The 'De-Skilling' Of Nursing The 'De-Skilling' Of Nursing - pg.18 | allnurses

The 'De-Skilling' Of Nursing - page 18

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  turnforthenurse profile page
    5
    And don't forget HCAHPS. This idea of "customer service" over my professional judgement is also leading to the deskilling of nursing, IMO.
    SoldierNurse22, noyesno, tnmarie, and 2 others like this.
  2. Visit  Esme12 profile page
    1
    Quote from eCCU
    The only thing that pharmacy techs do in my hospital is restock pyxis and bring up meds. We have a pharmacist in the I.V room whose job is to mix medications and others who accepts orders, process them and the tech brings the meds to the nursing station or pyxis.

    Techs mixing sterile I.V drugs? ....where the heck is this?
    Here is one..........
    $8.25 Million Settlement Reached After Premature Infant Died From Fatal Overdose of Medication
    According to reports by the Chicago Daily Law Bulletin, the infant was born three months premature, weighing less than 2 pounds. Nevertheless, during his stay at Lutheran General Hospital in Park Ridge, Illinois, he made “terrific progress through the 40 days of his life...and there was every reason to believe he was going to survive.”


    A pharmacy technician working for the hospital prepared a prescription of sodium chloride to be given to the baby boy. Because of the technician’s negligence, the dose was more than 60 times the amount of sodium chloride that the physician ordered, and the child died of an overdose. The boy died in the arms of his mother who had suffered two prior miscarriages, reported the Chicago Daily Law Bulletin.


    Following an immediate investigation into the infant’s death, the hospital changed its policy to ensure that each staff member double-checks intravenous bags so the label matches what’s in the bag. Nevertheless, because of the pharmacy technician’s carelessness, Lutheran General Hospital was liable for the child’s death.
    Pharmacy technicians are an integral part of hospital health-system pharmacies. The National Association of Boards of Pharmacy defines pharmacy technician as a board-registered employee who may dispense medications, handle clinical conflict resolution, prepare IV admixtures, and prepackage and repackage medications under the supervision of a licensed pharmacist.1

    The Pharmacy Technician’s Role

    The pharmacy technician’s role is evolving and varies widely between the retail industry and hospital health systems, as well as from state to state. Job descriptions and responsibilities have changed considerably over the past few decades. The impetus behind many of these changes is actually the desire to redefine the role of the pharmacist. Some states are looking to broaden the pharmacy technician’s role, allowing more control and responsibility for duties traditionally performed by pharmacists, such as clarifying prescriptions, reviewing orders for unacceptable abbreviations, and entering orders.
    http://www.uspharmacist.com/content/d/feature/c/31431/
    Wise Woman RN likes this.
  3. Visit  eCCU profile page
    0
    Well...what can i say we are spoiled where we work, and the more i read about all these the more am glad i work where i do!!!!
    We have a different clinical pharmacists assigned to each ICUs since they are quite busy. These pharmacist are to confirm physician orders and make sure they get to the pharmacist downstairs at the pharmacy. The clinical pharmacist also has to round with the physicians and other team members during rounds and is a great resource for everyone they are also rarely rotated as they have already developed a rapport with the team.
    Again sorry but pharmacy techs don't fill meds my hospital! They might at other places just not here. Even specifically even asked this to her and she was like nope especially not iv!!
    STAT meds like levo, amio, heparin, narcotics needed stat she literally goes to the pharmacy to pick them up and brings it to the nurse! Plus the facility has policies any mixed iv by the nurse as a stat should be replaced ASAP with one mixed by the pharmacist under sterile condition....again spoiled n loving it;-)
  4. Visit  eCCU profile page
    0
    I bet this dangerous errors do not scan their manufacturer barcodes to link up with their MAR and IV pumps...trying to save up the costs
  5. Visit  tnmarie profile page
    2
    Quote from VICEDRN
    Despite the endless and ever growing pile of studies that show that when there are more Bsn nurses in a unit, the less patient t mortality there is?I honestly can't believe that there are still corners of the nursing universe that haven't accepted this as a basic fact of life.And for brandonlpn, yes, the doctors care. They read those studies and now, they want to know why all the nurses aren't bsn and how crazy it is that we accept anything less for our profession. True.
    Can you please site some of these studies? I've done a quick search myself and the primary studies I have found are more related to staffing ratios and nursing care environments than the education of the nurses on the units. The only study I found that considered education level of nursing staff was from JONA:

    "Results: Controlling for patient acuity, hours of nursing care, and staff mix, units with more experienced nurses had lower medication errors and lower patient fall rates. These adverse occurrence rates on units with more baccalaureate-prepared nurses were not significantly better."

