The 'De-Skilling' Of Nursing - page 2
by TheCommuter 33,158 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
- 30Aug 25, '12 by GeneralJinjurQuote from woohToo bad we couldn't bill for each call light answered.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.
- 16Aug 25, '12 by Esme12 Senior ModeratorI have said on many occasions.....we are going to educate ourselves out of the bedside if we keep insisting that "isn't a nursing duty". I have worked in ICUs that I draw all labs and EKGS and I have worked in ICUs that those tasks were done by someone else.
When I started nursing in the ICU we did it all. We mixed our meds, did our own labs, mixed our own gtts and "Hyperal" We had to be very specially trained to be there and our patients needed very specialized care. We may not have had all the "fancy equipment" but we had vents, balloon pumps, temp pacers, and gambros. Our MI's had all the arrhythmias because we didn't intervene. Inferiors had Brady's and heart blocks...your anteriors Vtach/Vfib. If they developed a murmor......we called the MD......they weren't going to do well.
We trialed the new meds....hung IV nitro, TPA, IV bretylium....... for the first time. I have seen and cared for the first "artificial heart" LVADS that turned into the portable LVADs ........I have practiced through medical history. Our calculations were by hand. I remember the first computers installed, the first printer for lab results....that was a great day. I am highly trained, very well educated.....at the bedside not with degrees.....I am extremely specialized the MD's depended on me. It was the nurse at the bedside that did all these things.
Now, If they can find someone else to bathe, assess a patient from a TV monitor in a remote location, read my strips, change me dressings, watch my balloon pump, run my gambro or ECCMO...... fix my drips or pass my meds...... what will they need me for?
That will be a sad day.Last edit by Esme12 on Aug 25, '12
- 27Aug 25, '12 by lindarnNurses, you have made your bed, and are now suffering the results of it.
Nurses need to belong to a powerful national union to protect our best interests. By refusing to organize years ago, we have surrendered our professional identity and practice to hospital administrators,who would like nothing more than to be able to run a hospital with as few nurses as possible. I have heard all of the views against unions, but reality is, with no national union/organization to represent OUR BEST INTERESTS, we will ALWAYS LOSE OUT TO THE INDIVIDUALS WHO DO HOLD THE POWER!!
Nurses, you cannot speak for yourself when it comes to issues like this. You are out gunned, and out spent by the ptb, who have their best interests in mind $$$$$, not yours.
I will say it again, nurses need to join the National Nurses United, and become a force to be reckoned with. Without it, nursing will cease to exist as it is now, in a generation. It is already happening.
Our professional practice is being sold to the highest bidder. When did it become a funcion of PTs and OTs to do dressing changes? They do not learn sterile technique in school, and nurses do. Their professional organizations are being proactive in ensuring that they have billable skills to add $$ to the hospital. Especially since they have gone to a doctorate and masters degree as entry into practice. As long as a nurses professional practice is rolled into the room rate, housekeeping, and complimentary roll of toilet paper, nurses will always be an expense, instead of an asset to the hospital.
Why should RTs charge to do ABGs? I did them in the ICU, and was not able to bill for them. But the RTs did. Again, another instance of RTs making themselves valuable to the hospitals. It is called job security, and nurses have not learned that skill.
WAKE UP NURSES, OR WE WILL NOT BE AROUND FOR MUCH LONGER!!
JMHO AND MY NY $0.02.
Lindarn, RN, BSN, CCRN
Somewhere in the PACNW
- 5Aug 25, '12 by kitty13ADNRNStudent reply says it all in one short sentence. We as nurses are allowing others to take away our profession. Hospitals want magnet status. What does it do for hospitals, not a darn thing, stating that outcomes will improve as the level of education is "ELEVATED" Give me a break. Nurses face the same issues all over the US; time behind the computer charting has taken time from our real patient care that used to include passing meds, pt assessments, VS, IV infusions, cath care and insertions. HAIs' are on the rise so hospitals throw in hand sanitizer, gee that still doesn't decrease HAI's! Scrub the hub, half the US wipes the hub of their IV line, i know i have been a traveler. I have watched with disgust, even had one nurse say it doent matter their all on antiobiotics, Hospitals once again spend money on products that are going to decrease HAI, gee, swab cap, has it helped?
