Beyond Bedside? Advanced Practice? Really? - page 2

Call me naive, but maybe someone could explain something to me: Why, in our profession, is it considered advanced NURSING practice to leave the bedside? The ADN goes in, does a shift, cares for... Read More

  1. by   Susie2310
    Quote from elkpark
    FWIW, Florence Nightingale did very little hands-on nursing over her lifetime. She was, as you noted, an educator and social reformer. Her great contribution to nursing was the creation of a discipline and practice, not what a great bedside nurse she was. Her first nursing position, on returning from her education in Germany, was as director of nursing at a hospital in London. If you read up on her work at Scutari, you will learn that her role there was primarily hospital administrator, while the nurses she brought with her did the actual nursing care. At night, after the other nurses had gone to bed for the night, she would go about the wards with a lamp and check on the sickest clients herself, which is how she got the nickname and the poem was inspired. But that was after a day of managing the hospital while the other nurses provided the actual nursing care.
    Florence Nightingale's work supported bedside nurses directly. She was committed to quality hands-on nursing care of patients. I think that was the OP's point.
    Last edit by AN Admin Team on Jan 22 : Reason: quoted edited post
  2. by   LibraSunCNM
    Quote from EGspirit
    Why in our profession are we always running away from the bedside? I mean, why be in the profession?
    Because by and large, bedside nursing is backbreaking, sometimes demoralizing, and often underappreciated work. It is also work that has drastically changed over the course of a generation or so---even more physical as patients got fatter and sicker, even more complex as healthcare technology continues to evolve and patients live longer, and even more soul-crushing as patient satisfaction has started to be viewed as more important than actual patient care. Keep complaining if you like, but nursing has greatly evolved to be so much more than (but certainly still inclusive of) bedside nursing.
  3. by   elkpark
    Quote from Susie2310
    Florence Nightingale's work supported bedside nurses directly. She was committed to quality hands-on nursing care of patients. I think that was the OP's point.
    Someone else first brought up Flo, not the OP. The OP's original point was to criticize nurses "running away from the bedside" and criticize the current conception of "advanced practice" in nursing. OP's response to the mention of Flo suggested that he was not aware that her career was focused on administration rather than bedside nursing. Of course the administrative role is one (of many) that supports bedside nursing and promotes quality hands-on nursing care, but he is specifically critical of other nurses who leave the bedside for management/administrative positions, so it seemed to me that he was confused or uninformed about Flo's practice.
  4. by   Susie2310
    Quote from elkpark
    Someone else first brought up Flo, not the OP. The OP's original point was to criticize nurses "running away from the bedside" and criticize the current conception of "advanced practice" in nursing.
    The OP replied to the person who first brought up Flo (OP's post #2): That is the post I am referring to.
  5. by   SpankedInPittsburgh
    What exactly is the opinion proffered? That Nurses shouldn't seek to move away from the bedside? Nursing has many roles and nurses do many things. Nurses in administration, case management, business enterprises, and many, many other roles isn't exactly a new phenomenon under the sun. Nor is it new that many nurses start in a bedside role and decide to move on to something else which is their prerogative. Nurse Practitioners have been filling their roles since before anybody on this post was born. I think this is how its always been and probably is at it should be. Nursing is many things to many nurses and the individual nurse gets to choose what opportunities to pursue & that freedom is part of the beauty of being a nurse. As far as what titles they hold and the zillion credentials behind their names well if that's our biggest problem in nursing we are a very lucky lot indeed.
  6. by   brandy1017
    I used to feel like the OP and take pride in being a floor nurse, but I've learned thru the years that it is overrated. I've come to realize we are overworked, stresssed, short staffed, mistreated and taken advantage of! Your choices are put up with it, move on either by looking for a different employer or type of nursing ie home health, clinic, etc or go back to school for an advanced degree. From those who have moved on many are still unable to find decent working conditions. Home health involves lots of unpaid time charting as well as the wear and tear of your car. I've learned if you go into dialysis nursing they will overwork you and mandate you into 16+ hour shifts as the for profits running the dialysis center refuse to hire adequate staff. I've heard some clinics are good but there aren't enough clinic jobs for all of us!

    I think NP is the best bet if you enjoy learning. I don't see a problem with it being aligned with medicine because even as a nurse we use medical treatments in our job and frankly the NCP is a joke and waste of time! I'm not saying NP's have it made because they are still on the assembly line that healthcare is today, but it probably doesn't bother them as much as doctors because they've already experienced even worse working conditions at the bedside so for them it is a break!

    I've come to realize the problem with bedside nursing is a combination of short staffing, too many alarms, too much physical hard labor, too high acuity and too many altered mental status patients. You spend your night chasing bed alarms trying to prevent weak or confused people from falling. The work itself is part of the problem, but management goes out of its way to make it even worse with the short staffing, lack of equipment, and overdocumentation.

    For my part, I'm just looking forward to early retirement because I know things aren't going to get better, only worse! So honestly I don't think anyone in their right mind would plan to stay at the bedside!
  7. by   FullGlass
    There are plenty of BSN RNs who are "bedside nurses."
  8. by   Here.I.Stand
    I dunno, this bedside BSN is glad that other RNs focus their careers on research and EBP. It means I don't have to. I'm pretty darn thankful for my 40something nursing instructors too, bc they were amazing.
  9. by   mmc51264
    "I agree with some of what you said. Particularly as it pertains to direct entry APNs- they've never been nurses, so how can they practice an advanced form of it?"
    This!!!!! Totally agree with you. I work with an ADN nurse who has 22+ years and is a fabulous nurse. Has no desire to "advance" but all the attending surgeons know her and go to her for advice. She is a charge nurse, a fabulous preceptor, on the clinical practice committee. The ultimate nurse. She could be our manager, but she doesn't want that. She likes the floor. She has been a great mentor to me.
    I am FLABBERGASTED that they are allowing APRNs to practice with zero experience. scary.
  10. by   kakamegamama
    Quote from mmc51264
    "I agree with some of what you said. Particularly as it pertains to direct entry APNs- they've never been nurses, so how can they practice an advanced form of it?"
    This!!!!! Totally agree with you. I work with an ADN nurse who has 22+ years and is a fabulous nurse. Has no desire to "advance" but all the attending surgeons know her and go to her for advice. She is a charge nurse, a fabulous preceptor, on the clinical practice committee. The ultimate nurse. She could be our manager, but she doesn't want that. She likes the floor. She has been a great mentor to me.
    I am FLABBERGASTED that they are allowing APRNs to practice with zero experience. scary.
    I SO wish they wouldn't allow APRNs without any experience at all to practice....
  11. by   squishyfish
    Quote from EGspirit
    Why in our profession are we always running away from the bedside? I mean, why be in the profession?
    Because bedside nursing sucks and not everyone wants to be miserable in the name of "compassion."
  12. by   Workitinurfava
    Whatever works for a person, let it. If you want to be at the bedside so bet it (stick with it and do your best), otherwise high tail it away from it and don't do like the Freddy Krueger movie (where the person looks back constantly and trips on a tree branch on the ground). Really book it.
  13. by   EGspirit
    Quote from squishyfish
    Because bedside nursing sucks and not everyone wants to be miserable in the name of "compassion."
    So why nursing? Why not business or finance or law? But whatever. I've worked around nurses who won't even give PRN pain meds when they're due, because it means they will have to chart it. I've watched many nurses ignore patients stewing in their own sh.. and pi.. , and nothing I say is going to change the world. And I'm sure not going to do it with this post. But for the love of God, why not go into insurance or teaching high school?

close