Beyond Bedside? Advanced Practice? Really? - page 3

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   EGspirit
    Quote from 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.
    I guess that's true. If a person won't give good care, and finds no glory in it, but only finds humiliation and resentment, then I guess it's good that there are other avenues that will take them from the bedside. The bedside is where nursing is distilled to its finest, only the finest should be there.
  2. by   brandy1017
    I used to have high ideals, not an par with an angel, just helping others, but the working conditions have gotten so bad over the years I now only look forward to retirement. I work my 3 shifts, do the best I can and I don't do extra. They call almost daily so if it were just about money I could makes lots of OT. The extra money isn't worth the stress and I refuse to be guilted into working extra when management refuses to hire enough nurses. That's on them!

    I do believe you are wrong that bedside nursing is all that counts. In fact the future is away from the hospital setting as more care is outpatient. The irony is my hospital has half as many beds as it used to and yet one thing never changes there is a perpetual nursing shortage given managements refusal to hire enough nurses and the majority of nurses which leave once they see the working conditions.

    It seems that you are romanticizing bedside nursing and will end up being a martyr rather the "angel" you aspire to be. Personally I don't like when management starts the nurse as angel routine, nominate your angel. It is a marketing gimmick to them and creates unrealistic, even impossible expectations. I don't think nurses should be put on a pedestal as we are only human. Management is quick to forget that we have needs such as safe staffing, adequate resources and time to eat and take a break, simply time to think!
    Best of luck of to you!
    Last edit by AN Admin Team on Jan 22 : Reason: quoted/referred to removed post
  3. by   EGspirit
    Quote from brandy1017
    I used to have high ideals, not an par with an angel, just helping others, but the working conditions have gotten so bad over the years I now only look forward to retirement. I work my 3 shifts, do the best I can and I don't do extra. They call almost daily so if it were just about money I could makes lots of OT. The extra money isn't worth the stress and I refuse to be guilted into working extra when management refuses to hire enough nurses. That's on them!
    Perhaps you could go into teaching nurses, CNA's, something like that. If you read my OP, that's the exception. Nurses have to teach nurses or we won't have any, so it's the place to go when the physical demands get to be too much for us later in life, or supervision if that's possible. The greatest glory is at the bedside, but once we are not able to do it anymore, if we don't want to retire, we could move into teaching or some supportive role.

    My contention is when those supportive roles get praised as more "advanced" nursing than just some lowly bedside nurse. I say let the first be last and the last be first.

    I do believe you are wrong that bedside nursing is all that counts. In fact the future is away from the hospital setting as more care is outpatient. The irony is my hospital has half as many beds as it used to and yet one thing never changes there is a perpetual nursing shortage given managements refusal to hire enough nurses and the majority of nurses which leave once they see the working conditions.
    I think the Missionaries of Charity have the same problem in Calcutta.

    It seems that you are romanticizing bedside nursing and will end up being a martyr rather the "angel" you aspire to be.
    Well, I have been once. I should tell that story some time. But it's a painful one for me, and all I would get is the vultures swooping into my post to pi.. on it.


    Personally I don't like when management starts the nurse as angel routine, nominate your angel. It is a marketing gimmick to them and creates unrealistic, even impossible expectations. I don't think nurses should be put on a pedestal as we are only human. Management is quick to forget that we have needs such as safe staffing, adequate resources and time to eat and take a break, simply time to think!
    Best of luck of to you!
    I absolutely agree with that.
    Last edit by AN Admin Team on Jan 22 : Reason: quoted now edited post
  4. by   BostonFNP
    Quote from EGspirit
    Call me naive, but maybe someone could explain something to me:

    But then the BSN becomes an NP, and now they're practicing low-skilled medicine, which isn't nursing at all! But they are the "Advanced Practitioners?"
    Low-skilled medicine? Please, enlighten us, what is the different legal standard that NPs have for the practice compared to physicians? What are the different quality of care measures? What is it exactly about NP practice that is "low-skilled"?

    Quote from EGspirit
    Seriously, wouldn't technical nursing certifications like ACLS and CCRN (or the other specialty certifications) really be what makes a nurse "Advanced."
    What makes an APRN "advanced" is the advanced scope of practice (based on advanced education, advanced knowledge base, etc). Specialty RN certifications demonstrate expertise at the RN level but they do not change the scope of practice.

