The 'De-Skilling' Of Nursing - page 17

by TheCommuter 33,740 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. 6
    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.
    Oh man, as I was reading these comments, I was hoping someone was going to say this! Working in the hospital, I met plenty of nurses who wanted absolutely nothing to do with CNA work. Clearly, my job developed for a reason. I worked with some great nurses who were always ready to help turn a patient, give a bath, etc. But I also worked with a whole lot that I am pretty sure had not done peri care themselves in multiple years, and would waste ten minutes looking for one of us to get a patient on a commode instead of doing it themselves while they were already in the room. Nurses asked for a lot of the "de-skilling" that is going on, and well, now they are getting it! Personally, witchy as this sounds, I'm kinda like, "Oh boo hoo, the poor nurses."
    anniv91106, kellieskorner, tnmarie, and 3 others like this.
  2. 2
    Quote from duskyjewel

    Oh man, as I was reading these comments, I was hoping someone was going to say this! Working in the hospital, I met plenty of nurses who wanted absolutely nothing to do with CNA work. Clearly, my job developed for a reason. I worked with some great nurses who were always ready to help turn a patient, give a bath, etc. But I also worked with a whole lot that I am pretty sure had not done peri care themselves in multiple years, and would waste ten minutes looking for one of us to get a patient on a commode instead of doing it themselves while they were already in the room. Nurses asked for a lot of the "de-skilling" that is going on, and well, now they are getting it! Personally, witchy as this sounds, I'm kinda like, "Oh boo hoo, the poor nurses."
    As a PCA I have come across nurses like that who would spend more time hunting me down when the task could have already been completed. And I also worked with nurses that have knocked out some of my job before I even knew it needed to be done. I really think all of us as nurses need to come together and stand together as a profession, because we are a very valuable part of healthcare. And also nurses who don't think they should do peri care need to go back to fundamentals of nursing.
    Fiona59 and lindarn like this.
  3. 3
    Quote from gummi bear
    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.
    I wish I could give you 1000 "likes" for this statement. These types are busy collecting pieces of paper (degrees) because while they like the idea of being called a nurse, they really see it as "much too icky" for them to do themselves. Therefore, they are very eager to "escape" the bedside role and do not care about improving conditions for bedside nurses. They just want to get away from it and keep climbing the ladder.
    tnmarie, gummi bear, and lindarn like this.
  4. 4
    After reading most of the responses on this thread, I have developed a few thoughts. As nurses, no matter what our education level, ADN, Diploma or BSN. We take the same boards. There is no difference, we are all the same. Scared too Death. It's organizations like the ANA that keeps pushing us to fight amonst ourselves. I have had the pleasures of working with some of the finest nurses you can possible imagine and guess what, they are LPN's. As nurses we are professionals, no matter what our education, and as such we need to band together to improve our profession. I dislike the ANA, while their code of ethics governing nursing is a valuable tool, the organization as a whole does nothing for our profession. If every nurse, from LPN to MSW joined a national nursing union, then as a whole, we would be better able to advance our profession. While I often precept student nurses and new graduates, one thing is clear. Our profession is at a dangerous turning point. Students and new grads are not taught critical things skills or hands on skills. They aren't taught to CYA, they are taught not to think for themselves. As a whole, we need to stop bitchin amonst ourselves and start looking out for each other. We need to come together before it is too late.
    mc3, JRP1120, RN, lindarn, and 1 other like this.
  5. 2
    For the millionth time-

    EVERY NURSE IN AMERICA NEEDS TO JOIN THE NNOC, AND THE NATIONAL NURSES UNITED!!

    They are the ONLY NURSE ORGANIZATION, to do ANYTHING FOR NURSES AND THE NURSING PROFESSION!!

    We ALL have to stand with them to protect our profession and professional prectice, and advance the profession before it is too late!
    \
    We need a national voice, and the ANA and our State Nurses Associations are, as we say in Brooklyn, as useful as tits on a bull!!

    We need a national voice to protect what we STILL HAVE LEFT that is shrinking on a regular basis, and to advocate for us at the National level!!

    JMHO and my NY $0.02.

    Lindarn, RN, BSN, CCRN
    Somewhere in the PACNW
    OCNRN63 and Wise Woman RN like this.
  6. 1
    Quote from Asystole RN
    The "just kidding" was not a clue as to my intentions?

    I 100% believe that you are practically a nurse.

    Kind of vicious, wasn't it?
    mc3
    Fiona59 likes this.
  7. 0
    Quote from mc3
    Kind of vicious, wasn't it?mc3
    Actually, I thought it was kind of funny. I'd be a bit of a DB if I could dish the insults but couldn't take them, wouldn't I?
  8. 0
    I dunno...I didn't see you putting anyone down...........just sayin'.....
    mc3
  9. 0
    Quote from wooh
    I think the balance is what's important. I just found out that repairing central lines has gone from being a surgeon's job to a nursing job. Which is great! Turning over less-skilled functions is fine as long as at the same time we're taking on more-skilled functions.

    I think the real problem comes from billing. As long as another department gets to charge, and nurses continue to earn no more for the hospital bottom line than the curtains in the room (but cost a lot more than the curtains), hospitals will look to find ways to cut our numbers. Other departments have found ways to ADD to the bottom line. RTs charge for each treatment. PTs charge for each wound treatment or therapy session. But nurses continue to just be bundled in with the room. Until nursing can start BILLING FOR OUR SERVICES, we're going to be considered merely a very expensive piece of furniture in the patient room.
    I actually don't know of a single PT or RT that gets to "bill" for services. Yes, these charges for services shows up on the patient's bill, but those folks get paid an hourly rate just like I do.
  10. 5
    Quote from Jory
    I actually don't know of a single PT or RT that gets to "bill" for services. Yes, these charges for services shows up on the patient's bill, but those folks get paid an hourly rate just like I do.
    At the facility where I work, PT, OT, and RT get to submit 'charges' for every task or service that they perform on each patient.

    Although these people are compensated in the form of hourly pay or flat salaries, those 'charges' that they submit generate tons of revenue for the hospitals that employ them. Therefore, healthcare facilities love having PT, OT, and RT on the payroll.

    On the other hand, nurses cannot submit 'charges' for every task that we perform. Since nurses cannot drum up revenue in the form of 'charges,' the administrative staff at hospitals dislike having nurses on the payroll because we are viewed as just another huge expense.

    The ability of PT, OT, and RT to submit 'charges' and 'bills' might not add to their pay, but it surely adds big bucks to the hospital's bottom line. Nurses cannot submit 'charges' and 'bills,' so we actually take away from that precious bottom line.
    gummi bear, SHGR, lindarn, and 2 others like this.


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