The 'De-Skilling' Of Nursing - page 15

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... Read More

  1. Visit  tothepointeLVN profile page
    2
    Yes but these won't be nurses just glorified techs. My friend in NZ is a Cardiac Physiologist which is a really really really fancy way of saying she assists with cath labs and stress tests but that and that only. (She has a science degree but I'm not sure if that was a requirement)

    So I see that happening at both ends nurses will hyperspecialize and so will the UAP's as more and more become expected of them.

    We can reasonably expect as much change in the future as we've had in the past.
    Fiona59 and lindarn like this.
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  3. Visit  Asystole RN profile page
    1
    Quote from tothepointeLVN
    Yes but these won't be nurses just glorified techs. My friend in NZ is a Cardiac Physiologist which is a really really really fancy way of saying she assists with cath labs and stress tests but that and that only. (She has a science degree but I'm not sure if that was a requirement)

    So I see that happening at both ends nurses will hyperspecialize and so will the UAP's as more and more become expected of them.

    We can reasonably expect as much change in the future as we've had in the past.
    Things will change but nursing is not going anywhere, at least not registered nursing. I do think that registered nursing will become more and more specialized similar to the physician model. There will be general practice nurses and specialists.
    lindarn likes this.
  4. Visit  tothepointeLVN profile page
    3
    Nursing as a concept is very old but licensing of nursing as a title only came about in the last 100 years or so. People always think the position they are in now will be the one to remain but we may find a different story when we are the ones in our nursing home beds which have been relocated to the moon for cost cutting efficiency and "nursing" has been outsourced to the illegal aliens
    decembergrad2011, Fiona59, and lindarn like this.
  5. Visit  tnmarie profile page
    2
    This has been a most interesting read. I hope everyone is as passionate about pt care as they are about their precious titles and degrees.

    To be honest, I naively thought that BSNs were strictly management. I suppose in hospitals where the are phasing out ASNs this won't be the case. To be fair, when I worked with RNs they were ALL BSNs (and oh yeah, officers). They gave meds and charted and we did everything else from wiping butt, VS, starting IVs, foleys, and dropping NG tubes. We were a hybrid of CNA and LPN but with the fancy title of Aerospace Medical Technician (I never called myself a nurse because I was not one at the time).

    I think phasing out ASNs is a mistake. That way nurses who don't want to wipe butt or touch a patient can become BSNs (and sit in their cushy offices ) and those of us who became nurses to actually touch and physically nurse people can do so and you won't have nurses on the floor afraid or too proud to wipe a butt.

    When my mom became a nurse 25 years ago, RNs were managers and LPNs did patient care. That is why she was never interested in becoming an RN (and she could nurse circles around many, many RNs, btw). I had to become an LPN to do the kind of patient care I did in the military in the civilian world. They seem to be phasing out LPNs here, so I am getting my ASN so I can continue to do what I'm doing now. I am not interested in my BSN because classes on management and a bunch more prereqs do not interest me and will do little to improve my patient care, IMO. Though if that is what I have to do to continue to do actual pt care, I will.

    Some nurses are good at management and don't want anything to do with hands on pt care. Some nurses want to be in the trenches. I think it is important to have BSNs and ASNs to differentiate the two. I also think we should all recognize that both have their place in nursing care and stop ******* bickering about it. Of course I have no idea where this will leave the LPN. I guess doing LTC, home health, private duty and other jobs where you need a nurse but no one wants to pay an RN salary to have one...
    Dragonnurse1 and Fiona59 like this.
  6. Visit  TheCommuter profile page
    3
    Quote from tnmarie
    To be honest, I naively thought that BSNs were strictly management.
    I've seen multiple RNs with BSN degrees who push medication carts and work as floor nurses at nursing homes and rehab facilities. On the other hand, I've seen LPNs in administrative positions such as assistant director of nursing, director of wellness, unit manager, and so forth. I've also seen a fair share of RNs with associate degrees in nursing management positions. Heck, I even work with an RN with a MSN degree who works as a floor nurse.

    Personality type plays a heavier role than educational attainment in whether the nurse desires to ascend to a managerial role. Even though a nurse might have an RN license and a BSN or MSN degree, higher education does not inculcate natural leadership qualities.
    Last edit by TheCommuter on Aug 29, '12
    tnmarie, lindarn, and SHGR like this.
  7. Visit  BrandonLPN profile page
    0
    I think the BSN program makes that nurse better at "managing" in the sense of managing care by delegating tasks to others. I always thought this was the intended role of the BSN within the team framework. I'm not sure that it actually makes the BSN better at performing the tasks themselves, more better at seeing the bigger picture and coordinating care. Management in an administrative sense is totally different, and doesn't have much to do with a nurse's level of licensure.
  8. Visit  OCNRN63 profile page
    1
    Quote from Asystole RN
    Now you get it.

    I never "didn't" get it.
    Fiona59 likes this.
  9. Visit  Asystole RN profile page
    1
    Quote from tnmarie
    This has been a most interesting read. I hope everyone is as passionate about pt care as they are about their precious titles and degrees.