    Quote from EGspirit
    I mean if my name looks like this:

    EGspirit, MS, APRN, ACNS-BC, CEN, FAWM, FAAN

    am I even a nurse anymore?
    Do the semantics really matter?

    On that topic, there is a semantic issue with the term "bedside" as well. What is your definition of "bedside"?

    Quote from EGspirit
    Why can't caring be the profession and leave medicine and surgery to the doctors, and the Ph.Ds to the Nursing school professors? Wouldn't being really good at running a code or starting an IV, or even being really effective at feeding and bathing a patient be the definition of the advanced nurse?
    Again, the role and the scope (and everything that goes with it) is much different between RN and APRN.
    Last edit by BostonFNP on Jan 16
  5. by   Farawyn
    Meh. I like bedside nursing. I'm certainly no angel. Whoever said it sucks, don't do it. I'll take care of your dad when he has CHF just the same.
  6. by   BostonFNP
    Quote from EGspirit
    I'm not sure what that has to do with my point that today we tend to think of all the "advanced" positions as being away from the direct care of patients.
    The vast majority of APRNs are involved with direct patient care.
  7. by   BostonFNP
    Quote from Jedrnurse
    Particularly as it pertains to direct entry APNs- they've never been nurses, so how can they practice an advanced form of it?
    They go to graduate school and complete the same curriculum and clinical requirements as student NPs with prior nursing experience (and often they pause along the way to work as RNs while going to school part time). Then they pass the same national board certifications just like those with prior RN experience. Then then enter practice as a novice just like those with prior RN experience.
  8. by   elkpark
    Quote from SpankedInPittsburgh
    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.
    (Just a minor historical correction, the NP role was initially developed in the mid-1960s. Plenty of folks here have been around a lot longer than that.)
  9. by   Libby1987
    No one, no thing, and certainly no one else's journey takes away from who I am as a nurse.


    Just be the best you and shape the perception of your practice by your practice.
  10. by   BostonFNP
    Quote from elkpark
    (Just a minor historical correction, the NP role was initially developed in the mid-1960s. Plenty of folks here have been around a lot longer than that.)
    By mid-70s I hope they can "escape the bedside"! Those transfers must be brutal!
  11. by   SpankedInPittsburgh
    Yeah Society can take that "halo" and park it up it's butt. I don't want to be looked at as an angel but as a compassionate, highly trained & educated medical professional regardless of title. I agree with the poster above who basically stated that this whole "halo" nonsense and lead to unrealistic expectations from employers, patients and most of all from ourselves. This "halo" stuff also leads to a devaluing of our services. After all angels work for free. I don't have the delusion or ego frankly to place myself in the rarified air of angel-dom. I'm very human and rejoice in that fact. I don't work for free or anything close to it. I expect to be well compensated for excellent professional medical care delivered. Sound like an angel? Nope, just a very human part of a medical team who expects something back for his efforts besides putting a smile on the big guy's face in the sky.
  12. by   Nurse Beth
    Nurses who practice hands-on nursing should be given more respect. Let's call them clinical practice nurses rather than bedside nurses (credit: AMSN)
  13. by   BCgradnurse
    Quote from SpankedInPittsburgh
    Yeah Society can take that "halo" and park it up it's butt. I don't want to be looked at as an angel but as a compassionate, highly trained & educated medical professional regardless of title. I agree with the poster above who basically stated that this whole "halo" nonsense and lead to unrealistic expectations from employers, patients and most of all from ourselves. This "halo" stuff also leads to a devaluing of our services. After all angels work for free. I don't have the delusion or ego frankly to place myself in the rarified air of angel-dom. I'm very human and rejoice in that fact. I don't work for free or anything close to it. I expect to be well compensated for excellent professional medical care delivered. Sound like an angel? Nope, just a very human part of a medical team who expects something back for his efforts besides putting a smile on the big guy's face in the sky.
    THIS^^^^

    I also love what I do, but it's not a religious calling and I am certainly not superior to someone who has chosen another field. And, yes, I do it for the money. Bills have to be paid, children and animals need to be fed. I get to utilize my love of science and helping others, and be well compensated for it.

    I'd like to know what the OP defines as bedside. Does that include school nurses, employee health nurses, infusion nurses, etc? I think they're pretty important. Apparently APNs, and I assume CRNAs are not providing direct patient care. What about midwives? What do you think we do all day???
    Last edit by BCgradnurse on Jan 16

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