesn't matter what you chart in your notes besides vital signs"!!!!!! Of course, what we chart could potentially save an MD's as* in court if he were sued. Many MD's have very little respect for us and don't realize the incredible amounts of stress we experience on a day-to-day basis. They "make rounds" and see the patient for 15 minutes tops (some don't even go in the room and shouldn't even bother carrying a stethiscope) and have the nerve to COPY what's in the nurses notes word-for -word in their progress notes.

Norbert Holz · Jul 5, 2001

I have worked in a wide variety of settings. I "accept" any assignment I'm given because I never really knew there was another option.

I have been told that I need to work on my time management skills. Because I "could not handle" the patient load.

I've been fired from a staff position because I did not give a ped (on a primairily adult burn unit) an antibiotic through a central line that did not flush first with a pump I had never seen before.

I've worked agency (total float) at local hospitals. Whenever there is a question about my work (some say pratice) I am not given the benefit of doubt; I'm simply told I am not wanted to return- DO NOT USE!

Here in Tampa the employers are highly selective. They want the best nurses $16/hr can buy. They want "perfect" obedient clones of the stereotypical cute young blond bimbo.

Face it! we are all interchangable to the institutions and MD's; simply another cog in the health care machine.

I always get a big charge when I hear a RN saying they pratice in a specialty area. All that really means is that an institution has decided that they wanted to provide the training and clinical experience necessary to do the job they are hired for.

For the most part any nurse can do any job in nursing if given the training and experience. Failure to provide adequate training and experience is the only problem preventing a nurse from taking any assignment.

So if you have a "specialty" remember- it is only due to the generosity of your employer that you can make that claim. Even then, your specialty experience is only as extensive as the training and experience your employer allows.

So whenever applying for a job and being asked what is my specialty I reply I can do any job here (if you give me the appropriate additional training). The problem seems to me that the employer dosen't want to provide the essential training to do the job. If I haven't been trained by another facility then I'm not the selected candidate for thier machine! "Sorry not enough experience."

If I was young, cute, (blond) then I'd be able to apply and get any position and the necessary training needed to adequately do the job. I am however 42, balding and a man.

Ellen in Ont · Jul 5, 2001

In reply to CraigB-RN,

I have worked in a 7 bed ICU in a rural hospital for 11 years. I also have my CCRN (or the Canadian equivalent, CNCC© (certified nurse critical care Canada). We are the only ICU within about 220 miles. We accept all kinds of patients (Peds, Post-partum, Medical, Cardiac, Surgical, Respiratory, and when the weather prevents evacuation to another facility (we are in Northern Ont), we must manage burns and head injuries until they can be flown out. We also do not have the Internist or Surgeon present 24 hrs/day and no respiratory therapists at night (we can set up and manage ventilators and make adjustments according to ABGs). Just because we do not see the Surgical acuity that you do, do not assume that our knowledge and experience does not count the way yours does. I respect the expertise of nurses in specialized units but feel that my knowledge is just as beneficial in studying for the CCRN exam. I am not trying to start an arguement, just trying to show another point of view.:)

ladybyrd · Jul 5, 2001

Curlytop said...."I even had one MD who had the AUDACITY to say "it doesn't matter what you chart in your notes besides vital signs"!!...."

CurlyT...which floor do ya work at my hospital??

The first words outta the MD's mouth in the morning is "wheres the vitals" and "how much was the i/o" .....Both of which are taken by the techs!!!

The patients usually mostly care about about "baths and bedpans"....Both of which are usually delivered by the techs...

The hospital & public thinks nurses are "overpaid & lazy" because all we do is "push pills" and "sit around chatting & doing paperwork" :rolleyes:

They should ALL have to "walk a mile" in our 12 hour shoes...(about 2 hours on a SLOW nite!) :eek:

fergus51 · Jul 5, 2001

I don't get you Norbert. I am a young blond and no, I can not get any job and any training I want. Neither can my young cute friends. As an experienced nurse you have a big advantage over those new grads. And my specialty: I got myself the training and education necessary. My employer did not. They had absolutely nothing to do with me taking post grad courses and practicums to be trained in my specialty. I take ownership of my training and control of my career very seriously. I just don't understand where you are coming from.

Mijourney · Jul 7, 2001

Hi. I don't agree that a nurse is a nurse, but since this vice president seemed to put it in that context, is a patient a patient? A hospital a hospital? A state a state? A vice president a vice president? Does everyone go by the name of Goodall? As we all know, there are nuisances from hospital to hospital within our respective locales. This mentality of a nurse is a nurse fails to recognize that nurse practice acts vary from state to state and that hospitals or other settings may have their services designed to meet the needs of a particular community which may differ dramatically from communities even surrounding it. Perhaps he is making the case for more widespread interstate licensure among practitioners.

jamistlc · Jul 11, 2001

originally posted by little_bit
i agree completely with the l&d nurse who was floated to the medical floor. i work for a contract agency & provide supplemental nursing in a part of my state where there is a shortage of nurses. i have been put everywhere by the hospitals i am sent to. no one bothers to ask... "by the way, have you ever worked icu before?"
there are far too many areas of speciality in nursing for nurses to be thrown here & there to satisfy staffing needs. facilities are only worried about cya - not the welfare & safety of their employees or their patients.
what this profession needs to do is focus on finding ways to draw new nurses in before the rest of us "dinosaurs" become extinct.

i agree! i tried to send this to you little_bit by e mail or pm but you have them disabled so here it is: happy birthday!!!!!!

mustangsheba · Jul 11, 2001

This quote is out of context, so it's hard to tell, but I don't read what the posts are responding to. It seems to me he's saying that no matter what area we live in, if we are licensed nurses. we are capable of doing basic nursing. Of course we need extra training for each specialty, just as each doc needs training for his/her specialty.

mustangsheba · Jul 11, 2001

This quote is out of context, so it's hard to tell, but I don't read what the posts are responding to. It seems to me he's saying that no matter what area we live in, if we are licensed nurses. we are capable of doing basic nursing. Of course we need extra training for each specialty, just as each doc needs training for his/her specialty. :cool:

BeBeSweet · Jul 11, 2001

Hey Norbert. I am getting the message from reading several of your posts that you are not happy.Is it Tampa?Is it nursing itself?I am definatly not blond,young or cute,but when I have expressed a genuine desire to cross train or learn new skills that might assist me in choosing a specialty,I have found positive response from management. Not always, but the majority of the time. You sound like you need a vacation.Good Luck