Magnet status will require monitoring of clinical data, another job created for what.
The more we give up as Nurses the more likely it is to plan that the next time you are in that hospital bed your medication aide will provide your med/iv infusion, CNAs will assess and provide your care.
Lets think about where we are headed!
- 13Aug 25, '12 by woohPTs doing wound care, can almost get it. RTs doing blood gases, can almost get it. Apparently we now have RTs that are hanging blood.
If I put O2 on a patient, no charge. Once an RT comes into the room and charts the pulse ox off of the pulse ox that I put on along with the O2 amount that I set the O2 at, now there's a charge.
Those who make money will have jobs. Those of us that just cost money, won't.
- 9Aug 25, '12 by Wise Woman RNIt's not just that nurses are being let go, but that now, with the task-based nursing aides, the hospital can load more patients on less nurses. The responsibility is still there for the nurse, but the time needed to ensure that tasks are done safely and properly is not. The PTB don't know, or don't care that many of the tasks still require the knowledge and expertise of the nurse to assess underlying causes and implications of the tasks, such as evaluating wound healing, response of the patient to medication changes, disease process, family support, etc. People are dying for lack of nurse assessment and intervention. The CNA's do not have, and are not trained to have, critical thinking skills. They do a task. There is no care for the intangible needs that patients and their families have. We are all warm bodies, there to fulfill the needs of the "staffing grid," without taking into account patient needs and acuity. As far as being "less needed," we are less needed by the corporations and hospitals, but we are far more needed by the patient in the bed, who are now being cared for by staff who do not have the wherewithal to detect serious complications until it is far too late.Last edit by Wise Woman RN on Aug 25, '12 : Reason: added some thoughts
- 18Aug 25, '12 by lindarnWe, as nurses, have an obligation to inform and EDUCATE the public as to what is going on, and how it is negatively effecting the care and safety, in the hospital, and also doctors' offices, and clinics. MA, answering the phone and identyfing themselves, as, "doctor so and so's nurse, ", nurses aides referring to themselves as nurses.
Nurses need to take a page from teachers. Teachers are almost 100% unionized. They can speak without fear of repercussion, can and do, organize large gatherings in very public places, to inform the public about changes in the schools that are determental to the students. They miss no opportunity to voice their concerns to the parents.
Why this is admirable, lets face it folks- no one ever died because they could not do long division or diagram a sentence. But how many patients are experiencing poor outcomes because of deliberate short staffing, that hospitals take no responsibilty for.
Why are peoples' lives being put at risk and we sit around and do nothing but complain to each other, but not to the people who can force change- the patients who we care for and who DO care about dangerous staffing and poor outcomes.
It will not change unless we organize under a strong unbrella of an organization who has OUR best interests at heart, and our patients.
Think about calling the NNOC, and get a unionizing campaign started. This is for your and your patients. You cannot defend your patients is you fear losing your job and getting blackballed!
JMHO and my NY $0.02.
Lindarn, BSN, CCRN
Somewhere in the PACNW
- 9Aug 25, '12 by BrandonLPNHow long until the task-specific unlicensed techs become a majority and decide they have no further need of US? Throw together a couple medication aides, a wound tech and a "data collection specialist" and it's all over.
- 9Aug 25, '12 by OCNRN63No nurse was able to save a patient's life without the help of a teacher.
I agree with the fact that nurses are being de-skilled right out of the hospital, but minimizing the impact teachers have had on our lives is just petty.
I'm a member of NNOC. They don't represent nurses in my area, but I am ever-hopeful.
I don't think most patients care about short staffing. As long as someone shows up with their Cokes and sandwiches, a lot of them could give a rip if the person on the other side of the bed is an RN, LPN, UAP, RMA or M-O-U-S-E.