    To be honest, I naively thought that BSNs were strictly management. I suppose in hospitals where the are phasing out ASNs this won't be the case. To be fair, when I worked with RNs they were ALL BSNs (and oh yeah, officers). They gave meds and charted and we did everything else from wiping butt, VS, starting IVs, foleys, and dropping NG tubes. We were a hybrid of CNA and LPN but with the fancy title of Aerospace Medical Technician (I never called myself a nurse because I was not one at the time).

    I think phasing out ASNs is a mistake. That way nurses who don't want to wipe butt or touch a patient can become BSNs (and sit in their cushy offices ) and those of us who became nurses to actually touch and physically nurse people can do so and you won't have nurses on the floor afraid or too proud to wipe a butt.

    When my mom became a nurse 25 years ago, RNs were managers and LPNs did patient care. That is why she was never interested in becoming an RN (and she could nurse circles around many, many RNs, btw). I had to become an LPN to do the kind of patient care I did in the military in the civilian world. They seem to be phasing out LPNs here, so I am getting my ASN so I can continue to do what I'm doing now. I am not interested in my BSN because classes on management and a bunch more prereqs do not interest me and will do little to improve my patient care, IMO. Though if that is what I have to do to continue to do actual pt care, I will.

    Some nurses are good at management and don't want anything to do with hands on pt care. Some nurses want to be in the trenches. I think it is important to have BSNs and ASNs to differentiate the two. I also think we should all recognize that both have their place in nursing care and stop ******* bickering about it. Of course I have no idea where this will leave the LPN. I guess doing LTC, home health, private duty and other jobs where you need a nurse but no one wants to pay an RN salary to have one...
    The BSN nurse predates all other forms of nursing except the Diploma nurse. Many hospitals are actively attempting to increase the ratio of BSN nurses on the floor.

    The level of academic achievement of a nurse however has nothing to do with their clinical practice however.
    dudette10 likes this.
  10. Visit  Asystole RN profile page
    0
    Quote from OCNRN63
    I never "didn't" get it.
    My original statement was facetious, now you get it?
  11. Visit  BrandonLPN profile page
    1
    Quote from Asystole RN
    The level of academic achievement of a nurse however has nothing to do with their clinical practice however.
    I don't understand what you mean by this. Education should determine how a nurse can practice. Since a BSN nurse has more schooling, he should have a wider scope of practice and probably it's own licensure. With an enhanced license of its own, the BSN nurse would be in a better position to demand more money. Without something like this it just seems like education for the sake of education. Why have extra training if it doesn't result in more privileges and money?
    lindarn likes this.
  12. Visit  animal1953 profile page
    0
    Quote from luv2
    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?
    I'm not sure if I'll go one to get my LPN because the hospitals are phasing them out here in Florida (at least where I live). Because of my age, 58, I haven't made up my mind yet. I think you miss understood my comment about"coaching" a patient having breathing problems. I have been in the situation where my wife has gone into respiratory distress and by the time staff got there, I was able to talk her through slow breathing techniques. Not teaching, working gently and calmly with the patient. Those are skill I have learned because of my own asthma and working with respiratory staff. Once more qualified staff get there, let them take over unless I'm asked to continue with assisting the patient. No more, no less. I think my background has given me skills that other CNAs. I've had the opportunity to learn skills outside of schooling that most have not but in a critical situation ( for lack of a better term) doing what you can after calling for assistance makes more sense to me.
    Last edit by animal1953 on Aug 29, '12 : Reason: added to post
  13. Visit  nursel56 profile page
    1
    Quote from BrandonLPN
    I don't understand what you mean by this. Education should determine how a nurse can practice. Since a BSN nurse has more schooling, he should have a wider scope of practice and probably it's own licensure. With an enhanced license of its own, the BSN nurse would be in a better position to demand more money. Without something like this it ju,st seems like education for the sake of education. Why have extra training if it doesn't result in more privileges and money?
    It would depend on what the identified differences are in a BSN program vs an ADN program. Many of them, as has been said, focus on leadership, community health, health care policy, etc. so maybe I don't understand what you mean by "scope of practice"?
    gummi bear likes this.
  14. Visit  tothepointeLVN profile page
    2
    Quote from BrandonLPN
    I don't understand what you mean by this. Education should determine how a nurse can practice. Since a BSN nurse has more schooling, he should have a wider scope of practice and probably it's own licensure. With an enhanced license of its own, the BSN nurse would be in a better position to demand more money. Without something like this it just seems like education for the sake of education. Why have extra training if it doesn't result in more privileges and money?
    I think she's referring to the things that are inherent to all nurses. Common sense/critical thinking, compassion, being able to see the big picture. If you took a cross section of nurses and placed them at a level that all the nurses SOP covered you'd probably get the same results.

    That's what most of the LPN vs RN's miss. I can do MY job as well as an RN can. I'm not saying that I can do her job but if she were to do mine it would be about the same.
    mc3 and Fiona59 like this.


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