Ch, ch, ch, ch... changes. What are your long term goals? - page 6

(thanks Mr. Bowie for the thread title). Those of us in the nursing field for twenty or more years have seen many changes to our profession, not in knowledge or scope of practice per se, but in... Read More

  1. Visit  Guttercat} profile page
    1
    Amazing perspectives and responses in this thread.

    Thanks all!
    nursel56 likes this.
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  3. Visit  gypsyd8} profile page
    7
    Quote from workingharder
    1) Raise the bar for membership. Make nursing a Masters level degree and mandate 2500 hrs of clinical time for graduation. And I mean real down and dirty patient care. Not following around someone for six hours. 2) Follow the leads of the therapies and limit the number of schools who can teach nursing. 3) Have a clearly defined scope of practice for nurses that says only nurses can perform such and such duties. As is, our scope is fuzzy and when clearly defined it is incredibly small. 4) Stop trying to create something separate from medicine. We are part of medicine. And trying to deny it is further throwing the profession into uncertainty and ridicule. (I know, 3&4 seem like a dichotomy, but I believe it can be done) 5) Retool the boards. NCLEX is pathetic and just like "No Child Left Behind", the schools are teaching to the test. 6) Have a clearly defined and rigorous academic pathway on a national scale which drops the silly classes and concentrates on patient care, A&P, patho, pharm (HEAVY), and micro.
    .
    While I appreciate your insights, there are a few quibbles I have:

    #1) nobody is going to spend the time & money it takes to earn a Masters to go clean $#!% for a living. The system as it was envisioned in the 1960's would have worked just fine e.g. ADN prepared nurses at the bedside with a clinical ladder that broadens scope of practice and care. I know of no Masters prepared RN who wants to go back to the bedside. That is why we get our Masters after all.

    #2) I agree wholeheartedly, but how? Admittedly I am not familiar with the "therapies" that you speak of. I should research that but honestly I don't know where to start. Would you use Government mandates? Shouldn't the free market decide? I think the problem is more with the chaotic mess that is the current accreditation system and the fact the the State BON's basically make their own rules as to who can take NCLEX. There is no national regulatory standard. Then again, that's not free market.

    #3) agreed.

    #4) agreed.

    #5) Agreed. I passed NCLEX in half an hour with 75 questions. It was too easy.

    #6) I worry about the term "silly classes." What classes are you referring to? I value my liberal arts education, the classes I had to take for my Associate and Bachelors degree requirements, e.g. the Arts & humanities (American Studies, Criminal Justice, critical thinking, Cultural Anthropology, English, history, psychology, sociology, speech) were the best classes I have taken in my academic career and greatly enhanced not only my learning at the time but my appreciation for learning in general. These classes are essential in a holistic field such as nursing. We are generalists by nature, we deal with the whole spectrum of human ills and responses to those ills, a well-rounded education is integral to our practice. I worry much more about the "diploma mills" and foreign schools that churn our newly minted nurses who have no idea who they are taking care of.

    Case in point: we had a Coptic Christian on our unit recently. Most of my colleagues had no idea what a Coptic Christian was, just though it was some weird cult, and had no idea how to be culturally sensitive to this individual or his family. They had no idea that Coptic Christians had been slaughtered in religious wars in the recent past, and no idea that a Muslim nurse might not be the best caregiver for said patient. I have other examples of sheer cultural ignorance but I will leave them out for brevity.

    In short, I have NEVER taken "silly classes," education is what the individual makes of it and a well educated person is a professional person. The lack of professionalism in our field might be indirectly related to ignorance that is a result of Nursing being treated like something one can learn in a trade school. We do not need Master's prepared nurses at the bedside, we need Nurses who graduate from Colleges that utilize a liberal arts paradigm. You can have an Associates program that covers the bredth and depth necessary to graduate a Professional Nurse. Unfortunately, you can also have a Masters program that covers nothing but the basics needed to pass NCLEX.
    Last edit by gypsyd8 on Feb 22, '12 : Reason: errors
    dmdmd, MinnieMomRN, lelafin, and 4 others like this.
  4. Visit  Guttercat} profile page
    0
    Quote from gypsyd8
    While I appreciate your insights, there are a few quibbles I have:

    #1) nobody is going to spend the time & money it takes to earn a Masters to go clean $#!% for a living. The system as it was envisioned in the 1960's would have worked just fine e.g. ADN prepared nurses at the bedside with a clinical ladder that broadens scope of practice and care. I know of no Masters prepared RN who wants to go back to the bedside. That is why we get our Masters after all.

