CHANGES IN NURSING

[askater]

Hi--I've been a R.N. for 4 years. I've seen changes in nursing. Nurses are becoming more multiply disciplined. Having increased responsibilities. For example, aides learning to phlebotomy and doing E.K.G.'s.

Some changes with technology. I work on a angioplasty unit. They've come out with Angioseal. A product closes up the artery. That way we don't have to hold manual pressure to a patients groin after a catherization. And the patient can ambulate a lot sooner.

Less ancillary help. We've recently stopped having dietitians educate patients. Before the doctor would write "consult dietitian to educate patient with diabetic diet"....Now the responsibility falls on nurses. I know basic things about diabetic diets. But I truly believe dieticians are much more beneficial than me. Patients deserve much more.

What type of changes have you noticed?

[Erbn Girl]

I have seen a few changes myself in the last few years. I work on an IMCU/Telemetry Unit and our aides are trained to do CAPD (peritoneal dialysis). Granted, it is not difficult BUT, I feel that is a nursing function, not for an aide. Our aides are very trusted and educated on our midnight shift but I prefer to do the CAPD myself. We also have Respiratory Therapists that do stat EKG's on nights and put on and remove 24hr Holter monitors. Seems a little out of their leagues but our hospital has been doing this for awhile now. I wouldn't feel comfortable having aides do phlebotomy. I don't want to be responsible/trained to fix our ice machine or be a security guard or mailman. I trained to be a nurse. We all have our chosen professions and certain qualifications apply. Sounds like the same old song to me...hospitals trying to save money and place more responsibility where it doesn't belong!

Our hospital ALSO expects us to do diabetic teaching, (ie, diet, how to inject insulin and how to monitor blood sugar) We try our best to teach as we are checking their sugars, giving their snacks and administering their insulin or hypoglycemic agents, BUT...they want us to have separate forms to be filled out etc, etc. They have a diabetic instructor but now most of this is falling on the nurse. I always do my best to educate my patients in every way possible, but where do we draw the line? How much can our plates hold? I know I am not alone in my feelings.

[Irishorchid]

If we keep giving away our role soon we will have no role at all. I am a nurse working in Ireland and I know things are very different here. We have public health care which is ALOT different to private hospitals. The nursing profession is in its infacy compared with the States. However we have just recently had our first ever national strike. The strike was fundamentally about money. But the under tones we about solidarity as a profession and the future development of nursing in Ireland. We are always undermining ourselves as nurses. We have a VITAL position in society and I for one want to maintain it. I do not want to be a dietitian. So I would be very loth to give patients advice on diet. Lets stick to what we know best and everyone will be better off. We must hold onto our unique role for all our sakes.

[askater]

Irishorchid--

I'm interested how the hospitals are run in Ireland. What's R.N.'s responsibilities, nurse:patient ratio, technology and so forth. It would be interesting to find out what hospitals are like outside U.S.A.?

Thanks