The 'De-Skilling' Of Nursing - page 4

by TheCommuter Asst. Admin

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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. 2
    Quote from tothepointeLVN
    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.
    Probably more about the dearth of career employment opportunities than the thrill of wearing scrubs.
  2. 4
    Quote from ♪♫ in my ♥
    Probably more about the dearth of career employment opportunities than the thrill of wearing scrubs.
    Now perhaps but people were flocking to become MA's and such like even when the economy was great and I see them flounce around the Dr's office twirling their stethescopes etc and playing nurse.
    VICEDRN, mc3, Szasz_is_Right, and 1 other like this.
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    Quote from ♪♫ in my ♥
    Probably more about the dearth of career employment opportunities than the thrill of wearing scrubs.
    And the surplus of for-profit educational institutions all willing to provide that magic certificate of being desparately needed in the industry!!!
  4. 6
    Said this before a long time ago.

    Nurses were quick to ditch caps, whites and all the "pillow-plumping" aspects of the practice along with quite allot of other things in favor of elevating the "Profession" (with a capital "P"). By and large everyone jumped at the chance to write scripts and or move into roles that were formerly reserved for physicans. Well on the way quite allot got dropped and or otherwise shifted to UAPs and others because now a nurse's time was too valuable.

    Ever single function/task not strictly mandated to be performed by a license is up for grabs, and everytime there is a "nursing shortage" yet more is chipped away.


    Everyone comes to work in their PJ's and patients are for the most part blissfully unaware that by and large there isn't anything the various UAPs and others coming in and out of their rooms do that a nurse cannot. Nor do they know that she or he can do things that the aforementioned cannot. Facilities and others love this little bit of confusion as to "who is a nurse" because what people don't know won't often hurt them. That is unless something goes south. I mean look at all the posts/reports of UAPs and others calling themselves "nurse" when they aren't and worse management or those running a facility backs them up. Twenty or ten years ago that just wouldn't have been tolerated.

    Something else one has said before, little by little the ANA and their little white paper are winning. Soon all nurses in most areas will have the BSN and will mainly be responsible for planning, assignment,evaluation, management and so forth of care. The actual implementation will be done by various other personnel who report back to the nurse.
    catlvr, Szasz_is_Right, elkpark, and 3 others like this.
  5. 1
    De-skilling the RN, LPN, and hospitals drive to be magnet. Nurses!! the ANCC is getting money from the gov, making money off each of us, driving the hospitals to believe there will a rosy world if they see the light, all the time we are left to be at the bedside, running night after night, patients that are really sick and need one on one care!
    How many times do you wake up and panic wondering did i chart this or that, did i give that med. In-services while i run trying to get my meds passed on time, change my dressing

    Lets begin to make a difference, lets stand up and fight for our license and the years of knowledge we have!
    lindarn likes this.
  6. 0
    Quote from kitty13
    De-skilling the RN, LPN, and hospitals drive to be magnet. Nurses!! the ANCC is getting money from the gov, making money off each of us, driving the hospitals to believe there will a rosy world if they see the light, all the time we are left to be at the bedside, running night after night, patients that are really sick and need one on one care!
    How many times do you wake up and panic wondering did i chart this or that, did i give that med. In-services while i run trying to get my meds passed on time, change my dressing

    Lets begin to make a difference, lets stand up and fight for our license and the years of knowledge we have!
    The ANCC is conspiring to ruin nursing? Magnet status is somehow subverting patient care?



    I want whatever you're smoking.
  7. 5
    Quote from Asystole RN
    Magnet status is somehow subverting patient care?
    I'll agree with THAT one. In addition to caring for the ridiculously high number of patients, we have to make sure to keep up with our career ladder points and participate in committees where the only point is to pretend nurses have a say when it won't actually make a bit of difference if anything the nurses say will cost money or effort on the part of non-nurses.
    VICEDRN, Szasz_is_Right, lindarn, and 2 others like this.
  8. 0
    Quote from wooh
    I'll agree with THAT one. In addition to caring for the ridiculously high number of patients, we have to make sure to keep up with our career ladder points and participate in committees where the only point is to pretend nurses have a say when it won't actually make a bit of difference if anything the nurses say will cost money or effort on the part of non-nurses.
    That would be an issue with the facility administration, not with magnet status.
  9. 5
    Quote from Asystole RN
    That would be an issue with the facility administration, not with magnet status.
    What problems are magnet status supposed to solve? Are those problems being solved through a hospital's attainment of magnet status? Are patient outcomes better? Are nurses' working conditions better?

    Magnet status: What is is, what it is not, and what it could be

    Working Conditions for Nurses: Does Magnet Status Make a Difference?
    on eagles wings, Sun0408, lindarn, and 2 others like this.
  10. 3
    I think it depends where you work.

    I work for the VA since my externship in two different VA medical centers (within a VA system) and currently in another one in a different state. In the first VA system, certain tasks were given to other departments, for example: respiratory techs administer the nebulizer treatments and PT techs would put the total knee replacement patients on CPM therapy.

    But in the current VA med center I work in, I do all those things myself. I personally like it this way because I don't have to wait for other people to do them and I can assess and do any additional care that's needed. As for wound care, it depends. If its surgical stuff, then orders normally are to just reinforce and notify the surgeon, but we do most other types ourselves.

    I also agree with wooh - we may lose some tasks to other departments, but we do get to acquire some skills that an MD/surgeon might normally do. As wooh had mentioned, RNs here are can administer Cathflo with an MD order for occluded central lines - metoprolol IVP in certain circumstances also comes to mind. It's not much but it's something. I think most of the doctor skills given away are to the nurse practitioners though (think nurse anesthetist), which I don't mind. I may want to go on to that some day, God willing.

    Also, Despareux had mentioned CNAs. In my unit, they are phasing them out along with the LPNs, meaning they are keeping the ones we already have, but no longer hiring new ones so that the RNs are pretty much doing everything. This seems to work out well so far but I think it's because we have a decent patient-to-nurse ratio and everyone is willing to help each other out. I don't think this will work otherwise.

    Right now, we only have two CNAs in the entire unit, one on evening shift and one on night shift and three LPNs, one on each shift. We had more, but a lot of them went to the nursing home units and one LPN went to telehealth. I really value the ones we still have - they have tons of experience and knowledge. So for hospitals with units like mine, the concern is more for CNAs and LPNs where we're kind of shoving them off to less acute areas.


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