    #2) I agree wholeheartedly, but how? Admittedly I am not familiar with the "therapies" that you speak of. I should research that but honestly I don't know where to start. Would you use Government mandates? Shouldn't the free market decide? I think the problem is more with the chaotic mess that is the current accreditation system and the fact the the State BON's basically make their own rules as to who can take NCLEX. There is no national regulatory standard. Then again, that's not free market.

    #3) agreed.

    #4) agreed.

    #5) Agreed. I passed NCLEX in half an hour with 75 questions. It was too easy.

    #6) I worry about the term "silly classes." What classes are you referring to? I value my liberal arts education, the classes I had to take for my Associate and Bachelors degree requirements, e.g. the Arts & humanities (American Studies, Criminal Justice, critical thinking, Cultural Anthropology, English, history, psychology, sociology, speech) were the best classes I have taken in my academic career and greatly enhanced not only my learning at the time but my appreciation for learning in general. These classes are essential in a holistic field such as nursing. We are generalists by nature, we deal with the whole spectrum of human ills and responses to those ills, a well-rounded education is integral to our practice. I worry much more about the "diploma mills" and foreign schools that churn our newly minted nurses who have no idea who they are taking care of.

    Case in point: we had a Coptic Christian on our unit recently. Most of my colleagues had no idea what a Coptic Christian was, just though it was some weird cult, and had no idea how to be culturally sensitive to this individual or his family. They had no idea that Coptic Christians had been slaughtered in religious wars in the recent past, and no idea that a Muslim nurse might not be the best caregiver for said patient. I have other examples of sheer cultural ignorance but I will leave them out for brevity.

    In short, I have NEVER taken "silly classes," education is what the individual makes of it and a well educated person is a professional person. The lack of professionalism in our field might be indirectly related to ignorance that is a result of Nursing being treated like something one can learn in a trade school. We do not need Master's prepared nurses at the bedside, we need Nurses who graduate from Colleges that utilize a liberal arts paradigm. You can have an Associates program that covers the bredth and depth necessary to graduate a Professional Nurse. Unfortunately, you can also have a Masters program that covers nothing but the basics needed to pass NCLEX.

    Very insightful post. Thank you.

    A side thought: a problem with the nursing profession is the word "nurse." Even a Masters prepared RN still has the word "nurse" attached.

