Beyond Bedside? Advanced Practice? Really? - page 4

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   Farawyn
    Quote from 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)
    I don't care what you call me. Just pay me.
  2. by   leilo0
    Quote from squishyfish
    Because bedside nursing sucks and not everyone wants to be miserable in the name of "compassion."

    Amen.
    When I was a young nursing student, I couldn't fathom the idea of "nursing burnout" and ever leaving the bedside. I just couldn't. Six years of bedside later, I understand too well now when experienced nurses in clinicals would used to asked me "Why did you ever choose nursing?" Simply put, there's a better way to earn a decent living that doesn't cost your sanity and humanity and if I stay, i know I will lose both.
    Last edit by leilo0 on Jan 16 : Reason: added quote
  3. by   Susie2310
    Quote from BostonFNP
    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"?

    My guess is that the OP may be referring to the vast difference between physicians medical education and training versus that of a NP. Physicians are trained in the Medical Model and are uniquely qualified to practice medicine, hence the credential "Doctor of Medicine." NP's do not have the level of education and training a physician does (and anyone who disbelieves this can research for themselves the significant differences in Medical School versus NP School admission requirements, course content, years of education/training, clinical practice hours, etc.). This is simply a fact. So a NP, by virtue of their education and training compared to a physician, does not practice at the level of medical expertise a physician does.
    Last edit by Susie2310 on Jan 16
  4. by   BostonFNP
    Quote from Susie2310
    My guess is that the OP may be referring to the vast difference between physicians medical education and training versus that of a NP. Physicians are trained in the Medical Model and are uniquely qualified to practice medicine, hence the credential "Doctor of Medicine." NP's do not have the level of education and training a physician does (and anyone who disbelieves this can research for themselves the significant differences in Medical School versus NP School admission requirements, course content, years of education/training, clinical practice hours, etc.). This is simply a fact. So a NP, by virtue of their education and training compared to a physician, does not practice at the level of medical expertise a physician does.
    Susie, why don't you share with everyone the outcomes studies that have examined quality of care of physicians vs NPs? Or explain to us the different legal standards of care between physicians and NPs? Or tell us about how quality measures used by MCOs are different for NP directed care vs physician directed care?
  5. by   dirtyhippiegirl
    There are a lot more non-bedside positions than management and advanced practice and teaching? Who is supposed to coordinate case management for medically complex patients or run infusion clinics or manage a hapless surgeon's schedule/clinic?

    I DO think there is a problem with nurses getting their year or two of direct patient care and than leaving -- generally because non-bedside care is seen as less stressful and the hours are generally better. I'm not sure if it's because people think that non-management/NP/CRNA roles are more superior to bedside nursing. In fact, you often hear of people transitioning to clinic or case management and complaining that they feel like "less" of a nurse and they sometimes have problems trying to find bedside roles down the road because their experience is often seen as less than that of a nurse with recent bedside experience.

    I think mandated ratios and appropriate nurse-assistant staffing would help stem some of the exodus. Rebranding bedside nurses as saintly mini-Jesus', probably not. Although nursing has historically always had a pretty high turnover rate even when it was basically the only career pathway for women interested in medicine.
  6. by   opalbee
    Quote from EGspirit
    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?
    Are you being serious right now lol? Is that seriously what you're going with? So if a nurse is being over-worked and not respected at the bedside, instead of choosing to further their education or work in a different area (that needs help), that nurse should completely leave the profession because YOU dislike that they're leaving the bedside to fill roles that are needed in different areas?

    "To speak without thinking is to shoot without aiming."
  7. by   zenman
    Quote from EGspirit
    Why in our profession are we always running away from the bedside? I mean, why be in the profession?

