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

Nurses General Nursing

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(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 the actual process of delivering care. We have rolled with it and adapted.

Until now. Somehow, this time it is different.

There is a distant whiff of change in the air, an ominous yet unseen brewing storm on the horizon that we can smell, and we instinctually know this is not just another policy revision; not just another economic dip.

There is a growing sense that nursing is being redefined as cheap, blue-collar labor, yes-men, and trained monkeydom. Especially floor nurses on the front lines.

Even my latest issue of "The American Nurse" is greatly devoted to the future of nursing and nurses who have or are furthering their education in the (hinted- at undercurrent) context of Health Care Reform, ACO's and Bundling.

Is education advancement enough? I listened to a flustered and overwhelmed hospitalist vent to me a few days ago, that they'd taken away half of the PA's effectively doubling her workload.

I see MSN's working the floor.

I see BSN's unable to find employment as a floor RN.

I see my own department ripped to pieces and sold to the highest bidder.

So, how many of you are rethinking your career path? If I was an Appliance RN (RN married to a high-earner and only needs a little income to buy the latest Cuisinart or a gym membership) I probably wouldn't bother.

But as it is...I'm about to bother.

Specializes in Rehab, critical care.

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.

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.

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.

Specializes in Med-Surg; Telemetry; School Nurse pk-8.

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...

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.

Specializes in Family Nurse Practitioner.

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:no:

Specializes in ICU, PACU, OR.

Thanks for the insight and suggestion.

Thanks for reading

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...

Will you be fired if you don't return to school?

Over the last few years, I have seen my hospital send more and more staff home on "LCs" or low census days without pay. I am beginning to see the value of being salaried, as my income has been so affected I have taken on another job to fill in the difference. My MSN is in "wait" mode until I can afford it. My hospital has figured out amazing ways to get us to make less money. I.E. being "encouraged" to "chip in" for our new building - so you see, we aren't hurting for patients, just being cut to bring in more and more cash. I am saddened to see this and experience it, but I still get frustrated by the fact that if we had more say that was respected as a profession, perhaps we could all stand together and stop it.

I.E. being "encouraged" to "chip in" for our new building - .

Our hospital just completed and opened a new building to the tune of millions. Part of the fundraising campaign asked for staff to donate $$ up front, or part of their salaries over time.

Some of these same staff that signed up and donated from their own pockets in the name of "team spirit" have and are now, being laid off and/or unceremoniously disposed of as the hospital goes bankrupt, and is being forced to partner with another health care entity.

Cute.

Specializes in Med-Surg; Telemetry; School Nurse pk-8.

Anniv91106,

My position in the school is funded through a grant which specifies that in order for the school to receive the grant money, the nurse must be a licensed school nurse. If I do not meet the requirements to keep my educator's license, my contract with the school would not be picked up. At this point, I think I will probably go the route of taking the certification exam. I've heard it's tough, but it certainly would be cheaper!

You know what I will get when I finish my VERY COSTLY MSN????? A big ole 50 cents an hour. Why am I doing an MSN then? I want to teach, and need it. For me, not for a raise. I hope I can teach my students to make nursing a better place - for them AND for me when I am in that bed. I can't change it by myself, but I can lead by example.

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