    Within the medical community at large, and the lay public, there is a long and deeply rooted connotation of "weak" or "less skilled" or "bed pan toter" or "food tray fetcher" or "servitude", attached to that word.
  5. Visit  annlewis} profile page
    0
    I have to stop reading all of you are depressing me
  6. Visit  riw1} profile page
    1
    I have been a nurse for thirty years. attitiudes have changed toward nursing and those practicing nursing and not for the better. I have to ask myself why anyone would submit to working a twelve hour shift with no breaks. most hospitals have a rule that there can be no food or drink at the nursing station. this means poor eating habits or worse no food or drink for 12 hours. WHY ARE WE PUTTING UP WITH ABUSE THAT IS UNACEPTABLE IN ANY OTHER PORFESSION?
    there over whelming numbers of nurses. we could make a hugh difference if we banded together and had lobbists in DC like big business does. but everyone just wants to go home and ignore conditions as if they were a blue collar worker. is it any wonder that that is how our employers see us?
    nursemarion likes this.
  7. Visit  cdsga} profile page
    1
    Guilt trip is pulled-even among ourselves. How many times have you heard-What if it was your family? I've seen my family taken care of and I know unequivocally I take care of people just like I'd treat my family, and better than most nurses I have witnessed and experienced. Thank God I am a nurse because I know the difference between good care, poor care, and mediocre care. I also know that I wouldn't leave my family member in the hospital unattended in any circumstance. What does that say about us? I don't only stay to ensure safe and adequate care, I also stay because staffing issues make it difficult for nurses to see to the intricate needs of sick people. There I said it. With all the paperwork, checklists, second guessing of our treatment/medications, etc., it's a wonder anyone actually sees a nurse. I understand regulations and safeguards, but it has become such a burden and almost a conspiracy to keep the nurse away from the bedside. Where is the nurse who should be giving some helpful guidelines, insight to health and recuperation? Isn't one of the regulations now to allow the patient to be a part of their care? Isn't one of the regulations that we are to allow time for the patient to ask questions? Isn't it a federal law that states we must provide a legit. interpreter for our non-English speaking patients? How many times is it documented but not followed as it should be, but a box is checked to pass the regulations? Domestic violence questions, a consent for disposition of remains for retained placenta, when you have a live baby sitting with the Dad/family member/friend in the waiting room? Do we have to be told by the Joint that we have to do these things in order to get reimbursement for Medicare and Medicaid patients? When is someone in the ANA going to suggest streamlining of these processes and get the nurse subservient as it is back to the bedside? I don't mind working through a break just to get one if it means that there is a better continuity without that break, especially at a crucial time with a patient, but how many actually think about that? Nursing is not for the weak and passive. It's a complex job, requires some sacrifice, requires critical thinking, prioritization and current knowledge of clinical/pharmaceutical subjects. Since we are one of the most trusted and respected of professions shouldn't we own it? We've done enough talking about the profession, we've done enough surveys, we've done enough research on salaries and all lack substance. I'm just going to be the best nurse I can be, lead by example, take excellent care of the patients assigned to me, follow the policies and keep up with my education-since change is everpresent. Our national voice has sold out to the latest person in the Whitehouse, and they'll change again when someone else is elected or move us toward the regulatory, gov't mess that's already starting. Their lobbying voice is not my voice. So I guess I am going to have to live and roll with the changes as they come. I'll speak my piece when allowed and keep my ear to the ground. I love healing and helping people through sickness to some semblance of wellness. When I lose that love-I'll retire. Oh wait, nursing is 24-7.
    MinnieMomRN likes this.
  8. Visit  cdsga} profile page
    0
    Oh and don't get me wrong, I don't mind asking all patients these questions, but it's hard to take when the treatment is only going to take 30 minutes. The admission process takes longer than the treatment. Amazing.
  9. Visit  Good Morning, Gil} profile page
    0
    I actually like my job. It can be stressful, but I work with a great team, and feel I am making a difference. The only thing I would want to change in the future would be the hours. Nights are tough, but I've learned to adapt, and still love my job.

    long-term career goals: become an FNP, work part-time, and raise my family. Or maybe become an acute care NP so that I could still work in critical care . We'll see... . Also, want to go on a medical missions trip, and want that to be a more regular thing I can do. I have heard that some docs and nurses at my hospital go every year or so, so I'm looking forward to joining them in the future. Don't know how that will be compatible with having a family, but I'm sure it works out, and I will ask those that go regularly how they manage that when the time comes. Probably drop kids off at a friend's house or grandma's for those few weeks lol.
  10. Visit  nursemarion} profile page
    1
    Quote from Guttercat
    Very insightful post. Thank you.

    A side thought: a problem with the nursing profession is the word "nurse." Even a Masters prepared RN still has the word "nurse" attached.

    Within the medical community at large, and the lay public, there is a long and deeply rooted connotation of "weak" or "less skilled" or "bed pan toter" or "food tray fetcher" or "servitude", attached to that word.
    I think nurse has a positive connotation for many people, though it is not necessarily a professional one. Things have changed so much in even 50 years in nursing that you have to wait for attitudes to change too. The old images from nursing's past are still with us, but so are old images of pharmacists, school teachers, etc.