    Source: Nurse Experience and Education: Effect on Quality of Care : Journal of Nursing Administration
    BrandonLPN and nursel56 like this.
  6. Visit  BrandonLPN profile page
    3
    I've never met a doctor in my life who gave a **** whether they were talking to a ADN RN or a BSN RN. And I'm willing to bet the vast majority of nurses here would agree...
    Last edit by Esme12 on Nov 6, '12 : Reason: TOS/profanity
  7. Visit  RN34TX profile page
    3
    Quote from VICEDRN
    Despite the endless and ever growing pile of studies that show that when there are more Bsn nurses in a unit, the less patient t mortality there is?I honestly can't believe that there are still corners of the nursing universe that haven't accepted this as a basic fact of life.And for brandonlpn, yes, the doctors care. They read those studies and now, they want to know why all the nurses aren't bsn and how crazy it is that we accept anything less for our profession. True.
    There is no endless or ever growing pile of studies on BSN nurses and patient mortality. There has been only one study by Linda Aiken so it's far from being a basic fact of life. It's another example where if something gets repeated enough times, it starts to become accepted as the truth.
    tnmarie, BrandonLPN, and nursel56 like this.
  8. Visit  nursel56 profile page
    2
    Quote from tnmarie
    Can you please site some of these studies? I've done a quick search myself and the primary studies I have found are more related to staffing ratios and nursing care environments than the education of the nurses on the units. The only study I found that considered education level of nursing staff was from JONA:

    "Results: Controlling for patient acuity, hours of nursing care, and staff mix, units with more experienced nurses had lower medication errors and lower patient fall rates. These adverse occurrence rates on units with more baccalaureate-prepared nurses were not significantly better."

    Source: Nurse Experience and Education: Effect on Quality of Care : Journal of Nursing Administration
    That's an interesting result because one of the findings of the so-called "landmark" study by Linda Aiken in 2003 used a model that included the finding that experience is of little importance. Instead of questioning the model they reported in their conclusions that we might be over-emphasizing the importance of experience.
    tnmarie and RN34TX like this.
  9. Visit  TheCommuter profile page
    2
    Perhaps facilities and units staffed with a greater proportion of BSN-educated nurses result in better outcomes because RNs with BSN degrees are typically less likely to end up in settings with horrid nurse/patient ratios (LTC, acute rehab, prisons) and more likely to work in settings with lower nurse/patient ratios (acute care hospitals).
    tnmarie and BrandonLPN like this.
  10. Visit  VICEDRN profile page
    2
    Quote from RN34TX
    There is no endless or ever growing pile of studies on BSN nurses and patient mortality. There has been only one study by Linda Aiken so it's far from being a basic fact of life. It's another example where if something gets repeated enough times, it starts to become accepted as the truth.
    No. There are at least three studies and I know of at least one study that is a meta analysis of other studies.

    From: American Association of Colleges of Nursing | Creating a More Highly Qualified Nursing Workforce


    • In the January 2007 Journal of Advanced Nursing, a study of 46,993 patients conducted by researchers at the University Toronto found that hospitals with higher proportions of baccalaureate-prepared nurses tended to have lower 30-day mortality rates. The findings indicated that a 10% increase in the proportion of baccalaureate prepared nurses was associated with 9 fewer deaths for every 1,000 discharged patients.
    • In a study published in the March/April 2005 Nursing Research, Dr. Carole Estabrooks and her colleagues at the University of Alberta found that baccalaureate prepared nurses have a positive impact on mortality rates following an examination of more than 18,000 patient outcomes at 49 Canadian hospitals. This study, The Impact of Hospital Nursing Characteristics on 30-Day Mortality, confirmed the findings from Dr. Aiken’s landmark study from 2003.
    • In a study published in the September 24, 2003 Journal of the American Medical Association, Dr. Linda Aiken and her colleagues at the University of Pennsylvania identified a clear link between higher levels of nursing education and better patient outcomes. This extensive study found that surgical patients have a "substantial survival advantage" if treated in hospitals with higher proportions of nurses educated at the baccalaureate or higher degree level. A 10% increase in the proportion of nurses holding BSN degrees decreased the risk of patient death and failure to rescue by 5%.

    For more information on the link between nursing education and patient outcomes, see www.aacn.nche.edu/media-relations/fact-sheets/impact-of-education.
    SoldierNurse22 and tnmarie like this.
  11. Visit  VICEDRN profile page
    0
    Quote from TheCommuter
    Perhaps facilities and units staffed with a greater proportion of BSN-educated nurses result in better outcomes because RNs with BSN degrees are typically less likely to end up in settings with horrid nurse/patient ratios (LTC, acute rehab, prisons) and more likely to work in settings with lower nurse/patient ratios (acute care hospitals).
    I don't think so because the studies compared units in acute care facilities, not nurses at different types of hospitals.
  12. Visit  nursel56 profile page
    0
    Perhaps one could get their sources from an unbiased observer?
  13. Visit  VICEDRN profile page
    1
    Quote from nursel56
    Perhaps one could get their sources from an unbiased observer?
    Nursing journals, JAMA and IOM have all reviewed the issue. There are tens of thousands of patients in at least two countries. At this point, it's about believing what you want to believe, not about questioning the work itself.
    SoldierNurse22 likes this.

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