The 'De-Skilling' Of Nursing - page 14

by TheCommuter 33,748 Views | 240 Comments Senior Moderator

What should be our greatest concern for the future of nursing? We must fear the day if (or when) registered nurses (RNs) and licensed practical nurses (LPNs) will be less needed in healthcare due to systematic de-skilling of the... Read More


  1. 3
    Quote from Asystole RN
    The "just kidding" was not a clue as to my intentions?

    I 100% believe that you are practically a nurse.

    I am not sure what you are saying to BrandonLPN, but the words "I 100% believe that you are practically a nurse" do not leave a nice impression. Nor does saying that "just kidding" was not a clue as to your intentions in regard to his asking "I can't tell if you're being serious or facetious. Do you really think saying there's a difference between CNAs and LPNs is "splitting hairs?"

    I couldn't tell if you were being serious or facetious either. I am reading BrandonLPN's concerns as being sincere. I am not reading your comments the same way.
    mc3, OCNRN63, and Szasz_is_Right like this.
  2. 1
    Quote from Asystole RN
    It is about the professionalization of the occupation.
    How does my existing (or ADNs) prevent you from being a professional? So we have a multi tiered nursing model that includes LPNs and ADNs. So what? If BSNs want to be viewed as professionals why don't we make the BSN an exclusively management position? You'll still need someone to delegate the bedside tasks to. Or would you rather delegate them to an army of unlicensed personel?
    mc3 likes this.
  3. 1
    I am a relatively new RN (about 14 months). What I hear from more experience nurses is that the level of acuity has increased dramatically from say 15 years ago. I know that as a fairly new nurse I would not physically be able to complete all the tasks that other departments take care of. From pharm mixing most meds to RT performing treatments and lab doing draws. There is simply not time in my shift. The only way that would ever be possible is if I had like 2 or 3 patients versus my usual 5 to 7. And that will never happen because supposedly it's not "cost-effective." Nursing then and nursing now are two different professions. I frequently wonder how different we would all feel if we were nurses in Florence Nightingale's era. Did she feel the same pressures?
    lindarn likes this.
  4. 1
    Quote from BrandonLPN
    How does my existing (or ADNs) prevent you from being a professional? So we have a multi tiered nursing model that includes LPNs and ADNs. So what? If BSNs want to be viewed as professionals why don't we make the BSN an exclusively management position? You'll still need someone to delegate the bedside tasks to. Or would you rather delegate them to an army of unlicensed personel?
    The term profession is actually something that is defined by social scientists and there are specific characteristics that an occupation has to achieve in order to be identified as a true profession. Currently nursing is known as a developing profession, not a true profession.

    One of the big things holding back nursing is the lack of a unified level of entry or pathway of education.

    For example lawyers have X amount of school and a defined pathway. Physicians have X amount of school and a defined pathway. Nurses have a variable amount of school, depending on what type of nurse, and variable pathways.

    There is more to it but that is one of the reasons why the push for a standardized BSN level of entry into the profession.
    VanLpn likes this.
  5. 0
    I would like to add that part of the reason nursing *needs* different levels of nursing is because it's so broad an occupation. There are so many different levels of care and facilities with different types of accuities. In a LTC facility a BSN RN
    is overqualified as a staff nurse. But it's perfectly suitable to a LPNs level of training. The LPN will be more likely to stay, which is vital in a long term care model where stability is key. I notice that most of the nurses pushing to eliminate the LPN and ADN work in hospitals. If you worked in LTC, you'd realize that multiple levels of nursing is essential.
  6. 0
    Quote from arallenrn11
    I am a relatively new RN (about 14 months). What I hear from more experience nurses is that the level of acuity has increased dramatically from say 15 years ago. I know that as a fairly new nurse I would not physically be able to complete all the tasks that other departments take care of. From pharm mixing most meds to RT performing treatments and lab doing draws. There is simply not time in my shift. The only way that would ever be possible is if I had like 2 or 3 patients versus my usual 5 to 7. And that will never happen because supposedly it's not "cost-effective." Nursing then and nursing now are two different professions. I frequently wonder how different we would all feel if we were nurses in Florence Nightingale's era. Did she feel the same pressures?
    You should read her book, Notes on Nursing. It is a fantastic read and sheds light onto modern nursing, you would be surprised at the similarities in nursing...
  7. 0
    Quote from BrandonLPN
    I would like to add that part of the reason nursing *needs* different levels of nursing is because it's so broad an occupation. There are so many different levels of care and facilities with different types of accuities. In a LTC facility a BSN RN is overqualified as a staff nurse. But it's perfectly suitable to a LPNs level of training. The LPN will be more likely to stay, which is vital in a long term care model where stability is vital. I notice that most of the nurses pushing to eliminate the LPN and ADN work in hospitals. If you worked in LTC, you'd realize that multiple levels of nursing is essential.
    I have worked in sub-acute care for most of my career, and still do PRN. I would agree that there needs to be multiple levels of care.