    I think in general I have been more respected by other health care workers who know more of what nursing does than by outsiders - laypeople. A lot of this reflects too the general incivility of all people today. Changing our title will not necessarily make people respect us. I don't think people respect anyone today.
    Guttercat likes this.
  11. Visit  nursemarion} profile page
    0
    Quote from cdsga
    Guilt trip is pulled-even among ourselves. How many times have you heard-What if it was your family? I've seen my family taken care of and I know unequivocally I take care of people just like I'd treat my family, and better than most nurses I have witnessed and experienced. Thank God I am a nurse because I know the difference between good care, poor care, and mediocre care. I also know that I wouldn't leave my family member in the hospital unattended in any circumstance. What does that say about us? I don't only stay to ensure safe and adequate care, I also stay because staffing issues make it difficult for nurses to see to the intricate needs of sick people. There I said it. With all the paperwork, checklists, second guessing of our treatment/medications, etc., it's a wonder anyone actually sees a nurse. I understand regulations and safeguards, but it has become such a burden and almost a conspiracy to keep the nurse away from the bedside. Where is the nurse who should be giving some helpful guidelines, insight to health and recuperation? Isn't one of the regulations now to allow the patient to be a part of their care? Isn't one of the regulations that we are to allow time for the patient to ask questions? Isn't it a federal law that states we must provide a legit. interpreter for our non-English speaking patients? How many times is it documented but not followed as it should be, but a box is checked to pass the regulations? Domestic violence questions, a consent for disposition of remains for retained placenta, when you have a live baby sitting with the Dad/family member/friend in the waiting room? Do we have to be told by the Joint that we have to do these things in order to get reimbursement for Medicare and Medicaid patients? When is someone in the ANA going to suggest streamlining of these processes and get the nurse subservient as it is back to the bedside? I don't mind working through a break just to get one if it means that there is a better continuity without that break, especially at a crucial time with a patient, but how many actually think about that? Nursing is not for the weak and passive. It's a complex job, requires some sacrifice, requires critical thinking, prioritization and current knowledge of clinical/pharmaceutical subjects. Since we are one of the most trusted and respected of professions shouldn't we own it? We've done enough talking about the profession, we've done enough surveys, we've done enough research on salaries and all lack substance. I'm just going to be the best nurse I can be, lead by example, take excellent care of the patients assigned to me, follow the policies and keep up with my education-since change is everpresent. Our national voice has sold out to the latest person in the Whitehouse, and they'll change again when someone else is elected or move us toward the regulatory, gov't mess that's already starting. Their lobbying voice is not my voice. So I guess I am going to have to live and roll with the changes as they come. I'll speak my piece when allowed and keep my ear to the ground. I love healing and helping people through sickness to some semblance of wellness. When I lose that love-I'll retire. Oh wait, nursing is 24-7.
    I don't want to offend you, but more people would read your post if you would skip a space now and then and make paragraphs. It is hard to read when it is all run together like this and I see some good thoughts in there, but I had to stop about halfway through because it was too hard on my eyes and brain.
  12. Visit  MinnieMomRN} profile page
    1
    I work full-time between two jobs; one in a school, the other in a clinic. I love my jobs, and primarily because I have diversity and actually quite a bit of autonomy -- well, at least when compared to when I worked bedside. On the flip side, I am often asked if I miss "real nursing". It seems that the perception is that community nursing is not real -- this, even from my fellow nurses! Compensation sadly reflects that misconception.

    As a licensed School Nurse in my state, I must be licensed as an educator (the very same exam as the teachers take), licensed as an RN, and hold at minimum a BSN. Additionally, I must either become certified by taking the national certification exam, or obtain my Masters in Nursing or a related field such as Public Health within 5 years of obtaining my initial license.

    I'm not sure the way to go. I'd love to return to school for my Masters, but when I look at the average salary (the bump in pay is miniscule from what I now earn), I fail to see at 45 years old, that my ROI will be worthwhile. I'd love to be compensated for my education and experience. Oh, and a little R-E-S-P-E-C-T, find out what it means to me...
    Guttercat likes this.
  13. Visit  nursemarion} profile page
    3
    At 50 I have learned to ignore it. At first I cared and wanted everyone to see that I am still a real nurse no matter what the setting, now I don't care what anyone thinks. It is a paycheck and I am the one who has to earn it. I am going to do the kind of nursing that I want to do. I just don't discuss work with anyone. We don't have to be working in an ICU or ER to be real nurses. Let it go. Your life, your choices. Your patients still need you in whatever setting you are in.
    Guttercat, cdsga, and MinnieMomRN like this.
  14. Visit  Mom To 4} profile page
    1
    Bedside nursing i definitely not for this nurse. I am about to begin a BSN to DNP program this summer. In 3 years I will be a FNP. I can not imagine working on the floor until retirement
    Guttercat likes this.


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