    Just wondering and looking for opinions on the matter.
    Because your body is shot after a few years of lifting patients, walking miles down long hallways, etc., etc.
    Last edit by AN Admin Team on Jan 22
  8. by   AnnieNP
    It just sounds like the OP is mistakenly threatened by others who have chosen to get more education!
  9. by   kakamegamama
    Quote from zenman



    Because your body is shot after a few years of lifting patients, walking miles down long hallways, etc., etc.
    Exactly! I left the bedside because I couldn't walk due to a blown back. But, I wanted to continue to take care of people, in the nursing profession. So, NP was the right direction.
    Last edit by AN Admin Team on Jan 22 : Reason: quoted edited post
  10. by   kakamegamama
    Quote from 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.
    Exactly!
  11. by   mrcleanscrubs
    Hello EGspirit, RN ,

    I respectfully have to disagree with your divisive statements in your original post.
    Advanced Practice Nurses do not leave the bedside while working within the inpatient setting.

    To state that Associate Degree Nurses (ADN) simply clock in and care for their patients is belittling; I think ADNs are like any other nurse, however educated at the Associate level. (I know some that run circles around their BSN coworkers)
    Also, what do you mean by, "real patients in real beds?"
    Do Baccalaureate Degree Nurses (BSN) not treat real patients in real beds?
    Generally, BSNs do not seek to be managers, they just hope to increase their level of education to meet the ever changing needs of our demanding healthcare system. As well as to provide safe, and culturally competent care at the *bed side* to, "real patients," in "real beds."
    The BSN is at the bedside.
    The BSN may choose to pursue higher education and receive their Masters in Nursing, or may even pursue Nurse Practitioner studies.

    Nurse Practitioners (NP) and Physician Assistants (PA) alike do not practice, "low skilled medicine." What exactly is, "low skilled medicine?"
    NPs and PAs are advanced practice providers who are educated to provide care to patients in conjunction with a Physician; working as a team to lessen the load of the Physician and provide quality care. These providers provide diagnostic examinations, therapies, and interventions to patients in various settings. They do not practice, "low skilled medicine." NPs and PAs are at the bedside as well.

    Yes, if your name has all of those educational degrees attached to it, you can still be a nurse :-)
    Why? You may ask. Well, I will have you know that Nurses are educated healthcare professionals, and an integral piece of the healthcare team.
    I suggest you try to achieve further education yourself, it may help you move away from utilizing the crooked, generalizing thought processes you may be accustomed to.

    It sounds like you are one of those old veteran nurses who hates seeing any other nurses doing better than they themselves are - this is called, "Queen Bee Syndrome."
    Nursing once, in the past, was more of a hospitality profession; simple tasks were delegated to nurses by physicians. I am not sure if you are aware of the fact we are now in 2018, yes, I said it, two thousand eighteen. Nursing is a profession based on science(Associate of Science in Nursing, Baccalaureate of Science in Nursing). We provide care that is based on scientific evidence.
    There is no reason why we cannot be a caring profession.

    If you want to provide personal care, you can always go to school to become a Certified Nurse Assistant (CNA); this is a great path. I have a tremendous amount of respect for CNAs.

    This is America, you are free to voice your concerns about nurses "taking away physician jobs."
    It sounds like you may be a nervous physician or resident hiding behind the RN title on this forum just to direct some of your anger and frustration with the ever changing and elevating role of the educated nurse.

    P.S.
    Please enlighten me with the specialties you have listed as your own, "Cardiology, ICU, and Psych."
    Let me know how learning to give patients a bed bath helped you achieve your goals of managing care for such critical patients. :-)

    Just trying to understand your thought processes, if you have any. :-)
    Last edit by mrcleanscrubs on Jan 16
  12. by   SmilingBluEyes
    Quote from FullGlass
    There are plenty of BSN RNs who are "bedside nurses."
    And bedside RNs who hold an MSN as well.
  13. by   Farawyn
    Quote from zenman



    Because your body is shot after a few years of lifting patients, walking miles down long hallways, etc., etc.
    Many of us are. Shot, I mean. After 20 years I made the shift. I miss it every day. I loved the bedside, the hands on, being part of that team, the collaboration. I hated the short staffing that eventually leads to being burnt, physically and mentally.
    When I see a seasoned bedside nurse at the top of her game, it makes me smile.
    Last edit by AN Admin Team on Jan 22 : Reason: quoted edited post

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