    I predict that the future of nursing will have the BSN nurse finally become the standard of entry to be a registered nurse and LPNs will be left but required to have an associates degree. I would not be surprised if the two forms of nursing completely split into entirely separate professions with different educational pathways and different regulating bodies.
  8. 5
    It's kinda sad to see that some of you think that CNAs are a part of the problem and not a part of the team present to assist nurses. At my hospital, many nurses are more than happy to pass off "basic nursing skills" to the CNAs because they have "more important nurse stuff to do". Yes, some of them actually think this way, and have no problem saying so. Some of them try to have minimum physical contact with the patients as possible because they don't feel like dealing with the patients. And then you have the nurses on the opposite end of the spectrum, who'll do whatever it takes to get the job done and provide efficient patient care no matter what the task is. I think that most of this "deskilling" is being driven by nurses in higher positions with multiple degrees who no longer work at the bedside, and have "better things to do" than to assist patients with ambulation, insert catheters, and obtain vital signs. Blame these types nurses for the deskilling of the nursing profession, not the CNAs that are right next to you working their butts off, and often trying to attain a higher education at the same time too. These antibedside nurses are so preoccupied with trying to gain the same respect and recognition as physicians, that they start to believe that they are above and beyond giving basic nursing care.
  9. 1
    Quote from Asystole RN
    The term profession is actually something that is defined by social scientists and there are specific characteristics that an occupation has to achieve in order to be identified as a true profession. Currently nursing is known as a developing profession, not a true profession. One of the big things holding back nursing is the lack of a unified level of entry or pathway of education. For example lawyers have X amount of school and a defined pathway. Physicians have X amount of school and a defined pathway. Nurses have a variable amount of school, depending on what type of nurse,and variable pathways. There is more to it but that is one of the reasons why the push for a standardized BSN level of entry into the profession.
    All right, so why not say that BSN and higher is a separate profession in itself. We LPNs will be licensed to practice "practical nursing". BSNs are licensed to practice "professional nursing". Where's the problem in that. If you're point is to strip the LPN of the title "nurse", well you're wasting your breath. They can pry that from my cold, dead fingers.
    mc3 likes this.
  10. 3
    Quote from gummi bear
    It's kinda sad to see that some of you think that CNAs are a part of the problem and not a part of the team present to assist nurses. At my hospital, many nurses are more than happy to pass off "basic nursing skills" to the CNAs because they have "more important nurse stuff to do". Yes, some of them actually think this way, and have no problem saying so. Some of them try to have minimum physical contact with the patients as possible because they don't feel like dealing with the patients. And then you have the nurses on the opposite end of the spectrum, who'll do whatever it takes to get the job done and provide efficient patient care no matter what the task is. I think that most of this "deskilling" is being driven by nurses in higher positions with multiple degrees who no longer work at the bedside, and have "better things to do" than to assist patients with ambulation, insert catheters, and obtain vital signs. Blame these types nurses for the deskilling of the nursing profession, not the CNAs that are right next to you working their butts off, and often trying to attain a higher education at the same time too. These antibedside nurses are so preoccupied with trying to gain the same respect and recognition as physicians, that they start to believe that they are above and beyond giving basic nursing care.
    So true.


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