The 'De-Skilling' Of Nursing - page 3

by TheCommuter Asst. Admin

32,679 Views | 240 Comments

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


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    The missing component is critical thinking.
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    My response was not meant in any way to denigrate teachers. I was just pointing out that because teachers have a strong union, they have prevented the de skilling of the teaching profession, unlike nurses, and because they have a strong union, they can and have, made it their business to go public anything that inpacts their jobs and their ability to teach. Which, by the way, is the reason that teachers did unionize years ago, to protect their academic freedom. What is the difference in protecting your academic freedom to teach, and protecing a nurses ability to protect his/her, ability, to care for their patients with proper staffing? And being able to whistle blow insafe practices in a hospital or nursing home withour fear of retaliation?

    Is a teachers' ability of academic freedom more important than a nurses ability to save a patients life due to being forced to take an unsafe assignment of too many patients? I think not. That does not mean that I do not respect teachers and their contribution to society. I do believe that my need to advocate for a patient's life is more important than a teacher having the academic freedom to teach their students a subject that is not popular with their PTB.

    I did not mean to minimize the impact of teachers, and I have no idea how you read that into my response. That is what I meant with my statement.

    Patients don't care about short staffing becaus WE lead them to believe that everything is hunkydory with the staffing, and your ability to care for too many patients.

    But everything is not OK. Bedside nursing is a nightmare, and the name of the game is to get out of bedside nursing as fast as you can after graduation. Why is that? I don't hear PTs,OTs, even RTs, running away from their practice as fast as they can. Bedside nursing, and how it is being practiced around the country is unsafe for anyone, and most nurses cannot be the patient advocate that they are required to be by the Nurse Practice Act because they fear for their jobs.

    Why do we allow it? Because we have no strong organization to watch our backs, and advocate for us. And we allow it. JMHO and my NY $0.02.

    Lindarn, RN, BSN, CCRN
    Somewhere in the PACNW
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    Quote from TheCommuter
    Also, obstetrics was once within the strict realm of nursing (midwifery).
    As was anesthesia.

    I'd prefer to see the 'skills' be emphasized and have technology utilized to reduce the time spent on documentation.

    "EMR" is getting a bad rap due to selection of lousy systems and resistance of many nurses to its adoption. If done well, EMR could free up nurses to spend more time 'nursing' and less time 'charting.'

    There is also an incredibly large variation in the skill, judgment, knowledge, wisdom, and maturity of nurses which promotes, I think, the taking away of skilled work from the generalist nurses and handing it over to "specialists."
    on eagles wings, Mijourney, wooh, and 2 others like this.
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    As a Registered Nurse, I agree with what you wrote. I see it all the time cna/ pca are doing the skill aspect of our job. Which in my opinion is very dangerous. I am not trying to offend anyone, but the knowledge and skills that a R.N or LPN know is more than a pca or cna. It is offensive when I see the cna working as R.N because it is cost effective to hire them as oppose to R.N or LPN. It is about time stand up a unite especially in this upcoming elections and have our voice heard regardless of our race, religion, or political background. We need to have the same of power in D.C as the AMA. I could remember reading articles years ago of how jobs where being taken over by other medical professions. The medical doctors in the U.S banned together and made the voice heard. They set the tone on their profession. It is about time nurse really unite and stop getting trampled and passed aside.
    martinalpn, wooh, and lindarn like this.
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    Lindarn I agree with what you wrote
    lindarn likes this.
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    I am a new CNA. While I am still looking for my first job, I have aquired skills over the last 10 years while caring for my wife after her stroke. I learned critical skills in observation in the years since the stroke. I can look at her and tell if something is wrong and whether a call to the doctor is in order or a trip to the ER. Done it more times than I wish to count. I was trained to do wound care on her by the wound care doctor and staff after we found out that the visiting nurse was watching TV and trying to get my wife to do her own wound care on the backs of her knees with a mirror on the couch. The nurse was fired by me and dismissed from her agency. As a CNA I know my scope of practice and would never over step those boundries. I feel that most CNAs want to learn. Some are in school to become RNs. I have also had asthma all my life. When a patient is having breathing difficulties, who better to work with them until the RN arrives, coaching them to take slow deep breaths and urging the patient to try to relax, the CNA who is there. And what about the lowly CNA? Can we join the union also to help us? Some things to think about. I'm not there to take your job or do your job, RNs. I'm there to care for our patients and help you out and learn from you.
    MedChica, martinalpn, catlvr, and 4 others like this.
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    Sorry about your wife. I am surprise that nurse did that because most vns do not stay they are usually there for the treatment and other stuff and leave . I am appalled by what the nurse did to you and your wife. However, nursing is more than looking and having a feeling...I am glad you want to learn. I hope you continue down this path to become a R.N or LPN. As a CNA you should NEVER teach anyone anything. "When a patient is having breathing difficulties, who better to work with them until the RN arrives, coaching them to take slow deep breaths and urging the patient to try to relax, the CNA who is there." This exactly what irks me as a RN ...Do you see why we need to organize and start taking back our skills?
    Not_A_Hat_Person and lindarn like this.
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    It is very scary to think this could happen right now ......RN and LPN we need to embrace the technology i.e EMR to have more time for our patients to make sure you know what is going on....Do you recall the med tech who gave pt hep C because he was allowed to give meds ....This is scary and sad
    Last edit by luv2 on Aug 25, '12
    lindarn likes this.
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    Quote from wooh
    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.
    This really is the key issue. If the hospital can't bill directly for nursing services then they need to figure out a way to provide the services in a cost effective manner. Enter deskilling. If the hospitals COULD bill for nursing services based on the service we actually provide you can guarantee they'd want as many of us in there as possible being cash cows for them. Home health can charge for nursing services correct? Why not inpatient nursing?
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    I should also add as long as there is a steady stream of people willing to mop up our abandoned skills for less money and NO license then we will also continue to lose them. There is no shortage of people wanting to be medical assistants, medication aide or tech this or tech that all for the thrill of wearing scrubs and being in the medical profession and helping patients and doctors. Supply and demand. They demand a position and the powers that be dole out the skills just enough to keep them happy and barely enough money to make it worth it.

    (UAP's don't kill me for that comment I understand the drive really I do but it's a stick with two short ends. I still love you though mwah)


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